• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.269-275
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• 1999

Background : In April 6, 1990, a male researcher who has worked at a research unit at the Basic Research Building of Seoul National University(SNU) College of Medicine admitted to SNU Hospital due to persistent fever. He was diagnosed serologically as hemorrhagic fever with renal syndrome(HFRS). Another female researcher in the same unit was also diagnosed as HFRS at the same hospital several days later. Epidemic investigation of HFRS was conducted to determine the magnitude of the problems since these two cases were strongly suspected to have laboratory-acquired infections of HFRS. Methods : All researchers and employees working at the Basic Research Building(BRB) of SNU College of Medicine as of April 1, 1996 were recruited for the study, information on symptoms of HFRS and history of contact to experimental animals were collected by self-administered questionnaires and serological tests among study subjects were also conducted by indirect immunofluorescent antibody(IFA) to hantavirus. The experimental animals were also serologically tested for infection with hantavirus by IFA. Results : Among 218 surveyed, six researchers and an animal caretaker had hantavirus antibodies above 1:20 in IFA titer. Five of seven sero-positive subjects had antibodies above 1:640 in IFA titer and had shown clinical symptoms compatible to HFRS during Jan. 1 to Apr, 20, 1996. The sero-positive persons had handled animals more frequently than sero-negative persons (OR, 19,68; 95% Cl, 1.11-350.40) and handling animals at the animal quarter at School of Public Health(SPH) had shown consistently higher risk to get infected with hantavirus irrespective of types of animals handled (OR, 4.90-6.37). Sero-positivity of rats of the aniamal quarter at BRB was 30-60%, whereas 80% of rats at SPH tested were shown sero-positivity. Conclusion: There was a epidemic of HFRS in research units of a medical school during the period from Jan. through Apr, Further investigation is needed to determine the extent and the mode of transmission of the laboratory-acquired infection with hantavirus in other research facilities.

• Korean Journal of Veterinary Service
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• v.26 no.3
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• pp.203-214
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• 2003

Scrub typhus and murine typhus are common endemic febrile illness in the fall in Korea. Scrub typhus is caused by Orientia tsutsugomushi, murine typhus is caused by Rickettsia typhi. Trombiculid mites are known as both the vector and the reservoir host of O tsutsugamushi, the mites which transmit O tsutsugomushi have been reported to be Leptotrombidium pallidum and L scutellare. The author carried out an epidemiological study of scrub typhus and murine typhus in Kyodong-Myeon, Kanghwa-Gun, Incheon in relation to the residents and the host rodents, such as their distribution, seroepidemiology, and population density of chigger mites. 1. Out of 900 residents, 33(3.7%) showed positive reaction to O tsutsugamushi, 24(2.7%) to R typhi. 2. In the seropositives to O tsutsugamushi or R typhi, between the sixties and the seventies of the age were dominant. 3. In the seropositives to O tsutsugamushi serotypically Gilliam was dominant. 4. Among the total 42 field rodents trapped by the sherman traps, 18 rodents were Apodemus agrarius(42.9%), 13 rodents were Crocidura lasiura(31.0%), 5 rodents were Musmusculus(11.9%), 2 rodents(4.8%) were Crocidura suaveolens, Rattus norvegicus, Tscherskia triton, respectively. 5. Out of 42 field rodents, 25 were parasitized by 4,419 chigger mites, showing 59.5% of the infestation rate and 98.8 of the chigger index. L pallidum parasitized in A agrarius, C lasiura, M musculus, R norvegicus and T triton, and L scutellare parasitized only C lasiura. 6. Antibodies in the sera of field rodents against O tsutsugamushi and R typhi were investigated by indirect immunofluorescent antibody technique. Positive rate of antibody against O tsutsugamushi were 11.9(5 of 42) and all of the positive is A agrarius. Antibody against R typhi was not detected. These results might provide the basic information for the management of scrub typhus and murine typhus in Kyodong-myeon, where the epidemiological studies on scrub typhus and murine typhus was not carried out enough.

• Pediatric Infection and Vaccine
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• v.6 no.2
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• pp.219-233
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• 1999

Purpose : Respiratory syncytial virus(RSV) is the major cause of lower respiratory tract infection in infants and young children. This study was performed to analyze antigenic and genetic variation of G protein of subgroup A RSV. Methods : One hundred seventy-nine strains isolated at the Seoul National University Children's Hospital over 8 years-period from 1990 through 1998 were analysed for antigenic and genetic variability. Analysis was made by reactivity with monoclonal antibodies raised against RSV, and by restriction mapping and, for selected strains, nucleotide sequencing following amplification of full sequence of G gene by reverse transcription-polymerase chain reaction. Results : Restriction fragment analysis of the amplified G protein gene revealed 23 restriction patterns, 12 of which included more than 2 isolate, and the most frequent genetic type comprised 30% of the strains. Indirect immunofluorescent staining with monoclonal antibodies revealed 6 antigenic types with one predominant pattern accounting for 91% of the total strains. The most frequent antigenic type had 21 restriction patterns, and some viruses with same restiction pattern had different monoclonal antibody reaction pattern. Nucleotide sequence homology of subgroup A was 91~93% between reference(A2, Long) and Korean isolates, 93~99% among Korean isolates. Maximum-parsimony analysis demonstrated that Korean isolates were distinct from reference strains and subgroup A strains were clustered in 4 groups. Conclusion : The restriction analysis pattern of G protein gene identified greater diversity within subgroup A than was seen with the monoclonal analysis and a variety of antigenic and genetic types of RSV are circulating in Korea which are different from reference strains or strains isolated from other countries.

• Biomedical Science Letters
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• v.1 no.1
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• pp.27-35
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• 1995

Several studies showed that the immunological factors such as CD4+ cell number, CD4%, CD8+ cell number and CD4/CD8 ratio and the serological factors such as, ${\beta}^2$-microglobulin(${\beta}^2$-MG), neopterin, soluble CD4, and soluble CD8 are related to the risk of development of AIDS. Especially, the CD4+ cell counts have been used to monitor progresson of HIV disease, to stratify, and to follow patients in clinical trials. Recently, the Centers for Disease Control and Prevention(CDCP) in USA has made the CD4+ cell count as a part of the classification of HIV disease. It is composed of 3 categories such as 1, 2, and 3 which asr $\geq$ 500/$mm^3$, 200/$mm^{3} $\geq$ and < 500/$mm^3$, and < 200/$mm^3$, respectively. In this study, to estimate the differences of immunological factors between HIV-infected and normal human groups in Korea, CD4+ T and CD8+ T cells, and the CD4/CD8 ratio were measured in 185 HIV-infected subjects and 140 healthy adult subjects. The lymphocyte subsets such as CD4+ T and CD8+ T were analysed by flow cytometer(FACStar) with two-color immunofluorescent stain using monoclonal antibodies such as anti-CD4 and anti-CD8 antibodies. The absolute numbers and percentages of CD4+ T and CD8+ T and the CD4/CD8 ratio of HIV infected persons were $462\pm{277}/mm^3$, $18.2\pm7.7%$, $1,170\pm{534}/mm^3$, $47.0\pm10.6%$ and $0,43\pm0.26 whereas those of uninfected persons were $886\pm{299}mm^3$, $32.9\pm{7.0%}, 730{\pm}259/mm^3$, $26.8\pm6.4%$ and $1.31\pm0.46$(P<0.01). In addition, estimating the reference values of peripheral blood lymphocyte subsets of Korean, the absolute numbers and percentages of CD4+ T and CD8+ T and the CD4/CD8 ratio of 140 healthy adults persons were measured and compared with those of foreigners. The reference ranges of CD4+ T cells, CD8+ T cells, CD4％, CD8%, and the CD4/CD8 ratio and 1.31$\pm$0.46, respectively. The significant differences were not observed when compared with those of foreigners. However a little difference was observed in the percentages of CD4+ T and the absolute numbers of CD8+ T between the normal values of Korean and those of foreigners were $43.6\pm8.9%$, $560\pm{230}/mm^3$. This result can also be useful as a basic data for the treatment and surveillance of HIV-infected patients in Korea.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.67-73
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• 2002

Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.182-192
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• 2002

Purpose : This study was performed to characterize the epidemiologic and clinical features of acute adenoviral lower respiratory tract infections(LRTIs). Methods : Virological analysis was done from respiratory specimens obtained from patients with LRTIs hospitalized to other hospitals and referred to the Department of Pediatrics, Seoul National University Children's Hospital(SNUCH) from June 1998 to July 2000. Viral diagnosis was made by isolation of viruses employing HEp-2 cell culture and indirect immunofluorescent staining with monoclonal antibodies. Serotypes of adenoviruses were determined by neutralization test using antiserum for types 1, 2, 3, 4, 5, 6, 7 and 11. Medical records of children admitted to the SNUCH were reviewed retrospectively. Results : Adenovirus was isolated from 118(9.0%) of 1,305 children with LRTIs. Serotypes were 3(39.0%), 7(16.9%), 1(11.0%), 2(7.6%), 4(7.6%), 6(5.9%), 11(2.5%), and 5(0.8%) and 10 strains(8.5%) were not neutralized by antisera included in the study. Infections by type 3 and type 7 occurred in outbreaks. Male to female ratio was 1.0:0.9 and mean age was 1.95 years. The clinical diagnoses were pneumonia(83%), acute tracheobronchitis(12%) and bronchiolitis(5%). Associated symptoms, signs and abnormal laboratory findings included cough(100%), sputum(73.5%), fever(54.2%), rale(59.3%), wheezing(34%), anemia(35%) and leukopenia(15.8%). Mortality was in 13.5%. Residual radiologic sequelae was identified in 32.6% of the patients followed. Conclusion : These data confirms that adenovirus may cause severe lower respiratory tract diseases, and infections by type 3 and 7 may occured in outbreaks.