• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.864-869
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• 2006

Purpose : We evaluated the immunogenicity and safety of eIPV(Imovax $Polio^{(R)}$) in a group of healthy Korean infants on a three-dose primary vaccination. Methods : Eighty one healthy infants aged 8-10 weeks were enrolled, and 79(male 42, female 37) completed the study. Three doses of eIPV were injected intramuscularly at 2, 4 and 6 months of age as of primary vaccination. Most subjects received concomitant vaccines such as DTaP and/or Hib at 2, 4, and 6 months of age. Immediate reactions were monitored for 30 minutes after each injection. Local and systemic events were recorded for 72 hours following each immunization by parents/guardians. Poliovirus specific neutralizing antibodies were measured using enzyme immuno-assay (EIA) at prior to and 1 month after the third dose. An antibody titer of 1:8 or higher was considered seroprotective. Geometric mean titers(GMTs) to each poliovirus type antigen were also measured. Results : One month after the third dose of eIPV, all infants(100 percent) were seroprotective. The geometric mean titers(GMTs) were 1,532(95 percent CI : 1,312-1,788) in type 1 and 835(95 percent CI : 684-1,018) in type 2 and 846(95 percent CI : 692-1,035) in type 3. Overall, local reactions were observed in 10 percent of infants and systemic reactions in 26.2 percent of infants. All reactions were observed within 3 days after vaccination and resolved without treatment. Conclusion : eIPV(Imovax $Polio^{(R)}$) is a well-tolerated and highly immunogenic vaccine. It can be administered either alone or simultaneously with other routine vaccines to Korean infants.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.175-184
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• 1996

Purpose : This study was intended to measure seropositivities and the levels of mumps- and rubella-specific IgG of MMR vaccinees over 17 months of age in Korea. Materials and Methods : From June 1994 to April 1995 we obtained sera from visitors of well baby clinic and patients in Korea University Hospital, who were MMR vaccinees over 17 months of age and had no evidence of immunodeficiency. These 275 study population include 145 males and 130 females. Mumps- and rubella-specific IgG antibody levels were measured by ELISA. Cut-off values for seropositivity were 20 GU(Gamma Unit) in mumps and 0.17 in rubella. Results : 1) As age increased, seropositivities of mumps-specific IgG increased significantly, being 69.0% in 1.5~2 year, 75.0% in 3~4 year, 76.0% in 5~6 year, 90.0% in 7 year, 100% in 8 year, 96.9% in 9 year, 97.4% in 10 year, 97.4% in 11 year, and 96.6% in 12 year of age(p<0.001). 2) As age increased, the levels of mumps-specific IgG antibody(mean${\pm}$standard deviation, GU) increased significantly, being $64.9{\pm}66.5$ in 1.5-2 year, $117.7{\pm}126.4$ in 3~4 year, $152.3{\pm}147.1$ in 5~6 year, $194.3{\pm}168.2$ in 7 year, $258.1{\pm}190.6$ in 8 year, $193.1{\pm}130.1$ in 9 year, $225.7{\pm}119.6$ in 10 year, $220.7{\pm}114.3$ in 11 year, and $222.3{\pm}127.1$ in 12 year of age(p<0.001). There was positive correlation between age and mumps-specific antibody level (r=0.3282, p<0.001). 3) As age increased, seropositivities of rubella-specific IgG decreased significantly, being 72.4% in 1.5~2 year, 75% in 3~4 year, 72% in 5~6 year, 60% in 7 year, 44.4% in 8 year, 40.6% in 9 year, 28.2% in 10 year, 23.1% in 11 year, and 17.2% in 12 year of age(p<0.001). 4) As age increased, rubella-specific IgG decreased significantly, being $0.462{\pm}0.356$ in 1.5~2year, $0.438{\pm}0.306$ in 3~4 year, $0.287{\pm}0.179$ in 5~6 year, $0.204{\pm}0.139$ in 7 year, $0.189{\pm}0.153$ in 8 year, $0.124{\pm}0.121$ in 9 year, $0.093{\pm}0.114$ in 10 year, $0.104{\pm}0.135$ in 11 year, and $0.080{\pm}0.001$ in 12 year of age(p<0.001). There was negative correlation between age and rubella-specific IgG titer (r=-0.551, p<0.001). Conclusions : Eventhough seropositivities and the level of mumps-specific IgG increased as age increased, they are not enough to prevent mumps infection in 1.5 to 6 years of age. Seropositivities and the level of rubella-specific IgG decreased as age increased. Appropriate change in vaccine schedule may be needed to decrease the risks of mumps and rubella infection.

• Korean Journal of Poultry Science
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• v.37 no.4
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• pp.361-372
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• 2010

Serological evaluation for the poultry is important for various reasons, such as designing and assessing the vaccination program and diagnosing diseases and for this reason, serologic tests for the layer flocks have been conducted on a regular basis. Moreover, the nationwide serological survey and analysis are essential to understand the epidemiological status of national poultry industry. In this sense, the study was conducted to evaluate the immune status of the layer flocks with the sera submitted to Avian Disease Laboratory, Chungbuk National University in 2009, and several important viral diseases were selected for evaluation including low pathogenic avian influenza (LPAI), Newcastle disease (ND), infectious bronchitis (IB) and avian metapneumovirus (aMPV). For LPAI and ND, the age-related patterns of geometric mean titer (GMT) changes were similar but there were differences in the flock positive rate and the level of GMT due to the different vaccination policy. In the case of IB, the values of GMT showed that the field infection was more prevalent than expected. For aMPV, positive birds in a flock increased as the layers got older, which reflected the course of field infection because vaccination against aMPV was not allowed in 2009. From this study, the immune status for the main viral diseases in layers became more clarified but this information was limited because of only one year study. Therefore, serological survey needs to be conducted on a yearly basis and furthermore include broilers and breeders for a better understanding of the health status in the national poultry industry.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.63-68
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• 2015

Purpose: This study analyzed a small outbreak of measles at a single hospital located in northern Gyeonggi-do in 2013. Methods: We reviewed the medical records of measles patients at The Catholic University of Korea Uijeongbu St. Mary's Hospital from August to October, 2013. Results: Fifteen children were confirmed to have measles by RT-PCR and serum IgM test; 1 neonate, 11 infants, and 3 toddlers. None of the patients had received Measles-Mumps-Rubella vaccination. All patients showed B3 type in viral genotyping. Nine children (60%) had been exposed to measles during treatment for other diseases in the pediatric ward. Incubation period was between 8 and 15 days. Fever started at a median 10 days after exposure and persisted for a median of 8 days. Rash showed at a median 13 days after exposure. Respiratory complications were observed in 40% of patients. Diarrhea developed in 53% of patients. Conclusion: Although measles has been well-controlled due to the high rate of vaccination coverage, it is possible to have an outbreak at any given time, especially in infants. We must learn from this outbreak, and remain fully aware of the possibility of reemergence and provide proper management, including vaccination or immune globulin administration, to infants exposed to measles. Reevaluation of serum IgG titer of neonates, infants, and pregnant women may be the first step to prevent further outbreaks.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1373-1380
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• 2002

Purpose : Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME. Methods : This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME. Results : There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness( 10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : $124{\pm}60mg/dL$) and WBC counts(mean : $158{\pm}157/{\mu}L$) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight). Conclusion : Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.85-94
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• 2002

Purpose: This study was performed for analysis of the results of polymerase chain reaction(PCR) and antibody test of Mycoplasma pneumoniae(M. pneumoniae) in children with symptoms of respiratory tract infection. In the cases of both positive antibody test and PCR for M. pneumoniae, the chest X-ray findings were assessed. Methods: The antibody test was done in 1,979 cases who have been admitted to Wonkwang university hospital department of pediatrics with symptoms of respiratory tract infection from January, 2000 to December, 2001. The positive antibody test was defined as titer of 1 : 80 and over 1 : 80. The PCR of M. pneumoniae were done in randomly selected 131 cases of respiratory tract infection. The chest X-ray findings were assessed in the cases of positive antibody test and PCR. Results: The numbers of cases of the positive antibody test for M. pneumoniae were 499 cases(25%). The PCR for M. pneumoniae were performed in 131 cases and the 45 cases(34%) were positive and 86 cases(66%) were negative. The 56 of 86 PCR negative cases were also negative antibody test, but 30 cases were positive antibody test. The 36 cases of 45 PCR positive cases were antibody positive, and 9 cases were antibody negative. The sputum Gram stain and culture for M. pneumoniae were negative in all the 499 cases of mycoplasma antibody positive respiratory infection. In these antibody positive 499 cases, the most common X-ray findings was interstitial pneumonic infiltration in 266 cases(53%), and pleural effusion were detected in 22 cases(4%), but nonspecific chest X-ray finding showed in 129 cases(26%). In PCR positive 45 cases, the most common chest X-ray finding was interstitial pneumonic infiltration in 32 cases(71%). Conclusion: The PCR for M. pneumoniae is more useful method for detection of mycoplasma infection in children with respiratory tract infection. The M. pneumoniae is a important etiologic agent for respiratory infection in children.

• Pediatric Infection and Vaccine
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• v.30 no.2
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• pp.73-83
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• 2023

Purpose: This study aimed to investigate the viral load dynamics in children with underlying malignancies diagnosed with symptomatic coronavirus disease 2019 (COVID-19). Methods: This was a retrospective longitudinal cohort study of patients <19 years old with underlying hemato-oncologic malignancies that were diagnosed with their first symptomatic severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (PCR)-confirmed COVID-19 infection during March 1 to August 30, 2022. Review of electronic medical records and telephone surveys were undertaken to assess the clinical presentations and transmission route of the patients. Thresholds of negligible likelihood of infectious virus was defined as E gene reverse transcription (RT)-PCR cycle threshold (Ct) value ≥25. Results: During the 6-month study period, a total of 43 children with 44 episodes of COVID-19 were included. Of the 44 episodes, the median age of the patients included was 8 years old (interquartile range [IQR], 4.9-10.5), and the most common underlying disease was acute lymphoid leukemia (n=30, 68.2%), followed by patients post-hematopoietic stem cell transplantation (n=8, 18.2%). Majority of the patients had mild COVID-19 (n=32, 72.7%), and three patients (7.0%) had severe/critical COVID-19. Furthermore, 2.3% (n=1) died of COVID-19 associated acute respiratory distress syndrome. The largest percentage of the patients showed E gene RT-PCR Ct value ≥25 between 15-21 days (n=13, 39.4%), followed by 22-28 days (n=10, 30.3%). In 15.2% (n=5), E gene RT-PCR Ct value remained <25 beyond 28 days after initial positive PCR. Refractory malignancy status (β, 67.0; 95% confidence interval, 7.0-17.0; P=0.030) was significantly associated with prolonged duration of E gene RT-PCR <25. A patient with prolonged duration of E gene RT-PCR Ct value <25 was suspected to have infectivity shown by the transmission of the virus to his mother at day 86 after his initial positive test. Conclusions: Children that acquire symptomatic COVID-19 during refractory malignancy state are at a high risk for prolonged shedding warranting PCR-based transmission precautions in this cohort of patients.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.128-135
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• 1998

Purpose : This study was intended to measure seropositivities and the level of mumps- and rubella-specific IgG of MMR vaccinees from 12 to 17 years of age in Korea. Materials and Methods : From May 1996 to July 1996 we obtained sera from students of 1 middle and 2 high schools in Seoul, who were MMR vaccinees from 12 to 17 years of age and had no evidence of immunodeficiency. These 216 study population include 110 males and 106 females. Mumps- and rubella-specific IgG antibody levels were measured by ELISA. Cut-off values for seropositivity were 20 U(Gamma Unit) in mumps and over 0.17 in rubella. Results : 1) As age increased, seropositivities to mumps increased, being 68.4% in 12 year, 79.3% in 13 year, 72.2% in 14 year, 82.0% in 15 year, 87.5% in 16 year, 87.0% in 17 year, which however has no statistical significance. 2) As age increased, the level of mumps-specific IgG antibody(mean+standard deviation, GU) increased, being $52.0{\pm}49.2$ in 12 year, $65.9{\pm}51.4$ in 13 year, $71.1{\pm}66.0$ in 14 year, $67.8{\pm}53.6$ in 15 year, $82.8{\pm}67.8$ in 16 year, $92.0{\pm}68.9$ in 17 year, which however has no statistical significance. 3) As age increased, seropositivities of rubella-specific IgG increased significantly, being 26.3% in 12 year, 20.7% in 13 year, 50.0% in 14 year, 67.2% in 15 year, 66.7% in 16 year, 65.2% in 17 year(P<0.001). 4) As age increased, rubella-specific IgG increased significantly, being $0.13{\pm}0.145$ in 12 year, $0.087{\pm}0.101$ in 13 year, $0.194{\pm}0.168$ in 14 year, $0.260{\pm}0.187$ in 15 year, $0.305{\pm}0.213$ in 16 year, $0.325{\pm}0.221$ in 17 year(P<0.001). There was positive correlation between age and rubella-specific IgG titer(rubella-specific $IgG=0.0517{\times}age-0.5586$, r=0.3752, P<0.001). Conclusion : In adolescent, seropositivities and the level of mumps-specific IgG remained relatively high, but approximately 20% of study population showed seronegativity. Seropositivities and the level of rubella-specific IgG showed the lowest level at 13 years of age and were increased with age after 14 years of age. Further evaluation may be needed to elucidate the cause of these changes of rubella-specific IgG.