• The Korean Journal of Medicine
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• v.91 no.1
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• pp.88-91
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• 2016

Influenza infection may be complicated by various infectious or non-infectious diseases. Among them, hemophagocytic lymphohistiocytosis (HLH) is an uncommon hyperinflammatory syndrome caused by uncontrolled proliferation and activation of macrophages and lymphocytes, and it is often life threatening. A previously healthy male patient was suspected to have HLH after influenza B infection. The diagnosis was established based on clinical diagnostic criteria suggested in the HLH-2004 trial. Despite prompt antiviral therapy, the patient expired on day 19 of hospitalization. Influenza can thus be complicated by HLH. Due to the non-specific manifestations of HLH, clinical suspicion and early diagnosis are important.

• Pediatric Infection and Vaccine
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• v.24 no.1
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• pp.16-22
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• 2017

Purpose: We suspect there is a difference in the clinical manifestations and treatment response to antiviral drugs for influenza A and B. This study was conducted to investigate this difference. Methods: We collected information on pediatric patients, infected with the influenza virus, admitted to Dongguk University Ilsan Hospital from October 2013 to May 2015. We investigated the clinical manifestations of influenza and differences in treatment response to oseltamivir treatment for the two types of influenza. Results: A total of 138 patients were included. The mean age was $3.5{\pm}4.0$ years. When comparing the diseases associated with influenza A and B, croup (19.2% vs. 1.7%, P=0.001) was more common with influenza A infection. Myositis (0% vs. 6.7%, P=0.021) and gastroenteritis (29.5% vs. 46.7%, P=0.038) were more common with influenza B infection. When comparing the total fever duration from the start of oseltamivir administration, patients treated with oseltamivir within 2 days of fever had the shortest duration. Among the patients treated with oseltamivir, the duration of fever, after the start of oseltamivir treatment, for was shorter for influenza A infection than for influenza B infection ($16.0{\pm}19.1$ hours vs. $28.9{\pm}27.9$ hours, P=0.006). Conclusions: There appear to be differences in the accompanying diseases and antiviral medication responses between the two types of influenza. It is important to administer oseltamivir within 2 days of fever.

• Korean Journal of Microbiology
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• v.43 no.3
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• pp.173-178
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• 2007

The occurrence of acute respiratory infections caused by the influenza virus are particularly high during the winter season in Busan, Korea. In 2004 and 2005, a study of the rate of occurrences of the influenza virus was conducted. The results reveal that in 2004, of the 1,869 people with an acute respiratory infection that 154 (8.2%) people were infected by the influenza virus. In 2005, of the 1,579 people infected with an acute respiratory infection that 19 people (1.2%) were infected with the influenza virus. The study shows a decrease in the numbers of an influenza virus infection from 2004 to 2005. Data was collected by inspecting throat swabs and nasal discharge from those with an acute respiratory infection. Further inspection of the throat swab and nasal discharge from the infected individuals during 2004 and 2005 study show the occurrence of the different types of influenza virus in the population: 6 cases (3.5%) of influenza type A/H1N1, 129 cases (74.5%) of A/H3N2, and 38 cases (22.0%) of type B. The study conducted in 2004 and 2005 reveal that children between the ages of two and five were more likely to be infected than any other age group. In the study, about 62.2% of the infected individuals were between two and five years old. The detection rates between males and females are similar. However, it is notable that females are slightly more likely to develop an acute respiratory infection caused by the influence virus compared to their male counterparts.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.261-266
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• 2002

Vascular ring, originating from abnormal regression of the aortic arch during fetal life, can cause prolonged and recurrent respiratory symptoms and dysphagia when the diagnosis is delayed. We report a 4 month old girl with vascular ring, who had been treated for persistent respiratory symptoms including stridor, wheezing, and dyspnea soon after birth. Initially her respiratory symptoms were thought to be due to bronchiolitis, for which respiratory syncytial virus was confirmed by immunofluorescent staining. Her clinical course was again complicated with tracheitis and pneumonia due to Haemophilus influenzae type b. The possibility of anatomical anomaly was investigated when it was felt to be difficult to insert a suction catheter deep down through a endotracheal tube which was placed for adequate ventilatory management. A three-dimensional chest CT revealed a vascular ring consisting of a double aortic arch. For 5 months following surgery, her respiratory symptoms have slowly been improving. She developed another episode of pneumonia which was milder than the one which occurred before the surgery.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.171-179
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• 2020

Purpose: In Korea, seasonal influenza is an important respiratory illness afflicting children every year. We aimed to investigate the childhood epidemiology in Jeju during the 2017-2018 and 2018-2019 seasons. Methods: Children aged <13 years, who were tested for influenza at the Jeju National University Hospital during the 2017-2018 and 2018-2019 influenza seasons, were included. Demographics and the influenza test results were retrospectively reviewed from their medical records. Results: This study included 5,219 cases of influenza-like illness (ILI) (2017-2018: n=2,279; 2018-2019: n=2,940). The mean age of the eligible children was 2.85±2.79 years, and the most common age among ILI patients in each season was 1 year group. There were 902 (17.3%, 902/5,219) confirmed influenza cases during the 2 seasons. The rate of influenza confirmed by rapid influenza diagnostic test or polymerase chain reaction among ILI patients in the 2017-2018 and 2018-2019 seasons was 10.4% (236/2,279) and 10.3% (303/2,940) for influenza A, and 9.1% (208/2,279) and 5.3% (155/2,940) for influenza B, respectively. The mean age of influenza-confirmed cases was 4.09 years and 5.05 years in the 2017-2018 and 2018-2019 seasons, respectively (P<0.05). Weekly distribution of influenza was similar to that of ILI in the clinical sentinel surveillance system in both seasons. Conclusion: The difference in the influenza epidemic trend and age-group distribution between the 2017-2018 and 2018-2019 seasons was distinct in Jeju. Steady epidemiological studies on influenza in Jeju are needed for comparison with other regions of Korea.

• Korean Journal of Microbiology
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• v.37 no.4
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• pp.284-288
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• 2001

Respiratory viruses are one of the most infectious agent in human. Six different respiratory tract viruses were detected from Busan while working on the preventive surveillance in 1997-2000. The isolation rate from suspected specimens were 8.4%. Influenza virus A, B type, parainfluenza virus, adenovirus, mumps virus, and measles virus were examined from throat swabs, serum, and secretions of patients. Influenza A/Sydney/05/97(H3N2)-like, A/Johanesburg/33/94(H3N2)-like, A/Beijing/262/95(H1N1)-like and Influenza B/Beijing/262/95-like, B/Harbin/07/94-like, B/Guangdong/08/93-like were found. Adenovirus serotype 1, 2, 3 and 5 were detected, antibody of mumps both IgM and IgG were shown and outbreaks of measles were confirmed. Different antigenic types of influenza virus were detected every year, one outbreak of parainfluenza in 1999, mumps outbreak in 1999 and 2000, and incidence of measles in 2000 were noticeable. Monthly outbreaks were November through following March with influenza virus, January through June with adenovirus, February through May and December with mumps, April through August and November, December with measles, respectively. The size of isolated viruses were 130 nm with influenza virus B type, non-enveloped, icosahedron with 70 nm with adenovirus, 170 nm with mumps virus and 180 nm with parainfluenza virus in diameter, respectively.

• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.310-310
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• 2005

• Pediatric Infection and Vaccine
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• v.15 no.2
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• pp.121-128
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• 2008

Purpose : The seasonality of influenza virus and rotavirus are well recognized in winter and so viral surveillance and laboratory-based diagnostics are important to guide the timing of prophylaxis and other interventions. Yet the seasonality of these two viruses are changing in Korea. We evaluated the prevalence and clinical features of influenza virus and rotavirus. Methods : From September 2001 to August 2005, nasopharyngeal aspirates were cultured from the hospitalized patients with lower respiratory infections and the stools from hospitalized patients with gastroenteritis were tested for rotavirus. We retrospectively analysed the medical records. Results : During the study period, respiratory virus was isolated in 578 (18.5%) out of 3,121 patients. Influenza virus was isolated in 143 cases. The seasonal distribution of influenza infection was from December to June of the next year. The ratio of males to females was 1.3:1 and the median age was 17 months. The most common diagnosis of influenza infection was bronchiolitis. Fever and cough were present in 94.4% and 83.9% of the patients, respectively. During the same period, 3,850 patients were admitted for gastroenteritis and 1,047 (27%) patients were positive for rotavirus. Rotavirus was prevailed from December to June of the next year and it presented in year-round. The ratio of males to females was 1.1:1 and the median age was 16 months. Diarrhea and vomiting were the most common symptoms. Conclusion : The recent peak prevalence of influenza virus and rotavirus in Korea was in winter and the late spring, respectively. So we need to expand surveillance and carefully consider the correct period to vaccinate people.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.885-888
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• 2010

현재 우리나라는 보건소 중심의 예방접종등록사업을 진행 중에 있다. 2004년부터 시작된 이 사업은 현재는 전국민을 대상으로 실시하고 있다. 예방접종등록사업은 피접종자들은 대체적으로 예방접종에 대한 적절한 시기를 판단할 수 있는 정보가 부족하기 때문에 예방접종과 관련된 정보들을 국가나 사회에서 적시에 피접종자들에게 제공해 줄 수 있다. 따라서 이에 대한 확인이 등록에 앞서 그 정확성을 확인 필요가 있다. 예방접종등록사업의 가장 기본적인 사업으로 진행된 것은 예방접종 수첩의 제공과 그 관리를 통한 예방접종 사업으로 지속적으로 전개되어 왔으며, 일반 국민과 개원의사들에서도 대중적으로 보급되어 있다. 국가 예방접종률의 산출 그리고 취학 어린이 예방접종력 증명서 제출 제도를 위하여 예방접종 수첩을 활용하는 방법이 현실적으로 유용할 수 있다. 따라서 예방접종 수첩의 예방접종력 정확성을 확인할 필요가 있다. 지역조사에서 접종기관으로 확인된 민간 의료기관 365곳 가운데 의료기관 이전 및 폐업으로 반송된 경우가 4건(1.1%)이었으며, 응답한 경우는 129곳으로 응답률은 35.3%였다. 조사된 의료기관 전체를 대상으로 확인된 1,201건에 대한 BCG 접종여부의 정확도는 69.5%였다. B형 간염의 정확도는 1차가 41.3%로 낮았으며, 2차와 3차는 각각 76.6%, 79.7%였다. DTaP의 정확도는 약 80%였으며, 정확도가 제일 높은 것은 DTaP 3차로 82.5%였으나 다른 것과 가장 낮은 정확도와 2% 정도 밖에 차이가 나지 않았다. 폴리오의 정확도는 약 80%였다. MMR의 정확도는 83.2%였다. 일본뇌염의 경우 약 80.0%였으며, 수두의 정확도는 74.9%로 다른 질병과 비교하여 낮은 수치를 보였다. 조사된 의료기관을 전체로 한 기타예방접종별 예방접종수첩의 접종여부의 정확도는 인플루엔자는 정확도는 74.1%였으며, 뇌수막염은 72.7%의 정확도를 보였다. A형 간염 1차의 정확도79.5%였으며, 폐렴구균 1차의 경우 73.2%로 나타났다. 국가필수예방접종별 예방접종수첩의 접종일자에 대한 정확도는 BCG 80.1%로 확인되었고, B형 간염 1차 89.7% 2차는 82.1% 3차는 79%로 B형 간염 중 가장 낮은 정확도를 보였다. DTaP는 1차와 2차는 약 87% 3차는 85.1% 4차는 83.5%로 확인이 되었다. 폴리오는 1차가88.1%로 가장 높은 정확도를 보였고 그 다음으로 2차가 86.2%, 3차가 84.8%로 확인되었다. MMR의 정확도는 84%였으며, 일본뇌염 1차의 정확도는 83.1%로 나타났다. 수두의 접종일자 정확도는 83.7% 이고, 인플루엔자의 정확도는 55.3%로 상대적으로 낮은 수치를 보였다. 기타예방접종별 접종일자 정확도의 조사 결과 뇌수막염 1차과 폐렴구균 1차는 약 90%로 상대적으로 높은 정확도를 보였고, A형 간염 1차는 88.4%의 정확도를 보였다.

• Proceedings of the Korean Society of Life Science Conference
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• 2000.12a
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• pp.20-26
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• 2000

호흡기계 및 소화기계에 감염된 전염성 바이러스에 대한 역학적 기초자료로 이용하고자 1999년 1월부터 12월까지 부산지역에서 분리된 전염성 바이러스의 특징과 계절적 발생추이, 환자의 성별, 연령별 발생에 대해 조사한 결과는 다음과 같다. 1. 1999년도 바이러스 가검물 2261건에서 분리한 호흡기계감염 바이러스 279건과 소화기계 감염 바이러스 83주를 분리하였으며, 이중 인플루엔자 바이러스 A형이 96주(29.6%), B형이 107주(33.0%)로 대부분을 차지하였다. 2. 1999년의 바이러스 분리의 성별 분포는 총 360명의 환자 중 179명(49.7%)의 남성 및 181명(50.3%)의 여성으로 비슷한 양상을 나타내었다. 이중 호흡기계의 경우 279명의 감염환자 중 남성이 130명(46.6%), 여성이 149명(53.4%)으로 여성의 감염율이 비교적 높았으나, 소화기계의 경우 83명의 감염환자 중 남성이 51명(61.4%), 여성이 32명(38.5%)으로 남성의 감염율이 거의 2배정도 높게 나타났다. 3. 1999년의 연령별 분포는 10세 이하의 어린이가 194명(59.9%)으로 대부분을 차지하였으며, 이중 인플루엔자 바이러스가 99명(30.6%)으로 가장 높은 감염을을 나타내었다 유행성이하선염 바이러스의 감염어린이 중에 $l1{\sim}15$세의 연령층이 15명으로(53.3%)로 가장 높게 나타났다. 4. 1999년 월별 감염율은 호흡기계 감염증 바이러스의 경우 1월부터 4월까지, 그리고 12월에 증가 추세를 보이면서 4월에 가장 높은 감염율을 나타내었다 소화기계 감염증 바이러스의 경우 9, 10, 11월을 제외한 모든 월별에 관찰되었으며, echo와 coxsackie 바이러스는 무균성 수막염 환자에서 하절기에 집중적으로 발생하였다. 동절기에 유행하는 설사 바이러스는 12월에 비교적 높은 양상을 나타내었다. 5. 인플루엔자 바이러스는 MDCK 세포에서, 아데노 바이러스와 유행성 이하선염 바이러스는 HEp-2 세포에서, 파라인플루엔자 바이러스는 Vero 세포에서, 그리고 echo, coxsackie B 바이러스와 장내 바이러스는 HEp-2, Vero, BGM 세포에서 뚜렷한 세포병변 효과를 나타내었다. 6. 분리한 바이러스는 전자현미경으로 관찰한 결과 인플루엔자 바이러스 A 형(HINI, H3N2)은 95nm, B 형은 70nm크기의 구형을 나타내었으며, 바이러스표면의 지질 이중층이 뚜렷하게 관찰되었다. 아데노 바이러스는 외피가 관찰되지 않았으며, nucleocapsid는 symmetry이고 크기는 71nm로서 바이러스 입자 표면에 icosaheral capsomer의 배열이 명확하게 관찰되었고, 파라인플루엔자 바이러스와 유행성 이하선염 바이러스는 외피가 있는 구형의 큰 viron으로180, 170nm 크기이었다. 7. Echo와 coxsackie B group 바이러스는 모두 외피가 없는 isometric 형으로 크기는 $30{\sim}45nm$ 이었고, enteric adeno 바이러스는 84nm 크기로서 외피가 없고, 입자 표면에 capsomer의 배열이 명확하게 관찰되었고, rotavirus는 크기가 70nm이며 외층 capsid 단백질과 내층 capsid 단백질이 두층으로 되어 있는 전형적인 수레바퀴 모양을 나타내었다. 이상의 결과로 보아 호흡기계 및 소화기계에 감염되는 전염성 바이러스는 연중 지속적으로 분리되고 있으며 전염성이 강하여 집단 발생은 일으키는 경우도 많고 최근 들어 유행성 이하선염과 흥역 바이러스의 발생률이 높은 추이를 나타내고 있지만 아직은 특이한 바이러스 치료제가 개발되어 있지 않았으므로 지속적인 대책과 아울러 장기적인 발생 가능에 대한 예방책을 흥보하여야 할 것으로 보이며 계속적인 바이러스성 전염병 유행예측조사 및 역학조사가 적극적으로 이루어져야 할 것으로 사료된다.