• 제목/요약/키워드: Epidemiologic investigation

검색결과 75건 처리시간 0.028초

1995~2000년 예방접종 후 이상반응 사례 분석 - 국가보상 신청 사례와 예방접종 후 이상반응 감시체계 보고 사례를 중심으로 - (Analysis of The Adverse Events Following Immunization of the National Compensation Program and the Surveillance System in Korea, 1995~2000)

  • 이홍주;손영모;김정순;김영택;이종구;최보율
    • Pediatric Infection and Vaccine
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    • 제8권2호
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    • pp.135-149
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    • 2001
  • 목 적 : 예방접종 사업의 안정화를 위해서는 발생된 이상반응이 적절하게 보고되고, 발견된 이상반응에 대하여 신속하고 정확한 원인 규명을 위한 역학조사를 시행하여 조사된 결과에 따라 적절하게 대응하는 것이 필요하다. 이에 연구자들은 1995년부터 2000년까지 국가 보상을 신청하거나 보고된 예방접종 후 이상반응 감시체계를 통해 보고된 이상반응 사례들을 수집하여 보고 사례와 국가 보상의 변화 양상과 사례의 역학적 특성을 파악하여 이상반응 감시체계의 개선 방향을 제시할 수 있는 기반을 마련하고자 하였다. 방 법 : 1995년부터 1996년까지 예방접종 후 이상반응에 대하여 국가보상신청을 하거나 국립보건원 방역과로 보고된 61건을 대상으로 국가보상 신청시 제출한 자료와 역학조사와 관련된 모든 자료들을 수집, 정리하여 사례들의 역학적 특성들을 파악하였으며, 역학조사 방법과 보상과 관련된 사항들에 대하여 정리 분석하였다. 결 과 : 연도별 보고 건수는 1995년 12명, 1996년 3명, 1998년 12명, 1999년 5명, 2000년 29명으로 총 61명이었으며, 이 중 사망자는 24명(39.3%)이고, 이 중 16명(66.7%)에서 부검이 시행되었다. 보상 심의를 신청한 경우는 36건(59.0%)이었는데, 이 중 17건(47.2%)이 보상받았고, 역학조사를 실시한 경우는 49건(80.3%)이었다. 보고 사례 중 보상 신청 사례는 1995~1998년에는 17건 중 15건(88.2%), 1999~2000년에는 38건 중 15건(76.3%)으로 감소하였으나, 심의 결과 보상을 받는 비율은 1995~1998년 26.6%에서 1999~2000년 53.3%로 증가하였다. 보고 사례 중 역학조사가 이루어진 경우는 1995~1998년에는 17건 중 14건(82.4%), 1999~2000년에는 38건 중 29건(76.3%)으로 역학조사를 실시하는 비율은 감소하였으나 반드시 역학조사가 필요하나 누락되는 경우는 개선되었다. 이상반응 발생을 인지한 후 역학조사에 착수하기까지의 소요시간이 1일 이내인 경우가 1995~1998년에는 전체의 25%에 불과하던 것이 1999년 이후에는 전체의 43.5%로 증가하였다. 전체 이상반응 발생에 있어 남녀간 차이는 보이지 않지만 사망자 21명만을 살펴보면 남자가 14명(66.7%), 여자가 7명(33.3%)으로 남자가 2배나 많았다. 연령별 분포는 정기예방접종이 집중되어 있는 생후 2개월부터 24개월까지가 전체의 75.4%를 차지하고 있다. 접종에서 발병까지의 기간은 전체의 78.4%가 접종 후 일주일 이내에 발생하였다. 결 론 : 보고체계 도입 이후 역학조사가 필요한 경우 대부분에서 조사가 시행되었고, 보고를 받고 신속하게 조사를 착수하는 비율이 증가한 것은 긍정적인 변화로 평가된다. 그러나, 전체적으로 보았을 때 외국에 비하여 감시체계를 통해 보고되는 사례 수가 매우 적어 이상반응의 역학적 양상을 파악함에는 제한점이 있다. 예방접종 사업의 안정성 확보라는 목표를 달성하기 위해서는 무엇보다 보고율 향상을 위한 노력이 경주되어야 할 것으로 생각된다.

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Humidifier disinfectant disaster: what is known and what needs to be clarified

  • Kim, Sungkyoon;Paek, Domyung
    • Environmental Analysis Health and Toxicology
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    • 제31권
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    • pp.25.1-25.9
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    • 2016
  • Objectives After the initial investigations by the Korea Centers for Disease Control in 2011, over 1000 suspicious cases of humidifier disinfectant (HD) victims were subsequently reported by 2015, and numbers are still increasing dramatically in 2016 in the midst of the prosecutors' office investigation. This study attempts to summarize the current understandings of the related health effects of HD based upon a systemic review of published epidemiologic studies and toxicology investigations. Methods Published studies of HDs were searched through PubMed and TOXLINE under the search words 'humidifier disinfectant,' and related reports were identified from the references and published report list of regulatory agencies including the Korean National Institute of Environmental Research, US Environmental Protection Agency, and EU European Chemicals Agency. Results Case reports and epidemiologic studies have reported the clinical features of severe forms of HD lung damage, together with epidemiologic findings of seasonal occurrence and demographic variations, including the heightened susceptibility of young children. Toxicological studies have reported inhalation toxicities together with positive findings of in vitro genotoxicity studies. Conclusions This study examined unsolved issues based on cases of upper respiratory diseases and diseases of other organs, including cancers, among suspected victims of HDs. These issues should be clarified in future research for the management and prevention of health effects from HDs and chemicals of other related household products.

Issues in the Design of Molecular and Genetic Epidemiologic Studies

  • Fowke, Jay H.
    • Journal of Preventive Medicine and Public Health
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    • 제42권6호
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    • pp.343-348
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    • 2009
  • The final decision of study design in molecular and genetic epidemiology is usually a compromise between the research study aims and a number of logistical and ethical barriers that may limit the feasibility of the study or the interpretation of results. Although biomarker measurements may improve exposure or disease assessments, it is necessary to address the possibility that biomarker measurement inserts additional sources of misclassification and confounding that may lead to inconsistencies across the research literature. Studies targeting multi-causal diseases and investigating gene-environment interactions must not only meet the needs of a traditional epidemiologic study but also the needs of the biomarker investigation. This paper is intended to highlight the major issues that need to be considered when developing an epidemiologic study utilizing biomarkers. These issues covers from molecular and genetic epidemiology (MGE) study designs including cross-sectional, cohort, case-control, clinical trials, nested case-control, and case-only studies to matching the study design to the MGE research goals. This review summarizes logistical barriers and the most common epidemiological study designs most relevant to MGE and describes the strengths and limitations of each approach in the context of common MGE research aims to meet specific MEG objectives.

울주군에서 발생한 장출혈성대장균 감염증의 발생 원인 (Cause of Enterohemorrhagic Escherichia coli Infection in Ulju County, Korea)

  • 이상원;양병국;이복권;박재구;황병훈;임현술;배근량
    • Journal of Preventive Medicine and Public Health
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    • 제36권1호
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    • pp.77-84
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    • 2003
  • Objectives : Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. Methods : We peformed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we peformed rectal swabs on the cattle raised by the household of the index patient. Results : We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. Conclusions : We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.

경주시 배반동에서 발생한 탄저병에 관한 역학조사 (An Epidemiologic Investigation on an Outbreak of Anthrax Occurred in Kyongju by Eating Dead Cow's Meat)

  • 임현술;정해관;김정순;오희철;이동모;김호훈
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.693-709
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    • 1994
  • This epidemiologic study was carried out to investigate cauuse and magnitude of food-poisoning like epidemic occurred among inhabitants of a village who have eaten dead cow's meat near Kyongju in February of 1994, around lunar new year, The investigation consisted of interview survey on all inhabitants of 77 households (111 males and 119 females) and their visitors (40 males and 35 females), skin test with anthraxinum (Russian product), study on clinical characteristics for the patients hospitalized, and microbiologic examination on microbes isolated from cow's meat, patient and soils of dead cow's barn. The results obtained are as followings; 1. The proportion of the inhabitants who ingested the dead cow's meat was 36.4%. The incidence rate of the disease was 65.1% for males, 41.7% for females and the cases were distributed evenly for all age groups. The group ingested raw meat showed higher incidence than the group ingested cooked meat. There was no case among people who did not eat the meat. 2. The most clinical symptoms were significantly more frequent among cases than non-cases : sore throat (57%), nausea (51%), fever (47%), indigestion (43%), cough (41%), anorexia (41%), abdominal distention (41%), and abdominal pain (39%) were the major symptoms among cases. 3. Among 29 cases hospitalized out of total 61 cases, three patients, all old and feeble persons, deceased from the disease resulting in 4.9% fatality rate among total patient and 10.3% among hospitalized. Septicemia and meningitis were the causes of the deaths. 4. Three strains isolated from patients, and three strains from dead cow's meat and soil revealed typical microbiologic characteristics of Bacillus Anthracis, which also proved to be fatal to experimentally infected mice.

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Epidemiologic investigation of gastrointestinal pathogens for Korean cats with digestive sign

  • Lee, Mi-Jin;An, Fujin;Lee, Gijong;Park, Jin-ho
    • 한국동물위생학회지
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    • 제45권2호
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    • pp.101-110
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    • 2022
  • This study was performed to investigate infectious gastrointestinal diseases in 115 Korean cats (83 indoors and 32 outdoors) with digestive signs such as diarrhea, anorexia or abdominal distention. Detection of infectious pathogens was analyzed using real-time PCR. As a result, 85 of 115 Korean cats were detected with feline corona virus (FCoV), feline parvo virus, Group A rotavirus, Clostridium perfringens (C. perfringens), Campylobacter coli (C. coli), Campylobacter jejuni, enterotoxigenic Escherichia coli, enteropathogenic Escherichia coli, Salmonella spp., Tritrichomonas foetus, Cyclospora cayetanensis, and Giardia lamblia. The most frequently detected pathogen was C. perfringens (52 cats, 61.2%), followed by FCoV (43 cats, 50.6%) and C. coli (16 cats, 18.8%). Also, single infection was the most common (43 cats), followed by double infection in 31 cats, triple infection in 7 cats, and quadruple infection in 4 cats. There was no significant relationship between pathogen detection and age, gender, living environment, weather, and diarrhea. However, there was a significant difference between the age group under 1 year and the age group 1~7 (P value<0.05). In this study, cats with suspected gastrointestinal infection were randomly evaluated, and other factors that could affect pathogen detection were insufficiently considered. For this reason, additional epidemiological investigations with a larger number of cats and sufficient consideration of the causes that may affect the results are needed. Nevertheless, it is thought that this study can also provide valuable information on gastrointestinal pathogens in Korean cats.

고성 폐금속 광산 오염 사건의 교훈 (Lessons of Goseong Abandoned Metal Mine Accident)

  • 권호장
    • 한국환경보건학회지
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    • 제37권5호
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    • pp.335-341
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    • 2011
  • The Goseong abandoned mine accident was a typical case of long-term sequela resulting from environmental disruption during the rapid economic development of Korea. While the final conclusion of epidemiologic investigation was that residents surrounding the abandoned mine were simply exposed to cadmium from the abandoned mine without any patient contracting 'itai-itai' disease, not only did residents around the abandoned mine suffer enormous psychological and economic damage, but people in neighbouring communities did as well when the entire area was stigmatized as an contaminated area. Environmental civic groups and the government worked together to solve the problem by forming a joint committee which held the right of decision in any matter to be determined. By inviting all the stakeholders to participate in the joint committee, a transparent investigation was guaranteed and the results of investigation and recommendations to solve the problem were accepted by all involved. Even though the environmental health division in Ministry of Environment has developed considerably and built up a capacity to deal with environmental accidents, the process which was adopted to solving the Goseong abandoned mine accident can be useful to settle environmental health issues with severe conflicts among stakeholders.