• 한국보건간호학회지
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• 제13권1호
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• pp.88-96
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• 1999

This study was conducted in May of 1996 to December of 1996 in order to investigate the status of rubella antibodies in the women of childbearing age. The subjects were 543 fertile women (Ages 21-42 years). ELISA method was used for the detection of rubella antibodies and then questionaire survey was performed to know about the variables of past history of rubella. past rubella immunization. parity and cognition. The results were as follows: 1. The Positive rate of rubella Ig G antibody in total subjects was $65.0\%$. The positive rate of rubella Ig G antibody was $72.2\%$ in 21-25 age group. $71.4\%$ in 26-30 age group. $54.5\%$ in 31-35 age group, $52.6\%$ in 36-42 age group. As age increased, the positive rate of rubella Ig G antibody was decreased. There was statistically significant difference by age group(P=0.00l). In the subjects with a history of rubella immunization, the positive rate of rubella IgG antibody was $81.8\%$, and in those with past history of rubella was $83.3\%$ of positive rate. 2, Cognition rate about rubella immunization showed $50.8\%$ in total subjects. and there was no significant difference between parity and cognition rate of rubella immunization(P=0.85l). observed a low positive rate of rubella IgG antibody as compaired with other studies. Therefore, to prevent congenital rubella infection, rubella immunization was needed for unmarried women.

• Journal of Preventive Medicine and Public Health
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• 제33권3호
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• pp.280-284
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• 2000

Background : Congenital rubella syndrome (CRS) can be controlled by vaccination. Because rubella is typically a childhood disease, occurring predominantly in the 5 to 14 year age group, female school teachers nay be a high-risk population for CRS. Objectives : To determine the prevalence rate of rubella antibodies in school teachers of child bearing age. Methods : The study population consisted of primary, middle and high school teachers of child bearing age. The subjects were aged 35 years and younger, and consented to immunoglobulin (Ig) level testing using the ELISA method. Results : The positive rate of IgG was 77.9% in the study subjects (n=314). Sixty-three teachers (21.4%) were susceptible to rubella infection. Thirty-seven teachers (11.8%) had a history of rubella vaccination. Among the female teachers with no vaccination history, the proportion of negative IgM and IgG was 21.7%, and the proportion of positive IgM was 2.9%. Seventy-nine percent of the study subjects did not know that they should not become pregnant for three months after receiving the rubella vaccine. Conclusion : School teachers of child bearing age should be considered a high risk group for CRS, and should be vaccinated if they are found to be seronegative.

• Pediatric Infection and Vaccine
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• 제20권3호
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• pp.115-122
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• 2013

Reemerging infectious diseases are infections that had decreased in incidence in the global population and were brought under control through effective health care policy such as vaccination, but more recently, began to resurge as a health problem due to many reasons. Measles, rubella, mumps and pertussis are the examples. Immunization with MMR (measles, mumps, rubella) and pertussis vaccine has contributed to marked decrease in measles, mumps, rubella and pertussis incidence worldwide. In Korea, measles and rubella almost disappeared after the introduction of 2 doses of MMR immunization schedule. Recently, these infections have been reemerging in many countries with low vaccination rates and can be introduced again in Korea. However mumps and pertussis outbreaks are reported among fully vaccinated populations. Declining vaccine effectiveness, an increased awareness and surveillance of the disease or improved laboratory diagnostic tools had been suggested as possible causes. For the clinicians, it is difficult to diagnose these reemerging infectious diseases partly because of few experience of typical cases of measles and rubella or partly because of modification of clinical symptoms and signs of infectious diseases in immunized population. In this article, the diagnosis of measles, mumps, rubella and pertussis will be reviewed in the aspects of clinical characteristics, serologic methods, virus isolation, and polymerase chain reaction.

• Journal of Preventive Medicine and Public Health
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• 제27권2호
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• pp.337-365
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• 1994

Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.

• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.279-292
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• 1997

The vaccinations of susceptible children and postpubertal females are the major means to prevent congenital rubella syndrome(CRS). Another means for reducing the CRS is therapeutic abortion or fetal monitoring for women who are infected in the first four months of pregnancy. We could not estimate the incidence of CRS in Korea, because there was no surveillance system for rubella and CRS. Nationwide vaccination program for 15months infant had been started early 1980s. So, most women at childbearing age during study period were not received rubella vaccination. We set forth CRS management system for pregnant women in two rural county of Kyonggi province, Korea. In this system, the presence of rubella IgG and IgM antibodies for early pregnant women were examined with MEIA(Microparticle Enzyme Immunoassay) method by IMx automated analyzer $Abbott^(R)$. The infected pregnant women followed up in order to confirm their childrens CRS. This study was carried out from Mu. 1993 to Jun. 1994, and pregnant women examined were 874 persons. The results were summarized as follows. The overall positive .ate of rubella IgG antibody was 94.5%(826/874). The positive rate was significantly increase as the age increased, and reached 100% in pregnant women who were over 35 years old. This results suggest that a meaningful number of women are infected during childbearing years. The geometric mean titer of IgG of sero-positive subjects was significantly declined as the age increased. On the question about history of URI symptoms and rash in pregnancy, 20.7% of respondents checked on URI symptoms with .ash, 13.5% only URI symptoms without .ash, and 65.8% no symptoms. However there was no demonstrable association between the rubella like infection history in pregnancy and the rubella IgG and IgM antibody status. Rubella infection .ate in pregnant women was 0.9%(95% CI 0.4-1.8%). Two of these 8 infected pregnancies were terminated by therapeutic abortion. One of them was not followed. Five babies had no gross anomalies at birth. In Dec. 1996, three of five babies were normal appeared infants. Two of them were not followed. Throughout this study results, we confirmed the need of CRS management system for pregnant women, in Korea.

• 대한미생물학회지
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• 제22권4호
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• pp.473-483
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• 1987

Present study was undertaken to find when is right time for vaccination against Measles, Mumps and Rubella and what is the seropositive conversion rate after those vacinations. For this purpose, sera from 106 infants and children adimitted in Prediatric Department of Won Kwang University Hospital, Iri, Chonbuk, Korea were divided into 3 groups, such as (1) Vaccination group with definite information when it was given, (2) Unknown group whether vaccination was given or not, (3) Not vaccinated group. They were tested of IgG and IgM antibodies against Measles, Mumps and Rubella using Enzyme Immunoassay method and the following results were obtained. 1. Infants below 6 month of age showed to have IgG antibodies which seemed to have been transferred from mother in 87.8%(29/33) for Measles, 78.8%(26/33) for Mumps and 39.4%(13/13) for Rubella. And they showed IgM antibodies which are thought to have been produced by recent infection in 24.2%(8/33) for Measles, 48.5%(16/33) for Mumps and 9.1%(3/33) for Rubella. 2. Positivity of antibody IgG against Rubella was observed remarkably lower than it is against Measles and Mumps being only 39.4%(13/33) in $0{\sim}5$ month, 30.8%(8/26) in $6{\sim}11$ months, 30%(3/10) in $12{\sim}14$ months and 62.9%(22/35) in $18{\sim}36$ months of age. 3. ${\Delta}OD's$ of IgG and IgM antibodies against Measles were observed increasing with age being 0.444, 0.220 in $0{\sim}5$ months, 0.326, 0.134 in $6{\sim}11$ months, 0.581, 0.140 in $12{\sim}14$ months, 0.512, 0.000 in $15{\sim}17$ months and 0.887, 0.278 in $18{\sim}36$ months of age, respectively. 4. ${\Delta}OD's$ of IgG and IgM antibodies against Mumps were observed increasing with age being 0.427, 0.340 in $0{\sim}5$ months, 0.400, 0.249 in $6{\sim}11$ months, 0.694, 0.314 in $12{\sim}14$ months, 0.539, 0.165 in $15{\sim}17$ months and 0.854, 0.350 in $18{\sim}36$ months of age, respectively. 5. Vaccination for Measles, Mumps and Rubella is generally to start at 15 months of age in Korea, by which age their antibodies are found to exsist in more than 80% of tested samples. So, it seems to be very reasonable to start the vaccination schedule at earlier age than it does currently. 6. From the present study, it seems to have been clearly confirmed that Enzyme Immunoassay method is a reliable method with good reproducibility for mass survey of IgG and IgM antibodies against Measles, Mumps and Rubella in infants and children.

• Pediatric Infection and Vaccine
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• 제18권2호
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• pp.117-123
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• 2011

목 적: 홍역, 유행성이하선염 및 풍진 예방접종 시행후 연령 증가에 따른 항체양성율의 변화를 조사한다. 방 법: 병원에 내원한 7-20세의 환아를 대상으로 잔여 혈청을 이용하여 IgG 항체를 검사하였다. 결 과: 총 408례 중 홍역은 275례로 67.4%, 유행성이하선염은 112례로 27.5%, 풍진은 367례로 90.0%의 양성율을 보였다. 양성자의 IgG 수치는 각각 $2.77{\pm}1.18$ Index, $2.08{\pm}1.29$ Index 및 $60.46{\pm}63.47$ IU/mL 이었다. 결 론: 홍역 67.4%, 유행성이하선염 27.5% 및 풍진 90.0%의 IgG 항체 양성율을 보였다. 홍역, 유행성이하선염 및 풍진의 유행을 막기 위해서는 높은 접종율의 유지가 중요하며, 또한 보호자에 대한 접종기록 등의 관리가 중요할 것으로 생각된다.

• 대한바이러스학회지
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• 제30권1호
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• pp.51-59
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• 2000

During the recent epidemic period ($1995{\sim}1996$), seven strains of rubella virus were isolated in Korea. To analyze phylogenetic relationship between seven Korean strains and rubella virus strains from other different geographical areas, structural genes (E1, E2 and C) of Korean strains were enzymatically amplified and automatically sequenced. The sequence similarities of the E1, E2 and C genes of the cosmopolitan types were $95.8{\sim}98.1%$, $92.6{\sim}99.2%$ and $96.4{\sim}99.3%$ based on 1,441, 122 and 139 nucleotides and $96.9{\sim}98.5%$, $90{\sim}100%$ and $97.8{\sim}100%$ based on 480, 40 and 46 amino acids compared to the sequences of strain RA27/3, respectively. In contrast, the sequence similarities of the E1, E2 and C genes of the Asian types were $91.5{\sim}92.1%$, $83.6{\sim}88.5%$ and 91.4% based on nucleotides and $96.9{\sim}97.7%$, 85.5% and 97.8% based on amino acids compared to the sequences of strain RA27/3, respectively. However, immunodominent epitopes of the E1 gene of the cosmopolitan and Asian types were well conserved, and the growth patterns in cell culture and immunofluorescent antibody titers in cross-reaction test showed no differences between two different types. In phylogenetic analysis based on nucleotide sequences of each gene regions, the cosmopolitan and Asian types formed two distinct phylogenetic lineages. These data showed two distinct genotypes of rubella viruses cocirculated in Korea, but no significant differences in the antigenicity of two different rubella virus strains were found.

• Pediatric Infection and Vaccine
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• 제3권2호
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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.

• Pediatric Infection and Vaccine
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• 제5권1호
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• pp.128-135
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• 1998

목 적 : MMR백신의 예방접종에도 불구하고 우리나라에는 홍역, 볼거리, 풍진의 유행이 아직도 지속되고 있고, 풍진의 경우 이환 연령군의 증가와 집단적, 지역적인 유행이 보고되고 있으나 원인은 아직 밝혀지지 않았다. 이에 저자들은 우리나라 청소년의 연령 증가에 따른 볼거리 및 풍진 항체 보유 실태에 관한 기본적인 자료를 얻고자 다음의 연구를 시행하였다. 대상 및 방법 : 1996년 5월부터 1996년 7월까지 3개월간 서울시내의 중학교 1개교 및 고등학교 2개교 학생들을 대상으로 ELISA를 이용하여 볼거리 및 풍진 특이 IgG 항체를 측정하였다. 양성 기준치는 정해진 검사 방법에 따라 볼거리 항체는 20 GU(Gamma Unit; 임의의 단위) 이상으로 하였으며 풍진항체는 0.17 이상으로 하였다. 결 과 : 1) 대상자는 12세에서 17세까지 남아 110명, 여아 106명으로 총 216명이었다. 2) 연령에 따른 볼거리항체 양성율은 12세 68.4%, 13세 79.3%, 14세 72.2%, 15세 82.0%, 16세 87.5%, 17세 87.0%로 전체적으로는 80.6%였으며, 14세군(P<0.05)을 제외하고는 남녀간에 유의한 차이는 없었고, 연령군간의 유의한 차이는 없었다. 3) 볼거리 항체가(평균${\pm}$표준편차, GU)는 12세 $52.0{\pm}49.2$, 13세 $65.9{\pm}51.4$, 14세 $71.1{\pm}66.0$, 15세 $67.8{\pm}53.6$, 16세 $82.8{\pm}67.8$, 17세 $92.0{\pm}68.9$였으며 연령군간의 유의한 차이는 없었고, 연령의 증가에 따라 항체가가 증가하는 추세를 보였으나 유의성은 없었다. 4) 연령에 따른 풍진 항체 양성율은 12세 26.3%, 13세 20.7%, 14세 50.0%, 15세 67.2%, 16세 66.7%, 17세 65.2%로 전체적으로 54.2%의 양성율을 보였고 연령에 따라 유의하게 증가 하였으며(P<0.001), 성별에 따른 차이는 없었고, 13세에서 14세사이(P<0.05)를 제외하고는 연령군별간에 유의한 차이는 없었다. 5) 풍진 항체가(평균${\pm}$표준편차)는 12세 $0.13{\pm}0.145$, 13세 $0.087{\pm}0.101$, 14세 $0.194{\pm}0.168$, 15세 $0.260{\pm}0.187$, 16세 $0.305{\pm}0.213$, 17세 $0.325{\pm}0.221$로 13세에 최저치를 보이고 이후는 연령의 증가에 따라 유의하게 증가하였으며(P<0.001), 풍진 항체가=0.0517${\times}$연령-0.5586의 비례관계를 보였다(r=0.3752, P<0.001). 결 론 : 청소년기의 볼거리 항체 양성율과 항체가는 전체적으로 높은 수준을 보였으나 대상군중 약 20%는 항체 음성을 보였다. 풍진의 경우 13세까지는 매우 낮은 항체양성율을 보이다가 14세 이후 점진적으로 증가하였으며 이러한 항체가의 변동 원인에 대한 연구가 필요할 것으로 생각된다.