OBJECTIVES: Outbreaks of scarlet fever in Mexico in 1999, Hong Kong and mainland China in 2011, and England in 2014-2016 have received global attention, and the number of notified cases in Korean children, including in Jeju Province, has also increased since 2010. To identify relevant hypotheses regarding this emerging outbreak, an age-period-cohort (APC) analysis of scarlet fever incidence was conducted among children in Jeju Province, Korea. METHODS: This study analyzed data from the nationwide insurance claims database administered by the Korean National Health Insurance Service. The inclusion criteria were children aged ≤14 years residing in Jeju Province, Korea who received any form of healthcare for scarlet fever from 2002 to 2016. The age and year variables were categorized into 5 groups, respectively. After calculating the crude incidence rate (CIR) for age and calendar year groups, the intrinsic estimator (IE) method was applied to conduct the APC analysis. RESULTS: In total, 2345 cases were identified from 2002 to 2016. Scarlet fever was most common in the 0-2 age group, and boys presented more cases than girls. Since the CIR decreased with age between 2002 and 2016, the age and period effect decreased in all observed years. The IE coefficients suggesting a cohort effect shifted from negative to positive in 2009. CONCLUSIONS: The results suggest that the recent outbreak of scarlet fever among children in Jeju Province might be explained through the cohort effect. As children born after 2009 showed a higher risk of scarlet fever, further descriptive epidemiological studies are needed.
Child ; China ; Cohort Effect ; Delivery of Health Care ; Disease Outbreaks ; England ; Epidemiologic Studies ; Exotoxins ; Female ; Hong Kong ; Humans ; Incidence ; Insurance ; Korea ; Methods ; Mexico ; National Health Programs ; Scarlet Fever ; Streptococcus pyogenes

Severe fever with thrombocytopenia syndrome (SFTS) is caused by the SFTS virus (SFTSV). The SFTSV appears to have a wide host range, as SFTSV-positive ticks have been isolated from both farm animals and wild rodents. Therefore, it is important to monitor SFTSV-positive animals to prevent the transmission of SFTSV from animals to humans. Previously, we developed a competitive enzyme-linked immunosorbent assay (cELISA) to detect SFTSV-specific antibodies from field animals and compared the cELISA results to those from an indirect immunofluorescence assay (IFA). In this study, cELISA results were compared to and evaluated against the results from both an IFA and a virus neutralization (VN) test of 193 bovine serum samples (including two bovine positive control sera) and 70 horse serum samples. The consistency (98.9%) between cELISA and VN results was higher than that (97.4%) between cELISA and IFA for the bovine serum samples. Similarly, for the horse serum samples, the consistency (88.6%) between cELISA and VN results was higher than that (84.3%) between the cELISA and IFA. These findings indicate that our newly developed cELISA can be used for surveillance or epidemiological studies of SFTSV in animals.
Animals ; Animals, Domestic ; Antibodies ; Enzyme-Linked Immunosorbent Assay* ; Epidemiologic Studies ; Fever* ; Fluorescent Antibody Technique, Indirect ; Horses ; Host Specificity ; Humans ; Neutralization Tests* ; Rodentia ; Thrombocytopenia* ; Ticks

PURPOSE: Status epilepticus (SE) is a neurological emergency disease because it can cause severe neurological complications. In order to avoid these complications, early diagnosis and appropriate treatment is required in SE. Febrile SE is the most common form of SE in children. We investigated the clinical characteristics and prognosis of patients with febrile SE is the first seizure of life. METHODS: We retrospectively reviewed the medical records of patients with SE as the first presentation of fever related seizures who visited our hospital from July 1996 to January 2013. Clinicodemographic characteristics, brain magnetic resonance imaging (MRI) and electro-encephalogram (EEG) findings, and anti-epileptic treatment were compared between two groups divided according to prognosis; fair vs. poor prognosis. RESULTS: Seventy-eight children were included in this study. The median age of the subjects was 20.0 months (interquartile range [IQR] 12.0–42.8). Fifty-one subjects had a fair prognosis, while twenty-seven subjects had a poor prognosis. Statistically significant differences was observed in the duration of seizure (P=0.043), the number of antiepileptic drugs (P<0.001) and the presence of abnormal EEG findings (P<0.001). CONCLUSION: Children with febrile SE as the first seizure of life are likely to reveal a poor prognosis in those whose seizure last longer or are controlled only through high step anti-epileptic drugs. Thus, in order to ensuring a better prognosis for such patients, appropriate treatment is needed to stop the seizure.
Anticonvulsants ; Brain ; Child* ; Early Diagnosis ; Electroencephalography ; Emergencies ; Epidemiologic Study Characteristics as Topic ; Fever* ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Prognosis ; Retrospective Studies ; Seizures* ; Status Epilepticus*

BACKGROUND: Eczema herpeticum (EH) is caused by viral infection, usually with the herpes simplex virus (HSV), and most often occurs in patients with atopic dermatitis (AD). Although EH is a common dermatosis, predisposing factors are largely unknown, and there have been few clinical and epidemiologic studies in Korea. OBJECTIVE: This study evaluated the clinical characteristics of inpatients diagnosed with EH over the last 10 years. METHODS: We reviewed the medical records of 62 patients who were diagnosed with EH and were hospitalized at the Chonnam National University Hospital in Gwangju from January 2004 to July 2014. RESULTS: The ratio of male to female patients with EH was about 2:1, and the mean age at onset of EH was 25.3 (+/-17.3) years. In this study, AD (67.7%) was the most common preceding skin disorder, followed by nummular eczema (6.5%), and seborrheic dermatitis (3.2%). Patients with EH had other systemic symptoms such as fever (22.6%), headache (4.8%), and lymphadenopathy (4.8%). Patients with recurrent infection of HSV had longer hospitalizations compared to those with primary infection (9.35 vs. 6.49 days), but the difference was not significant (p=0.269). There was no significant difference in the number of hospitalized days between patients receiving antiviral agents vs. antibiotics (p=0.153). Systemic steroids were administered in 66.1% patients, which had no correlation with the number of hospitalized days (p=0.203). CONCLUSION: The present retrospective analysis contributes to our understanding of the clinical characteristics of EH.
Anti-Bacterial Agents ; Antiviral Agents ; Causality ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Eczema* ; Epidemiologic Studies ; Female ; Fever ; Gwangju ; Headache ; Hospitalization ; Humans ; Inpatients* ; Jeollanam-do ; Kaposi Varicelliform Eruption* ; Korea ; Lymphatic Diseases ; Male ; Medical Records ; Retrospective Studies ; Simplexvirus ; Skin ; Skin Diseases ; Steroids

BACKGROUND: In low-risk women at term, epidemiologic studies have shown that fever in nulliparous parturients during labor is related to epidural use. Moreover, effects of fever associated with epidural analgesia on adverse neonatal outcomes have been debated. The purpose of this study is to evaluate the influence of epidural analgesia on intrapartum fever, neonatal outcomes in deliveries including nulliparity and multiparity. METHODS: We retrospectively investigated normal full-term spontaneous deliveries during 2012. Of 3,858 mother-infant pairs, 3,179 (82%) parturients received and 679 (18%) parturients did not receive epidural analgesia during labor. We regarded intrapartum fever greater than 37.5degrees C, and the parturients with fever were treated with intravenous propacetamol. We divided the study population according to labor epidural analgesia use and, fever and compared the incidence of fever and neonatal outcomes. RESULTS: Incidence of fever was higher in the epidural group compared with the no epidural group (21 vs. 5%). The number of babies with a 1 min Apgar < 7 was lower in the no epidural with no fever group, and neonatal seizure was more frequent in the epidural with fever group compared with the no epidural without fever group, no epidural with fever group, and the epidural without fever group. CONCLUSIONS: Incidence of fever was increased in the epidural analgesia group. Adverse neonatal outcomes were more frequent in the epidural with fever group. No conclusion whether the epidural analgesia cause neonatal adverse outcomes can be drawn due to confounding factors.
Analgesia, Epidural* ; Apgar Score ; Epidemiologic Studies ; Female ; Fever* ; Humans ; Incidence ; Parity ; Retrospective Studies ; Seizures

INTRODUCTIONWe studied the epidemiological trends of enteric fevers (typhoid and paratyphoid fever) in Singapore from 1990 to 2009 and carried out a review of the current prevention and control measures.

MATERIALS AND METHODSEpidemiological records of all reported enteric fevers maintained by the Communicable Diseases Division, Ministry of Health from 1990 to 2009 were analysed.

RESULTSA total of 2464 laboratory confirmed cases of enteric fevers (1699 cases of typhoid and 765 cases of paratyphoid) were reported. Of these, 75% were imported, mainly from India and Indonesia. There had been a significant fall in the mean annual incidence rate of indigenous enteric fevers from 4.3 per 100,000 population in 1990 to 0.26 per 100,000 population in 2009 (P <0.005) with a corresponding increase in the proportion of imported cases from 71% between 1990 and 1993 to 92% between 2006 and 2009 (P <0.0005). Imported cases involving foreign contract workers increased significantly from 12.8% between 1990 and 1993 to 40.4% between 2006 and 2009 (P <0.0005).

CONCLUSIONSingapore has experienced a marked decline in the incidence of enteric fevers that is now comparable to that of other developed countries. Continued vigilance and proactive measures that address the changing epidemiology of enteric fevers in Singapore are necessary to sustain the milestone achieved in the past 2 decades.

Adolescent ; Adult ; Child ; Child, Preschool ; Disease Outbreaks ; Epidemiologic Studies ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Paratyphoid Fever ; epidemiology ; prevention & control ; Population Surveillance ; Singapore ; epidemiology ; Typhoid Fever ; epidemiology ; prevention & control ; Young Adult

A survey was performed in Korea to monitor the prevalence of five bovine arboviruses [Akabane virus, Aino virus, Chuzan virus, bovine ephemeral fever (BEF) virus, and Ibaraki virus] in arthropod vectors, such as Culicoides species. To determine the possible applications of survey data in annual monitoring and warning systems in Korea, we examined the prevalence of bovine arboviruses in arthropod vectors using RT-PCR. To compare the sensitivity and specificity of virus detection, nested PCR was also performed in parallel for all five viruses. Using the RT-PCR, the detection limits were at least up to 10(1.5), 10(2.8), 10(2.0), 10(1.8), and 10(4.0) TCID50/ml for Akabane virus, Aino virus, Chuzan virus, BEF virus, and Ibaraki virus, respectively. When nested PCR was performed using 1 micronl of PCR product, the detection limits were increased, to 10(0.05), 10(1.8), 10(1.0), 10(0.008), and 10(2.0) TCID50/ml for Akabane virus, Aino virus, Chuzan virus, BEF virus, and Ibaraki virus, respectively. Thus, nested PCR increased the sensitivity of the virus detection limit by 1~2 log. We pooled 30~40 mosquitoes in one sample. We collected 113 samples in 2006, 135 samples in 2007, and 100 samples in 2008. Among these samples, Chuzan virus and BEF virus genes were detected at a range between 0.82% and 1.19%, and Akabane virus, Aino virus, and Ibaraki virus genes were detected at less than 0.20%. These data may provide some insight into future epidemiological studies of bovine arboviral diseases in Korea.
Animals ; Arboviruses ; Arthropod Vectors ; Arthropods ; Cattle ; Ceratopogonidae ; Culicidae ; Ephemeral Fever ; Epidemiologic Studies ; Korea ; Limit of Detection ; Organothiophosphorus Compounds ; Palyam Virus ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity ; Viruses

Hepatitis A virus (HAV) is mostly transmitted by the oral-fecal route. However, rare cases of transmission via blood transfusion still exist. A retrospective study was designed to trace a case of transfusion transmitted HAV (TTHAV) infection through the Post Donation Infection (PDI) system in Korea in 2006. We report here on a case of TTHAV that was identified through a lookback study. A 35-year old woman received 6 units of packed red cell transfusion when undergoing Caesarian section in a hospital. Ten days later, she developed a high fever and sore throat. Anorexia and abdominal pain developed in 45 days after transfusion. She was diagnosed with acute tonsillitis at the hospital, and she was not aware of her HAV infection at that time. Then, a donor informed the blood center of his HAV infection 10 days after donation to request his blood be discarded. The recipients of the blood were traced and epidemiological studies lead to the patient, which prompted her serum to be collected and tested. Finally, TTHAV was identified for this patient with positive anti-HAV IgG/IgM results. This is the first case of TTHAV to be identified through the HAV lookback study in Korea.
Abdominal Pain ; Anorexia ; Blood Transfusion ; Epidemiologic Studies ; Female ; Fever ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Humans ; Korea ; Palatine Tonsil ; Pharyngitis ; Retrospective Studies ; Tissue Donors ; Tonsillitis

Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases also has increased in Korea. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise- induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.
Adolescent ; Animals ; Anti-Bacterial Agents ; Asthma ; Body Mass Index ; Cats ; Child ; Cohort Studies ; Cough ; Dermatitis, Atopic ; Dogs ; Epidemiologic Studies ; Fever ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Korea ; Parturition ; Prevalence ; Public Health ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Tobacco Smoke Pollution

Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.
Adolescent ; Animals ; Anti-Bacterial Agents ; Asthma ; Body Mass Index ; Cats ; Child ; Cohort Studies ; Cough ; Dermatitis, Atopic ; Dogs ; Epidemiologic Studies ; Fever ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Korea ; Parturition ; Prevalence ; Public Health ; Surveys and Questionnaires ; Rhinitis ; Rhinitis, Allergic, Perennial ; Risk Factors ; Tobacco Smoke Pollution