BACKGROUND: Dengue fever is one of the most dominant vector-borne diseases, putting approximately 3.9 billion people at risk worldwide. While it is generally vector-borne, other routes of transmission such as needlestick injury are possible. Laboratory workers can be exposed to dengue virus transcutaneously by needlestick injury. This is the first case, to our knowledge, of dengue virus infection by needlestick injury in a laboratory environment. This paper evaluates the risk and related health concerns of laboratory workers exposed to dengue virus. CASE PRESENTATION: We evaluated a 30-year-old female laboratory worker exposed to the dengue virus by needlestick injury while conducting virus filtering. During admission, she showed symptoms of fever, nausea, myalgia, and a characteristic maculopapular rash with elevated aspartate aminotransferase (AST) of 235 IU/L and alanine aminotransferase (ALT) of 269 IU/L. She had been diagnosed by a positive nonstructural protein 1 (NS1) antigen (Ag) rapid test one day prior to symptom onset along with positive immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) on the ninth day of symptom onset. Reverse transcription polymerase chain reaction (RT-PCR), also conducted on the ninth day, was negative. After proper symptomatic treatment, she recovered without any sequelae. As a result of thorough epidemiologic investigation, it was determined that she had tried to recap the needle during the virus filtering procedure and a subsequent needlestick injury occurred. CONCLUSIONS: In the context of health promotion of laboratory workers, we suggest that the laboratory biosafety manual be revised and reinforced, and related prevention measures be implemented. Furthermore, health authorities and health care providers in Korea should be fully informed of proper dengue fever management.
Adult ; Alanine Transaminase ; Aspartate Aminotransferases ; Dengue Virus* ; Dengue* ; Enzyme-Linked Immunosorbent Assay ; Exanthema ; Female ; Fever ; Health Personnel ; Health Promotion ; Humans ; Immunoglobulin M ; Korea* ; Myalgia ; Nausea ; Needles ; Needlestick Injuries* ; Polymerase Chain Reaction ; Reverse Transcription

The hepatitis A virus (HAV) has been the leading cause of viral hepatitis in Korea since the 2000s. We aimed to describe the current status and regional differences in hepatitis A incidence. We studied the total number of hepatitis A cases reported to the Korea Centers for Disease Control and Prevention through the National Infectious Diseases Surveillance System between 2011 and 2013. Additionally, National Health Insurance Review and Assessment Service data and national population data from Statistics Korea were used. In total, 7,585 hepatitis A cases were reported; 5,521 (10.9 cases per 100,000 populations), 1,197 (2.3 cases per 100,000 populations), and 867 (1.7 cases per 100,000 populations) in 2011, 2012, and 2013, respectively. Fifty-eight patients were infected outside of the country and 7,527 patients represented autochthonous HAV infection cases. Autochthonous HAV infection occurred more frequently among men than women (4,619 cases, 6.1 cases per 100,000 population vs. 2,908 cases, 3.9 cases per 100,000 population). The incidence rate was higher in the 20-29 yr-old group (2,309 cases, 11.6 cases per 100,000 populations) and 30-39 yr-old group (3,306 cases, 13.6 cases per 100,000 populations). The majority of cases were reported from March to June (53.6%, 4,038/7,527). Geographic analyses revealed a consistently high relative risk (RR) of HAV infection in mid-western regions (2011, RR, 1.25, P=0.019; 2012, RR, 2.53, P<0.001; 2013, RR, 1.86, P<0.001). In summary, we report that hepatitis A incidence has been decreasing gradually from 2011 to 2013 and that some regions show the highest prevalence rates of HAV infection in Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Databases, Factual ; Female ; Hepatitis A/*epidemiology/pathology ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk ; Seasons ; Sex Factors ; Young Adult

This study was performed to measure early changes in the serotype distribution of pneumococci isolated from children with invasive disease during the 3-year period following the introduction of 10- and 13-valent pneumococcal conjugate vaccines (PCVs) in Korea. From January 2011 to December 2013 at 25 hospitals located throughout Korea, pneumococci were isolated among children who had invasive pneumococcal disease (IPD). Serotypes were determined using the Quellung reaction, and the change in serotype distribution was analyzed. Seventy-five cases of IPD were included. Eighty percent of patients were aged 3-59 months, and 32% had a comorbidity that increased the risk of pneumococcal infection. The most common serotypes were 19A (32.0%), 10A (8.0%), and 15C (6.7%). The PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F, and 6A) accounted for 14.7% of the total isolates and the PCV13 minus PCV7 types (1, 3, 5, 7F and 19A) accounted for 32.0% of the total isolates. Serotype 19A was the only serotype in the PCV13 minus PCV7 group. The proportion of serotype 19A showed decreasing tendency from 37.5% in 2011 to 22.2% in 2013 (P = 0.309), while the proportion of non-PCV13 types showed increasing tendency from 45.8% in 2011 to 72.2% in 2013 (P = 0.108). Shortly after the introduction of extended-valent PCVs in Korea, serotype 19A continued to be the most common serotype causing IPD in children. Subsequently, the proportion of 19A decreased, and non-vaccine serotypes emerged as an important cause of IPD. The impact of extended-valent vaccines must be continuously monitored.
Adolescent ; Bacteremia/complications/diagnosis ; Child ; Child, Preschool ; Female ; Hospitals ; Humans ; Infant ; Male ; Pneumococcal Infections/microbiology/*prevention & control ; Pneumococcal Vaccines/*immunology ; Republic of Korea ; Serotyping ; Streptococcus pneumoniae/*classification/isolation & purification ; Vaccines, Conjugate/*immunology

Although vaccination is regarded as one of the most effective public health measure to prevent and control infectious diseases, no vaccine is perfectly safe. Therefore, safety management is an essential component in running National Immunization Program. Here, we review the current issues and suggest future perspectives of Korean vaccine safety management system.
Communicable Diseases ; Drug Toxicity ; Immunization Programs ; Korea ; Public Health ; Running ; Safety Management ; Vaccination ; Vaccines

Following the Five Year Measles Elimination Program, measles has been declared eliminated from the Republic of Korea since 2006. However, there remain challenges related to the surveillance of measles in the postelimination phase. Even though the routine surveillance system has revealed a gradual decrease in the number of reported cases since 2002, 4 resurgences have occurred, notably due to outbreaks. Because vaccine-modified measles is becoming widespread due to high vaccination coverage, conducting laboratory confirmation in each case becomes important. Moreover, susceptible individuals with measles have been identified through seroprevalence studies. Lastly, the efforts to improve the timeliness of measles reporting have led to the establishment of an active laboratory-based surveillance network, which has shortened the interval between diagnosis and notification. In these circumstances, searching for more sensitive and effective surveillance measures is important for maintaining the elimination status and preventing future outbreaks of measles in Korea.
Disease Outbreaks ; Korea ; Measles ; Republic of Korea ; Seroepidemiologic Studies ; Vaccination

OBJECTIVE: The objective of the study was to estimate socioeconomic burden of polycystic ovary syndrome (PCOS) during the reproductive life span using current definitions and prevalence or incidence data. METHODS: Questionnaires were given to 8,588 reproductive women reviewed at Ewha Womans University Mokdong hospital. The PCOS affected approximately 10.4% of reproductive-aged women (11 million women in Korea, prevalence rate according to 1990 National Institutes of Health PCOS diagnosis criteria). We tied general societal cost data for the different health consequences to reproductive-age PCOS costs, using prevalence data. RESULTS: We estimated the mean annual cost of the initial evaluation to be 76 hundred million won, that of hormonally treating menstrual dysfunction, providing infertility care, diagnosis/treatment of endometrial hyperplasia, GDM, type 2 DM, and hypertension to be 280 billion won. The total annual socioeconomic cost of evaluating and providing care to reproductive-aged PCOS women in Korea is 350 billion won. CONCLUSION: Because the cost of the diagnostic evaluation accounted for a relatively minor part of the total socioeconomic costs, more widespread screening for PCOS appears be a cost-effective strategy, leading to earlier diagnosis and intervention and possibly the amelioration and prevention of serious sequelae.
Endometrial Hyperplasia ; Female ; Humans ; Hypertension ; Incidence ; Infertility ; Korea ; Mass Screening ; National Institutes of Health (U.S.) ; Polycystic Ovary Syndrome ; Prevalence ; Surveys and Questionnaire

PURPOSE: To maintain measles elimination status, we evaluated the seropositivity of measles and mumps according to time interval since the first or second dose of MMR in children aged 4 to 6 years, who are starting communal life. MATERIALS AND METHOD: 2,447 children aged 4 to 6 years were enrolled at 251 public health centers over the period of March to May 2007. Subjects were verified their date of MMR vaccination and then their blood was sampled for serologic test. Measles and mumps IgG antibody was tested by ELISA at Korea CDC. RESULTS: Vaccination coverage was 99.9% in the first dose, 64.9% in the second dose regardless of gender. Seropositivity of measles and mumps was 95.7%, 85.5% in the first dose and 98.7%, 98.1% in the second dose, respectively. The seropositivity of measles was 88.1% in 6-year-olds who did not receive the second dose of MMR. As time since receipt, seropositivity of measles tended to decrease over time and was 93.3% in vaccinees over 48 months after the first dose. CONCLUSION: A first dose MMR at 12-15 months cannot lead to herd immunity. More public information is needed to encourage second dose vaccination before admission to day-care center or kindergarten.
Aged ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunity, Herd ; Immunoglobulin G ; Korea ; Measles ; Measles-Mumps-Rubella Vaccine ; Mumps ; Public Health ; Seroepidemiologic Studies ; Serologic Tests ; Vaccination

OBJECTIVE: To estimate the prevalence and risk factors of fibromyalgia syndrome (FMS) and chronic widespread pain (CWP) in Korean. METHODS: Those who participated chronic pain field study in Uljin and Pohang, Kyongsangbuk-do in 2004 were evaluated for the prevalence of FMS and CWP. Diagnosis of FMS and CWP were made using American College of Rheumatology criteria. All 1,028 were interviewed based on a detailed questionnaire and 144 CWP patients were examined for tender points. RESULTS: Among the 1,028 participants (mean age+/-SD, 63.3+/-12.7 years), 676 participants were female (mean age+/-SD, 62.1+/-13.5 years) and 352 participants were male (mean age+/-SD, 65.7+/-10.5 years). There were 23 cases of FMS (2.2%), which consisted of 21 female cases and 2 cases of male. Prevalence of FMS was significantly higher in female compared to male (3.1% vs 0.6%, p<0.01). Prevalence of FMS showed increasing trend in the ascending order of age in decade (p<0.001). CWP was detected in 144 cases (14.0%), which consisted of 130 female cases and 14 cases of male. Prevalence of CWP was also significantly higher in female compared to male (19.2% vs 4.0%, p<0.001). Prevalence of CWP also showed increasing trend in the ascending order of age in decade (p<0.001). Except for age and sex, hating vegetables is an associated factor for the development of FMS in CWP [OR 18.7 (95% CI 2.4, 145.3)] and diabetes is a risk factor for the development of FMS in normal population [OR 3.7 (95% CI 1.1, 11.9)] on multivariate analyses. CONCLUSION: The prevalence of FMS and CWP were 2.2% and 14.0% in Korean, respectively. The prevalence of FMS and CWP were significantly higher in female and aged individuals. Aging, female sex, hating vegetables and diabetes are prognostic factors for the development of FMS.
Aging ; Chronic Pain ; Diagnosis ; Female ; Fibromyalgia* ; Gyeongsangbuk-do ; Hate ; Humans ; Male ; Multivariate Analysis ; Prevalence* ; Questionnaires ; Rheumatology ; Risk Factors* ; Vegetables

BACKGROUND: Organophosphate poisoning is one of the most common toxicologic emergencies in Korea. Acute organophosphate poisoning and delayed polyneuropathy by ingestion are well published. There have been several reports about intermediate syndrome in organophosphate poisoning by ingestion but few about intermediate syndrome via dermal route. CASE REPORT: We observed a 59-years-old male who had weakness of proximal limb muscles and respiratory muscles 2 days after dermal exposure by unidentified pesticide. The paralytic symptoms lasted up to 20 days but the delayed polyneuropathy did not develop. The patient needed mechanical ventilatory support for 2 weeks and had completely recovered from IMS 6 weeks later. Electrophysiological study was characterized by an axonal polyneuropathy pattern on the proximal limb muscles. Serum acetylcholinesterase level was below half of normal level. Clinical manifestations and electrophysiological study support the clinical diagnosis of intermediate syndrome. CONCLUSION: Intermediate syndrome is commonly developed by ingestion of organophosphate but, as in this case, dermal absorption can also lead to intermediate syndrome. More detailed history taking and close observation is needed for about 3 or more days after intoxication because of the risk of respiratory failure.
Absorption ; Acetylcholinesterase ; Axons ; Diagnosis ; Eating ; Emergencies ; Extremities ; Humans ; Korea ; Male ; Muscles ; Organophosphate Poisoning* ; Polyneuropathies ; Respiratory Insufficiency ; Respiratory Muscles

PURPOSE: This study was conducted to improve the Korean influenza management system and to determine the status of influenza vaccination in some community health centers through a survey of the officers in charge of influenza vaccination. METHODS: The authors conducted a questionnaire survey by e-mail for the officers in charge of influenza vaccination of 8 community health centers in Daegu-si, 5 community health centers in Ulsan-si and 25 community health centers in Gyeongsangbuk-do. The authors developed a questionnaire including selection methods of the influenza vaccination objects, results of influenza vaccination in 2002, problems of influenza vaccination, the population within the respondents`jurisdiction and so on. RESULTS: The proportion of influenza vaccination at community health centers among all residents in the 2002-2003 influenza season was 3.8% in Daegu-si, 14.8% in Ulsan-si, 15.1% in urban Gyeongsangbuk-do and 24.9% in rural Gyeongsangbuk-do. The proportion of influenza vaccination at community health centers among priority cases for vaccination was 12.9% in Daegu-si, 43.1% in Ulsan-si, 39.3% in urban Gyeongsangbuk and 41.6% in rural Gyeongsangbuk-do. The officers in charge of influenza vaccination stated that the problems of influenza vaccination were deficiencies in preparatory examination such as manpower shortage. Twenty-five persons stated as a problem that influenza vaccinations conducted in the hospitals were hardly reported, and fifteen of these clarified that this was due to hospital indifference. CONCLUSIONS: The authors examined all community health centers of Daegu-si, Ulsan-si, and Gyeongsangbuk-do, and investigated the vaccination states and problems that health officers were dealing with. Therefore, this study is meaningful with its basic data for the management of domestic influenza vaccination.
Community Health Centers* ; Electronic Mail ; Gyeongsangbuk-do ; Humans ; Influenza, Human* ; Seasons ; Vaccination* ; Surveys and Questionnaires