Outbreaks of porcine epidemic diarrhea (PED) have resulted in significant economic losses in the swine industry, and another PED outbreak occurred in 2014 in Korea. Isolating and culturing PED virus (PEDV) allow investigations into its pathogenesis and the development of vaccines and diagnostic assays. In this study, we successfully isolated two PEDV isolates (QIAP1401 and QIAP1402) from naturally infected piglets at Jeju-do, Korea. Viral propagation was confirmed in Vero cells based on cytopathic effect, immunofluorescence assay, reverse transcription-polymerase chain reaction, and electron microscopic analyses. The QIAP401 isolate propagated well in Vero cells for 70 passages, with titers of 10(6.5) to 10(7.0) 50% tissue culture infectious dose/mL, which increased gradually with passaging. The nucleotide and amino acid sequences of the QIAP1401 isolate were determined and compared with those of other PEDV isolates. The QIAP1401 isolate was determined to be closely related to the USA/Minnesota271/2014 strain (> 99.9% nucleotide similarity) that was isolated in the USA in 2014. Phylogenetic analysis based on several PEDV genes suggested that a new PEDV variant is circulating in the Korean swine industry, with 93.08% similarity to the SM98 strain isolated in 1998. In addition, the QIAP1401 strain showed strong virulence in 3-day-old piglets and 11-week-old growing pigs.
Amino Acid Sequence ; Diarrhea ; Disease Outbreaks ; Fluorescent Antibody Technique ; Jeju-do ; Korea ; Porcine epidemic diarrhea virus ; Swine ; Vaccines ; Vero Cells ; Virulence

BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by ossification of the enthesis. The diagnosis has been mainly based on the chest or whole spine lateral plain film. Recently, chest or thoracolumbar computed tomography (CT) has been reported to be more reliable for the diagnosis of DISH. The purposes of this study were to investigate the prevalence and location of DISH and evaluate the prevalence of comorbidities, such as ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF), using whole spine CT. METHODS: Whole spine CT scans of patients over 16 years of age who were examined at Cheju Halla General Hospital between February 2011 and December 2016 were reviewed for this study. The diagnosis of DISH was made according to the modified Resnick criteria. The prevalence of DISH in each age decade and its location were evaluated. Also, the prevalence of OPLL and OLF in DISH patients was investigated. RESULTS: The overall incidence of DISH was 24.4% (40 of 164 cases). There was no case of DISH in patients in their 40s and younger. The percentile incidences of DISH in patients in their fifth, sixth, seventh, eighth, and ninth decades were 20.0% (4 of 20 cases), 32.3% (10 of 31 cases), 40.0% (10 of 25 cases), 34.5% (10 of 29 cases), and 27.3% (6 of 22 cases), respectively. A strong positive correlation between the age decade and the incidence of DISH was noted (r = 0.853, p = 0.007). DISH patients had higher incidences of OLF (22.5%) and OPLL (37.5%). The most common location of DISH was the middle thoracic spine (90.0%) followed by the lower thoracic spine (87.5%). There was one case of DISH involving only the cervical spine. CONCLUSIONS: The incidence of DISH diagnosed by CT was higher than we expected. Whole spine CT can be a valuable modality to evaluate the location of DISH in the cervical and lumbar spine and the comorbidity rates of OLF and OPLL.
Comorbidity ; Diagnosis ; Hospitals, General ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Incidence ; Jeju-do ; Ligamentum Flavum ; Longitudinal Ligaments ; Prevalence* ; Spine* ; Thorax ; Tomography, X-Ray Computed

Lyme borreliosis (LB) is the most common tick-borne infectious disease in North America, and it was designated as a national notifiable infectious disease in Korea in December 2010. While no cases in Jeju-do were recorded from 2012 to 2016, a recent survey reported that the seroprevalence of Borrelia burgdorferi using enzyme-linked immunosorbent assays in horses in Jeju-do was 19.0% (95% confidence interval, 12.0 to 28.3%). This fact suggests that horses may be a potential reservoir of LB in Jeju-do and that individuals in close contact with horses may be a high-risk group. Thus, a serological study in this high-risk group is urgently needed.
Borrelia burgdorferi ; Communicable Diseases ; Enzyme-Linked Immunosorbent Assay ; Horses* ; Ixodes ; Jeju-do* ; Korea* ; Lyme Disease* ; North America ; Seroepidemiologic Studies ; Ticks

BACKGROUND: Exposure to secondhand smoke (SHS) is one of the biggest health hazards. Quantifying the related burden of disease (BOD) is a powerful tool for making evidence-based policies. This study calculated the BOD due to SHS at sub-national level using the most recent statistics of Korea. METHODS: SHS related diseases were selected by the systematic review of previous studies. Population attributable fraction (PAF) was calculated by using the standard formula using prevalence of exposure derived from Community Health Survey (CHS) 2013. SHS burden was calculated by multiplying nonsmoker's disability adjusted life years (DALYs) with PAF of SHS. RESULTS: SHS burden at sub-national level ranged between 460 DALYs in Cheonan to 5 DALYs in Pyeongtaek, Songtan region. Median of DALY was highest in districts of metropolitan cities and lowest in small towns and rural areas. Twelve out of fifteen regions with highest DALY per 1,000 were small towns and rural areas. Gender and age standardized DALY was highest in Seogwipo (west) in Jeju-do (1.66/1,000) and lowest in Dong-gu, Ulsan (0.17/1,000). CONCLUSION: There were substantial variations between regions according to BOD. Regional governments should implement policies according to specific situation in each region and regular monitoring should be done by calculating BOD. Big cities need to focus more on control of active and SHS prevalence. Resources in small towns and rural areas need to be allocated more towards implementation of screening programs, early diagnosis and treatment of diseases especially in the elderly population.
Adult* ; Aged ; Chungcheongnam-do ; Early Diagnosis ; Gyeonggi-do ; Health Surveys ; Humans ; Jeju-do ; Korea ; Mass Screening ; Prevalence ; Quality-Adjusted Life Years ; Tobacco Smoke Pollution* ; Ulsan

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea. METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis. RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do. CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox* ; Child* ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence* ; Insurance ; Jeju-do* ; Korea* ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

OBJECTIVES: Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea.METHODS: The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2–13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis.RESULTS: As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do.CONCLUSIONS: The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
Chickenpox Vaccine ; Chickenpox ; Child ; Cohort Effect ; Delivery of Health Care ; Epidemiology ; Fees and Charges ; Humans ; Immunization Programs ; Immunization Schedule ; Incidence ; Insurance ; Jeju-do ; Korea ; Measles-Mumps-Rubella Vaccine ; Methods ; National Health Programs ; Parturition ; Patient Selection ; Vaccines

The crustose lichen genus Pertusaria comprises over ca. 800 species worldwide. In total, 20 Pertusaria species were localized to the Mt. Sorak and Jeju-do in Korea. To date, information regarding the distribution of Pertusaria species in the South Korean peninsula is scarce. In this study, we collected Pertusaria species across South Korea and identified them based on morphological, chemical, and molecular characteristics. Of the 387 samples collected, we identified 24 taxa and 1 variety, of which 17 were previously recorded, and 6 taxa were newly found in South Korea (P. leioplaca, P. leucosora var. violascens, P. texana, P. thiospoda, P. thwaitesii, and P. xanthodes), 2 known species were transferred to Varicellaria (Varicellaria lactea and V. velata), one species was transferred to Variolaria as a new record (Variolaria multipunctoides) and one was a new species (P. jogyeensis J. S. Park & J.-S. Hur, sp. nov.). Characteristics of the newly discovered species, P. jogyeensis, are as follows: smooth to bumpy thallus, scattered to crowded poriform apothecia, blackish ostioles, definitely sunken, thin yellowish green rims around ostioles, 8-spored ascus, and the presence of perlatolic acid and thiophaninic acid (chlorinated xanthone). Phylogenetic studies on P. jogyeensis based on the mitochondrial small subunit sequence revealed proximity to P. flavicans and P. texana, and supported its classification as a new species within the genus Pertusaria. Additionally, we describe the chemical composition and morphology of all listed species in detail and provide an artificial key for identification.
Atypical Squamous Cells of the Cervix ; Classification ; Jeju-do ; Korea* ; Lichens*

OBJECTIVES: Confirmation of Kudoa septempunctata (K. septempunctata) as the pathogenic agent causing acute food poisoning remains under debate owing to inconsistencies in the reproducibility of experimental evidence. Higher intake of olive flounder infected with K. septempunctata would result in increased diagnosis of food poisoning by K. septempunctata, if the latter was one of the causal agents of acute food poisoning. The aim was to evaluate the relationship between the shipping amount of olive flounder aquacultured from Jejudo and the incidence of K. septempunctata food poisoning in 2015, Korea. METHODS: Data of shipping amounts between March 2014 and February 2016 and of monthly reported events of Kudoa food poisoning were taken from Jejudo Fish-Culture Fisheries Cooperatives and Korea Centers for Disease Control and Prevention, respectively. Non-parametric correlation analyses were conducted. RESULTS: Shipping amounts indicated the seasonal changes according to variation of consumption. Spearman's rho and Kendall's tau-a between the monthly shipping amounts and the reported events in 2015 were 0.39 (p=0.21) and 0.27 (p=0.20), respectively. CONCLUSIONS: An independent relationship was noted between the shipping amount and the reported events, which contrasted with the claim that the virulence of K. septempunctata caused acute food poisoning.
Bias (Epidemiology) ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Fisheries ; Flounder* ; Food Parasitology ; Foodborne Diseases* ; Incidence ; Intestinal Diseases, Parasitic ; Jeju-do* ; Korea* ; Myxozoa ; Olea* ; Seasons ; Ships* ; Virulence

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do. METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC. RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications. CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox* ; Child* ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea* ; Vaccination*

OBJECTIVES: The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do.METHODS: Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC.RESULTS: Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications.CONCLUSIONS: As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Centers for Disease Control and Prevention (U.S.) ; Chickenpox Vaccine ; Chickenpox ; Child ; Humans ; Immunization ; Incidence ; Jeju-do ; Korea ; Vaccination