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Epidemiologic characteristics of leptospiral infection in healthy population in special service and their neighboring civilians in Korea
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Joung Soon Kim, J.S Kim, Y Heo, H.W Chung, W.Y Lee, Y.C Hahn, H.G Byun, J.D Suh, H.K Chung
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Korean J Epidemiol. 1987;9(2):264-270.
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Abstract
The specific aim of this study was to provide epidemiologic information on leptospiral infection in healthy population in special service. These are considered to be the most important group in leptospirosis control not only due to the fact that they have frequent chance of exposure to the potentially dangerous environment for leptospiral infection but also the fact that an efficient preventive measure is urgently required for them.
Seven hundred and fifty six service men and 197 their civilian neighbor were subjected for the study. The study included an epidemiologic analysis of the population through interview survey and this was further supported by bacteriologic and serologic confirmatory tests.
Leptospira were isolated from the peripheral blood samples from those cases. The isolation positive rate were 0.5% of service men and 1.3% of the civilians. Percent of sereum antibody positives for microagglutination test (MAT) were varied from 8.3% of service men to 12.1% of the civilians. When the same population were subjected to the bacteridogical and serologic studies following the exposure to the time of harvesting, the percent of positives in both tests were increased 2.5 times comapared to those found in the same population before harvest season. Almost all of the bacteria positives (6/7) were found to be cases of inapparent infection. Only one out of the seven suffered from mild symptoms of leptospirosis complaining fever, conjuctival hemorrhage, headache, and nausea.
More than half (53%) of the serum samples were reacted with L. icterohemorrhagiae serovar lai and 22% with L. irterohemorrhagiae serovar copenhageni. The rests (25%) were reacted with other groups, L. bataviae, L. canicola, L. grippothyposa, L. automnalis, and L. semaranga.
none of the bacteria positives were antibody positives. The seroconversion rate following the expousre (harvest period) were 7.6% in service men and 9.3% in civilians, which were studies on month after the time.
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An epidemiological characteristic of dysentery outbreak in a rural area
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Y.H Kim, S Bang, J.S Kim, Y Heo, H.K Chung, M.Y Ahn, J.K Lee, C.I Ku, H Kim, S.M Kwon, W.H. Chang
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Korean J Epidemiol. 1986;8(2):330-336.
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In the middle of August 1986, several people in a small rural village(179 residents) had a similar disease that was characterized by watery diarhea, crampy adominal pain, fever and vomiting. On this outbreaks, local health department collected stool specimens for culture and administered antibiotics prophylactically. From ten stool cultures the Korean National Institute of Health isolated two strains of Shigella flexneri.
Even after the massive prophylactic administration of antibiotics, the occurrence of the cases did not show any change. Therefor the community health program of Soonchunhyang medical school and the health department in the area devided to conduct an epidemiological investigation jointly with the team of Seoul National University, in order to find epidemiological characteristics of the outbreak.
Followings are the results summarized:
1) Five strains of bacteria isolated and identified independently by three different institutes, two strains in Korea NIH, two strains in Seoul National University and one in local hospital, were all Shigella flexneri, which confirmed the cause of the outbreak being Shigella flexneri.
2) Incidence rate of the bacterial dysentary among 163 population in 41 households was 35%. It was not significantly different by age group and sex.
3) On the study of environmental factors such as water supply, sewer system, struction of privy, and communal dinning and etc. to explore a possible common source of infection, no such factor assciated with the outbreak was found.
4) Familial aggregation statistically examined by binomial distribution revealed strong(p< 0.005) association. Age and sex specific incidence rate of index cases was significantly high in female old aged(over 60 years of age), suggesting that the dysentery primarily spread by grand-mothers visiting around neighbours.
Thus it was concluded that this dysentery has spread insidiously in a small rural village through person-to-person transmission by intimate association between neighbours, particularly by old aged females.
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Summary
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A study on leptospiral infection among healthy young men, a special group by leptospira isolation from blood culture in an endemic area of Korean hemorrhagic fever
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Joung Soon Kim, H.K Chung, H.W Chung, S.S Lee, J.K Kim, W.Y Lee, H.K Byun
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Korean J Epidemiol. 1986;8(1):174-181.
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This study was carried out on special groups consisted of homogeneous healthy and young Korean males stationed middle part of Korea, in order to understand the magnitude of subclinical leptospiral infection among these special groups and particularly the reationship between leptospirosis and Korean hemorrhagic fever that have shown similarity in many aspects.
One hundred eighteen subjects from the well-known endemic area of KHF and 406 subjects from non-endemic area were interviewed for the information on their behavior and environments exposed for the last one month on weekly basis; all study subjects were blood drawn for leptospira isolation by culture in newly developed media, YUMC-5050.
From the vicinity of stations studied 25 rats were captured alive, anesthesized with ether and autopsied. Lungs, liver and kidney were sectioned with a sharp scalpel and touch printed on slide glasses. These specimens were stained by IF techeique and examined for the presence of leptospiral bacteria.
Summarized results of the study are as followings：
1) The overall leptospira culture positive rate was 2.8% that was much lower than that of Korean healthy rural farmers(16%).
2) Twelve out of 15 leptospira positives were followed up to 2 months by re-culturing their blood and found none of them remained positive.
3) Leptospira culture positive rate was 9 times higher among the groups stationed in KHF endemic area(9.3%) than those stationed in non-endemic area
4) The leptospira positive status did not have any statistical correlation with the variables such as the length of stay in current station, former residence area and educational level
5) The behavioral and environmental characteristics also failed to reveal any statistical association with the leptospiral positive status
6) Clinical symptoms and signs experienced during the last one month were more frequent and various among leptospira negatives than among positives
7) Nineteen Rattus norvegicus and Rattus rattus examined by organ touch printed specimens with IF technique showed leptospira positive in 24 rats, 96% positive rate; 22 rats had leptospira in all three organs, one in kidney and liver, and the other one only in kidney
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A report on epidemiologic characteristics of 1980 cholera epidemic occurred in Korea
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J.S Kim, H.K Chung, H.C Oh, W.H Cho, B.Y Kim
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Korean J Epidemiol. 1980;2(1):43-52.
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Upon an outbreak of cholera in Jheonnam area, 1980, five members of the epidemiologic survey team were dispatched to the area by the Ministry of Health & Social Affaires in order to provide epidemiologic consultation to the local surveillance team for more effient control measures. This paper is prepared by the team based on the experiences obtained in the fields and data collected from the hospitalized patients, which is considered to be valuable to share with those responsible collegues for the future.
The major findings summarized are as follows :
1. The epidemiologic characteristics of the 1980 cholera epidemic, for instance the patten of spread, clinical pictures, distribution of cases by age and sex, secondary attack rate, rate of inapparent infection, fatality rate, and incubation period, were quite similar to that of previous El Tor cholera epidemics. The only difference was that the serotype of this epidemic was Inaba instead of Ogawa type, which had been the only serotype for all the previous epidemics in Korea.
2. Many problems that hindered an efficient prevention of the spread were analysed and discussed in detail；problems involved in reporting system, follow-up management of reported cases, delayed financial support from the central government, out-dated epidemiolgic investigation, inconsistent policy for isolation and quarantine etc.
3. Recommendations to the government including the proposal that well trained epidemiologist should be posted to each institute of health and laboratory (Provinces and cities) were made.
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