Epidemiology and Health

Original Articles

Aspergillus sensitization associated with current asthma in children in the United States: an analysis of data from the 2005-2006 NHANES: Hui-Ju Wen, Shu-Li Wang, Ming-Chieh Li, Yue Leon Guo; Epidemiol Health. 2022;44:e2022099. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022099

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Abstract

OBJECTIVES
This study investigated the association between allergen sensitization and current asthma in children in the United States using data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES).

METHODS

Children who participated in the 2005–2006 NHANES, aged 6 years to 19 years, were included in this study. A structured questionnaire was used to assess asthma status (without asthma, asthma in remission, or current asthma). Nineteen specific immunoglobulin E (sIgE) levels were measured using the Pharmacia Diagnostics ImmunoCAP 1000 System (Kalamazoo, MI, USA). A machine-learning method was applied to select important sIgEs related to childhood asthma. Multivariate regression analysis was used to test this hypothesis.

RESULTS

In total, 2,875 children were recruited. The prevalence of ever having asthma and current asthma was 16.5% and 5.6%, respectively. Six sIgE levels were found to contribute to asthma using bootstrap forest selection. After adjusting for the child’s sex, age, and family income, children with double the sIgE levels of Dermatophagoides farinae, dogs, and Aspergillus were more likely to have current asthma than children without asthma (odds ratio [95% confident interval]: 1.11 [1.04 to 1.19], 1.30 [1.16 to 1.46], and 1.55 [1.39 to 1.72], respectively).

CONCLUSIONS

Our findings suggest that allergen sensitization, especially to Aspergillus, is associated with current asthma in children. Strategies to reduce sensitization may help prevent and manage asthma.

Summary

Key Message
This investigation studied 2,875 children from the National Health and Nutrition Examination Survey (NHANES) 2005-2006, aged less than 19 years, for the association between allergen sensitization and persistent asthma. Six specific IgE levels (i.e. Dermatophagoides farina, Dermatophagoides pteronyssinus, cat, dog, Alternaria, and Aspergillus) were found to contribute to asthma using bootstrap forest selection. Our findings suggested that allergen sensitization, especially to Aspergillus, is associated with asthma persistence in children after adjusting for potential confounders. Strategies to reduce sensitization may help prevent and manage asthma.

Citations

Citations to this article as recorded by

Age-related differences in IgE between childhood and adulthood allergic asthma: Analysis of NHANES 2005–2006
Heping Fang, Juan Li, Luo Ren, Enmei Liu
World Allergy Organization Journal.2023; 16(12): 100842. CrossRef

Modeling the relationship between malaria prevalence and insecticide-treated bed net coverage in Nigeria using a Bayesian spatial generalized linear mixed model with a Leroux prior: Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Adewale F. Lukman; Epidemiol Health. 2021;43:e2021041. Published online June 4, 2021; DOI: https://doi.org/10.4178/epih.e2021041

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Abstract

OBJECTIVES
To evaluate malaria transmission in relation to insecticide-treated net (ITN) coverage in Nigeria.

METHODS

We used an exploratory analysis approach to evaluate variation in malaria transmission in relation to ITN distribution in 1,325 Demographic and Health Survey clusters in Nigeria. A Bayesian spatial generalized linear mixed model with a Leroux conditional autoregressive prior for the random effects was used to model the spatial and contextual variation in malaria prevalence and ITN distribution after adjusting for environmental variables.

RESULTS

Spatial smoothed maps showed the nationwide distribution of malaria and ITN. The distribution of ITN varied significantly across the 6 geopolitical zones (p<0.05). The North-East had the least ITN distribution (0.196±0.071), while ITN distribution was highest in the South-South (0.309±0.075). ITN coverage was also higher in rural areas (0.281±0.074) than in urban areas (0.240±0.096, p<0.05). The Bayesian hierarchical regression results showed a non-significant negative relationship between malaria prevalence and ITN coverage, but a significant spatial structured random effect and unstructured random effect. The correlates of malaria transmission included rainfall, maximum temperature, and proximity to water.

CONCLUSIONS

Reduction in malaria transmission was not significantly related to ITN coverage, although much could be achieved in attempts to curtail malaria transmission through enhanced ITN coverage. A multifaceted and integrated approach to malaria control is strongly advocated.

Summary

Key Message
Scaling up equity in ITN distribution and coverage, awareness and knowledge on ITN utilization are important integrated approaches to mitigate malaria transmission in Nigeria.

Citations

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Vegetation index and livestock practices as predictors of malaria transmission in Nigeria
Oluyemi Okunlola, Segun Oloja, Ayooluwade Ebiwonjumi, Oyetunde Oyeyemi
Scientific Reports.2024;[Epub] CrossRef
A Systematic Review of Areal Units and Adjacency Used in Bayesian Spatial and Spatio-Temporal Conditional Autoregressive Models in Health Research
Zemenu Tadesse Tessema, Getayeneh Antehunegn Tesema, Susannah Ahern, Arul Earnest
International Journal of Environmental Research and Public Health.2023; 20(13): 6277. CrossRef
Malaria transmission in Africa: Its relationship with yellow fever and measles
Oluyemi A. Okunlola, Oyetunde T. Oyeyemi, Luzia Helena Carvalho
PLOS ONE.2022; 17(5): e0268080. CrossRef
Bayesian spatio-temporal modelling and mapping of malaria and anaemia among children between 0 and 59 months in Nigeria
Jecinta U. Ibeji, Henry Mwambi, Abdul-Karim Iddrisu
Malaria Journal.2022;[Epub] CrossRef

Systematic Review

Distribution pattern and prevalence of West Nile virus infection in Nigeria from 1950 to 2020: a systematic review: Idris Nasir Abdullahi, Anthony Uchenna Emeribe, Peter Elisha Ghamba, Pius Omoruyi Omosigho, Zakariyya Muhammad Bello, Bamidele Soji Oderinde, Samuel Ayobami Fasogbon, Lawal Olayemi, Isa Muhammad Daneji, Muhammad Hamis Musa, Justin Onyebuchi Nwofe, Nkechi Blessing Onukegbe, Chukwudi Crescent Okume, Sanusi Musa, Abubakar Muhammad Gwarzo, Odunayo Oyetola Rahmat Ajagbe; Epidemiol Health. 2020;42:e2020071. Published online November 26, 2020; DOI: https://doi.org/10.4178/epih.e2020071

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Abstract PDF

Abstract

OBJECTIVES
West Nile virus (WNV) is a re-emerging mosquito-borne viral infection. This study investigated the pooled prevalence pattern and risk factors of WNV infection among humans and animals in Nigeria.

METHODS

A systematic review was conducted of eligible studies published in PubMed, Scopus, Google Scholar, and Web of Science from January 1, 1950 to August 30, 2020. Peer-reviewed cross-sectional studies describing WNV infections in humans and animals were systematically reviewed. Heterogeneity was assessed using the Cochrane Q statistic.

RESULTS

Eighteen out of 432 available search output were eligible and included for this study. Of which 13 and 5 were WNV studies on humans and animals, respectively. Although 61.5% of the human studies had a low risk of bias, they all had high heterogeneity. The South West geopolitical zone of Nigeria had the highest pooled prevalence of anti-WNV immunoglobulin M (IgM; 7.8% in humans). The pooled seroprevalence of anti-WNV IgM and immunoglobulin G (IgG) was 7.1% (95% confidence interval [CI], 5.9 to 8.3) and 76.5% (95% CI, 74.0 to 78.8), respectively. The WNV RNA prevalence was 1.9% (95% CI, 1.4 to 2.9), while 14.3% (95% CI, 12.9 to 15.8) had WNV-neutralizing antibodies. In animals, the pooled seroprevalence of anti-WNV IgM and IgG was 90.3% (95% CI, 84.3 to 94.6) and 3.5% (95% CI, 1.9 to 5.8), respectively, while 20.0% (95% CI, 12.9 to 21.4) had WNV-neutralizing antibodies. Age (odds ratio [OR], 3.73; 95% CI, 1.87 to 7.45; p<0.001) and level of education (no formal education: OR, 4.31; 95% CI, 1.08 to 17.2; p<0.05; primary: OR, 7.29; 95% CI, 1.80 to 29.6; p<0.01) were significant risk factors for WNV IgM seropositivity in humans.

CONCLUSIONS

The findings of this study highlight the endemicity of WNV in animals and humans in Nigeria and underscore the need for the One Health prevention and control approach.

Summary

Citations

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Comparison of West Nile Virus Disease in Humans and Horses: Exploiting Similarities for Enhancing Syndromic Surveillance
Erika R. Schwarz, Maureen T. Long
Viruses.2023; 15(6): 1230. CrossRef
Seroprevalence of IgG Antibodies Directed against Dengue, Chikungunya and West Nile Viruses and Associated Risk Factors in Madagascar, 2011 to 2013
Anaïs Broban, Marie-Marie Olive, Michael Luciano Tantely, Anne-Claire Dorsemans, Fanjasoa Rakotomanana, Jean-Pierre Ravalohery, Christophe Rogier, Jean-Michel Heraud, Soa Fy Andriamandimby
Viruses.2023; 15(8): 1707. CrossRef
Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?
Josselin Brisset, Karl Angendu Baki, Laurence Watier, Elisée Kinkpé, Justine Bailly, Linda Ayédadjou, Maroufou Jules Alao, Ida Dossou-Dagba, Gwladys I. Bertin, Michel Cot, Farid Boumédiène, Daniel Ajzenberg, Agnès Aubouy, Sandrine Houzé, Jean-François Fau
Infectious Diseases of Poverty.2022;[Epub] CrossRef
A Scoping Review of West Nile Virus Seroprevalence Studies among African Equids
Olaolu T. Olufemi, Marta Barba, Janet M. Daly
Pathogens.2021; 10(7): 899. CrossRef

Case Report

Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned: Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, Azza Al Hattali, Khalid Salim, Issa S. Al Fulaiti, Mahmood S. Al Subhi; Epidemiol Health. 2019;41:e2019033. Published online July 12, 2019; DOI: https://doi.org/10.4178/epih.e2019033

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Abstract

Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.

Summary

Citations

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Perception of the health surveillance users on the health electronic surveillance network (HESN), Saudi Arabia, 2016
Zayid K. Almayahi, Fahad Alswaidi, Abdullah Alzahrani
Journal of the Egyptian Public Health Association.2021;[Epub] CrossRef

Original Article

Community-based surveillance of Cryptosporidium in the indigenous community of Boliwong, Philippines: from April to December 2017: Ryan V. Labana, Julieta Z. Dungca, Veeranoot Nissapatorn; Epidemiol Health. 2018;40:e2018047. Published online September 28, 2018; DOI: https://doi.org/10.4178/epih.e2018047

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Abstract PDF

Abstract

OBJECTIVES
For the first time, Boliwong, an indigenous community in the Philippines, was surveyed for the prevalence of Cryptosporidium from April to December 2017.

METHODS

Cryptosporidium oocysts were detected in samples from the river, creek, and water pumps via immunomagnetic separation techniques, and from human and animal concentrated faecal samples using the modified Ziehl-Neelsen technique.

RESULTS

Seven of the 24 water samples (29.2%) were positive for Cryptosporidium, with the highest concentration (0.8 oocyst/L) detected in the creek. Of 35 fecal samples from different animal groups, 8 (21.6%) were positive for Cryptosporidium oocysts. The highest intensity of oocyst shedding was detected in dogs (χ2 =8.00). Of the 137 human fecal samples, 39 (28.5%) were infected with Cryptosporidium. In this study, 3 risk factors were found to be associated with infection: (1) location (crude odds ratio [cOR], 16.39; 95% confidence interval [CI], 2.11 to 127.41; p=0.008), (2) drinking water from the natural spring (cOR, 0.29; 95% CI, 0.11 to 0.82; p<0.05), and (3) using an open pit as a sanitary toilet facility (cOR, 2.44; 95% CI, 1.14 to 5.20; p<0.05). When the cOR was adjusted, using an open pit as a sanitary toilet facility remained a significant risk factor of infection (adjusted OR, 0.41; 95% CI, 0.19 to 0.90; p<0.05).

CONCLUSIONS

There is a potentially emerging Cryptosporidium zoonosis in Boliwong, Lagawe, Philippines. It is recommended that the toilet facilities and the water system in the community be rehabilitated to avoid any possible disease outbreak. Health education is also needed in the community to maintain proper hygiene and sanitation practices.

Summary

Citations

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Cryptosporidium and Giardia in cats and dogs: What is the real zoonotic risk?
Amanda D. Barbosa, Siobhon Egan, Yaoyu Feng, Lihua Xiao, Una Ryan
Current Research in Parasitology & Vector-Borne Diseases.2023; 4: 100158. CrossRef
Molecular Epidemiology of Human Cryptosporidiosis in Low- and Middle-Income Countries
Xin Yang, Yaqiong Guo, Lihua Xiao, Yaoyu Feng
Clinical Microbiology Reviews.2021;[Epub] CrossRef
Molecular surveillance of Cryptosporidium spp. for microbial source tracking of fecal contamination in Laguna Lake, Philippines
Laurice Beatrice Raphaelle O. dela Peña, Mark Raymond A. Vejano, Windell L. Rivera
Journal of Water and Health.2021; 19(3): 534. CrossRef
Cryptosporidium in the Philippines
Ryan Vidal Labana
International Annals of Science.2018; 6(1): 18. CrossRef

Perspective

Interpretation of the hygiene and microflora hypothesis for allergic diseases through epigenetic epidemiology: Jong-Myon Bae; Epidemiol Health. 2018;40:e2018006. Published online March 10, 2018; DOI: https://doi.org/10.4178/epih.e2018006

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Abstract

The hygiene hypothesis (HH) proposed by Strachan in 1989 was expanded to explain the inverse association between the occurrence of allergy disorders and the risk of infectious diseases and parasite infestation. The microflora hypothesis (MH) suggests that gut microbial dysbiosis in early life might trigger hypersensitivity disorders. The sharing concept of both HH and MH is gene-environment interaction, which is also a key concept in epigenetics. The amalgamation of epidemiology and epigenetics has created a scientific discipline termed epigenetic epidemiology. To accomplish an era of gene-environment-wide interaction studies, it is necessary to launch a national human epigenome project.

Summary

Korean summary
1989년 제시된 위생가설 (Hygiene hypothesis)은 최근 체내미생물가설 (Microflora hypothesis) 대치되어 알레르기 질환의 발생기전을 해석하고 있다. 두 가설 모두 유전-환경 상호작용 gene-environment interaction) 을 강조하고 있다는 점에서 향후 후성유전역학 연구에 대한 활성화가 필요하다.

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Multicenter study of seasonal and regional airborne allergens in Chinese preschoolers with allergic rhinitis
Zhifeng Huang, Aoli Li, Huiqing Zhu, Junxiu Pan, Jun Xiao, Jiang Wu, Yumin Han, Lili Zhong, Xuhui Sun, Lei Wang, Liang Hu, Cuihua Wang, Xingkai Ma, Zaixia Qiao, Min Zhang, Ling Yuan, Xin Liu, Jun Tang, Yue Li, Hong Yu, Zhaobing Zheng, Baoqing Sun
Scientific Reports.2024;[Epub] CrossRef
A Higher Incidence of Isolated Biliary Atresia in Rural Areas
Mark Nomden, Daan B.E. van Wessel, Solomon Ioannou, Henkjan J. Verkade, Ruben H. de Kleine, Behrooz Z. Alizadeh, Janneke L.M. Bruggink, Jan B.F. Hulscher
Journal of Pediatric Gastroenterology and Nutrition.2021; 72(2): 202. CrossRef
Eradication of Helicobacter pylori and Gastric Cancer: A Controversial Relationship
Mariagrazia Piscione, Mariangela Mazzone, Maria Carmela Di Marcantonio, Raffaella Muraro, Gabriella Mincione
Frontiers in Microbiology.2021;[Epub] CrossRef
Pathogenesis of Children’s Allergic Diseases: Refocusing the Role of the Gut Microbiota
Tingting Hu, Yinmiao Dong, Chenghao Yang, Mingyi Zhao, Qingnan He
Frontiers in Physiology.2021;[Epub] CrossRef
Pilot study of the SCFA Headspace Analysis of Streptococcus mutans Metabolites in Media with and without Polyols
Goudarzi S Habibi, B Kabat, M Cannon, M Gashkoff, R Zurek
Edelweiss Journal of Biomedical Research and Review.2020; : 24. CrossRef
Blockade of enhancer of zeste homolog 2 alleviates renal injury associated with hyperuricemia
Yingfeng Shi, Liuqing Xu, Min Tao, Lu Fang, Jiasun Lu, Hongwei Gu, Shuchen Ma, Tao Lin, Yi Wang, Wenfang Bao, Andong Qiu, Shougang Zhuang, Na Liu
American Journal of Physiology-Renal Physiology.2019; 316(3): F488. CrossRef
Researches of Epigenetic Epidemiology for Infections and Radiation as Carcinogen
Jong-Myon Bae
Journal of Preventive Medicine and Public Health.2018; 51(4): 169. CrossRef
Necessity of Epigenetic Epidemiology Studies on the Carcinogenesis of Lung Cancer in Never Smokers
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Original Articles

Changes in seroprevalence of hepatitis B surface antigen and epidemiologic characteristics in the Republic of Korea, 1998-2013: Hyerin Lee, Hyungmin Lee, Yumi Cho, Kyungwon Oh, Moran Ki; Epidemiol Health. 2015;37:e2015055. Published online December 23, 2015; DOI: https://doi.org/10.4178/epih/e2015055

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated changes in hepatitis B seroprevalence from 1998 to 2013, and to identify differences in epidemiologic characteristics between hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative people.

METHODS

HBsAg seropositive rates were compared by year, sex, and age using the blood test data from the periods I to VI (1998-2013) of the Korea National Health and Nutrition Examination Survey. Interviews and self-administered surveys were conducted to collect data on health behavior, quality of life, comorbidities, and health care utilization.

RESULTS

HBsAg seropositive rates in the Republic of Korea decreased from 4.6% in 1998 to 2.9% in 2008, and then remained the same for the next five years. While seropositive rates by age were the highest at 35 to 39 years of age in 1998, it peaked at 50 to 54 years of age in 2013. HBsAg-positive people showed high values from two liver function tests, including glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase, and the prevalence rates of liver cirrhosis and liver cancer were also significantly high. Indices for health behavior and quality of life showed no significant differences between HBsAg-positive and HBsAg-negative people.

CONCLUSIONS

While HBsAg seropositive rates tended to decline after 1998, there have been no significant changes over the most recent five years. We should focus on treatment of existing hepatitis B patients along with immunization programmes to prevent new hepatitis B infections. In addition, it may be necessary to encourage HBsAg-positive people to follow healthier life-styles in order to prevent further progression of hepatitis B to liver cirrhosis and liver cancer.

Summary

Korean summary
한국 국민건강영양조사 자료로 본 HBsAg 양성률은 1998 년 4.6%에서 2008 년에 2.9%로 감소한 이후 5 년간 증감없이 2013 년에 2.9%로 나타났다. 한국 HBsAg 양성률을 더욱 감소시키기 위해서는 예방접종사업뿐 아니라 B형 간염 환자 치료를 보다 적극적으로 해야 될 것으로 보인다. 또한 HBsAg 양성자는 간경화나 간암 예방을 위해 건강한 생활습관을 가지도록 노력하는 것이 필요하다.

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Nguyen H. Tran
Current Oncology Reports.2022; 24(2): 187. CrossRef
Proportion of People Who Are Positive for HBsAg and Anti-HCV Antibody Among Participants in a Community Screening Campaign in Malaysia
Zhuo-Zhi Lim, Jau Shya Teo, Ah Choon Tan, Teck-Onn Lim
Hepatitis Monthly.2022;[Epub] CrossRef
The changing epidemiology of liver diseases in the Asia–Pacific region
Martin C. S. Wong, Jason L. W. Huang, Jacob George, Junjie Huang, Colette Leung, Mohammed Eslam, Henry L. Y. Chan, Siew C. Ng
Nature Reviews Gastroenterology & Hepatology.2019; 16(1): 57. CrossRef
Incidence and Overall Survival of Biliary Tract Cancers in South Korea from 2006 to 2015: Using the National Health Information Database
Byung-Woo Kim, Chang-Mo Oh, Hwa Young Choi, Joong-Won Park, Hyunsoon Cho, Moran Ki
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So-Ryoung Lee, Hyun-Jung Lee, Eue-Keun Choi, Kyung-Do Han, Jin-Hyung Jung, Myung-Jin Cha, Seil Oh, Gregory Y.H. Lip
Journal of the American College of Cardiology.2019; 73(25): 3295. CrossRef
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SKM Azizul Islam, Jin Wook Chung, Young-Sil Lee, HoChan Cho, Seong-Su Moon
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Ji Young Chang, Sung-Ae Jung, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Ki-Nam Shim
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Hogil Kim, Yun Kyung Chung, Inah Kim
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International Journal of Molecular Sciences.2017; 18(4): 737. CrossRef

Analysis of Transmission Mode of Confirmed Shigellosis in Gyeongju, Korea.: Cheoll Jung, Hyun Sul Lim, Gyoung Yim Ha, Hee Su Kim; Korean J Epidemiol. 2004;26(1):1-16.

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Abstract PDF: Abstract
PURPOSE
This study was carried out to investigate the sources of infection and modes of transmission of an 107 (54males, 53 females) confirmed shigellosis in Gyeongju from Sept. 24 to Oct. 24, 1998.
METHODS
We reviewed hospital records of all confirmed shigellosis. Thirty-two strains of Shigella sonnei isolated were analyzed in order to trace the source of infections by plasmid profile, antimicrobial drug resistance pattern, biotyping and pulsed-field gel electrophoresis (PFGE).
RESULTS
The first source of infection was estimated to be contaminated underground water and simple piped water caused by leakage from the cess pool. Antimicrobial drug resistance pattern showed that all strains were multi-resistant. All isolates had the same XbaI and SfiI PFGE patterns, indicating the epidemiological relationship of the outbreaks strains in this area. The major characteristics of diarrhea were watery (84.2%) in nature. The clinical symptoms among the diarrheal cases included abdominal pain (86.1%), fever (83.2%), headache (78.2%), chill (45.5%) and tenesmus (41.6%). Six cases were asymptomatic. From initial manifestation to admission were 6.2+/-1.6 (median 6) days, so it could be transmitted to others in this infective period. Duration of admission were 5.5 +/-2.4 (median 6) days. We can find familial mean secondary attack rate were 38.5%.
CONCLUSION
It's transmission to other areas were certified by contaminated water and contact with shigellosis, and unknown cases were estimated to be transmitted by contacts with inapparent infection. By plasmid profile and PFGE, the epidemiological relationship of the outbreaks strains in this area seemed to be the same micro-organisms.; Summary

A Epidemic Survey of the Shigellosis in Jeju Island during the First Half of Year 2000.: Jong Myon Bae, Sang Won Lee, Byung Guk Yang, Seong Chul Hong, Geun Ryang Bae, Sung Hack Kang; Korean J Epidemiol. 2001;23(1):80-80.

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Abstract PDF: Abstract
PURPOSE
A field investigation was done to evaluate the level of the epidemic of Shigellosis in Jeju Island during the first half of year 2000.
METHODS
Confirming the Shigellosis was done by the structured questionnaire and the result of rectal swab for the residents having a diarrhea.
RESULTS
As the confirmed patients with Shigella sonnei were 933 from 25 April to 14 August 2000, the crude incidence rate was 174 per 100,000 persons. The highest incidence rate was shown in 5-9 year-old group. Especially the south area of Jeju Island, called as Namjejugun, had the major epidemic occurrence.
CONCLUSIONS
The huge and chronic epidemic of Shigellosis was confirmed. The nature of this epidemic suggested that the endemic occurrence had been existed in Jeju Island.; Summary

An Epidemiologic Investigation of Shigellosis Outbreak in Gangnung 1998.: Sang Hyuk Jung, Woong Sub Park; Korean J Epidemiol. 2000;22(1):1-10.

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Abstract PDF: Abstract
An epidemiologic investigation was carried out to identify the distribution and the cause of Shigellosis outbreak, which was occurred in Gangnung city from August to November, 1998. This study carried out from September, 14, to November, 20, 1998. The total number of Shigellosis confirmed patient is 87. We surveyed and obtained the stool sample from all suspected patients and their members of household. The major findings of this study are as follows. 1. The first patient appeared in September 11 and the number of patients increased to September 13, that is peak time, and the patient number tailed down apparently from September, 18, 1998. 2. The incidence rate per 1,000 is largest in Wangsan-Myeon Doma-Ri(32.9), and second largest in Wangsan-Myeon Mokgea-Ri(31.6), The total incidence rate in Gangnung-shi is 0.4(0.4 for man and 0.3 for woman). The age group with the largest incidence rate per 1,000 is 5-14 age group whose incidence rate is 1.4. 3. The secondary generation attack rate in confirmed patient family is 20.6%, and the secondary attack is 7.8%. 4. We considered the meal of school, environmental factor, milk, carrier of Shigellosis as the cause of outbreak, but we were not able to identify the bacteria of shigellosis. But we suspected the meal of school that played important role in outbreak, because outbreak occurred explosively after students ate the meal of school. 5. We considered three hypotheses for the cause of the outbreak. First, a propagation from external regions; Second, an outbreak from contaminated foods; Third, a propagation from carriers in Gangnung. In order to obtain the further information for first and third hypothesis, we should perform PFGE(Pulsed-field gelectrophoresis) with the shigella bacteria of each epidemic region.; Summary

Characteristics of Shigella sonnei Isolated in Kyungsangbuk-do in 1998: Biochemical Characteristics, Biotyping, Antibiotic Resistance Pattern, and Plasmid Profile.: Chang Kyu Sohn, Wan Huh, Doo Young Lee, Si Kyu Lim, Je Wook Lee, Byung Chun Kim, Wan Park; Korean J Epidemiol. 1999;21(2):227-233.

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Thirty nine strains and 109 strains of Shigella sonnei were isolated from the outbreaks of Youngchun and Kyungju, respectively, while 15 strains were isolated from sporadic cases of eight regions in Kyungbuk province from September to November in 1998. We investigated the relationship among the S. sonnei strains by using biochemical characteristics, biotyping, antibiotic resistance pattern, and plasmid profile. Among the isolates, seven strains of S. sonnei isolated in Youngchun showed gelatin hydrolyase positive but the others showed gelatin hydrolyase negative. One hundred and fifty two strains were a type, while eleven among thirty nine strains isolated in Youngchun were g type. Antibiotics resistance patterns of S. sonnei strains isolated in Youngchun and Kyungju were significantly different. Thirty nine strains of S. sonnei isolated in Youngchun were resistant to SM, TE, and TMP/SMX, while eighty six of S. sonnei among one hundred and nine strains isolated in Kyungju were resistant to AM, CB, K, SM, TE, and TMP/SMX. Antibiotics resistance patterns of residual twenty three isolates were similar to those of eighty six strains. The Plasmid profiles of strains of S. sonnei isolated from the Kyungju were different from those of S. sonnei strains isolated in Youngchun. The Plasmid profiles of S. sonnei strains isolated from Youngchun were identical to those of a S. sonnei strains randomly selected from the outbreak in Daegu in 1998. The Plasmid profiles of S. sonnei strains isolated from Kyungju were identical to those of two strains of S. sonnei randomly selected from the outbreaks of Kanglung and Wonju in 1998. From the above results, it is considered that the strains of S. sonnei isolated from Kyungju and Youngchun region are not identical clone.; Summary

The Epidemiological Characteristics of a Shigellosis Outbreak (1998) in Wonju City, Kangwon-Do.: Jong Ku Park, Chun Bae Kim, Won Seok Seok, Kee Ho Park, Seungjun Wang; Korean J Epidemiol. 1999;21(2):131-141.

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From September 8-28 1998, 55 cases of shigellosis, characterized by watery diarrhea, high fever, abdominal cramps and headache were reported at K elementary school in Wonju City. The isolated serotype was Shigella sonnei (group D). We collected bacteriologic specimens from high-risk populations, disinfected epidemic areas, and monitored all the medical facilities in Wonju City. Through these efforts, we found 168 cases of shigellosis, and of these, 117 were culture-confirmed and 51 were diagnosed by symptoms. The incidence rate per 10,000 population in Wonju City was 1.00 in males and 1.19 in females. The secondary attack rate was 13.6%. The mode of transmission at K elementary school was most often caused by the common epidemic source of single exposure. The source of infection was believed to be the foods distributed on September 7. However, epidemiologic evidence suggested that the sources of infection were scattered over many places within the city. The reasons included: i) shigellosis is an endemic disease in Korea; ii) there were shigellosis-like patients at J primary school in Wonju City in late August; and iii) there was a shigellosis outbreak at Chongil Myun, Hoeng Seong Gun, which was located near Wonju City, in early August.; Summary

Indigenous Malaria Surveillance in Korea.: Dae Seong Kim, Soon Duck Kim, Yong Tae Yum, Chae Seung Lim, Kab Ro Lee, Mi Sook Park, Bae Jung Yoon; Korean J Epidemiol. 1997;19(2):180-189.

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Malaria, one of the compulsory notifiable diseases, has been diappeared from Korea based on that fact no notification on malaria case was received from local health agencies during the last decade or so. Recently, Indigenous malaria has been re-emerged since 1993 and 549 cases was notificated till 1996. We conducted a surveillance system on the resurgent malaria outbreaks in the northern area of Kyonggi Province around the Imjin River. Malaria Surveillance Networks(MSNs) were established in Paju and Yoncheon between August 1996 and December 1996. When a febrile patient visits a clinic or a hospital, clinician takes a blood sample and refer to district malaria laboratory for the sample. The blood sample is examined in the malaria laboratory(public health center), and if malaria parasites are found, a radical or curative treatment is offered to patients. MSNs took 94 febrile cases and identified 23 malaria cases(24.5%). All malaria cases were infected by the indigenous vivax malaria. In Paju, 14 of 62 febrile cases(22.6%) were malaria outbreaks and 9 of 32 febrile cases(28.1%) in Yoncheon. In Korea resurgent malaria, malaria surveillance system should be operated for a program based on the district public health center with the coupled laboratory and dispensary.; Summary

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