Epidemiology and Health

Data Profiles

Data resource profile: the Korean Community Health Status Indicators (K-CHSI) database: Hye-Eun Lee, Yeon-gyeong Kim, Jin-Young Jeong, Dong-Hyun Kim; Epidemiol Health. 2023;45:e2023016. Published online February 2, 2023; DOI: https://doi.org/10.4178/epih.e2023016

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Abstract

Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants at the municipal level (si/gun/gu-level regions, including mid-sized cities, counties, and districts). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data sources are 71 public databases, including Causes of Death Statistics, Cancer Registration Statistics, Community Health Survey, Population Census, and Census on Establishments and Statistics of Urban Plans. This dataset covers Korea’s 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (si/gun/gu). The current version of the database (DB version 1.3) was built using 12 years of data from 2008 to 2019. All data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do). K-CHSI covers extensive health outcomes and health determinants at the municipal level over a period of more than 10 years, which enables ecological and time-series analyses of the relationships among various health outcomes and related factors.

Summary

Korean summary
지역사회 건강관련요인 데이터베이스는 17개 광역시도와 약 250개 시군구의 건강 결과 및 결정 요인에 대한 연간 데이터를 포함하는 모델 기반 데이터베이스이다. 본 데이터베이스의 건강 결과에는 사망률, 질병 발생률, 유병률, 자가 보고 건강상태 등이 포함되며 건강 결정 요인은 인구사회학적 환경, 건강 행태, 사회적 환경, 물리적 환경, 보건의료 체계의 5개 영역으로 구성되었다. 데이터는 질병관리청 지역사회건강조사 사이트에서 로그인 없이 다운로드할 수 있다(https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).

Key Message
Korean Community Health Status Indicators (K-CHSI) is a model-based database containing annual data on health outcomes and determinants from 17 metropolitan cities and provinces, with data from approximately 250 municipal regions (si/gun/gu). K-CHSI’s health outcomes include overall mortality, disease incidence, prevalence rates, and self-reported health. Health determinants were measured in 5 domains: socio-demographic factors, health behaviors, social environment, physical environment, and the healthcare system. The data included in K-CHSI may be downloaded via the Korea Community Health Survey site, with no login requirement (https://chs.kdca.go.kr/chs/recsRoom/dataBaseMain.do).

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Journal of Dental Hygiene Science.2025; 25(3): 237. CrossRef
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2024년 지역사회건강조사 기반 충청권 만성질환 건강지표의 지역별 현황 분석
준형 장, 연화 최
Public Health Weekly Report.2025; 18(41): 1510. CrossRef

Data resource profile: the Korea National Hospital Discharge In-depth Injury Survey: Yeon-Kyeng Lee, Sung Ok Hong, Soo-Jung Park, Mijin Park, Kyunghae Wang, Mini Jo, Jeongah Oh, Sin Ae Lee, Hyeon Ju Lee, Jungeun Oh, Dosang Lim, Sanghui Kweon, Youngtaek Kim; Epidemiol Health. 2021;43:e2021052. Published online August 17, 2021; DOI: https://doi.org/10.4178/epih.e2021052

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Abstract

The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), which was started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency (KDCA). The KNHDIS captures approximately 9% of discharged cases from sampled hospitals using a 2-stage stratified cluster sampling scheme, among which 13% are injury related cases, defined as S00-T98 (injury, poisoning, and certain other consequences of external causes) using International Classification of Diseases, 10th revision codes. The KNHDIS collects information on characteristics of injury-related discharges in order to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies and intervention strategies. The types of data captured include the hospitals’ information, detailed clinical information, and injury-related codes such as the mechanism, activities undertaken when injured (sports, leisure activities, work, treatment, and education), external causes of the injury, and location of the occurrence of the injury based on the International Classification of External Causes of Injuries. Furthermore, the means of transportation, risk factors for suicide, and toxic substances are recoreded. Annual reports of the KNHDIS are publicly accessible to browse via the KDCA website (http://www.kdca.go.kr) and microdata are available free of charge upon request via email (kcdcinjury@korea.kr).

Summary

Korean summary
퇴원손상심층조사는 손상발생 규모 및 손상 퇴원환자의 발생 추이를 파악하고자 2005년 도입된국가 단위 통계를 산출하는 표본 조사 사업이다. 본 연구는 퇴원손상심층조사의 표본설계, 조사방법, 조사항목과 함께 그간의 조사결과의 활용도 등 성과에 대해 살펴보았다. 조사결과는 국가 손상예방관리를 위한 기초자료로 활용되고 있으며, 조사 원자료는 공개하고 있다.

Key Message
The Korea National Hospital Discharge In-depth Injury Survey (KNHDIS), started in 2005, is a national probability survey of general hospitals in Korea with 100 or more beds conducted by the Korea Disease Control and Prevention Agency. The KNHDIS collects information on characteristics of injury-related discharges to understand the scale of injuries, identify risk factors, and provide data supporting prevention policies. The data captured including the hospitals’ information, and injury-related codes based on the International Classification of External Causes of Injuries. Annual reports of the KNHDIS are publicly accessible from KDCA website and microdata are available upon request via email.

Citations

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The Gender Distribution and Association between Sociodemographic Factors and Hospital-Presenting Self-Injury: Analysis from the Korea National Hospital Discharge In-Depth Injury Survey
Meekang Sung, S. V. Subramanian, Rockli Kim
Archives of Suicide Research.2025; : 1. CrossRef
Temporal trends and the association between self-rated oral health and falls in community-dwelling older adults in South Korea: a secondary analysis of survey data
Hyun-Ju Seo, Soon-Ki Ahn, Min-Jung Choi
BMJ Open.2024; 14(4): e081549. CrossRef
Assessing Trends in Hospitalizations for Breast Cancer among Women in Korea: A Utilization of the Korea National Hospital Discharge In-depth Injury Survey (2006–2020)
Jieun Hwang, Jeong-Hoon Jang
Journal of Epidemiology and Global Health.2024; 14(2): 411. CrossRef
Mortality and Discharge Outcome in Acute Myocardial Infarction Patients: A Study Based on Korean National Hospital Discharge In-Depth Injury Survey Data
Jieun Hwang, Kyunghee Lee
Risk Management and Healthcare Policy.2024; Volume 17: 2045. CrossRef
Predictive model for early functional outcomes following acute care after traumatic brain injuries: A machine learning-based development and validation study
Meng Zhang, Moning Guo, Zihao Wang, Haimin Liu, Xue Bai, Shengnan Cui, Xiaopeng Guo, Lu Gao, Lingling Gao, Aimin Liao, Bing Xing, Yi Wang
Injury.2023; 54(3): 896. CrossRef
Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008–2015
Hang A Park, Federico E. Vaca, Kyunghee Jung-Choi, Hyesook Park, Ju Ok Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
Sung-Soo Kim, Hun-Sung Kim
Journal of Personalized Medicine.2023; 14(1): 42. CrossRef
Estimated trends in hospitalizations due to occupational injuries in Korea based on the Korean National Hospital Discharge In-depth Injury Survey (2006-2019)
Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon
Epidemiology and Health.2023; 45: e2023042. CrossRef
The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study
Kyunghee Lee, Jieun Hwang
International Journal of Environmental Research and Public Health.2022; 19(10): 6277. CrossRef

COVID-19: Original Article

Epidemiological characteristics of a COVID-19 outbreak caused by religious activities in Daegu, Korea: Jong-Yeon Kim, Yu-Mi Lee, Hwajin Lee, Jung-Whan Kim, Shin-Woo Kim; Epidemiol Health. 2021;43:e2021024. Published online April 14, 2021; DOI: https://doi.org/10.4178/epih.e2021024

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. This outbreak spread rapidly to the community through high-risk groups. This study describes the characteristics of COVID-19 cases based on S religious group membership and summarizes the Daegu municipal government’s processes and responses to control the outbreak.

METHODS

The epidemiological characteristics of confirmed cases were obtained through basic and in-depth epidemiological surveys. General characteristics, the proportion of asymptomatic cases, the case-fatality rate, and the time-to-event within each group were presented after stratifying confirmed cases according to S religious group membership.

RESULTS

Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and 61.5% (n= 4,309) were S religious group members. Compared with non-members, members had a higher proportion of female (p< 0.001) and younger age (p< 0.001), as well as lower disease prevalence. At the time of the investigation, 38.4% of cases in members were asymptomatic versus 23.7% of cases in non-members (p< 0.001). The case-fatality rate of non-members aged ≥ 60 years was significantly higher than that of members (p< 0.001). Compared with non-members, members had longer intervals from symptom onset to diagnosis (p< 0.001) and from diagnosis to admission (p< 0.001), and a shorter interval from admission to discharge (p< 0.001).

CONCLUSIONS

The epidemiological features of S religious group members, including the proportion of asymptomatic cases, case-fatality rate, and time-to-event, differed from non-members. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.

Summary

Korean summary
2020년 2월 대구에서는 종교활동에 의한 코로나바이러스감염증-19(COVID-19) 유행이 발생하였다. 2020년 2월 18일부터 6월 30일까지 대구에서 7,008명이 확진되었으며, 이 중 약 61.5%가 S 종교집단의 신도였다. 비신도인 확진자에 비하여 S 종교집단의 신도인 확진자는 높은 여성 비율, 낮은 연령, 낮은 기저질환 유병률, 높은 무증상 감염율, 동일 연령대에 비하여 낮은 치명률을 보였다. 대구시 보건당국은 S 종교집단의 모든 회원에 대한 즉각적인 격리와 적극적인 선별검사를 통해 지역사회 내 더욱 광범위한 COVID-19 확산을 막을 수 있었다.

Key Message
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and approximately 61.5% were S religious group members. Compared with non-members, members had a higher proportion of women, younger age, and lower disease prevalence, higher proportion of asymptomatic cases and lower case-fatality rate within the same age group. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.

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Quantitative analysis of self-reporting and contact tracing in heterogeneous risk groups: a stochastic modeling study of the COVID-19 outbreak in Daegu, Korea
Jiwon Han, Eunok Jung
BMC Public Health.2025;[Epub] CrossRef
Achieving COVID-19 zero without lockdown, January 2020 to March 2022: The Taiwan model explained
Yi-Hsuan Chen, Chi-Tai Fang
Journal of the Formosan Medical Association.2024; 123: S8. CrossRef
New framework to assess tracing and testing based on South Korea’s response to COVID-19
Junhyoung Kim, Suyoung Jo, Sung-il Cho
BMC Infectious Diseases.2024;[Epub] CrossRef
Estimation of the Effectiveness of a Tighter, Reinforced Quarantine for the Coronavirus Disease 2019 (COVID-19) Outbreak: Analysis of the Third Wave in South Korea
Marn Joon Park, Ji Ho Choi, Jae Hoon Cho
Journal of Personalized Medicine.2023; 13(3): 402. CrossRef
COVID-19 outbreak in a religious village community in Republic of Korea and risk factors for transmission
Jiae Shim, Eunju Lee, Eunyoung Kim, Yeonhwa Choi, Giseok Kang, Bryan Inho Kim
Osong Public Health and Research Perspectives.2023; 14(2): 110. CrossRef
Factors Related to the Transmission of COVID-19 within Households from Pediatric Initial Cases
Da Hye Lee, Jong Yeon Kim, Youn Joo Kim, Seung Soo Lee, Won Kee Lee
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Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020
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Original Articles

A small window into the status of malaria in North Korea: estimation of imported malaria incidence among visitors from South Korea: Jisun Sung, Hae-Kwan Cheong, Ah-Young Lim, Jong-Hun Kim; Epidemiol Health. 2020;42:e2020068. Published online November 21, 2020; DOI: https://doi.org/10.4178/epih.e2020068

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Abstract

OBJECTIVES
This study aimed to develop hypotheses on trends in malaria incidence in North Korea using malaria incidence among South Korean visitors to North Korea.

METHODS

The number of South Korean tourists who visited Mount Kumgang from 2000 to 2008 and the number of South Korean employees at the Kaesong Industrial Complex from 2005 to 2015 were obtained from the Korean Statistical Information Service. The number of malaria cases among South Koreans who visited North Korea was obtained from a previous report. The incidence of malaria per 100,000 person-years was calculated using these data and compared with the malaria incidence in North Korea derived from published articles.

RESULTS

A high incidence of malaria in 2001 and a sharp decline in the following years were observed in both South and North Korean data. Since then, North Korean data showed a relatively low and stable incidence, but the incidence among South Koreans visiting North Korea increased in 2006. Considering the trends in mass primaquine preventive treatment, floods, and economic growth rate, the incidence of malaria may have increased in North Korea in 2006. Since 2009, the incidence of malaria decreased gradually according to both South and North Korean data.

CONCLUSIONS

The trends of malaria incidence in North Korea could be reflected through its incidence among South Koreans who visited North Korea. For future inter-Korean collaboration aiming to eradicate malaria, we propose that a North Korean malaria monitoring system be established applying this method.

Summary

Korean summary
본 연구는 2000-2008년 금강산을 여행한 대한민국 국민과 2005-2015년 개성공단에서 근무한 대한민국 국민에서의 말라리아 발생률을 추정하여 국제사회에 보고된 북한의 말라리아 발생률과 비교 평가하였다. 향후 남북한의 교류가 활성화 되었을 때 북한을 방문하고 돌아온 국민에서의 말라리아 발생률 자료를 사용하여 북한 현지에서의 말라리아 발생률 현황 추이를 살펴볼 수 있을 것으로 보인다.

Citations

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Development of a Plasmodium vivax malaria model for evaluating the effects of control strategies on the malaria burden in Democratic People’s Republic of Korea
Hye Seong, Jiyeon Suh, Jun Yong Choi, Jeehyun Lee, Joon-Sup Yeom
Frontiers in Public Health.2024;[Epub] CrossRef

Main results of the Korea National Hospital Discharge In-depth Injury Survey, 2004-2016: Sung Ok Hong, Boae Kim, Joongho Jo, Yunhyung Kwon, Yeon-Kyeng Lee, Youngtaek Kim; Epidemiol Health. 2020;42:e2020044. Published online June 20, 2020; DOI: https://doi.org/10.4178/epih.e2020044

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Abstract Summary PDF

Abstract

OBJECTIVES
The purpose of this study was to estimate the incidence of injuries and to identify their causes by classifying injuries according to various categories including age, sex, mechanism of injury, body parts injured, and place of injury.

METHODS

This study used data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2016. The KNHDIS is conducted annually by the Korea Centers for Disease Control and Prevention, and its survey population includes all hospitalized patients discharged from medical institutions that have 100 or more beds, such as hospitals, general hospitals, and secondary community health centers. The number of injured cases is weighted and estimated using the mid-year estimated population of each year.

RESULTS

The injury discharge rate steadily increased since 2004 (1,505 per 100,000 population in 2004, 2,007 per 100,000 population in 2016) and most injuries were unintentional (annual average of 94.7%). On average, during the 13-year study period, the injury rate for males was 1.5 times as high as for females. The 2 main causes of injury were consistently traffic accidents and falls. Notably, the rate of injuries resulting from falls rose by 1.7-fold from 463 to 792 per 100,000 people, and exceeded the rate of traffic accidents in 2016.

CONCLUSIONS

The incidence of injuries steadily increased after the survey was first conducted, whereas mortality resulting from injuries mostly remained unchanged. This suggests that effective strategies and interventions should be reinforced to reduce unintentional injuries.

Summary

Korean summary
질병관리본부가 2005년부터 구축하여 운영 중에 있는 퇴원손상심층조사의 연도별 조사자료를 분석한 결과 10만명당 손상발생규모는 2004년 1,505명에서 2016년 2,007명으로 지속적으로 증가하였다. 이러한 꾸준한 증가 추세는, 손상으로 인한 사망률은 감소하였을지라도 손상 예방을 위한 효과적인 정책과 전략, 지속적인 모니터링이 필요성을 제시한다.

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The Impact of the Association between Cancer and Diabetes Mellitus on Mortality
Sung-Soo Kim, Hun-Sung Kim
Journal of Personalized Medicine.2022; 12(7): 1099. CrossRef
Comparison of Prediction Models for Mortality Related to Injuries from Road Traffic Accidents after Correcting for Undersampling
Yookyung Boo, Youngjin Choi
International Journal of Environmental Research and Public Health.2021; 18(11): 5604. 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

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Environmental and human drivers of cercarial emergence in freshwater snails of the Maha Oya River, Sri Lanka
Lakshmi Sakunthala, Rupika S. Rajakaruna, Gajaba Ellepola, Nuwandi U. K. Pathirana
Journal of Parasitic Diseases.2025;[Epub] CrossRef
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

Brief Communication

Emergence of Neisseria meningitidis W135 in Cote d’Ivoire: laboratory based-surveillance: Man-Koumba Soumahoro, Clarisse Kouamé-Elogne, Jean-Claude Anné, Soualihou Noufé, Kouakou Christophe N’Guessan, Adèle Kacou-N’Douba, Thomas Hanslik, Mireille Dosso; Epidemiol Health. 2018;40:e2018058. Published online November 28, 2018; DOI: https://doi.org/10.4178/epih.e2018058

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Abstract PDF

Abstract

OBJECTIVES
To describe the emergence of Neisseria meningitidis (Nm) W135 in Côte d’Ivoire and its characteristics compared to NmA.

METHODS

Data on Nm samples isolated at the National Reference Center for meningitis in Côte d’Ivoire between 2007 and 2012 were analyzed. Socio-demographic data and biological information on the samples were extracted from the database. Categorical variables, such as sex and the serotype of the bacteria, were compared using the Fisher exact test, while the distribution of continuous variables, such as age, was compared using the Wilcoxon test.

RESULTS

Among the 175 Nm samples, 57 were NmA, 4 were NmB, 13 were NmC, and 99 were NmW135. The geographical distribution of NmA and NmW135 did not show a significant difference according to age or sex. NmW135 was more common than NmA in the northern health districts of Cote d’Ivoire (85.9 vs. 45.5%; p<0.001). No sample of NmA has been isolated since 2009, while 95% of the type W135 samples were isolated between 2010 and 2012.

CONCLUSIONS

This study highlighted the emergence of NmW135 in Côte d’Ivoire, as well as the simultaneous disappearance of NmA. It is important to improve laboratory-based surveillance of meningitis to assess trends in the circulation of bacteria and to detect the emergence of new serogroups earlier.

Summary

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Togbemabou Primous Martial Godjedo, Alidehou Jerrold Agbankpe, Moussiliou Noël Paraiso, Tamegnon Victorien Dougnon, Marie Hidjo, Lamine Baba-Moussa, Honore Bankole
Advances in Public Health.2020; 2020: 1. CrossRef

Original Article

Estimation of the size of the iatrogenic Creutzfeldt-Jakob disease outbreak associated with cadaveric dura mater grafts in Korea: Byoung-Hak Jeon, Jinseob Kim, Ganghyun Kim, Soochul Park, SangYun Kim, Hae-Kwan Cheong; Epidemiol Health. 2016;38:e2016059. Published online December 19, 2016; DOI: https://doi.org/10.4178/epih.e2016059

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Abstract

OBJECTIVES
This study estimated the overall incidence of iatrogenic Creutzfeldt-Jakob disease (iCJD) based on dura graft cases in Korea using a mathematical model.

METHODS

We estimated the number of annual dura grafts performed between 1980 and 1995 by applying the proportion of dura grafts recorded by the Health Insurance Review Agency claim dataset in Korea to the number of nationwide neurosurgery cases. The distribution of the incubation period was assumed to fall under a Weibull distribution with density function or a log-logistic distribution with density function.

RESULTS

The total number of neurosurgery procedures performed from 1980 to 1995 was estimated to be 263,945, and among those operations, 37% used dura graft products. Between the years of 1980 and 2020, our model predicted that the total number of iCJD cases would be between 14.9 and 33.2 (95% confidence interval [CI], 13.4 to 50.9). Notably, we estimated that the cumulative number of iCJD cases caused by dura grafts between 1980 and 2011 was approximately 13.3 to 27.3 (95% CI, 12.2 to 40.6).

CONCLUSIONS

Based on our model, we postulate that the incidence of iCJD will sharply decline from 2012 to 2020. However, additional new cases are still expected, which necessitates a strong national surveillance system.

Summary

Korean summary
국내 경막유래 의인성 크로이츠펠트-증후군 환자의 발생규모 추정 본 연구는 국내 가용한 모든 자료원을 활용하여 국내 의인성 CJD 위험인구를 추산하고 이를기반으로 발생 가능한 의인성 CJD 환자의 규모를 수학적 모형을 통해 추산하는 것을 목적으로 시행하였으며, 예측모형 결과 2020년까지 가파르게 감소할것으로 보이나, 추가 발생에 대비한 국가감시체계의 강화가 필요할것으로 사료된다.

Citations

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Iatrogenic cerebral amyloid angiopathy: more cases to come
Till Turloff, Ulf Jensen-Kondering
Frontiers in Neurology.2025;[Epub] CrossRef
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Matt Stevenson, Lesley Uttley, Jeremy E Oakley, Christopher Carroll, Stephen E Chick, Ruth Wong
Health Technology Assessment.2020; 24(11): 1. CrossRef

REVIEW

Review of Brucellosis in Nepal: Krishna Prasad Acharya, Nirajan Niroula, Krishna Kaphle; Epidemiol Health. 2016;38:e2016042. Published online October 1, 2016; DOI: https://doi.org/10.4178/epih.e2016042; Retraction in: Epidemiol Health 2017;39(0):e2017018

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MERS-Epidemiologic Investigation

Surveillance operation for the 141st confirmed case of Middle East Respiratory Syndrome coronavirus in response to the patient’s prior travel to Jeju Island: Jong-Myon Bae; Epidemiol Health. 2015;37:e2015035. Published online August 7, 2015; DOI: https://doi.org/10.4178/epih/e2015035

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Abstract Summary PDF Supplementary Material

Abstract

The provincial government of Jeju, South Korea, was notified that a 42-year-old man infected with the Middle East Respiratory Syndrome (MERS) coronavirus had gone sightseeing in Jeju Island. Although the visiting period might be interpreted as the incubation period of MERS, the province decided to conduct active surveillance to prevent a worst-case scenario. Based on the channel of movement of the patient, healthy isolation and active monitoring were conducted for persons who came in contact with the patient. During the active surveillance, none of the 56 persons in self-isolation and 123 persons under active monitoring became infected. This fact supports that MERS is not contagious during the incubation period.

Summary

Korean summary
141번 MERS 양성확진자에 대한 역학조사를 통해 잠복기간에 제주도를 여행한 것이 확인되었다. 이에 제주도 MERS 방역본부는 최악의 경우를 염두에 두고, 밀접접촉자 56명과 일상접촉자 123명을 각각 자택격리와 능동모니터링 대상자로 조치하였다. 잠복기 14일을 기준으로 감시체계를 운영하였지만, 양성감염자는 전무하였다. 이는 MERS의 잠복기 동안에는 감염력이 없다는 근거가 된다.

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Scientific Data.2019;[Epub] CrossRef

Data Profile

National Infectious Diseases Surveillance data of South Korea: Sunhee Park, Eunhee Cho; Epidemiol Health. 2014;36:e2014030. Published online November 11, 2014; DOI: https://doi.org/10.4178/epih/e2014030

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Abstract Summary PDF Supplementary Material

Abstract

The Korea Centers for Disease Control and Prevention (KCDC) operate infectious disease surveillance systems to monitor national disease incidence. Since 1954, Korea has collected data on various infectious diseases in accordance with the Infectious Disease Control and Prevention Act. All physicians (including those working in Oriental medicine) who diagnose a patient with an infectious disease or conduct a postmortem examination of an infectious disease case are obliged to report the disease to the system. These reported data are incorporated into the database of the National Infectious Disease Surveillance System, which has been providing web-based real-time surveillance data on infectious diseases since 2001. In addition, the KCDC analyzes reported data and publishes the Infectious Disease Surveillance Yearbook annually.

Summary

Korean summary
감염병웹통계(http://is.cdc.go.kr)에서는 전수감시 대상 54종 감염병에 대한지역별, 성별, 연령별, 감염지역별, 기간별, 전년대비 주간 발생현황 등 실시간 기간 검색이 가능하며, 검색된 통계를 표 또는 다양한 그래프로 볼 수 있으며, 또한 이러한 자료들은 엑셀로 다운로드하여 사용이 가능하다. 표본감시 대상 24종 감염병의 통계도 제공되고 있다.

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Original Articles

Factors Associated with a Low-sodium Diet: The Fourth Korean National Health and Nutrition Examination Survey: Won Joon Lee, Hyeon Chang Kim, Sun Min Oh, Dong Phil Choi, Jaelim Cho, Il Suh; Epidemiol Health. 2013;35:e2013005. Published online June 20, 2013; DOI: https://doi.org/10.4178/epih/e2013005

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>The low-sodium diet is a known preventive factor for hypertension and cardiovascular disease. Factors associated with low-sodium diets should be identified to reduce sodium intake effectively. This study was conducted to identify factors correlated with a low-sodium diet.</sec><sec><title>METHODS</title>This cross-sectional study analyzed data from a total of 14,539 Koreans aged 20 years or older, who participated in the Fourth (2007-2009) Korean National Health and Nutrition Examination Survey. A low-sodium diet was defined as having ≤2,000 mg/day based on 24-hour recalls. Multiple logistic regression models were used to assess sex, age, education, number of family members, household income, occupation, alcohol drinking, total energy intake, frequency of eating out, and hypertension management status for their associations with low-sodium diets.</sec><sec><title>RESULTS</title>Among all participants, only 13.9% (n=2,016) had low-sodium diets. In the multivariate analysis, 40-49 years of age, clerical work jobs, higher total energy intake, and frequent eating out were inversely associated with low-sodium diets. And female sex and living-alone were associated with low-sodium diets. Lower frequency of eating out was significantly associated with low-sodium diets, even after adjusting for total energy intake and other potential confounders. Adjusted odds ratios (95% confidence interval) for a low-sodium diet were 1.97 (1.49-2.61), 1.47 (1.13-1.91), 1.24 (0.96-1.61), and 1.00 (reference) in people who eat out <1 time/month, 1-3 times/month, 1-6 times/week, and ≥1 time/day, respectively.</sec><sec><title>CONCLUSIONS</title>Our study suggests that sex, age, number of family members, occupation, total energy intake, and lower frequency of eating out were associated with a low-sodium diet in Korean adults.</sec>

Summary

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A Population Health Surveillance Theory: Farouk El Allaki, Michel Bigras-Poulin, Pascal Michel, André Ravel; Epidemiol Health. 2012;34:e2012007. Published online November 30, 2012; DOI: https://doi.org/10.4178/epih/e2012007

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>Despite its extensive use, the term "Surveillance" often takes on various meanings in the scientific literature pertinent to public health and animal health. A critical appraisal of this literature also reveals ambiguities relating to the scope and necessary structural components underpinning the surveillance process. The authors hypothesized that these inconsistencies translate to real or perceived deficiencies in the conceptual framework of population health surveillance. This paper presents a population health surveillance theory framed upon an explicit conceptual system relative to health surveillance performed in human and animal populations.</sec><sec><title>METHODS</title>The population health surveillance theory reflects the authors' system of thinking and was based on a creative process.</sec><sec><title>RESULTS</title>Population health surveillance includes two broad components: one relating to the human organization (which includes expertise and the administrative program), and one relating to the system <italic>per se</italic> (which includes elements of design and method) and which can be viewed as a process. The population health surveillance process is made of five sequential interrelated steps: 1) a trigger or need, 2) problem formulation, 3) surveillance planning, 4) surveillance implementation, and 5) information communication and audit.</sec><sec><title>CONCLUSIONS</title>The population health surveillance theory provides a systematic way of understanding, organizing and evaluating the population health surveillance process.</sec>

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Evaluation of Acute Flaccid Paralysis in Hamadan, Iran from 2002 to 2009: Jalal Poorolajal, Shadi Ghasemi, Leila Nezamabadi Farahani, Atefeh Sadat Hosseini, Seyyed Jalal Bathaei, Ali Zahiri; Epidemiol Health. 2011;33:e2011011. Published online November 16, 2011; DOI: https://doi.org/10.4178/epih/e2011011

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Abstract PDF

Abstract

<sec><title>OBJECTIVES</title>To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran.</sec><sec><title>METHODS</title>A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis.</sec><sec><title>RESULTS</title>During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ≤5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected.</sec><sec><title>CONCLUSION</title>The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.</sec>

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Brief Communication

A community-level Communicable Disease Surveillance System in a Metropolitan city.: Sun Seog Kweon, Hyung Cheol Park, Hyun Nam, Jin Su Choi; Korean J Epidemiol. 2008;30(2):294-300. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.294

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Abstract PDF: Abstract
OBJECTIVES
The surveillance of infectious diseases, which is crucial in public health, may also suffer from poor community support. In South Korea, the government operates several national surveillance system for the National notifiable infectious diseases(NNID). Some programs work satisfactorily but other programs may not be fully accepted at the community level which result in low participation and delayed report.
METHODS
May 2003, to improve the blind side of the National Surveillance System, a district health agency initiated a community based surveillance system for infectious diseases called as Communicable Disease Information Sharing System (CDISS) to complement the national program. As the name suggests, it underscores the mutual benefit of surveillance for public and private health sectors through partnership. With collaboration of participating private clinics and hospitals around the district, the health agency collects data and provides the health practitioners more up-to-dated information on the trend of infectious diseases than National level information. Total population of study area, Dong-gu which locate in the center of Gwangju-metropolitan city, is about 120,000 in 2005. Reporting facilities consist of 6 daycare clinics, 3 hospitals, and 1 university hospital, 2 local public health organizations.
RESULTS
CDISS was introduced in May 2003, and full system has been successfully operated since March 2004 with 10 participating facilities. Each reporting facility regularly sends the weekly reporting form, filled with the number of patients in last week, to Dong-gu District Health Center in every Wednesday. All data were organized in tables and graphs by weekly summarizing the reporting data and interpreted information. Feedback is done to reporting facilities until Friday through faxes, email, website (http://kjdisweb.richis.org) ?at least a week earlier than National Surveillance System.If reported data exceeded epidemic alert level, the community warnings are issued through mass-media and other means of public communication.During the period of CDISS operation, some epidemic events and sporadic outbreak occurred in Dong-gu were detected well-earlier than the notification at national level, such as chickenpox, viral enteritis, and epidemic keratoconjunctivitis(EKC).
CONCLUSIONS
The program has been functioning successfully with active community participation and revealed to be economic and effective way of disease surveillance in the community. Several episodes of disease epidemic were reported by the program well before the recognition of the epidemic at the national level. We suggest that the community surveillance program may well complement national surveillance system.; Summary

Original Articles

Perspectives of Communicable Disease Surveillance in Korea.: Hyun Sul Lim; Korean J Epidemiol. 2006;28(1):28-35.

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Abstract PDF: Abstract
Environmental and climatic changes and the mobility of ever-increasing numbers of people increase the risks for the emergence and reemergence of infectious diseases. Since communicable disease trends change rapidly, many nations have developed individualized communicable disease surveillance systems. In Korea, notification of the incidence of communicable diseases has been the most important form of surveillance since 1954. In addition, the government has established various surveillance systems since the late 1990s. Current problem areas of surveillance systems are the low reporting rate, a lack of representativeness, a lack of participation, and poor utilization. The government has not fully evaluated these systems. For many diseases, it is of critical importance to maintain the confidentiality of surveillance data. Issues of confidentiality are critical and must be considered in order to obtain valid data and protect those surveyed. In the future, we have to improve the reporting rate, enhance collaborations with veterinarians and gain the full support from the governmental departments of agriculture and defense. Surveillance systems should be evaluated regularly. The most dynamic and important part of surveillance is the feedback mechanism. To develop positive feedback, we must disseminate the collected and analyzed information and give reimbursement to the reporters. We have to built close partnerships with governmental agencies, international organizations, research institutes, private health corporations, and academia.; Summary

Surveillance System for Communicable Disease in Korea.: Ok Park; Korean J Epidemiol. 2006;28(1):22-27.

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Abstract PDF: Abstract
Korea has experienced sporadic cases or outbreaks of emerging and reemerging infectious diseases since the 1980s. Confirmed outbreaks have included leptospirosis and legionellosis in 1984, HIV infection in 1985, enterohemorrhagic E-coli infection in 1998, staphylococcus aureus infection with decreased vancomycin susceptibility in 1999, brucellosis in 2002, and botulism in 2003. Korea has also suffered from reemerging diseases such as vivax malaria along the Demilitarized Zone (DMZ) since 1993. Owing to globalization, imported cases of diarrheal diseases, malaria, and dengue have been increasing. In addition, the overall incidence of acute infectious diseases such as shigellosis, scrub typhus, and mumps, which had been decreasing since 1970 until the late 1990s, began to increase again after the late 1990s. The range of emerging and reemerging diseases poses serious public health threats to the public. The Korean government has been striving to build capacity to detect and respond to these infectious disease threats in a timely manner since the late 1990s. For this, the government revised the Communicable Disease Prevention Law, reorganized the government structure for communicable disease control, and developed human resources through field epidemiology and various other training programs. SARS and highly pathogenic avian influenza provided momentum to accelerate these endeavors. Korea has thus far achieved significant improvements in the field of infectious disease surveillance. There are, however, gaps that need to be addressed including insufficient capacity for disease surveillance and response for emerging infectious disease at the local government level, inadequate operation of various surveillance systems, insufficient integration among surveillance systems, and low participation rate for notification among physicians. Therefore, the Korean government plans to improve infectious disease surveillance by implementing the following procedures: establishment of a web-based reporting system, integration of EDI and laboratory surveillance systems, extension of the electronic reporting system to the private sector, continuous development of human resources to build capacity, and enhancement of collaboration with the private sector.; Summary

Review

Development of Policy and Strategy for the Control of Creutzfeldt-Jakob Disease in Korea.: Seung Il Choi, Byung Hoon Jeong, Yong Sun Kim; Korean J Epidemiol. 2005;27(1):81-89.

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Abstract PDF: Abstract
PURPOSE
Through the understanding of the current status of transmissible spongiform encephalopathy(TSE), this study was conducted to contribute to the development of policy and strategy for the control of TSE in Korea in order to keep Korea as a bovine spongiform encephalopathy(BSE)- and variant Creutzfeldt-Jakob disease(vCJD)-free country. BSE and vCJD cases have not been found in Korea. During 2001-2004, the number of patients who have been diagnosed as a definite or probable CJD was 121, which are consisted of 62 male and 59 female(average age: 63 years old). The occurrence of the patients was 5-59 people per year until 2003 and has been gradually increasing due to the recent increase in the diagnostic rate rather than the increase of the incidence. In 2004, the annual occurrence of sporadic CJD(sCJD) in Korea was 1 people per million, which is similar to the average occurrence rate of the world. Two cases of chronic wasting disease(CWD) in deer were found in Chungcheongbuk-do, one in August 2001 and one in October 2001. After that, 4 more CWD-affected deer have been reported in Kyungsangnam-do area in November 2004. We have also examined the possibility that Korean CJD occurred as a result of dietary exposure to BSE. Fortunately, all of Korean CJD patients were not vCJD cases. However, if BSE occurs in Korea, there is a great potential for most of the Korean population to be easily infected with BSE due to their highly susceptible genotype to BSE infection as well as their traditional food habit. In 2003, the total number of people who left Korea was almost identical with the total number of people who entered Korea. However, we could not analyze the number of people who visited or stayed in the UK and Europe during 1980s~1990s, in which BSE was prevalent in Europe, because there was no statistical data available.; Summary

Original Articles

Sentinel Surveillance System for Pediatric Communicable Diseases.: Young Ohk Yoo, Eun Kyeong Jeong, Ok Park, Byung Chul Chun; Korean J Epidemiol. 2004;26(2):32-42.

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Abstract PDF: Abstract
PURPOSE
The purpose of this study is to review the process for establishing a pediatric communicable diseases sentinel surveillance system, and the results of operation based on the accumulated data to understand the descriptive epidemiologic characteristics of pediatric communicable diseases.
METHODS
A sentinel surveillance system for pediatric communicable diseases was developed in May 2001 with the 202 doctors in pediatric clinics who participated voluntarily. The target diseases for sentinel surveillance were measles, mumps, rubella, chicken pox and aseptic meningitis. The case definitions of those diseases for surveillance were divided into confirmed cases and suspected cases by the diseases definitions of national notifiable diseases system. The participants should report as soon as possible when they diagnosed measles, mumps, rubella cases including suspected ones. But chicken pox and aseptic meningitis cases were reported once a week in regular base including zero report. We collected the data from May 2001 to December 2003 and showed the descriptive epidemiologic characteristics of each disease.
RESULTS
The average reporting proportion among survellance doctors has been increased, about 88% in 2003. For measles, 206 cases were reported in 2001, 10 cases in 2002, and 2 cases in 2003. Children under the age of 2 (53.4 %) showed the highest. Among the measles cases, 86.4% had no previous vaccination history. In case of mumps, 246 cases in 2001, 241 in 2002, and 566 cases in 2003 were reported. Mumps showed seasonality, highest from April to June in each year. The sex ratio was about 1.5(M:F = 6:4). Among the reported cases, 76.9 % had previous MMR immunization history at least one time. For Rubella, 9 cases in 2001, 3 in 2002, and no case were reported in 2003. The chicken pox case proportion per 100 pediatric consultations showed peak in from May to June and from November to January. 3-5 year-old children (45.7%) were showed high proportion by age.
CONCLUSION
This study described the process of establishing and operating a system for the pediatric communicable disease sentinel surveillance. We analyzed the desriptive epidemiologic characteristic of the reported data from May 2001 to December 2003. These data maybe useful to build the policy of public health management for communicable diseases control system and vaccine preventable diseases.; Summary

Occupational Cancer Surveillance System Using Data Linkage Analysis in Korea.: Sang Yun Lee, Jaiyong Kim, Seongwoo Choi, Hyungjun Im, Kijung Yoon, Ho Jang Kwon, Soo Hun Cho, Daehee Kang; Korean J Epidemiol. 1999;21(2):276-282.

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Abstract PDF: Abstract
To develop the occupational cancer surveillance system in Korea, data linkage analysis was performed on the subjects of Health-monitoring-pocketbook (the list of subjects who were exposed to selected occupational carcinogens) and the retired workers of a cokes manufacturing factory using the Korean medical insurance data, Korean death certificate data and Korean cancer registry data. Study subjects comprised the 822 retired subjects and the 3101 present-post subjects of Health-monitoring-pocketbook and the 182 retired workers of a cokes manufacturing factory. The incidence of cancer of these study subjects was ascertained by linkage of Korean medical insurance data of year 1995-6, Korean death certificate data of year 1992-8 and Korean cancer registry data of year 1993-5. In the study subjects, Eighty seven percent were males and mean age was 39.3+/-8.9 year-old, Average work duration was 8.0+/-5.5 years. Chrome, asbestos and cokes were the most frequent exposed agents. In the study subjects, total 13 cancer cases were ascertained by data linkage analysis. In the ascertained cancer cases, 8 cases were male and 5 cases were female, and 7 cases were aged 40-49 yr, 5 cases were aged 50-59 yr and 1 cases were aged 30-39 yr. The commonest exposure agent in the ascertained cancer cases was asbestos and cokes. By the site of cancer, 3 stomach cancer cases, 2 hematopoietic cancer cases and 2 biliary tract cancer cases were ascertained. The occupational cancer surveillance system using data linkage analysis on the workers exposed to hazardous agents was the most feasible and efficient method in Korea. And to do this, establishment of occupational history information in several disease registry database is needed with the effort of estimating the proper size of workers exposed hazardous agents.; Summary

The Usefulness of the Secondary Database for Occupational Asthma Surveillance System in Korea.: Hyungjune Im, Sungwoo Choi, Jaiyong Kim, Sang Yun Lee, Kijung Yoon, Youngju Lee, Ho Jang Kwon, Daehee Kang, Soo Hun Cho; Korean J Epidemiol. 1999;21(2):266-275.

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Abstract PDF: Abstract
Occupational asthma is defined as a disease that is characterized by airway narrowing and bronchial hyperresponsiveness caused by specific working environment. It is estimated that occupational asthma cases in Korea have been underreported. This study, using Korean Medical Insurance Data(KMID), examined the distribution of asthma patients' occupations and the frequency of high risk occupations for occupational asthma in Seoul, Korea to evaluate the usefulness of the KMID data as a database for active occupational asthma surveillance system. Six hundreds and forty two(30.7%) of 2093 patients who were finally chosen as a study population by using 1995-year KMID, were contacted by telephone. 296 persons(47.4%) of 642 patients replied that they were diagnosed as asthma. The occupations of 296 asthma patients were classified by Korean standardized industrial classfication (KSIC). The most common occupations included Wholesale and Retail trade(19.5%), Real estate, Renting and Business activities(14.9%), Construction(14.9%), Manufacturing(12.3%). Forty(13.5%) of 296 patients who could be classified by KSIC were working at high risk jobs for occupational asthma. KMID could be used as a useful data for occupational asthma surveillance system if the limitations of KMID, which is the accuracy of diagnosis, data accessibility, difficulty of following up study subjects, would be solved. The prevalence of occupational asthma could be estimated if the follow-up study diagnosing occupational asthma for asthma patients working in high risk jobs would be held.; 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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Abstract PDF: Abstract
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

Reviews

Laboratory Based Surveillance System of Communicable Disease in Korea.: Bok Kwon Lee; Korean J Epidemiol. 1997;19(1):22-28.

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Abstract PDF: Abstract
Since the communicable disease trend changes rapidly, many nations have developed communicable disease surveillance system according to their system. Among the surveillance, the laboratory based surveillance system has been particulary important for epidemiological analysis of various communicable diseases. Some communicable diseases, such as salmonellosis and shigellosis can be monitored accurately only through the laboratory based surveillance system because of the nonspecificity of the clinical syndrome. And clinical surveillance data are confirmed with laboratory findings can have substantial impacts of reporting rate and can increase the reliablity of survillance data. The current communicable disease surveillance system in Korea is notitiable disease report system and has problems in representativeness of reports and reporting rate. The object of this study is to find problems of present laboratory based surveillance system in Korea and to suggest implementation strategies.; Summary

Communicable Disease Surveillance System and Sentinel Surveillance.: Eui Chul Shin, Kwang Ho Meng; Korean J Epidemiol. 1997;19(1):14-21.

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Abstract PDF: Abstract
Surveillance is the ongoing and systematic collection, analysis of disease related data and dissemination of the information to the people who need it, and application of it to disease prevention and control. So, it is composed of reportable disease; system of data collection, analysis, distribution; coorporation of medical institution with public health organization and effective control. The most dynamic and important part of surveillance is the feedback mechanism. As for positive ways of feedback, there are dissemination of collected and analysed information and reimbursement to the reporters. Legal punishment is the negative way of feedback. The common systems that the developed countries use for communicable disease surveillance are notifiable disease surveillance, sentinel surveillance, and laboratory surveillance systems. Notifiable disease surveillance is for the diseases that their impact is serious to the community when epidemic occurs even though the number of cases is small. Most countries have this type of surveillance, but they suffer from low reporting rate. Sentinel surveillance is for the disease which is mild or whose trend is to be traced for the evaluation of the public health programs. Sampled reporters notifies the disease information voluntarily not by law. Laboratory surveillance is to support the notifiable and sentinel surveillance. It provides laboratory information on the microorganism and antibody level of the disease. Surveillance of communicable diseases in Korea is totally dependent on the notifiable disease reporting system, and there are many problems involved. To improve the surveillance of communicable diseases, it is strongly recommended that the sentinel and laboratory surveillance systems be adopted.; Summary

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