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Korean Journal of Epidemiology 1986;8(2): 330-336.
일부 농촌 부락에서 집단 발생한 세균성 이질의 역학적 특성
김양호, 방숙, 김정순, 허용, 정해관, 안문영, 이종구, 구자일, 김헌, 권순만, 장우현
An epidemiological characteristic of dysentery outbreak in a rural area
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
Abstract
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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