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Park NY, Cho CM, Lee EH, Park JM, Lee YR, Hong JI, Kwon GY. Job analysis of vaccination health workers at public health centers and sub-centers. Public Health Nurs 2024. [PMID: 38588062 DOI: 10.1111/phn.13325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To analyze duties, tasks, and task elements of health workers in charge of vaccination at public health centers in South Korea. DESIGN Descriptive study using a survey. SAMPLE Health workers in charge of vaccination for more than 1 year at 254 public health centers in South Korea. Of 631 health workers, 401 responded to the questionnaire, and 379 responses were included in the analysis after excluding 22 incomplete responses. MEASUREMENTS The Developing A Curriculum (DACUM) workshop was conducted to identify the frequency, importance, and difficulty of duties, tasks, and task elements. RESULTS Four duties (vaccination promotion, vaccination administration and symptom management, execution of vaccination, and vaccination education), 18 tasks, and 81 task elements were identified. "Execution of vaccination" exhibited the highest determinant coefficient. "Implementing the budget" exhibited the highest determinant coefficient among tasks, and "dealing with an emergency in the case of adverse events" exhibited the highest determinant coefficient among task elements. CONCLUSIONS Duty, task, and task elements with high determinant coefficients have high educational needs. Education demands was higher for administrative work than for direct vaccination. Developing an educational curriculum based on DACUM results could contribute to the professional education of vaccine workers.
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Affiliation(s)
- No-Yai Park
- Graduate School of Public Health, Inje University, Gimhae, Republic of Korea
| | - Chung-Min Cho
- College of Nursing, Sungshin Women's University, Seoul, Republic of Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Jeong-Mo Park
- Department of Nursing, Kyungin Women's University, Incheon, Republic of Korea
| | - Young-Ran Lee
- Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Jeong-Ik Hong
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Cho J, Kim EM, Kim J, Shin JY, Kim EH, Park JH, Kwon SL, Kwon GY, Shin SA, Kim J. Effect of the human papillomavirus vaccine on the risk of genital warts: a nationwide cohort study of South Korean adolescent girls. Epidemiol Health 2024:e2024040. [PMID: 38549356 DOI: 10.4178/epih.e2024040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/04/2024] [Indexed: 04/17/2024] Open
Abstract
Objectives The purpose of this study was to assess the effectiveness of human papillomavirus (HPV) vaccination administered to adolescent girls through South Korea's National Immunization Program. Methods This retrospective cohort study included individuals who were 12 to 13 years old, whether vaccinated or unvaccinated, between July 2016 and December 2017. The incidence of genital warts (GWs) was monitored through 2021. Time-stratified hazard ratios (HRs) were estimated, adjusting for birth year, socioeconomic status, and the level of urbanization of the region, and were presented with 95% confidence intervals (CIs). Data were sourced from the Immunization Registry Integration System, linked with the National Health Information Database. Results The study included 332,062 adolescent girls, with an average follow-up period of approximately 4.6 years. Except for the first year, the HRs for the vaccinated group were lower than those for the unvaccinated group. The HRs for specific cutoff years were as follows: year 2, 0.62 (95% CI, 0.31 to 1.13); year 3, 0.58 (95% CI, 0.35 to 0.96); and year 4 and beyond, 0.39 (95% CI, 0.28 to 0.52). Conclusion Our findings indicate that HPV vaccination was associated with a reduction in the risk of GWs among adolescent girls. Notably, this reduction became significant as the incidence of GWs increased with age.
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Affiliation(s)
- Jaeyoung Cho
- Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
| | - Eun Mi Kim
- Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
| | - Jihye Kim
- Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Eui Hyeok Kim
- Department of Obstetrics & Gynecology, CHA Ilsan Medical Center, Goyang, Korea
| | - Jong Heon Park
- Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
| | - Seunghyun Lewis Kwon
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Geun-Yong Kwon
- Division of Immunization Planning, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Soon-Ae Shin
- Health Insurance Research Institute, National Health Insurance Services, Wonju, Korea
| | - Jaiyong Kim
- Department of Big Data Strategy, National Health Insurance Services, Wonju, Korea
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Kim HK, Park SK, Choe SA, Gwak ES, Cowling BJ, Kim YM, Lee KH, Lee SW, Kwon GY, Jang EJ, Kim RK, Choe YJ, Kwon D. Risk of SARS-CoV-2 breakthrough infection following NVX-CoV2373 and BNT162b2 vaccinations in Korean Adults: A population-based observational study. Vaccine 2024; 42:1440-1444. [PMID: 38365479 DOI: 10.1016/j.vaccine.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
South Korea experienced a low prevalence of SARS-CoV-2 until the emergence of the omicron in early 2022, triggering a major community epidemic. To evaluate effectiveness of NVX-CoV2373 and BNT162b2 vaccines in Korean population, we conducted an observational study utilizing individual-level case data on laboratory-confirmed SARS-CoV-2 infection, along with vaccination record. A total of 47,078 recipients of NVX-CoV2373 vaccine and 7,561 recipients of BNT162b2 vaccine were eligible for the study. Thirty days post-second doses, COVID-19 rates were 7.9% (595 out of 7561) of NVX-CoV2373 recipients and 8.6 % (647 out of 7561) of BNT162b2 recipients experienced COVID-19. NVX-CoV2373 rates increased to 9.8 % and 11.2 % at 60 and 90 days, while BNT162b2 rates were 10.5 % and 11.3 % at the same intervals. The 22-weeks risk ratios for recipients of the NVX-CoV2373 vaccine as compared with recipients of the BNT162b2 vaccine were 1.11 (95 % CI, 0.99 to 1.25) for laboratory-confirmed SARS-CoV-2 infection. Continued monitoring is essential to evaluate the duration of protection across different vaccine platforms and schedules.
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Affiliation(s)
- Hee Kyoung Kim
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Korea
| | - Seon Kyeong Park
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Seung Ah Choe
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eun Sun Gwak
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Benjamin John Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong
| | - Young-Man Kim
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Kil Hun Lee
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sang Won Lee
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Geun-Yong Kwon
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Eun Jung Jang
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ryu Kyung Kim
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, and Allergy and Immunology Center, Korea University, Seoul, Korea.
| | - Donghyok Kwon
- Director for Epidemiological Investigation Analysis, Korea Disease Control and Prevention Agency, Cheongju, Korea.
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Lee H, Park JH, Kim S, Seo S, Lee M, You M, Choi EH, Kwon GY, Shin JY, Lee MA, Jeong MJ, Choe YJ, Choi S. Effect of information provision on parental intention toward COVID-19 vaccination for children: a nationwide survey experiment. Sci Rep 2024; 14:5354. [PMID: 38438659 PMCID: PMC10912657 DOI: 10.1038/s41598-024-56116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
The reluctance of parents to vaccinate their children against COVID-19 was prevalent particularly when uncertainty over vaccination outcomes prevailed. We conducted a nationwide randomized online survey experiment to assess the effect of information provision on parental intention for COVID-19 vaccination before the government started vaccination for children in South Korea. Parents of elementary school children were provided with either no information (Control), information on vaccine profile (vaccine informed group; VI), or COVID-19 (disease informed group; DI). Among 359,110 participants, parental intention for vaccination of children was significantly higher in both VI and DI groups compared with the Control group. In terms of effect size, information on COVID-19 vaccine increased likelihood to vaccinate by 1620 per 100,000 parents and reduced vaccine hesitancy by 1340 per 100,000 parents. Consistently with the positive effect on vaccination intention, both VI and DI interventions increased participants' perceptions on vaccination benefits being higher than its risks and vaccination risks being lower than health risks of COVID-19 infection, and self-reported trust in COVID-19 information. Our results lend strong support to the claim that the provision of targeted, tailored information on COVID-19 vaccine and infection increases parental intention to vaccinate children and reduces vaccine hesitancy.
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Affiliation(s)
- Hyunju Lee
- Department of Paediatrics, Seoul National University Bundang Hospital, Seongnam-Si, Korea
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Hyun Park
- Department of Economics. College of Social Sciences, Seoul National University, Seoul, Korea
| | - Shinkyeong Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sujin Seo
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Minjung Lee
- Yale School of Nursing, Yale University, New Haven, CT, USA
| | - Myoungsoon You
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Eun Hwa Choi
- Department of Paediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju-si, Korea
| | - Jee Yeon Shin
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju-si, Korea
| | - Min-Ah Lee
- Korea Disease Control and Prevention Agency COVID-19 Vaccination Task Force, Cheongju-si, Korea
| | - Mi Jin Jeong
- Korea Disease Control and Prevention Agency COVID-19 Vaccination Task Force, Cheongju-si, Korea
| | - Young June Choe
- Department of Paediatrics, Korea University Anam Hospital, Seoul, Korea.
| | - Syngjoo Choi
- Department of Economics. College of Social Sciences, Seoul National University, Seoul, Korea.
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Kim RK, Choe YJ, Jang EJ, Chae C, Hwang JH, Lee KH, Shim JA, Kwon GY, Lee JY, Park YJ, Lee SW, Kwon D. Comparative Effectiveness of COVID-19 Bivalent Versus Monovalent mRNA Vaccines in the Early Stage of Bivalent Vaccination in Korea: October 2022 to January 2023. J Korean Med Sci 2023; 38:e396. [PMID: 38013649 PMCID: PMC10681846 DOI: 10.3346/jkms.2023.38.e396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/24/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND This retrospective observational matched-cohort study of 2,151,216 individuals from the Korean coronavirus disease 2019 (COVID-19) vaccine effectiveness cohort aimed to evaluate the comparative effectiveness of the COVID-19 bivalent versus monovalent vaccines in providing additional protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, critical infection, and death in Korea. METHODS Among individuals, those vaccinated with COVID-19 bivalent vaccines were matched in a 1:1 ratio with those who were vaccinated with monovalent vaccines (bivalent vaccines non-recipients) during the observation period. We fitted a time-dependent Cox proportional-hazards model to estimate hazard ratios (HRs) of COVID-19 outcomes for infection, critical infection, and death, and we defined vaccine effectiveness (VE) as 1-HR. RESULTS Compared with the bivalent vaccination group, the incidence proportions in the monovalent vaccination group were approximately three times higher for infection, nine times higher for critical infection, and 11 times higher for death. In the early stage of bivalent vaccination, relative VE of bivalent vaccine against monovalent vaccine was 42.4% against SARS-CoV-2 infection, 81.3% against critical infection, and 85.3% against death. In addition, VE against critical infection and death according to the elapsed period after bivalent vaccination was maintained at > 70%. CONCLUSION The bivalent booster dose provided additional protection against SARS-CoV-2 infections, critical infections, and deaths during the omicron variant phase of the COVID-19 pandemic.
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Affiliation(s)
- Ryu Kyung Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young June Choe
- Korea University Anam Hospital and Allergy and Immunology Center, Korea University, Seoul, Korea
| | - Eun Jung Jang
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Chungman Chae
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ji Hae Hwang
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Kil Hun Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ji Ae Shim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Geun-Yong Kwon
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jae Young Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young-Joon Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sang Won Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Donghyok Kwon
- Korea Disease Control and Prevention Agency, Cheongju, Korea.
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Lee J, Kwon SL, Park J, Bae H, Lee H, Kwon GY. JYNNEOS vaccine safety monitoring in the Republic of Korea, 2022: a cross-sectional study. Osong Public Health Res Perspect 2023; 14:433-438. [PMID: 37920899 PMCID: PMC10626317 DOI: 10.24171/j.phrp.2023.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND With the recent global mpox outbreak, the JYNNEOS vaccine (Modified Vaccinia Ankara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initially favored for mpox immunization. Vaccine-associated side effects contribute to vaccine hesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events. METHODS Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information about specific adverse events, including both local and systemic reactions, was collected. RESULTS The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site. CONCLUSION The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccine administration techniques and the vaccine's effects on broader demographics.
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Affiliation(s)
- Jaeeun Lee
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Seunghyun Lewis Kwon
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- KDI School of Public Policy and Management, Sejong, Republic of Korea
| | - Jinhee Park
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyuna Bae
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyerim Lee
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Division of Immunization Planning, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Geun-Yong Kwon
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
- Division of Immunization Planning, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Park SK, Choe YJ, Jang EJ, Kim RK, Lee SW, Kwon GY, Shin J, Choi SY, Jeong MJ, Park YJ. Effectiveness of Heterologous COVID-19 Vaccine Booster in Korean Elderly Population, 2022. J Korean Med Sci 2023; 38:e143. [PMID: 37191847 DOI: 10.3346/jkms.2023.38.e143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/21/2023] [Indexed: 05/17/2023] Open
Abstract
We conducted a cohort study to assess vaccine effectiveness (VE) of coronavirus disease 2019 vaccine combinations on severe acute respiratory syndrome coronavirus 2 critical infection and death among elderly population in Korea. From January to August 2022, VE against death for 4 doses mRNA recipients was 96.1%, whereas 1-dose viral vector + 3-dose mRNA recipients had VE of 90.8%.
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Affiliation(s)
| | - Young June Choe
- Korea University Anam Hospital and Allergy and Immunology Center, Korea University, Seoul, Korea
| | - Eun Jung Jang
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Ryu Kyung Kim
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sang-Won Lee
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Geun-Yong Kwon
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jeeyeon Shin
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sang-Yoon Choi
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Mi Jin Jeong
- Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Young-Joon Park
- Korea Disease Control and Prevention Agency, Cheongju, Korea.
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Kim SJ, Kwon SL, Lee JY, Oh J, Kwon GY. Why school is crucial to increase vaccination coverage for children: Evaluation of school vaccination check program in South Korea 2021-2022. Vaccine 2023; 41:3380-3386. [PMID: 37105889 DOI: 10.1016/j.vaccine.2023.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
The School Vaccination Check Program (SVCP) is a public health measure that aims to achieve high levels of National Immunization Program (NIP) vaccination coverage for children by checking the completion of the vaccination schedule for students when they enter elementary or middle school. Due to the COVID-19 pandemic, the SVCP was stopped in 2020 and 2021, and restarted in June-August 2022. In this study, we examined and quantified the relationship with SVCP and the vaccination uptake by comparing the vaccination coverage of 2021 and 2022. Based on the standard schedule, the vaccination records of DTaP5, IPV4, MMR2 and IJEV4 were evaluated for elementary school students. The Tdap6, IJEV5 and HPV1 were evaluated for the students from middle school. Using a difference-in-difference study design and national level big data, the study compared vaccination coverage as of August 2021 and 2022. The study found that the SVCP was effective in increasing vaccination coverage for targeted vaccinations such as DTaP5, IPV4, MMR2 and IJEV4 for elementary school students, and Tdap6, IJEV5 for middle school students. However, the SVCP did not show a statistically significant effect on increasing vaccination coverage on HPV1 for middle school students. School can play an important role to improve vaccination coverage. Therefore, close collaboration with health and education authority is crucial to accomplish successful vaccination program reducing vaccine preventable disease outbreaks in schools.
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Affiliation(s)
- Seon Ju Kim
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Seunghyun Lewis Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea; KDI School of Public Policy and Management, Sejong, Republic of Korea.
| | - Jae Young Lee
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Juhwan Oh
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Park SK, Choe YJ, Jang EJ, Kim RK, Lim DS, Yi S, Lee S, Kwon GY, Shin JY, Choi SY, Jeong MJ, Park YJ. Effectiveness of fourth dose of COVID-19 mRNA vaccine in elderly population during Omicron BA.2 and BA.5 circulation: nationwide cohort study in Korea (K-COVE). Open Forum Infect Dis 2023; 10:ofad109. [PMID: 36968954 PMCID: PMC10034752 DOI: 10.1093/ofid/ofad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Abstract
We estimate the effectiveness of 4th dose booster of COVID-19 mRNA vaccine in individuals aged >=60 years during Omicron BA.2 and BA.5 circulation in Korea. The effectiveness against critical infection was 67.7% (95% CI 50.7%-78.8%) at 31-60 days and 62.1% (45.5%-73.7%) at 61-90 days.
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Affiliation(s)
- Seon Kyeong Park
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | | | - Eun Jung Jang
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Ryu Kyung Kim
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Do-Sang Lim
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Seonju Yi
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Sangwon Lee
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Geun-Yong Kwon
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Jee Yeon Shin
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Sang-Yoon Choi
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Mi Jin Jeong
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
| | - Young-Joon Park
- Korea Disease Control and Prevention Agency , Cheongju , South Korea
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Cho HK, Lee H, Choe YJ, Kim S, Seo S, Moon J, Choi EH, Kwon GY, Shin JY, Choi SY, Jeong MJ, You M. Parental concerns on COVID-19 vaccine safety and hesitancy in Korea: Implications for vaccine communication. Epidemiol Health 2022; 45:e2023004. [PMID: 36596737 DOI: 10.4178/epih.e2023004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/13/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives Vaccination is one of the most important strategies to contain the spread of COVID-19. As vaccination in children is dependent on parents, it is important to understand parents' awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children. Methods A web-based nationwide survey was conducted among Korean parents of 7-18- year-old children in August 2021 to estimate parents' intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy using regression analysis. Results Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were mothers (aOR 0.36, 95% CI 0.25-0.52), parents with lower education (aOR 0.83, 95% CI 0.70-0.97), hesitancy to other childhood vaccines (aOR 0.78, 95% CI 0.64-0.96), and refusal to vaccinate themselves (aOR 0.08, 95% CI 0.02-0.20). Children of older age (aOR 1.2, 95% CI 1.13-1.28), trust to child's doctor (aOR 1.19, 95% CI 1.07-1.32),parents who showed positive perception about the effectiveness of the COVID-19 (aOR 2.6, 95% CI 1.9-3.57), and those who reported low risk of COVID-19 vaccine (aOR 1.68, 95% CI 1.27-2.24) were associated with COVID-19 vaccine acceptance. The most common cause of hesitancy was a concern about experiencing adverse reactions. Conclusion Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase uptake of COVID-19 vaccine in children. Differential or targeted approaches to parents according to gender, age and age of children are necessary for effective communication on the vaccination in children.
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Affiliation(s)
- Hye-Kyung Cho
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Shinkyeong Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sujin Seo
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Jiwon Moon
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jee Yeon Shin
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Sang-Yoon Choi
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Mi Jin Jeong
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Myoungsoon You
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
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11
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Lee M, Seo S, Choi S, Park JH, Kim S, Choe YJ, Choi EH, Kwon GY, Shin JY, Choi SY, Jeong MJ, Lee H, You M. Parental Acceptance of COVID-19 Vaccination for Children and Its Association With Information Sufficiency and Credibility in South Korea. JAMA Netw Open 2022; 5:e2246624. [PMID: 36515950 PMCID: PMC9856328 DOI: 10.1001/jamanetworkopen.2022.46624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Vaccination against COVID-19 is an effective method for individuals to reduce negative health outcomes. However, widespread COVID-19 vaccination among children has been challenging owing to parental hesitancy. OBJECTIVE To examine parental decision-making in favor of the COVID-19 vaccine for their children and its association with the sufficiency and credibility of the information about the vaccine. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study was conducted in South Korea from February 7 to 10, 2022, 7 weeks before initiation of the COVID-19 vaccine for children aged 5 to 11 years. Parents were included if they spoke Korean and had at least 1 child in elementary school (grades 1-6). Parents and children were included in a 1:1 ratio; a total of 113 450 parents and 113 450 children were included in the analysis. Statistical analysis was performed between March and April 2022. MAIN OUTCOMES AND MEASURES The main outcomes of interest were (1) parental acceptance of COVID-19 vaccination for their children and (2) its association with self-reported sufficiency and credibility of information about the vaccine. A multivariable logistic regression was used to evaluate factors associated with parental decision-making in favor of COVID-19 vaccination; path analysis was used to examine indirect effects of information sufficiency and credibility. RESULTS Of the 113 450 children, 58 342 (51.4%) were boys, and the mean (SD) age was 10.1 (1.5) years. Of the 113 450 parents who responded, 7379 (6.5%) were accepting vaccination for their children; 15 731 (13.9%) reported the vaccine-related information they received was sufficient, and 23 021 (20.3%) reported the information was credible. Parents who reported that the information was sufficient were 3.08 times (95% CI, 2.85-3.33; P < .001) more likely to report being willing to vaccinate their children than those who believed the information was insufficient, and those who reported that the information was credible were 7.55 times (95% CI, 6.46-8.87; P < .001) more likely to report being willing to vaccinate their children than those who believed the information was not credible. Higher levels of information sufficiency and credibility were associated with perceptions of increased vaccine safety (sufficiency: β = 0.08; P < .001; credibility: β = 0.59; P < .001) and effectiveness (sufficiency: β = 0.05; P < .001; credibility: β = 0.60; P < .001). CONCLUSIONS AND RELEVANCE In this study, a significant association was found between self-reported sufficiency and credibility of vaccine-related information and parental decision-making regarding COVID-19 vaccination for their children, suggesting that communications and policies that provide sound information are essential to improve vaccination rates.
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Affiliation(s)
- Minjung Lee
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
- Office of Dental Education, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Sujin Seo
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Syngjoo Choi
- Department of Economics, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jung Hyun Park
- Department of Economics, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Shinkyeong Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Young June Choe
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Republic of Korea
| | - Geun-Yong Kwon
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jee Yeon Shin
- Division of Immunization, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Sang-Yoon Choi
- COVID-19 Vaccination Task Force, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Mi Jin Jeong
- COVID-19 Vaccination Task Force, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Myoungsoon You
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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12
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Kim YY, Choe YJ, Kim J, Kim RK, Jang EJ, Park SK, Lim DS, Yi S, Lee S, Kwon GY, Shin JY, Choi SY, Jeong MJ, Park YJ. Effectiveness of Second mRNA COVID-19 Booster Vaccine in Immunocompromised Persons and Long-Term Care Facility Residents. Emerg Infect Dis 2022; 28:2165-2170. [PMID: 36191615 PMCID: PMC9622254 DOI: 10.3201/eid2811.220918] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We used a nationwide population registry in South Korea to estimate the effect of a second booster dose of mRNA COVID-19 vaccine on the risk for laboratory-confirmed SARS-CoV-2 infection, critical infection, and death in immunocompromised persons and long-term care facility (LTCF) residents. During February 16-May 7, 2022, among 972,449 eligible persons, 736,439 (75.7%) received a first booster and 236,010 (24.3%) persons received a second booster. Compared with the first booster group, at 30-53 days, the second booster recipients had vaccine effectiveness (VE) against all infections of 22.28% (95% CI 19.35%-25.11%), VE against critical infection of 56.95% (95% CI 29.99%-73.53%), and VE against death of 62.96% (95% CI 34.18%-79.15%). Our findings provide real-world evidence that a second booster dose of mRNA vaccine substantially increases protection against critical infection and death in these high-risk population groups.
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13
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Kwon SL, Ban S, Shin J, Bae H, Park H, Kwon GY. Monkeypox Vaccination in the Republic of Korea: Identifying the High-Risk Target Group. J Korean Med Sci 2022; 37:e239. [PMID: 35880509 PMCID: PMC9313979 DOI: 10.3346/jkms.2022.37.e239] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/26/2022] Open
Abstract
In June 2022, the first monkeypox case was reported as imported into Korea. The general public asked whether they should get vaccinated against monkeypox because of the recent COVID-19 vaccination experience. As of the current monkeypox outbreak situation, a ring vaccination strategy for the high-risk group is more appropriate than the mass population vaccination with smallpox vaccines. Therefore, identifying the proper target group by available vaccines based on the risk and benefit analysis is a key issue of the vaccination program. In addition, the target group should be reviewed by the epidemiological situation of the jurisdiction along with the updated evidence of the monkeypox virus on transmission dynamics, severity, and fatality.
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Affiliation(s)
- Seunghyun Lewis Kwon
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea.
| | - Seonhwa Ban
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Jeeyeon Shin
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hyuna Bae
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Heeyoun Park
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Geun-Yong Kwon
- Division of Immunization, Bureau of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea
- Central Disease Control Headquarters of Monkeypox, Korea Disease Control and Prevention Agency, Cheongju, Korea
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14
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Choi YK, Moon JY, Kim J, Yoo IS, Kwon GY, Bae H, Song MS, Kym S. Postvaccination Multisystem Inflammatory Syndrome in Adult with No Evidence of Prior SARS-CoV-2 Infection. Emerg Infect Dis 2021; 28:411-414. [PMID: 34852213 PMCID: PMC8798698 DOI: 10.3201/eid2802.211938] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ten days after receiving the first dose of coronavirus disease vaccine, a 22-year-old woman in South Korea experienced myocarditis, myopathy, pericarditis, and gastroenteritis; rash subsequently developed. There was no evidence of prior infection with severe acute respiratory syndrome coronavirus 2. The diagnosis was multisystem inflammatory syndrome resulting from coronavirus disease vaccination.
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15
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Kim YI, Kim SM, Park SJ, Kim EH, Yu KM, Chang JH, Kim EJ, Casel MAB, Rollon R, Jang SG, Um J, Song MS, Jeong HW, Kim EG, Kim Y, Kim SY, Park JS, Park MS, Kwon GY, Yeo SG, Lee SA, Choi YJ, Jung JU, Choi YK. Critical role of neutralizing antibody for SARS-CoV-2 reinfection and transmission. Emerg Microbes Infect 2021; 10:152-160. [PMID: 33407005 PMCID: PMC7832474 DOI: 10.1080/22221751.2021.1872352] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/07/2020] [Accepted: 12/30/2020] [Indexed: 01/22/2023]
Abstract
Cases of laboratory-confirmed SARS-CoV-2 reinfection have been reported in a number of countries. Further, the level of natural immunity induced by SARS-CoV-2 infection is not fully clear, nor is it clear if a primary infection is protective against reinfection. To investigate the potential association between serum antibody titres and reinfection of SARS-CoV-2, ferrets with different levels of NAb titres after primary SARS-CoV-2 infection were subjected to reinfection with a heterologous SARS-CoV-2 strain. All heterologous SARS-CoV-2 reinfected ferrets showed active virus replication in the upper respiratory and gastro-intestinal tracts. However, the high NAb titre group showed attenuated viral replication and rapid viral clearance. In addition, direct-contact transmission was observed only from reinfected ferrets with low NAb titres (<20), and not from other groups. Further, lung histopathology demonstrated the presence of limited inflammatory regions in the high NAb titre groups compared with control and low NAb groups. This study demonstrates a close correlation between a low NAb titre and SARS-CoV-2 reinfection in a recovered ferret reinfection model.
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Affiliation(s)
- Young-Il Kim
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Se-Mi Kim
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Su-Jin Park
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
- Division of Life Science and Research Institute of Life Sciences, Gyeongsang National University, Jinju, Korea
| | - Eun-Ha Kim
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Kwang-Min Yu
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Jae-Hyung Chang
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Eun Ji Kim
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Mark Anthony B. Casel
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Rare Rollon
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Seung-Gyu Jang
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Jihye Um
- Research institute of Public Health, National Medical Center, Seoul, Republic of Korea
| | - Min-Suk Song
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Hye Won Jeong
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Eung-Gook Kim
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Yeonjae Kim
- Research institute of Public Health, National Medical Center, Seoul, Republic of Korea
| | - So Yeon Kim
- Research institute of Public Health, National Medical Center, Seoul, Republic of Korea
| | - Jun-Sun Park
- Research institute of Public Health, National Medical Center, Seoul, Republic of Korea
| | - Mi Sun Park
- Div. of Public Health Research, Sejong Institute of Health & Environment, Sejong City, Republic of Korea
| | - Geun-Yong Kwon
- Sejong Public Health Center, Sejong City, Republic of Korea
| | - Sang Gu Yeo
- Div. of Public Health Research, Sejong Institute of Health & Environment, Sejong City, Republic of Korea
| | - Shin-Ae Lee
- Department of Cancer Biology and Center for Global and Emerging Pathogen Research, Lerner Research Institute, Cleveland, OH, USA
| | - Youn Jung Choi
- Department of Cancer Biology and Center for Global and Emerging Pathogen Research, Lerner Research Institute, Cleveland, OH, USA
| | - Jae U. Jung
- Department of Cancer Biology and Center for Global and Emerging Pathogen Research, Lerner Research Institute, Cleveland, OH, USA
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
- Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
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16
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Choi GJ, Baek SH, Kim J, Kim JH, Kwon GY, Kim DK, Jung YH, Kim S. Fatal Systemic Capillary Leak Syndrome after SARS-CoV-2Vaccination in Patient with Multiple Myeloma. Emerg Infect Dis 2021; 27:2973-2975. [PMID: 34459725 PMCID: PMC8544977 DOI: 10.3201/eid2711.211723] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A young man with smoldering multiple myeloma died of hypotensive shock 2.5 days after severe acute respiratory syndrome coronavirus 2 vaccination. Clinical findings suggested systemic capillary leak syndrome (SCLS); the patient had experienced a previous suspected flare episode. History of SCLS may indicate higher risk for SCLS after receiving this vaccine.
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17
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Park JH, Kim HJ, Kwon GY, Gwack J, Park YJ, Youn SK, Kwon JW, Yang BG, Lee MS, Jung M, Lee H, Jun BY, Lim HS. Humidifier Disinfectants Are a Cause of Lung Injury among Adults in South Korea: A Community-Based Case-Control Study. PLoS One 2016; 11:e0151849. [PMID: 26990641 PMCID: PMC4798643 DOI: 10.1371/journal.pone.0151849] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/04/2016] [Indexed: 11/19/2022] Open
Abstract
Backgrounds An outbreak of lung injury among South Korean adults was examined in a hospital-based case-control study, and the suspected cause was exposure to humidifier disinfectant (HD). However, a case-control study with community-dwelling controls was needed to validate the previous study’s findings, and to confirm the exposure-response relationship between HD and lung injury. Methods Each case of lung injury was matched with four community-dwelling controls, according to age (±3 years), sex, residence, and history of childbirth since 2006 (for women). Environmental risk factors, which included type and use of humidifier and HD, were investigated using a structured questionnaire during August 2011. The exposure to HD was calculated for both cases and controls, and the corresponding risks of lung injury were compared. Results Among 28 eligible cases, 16 patients agreed to participate, and 60 matched controls were considered eligible for this study. The cases were more likely to have been exposed to HD (odds ratio: 116.1, 95% confidence interval: 6.5–2,063.7). All cases were exposed to HDs containing polyhexamethyleneguanidine phosphate, and the risk of lung injury increased with the cumulative exposure, duration of exposure, and exposure per day. Conclusions This study revealed a statistically significant exposure-response relationship between HD and lung injury. Therefore, continuous monitoring and stricter evaluation of environmental chemicals’ safety should be conducted.
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Affiliation(s)
- Ji-Hyuk Park
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Jin Gwack
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Young-Joon Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Jun-Wook Kwon
- Center for Infectious Disease Control, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Byung-Guk Yang
- Bureau of Public Health Policy, Ministry of Health and Welfare, Sejong, South Korea
| | - Moo-Song Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Miran Jung
- Department of Nursing, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hanyi Lee
- Department of Nursing, Hanyang University, Seoul, South Korea
| | - Byung-Yool Jun
- Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Hyun-Sul Lim
- Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea
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18
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Hwang SM, Yoon SJ, Jung YM, Kwon GY, Jo SN, Jang EJ, Kwon MO. Assessing the impact of meteorological factors on malaria patients in demilitarized zones in Republic of Korea. Infect Dis Poverty 2016; 5:20. [PMID: 26955803 PMCID: PMC4782315 DOI: 10.1186/s40249-016-0111-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 03/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background The trend of military patients becoming infected with vivax malaria reemerged in the Republic of Korea (ROK) in 1993. The common explanation has been that infective Anopheles mosquitoes from the Democratic People’s Republic of Korea have invaded Republic of Korea’s demilitarized zone (DMZ). The aim of this study was to verify the relationship between meteorological factors and the number of malaria patients in the military in this region. Methods The authors estimated the effects of meteorological factors on vivax malaria patients from the military based on the monthly number of malaria cases between 2006 and 2011. Temperature, precipitation, snow depth, wind velocity, relative humidity, duration of sunshine, and cloud cover were selected as the meteorological factors to be studied. A systematic pattern in the spatial distribution of malaria cases was assessed using the Moran’s Index. Granger causality tests and cross-correlation coefficients were used to evaluate the relationship between meteorological factors and malaria patients in the military. Results Spatial analysis revealed significant clusters of malaria patients in the military in Republic of Korea in 2011 (Moran’s I = 0.136, p-value = 0.026). In the six years investigated, the number of malaria patients in the military in Paju decreased, but the number of malaria patients in the military in Hwacheon and Chuncheon increased. Monthly average, maximum and minimum temperatures; wind velocity; and relative humidity were found to be predicting factors of malaria in patients in the military in Paju. In contrast, wind velocity alone was not able to predict malaria in Hwacheon and Chuncheon, however, precipitation and cloud cover were able to predict malaria in Hwacheon and Chuncheon. Conclusions This study demonstrated that the number of malaria patients in the military is correlated with meteorological factors. The variation in occurrence of malaria cases was principally attributed to differences in meteorological factors by regions of Republic of Korea. Electronic supplementary material The online version of this article (doi:10.1186/s40249-016-0111-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Se-Min Hwang
- Korea Human Resource Development Institute for Health & Welfare, Osong, Republic of Korea. .,Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Armed Forces Medical Command, Seongnam, Republic of Korea.
| | - Seok-Joon Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea. .,Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University, 73 Inchon-ro., Seongbuk-Gu, Seoul, 136-705, Republic of Korea.
| | - Yoo-Mi Jung
- Korea Armed Forces Nursing Academy, 90 Jaun-ro, Yuseong-gu, Daejeon, 305-153, Republic of Korea.
| | - Geun-Yong Kwon
- Korean Centers for Disease Control and Prevention, Osong, Republic of Korea.
| | - Soo-Nam Jo
- Korean Centers for Disease Control and Prevention, Osong, Republic of Korea.
| | - Eun-Jeong Jang
- Korean Centers for Disease Control and Prevention, Osong, Republic of Korea.
| | - Myoung-Ok Kwon
- Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University, 73 Inchon-ro., Seongbuk-Gu, Seoul, 136-705, Republic of Korea. .,Korea Armed Forces Nursing Academy, 90 Jaun-ro, Yuseong-gu, Daejeon, 305-153, Republic of Korea.
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Kim SW, Kwon GY, Kim B, Kwon D, Shin J, Bae GR. Imported Melioidosis in South Korea: A Case Series with a Literature Review. Osong Public Health Res Perspect 2015; 6:363-8. [PMID: 26835246 PMCID: PMC4700768 DOI: 10.1016/j.phrp.2015.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 11/28/2022] Open
Abstract
Objectives Melioidosis is a potentially fatal infectious disease caused by the environmental anaerobic Gram-negative bacillus Burkholderia pseudomallei. Melioidosis is endemic to areas of northern Australia and Southeast Asia. With increasing international travel and migration, imported cases of melioidosis are being reported regularly. Here, we summarize the 11 cases of melioidosis reported in South Korea from 2003 to 2014. Methods Tracing epidemiological investigations were performed on every patient reported to the National Surveillance System since 2011. A systematic literature search was performed to identify melioidosis cases that occurred prior to 2011. Results The overall fatality rate was 36.4%. All the patients had visited Southeast Asia where melioidosis is endemic. The stay in the endemic region ranged from 4 days to 20 years. Of the seven patients who developed initial symptoms after returning to South Korea, the time interval between returning to South Korea and symptom onset ranged from 1 day to 3 years. The remaining four patients developed symptoms during their stay in the endemic region and were diagnosed with melioidosis in South Korea. Seven (63.6%) patients possessed at least one risk factor, all of whom were diabetic. Pneumonia was the most frequent clinical manifestation, but the patients showed a wide spectrum of clinical features, including internal organ abscesses, a mycotic aneurysm of the aorta, and coinfection with tuberculosis. Conclusion An early diagnosis and initiation of the appropriate antibiotics can reduce the mortality of melioidosis. Consequently, increased awareness of the risk factors and clinical features of melioidosis is required.
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Affiliation(s)
- Seung Woo Kim
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Geun-Yong Kwon
- Division of HIV and Tuberculosis Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Bongyoung Kim
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Donghyok Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Jaeseung Shin
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Geun-Ryang Bae
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongju, Korea
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Lönnroth K, Migliori GB, Abubakar I, D'Ambrosio L, de Vries G, Diel R, Douglas P, Falzon D, Gaudreau MA, Goletti D, González Ochoa ER, LoBue P, Matteelli A, Njoo H, Solovic I, Story A, Tayeb T, van der Werf MJ, Weil D, Zellweger JP, Abdel Aziz M, Al Lawati MR, Aliberti S, Arrazola de Oñate W, Barreira D, Bhatia V, Blasi F, Bloom A, Bruchfeld J, Castelli F, Centis R, Chemtob D, Cirillo DM, Colorado A, Dadu A, Dahle UR, De Paoli L, Dias HM, Duarte R, Fattorini L, Gaga M, Getahun H, Glaziou P, Goguadze L, del Granado M, Haas W, Järvinen A, Kwon GY, Mosca D, Nahid P, Nishikiori N, Noguer I, O'Donnell J, Pace-Asciak A, Pompa MG, Popescu GG, Robalo Cordeiro C, Rønning K, Ruhwald M, Sculier JP, Simunović A, Smith-Palmer A, Sotgiu G, Sulis G, Torres-Duque CA, Umeki K, Uplekar M, van Weezenbeek C, Vasankari T, Vitillo RJ, Voniatis C, Wanlin M, Raviglione MC. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J 2015; 45:928-52. [PMID: 25792630 PMCID: PMC4391660 DOI: 10.1183/09031936.00214014] [Citation(s) in RCA: 528] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 01/02/2015] [Indexed: 12/31/2022]
Abstract
This paper describes an action framework for countries with low tuberculosis (TB) incidence (<100 TB cases per million population) that are striving for TB elimination. The framework sets out priority interventions required for these countries to progress first towards "pre-elimination" (<10 cases per million) and eventually the elimination of TB as a public health problem (less than one case per million). TB epidemiology in most low-incidence countries is characterised by a low rate of transmission in the general population, occasional outbreaks, a majority of TB cases generated from progression of latent TB infection (LTBI) rather than local transmission, concentration to certain vulnerable and hard-to-reach risk groups, and challenges posed by cross-border migration. Common health system challenges are that political commitment, funding, clinical expertise and general awareness of TB diminishes as TB incidence falls. The framework presents a tailored response to these challenges, grouped into eight priority action areas: 1) ensure political commitment, funding and stewardship for planning and essential services; 2) address the most vulnerable and hard-to-reach groups; 3) address special needs of migrants and cross-border issues; 4) undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatment; 5) optimise the prevention and care of drug-resistant TB; 6) ensure continued surveillance, programme monitoring and evaluation and case-based data management; 7) invest in research and new tools; and 8) support global TB prevention, care and control. The overall approach needs to be multisectorial, focusing on equitable access to high-quality diagnosis and care, and on addressing the social determinants of TB. Because of increasing globalisation and population mobility, the response needs to have both national and global dimensions.
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Affiliation(s)
- Knut Lönnroth
- Global TB Programme, World Health Organization, Geneva, Switzerland
- Both authors contributed equally
| | - Giovanni Battista Migliori
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
- Both authors contributed equally
| | - Ibrahim Abubakar
- TB Section, University College London and Public Health England, London, UK
| | - Lia D'Ambrosio
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | - Roland Diel
- University Hospital Schleswig Holstein, Institute for Epidemiology, Kiel, Germany
| | - Paul Douglas
- Global Health Borders Refugee and Onshore Services, Dept of Immigration and Border Protection, Sydney, Australia
| | - Dennis Falzon
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Marc-Andre Gaudreau
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Delia Goletti
- National Institute for Infectious Diseases, Rome, Italy
| | - Edilberto R. González Ochoa
- Research and Surveillance Group on TB, Leprosy and ARI, Epidemiology Board, Institute of Tropical Medicine “Pedro Kourí”, Havana, Cuba
| | - Philip LoBue
- Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Howard Njoo
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Montreal, QC, Canada
| | - Ivan Solovic
- TB Dept, National Institute for TB, Respiratory Diseases and Thoracic Surgery, Vysne Hagy, Catholic University, Ružomberok, Slovakia
| | | | - Tamara Tayeb
- National TB Control Programme, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Diana Weil
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | - Stefano Aliberti
- Università degli Studi di Milano – Bicocca, UO Clinica Pneumologica, AO San Gerardo, Monza, Italy
| | | | | | - Vineet Bhatia
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Francesco Blasi
- Dipartimento Fisiopatologia Medico-Chirurgica e dei Trapianti, University of Milan, IRCCS Fondazione Cà Granda, Milan, Italy
| | - Amy Bloom
- US Agency for International Development, Washington, DC, USA
| | - Judith Bruchfeld
- Unit of Infectious Diseases, Institution of Medicine, Karolinska Institute Solna and Karolinska University Hospital, Stockholm, Sweden
| | | | - Rosella Centis
- WHO Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, IRCCS, Tradate, Italy
| | | | | | | | - Andrei Dadu
- TB and M/XDR-TB Control Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Ulf R. Dahle
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Hannah M. Dias
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | - Mina Gaga
- National Referral Centre for Mycobacteria, Athens Chest Hospital, Ministry of Health, Athens, Greece
| | | | - Philippe Glaziou
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Lasha Goguadze
- International Federation of Red Cross and Red Crescent Societies, Geneva, Switzerland
| | | | - Walter Haas
- Dept of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Asko Järvinen
- Finnish Lung Health Association, Helsinki, Finland
- Helsinki University Central Hospital, Division of Infectious Diseases, Helsinki, Finland
| | - Geun-Yong Kwon
- Korea Centers for Disease Control and Prevention (KCDC), Ministry of Health and Welfare, Seoul, Republic of Korea
| | - Davide Mosca
- International Organization for Migration, Geneva, Switzerland
| | - Payam Nahid
- University of California, San Francisco, CA, USA
- American Thoracic Society (ATS), New York, NY, USA
| | - Nobuyuki Nishikiori
- Stop TB and Leprosy Elimination, WHO Regional Office for the Western Pacific, Manila, Philippines
| | | | - Joan O'Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | | | | | | | | | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Biomedical Sciences, University of Sassari, Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Giorgia Sulis
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | - Carlos A. Torres-Duque
- Asociacion Latinoamericana de Torax (ALAT) - Fundacion Neumologica Colombiana, Bogota, Colombia
| | | | - Mukund Uplekar
- Global TB Programme, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Maryse Wanlin
- Fonds des Affections Respiratoires (FARES), Brussels, Belgium
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Kwon Y, Kim SJ, Kim J, Kim SY, Song EM, Lee EJ, Choi Y, Kim Y, Lim BO, Kim DS, Choi D, Kim HS, Park JE, Yun JE, Park JA, Jung JR, Kim JK, Kang SH, Hong SY, Lee SJ, Park SJ, Park SH, Yoon S, Kim Y, Choi Y, Seo YJ, Seo YA, Park J, Sung M, Shin M, Son H, Lee Y, Go U, Kwon GY. Results of tuberculosis contact investigation in congregate settings in Korea, 2013. Osong Public Health Res Perspect 2014; 5:S30-6. [PMID: 25861578 PMCID: PMC4301638 DOI: 10.1016/j.phrp.2014.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aimed to check the status of the contact investigation in congregate settings to eradicate tuberculosis (TB) in the Republic of Korea. Methods The “Integrated System for Disease and Public Health Management” is used for care and follow-up for patients and contacts of TB. We downloaded data for contact investigations conducted from January to December 2013. Results A total of 1,200 contact investigations in congregate settings were carried out by 25 field investigators in 2013. We performed the status of contact investigation, TB, and LTBI rate by age, accept rate of LTBI treatment, and complete rate of LTBI treatment during 2013. A total of 1,547 index TB patients, 149,166 contacts, and 259 additional TB patients were found through the investigation. Kindergartens showed the highest LTBI rate, 19.8%, among educational facilities. The second highest was in elementary schools and the subtotal LTBI rate of educational facilities was 7.8%. Social welfare/correctional facilities and workplaces showed relatively high LTBI rates of 23.8% and 23.6%, respectively. By age, individuals >35 years showed the highest LTBI rate, followed by those aged 0–4 years, 30–34 years, and 5–9 years, with rates of 18.1%, 16.4%, and 15.4% respectively. When comparing the tuberculin skin test (TST) positive conversion ratio by facility, middle school and high school were relatively high compared to the others. The accept rate of LTBI treatment in the workplace was lowest at 63% and the complete rate in elementary schools was lowest at 76.5%. Conclusion TB contact investigation is considered as a meaningful strategy for preventing TB outbreaks in congregate settings and decreasing the prevalence of TB in young people. Results of this study could be used to establish the LTBI management policy.
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Affiliation(s)
- Yunhyung Kwon
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - So Jung Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Jieun Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Seol-Yi Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Eun Mi Song
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Eun Jung Lee
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yun Choi
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yejin Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Byoung Ok Lim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Da Sul Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Duksun Choi
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Hye Sung Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Ji Eun Park
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Ji-Eun Yun
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Jin A Park
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Jong Rak Jung
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Joo-Kyoung Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Sang Hee Kang
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Seo Yean Hong
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Seung Jae Lee
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Soo Jin Park
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Sun Hwa Park
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Sunhye Yoon
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yoonsun Kim
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yunjeong Choi
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yun Jeong Seo
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Yul A Seo
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Jiseon Park
- KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Minhee Sung
- KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Minjang Shin
- KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
| | - Hyunjin Son
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Yeonkyeng Lee
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Unyeong Go
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Geun-Yong Kwon
- Division of HIV/AIDS and TB Control, Korea Centers for Disease Control and Prevention, Cheongju, Korea ; KTEIS (Korea Tuberculosis Epidemic Intelligence Service) Team, Cheongju, Korea
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Kwon GY, Lee H, Gwack J, Lee SW, Ki M, Youn SK. Regional distribution of hepatitis C virus infection in the Republic of Korea, 2007-2011. Gut Liver 2014; 8:428-32. [PMID: 25071909 PMCID: PMC4113042 DOI: 10.5009/gnl.2014.8.4.428] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 11/26/2013] [Accepted: 11/26/2013] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/AIMS In Korea, hepatitis C is included as an infectious disease in a sentinel surveillance system. Recently, a large variation in hepatitis C incidence between different regions in Korea has been noticed. The current study verified the nationwide distribution of hepatitis C infection for effective prevention and management. METHODS We counted the number of hepatitis C patients who visited a hospital per county using the National Health Insurance database from 2007 to 2011. The age-adjusted prevalence ratio was used, and the age adjustment method was used as an indirect standardization method. Disease mapping and spatial analysis were conducted using a geographic information system. RESULTS The annual prevalence of diagnosed hepatitis C was approximately 0.12% to 0.13% in Korea. The age-adjusted prevalence ratios in Busan, Jeonnam, and Gyeongnam were high (1.75, 1.4, and 1.3, respectively). The three regions in the southern coastal area of the Korean Peninsula were identified as a high-prevalence cluster (Moran's index, 0.3636). CONCLUSIONS The present study showed that hepatitis C infection has very large regional variation, and there are several high-risk areas. Preventive measures focusing on these areas should be applied to block the transmission of hepatitis C and reduce the disease burden.
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Affiliation(s)
- Geun-Yong Kwon
- Divisions of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Hyungmin Lee
- Divisions of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jin Gwack
- Divisions of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Sang-Won Lee
- Vaccine Research, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Moran Ki
- Department of Preventive Medicine, Eulji University, Daejeon, Korea
| | - Seung-Ki Youn
- Divisions of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
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Kim KW, Ahn K, Yang HJ, Lee S, Park JD, Kim WK, Kim JT, Kim HH, Rha YH, Park YM, Sohn MH, Oh JW, Lee HR, Lim DH, Choung JT, Han MY, Lee E, Kim HY, Seo JH, Kim BJ, Cho YA, Do KH, Kim SA, Jang SJ, Lee MS, Kim HJ, Kwon GY, Park JH, Gwack J, Youn SK, Kwon JW, Jun BY, Pyun BY, Hong SJ. Humidifier disinfectant-associated children's interstitial lung disease. Am J Respir Crit Care Med 2014; 189:48-56. [PMID: 24199596 DOI: 10.1164/rccm.201306-1088oc] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Beginning in 2006, epidemics of a fatal lung injury of unknown cause in children were observed in Korea every spring. A recent study demonstrated that this type of children's interstitial lung disease (chILD) is associated with humidifier disinfectant use. OBJECTIVES To determine the clinical characteristics of this type of chILD and to assess whether the nationwide suspension of humidifier disinfectant sales in the autumn of 2011 affected its incidence. METHODS The clinical characteristics of suspected cases between 2006 and 2011 were determined by a nationwide retrospective study. The potential causal relationship with humidifier disinfectants was examined by a prospective surveillance study after humidifier disinfectant sales were suspended. MEASUREMENTS AND MAIN RESULTS In total, 138 children were diagnosed with this type of chILD, which was characterized by rapid progression, high mortality, predominance in the spring season, and a familial tendency. The annual incidence increased in 2011 and then dropped to zero in 2012. The children were on average 30.4 months old. The most frequent symptoms at admission were cough and dyspnea. As the disease progressed, the typical complication was spontaneous air leak. Eighty children (58%) died. Two years after humidifier disinfectant-sale suspension, no more new cases were found. CONCLUSIONS This study suggests that humidifier disinfectant inhalation causes an idiopathic type of chILD that is characterized by spontaneous air leak, rapid progression, lack of response to treatment, and high mortality. Further safety studies must be performed on common environmental compounds, particularly those that enter the human body by an unusual route.
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Affiliation(s)
- Kyung Won Kim
- 1 Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
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Moon S, Sohn IW, Hong Y, Lee H, Park JH, Kwon GY, Lee S, Youn SK. Emerging Pathogens and Vehicles of Food- and Water-borne Disease Outbreaks in Korea, 2007-2012. Osong Public Health Res Perspect 2014; 5:34-9. [PMID: 24955310 PMCID: PMC4064638 DOI: 10.1016/j.phrp.2013.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 01/13/2014] [Accepted: 01/20/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Food- and water-borne disease outbreaks (FBDOs) are an important public health problem worldwide. This study investigated the trends in FBDOs in Korea and established emerging causal pathogens and causal vehicles. METHODS We analyzed FBDOs in Korea by year, location, causal pathogens, and causal vehicles from 2007 to 2012. Information was collected from the FBDOs database in the Korean Centers for Disease Control and Prevention. RESULTS During 2007-2012, a total of 1794 FBDOs and 48,897 patients were reported. After 2007, FBDOs and patient numbers steadily decreased over the next 2 years and then plateaued until 2011. However, in 2012, FBDOs increased slightly accompanied by a large increase in the number of affected patients. Our results highlight the emergence of norovirus and pathogenic Escherichia coli other than enterohemorrhagic E. coli (EHEC) in schools in 2012. We found that pickled vegetables is an emerging causal vehicle responsible for this problem. CONCLUSION On the basis of this study we recommend intensified inspections of pickled vegetable manufacturers and the strengthening of laboratory surveillance of relevant pathogens.
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Affiliation(s)
- Shinje Moon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Il-Woong Sohn
- Division of Health and Korean Medicine, Jeollanamdo Provincial Government, Muan, Korea
| | - Yeongseon Hong
- Department of Public Health, Sahmyook University Graduate School, Seoul, Korea
| | - Hyungmin Lee
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Ji-Hyuk Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Sangwon Lee
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
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25
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Kim HJ, Lee MS, Hong SB, Huh JW, Do KH, Jang SJ, Lim CM, Chae EJ, Lee H, Jung M, Park YJ, Park JH, Kwon GY, Gwack J, Youn SK, Kwon JW, Yang BG, Jun BY, Kim Y, Cheong HK, Chun BC, Kim H, Lee K, Koh Y. A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation. Thorax 2014; 69:703-8. [PMID: 24488371 DOI: 10.1136/thoraxjnl-2013-204132] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND In April 2011 a tertiary hospital in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. METHODS To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. Clinicopathological conferences led to the suspicion that the cases related to an inhalation injury. An age- and sex-matched case-control study was therefore performed to examine the inhalation exposure of the patients to various agents. RESULTS Of the 28 confirmed cases, 18 agreed to participate. A total of 121 age- and sex-matched controls with pulmonary, allergic or obstetric disease were selected. All patients and controls completed questionnaires with questions about exposure to various inhalants. The crude ORs for patient exposure to indoor mould, humidifier use, humidifier detergent use and insecticide use were 4.4 (95% CI 1.5 to 13.1), 13.7 (95% CI 1.8 to 106.3), 47.3 (95% CI 6.1 to 369.7) and 3.9 (95% CI 1.3 to 11.7), respectively. However, when considered concurrently, indoor mould and insecticide use lost statistical significance. Moreover, humidifier use was ruled out as the cause because of a lack of biological plausibility and the weak strength of the association. This suggested that humidifier disinfectant was the cause of the outbreak. This information led the Korean government to order the removal of humidifier detergents from the market. In the years following the ban, no additional cases were detected. CONCLUSIONS Epidemiological evidence strongly suggests that the lung injury outbreak was caused by humidifier detergent use at home.
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Affiliation(s)
- Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Moo-Song Lee
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Bum Hong
- Department of Pulmonary Medicine and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Won Huh
- Department of Pulmonary Medicine and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung-Hyun Do
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chae-Man Lim
- Department of Pulmonary Medicine and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun Jin Chae
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hanyi Lee
- Department of Nursing, Hanyang University, Seoul, Korea
| | - Miran Jung
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Young-Joon Park
- Division of Vaccine-preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Ji-Hyuk Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jin Gwack
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jun-Wook Kwon
- Center for Infectious Disease Control, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Byung-Guk Yang
- Bureau of Public Health Policy, Ministry of Health and Welfare, Seoul, Korea
| | - Byung-Yool Jun
- Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Heon Kim
- Department of Preventive Medicine and Medical Research Institute, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Kyuhong Lee
- Inhalation Toxicology Center, Korea Institute of Toxicology, Jeongeup, Korea
| | - Younsuck Koh
- Department of Pulmonary Medicine and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Kwon GY, Moon S, Kwak W, Gwack J, Chu C, Youn SK. Epidemic intelligence service officers and field epidemiology training program in Korea. Osong Public Health Res Perspect 2013; 4:215-21. [PMID: 24159559 PMCID: PMC3767107 DOI: 10.1016/j.phrp.2013.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/25/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022] Open
Abstract
Korea has adopted Epidemic Intelligence Service (EIS) officers through the Field Epidemiology Training Program (FETP) since 1999 for systematic control of emerging and re-emerging infectious diseases. Graduates of medical schools in Korea are selected and serve as public health doctors (PHDs) for their mandatory military service. The duration of service is 3 years and PHDs comprise general practitioners and specialists. Some PHDs are selected as EIS officers with 3 weeks basic FETP training and work for central and provincial public health authorities to conduct epidemiological investigations. The total number of EIS officers is 31 as of 2012. The Korea Centers for Disease Control and Prevention (KCDC) has 12 specialists, whereas specialists and each province has one or two EIS officers to administer local epidemiological investigations in 253 public health centers. The Korean EIS officers have successfully responded and prevented infectious diseases, but there is a unique limitation: the number of PHDs in Korea is decreasing and PHDs are not allowed to stay outside Korea, which makes it difficult to cope with overseas infectious diseases. Furthermore, after 3 years service, they quit and their experiences are not accumulated. KCDC has hired full-time EIS officers since 2012 to overcome this limitation.
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Affiliation(s)
- Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
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Yang HJ, Kim HJ, Yu J, Lee E, Jung YH, Kim HY, Seo JH, Kwon GY, Park JH, Gwack J, Youn SK, Kwon JW, Jun BY, Kim KW, Ahn K, Lee SY, Park JD, Kwon JW, Kim BJ, Lee MS, Do KH, Jang SJ, Pyun BY, Hong SJ. Inhalation toxicity of humidifier disinfectants as a risk factor of children's interstitial lung disease in Korea: a case-control study. PLoS One 2013; 8:e64430. [PMID: 23755124 PMCID: PMC3673956 DOI: 10.1371/journal.pone.0064430] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The occurrence of numerous cases of interstitial lung disease in children (chILD) every spring in Korea starting in 2006 raised suspicion about a causal relationship with the use of humidifier disinfectants (HDs). The aim of this study was to evaluate the association between HD use and the risk of chILD. METHODS This retrospective, 1∶3 matched case-control study consisted of 16 cases of chILD that had developed between 2010 and 2011. The three groups of parallel controls (patients with acute lobar pneumonia, asthma, and healthy children) were matched by age, gender, and index date. Indoor/outdoor environmental risk factors, including HD use, were investigated by asking the guardians to complete a questionnaire. RESULTS The median age of the affected children (43.8% male) was 26 months (18.25-36.25). The chILD group did not differ significantly from the control groups with respect to socio-demographic and clinical variables. Indoor and outdoor environmental factors were not associated with a risk of chILD. However, the previous use of HDs (OR; 2.73. 95% CI; 1.41-5.90, P = 0.00) were independently associated with an increased risk. CONCLUSIONS This study showed that HDs, which are widely used in South Korea in the winter season, independently increased the risk of chILD in spring. Therefore, continuous monitoring and, if needed, changes in policy are essential to prevent and control pediatric diseases caused by toxic chemicals.
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Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hwa-Jung Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Ho Jung
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyung-Young Kim
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Ji-Hyuk Park
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jin Gwack
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Jun-Wook Kwon
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Byung-Yool Jun
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
- Center for Infectious Disease Surveillance and Response, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Kyung Won Kim
- Department of Pediatrics and Institute of Allergy, Biomolecule Secretion Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Young Lee
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - June-Dong Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul University College of Medicine, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seoul University College of Medicine, Seungnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, University of Inje College of Medicine, Busan, Korea
| | - Moo-Song Lee
- Department of Preventive Medicine, Asan Cancer Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Hyun Do
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Se-Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bok-Yang Pyun
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- Research Center for Standardization of Allergic Diseases, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail: (BYP); (SJH)
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Seok HH, Kwon GY, Baek SH, Choi TH, Kim S. Comparison of the 3D Digital Photogrammetry and Direct Anthropometry in Unilateral Cleft Lip Patients. Arch Craniofac Surg 2013. [DOI: 10.7181/acfs.2013.14.1.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hyo Hyun Seok
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Geun-Yong Kwon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Seung-Hak Baek
- Department of Orthodontics, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae Hyun Choi
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sukwha Kim
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kim KZ, Min JY, Kwon GY, Sung JH, Cho SI. Directed Causal Network Construction Using Linkage Analysis with Metabolic Syndrome-Related Expression Quantitative Traits. Genomics Inform 2011. [DOI: 10.5808/gi.2011.9.4.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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30
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Kwon GY, Lim DS, Park EJ, Jung JS, Kang KW, Kim YA, Kim H, Cho SI. [Assessment of applicability of standardized rates for health state comparison among areas: 2008 Community Health Survey]. J Prev Med Public Health 2010; 43:174-84. [PMID: 20383051 DOI: 10.3961/jpmph.2010.43.2.174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES This study shows the issues that should be considered when applying standardized rates using Community Health Survey(CHS) data. METHODS We analyzed 2008 CHS data. In order to obtain the reliability of standardized rates, we calculated z-score and rank correlation coefficients between direct standardized rate and indirect standardized rate for 31 major indices. Especially, we assessed the change of correlations according to population composition (age and sex), and characteristics of the index. We used Mantel-Haenszel chi-square to quantify the difference of population composition. RESULTS Among 31 major indices, 29 indices' z-score and rank correlation coefficients were over 0.9. However, regions with larger differences in population composition showed lower reliability. Low reliability was also observed for the indices specific to subgroups with small denominator such as 'permanent lesion from stroke', and the index with large regional variations in age-related differences such as 'obtaining health examinations'. CONCLUSIONS Standardized rates may have low reliability, if comparison is made between areas with extremely large differences in population composition, or for indicies with large regional variations in age-related differences. Therefore, the special features of standardized rates should be considered when health state are compared among areas.
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Affiliation(s)
- Geun-Yong Kwon
- School of Public Health, Seoul National University, Korea
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Brar P, Kwon GY, Egbuna II, Holleran S, Ramakrishnan R, Bhagat G, Green PHR. Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease. Dig Liver Dis 2007; 39:26-9; discussion 30-2. [PMID: 16982222 DOI: 10.1016/j.dld.2006.07.014] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Revised: 07/10/2006] [Accepted: 07/26/2006] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.
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Affiliation(s)
- P Brar
- Department of Medicine, Pediatrics and Pathology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
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Lee J, Lee EN, Kim EY, Lee HJ, Park HJ, Sun CL, Lee SK, Joh JW, Lee KW, Kwon GY, Kim SJ. 4-1BB promotes long-term survival in skin allografts treated with anti-CD45RB and anti-CD40L monoclonal antibodies. Transplant Proc 2005; 37:123-5. [PMID: 15808569 DOI: 10.1016/j.transproceed.2005.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
4-1BB (CD137) is a T-cell co-stimulatory molecule that promotes T cell activation. Using a skin transplantation model, we observed that simultaneous administration of monoclonal antibodies (mAb) targeting CD45RB and CD40L prolonged skin allograft in co-stimulation blockade (CTLA4-Ig and anti-CD40L mAb)-resistant mice, because of reducing CD8(+) T cells and CD4(+) CD45RB(high) T cells. Anti-CD45RB mAb (45RB) blocks the activation of T helper 1 (Th1) cells and generates regulatory T cells (T(reg)). The experimental design included five groups: group 1, control; group 2, 45RB-MR1; group 3, 45B-MR1 + 4-IBBL; group 4, anti-CD4 mAb plus group 3 treatment; group 5, anti-CD8 mAb plus group 3 treatment. In this study we highlight the involvement of 4-1BB/4-1BBL in the development of T-cell responses. C57BL/6 recipients of BALB/c skin grafts were treated with 45RB, anti-CD40L mAb (MR1), and antagonistic anti-4-1BBL mAb (4-1BBL) on days 0, 2, 4, 6, and 8 posttransplantation. Additional 4-1BBL further prolonged skin graft survival, although the percentage of splenocyte-derived CD8(+) T cells was reduced similarly in both groups. Use of 4-1BBL seems to have additive effects on T(reg) cells, which play a major role in the maintenance of tolerance. Even after immunosuppressive therapy in combination with CD4(+) T-cell depletion, we did not achieve prolonged graft survival, possibly because of the absense of T(reg) cells, which require CD4-independent CD8(+) T cells, based on the observation of increasing proportion of CD8(+) T cells in similar degree as the control group.
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Affiliation(s)
- J Lee
- Transplantation Research Center, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, 135-710
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Abstract
The development of posttransplant lymphoproliferative disease (PTLD) is strongly linked to infection with the Epstein-Barr virus (EBV), immunosuppression-state, the type of allograft, and EBV-seronegativity. A 18-month-old girl who had undergone living donor liver transplantation using the left lateral segment from her father was treated with tacrolimus and corticosteroid as an immunosuppressant regimen. She was readmitted 3 months after the transplant to evaluate the etiology of dyspnea and abdominal fullness as well as a decreased urine volume. She was diagnosed as an anastomotic stenosis of the hepatic vein for which she underwent balloon angioplasty. The treatment was repeated at postoperative month 5, 8, and 11. As postoperative 6 months, the result of the serological EBV-CA (IgG/IgM) was positive. In postoperative month 10, the EBV PCR serologic test become positive, and a laryngeal biopsy revealed PTLD. She was treated with acyclovir and gangyclovir as well as reduced immunosuppression. We report herein a rare case of laryngeal PTLD in a patient who had undergone living donor liver transplant with paternal allograft.
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Affiliation(s)
- H H Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
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Kim SJ, Lee HH, Lee DS, Lee KW, Joh JW, Woo DH, Kwon GY, Oh HY, Kim YG, Huh WS, Kim DJ, Kim GS, Lee SK, Lee BB. Prognostic factors affecting graft and patient survival in cadaveric and living kidney transplantation. Transplant Proc 2004; 36:2038-9. [PMID: 15518737 DOI: 10.1016/j.transproceed.2004.08.071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Numerous studies have reported various prognostic factors that affect graft and patient survival in living and cadaveric donor kidney transplantation (KT). The purpose of this study was to evaluate the clinical outcomes and prognostic factors affecting graft and patient survivals in living and cadaveric donor KT. Between February 1995 and December 2001, 421 patients who had undergone cadaveric donor KT (group I: 216 cases, 51.3%) or living donor KT (group II: 205 cases, 48.7%), were retrospectively analyzed. Five-year overall graft survival rates in living was significantly better than that in cadaveric donor KT, respectively (P = .0234). There was no difference in patient survival rates between the two groups. Such factors as absence of rejection, female donor, female recipient, adult KT according to recipient age (>14 years), and donor serum creatinine level just before transplantation (< 2.5 mg/dL) were significantly associated with good graft survival among cadaveric donor KT, whereas two factors-absence of rejection and adult KT according to recipient age (>14 years)-influenced graft survival in living donor KT. In multivariate analysis, the only significant prognostic factor related to graft survival was the presence of rejection. In conclusion, we suggest that the presence of rejection is the only factor that impairs graft survival in both cadaveric and living donor KT, while other factors affected graft survival differently in the two groups.
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Affiliation(s)
- S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
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Abstract
We have investigated the expression of neuropeptide Y (NPY) in C6 glioma cells after the glutamatergic stimulation by the in situ RT-PCR and immunocytochemical techniques. The expression of NPY mRNA correlated well with immunocytological findings in each series of experiments. NPY protein expression was enhanced by glutamate (1, 10, 50, 100 microM, and 1 mM) dose-dependently, and its expression was slightly increased by N-methyl-D-aspartate (NMDA; 1, 10, 100, 500 microM, and 1 mM) and kainic acid (1, 10, 100, 300 microM, and 1 mM). We pretreated the cells with dopamine, haloperidol, pentylenetetrazol, and muscimol before each stimulation. The pentylenetetrazol and muscimol did not significantly alter the patterns of NPY expression induced by the glutamatergic stimulation. On the other hand, the dopamine and haloperidol pretreatment significantly elevated the levels of NPY expression that were induced by NMDA and kainic acid. Our results indicate that NPY release is closely related to glutamatergic stimulation, and it could be dynamically mediated by GABAergic and dopaminergic costimulation.
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Affiliation(s)
- S K Kim
- Department of Pharmacology, School of Medicine, Keimyung University, Chung-gu, Taegu, South Korea.
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Abstract
Kaposi's sarcoma (KS) had been a rare and unusual vascular tumor until a recent epidemic of a disseminated and fulminant form of KS in AIDS patients. Infectious agents have been suspected of causing KS, and recently partial genomic DNA sequences of human herpesvirus 8 (HHV8) have been identified in AIDS-associated KS lesions. Since then, genomic DNA sequences of HHV8 have been isolated in other forms of KS. Although the partial genomic DNA sequence of HHV8 was reported to be, if rare, identified in vascular tumors other than Kaposi's sarcoma (KS), the presence of HHV8 in a very large fraction of KS indicates that detection of HHV8 by PCR is a useful auxiliary tool in differentiating KS from other KS-mimicking vascular tumors. We examined whether the 233-bp segment of the viral DNA was detected in Korean patients with KS and other KS-mimicking vascular tumors. HHV8 sequences were identified in all of nine classic type of KS but not in three epithelioid hemangioendotheliomas and seven angiosarcomas. Our results confirm the relatively restricted distribution of HHV8 and also argue against the likelihood of secondary colonization of KS cells by HHV8.
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Affiliation(s)
- G H Kang
- Asan Medical Center, Ulsan University College of Medicine, Department of Pathology, Seoul, Korea
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Abstract
BACKGROUND Cystic hypersecretory carcinoma (CHC) of the breast is a rare variant of intraductal carcinoma. It is characterized by a multicystic, yellow-brown lesion with gelatinous material grossly and cystically dilated ducts with an eosinophilic secretion microscopically. The histologic or cytologic features can be deceptively bland. CASE A 37-year-old female presented with an 8-cm-diameter, firm mass in the breast. Radical mastectomy was performed after fine needle aspiration (FNA). The moderately cellular smear had a characteristic background of proficient, intensely staining secretion with bubbling. The cellular components were various, ranging from sheets of benign hyperplastic ductal cells to three-dimensional clusters or papillae of frankly malignant ductal cells, with varying degrees of secretory activity. The background consisted of inflammatory cells, naked nuclei and foamy histiocytes. The cytologic findings correlated well with the histologic features of the tumor, which showed both micropapillary intraductal carcinoma with apocrine metaplasia and focal high grade invasive carcinoma in a background of cystic hypersecretory hyperplasia. CONCLUSION This was the first reported case of FNA cytology of an invasive form of CHC. CHC has characteristic features on FNA, and so a reliable diagnosis can be made.
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Affiliation(s)
- M K Kim
- Department of Diagnostic Pathology, Samsung Medical Center, Seoul, Korea
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Kim CW, Kim I, Ko YH, Cho H, Yang WI, Kwon GY, Lee DG, Moon HB, Suh CH, Juhng SW. Clinicopathologic and immunophenotypic study of non-Hodgkin's lymphoma in Korea. Lymphoreticular Study Group of the Korean Society of Pathologists. J Korean Med Sci 1992; 7:193-8. [PMID: 1285918 PMCID: PMC3053778 DOI: 10.3346/jkms.1992.7.3.193] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study sponsored by the Lymphoreticular Study Group of the Korean Society of Pathologists was carried out to provide nationwide data about the histopathologic-immunophenotypic features of malignant lymphomas in Korea. Two hundred and ninety Non-Hodgkin's lymphoma (NHL) among 312 malignant lymphomas collected from three representative areas in Korea were histologically reclassified. Two hundred and fifty three cases were immunohistochemically studied. T-cell lymphoma comprised 35.2% of NHL in this study and showed a quite comparable incidence to that of Japan and China, but it was much higher than in Western countries. A very low prevalence rate of the follicular variety (4.0%) and a higher propensity of primary extranodal involvement (60%) are additional characteristics of NHL in Korea. The most common histologic subtype of B cell lymphoma was diffuse large cell type, whereas the most common subtype of T cell lymphoma was diffuse mixed small and large cell type.
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Affiliation(s)
- C W Kim
- Department of Pathology, Seoul National University College of Medicine, Yongon-Dong, Chongno-Ku, Korea
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