Epidemiology and Health

Volume 23 (1); June 2001

Original Articles

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

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

Prevalence of Stroke in Pyongchang County.: Jong Ku Park, Kyung Sook Cho, Chun Bae Kim, Jin Back Kim, Ha Ja Song, Kee Ho Park, Seong Gyu Ko; Korean J Epidemiol. 2001;23(1):69-79.

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Abstract PDF: Abstract
PURPOSE
The purpose of this study was to identify the prevalence of stroke in Pyongchang county, Kangwon do.
METHODS
The presumptive stroke patients of Pyongchang county were identified with a key-person method in October 2000. And then, medical records of these patients were reviewed by well-trained two students who major in the science of medical record.
RESULTS
In the year 2000, there were 92 males and 68 females of self-diagnosed stroke. Of these, stroke patients based on physician's diagnosis were 102, and stroke patients based on CT/MRI findings or Minnesota criteria were 93. Prevalence rate of self-reported stroke, stroke based on physician's diagnosis, and stroke based on CT/MRI findings or Minnesota criteria were 0.33%, 0.29%, and 0.26% respectively.
CONCLUSION
We conclude that verifying process of diagnosis is needed to estimate the prevalence of stroke in community.; Summary

An Epidemiologic Study on Sudden Deaths of Cattle Occurred in Kyongju.: Hyun Sul Lim, Hae Kwan Cheong, Jung Ran Kim, Ik Jung Kim, Gyoung Yim Ha; Korean J Epidemiol. 2001;23(1):59-68.

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Abstract PDF: Abstract
PURPOSE
This study was conducted to provide the baseline data for the epidemiologic and microbiologic investigation for the etiology of sudden deaths of cattle in Sara-Ri, Seo Myun, Kyongju.
METHODS
This survey was performed between April 11 and 22, 1994. Epidemiologic investigation consisted of interview of the residents, as well as pathologic and microbiologic test on tissues and blood samples from cardiac puncture.
RESULTS
The dead numbers of cattle were 149 in 35 households during about 20 years. The cows(63.9%) were more than bulls(36.1%) and most of them were raised in playpen(95.7%). The first death occurred in 1974, and then number of deaths increased until 1994. Besides the age of cattle at death was over two years old (88.3%), most of them(69.4%) died within one hour after onset of noticeable symptom by the farmers. The most common symptom of cattle at death was 'sudden death after screaming(71.1%)' and 'seizure (33.3%)'. Colonies from blood of case 3 showed double hemolysis in blood agar plate. The microbiologic test results in the culture of Clostridium perfringens. The pathological features were characterized as most of renal tubules revealed coagulative necrosis. Some gram-positive bacilli are scattered in interstitium.
CONCLUSIONS
Above results suggest C. perfringens as a possible pathogen of this ourbreak in livestock. The possibility of human infection, although nonfatal, and lack of vaccination against C. perfringens raises a need for stronger preventive action toward this communicable disease of cattle on this village.; Summary

Measles Outbreak among Institutional Infants after Hospital Infection.: Hyung Cheol Park, Eun Young Park, Sun Hee Cho, Young Jun Choi, Hyun Kyun Ki, Young Hwa Jung, Kyung Rye Moon, So Yeon Ryu, Ki Soon Kim; Korean J Epidemiol. 2001;23(1):50-58.

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Abstract PDF: Abstract
PURPOSE
S: This study was to investigate the source of infection, mode of transmission and incidence of a measles outbreak among infants living in a Gwangju welfare institution in July 2000.
METHODS
The information about 63 children was collected through the nurses interview and blood sampling and laryngopharyngeal swab were conducted to the children. In addition, an epidemiologic survey was performed to confirm the infection dissemination route.
RESULTS
Before the outbreak, two children living at the institution were admitted to a university hospital for other health problems. These children shared a room with a 5 year old diagnosed with meningitis who was later diagnosed as having measles after rashes appeared. The two children developed measles after returning to their institution and the infection spread to other children in the institution. Among 63 children observed, 14 children(22.2%) developed measles, secondary attack rate of measles due to index cases was 19.7%. And 78.6% of the patients were between 4 and 8 months old. The room where the index case lived showed an attack rate of 81.8%, which is a much higher rate compared to other rooms. The attack rate among boys(26.0%) was higher than that of girls(12.5%), but it was not statistically significant.
CONCLUSIONS
This outbreak was considered to be a nosocomial infection, where the index cases were admitted to a hospital, infected and the infection spread to children. Further studies are necessary to find out the maternal antibody levels of infants of post-vaccinated mothers and the optimal age for measles vaccination.; Summary

Coffee Consumption and Decreased Serum Gamma-glutamyltransferase Activity in Men of Rural Area.: Byung Min Son, Byung Mann Cho, Sang Don Lee, Moon Kee Chung, Don Kyoun Kim; Korean J Epidemiol. 2001;23(1):43-49.

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Abstract PDF: Abstract
PURPOSE
There has been various reports on the inverse association between coffee consumption and serum gamma-glutamyltransferase(GGT) activity in the general population of Western countries. However, this association is uncertain in the communities in which coffee consumption is less popular. So we tried to identify this association in men of rural area in Korea.
METHODS
We examined the association between coffee consumption and serum GGT activity in cross-sectional study involving 379 male population health examinees aged 40 years and older from rural areas in Kyungnam prefecture in Korea. Those who perceived their health status as poor were excluded. Possible confounding effects of age, body mass index, alcohol consumption and cigarette smoking were controlled by multiple regression analysis and analysis of covariance.
RESULTS
In multiple regression analysis, serum GGT activity was positively associated with alcohol intake, body mass index(P<0.001) and was negatively associated with coffee consumption(P=0.022), whereas no significant association was observed in cigarette smoking(P=0.094). Adjusted serum GGT activity level at the coffee consumption level of 0, one and two or more cups a day was 37.6 U/l, 35.9 U/l and 26.8 U/l respectively(Ptrend=0.008).
CONCLUSION
Decreased serum GGT activity appears to be associated with coffee consumption in men of rural area, and further studies on the interrelationships among coffee consumption, alcohol intake and obesity will be necessary.; Summary

Genetic Contribution to Cardiovascular Risk Factors in Korea: The Results from the 1998 Korean Nationwide Health and Nutrition Examination Survey.: Sun Ha Jee; Korean J Epidemiol. 2001;23(1):36-42.

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Abstract PDF: Abstract
PURPOSE
The purpose of this study was to estimate the heritability for cardiovascular disease(CVD) risk factors such as obesity, serum lipids, blood pressure and putative other risk factors.
METHODS
Familial correlations and heritability in CVD risk factors were investigated with use of data from a community-based sample of 435 families involving 2,507 persons collected in the 1998 Korean Nationwide Nutrition and Health Examination Survey over the period November to December in 1998. The risk factors considered were obesity indexes such as waist circumference(WC), hip circumference(HC), waist-to-hip ratio(WHR), body mass index(BMI), serum lipids(total cholesterol, LDL- and HDL- cholesterol and triglyceride), systolic and diastolic blood pressure(SBP and DBP) and other putative risk factors(fasting blood sugar, creatinine, platelet, blood urea nitrate).
RESULTS
First, the estimated heritabilites for obesity variables were 49.5% for WC, 46.6% for BMI, 43.2% for WHR and 39.2% for HC. Second, the estimated heritabilites for well-established CVD risk factors were 53% for LDL-cholesterol, 52% for total cholesterol, 52% for HDL-cholesterol, 24% for triglyceride, 39% for SBP and 30% for DBP. Third, the estimated heritabilites for the putative CVD risk factors were 39% for platelet, 39% for fasting blood sugar, 34% for blood urea nitrate, and 32% for creatinine level.
CONCLUSION
Future linkage studies in these families may be worthwhile to further clarify the molecular basis for biological mechanisms controlling these CVD risk factors showing high heritability.; Summary

Reviews

Epidemiological Researches on the Health Hazards in Veterans of United States of America.: Hyun Sul Lim; Korean J Epidemiol. 2001;23(1):23-35.

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Abstract PDF: Abstract
The Department of Veterans Affairs(VA) maintains some large automated databases that provide the opportunity for studying long-term health effects of military service. The Beneficiary Identification and Record Locator Subsystem(BIRLS) is an excellent source of vital status information on veterans. The VA Patient Treatment File(PTF) is a computerized hospital discharge abstract system of inpatient records, including patients' demographic data, surgical and procedural transactions, and patient movements and diagnosis. The computerized Agent Orange Registry data include veteran's name, address, some information on military service, and findings at the time of his physical examination. The US conducted 235 atmospheric nuclear tests from 1945 through 1962. Many of the 250,000 test participants were exposed to low levels of radiation. The overall average radiation dose was estimated as 0.6 rem per year. In 1976, a claim relating acute myelocytic leukemia to radiation exposure from nuclear weapon testing received extensive publicity. Several thousand "atomic veterans" have sought medical care and compensation from VA for medical conditions that they believe are related to the nuclear weapon testing. Many WWII veterans have contracted the US VA about health problems that they attribute to their exposure to mustard gas. From 1962 to 1971, 75 million liters of herbicides, including over 41 million liters of the phenoxy herbicide Agent Orange, were sprayed on almost 9% of Vietnam. Many studies have been conducted to determine the association of various cancers with military service in Vietnam. Some diseases have been compensated for Vietnam veterans. Health problems reported following the Gulf War include a wide variety of symptoms similar to those found in acute combat reaction, posttraumatic stress disorder, and chronic fatigue. Health problems associated with war have continued and in some ways intensified. Therefore, The United States developed a plan for establishing a national center for the study of war-related illnesses and post-deployment health issues.; Summary

The Role of Epidemiology against Emerging and Reemerging Diseases.: Joung Soon Kim, Min Jung Ko; Korean J Epidemiol. 2001;23(1):1-22.

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Abstract PDF: Abstract
PURPOSE
Due to remarkable developments in technology and great efforts made by Health Organizations, most of infectious diseases had been under control. However, ecological changes and biological variations resulted in emerging and re-emerging infectious diseases, which threaten the global health and may have the possibility of being abused as biological weapon. Therefore it is indispensable to understand the latest information and knowledge in order to cope with the emergency situation.
RESULTS
In Korea, several reemerging diseases such as Malaria, Hepatitis A, Shigellosis, Mumps, and food poisoning has been increasing conspicuously since 1990. Also Diphtheria, plague, yellow fever and dengue fever have been potential threats, considering substantial international trades.
CONCLUSION
There have many newly emerged and re-emerged infectious diseases identified in recent few decades in Korea. Thus as epidemiologic professionals, we have to get ready, particularly following missions to be carried out : 1) to keep eyes open to look for emerging and reemerging diseases continuously and keep up the latest global information, 2) establish the co-operational organizations to prepare immediate action against the sudden outbreak, 3) publicize, educate, establish and perform the missions, taking initiative in training clinicians, 4) upgrade professional competency by familiarizing ourselves with epidemiologic investigations, and 5) fulfill the responsibilities as health keepers of the nation.; Summary

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