Epidemiology and Health

Perspective

The direction of restructuring of a Korea field epidemiology training program through questionnaire survey among communicable disease response staff in Korea: Moo Sik Lee, Kwan Lee, Jee-Hyuk Park, Jee-Young Hong, Min-Young Jang, Byoung-Hak Jeon, Sang-Yun Cho, Sun-Ja Choi, JeongIk Hong; Epidemiol Health. 2017;39:e2017032. Published online July 24, 2017; DOI: https://doi.org/10.4178/epih.e2017032

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Abstract

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.

Summary

Korean summary
2015년 한국의 메르스 유행후 한국의 감염병 대응인력을 대상으로 한 조사분석을 통하여 역학조사관 교육 개편의 필요성을 확인하고, 세부 교육과정, 방법 및 내용 등 포괄적인 교육강화 및 개선방안을 모색하여 향후 역학조사관 신규 교육프로그램의 개발과 역량강화 방안을 제시하였다.

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Original Articles

Six year national trend of childhood aseptic meningitis incidence in Korea, 1996-2001.: Hae Kwan Cheong, Sue Kyung Park, Moran Ki, Kwan Lee; Korean J Epidemiol. 2008;30(2):252-262. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.252

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Abstract

BACKGROUND
AND OBJECTIVES: Aseptic meningitis is a disease of children with seasonal outbreak in summer. In spite of high morbidity, it is not notifiable without reported nationwide morbidity. The authors estimated incidence of aseptic meningitis and its descriptive characteristics and time- and space-clustering pattern. SUBJECTS AND METHODs: Cases of aseptic meningitis were extracted from National Health Insurance payment request data of National Health Insurance Corporation from January 1996 to December 2001. Cases were classified by region, institution, and hospitalization. Standardized incidence was calculated and compared by the region, month of the year whether there is any clustering.

RESULTS

Nationwide incidence of aseptic meningitis among children under 15 years old over the six year period was 3.48 per 1,000 per year. Incidence was higher in female (2.80/1,000) compared to male (4.02/1,000). Age-specific incidence was highest in 5 years old. Annual incidence was highest in 1997 (8.44/1,000) and lowest in 2000 (0.79 /1,000) with outbreak every 3 or 4 years. Outbreak was mostly confined in summer months, between May and Septe- mber. However, seasonal pattern was variable by year. Southern provinces and metropolitan areas had higher incidences and pattern was more prominent in the years with higher outbreak. Time-dependent pattern of the disease from south to north was not prominent.

DISCUSSIONS

AND CONCLUSIONS: We have calculated the nationwide incidence of the aseptic meningitis over six year period. In terms of aseptic meningitis, using National Health Insurance data for the estimation of the incidence is a plausible method for the surveillance of the disease.

Summary

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Jong-Hun Kim, Hae-Kwan Cheong, Byoung-Hak Jeon
Journal of Korean Medical Science.2018;[Epub] CrossRef
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Yadav Joshi, Jong-Hun Kim, Ho Kim, Hae-Kwan Cheong
International Journal of Environmental Research and Public Health.2018; 15(11): 2551. CrossRef
Associations between Meteorological Factors and Aseptic Meningitis in Six Metropolitan Provinces of the Republic of Korea
Yadav Joshi, Eun-Hye Kim, Jong-Hun Kim, Ho Kim, Hae-Kwan Cheong
International Journal of Environmental Research and Public Health.2016; 13(12): 1193. CrossRef
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Chan Hee Lee, Na Young Sung
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Transmission of Seasonal Outbreak of Childhood Enteroviral Aseptic Meningitis and Hand-foot-mouth Disease
Sue K. Park, Boyoung Park, Moran Ki, Ho Kim, Kwan Lee, Cheoll Jung, Young Mo Sohn, Sung-Min Choi, Doo-Kwun Kim, Dong Seok Lee, Joon Tae Ko, Moon Kyu Kim, Hae-Kwan Cheong
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A Study on the Epidemiologic Characteristics of Scrub Typhus in Gyeongsangbuk-do, 1999-2001.: Young Sun Min, Hyun Sul Lim, Kwan Lee, Cheoll Jung, Hae Kwan Cheong; Korean J Epidemiol. 2005;27(2):70-79.

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Abstract PDF: Abstract
ONJECTIVE: This study was carried out to investigate the epidemiologic characteristics and magnitudes of scrub typhus (tsutsugamushi disease) in Gyeongsangbuk-do, Korea.
METHODS
Resources of data collected were epidemiologic surveillance report to public health centers on each disease occurrence. The authors reviewed 344 epidemiologic surveillance reports for cases of scrub typhus developed in Gyeongsangbuk-do, Korea from Jan 1, 1999 to Dec 31, 2001.
RESULTS
The scrub typhus cases were 376 during three year period, and the incidence was significantly higher in the county area than in the city area. Incidence of scrub typhus was increasing each year. In 344 epidemiologic surveillance reports, the job of the cases was farmer (67.2%), housewife (4.7%), clerk (3.5%). Two hundred ninety eight cases (86.6%) have experienced outdoor activities before development of the scrub typhus. The outdoor places of exposure were dry field (64.8%), rice field (51.7%), hill (12.8), and grass field (9.7%). The symptoms reported were fever (93.3%), headache (83.7%), chill (69.5%), and rash (54.4%).
CONCLUSIONS
Incidence of scrub typhus was increasing in Gyeongsangbuk-do, Korea, this phenomenon may be related to change of climate, the reporting rate of disease and outing activities. Good surveillance and adequate analysis of epidemiologic data is a essential for the prevention of the disease. With this result, high risk population was identified and effective intervention should be done to prevent the disease.; Summary

Prevalence and Risk Factors of Green Tobacco Sickness among Korean Tobacco Harvesters, 2003.: Kwan Lee, Hyun Sul Lim; Korean J Epidemiol. 2005;27(1):129-139.

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Abstract PDF: Abstract
OBJECTIVES
This study was carried out to understand the prevalence and risk factors of green tobacco sickness (GTS) among Korean tobacco harvesters.
METHODS
The authors conducted a questionnaire among the tobacco harvesters (842 persons from 449 out of 500 tobacco harvesting households) in Cheongsong-gun for 4 days from Sep 1 to 4, 2003.
RESULTS
The study subjects contained 440 males and 402 females. The prevalence of GTS in 2003 was 39.2%, and was significantly higher in females (53.4%) than in males (25.6%, p<0.01). The incidence density of GTS according to the number of workdays in 2003 was 11.5 spells/100 person-days. The GTS symptoms reported by the tobacco harvesters in 2003 were nausea in 320 cases (97.0%), dizziness in 311 cases (94.2%), headache in 264 cases (80.0%) and vomiting in 209 cases (63.3%) etc. Through multiple logistic regression, the factors significantly associated with GTS were found. Odds ratio for smoking, age over sixty(compared with under forties), and working over 10 hours(compared with under 10 hours) were respectively 0.23 (95% CI: 0.16~0.33), 0.46 (95% CI: 0.23~0.93), and 1.53 (95% CI: 1.12~2.10).
CONCLUSIONS
Our studies before this, there were significant recall bias by time lag between harvesting period and survey time. We tried to study promptly after harvesting tobacco leaves to solve this recall bias. More extensive epidemiologic studies, and educations for harvesters are expected.; Summary

Epidemiologic Investigation into an Outbreak of Typhoid Fever Recognized by Electronic Data Interchange in Gyeongsangbuk-do, 2003.: Hyun Sul Lim, Young Sun Min, Kwan Lee, Sang Hyuk Lim; Korean J Epidemiol. 2004;26(1):59-68.

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Abstract PDF: Abstract
Epidemiologic Investigation into an Outbreak of Typhoid Fever Recognized by Electronic Data Interchange in Gyeongsangbuk-do, 2003 PURPOSE: Fourteen cases of typhoid fever occurred in Gyeongsan-si, Gyeongsangbuk-do from May 22 to July 19, 2003. Especially, 6 cases were students of Y University located in Gyeongsan-si. This investigation was carried out to study the infection source and transmission of typhoid fever and to institute an effective prevention counterplan.
METHODS
The authors conducted an epidemiologic survey from June 25, 2003 among the 14 cases, restaurants and employees of the whole neighborhood of Y University. Widal test was carried out for the restaurant employees and schoolmates of the 13-year-old case Miss Kim. The authors executed a pulsed field gel electrophoresis (PFGE) for Salmonella typhi cultured from 9 cases. The authors collected data about chloride and turbid levels of treated water from April to June in Gyeongsan-si water treatment plant and repair work records of waterworks pipe line in Gyeongsan-si city hall.
RESULTS
All cases had used restaurants of the whole neighborhood of Y University within 2 months before the typhoid fever symptoms were developed, but the restaurant that was rarely visited by any of the patients had a case to be matched. In the results of the Widal test, 9 out of 45 of subjects (20.0%) were suspicious cases or showed a value to suggest past infection. In the results of PFGE test, there were 3 subtypes, and each subtype had a similar DNA fragments array. In all cases the patients drank tap water when they visited the restaurants. The restaurants provided drinking water from filtered tap water rather than boiled water, and all patients had drunk this water. The chlorine level of the treated water was the normal value in the Gyeongsan-si water treatment plant, but in 2 times the value was the minimum standard level. There was water pipe construction work in some regions of the whole neighborhood of Y University. The number of gastrointestinal patients in 2003 was approximately 2 times that in 2002 at the health center in Y University.
CONCLUSIONS
The possibility that typhoid fever was generated in the whole neighborhood of Y University is very high. Among various possibilities, the highest possibility is the pollution of tap water intake by water leakage of a water pipe. There was no case of patient infection after strengthening of the tap water disinfection. Thorough disinfection, boiled drinking water and a periodic carrier inspection are necessary to prevent additional local occurrences of these typhoid infections.; Summary

Epidemiological Characteristics and Changes of Prevalence for Green Tobacco Sickness among Korean Tobacco Harvesters.: Joo Sub Lee, Sung Han Bae, Hyun Sul Lim, Kwan Lee; Korean J Epidemiol. 2004;26(1):39-49.

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Abstract PDF: Abstract
PURPOSE
This study was carried out to investigate the epidemiological characteristics and changes of prevalence for green tobacco sickness (GTS) for 2 years.
METHODS
The author conducted a questionnaire survey on the tobacco harvesters (875 persons from 478 out of 555 tobacco harvesting households surveyed last year) in Cheongsong-gun for 4 days from May 26 to 29, 2003.
RESULTS
The study subjects comprised 456 males and 419 females. The prevalence of GTS in 2002 was 50.5%, which was significantly higher than the 43.0% in 2001 (p<0.01). The incidence density of GTS in 2002 was 11.3 spells/100 person?working-days, which was lower than the 12.1 spells in 2001. Regardless of risk factors such as smoking, workingdays, and working hours, the prevalence of GTS in 2002 was higher than that in 2001. Among various GTS symptoms reported by the tobacco harvesters in 2002, cases of nausea were increased, while diarrhea, dyspnea and cough were decreased compared with 2001. The degree of GTS symptoms in 2002 was increased in 198 cases (64.5%), and decreased in 42 cases (13.7%). The proportion of harvesters who underwent treatment from their local medical facilities in 2002 was significantly decreased compared with that in 2001.
CONCLUSIONS
In Korea, there are many tobacco-harvesting households, most of which may be stricken with GTS. It is very important for doctors to diagnose the disease exactly and to develop prevention methods for GTS. I expect that more extensive epidemiological studies including the incidence and associated risk factors will be needed. In addition, surveillance system and measurements of urinary cotinine should be conducted.; Summary

Green Tobacco Sickness on Tobacco Harvesters in a Korean Village.: Hyun Sul Lim, Kwan Lee; Korean J Epidemiol. 2002;24(1):29-36.

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Abstract PDF: Abstract
PURPOSE
This study was conducted to understand the proportion and the risk factors of green tobacco sickness (GTS).
METHODS
The authors conducted a questionnaire among tobacco harvesters; 94 people from 59 households at a village in Youngduk-gun from Feb 1 to Feb 3, 2002.
RESULTS
The study group contained 49 females and 45 males. The mean durations of employment and the length of the working day were 23.3 14.2 years and 11.8 2.7 hours, respectively. The symptoms related to tobacco harvest were dizziness in 64 cases (68.1%), headache in 46 cases (48.9%), nausea in 45 cases (47.9%), sore eyes in 37 cases (39.4%), and vomiting in 36 cases (38.3%). The experience of GTS up until 2001 was 70.2%. The proportion of GTS in 2001 was 67.0% and was significantly higher in females (84.9%, p<0.01). The proportion of GTS by work days in 2001 was 16.4 spells/100 person days. The proportion of non-smokers was significantly higher than smokers (p<0.01). Therefore, smoking was negatively associated with GTS. The use of gloves and wristlets significantly increased the proportion of GTS (p<0.05). Through multiple logistic regression, significantly associated factors with GTS were found to be smoking (OR=0.18, 95% CI: 0.06-0.54), wearing of gloves (OR=9.20, 95% CI: 1.27-66.52), and sweating (OR= 3.52, 95% CI: 1.08-11.47). Of those who reported GTS in 2001, 65.6% underwent treatment from the local medical facilities. The distribution of the medical facilities utilized was pharmacies 39.3%, and medical health centers 26.2%.
CONCLUSIONS
: In Korea, there are many tobacco harvesters, and most may be stricken with green tobacco sickness. In the future it is hoped that more extensive epidemiological studies will be conducted; Summary

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