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Volume 2(1); June 2011
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Editorial
The Road Less Traveled
Chaeshin Chu
Osong Public Health Res Perspect. 2011;2(1):1-2.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.05.001
  • 1,351 View
  • 17 Download
  • 1 Citations
PDF
Invited Original Article
Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire
Martin Eichner, Scott F. Dowell, Nina Firese
Osong Public Health Res Perspect. 2011;2(1):3-7.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.001
  • 2,037 View
  • 14 Download
  • 39 Citations
AbstractAbstract PDF
Objectives
Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed.
Methods
We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period.
Results
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.
Conclusion
If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.
Original Articles
Genotypic Characterization of Vibrio vulnificus Clinical Isolates in Korea
Hye Sook Jeong, Jun Young Kim, Se Mi Jeon, Mi Sun Park, Seong Han Kim
Osong Public Health Res Perspect. 2011;2(1):8-14.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.008
  • 1,313 View
  • 15 Download
  • 4 Citations
AbstractAbstract PDF
Objectives
Vibrio vunificus is known to cause septicemia and severe wound infections in patients with chronic liver diseases or an immuno-compromised condition. We carried out the molecular characterization of V. vulnificus isolates from human Vibrio septicemia cases based on pulsed-field gel electrophoresis (PFGE) using NotI and SfiI.
Methods
and Results PFGE was used to characterize a total of 78 strains from clinical cases after NotI or SfiI digestion. The geographical distribution of PFGE patterns for the strains from the southern part of Korea, a high-risk region for Vibrio septicemia, indicated that the isolates from southeastern Korea showed a comparatively higher degree of homology than those from southwestern Korea.
Conclusions
We report the genetic distribution of V. vulnficus isolated from Vibrio septicemia cases during 2000–2004 in Korea. This method has potential use as a subspecies-typing tool for V. vulnificus strains isolated from distant geographic regions.
Pathogenesis and Chronologic Localization of the Human Influenza A (H1N1) Virus in Cotton Rats
Donghyok Kwon, Kyeongcheol Shin, Jin-Young Shin, Joo-Yeon Lee, Yooncheol Ha, Nam-Joo Lee, Hee-Bok Oh, Chanhee Chae, Chun Kang
Osong Public Health Res Perspect. 2011;2(1):15-22.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.005
  • 1,408 View
  • 22 Download
  • 7 Citations
AbstractAbstract PDF
Objectives
We aimed to evaluate the pathogenesis and chronologic localization of human influenza A (H1N1) virus in experimentally infected cotton rats.
Methods
The animals were intranasally inoculated with 107 plaque-forming units of A/Solomon Islands/3/2006 (H1N1) influenza virus and evaluated for pathogenicity for a period of 28 days. Virus replication kinetics and pathological properties were assessed chronologically. Acute antiviral responses were evaluated by mean of real-time polymerase chain reaction.
Results
Cotton rats infected with A/Solomon Islands/3/2006 virus lost weight until 6 days post-inoculation (DPI) and showed decreased activity until 3 DPI. At necropsy, focal areas of redness and consolidation of lungs were evident at 1, 2, and 3 DPI. Lung histopathology showed moderate to severe interstitial pneumonia, alveolitis and bronchiolitis. Influenza A specific viral protein was detected in bronchiolar epithelial cells, alveolar septa and pneumocytes. Influenza viruses were recovered from the lungs during the early period of infection and the titer peaked at 1 DPI. Viral proteins were detected from 4 hours to 6 hours DPI. These trends correlate with the up-regulation of mRNA expression of the IFN-α, Mx1, and Mx2 genes that play critical roles in the anti-influenza response at the early stage of infection.
Conclusion
Our results provide evidence that supports the use of cotton rats for the study of influenza virus pathogenesis and the immune response.
Infectivity of Homologous Recombinant HIV-1 Pseudo-virus with Reverse Transcriptase Inhibitor-related Mutations from Highly Active Antiretroviral Therapy Experienced Patients
Oh-Kyung Kwon, Ju-yeon Choi, Eun-Jin Kim, Sung Soon Kim
Osong Public Health Res Perspect. 2011;2(1):23-28.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.006
  • 1,382 View
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  • 3 Citations
AbstractAbstract PDF
Objectives
In this study, the viral fitness of pseudo-viruses with a drug-resistant site in the reverse transcriptase (RT) region of the genome was investigated. The pseudo-viruses were derived from highly active antiretroviral therapy (HAART)-experienced HIV/AIDS patients.
Methods
HIV-1 RNA was extracted from the plasma of HAART-experienced (KRB9149, KRB7021, KRC1097) and HAART-naïve (KRC5180, KRC5123) HIV-1 patients. The RT gene from the extracted viral RNA was amplified and the polymerase chain reaction product was cloned from the pHXB2Δ2-261 RT vector. C8166 and TZM-bl cell lines were used as the HIV-1 replication capacity measurement system. To quantify the infectivity of homologous recombinant HIV-1, the infectivity derived from each pseudo-virus was compared with the infectivity of the reference strain HXB2.
Results
Patient-derived HIV-1 was cotransfected into C8166 cells and the expression level of the p24 antigen was measured. The expression was high in the HIV-1 isolates from patients KRC5180 and KRB9149 and low in patients KRB7021, KRC5123, and KRC1097, when compared with the reference strain. The infectivity of the pseudo-virus measured in TZM-bl cells decreased in the order, reference strain HXB2 > KRC5180 > KRC5123 > KRB9149 > KRB7021 > KRC1097.
Conclusion
In this study, HIV-1 infectivity of the drug-resistant strain isolated from HAART-experienced patients with HIV/AIDS was found to be lower than the infectivity of the reference strain HXB2. This study provides useful data for the phenotypic susceptibility assay in HAART-experienced patients infected with HIV-1.
Serological Detection of Lyme Borreliosis Agents in Patients From Korea, 2005–2009
Sang-Hee Park, Kyu-Jam Hwang, Hyuk Chu, Mi-Yeoun Park
Osong Public Health Res Perspect. 2011;2(1):29-33.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.004
  • 1,358 View
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  • 13 Citations
AbstractAbstract PDF
Objectives
Laboratory tests are now being used to identify seropositive cases in patients suspected of having a Lyme borreliosis (LB) infection. From 2005 to 2009, we analyzed the serological and epidemiological characteristics of 53 LB positive cases in Korea using immunoblot assay.
Methods
During the five-year study period, a total of 1897 serum samples from suspected LB cases were referred to us for further laboratory diagnosis. The bacterial strains Borrelia afzeli pKo, Borrelia garinii 935T and Borrelia burgdorferi B31 were used for indirect immunofluorescent antibody assay. Immunoblot assay was performed using the recomBlot Borrelia.
Results
Based on the information from the clinicians, the main symptoms of LB infection were rash and fever (66.0%), neurological symptoms (30.2%), and arthritis (5.7%). Of the 53 cases, 16 (30.2%) were infected abroad and the remaining 37 cases (69.8%) were suspected to have been infected in Korea. Immunoblot assays detected high levels of the antigens p41 (FlaB) of B. burgdorferi and OspC of B. garinii in infected samples.
Conclusions
The causative bacteria of LB were not isolated from humans yet but from vector ticks and rodents in Korea, and a few cases were reported with serological diagnosis. Our results suggest that LB is present in all areas of Korea and indicate that B. garinii and B. burgdorferi may be the predominant bacteria in patients with LB. However, further studies are needed to isolate and identify the causative bacteria for LB in patients.
Identification of Dengue Type 1 Virus (DENV-1) in Koreans Traveling Abroad
Young Eui Jeong, Yeon Hee Kim, Jung Eun Cho, Myung Guk Han, Young Ran Ju
Osong Public Health Res Perspect. 2011;2(1):34-40.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.002
  • 1,402 View
  • 14 Download
  • 15 Citations
AbstractAbstract PDF
Objectives
To date, no indigenous dengue virus (DENV) transmissions have been reported in Korea. However, imported dengue infections have been diagnosed in travelers returning from endemic areas. This study presents the first virological evidence of travel-associated DENV importation into South Korea.
Methods
From January 2004 to June 2006, a total of 278 serum samples from 245 patients with suspected dengue fever were tested using the Panbio Dengue Duo IgM/IgG Rapid Strip Test. We selected 11 of the early symptomatic-phase sera that were negative for IgM and retrospectively studied them by virus isolation and reverse transcription-polymerase chain reaction.
Results
All 11 serum samples were found to be DENV positive by reverse transcription-polymerase chain reaction and viruses were successfully isolated from seven of the 11 serum samples. All the isolates were identified as DENV serotype-1.
Conclusion
We successfully isolated seven DENV serotype-1 strains for the first time in South Korea from imported infections. Considering that the vector mosquito, Aedes albopictus, already exists in South Korea, we propose that a vector surveillance program for dengue is urgently needed.
Prevalence of Antibiotic Resistance in Escherichia coli Fecal Isolates From Healthy Persons and Patients With Diarrhea
Seung-Hak Cho, Yeong-Sik Lim, Mi-Sun Park, Seong-Han Kim, Yeon-Ho Kang
Osong Public Health Res Perspect. 2011;2(1):41-45.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.05.003
  • 1,360 View
  • 16 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
This study aimed to investigate the prevalence of antibiotic resistance in fecal Escherichia coli isolates from healthy persons and patients with diarrhea.
Methods
E. coli isolates (n = 428) were obtained from fecal samples of apparently healthy volunteers and hospitalized patients with diarrhea. Susceptibility patterns of isolates to 16 antimicrobial agents were determined by agar disc diffusion.
Results
Most E. coli isolates exhibited less than 10% resistance against imipenem, cefotetan, aztreonam, cefepime, cefoxitin, amikacin and netilamicin, although greater than 65% were resistant to ampicillin and tetracycline. No significant difference in resistance rates for all tested antibiotics was found between isolates from the healthy-and diarrheal-patient groups, including for multi-drug resistance (p = 0.22). The highest number of resistant antibiotics was 12 antibiotics. No significant differences in antibiotic resistance were found among the sex and age strata for isolates from healthy individuals. However, antibiotic resistance rates to cefoxitin, cefotaxime, amikacin, and netilamicin were significantly higher in the isolates of men than those of women (p < 0.05) in isolates from patients with diarrhea. Furthermore, isolates from patients with diarrhea older than 40-years of age showed higher resistance to cefepime and aztreonam (p < 0.05).
Conclusion
High resistance to the antibiotics most frequently prescribed for diarrhea was found in isolates from patients with diarrhea and apparently healthy individuals without any significant difference.
Seroprevalence of Hepatitis A and E Viruses Based on the Third Korea National Health and Nutrition Survey in Korea
Haesun Yun, Hyeok-Jin Lee, Doosung Cheon, Chaeshin Chu, Kyung Won Oh, Young Taek Kim, Youngmee Jee
Osong Public Health Res Perspect. 2011;2(1):46-50.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.009
  • 1,400 View
  • 12 Download
  • 7 Citations
AbstractAbstract PDF
Objectives
The purpose of this study was to investigate the seroprevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) in Korea during 2005.
Methods
Study subjects were selected from across Korea using a stratified multistage probability sampling design, and HAV and HEV seroprevalence was compared on the basis of sex, age, and residency. A total of 497 rural and urban people aged 10–99 years of age (mean ± SD age = 28.87 ± 17.63 years) were selected by two-stage cluster sampling and tested serologically for anti-HAV and anti-HEV IgG using an enzyme-linked immunosorbent assay.
Results
Among this population, the overall seroprevalence of HAV was 63.80% (55.21% aged in their 20s and 95.92% in their 30s, p < 0.01) and that of HEV was 9.40% (5.21% aged in their 20s and 7.14% in their 30s, p < 0.01). Seroprevalence also varied according to area of residence. HEV prevalence in rural areas was higher than that of urban regions based on the anti-HEV antibody, odds ratio 3.22 (95% confidence interval: 1.46–7.10, p < 0.01). There were no significant differences between male and female against anti-HAV/HEV antibodies.
Conclusion
Our study suggested that the seropositive rates of HAV and HEV might be related to age and environmental conditions.
Mathematical Modeling of Vibrio vulnificus Infection in Korea and the Influence of Global Warming
Chaeshin Chu, Younghae Do, Yongkuk Kim, Yasuhisa Saito, Sun-Dong Lee, Haemo Park, Jong-Koo Lee
Osong Public Health Res Perspect. 2011;2(1):51-58.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.05.002
  • 1,451 View
  • 13 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
To investigate the possible link between Vibrio vulnificus population size in seawater and water temperature.
Methods
We collected incidence and water temperature data in coastal regions of Korea and constructed a mathematical model that consisted of three classes; susceptible fish, infected fish available to humans, and infected humans.
Results
We developed a mathematical model to connect V. vulnificus incidence with water temperature using estimated bacterial population sizes and actual coastal water temperatures.
Conclusion
Increased V. vulnificus population sizes in marine environments may increase the risk of infection in people who eat at coastal restaurants in Korea. Furthermore, we estimated the near-future number of infected patients using our model, which will help to establish a public-health policy to reduce the disease burden.
The Influence of Dietary Patterns on the Nutritional Profile in a Korean Child Cohort Study
Hyeon-Jeong Choi, Hyojee Joung, Hye-Ja Lee, Han Byul Jang, Jae-Heon Kang, Jihyun Song
Osong Public Health Res Perspect. 2011;2(1):59-64.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.007
  • 1,393 View
  • 14 Download
  • 12 Citations
AbstractAbstract PDF
Objectives
The aim of the present study was to identify the major dietary patterns of seven- and eight-year-old Korean children and to examine the relationship between dietary patterns and obesity, nutrient intake, and diet quality.
Methods
The subjects were 284 seven- and eight-year-old children who participated in the Gwacheon child cohort study. Three dietary patterns emerged from the factor analysis: Korean, modified Western, and Western. Cluster analysis was used to classify the subjects into two dietary groups: Korean and Western diet patterns.
Results
The two different dietary patterns were closely related to dietary quality which in turn was related to health risks. The Western diet group had a lower fiber intake, a higher intake of energy, fat and calcium and a higher dietary diversity score (DDS) than the Korean diet group. The number of days when fruit, milk and dairy products were omitted from the diet was higher for the Korean diet group than for the Western group.
Conclusions
Dietary patterns and related diet quality should be considered when designing nutrition policy and intervention programs for children.
Brief Report
National Action Plan for Response to Poliovirus Importation
Kyung Min Song, Young June Choe, Heeyeon Cho, Geun-Ryang Bae, Jong-Koo Lee
Osong Public Health Res Perspect. 2011;2(1):65-71.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.003
  • 1,459 View
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  • 5 Citations
AbstractAbstract PDF
The Division of Vaccine-Preventable Disease Control and National Immunization Program of the Korea Centers for Disease Control and Prevention has prepared a plan of action as a guide for key actions that will be taken if a poliovirus outbreak occurs in the Republic of Korea. The history of poliomyelitis and vaccination against poliovirus in the nation was reviewed and the routine surveillance procedures that are currently in place were described. The principles and specific actions for an effective response to a poliovirus outbreak were prepared. The guidelines clearly outline the actions to be taken in case of a polio outbreak. When a suspected case of poliovirus infection is reported, an immediate epidemiological investigation is to be conducted. The response to a poliovirus outbreak includes case isolation, management of potential contacts and immunization. All stakeholders are to be made aware of what key actions should be taken at each stage of the response to a poliovirus outbreak in the nation.

PHRP : Osong Public Health and Research Perspectives