Osong Public Health and Research Perspectives

Kyu Jam Hwang

3 Articles

Autochthonous Lyme Borreliosis in Humans and Ticks in Korea: Shinje Moon, Jin Gwack, Kyu Jam Hwang, Donghyuk Kwon, Suyeon Kim, Yoontae Noh, Jongyul Roh, E-hyun Shin, Kyungjin Jeong, Wonseok Seok, Seung-Ki Youn; Osong Public Health Res Perspect. 2013;4(1):52-56. Published online February 28, 2013; DOI: https://doi.org/10.1016/j.phrp.2012.12.001

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Abstract PDF: Objective: This study aimed at finding epidemiological and clinical features of autochthonous Lyme borreliosis in humans through epidemiological investigations and identifying its vectors and pathogens through analysis of ticks.
Method
Epidemiological investigations, including review of the retrospective medical records and patient interviews, were conducted in two cases that occurred in 2012. To identify the vectors and pathogens, ticks were collected between September 23 and October 6, 2012 from the area where the tick bite in the first patient occurred. The ticks were classified, and polymerase chain reaction (PCR) tests and cultures were performed.
Results
The first patient, a 46-year-old female, visited a forest in Gangwon province, which was 900 m above sea level, where the tick bite occurred. Two weeks after the tick bite, erythema migrans (12 × 6 cm² in size) appeared on the site of tick bite, along with fever, chill, fatigue, myalgia, and arthralgia on shoulders, knees, and hips. The second patient, a 44-year-old male, visited a mountain in Gangwon province, which was 1200 m above sea level, where a tick bite occurred. One month after the tick bite, erythema migrans appeared at the site of the tick bite, along with fatigue, myalgia, and arthralgia on the right shoulder and temporomandibular joint. Indirect fluorescent antibody testing and Western blotting were carried out in these two cases for diagnosis, and positive findings were obtained. As a result, Lyme borreliosis could be confirmed. To estimate the pathogens and vectors, the ticks were collected. A total of 122 ticks were collected and only two species, Haemaphysalis japonica and Haemaphysalis flava, were identified. PCR and culture were performed on ticks. However, Borrelia burgdo rferi sensu lato was not isolated from any collected ticks.
Conclusions
This study is significant to confirm Lyme borreliosis officially at first by the national surveillance system, although identification of the mites and pathogens failed.

Prion Diseases as Transmissible Zoonotic Diseases: Jeongmin Lee, Su Yeon Kim, Kyu Jam Hwang, Young Ran Ju, Hee-Jong Woo; Osong Public Health Res Perspect. 2013;4(1):57-66. Published online February 28, 2013; DOI: https://doi.org/10.1016/j.phrp.2012.12.008

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Abstract PDF: Prion diseases, also called transmissible spongiform encephalopathies (TSEs), lead to neurological dysfunction in animals and are fatal. Infectious prion proteins are causative agents of many mammalian TSEs, including scrapie (in sheep), chronic wasting disease (in deer and elk), bovine spongiform encephalopathy (BSE; in cattle), and Creutzfeldt–Jakob disease (CJD; in humans). BSE, better known as mad cow disease, is among the many recently discovered zoonotic diseases. BSE cases were first reported in the United Kingdom in 1986. Variant CJD (vCJD) is a disease that was first detected in 1996, which affects humans and is linked to the BSE epidemic in cattle. vCJD is presumed to be caused by consumption of contaminated meat and other food products derived from affected cattle. The BSE epidemic peaked in 1992 and decreased thereafter; this decline is continuing sharply owing to intensive surveillance and screening programs in the Western world. However, there are still new outbreaks and/or progression of prion diseases, including atypical BSE, and iatrogenic CJD and vCJD via organ transplantation and blood transfusion. This paper summarizes studies on prions, particularly on prion molecular mechanisms, BSE, vCJD, and diagnostic procedures. Risk perception and communication policies of the European Union for the prevention of prion diseases are also addressed to provide recommendations for appropriate government policies in Korea.

Epidemiological Characteristics of Serologically Confirmed Q Fever Cases in South Korea, 2006–2011: Wooseok Kwak, Hyuk Chu, Seondo Hwang, Ji-Hyuk Park, Kyu Jam Hwang, Jin Gwack, Young-Sil Choi, Seung-Ki Youn, Mi-Yeoun Park; Osong Public Health Res Perspect. 2013;4(1):34-38. Published online February 28, 2013; DOI: https://doi.org/10.1016/j.phrp.2012.12.006

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Abstract PDF: Objectives
Q fever has been reported worldwide; however, there was almost no official report of Q fever in Korea. In this study, we describe the current status of human Q fever occurrence in Korea.
Methods
Demographic data of Q fever patients were collected from the National Notifiable Diseases Surveillance System from 2006 to 2011. Case investigation reports from regional public health departments were used for additional information, like risk factors and clinical manifestation, of the patients since 2008.
Results
There were 65 serologically confirmed cases during the study period. The annual notification rate of Q fever was 0.22 cases per million persons. The majority of cases were men (87.7%), adults (98.5%), and urban inhabitants (67.7%). Relevant exposures to risk factors were identified in 45.7% of patients. The most common symptoms of acute Q fever were fever (89.3%), myalgia (67.9%) and asthenia (53.6%). Two cases with endocarditis were identified in chronic Q fever.
Conclusion
This study suggests that Q fever has a low endemicity in Korea. However, management and research at national level is required for prevention of a future epidemic.

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