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Original Articles
Community-Based Risk Communication Survey: Risk Prevention Behaviors in Communities during the H1N1 crisis, 2010
Soo Jeong Kim, Jin A. Han, Tae-Yong Lee, Tae-Yoon Hwang, Keun-Sang Kwon, Ki Soo Park, Kyung Jong Lee, Moon Shik Kim, Soon Young Lee
Osong Public Health Res Perspect. 2014;5(1):9-19.   Published online February 28, 2014
DOI: https://doi.org/10.1016/j.phrp.2013.12.001
  • 1,669 View
  • 17 Download
  • 15 Citations
AbstractAbstract PDF
Objectives
The present study aimed to investigate the prevalence of and factors associated with H1N1 preventive behaviors in a community-based population.
Methods
A cross-sectional study was conducted in three urban and two rural communities in Korea. Interviews were conducted with 3462 individuals (1608 men and 1854 women) aged ≥ 19 years during February–March 2010. Influenza-related information including anxiety, preventive behaviors and their perceived effectiveness, vaccination status, past influenza-like illness symptoms, and sources of and trust in information was obtained.
Results
Among 3462 participants, 173 reported experiencing influenza-like illness symptoms within the past 12 months. The mean H1N1 preventive behavior score was 25.5 ± 5.5 (out of a possible 40). The percent of participants reporting high perceived effectiveness and high anxiety was 46.2% and 21.4%, respectively. After controlling for potential confounders, H1N1 preventive behavior scores were predicted by a high (β = 3.577, p < 0.001) or moderate (β = 2.529, p < 0.001) perception of their effectiveness. Similarly, moderate (β = 1.516, p < 0.001) and high (β = 4.103, p < 0.001) anxiety scores predicted high preventive behavior scores.
Conclusion
Effective methods of promoting population behavior change may be nationwide campaigns through mass media, as well as education and promotion by health care providers and broadcasters.
Evaluation of the Effectiveness of Pandemic Influenza A(H1N1) 2009 Vaccine Based on an Outbreak Investigation During the 2010–2011 Season in Korean Military Camps
Kyo-Hyun Kim, Yoon Gu Choi, Hyun-Bae Yoon, Jung-Woo Lee, Hyun-Wook Kim, Chaeshin Chu, Young-Joon Park
Osong Public Health Res Perspect. 2013;4(4):209-214.   Published online August 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.07.002
  • 1,429 View
  • 15 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
In December 2010, there was an outbreak of acute febrile respiratory disease in many Korean military camps that were not geographically related. A laboratory analysis confirmed a number of these cases to be infected by the pandemic influenza A(H1N1) 2009 (H1N1pdm09) virus. Because mass vaccination against H1N1pdm09 was implemented at the infected military camps eleven months ago, the outbreak areas in which both vaccinated and nonvaccinated individuals were well mixed, gave us an opportunity to evaluate the effectiveness of H1N1pdm09 vaccine through a retrospective cohort study design.
Methods
A self-administered questionnaire was distributed to the three military camps in which the outbreak occurred for case detection, determination of vaccination status, and characterization of other risk factors. The overall response rate was 86.8% (395/455). Case was defined as fever (≥38 °C) with cough or sore throat, influenza-like illness (ILI), and vaccination status verified by vaccination registry. Crude vaccine effectiveness (VE) was calculated as “1 − attack rate in vaccinated individuals/attack rate in nonvaccinated individuals”, and adjusted VE was calculated as “1 – odds ratio” using logistic regression adjusted for potential confounding factor. A number of ILI definitions were used to test the robustness of the result.
Results
The attack rate of ILI was 12.8% in register-verified vaccinated individuals and 24.0% in nonvaccinated individuals. The crude VE was thus calculated to be 46.8% [95% confidence interval (CI): 14.5–66.9]. The adjusted VE rate was 46.8% (95% CI: –9.4 to 74.1). Various combinations of ILI symptoms also showed similar VE rates.
Conclusion
We evaluated the effectiveness of H1N1pdm09 vaccine in the 2010–2011 season in an outbreak setting. Although the result was not sensitive to any analytical method used and ILI case definition, the magnitude of effectiveness was lower than estimated in the 2009–2010 season.
Articles
The Emergence of Oseltamivir-Resistant Seasonal Influenza A (H1N1) Virus in Korea During the 2008-2009 Season
Woo-Young Choi, Inseok Yang, Sujin Kim, Namjoo Lee, Meehwa Kwon, Joo-Yeon Lee, Chun Kang
Osong Public Health Res Perspect. 2011;2(3):178-185.   Published online December 31, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.11.042
  • 1,384 View
  • 13 Download
  • 10 Citations
AbstractAbstract PDF
Objectives
To monitor antiviral drug resistance among seasonal influenza viruses isolated in Korea during the 2008-2009 influenza season, we examined influenza isolates collected through Korea Influenza Surveillance Scheme for antiviral drug susceptibility.
Methods
For genetic analysis of antiviral drug resistance, the matrix (M2) and neuraminidase (NA) genes of each isolate were amplified by reverse transcription-polymerase chain reaction and followed by nucleotide sequencing. For phylogenetic analyses, the sequences of hemagglutinin (HA) and NA genes of each isolate were aligned using multiple alignment program. For phenotypic analysis of antiviral drug resistance, drug susceptibilities against M2 inhibitor (amantadine) and NA inhibitors (oseltavimir and zanamivir) were determined by virus yield reduction assay and fluorometric NA inhibition assay, respectively.
Results
In Korea, the resistant influenza viruses against oseltamivir were first detected in sealsonal influenza A(H1N1) viruses on Week 48 of 2008. Since then, the number of oseltamivir-resistant A(H1N1) viruses was continuously increased and had reached the highest peak on Week 52 of 2008. 533 (99.8%) of 534 A(H1N1) viruses were resistant to oseltamivir and all of them harbored the H275Y mutation in the NA gene during the 2008-2009 season. The oseltamivir resistance identified by sequencing was confirmed by NA inhibition assay. Genetic analysis based on HA gene of the resistant A(H1N1) viruses revealed that the viruses were identified as A/Brisbane/10/2007-like strain which was vaccine strain for the 2008-2009 season.
Conclusions
The oseltamivir-resistant A(H1N1) viruses were first emerged in Europe in November 2007 and then circulated globally. One year later, the oseltamivir-resistant A(H1N1) viruses were first detected in Korea in November 2008 and continued circulating until the Week 7 of 2009 during the 2008-2009 season. Considering the pandemic preparedness, it should be continued to monitor the emergence and the characterization of antiviral drug resistant influenza viruses.
Original Article
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
  • 1,392 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.

PHRP : Osong Public Health and Research Perspectives