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KMID : 0378019760190040485
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New Medical Journal
1976 Volume.19 No. 4 p.485 ~ p.498
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An Epidemiological Study of Eradicating Leprosy in Ullung-do Island, Korea
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Abstract
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The island Ullung-do, semi-isolated in the center of Japan Sea in the east of Korea, administratively belongs, as the Ullung County, to North Kyungsang Province where the spread of leprosy patients is most in Korea.
The population is 27,500, in the ratio of 60% fishermen, 30% farmers and 10% others.
The author discovered 59 leprosy patients, for the first time, in 1956, through the mass survey of the islander´s skin disease: since that they were treated 3-4 times a year. Then, in 1961, the auther migrated to Ullung-do were he founded the Ullung-do Hospital. While discovering leprosy patients among the out patients at the hospital the author engaged in finding, treating and relieving patients by working as the school doctor of the primary schools and secondary schools.
For the past 17 years, 1956 through 1973, the author treated 126 leprosy patients in all (including those who removed or treated irregularly) in Ullung-do. The patients who were treated regularly, however, are: 59 in 1956; 48 in 1961; 63 in 1964; 68 in 1966; 65 in 1968; 56 in 1969; 47 in 1970; 38 in 1971; 28 in 1972; 14 in 1973; and 8 in 1974, showing gradual decrease.
In view of the fact that leprosy is eradicating in Ullung-do which belongs to North Kyungsang province where the spread of leprosy patients is greatest in Korea, this study has been made to find a possibility of showing a royal way directed to the eradication of leprosy from Korea, through the research and survey on such matters as: how leprosy was brought to Ullung-do, how they were found, how they were treated, the patients´ bacteriological test results, how the patients moved, the environmental change of islander´s life, the advancement of their education, the economical development, and how the treatment made at home secretly apart from the general society, instead of accommodating them in a settlement, brought better results eventually bringing good effect to the patient´s restoration of social life.
The results are summarized and concluded as follows:
The population of the island Ullung-do, a lost island in the center of Japan sea for from the Korean mainland, has engaged in a semi-isolated life. The record of this island first appeared in a historical book, Sam-kock-sa-ki (512, A.D. ) The indigenes once formed a nation, Woo-San-kock, but they surrendered to Silla, and then in the beginning of the 10th century, the people of WooSan-kock once presented tribute to King Taejo of koryo dynasty (930, A. D.) The island was evacuated in the time of Yi dynasty, but about 100 years ago in the 13th year or King Ko-jong (1877, A. D.) the migration was started again. Internationally speaking, Captain Dagelet of the French Explering Ship “Boussole” discovered the island on May 29, 1787, and it was first recorded as “Dagelet” in the international chart.
(1) It is assumed that the indigenes of the island were composed of Japanese (from Tsushima, 9himane, and Sanin-about 500 of them were detected in 1885, A. D. ), and the migrants who first moved to the provinces of Jolla and Kyungsang of Korean mainland from Jeju island because of famine, and mostly scattered in the coastal line finally reaching this Ullung-do. Though it is not clear when leprosy invaded this island, it may be assumed from the formation of indigenes that it took a course from Jeju-do to Jolla-do, Kyungsang-do and to Ullung-do.
(2) The author discovered new patients of early stage trough the mass survey in the physical examination of 11 primary school students, 1956-1973, and 3 secondary schools 1961-1973, and from the out-patients of Ullung-do Hospital, 1961-1973.
The number of patients found in above surveys are:
from primary school students, 1957-1959--------------------------6
from secondary school students, 1957-1965-----------------------18
from the out-patients of Ullung-do Hosp., 1961-1969---- 37
However, no new patients were found:
from primary school students, for 14 years, 1960-1973;
from secondary school students, for 8 years, 1966-1973; and
from out-patients of Ullung-do Hosp., for 4 years, 1970-1973.
The first leprosy patients found in the island were 59 in 1956. However, 68 patients were treated in 1967, for new patients were found and some patients moved since the Ullung-do Hospital was founded in 1961. After that the patients decreased as follows: 47 in 1970. 38 in 1971, 28 in 1972. 14 in 1973. and 8 in 1974 and 4 in 1975.
(3) The patients were dosed mainly with D.D.S. and CiBA 1906, and most patients regularly treated turned better in results, except 2 patients who were worsening. It maw by caused but their resistance to D. D. S.
(4) Since 1971, patients have been released from control under the basis provided by WHO, now to be left only 8. This will mean that leprosy is being eradicated in Ullung-do.
(5) It is considered that dosing such sulfone as D.D.S. and CIBA 1906 and taking protein have Contributed greatly to the eradicating leprosy in Ullung-do, accelerating the clinical improvement, and further that semi-isolated patient´s life in the highland of this semi-isolated island was a factor to decrease the opportunity of spreading leprosy among the islanders.
(6) The cultural advancement and the increase of educational facilities in the island promofed the hygienic sense of islanders, providing indirect or direct enlightenment to the prevention and treatment of this disease.
(7) It is evident in the island that the economical growth shown by the increase of farm products, live-stock products and fishing products can influence much to the advancement of national health. For example of 2 leprosy patients in the island, one lepromatous type ( ® ) patient residing in a highland was given a dairy goat to allow him to take its milk continuously; on the other hand, a Borderline type patient residing in urban area could not take milk. Clinical and bacteriological comparison made between the former and latter was that the former turned better becoming inactive; while, the latter turned to be a Lepromatous type (N) from the Borderline type.
(8) The number of leprosy patients in Korea is still not certain, and even the statistics made from the register in the Ministry of Health and Social Affairs in 1973 is considered to have some error. After releasing from control on the basis made by WHo, the leprosy patients in Ullung-do much decreased.
(9) It is considered that the discovery of early stage of leprosy in Korea may be effectively done through the mass survey, especially through the medical check-up of secondary school students, and the physical examination of recruits, and by the careful cooperation of general practitioners in treating local people.
(10) In case of even active leprosy patients, the infection can be prevented, ´.if we can let them reside in a different room, a little apart from the general community, even though they are not sent to collective settlement.
It leprosy patients are treated at home secretly not opening the fact to the general public, the restoration of their normal life in general society will not be a problem.
(11) Dosing sulfone together with the supply of enough protein will be necessary for treatment of leprosy patients, and to the patients resistant to sulfone, it may be replaced with such new medicine as Rifampicin, etc.
(12) The author could learn from his experience in Ullung-do that the accurate mass survey of leprosy patients and the discovery of early stage to be made through the cooperation of general practitioners and the register and estimate of exact number of the patients, and the early practice of releasing patients from control on the WHO´s basis will be royal way to re-arrange the leprosy problem of Korea.
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