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KMID : 0380819930150010074
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Korean Journal of Epidemiology
1993 Volume.15 No. 1 p.74 ~ p.84
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The Surveillance and Management System of Leptospirosis in a Rural Community of Korea, 1989 and 1990
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최보율
강성문/이수진/박향배/김동우/오세중/김정순
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Abstract
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Since 1975, The leptospirosis, which had been reported as hemorrhagic pneumonia like disease, epidemic pneumonitis and epidemic pulmonary hemorrhagic fever until 1984, has been occurred sporadically but steadily in middle inland of Korea. The
etiologic
agent of this disease was isolated in 1984 when the epidemic was out broken all over the nation. After the isolation of agent, many studies have been carried out to discover some epidemiological characteristics and to develop vaccine. Up to now,
there
remains a lot of problems to be solved such as organized surveillance and management of leptospiral infection and assessment of vaccine efficacy.
The goal of this study is to establish the surveillance and management system of leptospirosis in a rural community(county level) to reduce the occurrence of disease, disability and death caused by leptospirosis and to propose the generalized
model
applicable to every county level community in Korea.
The components of this system were 1) detection system of suspicious patient, 2) facilities for definite diagnosis and treatment of patient and 3) surveillance authority. The detection system included all medical facilities which were primary
health
care posts, health center and it's branches, local clinical and community hospital. Final diagnosis were performed in laboratory department of community hospital and a medical college. MAT(microscopic agglutination test) as a serologic test were
used
for final diagnosis according. To WHO guideline. Health center played the role of surveillance authority. This surveillance system mainly operated during the epidemic season from September to December.
This system launched from Sep. 1989 and the results of two year experience are summarized as followings.
Throughout the surveillance period, 27suspicious and 9 serologically confirmed cases detected in 1989 and 76 suspicious and 26 serologically confirmed cases in 1990. The serologically positive rate(58.5%) in patients who received serologic test
was
two
times higher than rate(27.1%) of patients who received serologic test once. The attack rates of leptospirosis during the epidemic season in 1989 and 1990 were estimated to 1. 12-3.35 and 3.63-9.85 persons per 10,000 persons when No. of patients
detected
projected to population of country as a base population.
In 1989 and 1990, month that many patients were detected is October and September. It was due to the flood that had resulted from the heavy rain(500 mm) for 4 consecutive days from the 8 the of September, 1990.
Key word : Leptospirosis, Surveillance system, Serology
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KEYWORD
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