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KMID : 0383919650020010011
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Report of National Institute of Health
1965 Volume.2 No. 1 p.11 ~ p.37
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The Epidemiological Study of Acute Communicable Diseases
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Abstract
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The purpose of this epidemiological study is to arrange and analyse the acute communicable diseases, i.e., Typhoid fever, Japnese encephalitis, Diphtheria, dysentery, Hemorrhagic fever, Para-typhoid fever, Cholera, Meningococcal meningitis, Epidemic typhus and Scarlet fever., in Korea 1964. It will be recommended the effective and rational policy making of preventive medicine to the authoritis concerned. It, particularly, has been compared with the Acute Communicable Diseases in 1962 and 1963.
1) Typhoid fever(4,394 cases. 115 deaths.)
The morbidity rate is the highest of all epidemic diseases in Korea i.e. 11.21 per 100,000 population, it is lower than 1962 and higher than 1963. (Chon puk by 31.66 is the highest area and Kang won by 3.04 is the lowest area), male cases are 56.14% of all Typhoid fever cases, age distribution is 21.26±13.66 of age group, in the occupational distribution of Typhoid fever cases, agricultrue by 24.62% is the highest than others, the case fatality rate is 2.61% (Pusan by 4.92% is is the highest and Chon nam by 0.18% is the lowest), it is higher than 1962 and lower than 1963. Typhoid fever is an endemic disease in ithe country, high epidemic period is from June through october. The duration onset to diagnosis is average 12 days and the curating duration is average 17 days, most of all patients in urban area used medical facility, i.e., city, provincial and university hospitals and isolation wards but the case in rural areas were isolated at their own house. most of all Typhoid fever cases were diagnosed by clinical-examinations.
We should recommend to improvement of the water supply system and digwells, and vaccination for people of 7 to 34 years old age group in March and diagnosis have to determine by the serological and the bacteriological methods in city or provincial hygiene laboratories than the clinical examination. I specially recommend that in viewpoint of epidemiology, all health centers have to have the examination for carrier detection, the cases and his family who suffered form Typhoid fever in former year.
2) Japanese encephalitis (2,942 cases, 890 deaths.)
The morbidity rate is comparatively high, i.e., 9.34 per 100,000 population (the highest area is Chon puk by 31.66 and the lowest Che ju by 0.70), male cases are 61.15% of all Japanese encephalitis cases, age distribution is almost 7.31±5.86 of age group and the case fatality rate is highest of all epidemic diseases in Korea 30.25% (Kyonggi by 52.38% is the highest and Chon nam by 16.51% is the lowest). Main epidemic weeks are 27 to 41 of week (July 1, till October 13,) in southern part of Korea. The duration from onset to diagnosis is average 3 days the hospitalized duration in average 10 days (including cured cases and deaths). Generally, facilities used for patients are city or provincial hoipitals and general hospitals in urban areas and home care in rural areas. Main diagnostic method is almost the clinical examination. The law od Communicable Disease Control in which Japnaese encephalitis had been set up as 2nd grade legal communicable disease should be amend as 1st grade legal communicable disease.
We should recommend improvement of the environmental sanitation for preventive disease policy and to be recognized the public health information to the people through the health education especially for the children of primary schools.
3) Diphtheria (cases 834, deaths 84)
The morbidity rate 2.46 per 100,000 population (Seoul by 13.23 is the highest area and Che ju by 0.06 is the lowest area). Male cases are 61.15% of all diphtheria cases. Age distribution is almost under 10 years old age group, the case fatality rate is 10.07% which is lower than in 1963 ´Kyong nam by 40.00% is the highest, there is no death in Pusan, Chon nam and Cheju). Diphtheria is an endemic disease in this country, particularly, epidemic season is almost in winter, the duration of onset to diagnosis is average 3 dyas and the curating duration is average 10 days. Generally, facilities used for patients are city or provincial hospitals and university hospitals in urban areas and home care in rural areas. Main diagnostic method is almost the clinical examination.
We should recommend vaccination for the people of 6 months to 10 years old in September and to test by the bacteriological examination.
4) Dysentery (428 cases, 13 deaths)
The morbidity rate is 1.15 per 100,000 population (Kyong nam by 5.23 is the highest areas and Kangwon, chung puk are no case), male cases are 69.81% of all Dysentery cases, age distribution is almost from 2 to 35 years old age group and the case fatality rate is 3.03% (Seoul and Pusan by 25% is the highest and there and there are no death in Kyonggi, Chon nam, Kyong puk and Che ju). Most of all cases are Amebic Dysentery momre than Bacillary in this country. Epidemic season ins almost in summer. The duration onset to diagnosis is average 7 days and the curating durating is average 9 days. Generally, facilities used for patients are city or provincial hospitals in urban areas and home care in rural areas. main diagnostic method is almost the clinical examination.
It is recommended to test Dysentery cases by bacteriological examinations rather than clinical examinations and to improvement of the water supply system and digwells as Typhoid fever.
5) Hemorrhagic fever (34 cases, 8 deaths)
The morbidity rate is 0.12 per 100,000 population (Kyong gi are 33 cases and Kang won is one (1) case), The case fatality rate is 23.52% (Kyong gi by 24.24% is high and there is no death in kang won) The Republic of Korean Army announced that 204 cases of Hemorrhagic fever breaked out in Army quater on armistice zone in 1964. Out of 34 cases, 33 cases are male one (1) is female. The duration onset to diagnosis is average 7 days and the curating duration is average 6 days. Age distribution is almost 30 years old age group, main epidemic season is in autumn.
6) Cholera (Eltor type) (11 cases, 1 death)
The morbidity rate is 0.12 per 100,000 population, (the case fatality rate is 9.00% which is higher than in 1963. Epidemic area is only Kyong gi province (Inchon city and Buchon county) Male cases are 54.54% of all Cholera cases. Age distribution is almost 30 years old age group, but there is one of 3 years old child. Epidemic period is from october 16, to November 6. The duration of onsent to diagnosis is average 2 days and the curating duration is average 8 days. Almost patients used isolation ward of Inchon city.
7) Other diseases
Prevalense of Para-typhoid fever, Meningococcal moningitis, Epidemic typhus and Scarlet fever, etc., are sporadic and nscarce, so there is not so much significance to standardize or confirm by theses datas.
8) Final recommendation
a) Diagnostic method in 1964 had improved than in 1962 and 1963, but diagnostic method should be determined by serological or bacterioloical examinations rather than the clinical examinations.
b) City and provincial laboratories should be improved both their technicians and facilities than in 1962 and 1963.
c) Legal reporting system in 1964 had improved than in 1962 and 1963.
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