창원에서 유행한 백일해의 임상적 특징 = Clinical Characteristics of Pertussis Epidemic in Changwon

국문 초록 (Abstract)

목적: 백일해는 백신접종으로 예방이 가능한 질환이지만 세계적으로 증가하고 있고, 국내에서도 환자 가 증가하고 있는 추세이다. 저자들은 최근 창원 지역에서 발생한 백일해 환자의 역학적인 특징과 임상 양상을 알아보고자 이 연구를 실시하였다. 방법: 2015년 7월부터 2016년 3월까지 호흡기 증상을 주소로 창원파티마병원 소아청소년과에 내원하는 환자 중 1주 이상의 기침을 하면서 발작적인 기침, 기침 후 구토, 흡기 시 `흡` 소리(whooping), 야 간 기침이 동반된 환자들을 대상으로 호흡기 검체를 채취하여 백일해에 대한 배양, 중합연쇄반응검사를 실시하였고, 혈액의 항백일해 독소 항체검사(anti-pertussis toxin of ELISA kit, IBL Interna-tional GmbH)를 실시하였다. 기저에 질환이 있거나 최근 1년 안에 DTaP 혹은 Tdap 백신 접종을 한 경우에는 제외하였다. 결과: 연구 기간 동안 대상 환자 50명 중 진단된 환자는 37명이었다. 이 중 중합연쇄반응검사에서 양성 인 환자는 2명이었고 혈청검사에서 양성인 환자는 37명이었다. 환자의 연령은 생후 1개월부터 15세였다. 항생제 사용 후 모든 환자가 합병증 없이 회복되었다. 결론: 2015년 7월부터 2016년 3월까지 창원 지역에 백일해의 유행이 있었으며, 이 연구 결과는 향후 국내에서 발생하는 백일해 역학 연구에 도움이 될 것으로 판단한다.

다국어 초록 (Multilingual Abstract)

Purpose: Pertussis can be prevented with a vaccine. Despite this, there have been an increasing number of cases worldwide, and also in Korea. This study aimed to investigate the epidemiology and clinical characteristics of the recent outbreak in the Changwon area. Methods: Patients who visited Changwon Fatima Hospital from July 2015 to March 2016 with respiratory symptoms, including spasmodic cough, cough induced vomiting, inspiratory `intake` sound (whooping), and a night-time cough for >1 week were included in this study. Respiratory specimens were collected from patients and a polymerase chain reaction (PCR) and detected anti-pertussis immunoglobulin G enzyme-linked immunosorbent assay kit test were performed. Patients with underlying diseases, or those who had received a DTaP or Tdap vaccination in recent 1 year were excluded. Results: Pertussis was diagnosed in 37 of 50 patients, two patients were positive according to the PCR, and 37 patients were positive according to serologic tests. The age distribution of the patients was 1 month to 15 years. After administering antibiotics, all patients recovered without complications. Conclusions: A pertussis outbreak occurred in Changwon in 2015 and 2016. This data can provide the basis for further study on the epidemiology of pertussis in Korea.

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