신종 감염병의 최신 지견 ; 뎅기열

정문현 ( Moon Hyun Chung ) 대한내과학회 2009 대한내과학회지 Vol.77 No.2

Dengue virus causes dengue fever and its more severe form, dengue hemorrhagic fever. The classical symptoms of dengue fever are high fever lasting for 5~7 days and bright reddish petechiae developed at the end of fever. The virus is transmitted by mosquitoes belonging to the genus Aedes, which are distributed in the tropical and subtropical areas of Africa, America, Southeast Asia, and Pacific islands. The currant pandemic of dengue viral infection began after the 1940s, possibly in consequence to the World War II, and the dengue virus infection has become the most important arthropod-borne viral infection. With an increase in the number of Koreans traveling to dengue fever-endemic areas since 1988, there has been an increase in the incidence of dengue viral infection and is reported to affect 50 to 90 patients annually. Further, it is the most common notifiable imported disease in Korea. Most of the patients with dengue infection presented with dengue fever or dengue hemorrhagic fever, and 1 fatal case of dengue shock syndrome was reported. (Korean J Med 77:165-170, 2009)

일개 대학 병원에서 경험한 뎅기열-뎅기출혈열 4예와 국내 문헌 고찰

최문한,추은주,김태형,전민혁,박의주,신동원,이설희,최종효 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.6

Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed. In addition, relevant domestic literatures from Korean bibliographic databases, which matched ‘dengue fever’, ‘dengue hemorrhagic fever’ or ‘dengue shock syndrome’ as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one, who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82 %), and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.

일개 대학 병원에서 경험한 뎅기열-뎅기출혈열 4예와 국내 문헌 고찰

최문한,추은주,김태형,전민혁,박의주,신동원,이설희,최종효 대한감염학회 2008 감염과 화학요법 Vol.40 No.6

Dengue virus infection is an emerging imported disease in Korea. A total of 4 cases of dengue fever or dengue hemorrhagic fever diagnosed at Soonchunhyang University Hospital in Bucheon between January 2001 and December 2007 were retrospectively reviewed, In addition, relevant domestic literatures from Korean bibliographic databases, which matched 'dengue fever', 'dengue hemorrhagic fever' or 'dengue shock syndrome' as key words, have been reviewed. Ten articles (13 patients) met the inclusion criteria and were included in this review. All the patients except for one who was infected in Africa, were infected in Asian countries: Philippines (4), Indonesia (3), India (2), Cambodia (2), Sri Lanka (1), Thailand (1), Bangladesh (1), Myanmar (1), and Malaysia (1). Clinical manifestations after returning from abroad were as follows: fever (100%), chills (82%), headache (65%), myalgia (53%), nausea (41%), neutropenia (82%), thrombocytopenia (82%) and elevation of AST (82%) and ALT (53%). Most of the patients improved with conservative care except for one who died of dengue shock syndrome.

필리핀에서 유입된 망막병증을 동반한 뎅기열 1례

김승민 ( Seung Min Kim ),김동현 ( Dong Hyun Kim ),신재령 ( Jae Ryung Shin ),오치혁 ( Chi Hyuk Oh ),유정선 ( Jung Sun Yoo ),정명화 ( Myoung Hwa Jung ),박선희 ( Sun Hee Park ),문수연 ( Soo Youn Moon ),손준성 ( Jun Seong Son ),한지상 전북대학교 의과학연구소 2013 全北醫大論文集 Vol.37 No.1

Over the last few decades, the incidence and distribution of dengue has increased. Although Korea is not an endemic area, the numbers of imported dengue cases are increasing because of an increasing number of people travelling overseas. Common symptoms of dengue are malaise, fever, musculoskeletal pain and headache. But ocular manifestations have only been reported in one case in Korea. Here, we report a case of imported dengue fever presenting with fever, petechiae and visual disturbance. This case highlights the ocular manifestations of dengue fever. Ophthalmologic evaluation should be performed in patients presenting with severe dengue fever and visual disturbances.

뎅기 바이러스 검출기술 관련 특허동향 분석

최재원,조병관,김학용 한국콘텐츠학회 2019 한국콘텐츠학회논문지 Vol.19 No.2

Dengue virus is a typical mosquito-borne virus, and the half of the world's population is exposed to infection. Dengue virus causes relatively mild symptoms such as dengue fever. However, when not treated properly, it is known to cause severe symptoms such as dengue hemorrhagic fever and dengue shock syndrome with a mortality rate of over 20%. Development of dengue virus detection technology is very important because it is reported that early diagnosis of dengue fever can lower the mortality rate to less than 1%. In this study, patent search related to dengue virus detection technology was conducted in Korea, USA, Europe, Japan, and China. The quantitative analysis of 69 validated patents from the searched patents was conducted by country, year, and patent holder. In addition, in-depth analysis was carried out by classifying into three categories: molecular diagnostics, immuno-diagnostics, and cell culture-based diagnostics from all validated patents. From these results, we analyzed the patent trend related to dengue virus detection and dengue fever diagnosis technology and discussed the features and limitations of molecular diagnostics and immuno-diagnostics at present level. Furthermore, we discussed the direction of technology development and future prospects to overcome limitations. 뎅기 바이러스는 대표적인 모기-매개 바이러스로, 전 세계 인구의 약 절반에 가까운 인구가 감염 위험에 노출되어 있다. 뎅기 바이러스는 뎅기열과 같은 비교적 경미한 증상을 나타내지만, 적절한 치료를 받지 않을 경우 치사율이 20%가 넘는 뎅기 출혈열 및 뎅기 쇼크 증후군과 같은 심각한 증상을 유발하기도 한다. 뎅기 바이러스 검출을 통해 감염 여부를 조기에 진단한다면 치사율을 1% 미만으로 낮출 수 있는 것으로 보고되고 있기 때문에, 뎅기 바이러스 검출기술의 개발이 매우 중요한 상황이다. 본 연구에서는 특허 5대 강대국인 한국・미국・유럽・일본・중국을 대상으로 뎅기 바이러스 검출기술 및 뎅기열 진단기술과 관련된 특허문헌 검색을 수행하였다. 검색된 특허문헌으로부터 관련도가 높은 유효 특허문헌 69건을 대상으로 국가별・연도별・특허권자별 정량분석을 수행하였으며, 모든 특허문헌을 검토하여 유전자 검출 기반의 분자진단, 단백질 검출 기반의 면역진단, 세포배양법을 통한 진단 등의 3가지 분류로 나누어 정성분석을 수행하였다. 이를 종합하여 뎅기 바이러스 검출기술 및 뎅기열 진단기술 관련 특허동향을 파악하였으며, 현재 수준에서의 분자진단과 면역진단의 특징 및 한계점을 분석하였다. 더 나아가 한계점을 극복하기 위한 기술개발 방향과 앞으로의 전망에 대해 논의하였다.

해외에서 유입된 뎅기열 1 예

김명수(Myung Soo Kim),김자경(Ja Kyung Kim),김영근(Young Keun Kim),이꽃실(Kkot Sil Lee),염준섭(Joon Sup Yeom),허애정(Ae Jung Huh),장경희(Kyung Hee Chang),송영구(Young Goo Song),김준명(June Myung Kim) 대한내과학회 2002 대한내과학회지 Vol.62 No.5

Dengue fever (DF) is an acute febrile viral disease frequently presenting with headache, bone or joint and muscular pain, rash and leukopenia. Dengue hemorrhagic fever (DHF) is characterized by four major clinical manifestations: high fever, hemorrhagic phenomena, often with hepatomegaly and in severe cases, signs of circulatory failure. Such patients may develop hypovolemic shock resulting from plasma leakage. This is called dengue shock syndrome (DSS) and can be fatal. The disease is one of the leading causes of hospitalization and death in children in several Asian, central and south American and African countries. Dengue fever and Dengue hemorrhagic fever have steadily increased in both incidence and distribution over the past 40 years. With an increased air travel, more travelers to the tropics and subtropics are returning within the incubation period of acute febrile infection. We experienced a Korean engineer with complaints of fever, chill, headache, nausea and myalgia after return from Malaysia and confirmed as dengue fever.(Korean J Med 62:548-551, 2002)

해외귀국 한국인의 뎅기 바이러스에 대한 항체 양성율

유정희,최택균,최우영,주영란,진성현,박근용 대한감염학회 2004 감염과 화학요법 Vol.36 No.4

목적 : 한국인의 해외여행이 지속적으로 증가함에 따라 해외 유행 질병의 유입 및 해외 감염 가능성이 점점 증가하고 있다. 특히 뎅기열은 동남아시아 등의 해외여행 및 거주 한국인이 증가함에 따라 감염기회가 점차 증가할 것으로 예상되고 있다. 따라서 뎅기열 유행지역의 여행 및 체류 한국인 가운데 뎅기열 의심증상을 보인 환자의 검체를 수집하여 혈청학적 및 역학적 상황을 확인함으로서 현재까지 확인되지 않았던 한국인의 뎅기 바이러스 감염 실태를 파악하여 국가의 보건지표를 확립하고자 하였다. 재료 및 방법 : 해외여행 후 뎅기열 의심증세를 보이는 환자의 혈청을 수집하여 상업용 진단 kit인 MAC-ELISA 및 ICA법을 사용하여 뎅기 바이러스에 대한 항체시험을 실시하고 성별, 연령, 방문국 등 뎅기 감염에 영향을 미치는 요인들을 분석하였다. 상업용 진단 kit에 의해 혈청학적 결과가 확인된 99건의 검체 가운데 25건의 검체에 대하여 본 실험실에서 제작한 IFA 슬라이드로 확인시험을 실시하고 그 결과를 상업용 진단 kit와 비교 분석하였다. 결과 : 99건의 뎅기열 유사증상 환자의 검체는 상업용 진단 kit에 의해 333%의 뎅기 항체 양성으로 확인되었으며 이들 환자의 해외 방문국의 조사 결과 타일랜드 등 4개국 여행자에서 절반 이상의 양성자가 확인되었다. 또한 진단법 비교시험을 위해 25개 검체를 상업용 진단 kit와 자체 제작한 IFA법으로 시험한 결과 진단 kit에서 양성 9명, IFA에서 양성 13명으로 나타나 결과의 차이가 있었다. 결론 : 한국인의 뎅기 바이러스 감염자가 국내에서 처음으로 확인되었으며 환자 발생의 원인과 지역, 환자의 발생을 확인할 수 있었다. 이에 따라 뎅기열에 대한 실험실적 감시체계 구축과 진단시험체계의 확립이 필요함을 확인하였다. 또한 상업용 진단 kit를 사용함에 따라 발생하는 고가의 비용을 최소화 할 수 있는 민감도와 특이도 등 효능이 높은 진단법 개발이 요구되었다. Background : Recently, dengue fever has increased throughout tropical regions and emerged as the most important vector borne viral disease in human. 4 serotypes of viruses are circulating concurrently in these regions and thus it may be anticipated to increase risk of dengue hemorrhagic fever. Even though dengue fever is still not endemic in Korea, it is necessary to test antibodies against dengue viruses because the number of Koreans who have visited these regions is continuously increasing. Materials and methods : Serum specimens from persons with suspected dengue fever had been collected. Commercial kit, immunochromatographic test (ICA), and the IgM capture enzyme-linked immunosorbent assay (MAC-ELISA) were employed for dengue fever detection in these studies. For confirmation randomized 25 specimens among total of 99 specimens were selected and compared with those results from commercial kit and IFA. Results : 33 (33.3%) among 99 specimens showed positive antibody against dengue virus by commercial kit. Positive rate of traveller who have visited Indonesia, Philippines, Malaysia, Thiland was 54.5%. To compare the efficiency of test methods, 25 randomly selected specimens were tested by the MAC-ELISA and IFA simultaneously. 9 specimens showed postive results with the MAC-ELISA method whereas 13 speciments were positive with the IFA methods. Conclusion : Confirming the diagnosis of dengue fever with antibody against dengue virus was attempted for the first time in Korea. The results from our study indicate that establishing a national surveillance and/or laboratory diagnostic system in Korea are necessary. In addtion, antibody test strategies for national surveillance system should be carefully considered.

Dengue Fever Mimicking Acute Appendicitis : A Case Report

Kang, Yoon Jung,Choi, Sung Youn,Kang, Im Ju,Lee, Jae Eun,Seo, Mi Hye,Lee, Tae Houn,Ghim, Byoung Kwon 대한감염학회 2009 감염과 화학요법 Vol.41 No.4

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.

Dengue fever: epidemiology, clinical manifestations, diagnosis, and therapeutic strategies

Teddy Namirimu,Sunjoo Kim 대한임상미생물학회 2024 Annals of clinical microbiology Vol.27 No.2

Dengue, a mosquito-borne viral infection, is rapidly increasing worldwide and affects overhalf of the world’s population in at-risk areas. Factors such as globalization, urbanization, andclimate change have fueled its rapid geographical expansion. Although no indigenous denguecases have been identified in Korea, the number of imported dengue cases has increasedfrom travel to endemic regions. In Korea, dengue diagnosis relies mainly on detecting anti-dengue antibodies or viral nucleic acids using real-time polymerase chain reaction. Althoughspecific antiviral treatments for dengue are currently unavailable, promising progress hasbeen made in developing antiviral agents that target viral replication. Single-dose tetravalentlive-attenuated dengue vaccine candidates are currently being evaluated for their safety andefficacy. Innovative vector control methods, including Wolbachia-infected and geneticallymodified species of Aedes mosquitos, have demonstrated promising results. Owing to thelimited therapeutic options, vector control strategies remain a primary focus for preventingtransmission, alongside ongoing research on antiviral drugs and vaccine development. Thisreview provides insight into dengue fever transmission, clinical manifestations, and diagnosis. Additionally, it covers current global control measures, emerging treatment options, and thestatus of vaccines in development.

Dengue Fever Mimicking Acute Appendicitis: A Case Report

강윤정,김병권,최성연,강임주,이재은,서미혜,이태현 대한감염학회 2009 Infection and Chemotherapy Vol.41 No.4

We experienced a case of enteritis mimicking acute appendicitis in Dengue fever. This is the first case report of such complication in Korea. A 36-year-old man presented with fever and abdominal pain after a trip to the Philippines. He complained of severe pain on the right iliac fossa region. Complete blood cell count showed thrombocytopenia with leucopenia. Computed tomogram (CT) of abdomen and pelvis revealed a normal appendix. Dengue fever was confirmed by IgM capture enzyme-linked immunosorbent assay against dengue virus. During the follow-up period of 4 weeks, he was recovered and platelet count gradually. We can see from this case that dengue fever may present with abdominal pain, which mimics acute appendicitis. Early recognition of dengue fever mimicking appendicitis is important to prevent unnecessary surgical intervention.