Publications by authors named "Deog-Yong Lee"

47 Publications

The laboratory test procedure to confirm rotavirus vaccine infection in severe complex immunodeficiency patients.

Osong Public Health Res Perspect 2021 Aug 13;12(4):269-273. Epub 2021 Aug 13.

Division of Viral Diseases, Bureau of Infectious Diseases Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju, Korea.

The rotavirus vaccine is a live vaccine, and there is a possibility of infection by the virus strain used in the vaccine. We investigated the process of determining whether an infection was caused by the vaccine strain in a severe complex immunodeficiency (SCID) patient with rotavirus infection. The patient was vaccinated with RotaTeq prior to being diagnosed with SCID. The testing process was conducted in the following order: confirming rotavirus infection, determining its genotype, and confirming the vaccine strain. Rotavirus infection was confirmed through enzyme immunoassay and VP6 gene detection. G1 and P[8] were identified by multiplex polymerase chain reaction for the genotype, and G3 was further identified using a single primer. By detecting the fingerprint gene (WC3) of RotaTeq, it was confirmed that the detected virus was the vaccine strain. Genotypes G1 and P[8] were identified, and the infection was suspected of having been caused by rotavirus G1P[8]. G1P[8] is the most commonly detected genotype worldwide and is not included in the recombinant strains used in vaccines. Therefore, the infection was confirmed to have been caused by the vaccine strain by analyzing the genetic relationship between VP4 and VP7. Rotavirus infection by the vaccine strain can be identified through genotyping and fingerprint gene detection. However, genetic linkage analysis will also help to identify vaccine strains.
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http://dx.doi.org/10.24171/j.phrp.2021.0079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408412PMC
August 2021

Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012-2019.

Viruses 2021 03 5;13(3). Epub 2021 Mar 5.

Division of Viral Diseases, Korea Disease Control and Prevention Agency, Cheongju 28159, Korea.

The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012-2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.
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http://dx.doi.org/10.3390/v13030411DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001888PMC
March 2021

Nationwide seroprevalence of hepatitis A in South Korea from 2009 to 2019.

PLoS One 2021 8;16(2):e0245162. Epub 2021 Feb 8.

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.

Hepatitis A, an acute type of hepatitis caused by the hepatitis A virus, occurs worldwide. Following the 2009 hepatitis A epidemic in South Korea, patient outbreak reports were collectively converted to an "all-patient report" in 2011, and national immunization programs were introduced for children in 2015. In this study, we aimed to analyze the changes and characteristics of hepatitis A antibody titers in South Korea following the epidemic. The results of hepatitis A antibody tests performed at clinical laboratories from 2009 to 2019 were analyzed based on year, age, region, sex, and medical institution. The average 2009-2018 positive anti-hepatitis A virus immunoglobulin G rate was 51.8%, but it increased (56.06%) in 2019. Significantly different antibody-positive rates were observed based on age: <10 years, 54.5%; 20-29 years, 19.5%; ≥50 years, almost 100%. The positive rate of individuals in their teens and 20s gradually increased, whereas that of those in their 30s and 40s gradually decreased. Males had higher antibody-positive rates than females, and samples from higher-level general hospitals exhibited higher antibody rates. The positive anti-hepatitis A virus immunoglobulin M rates gradually decreased after 2009 and were <1% after 2012. However, a high positive rate of 3.69% was observed in 2019 when there was an epidemic. Anti-hepatitis A virus immunoglobulin G-positive rates were similar throughout the year, but the anti-hepatitis A virus immunoglobulin M-positive rates increased from January, peaked in April, and decreased from July, exhibiting distinct seasonality. This is considered to be related to groundwater pollution during the spring drought season. The introduction of the "all-patient report" and national vaccination program for children has had an effective influence on hepatitis A management. However, for hepatitis A prevention, policy considerations for high-risk age groups with low antibody-positive rates will be necessary.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245162PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870085PMC
July 2021

Outbreak associated with Rotavirus G11,P[25] in Korea in 2018.

Infect Chemother 2020 Dec 24;52(4):616-620. Epub 2020 Nov 24.

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Korea.

We here report the first outbreak caused by rotavirus G11,P[25] in Korea in 2018, representing a case of re-assortment with pig-derived rotavirus. The genotype constellation was identical to the virus identified in Korea in 2012 as G11-P[25]-I12-R1-C1-M1-A1-N1-T1-E1-H1. The infection source was not known exactly but it must be considered infection from swine.
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http://dx.doi.org/10.3947/ic.2020.52.4.616DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779978PMC
December 2020

Trends in acute viral gastroenteritis among children aged ≤5 years through the national surveillance system in South Korea, 2013-2019.

J Med Virol 2021 08 23;93(8):4875-4882. Epub 2021 Mar 23.

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

Acute gastroenteritis is a global public health concern. This study aimed to analyze the trend and characteristics of acute viral gastroenteritis through a national surveillance network. Enteric viruses were detected in 9510 of 31,750 (30.1%) cases assessed from 2013 to 2019 by EnterNet. The most prevalent pathogens were norovirus (15.2%) and group A rotavirus (9.7%); most infections were reported in 2017 (34.0%). Norovirus and rotavirus coinfections were the most common. Norovirus infections were prevalent among 1-year-old children (1835 out of 9510 cases) during winter, and group A rotavirus infections were common during spring. Seasonality was not observed among enteric adenovirus, astrovirus, and sapovirus. The prevalent viral genotypes detected included norovirus GII.4, enteric adenovirus F41, astrovirus genotype 1, and sapovirus GI.1. However, changes in enteric virus trends were noted during the study period. Norovirus prevalence extended into spring, and new genotypes of enteric adenovirus, astrovirus, and sapovirus were identified. These surveillance data elucidate enteric virus epidemiological characteristics.
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http://dx.doi.org/10.1002/jmv.26685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360024PMC
August 2021

A Different Epidemiology of Enterovirus A and Enterovirus B Co-circulating in Korea, 2012-2019.

J Pediatric Infect Dis Soc 2021 Apr;10(4):398-407

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Republic of Korea.

Background: Enteroviruses (EVs) occur frequently worldwide and are known to be associated with a broad spectrum of clinical manifestations from mild syndromes to neurological disease. To understand the epidemiology of EV in Korea, we characterized EV-infected cases during 2012-2019 based on national surveillance.

Methods: We collected specimens from patients with suspected EV infections and analyzed the data using real-time reverse-transcription polymerase chain reaction and VP1 gene sequencing.

Results: Among the 18 261 specimens collected, EVs were detected in 6258 (34.3%) cases. Although the most common EV types changed annually, EV-A71, echovirus 30, coxsackievirus B5, coxsackievirus A6, and coxsackievirus A10 were commonly identified. Among the human EVs, the case numbers associated with the 2 major epidemic species (EV-A and EV-B) peaked in the summer. While EV-A species affected 1-year-old children and were associated with herpangina and hand, foot, and mouth disease, EV-B species were mostly associated with neurologic manifestations. The highest incidence of EV-B species was observed in infants aged <12 months. Feces and respiratory specimens were the most predictive of EV infection. Specimens collected within 5 days of symptom onset allowed for timely virus detection.

Conclusions: EV-A and EV-B species co-circulating in Korea presented different epidemiologic trends in clinical presentation, affected subjects, and seasonality trends. This study could provide information for the characterization of EVs circulating in Korea to aid the development of EV antivirals and vaccines, as well as public health measures to control enteroviral diseases.
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http://dx.doi.org/10.1093/jpids/piaa111DOI Listing
April 2021

An Outbreak Associated with Sapovirus GI.3 in an Elementary School in Gyeonggi-do, Korea.

J Korean Med Sci 2020 Aug 31;35(34):e281. Epub 2020 Aug 31.

Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Korea.

On October 4, 2018, an outbreak of gastroenteritis associated with sapovirus occurred among elementary school students in Gyeonggi-do, Korea. Epidemiologic studies were conducted in a retrospective cohort approach. Using self-administered questionnaires, we collected information on symptoms and food items consumed. Of the 999 subjects, 17 developed patients that met the case definition. The main symptom was vomiting (100%), and the symptomatic age was 6-12 years. Positive samples were identified by conventional reverse transcription polymerase chain reaction for sequencing. They were classified into genotype GI.3 by phylogenetic analysis. This is the first report of an outbreak associated with sapovirus GI.3 in Korea.
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http://dx.doi.org/10.3346/jkms.2020.35.e281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458851PMC
August 2020

Detection of Novel Coronavirus on the Surface of Environmental Materials Contaminated by COVID-19 Patients in the Republic of Korea.

Osong Public Health Res Perspect 2020 Jun;11(3):128-132

National Center for Medical Information and Knowledge, Korea Centers for Disease Control and Prevention, Chungju, Korea.

This study aimed to determine the presence of SARS-CoV-2 on surfaces frequently touched by COVID-19 patients, and assess the scope of contamination and transmissibility in facilities where the outbreaks occurred. In the course of this epidemiological investigation, a total of 80 environmental specimens were collected from 6 hospitals (68 specimens) and 2 "mass facilities" (6 specimens from a rehabilitation center and 6 specimens from an apartment building complex). Specific reverse transcriptase-polymerase chain reaction targeting of RNA-dependent RNA polymerase, and envelope genes, were used to identify the presence of this novel coronavirus. The 68 specimens from 6 hospitals (A, B, C, D, E, and G), where prior disinfection/cleaning had been performed before environmental sampling, tested negative for SARS-CoV-2. However, 2 out of 12 specimens (16.7%) from 2 "mass facilities" (F and H), where prior disinfection/cleaning had not taken place, were positive for SARS-CoV-2 RNA polymerase, and envelope genes. These results suggest that prompt disinfection and cleaning of potentially contaminated surfaces is an effective infection control measure. By inactivating SARS-CoV-2 with disinfection/cleaning the infectivity and transmission of the virus is blocked. This investigation of environmental sampling may help in the understanding of risk assessment of the COVID-19 outbreak in "mass facilities" and provide guidance in using effective disinfectants on contaminated surfaces.
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http://dx.doi.org/10.24171/j.phrp.2020.11.3.03DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282419PMC
June 2020

Plasmid-mediated transfer of CTX-M-55 extended-spectrum beta-lactamase among different strains of Salmonella and Shigella spp. in the Republic of Korea.

Diagn Microbiol Infect Dis 2017 Sep 30;89(1):86-88. Epub 2017 Mar 30.

Division of Enteric Diseases, Center for Infectious Diseases, National Research Institute of Health, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 28159, Republic of Korea. Electronic address:

We screened 10 CTX-M-55-producing Shigella and Salmonella isolates from a national surveillance in Korea. The bla was located on the IncI1 (n=5), IncA/C (n=4) and IncZ (n=1) plasmids, downstream of ISEcp1, IS26-ISEcp1 and ISEcp1-IS5 sequences, respectively. These results indicate that CTX-M-55 has disseminated to other bacteria by lateral plasmid transfer.
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http://dx.doi.org/10.1016/j.diagmicrobio.2017.03.014DOI Listing
September 2017

Emergence of Norovirus GII.17-associated Outbreak and Sporadic Cases in Korea from 2014 to 2015.

Osong Public Health Res Perspect 2017 Feb 28;8(1):86-90. Epub 2017 Feb 28.

Division of Enteric Diseases, Center for Infectious Diseases, National Research Institute of Health, Osong, Korea.

Human norovirus are major causative agent of nonbacterial acute gastroenteritis. In general, genogroup (G) II.4 is the most prominent major genotype that circulate in human population and the environment. However, a shift in genotypic trends was observed in Korea in December 2014. In this study, we investigated the trend of norovirus genotype in detail using the database of Acute Diarrhea Laboratory Surveillance (K-EnterNet) in Korea. GII.17 has since become a major contributor to outbreaks of norovirus-related infections and sporadic cases in Korea, although the reason for this shift remain unknown.
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http://dx.doi.org/10.24171/j.phrp.2017.8.1.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402847PMC
February 2017

Public health significance of major genotypes of Salmonella enterica serovar Enteritidis present in both human and chicken isolates in Korea.

Res Vet Sci 2017 Jun 17;112:125-131. Epub 2017 Feb 17.

Animal and Plant Quarantine Agency, Gimcheon-si, Gyeongsangbuk-do, Republic of Korea.

Salmonella enterica serovar Enteritidis is one of the most common serotypes implicated in Salmonella infections in both humans and poultry worldwide. It has been reported that human salmonellosis is mainly associated with the consumption of poultry products contaminated with serovar Enteritidis. The present study was to extensively analyze the public health risk of serovar Enteritidis isolates from chickens in Korea. A total of 127 chicken isolates were collected from clinical cases, on-farm feces, and chicken meat between 1998 and 2012 and 20 human clinical isolates were obtained from patients with diarrhea between 2000 and 2006 in Korea. To characterize the isolates from chickens and humans, we compared the pulsed-field gel electrophoresis (PFGE) patterns and multilocus variable-number tandem-repeat analysis (MLVA) profiles of the isolates. We further characterized representative isolates of different genotypes using a DNA microarray. PFGE revealed 28 patterns and MLVA identified 16 allelic profiles. The DNA microarray showed high genetic variability in plasmid regions and other fimbrial subunits of the isolates although the virulence gene contents of isolates from the same source and/or of the same genotype were unrelated. PFGE and MLVA showed that major genotypes were present in both human and chicken isolates. This result suggests that chickens in Korea pose a significant risk to public health as a source of serovar Enteritidis as has been noted in other countries.
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http://dx.doi.org/10.1016/j.rvsc.2017.02.010DOI Listing
June 2017

Complete Genome Sequence of Bacteriophage MA12, Which Infects both Campylobacter jejuni and Salmonella enterica Serovar Enteritidis.

Genome Announc 2016 Dec 8;4(6). Epub 2016 Dec 8.

Division of Enteric Diseases, Center for Infectious Diseases, National Institute of Health, KCDC, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea

Here, we announce the complete genome sequence of Salmonella enterica serovar Enteritidis (S Enteritidis) bacteriophage MA12, a 41-Kb chromosome. The strain can infect both Campylobacter jejuni (C. jejuni) and S Enteritidis and can be used in phage therapy experiments with poultry and poultry meat.
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http://dx.doi.org/10.1128/genomeA.00810-16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146428PMC
December 2016

Genome Sequence of Bacteriophage GG32, Which Can Infect both Salmonella enterica Serovar Typhimurium and Escherichia coli O157:H7.

Genome Announc 2016 Dec 8;4(6). Epub 2016 Dec 8.

Division of Enteric Diseases, Center for Infectious Diseases, National Institute of Health, KCDC, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, Republic of Korea

We report here a new virulent Salmonella enterica serovar Typhimurium (S Typhimurium) bacteriophage, GG32, which was isolated from the Guem River in the Republic of Korea. The strain can infect both S Typhimurium and Escherichia coli (E. coli) O157:H7 and may be a good candidate for a bio-control agent.
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http://dx.doi.org/10.1128/genomeA.00802-16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146427PMC
December 2016

Norovirus in benign convulsions with mild gastroenteritis.

Ital J Pediatr 2016 Nov 3;42(1):94. Epub 2016 Nov 3.

Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea.

Background: Benign convulsions with gastroenteritis (CwG) are defined as afebrile convulsions accompanying symptoms of gastroenteritis without evidence of laboratory derangement. Although the main pathogen has been known as rotavirus, since the introduction of rotavirus vaccine, associated viruses with CwG may have changed. Thus, we evaluated the viral association of CwG for patients admitting for recent 2.5 years.

Methods: All patients hospitalized for CwG between November 2012 and May 2015 were included in our study. Stool specimens were tested with reverse transcription polymerase chain reaction for detecting norovirus and astrovirus and with enzyme immunoassay for rotavirus and enteric adenovirus. Clinical data was gathered via chart review.

Results: Fifty patients were included. Except four patients who failed to collect stool samples, 46 patients were tested. Causative diarrheal viruses were detected in 38 patients and they were 29 norovirus, four rotavirus, four adenovirus, and one astrovirus. Norovirus was commonly identified during the months of November and December. No difference of the clinical characteristics and laboratory value was noted according to the number of seizure episodes.

Conclusions: Norovirus is a common pathogen in CwG. Understanding the viral associations can facilitate recognition of CwG.
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http://dx.doi.org/10.1186/s13052-016-0303-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096325PMC
November 2016

Occurrence of Norovirus GII.4 Sydney Variant-related Outbreaks in Korea.

Osong Public Health Res Perspect 2015 Oct 22;6(5):322-6. Epub 2015 Oct 22.

Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, KCDC, Osong, Korea.

Human noroviruses are major causative agents of food and waterborne outbreaks of nonbacterial acute gastroenteritis. In this study, we report the epidemiological features of three outbreak cases of norovirus in Korea, and we describe the clinical symptoms and distribution of the causative genotypes. The incidence rates of the three outbreaks were 16.24% (326/2,007), 4.1% (27/656), and 16.8% (36/214), respectively. The patients in these three outbreaks were affected by acute gastroenteritis. These schools were provided unheated food from the same manufacturing company. Two genotypes (GII.3 and GII.4) of the norovirus were detected in these cases. Among them, major causative strains of GII.4 (Hu-jeju-47-2007KR-like) were identified in patients, food handlers, and groundwater from the manufacturing company of the unheated food. In the GII.4 (Hu-jeju-47-2007KR-like) strain of the norovirus, the nucleotide sequences were identical and identified as the GII.4 Sydney variant. Our data suggests that the combined epidemiological and laboratory results were closely related, and the causative pathogen was the GII.4 Sydney variant strain from contaminated groundwater.
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http://dx.doi.org/10.1016/j.phrp.2015.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677502PMC
October 2015

Epidemics of Norovirus GII.4 Variant in Outbreak Cases in Korea, 2004-2012.

Osong Public Health Res Perspect 2015 Oct 22;6(5):318-21. Epub 2015 Oct 22.

Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, Osong, Korea.

Norovirus GII.4 is recognized as a worldwide cause of nonbacterial outbreaks. In particular, the GII.4 variant occurs every 2-3 years according to antigenic variation. The aim of our study was to identify GII.4 variants in outbreaks in Korea during 2004-2012. Partial VP1 sequence of norovirus GII.4-related outbreaks during 2004-2012 was analyzed. The partial VP1 sequence was detected with reverse transcription-polymerase chain reaction, seminested polymerase chain reaction, and nucleotide sequence of 312-314 base pairs for phylogenetic comparison. Nine variants emerged in outbreaks, with the Sydney variant showing predominance recently. This predominance may persist for at least 3 years, although new variants may appear in Korea.
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http://dx.doi.org/10.1016/j.phrp.2015.10.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677503PMC
October 2015

Rapid Emergence and Clonal Dissemination of CTX-M-15-Producing Salmonella enterica Serotype Virchow, South Korea.

Emerg Infect Dis 2016 Jan;22(1):68-70

The prevalence of cefotaxime-resistant Salmonella enterica serotype Virchow has dramatically increased in South Korea since the first isolation in 2011. Of 68 isolates collected over 10 years, 28 cefotaxime-resistant isolates harbored the bla(CTX-M-15) extended-spectrum β-lactamase gene and were closely related genetically, demonstrating the clonal dissemination of CTX-M-15-producing Salmonella Virchow in South Korea.
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http://dx.doi.org/10.3201/eid2201.151220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696704PMC
January 2016

Emergence of Norovirus GII.4 variants in acute gastroenteritis outbreaks in South Korea between 2006 and 2013.

J Clin Virol 2015 Nov 28;72:11-5. Epub 2015 Aug 28.

Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Background: New emerging strains of noroviruses (NoVs) often increase acute gastroenteritis (AGE) outbreaks worldwide.

Objective: We analyzed the epidemiological features and genotypic patterns of NoVs in AGE outbreaks.

Study Design: To elucidate the public health impact of NoVs during AGE outbreaks in South Korea, a molecular and epidemiological investigation was performed with 318 AGE outbreaks reported from the Gyeonggi province of South Korea during the period from 2006 to 2013.

Results: NoVs were associated with 102 (32.1%) of the AGE outbreaks. Epidemiological data revealed that the majority of NoV outbreaks were in the student group (47.1%), and the majority of AGE patients were identified in schools (68.8%). NoV genogroup (G) II strains were associated with 94 (92.2%) of the NoV outbreaks, and GII.4 strains were predominantly associated with 57.6% (n=49) of NoV GII outbreaks. Four GII.4 variants (2006b, 2007, 2009 and 2012 variants) emerged and showed different contributions to NoV outbreak activity. The 2006b variant was predominantly associated with NoV outbreaks during the early years of the study period, and was subsequently displaced by the New Orleans 2009 variant, and most recently by the Sydney 2012 variant. In addition, the GII.2, GII.14, and GII.17 strains have recently been often associated with NoV AGE outbreaks.

Conclusions: The emergence of new NoV GII.4 variants significantly affected the NoV outbreak activity in South Korea during the period from 2006 to 2013. The surveillance for new emerging strains affecting NoV outbreak activity should be intensified to develop an adequate policy to prevent further NoV outbreaks.
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http://dx.doi.org/10.1016/j.jcv.2015.08.012DOI Listing
November 2015

Characterization of Salmonella enterica serovar Typhimurium and Salmonella enterica serovar 4,[5],12:i:- isolates from pigs presenting with diarrhea in Korea.

J Vet Med Sci 2015 Nov 14;77(11):1511-5. Epub 2015 Jun 14.

Animal and Plant Quarantine Agency, Anyang 430-757, Republic of Korea.

Between 2011 and 2012, a total of 896 pig fecal samples were collected from nine provinces in Korea, and 50 salmonella enterica susp. enterica serovar Typhimurium (S. Typhimurium) was isolated. The characteristics of the 50 strains were analyzed, and 4 strains were identified as Salmonella enterica subsp. enterica serovar 4,[5],12:i:-. Salmonella 4,[5],12:i:- could not be distinguished from S. Typhimurium through phage typing, antimicrobial resistance testing or multiple-locus variable-number tandem repeat analysis (MLVA). However, among the four Salmonella 4,[5],12:i:- strains, one (KVCC-BA1400078) was identified as a Salmonella 4,[5],12:i:- clone isolated from humans in the United States, and another (KVCC-BA1400080) was identified as DT193, which has been primarily isolated from humans and animals in European countries. The presence of Salmonella 4,[5],12:i:- in Korea poses a significant threat of horizontal transfer between pigs and humans.
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http://dx.doi.org/10.1292/jvms.15-0151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4667674PMC
November 2015

Three gastroenteritis outbreaks in South Korea caused by the consumption of kimchi tainted by norovirus GI.4.

Foodborne Pathog Dis 2015 Mar;12(3):221-7

1 Department of Preventive Medicine, Donngguk University College of Medicine , Gyeongju-si, Gyeongsangbuk-do, South Korea .

Background: In April 2013, outbreaks of acute gastroenteritis were reported at three schools in Jeonju, South Korea. Epidemiological investigations were performed to characterize the outbreaks and implement appropriate control measures.

Materials And Methods: Retrospective cohort studies were performed at these schools. Stool and environmental samples were collected for bacterial and viral assessment. A food supplier of the schools, food company X, was inspected, and samples of cabbage kimchi and groundwater were tested for norovirus by real-time reverse-transcriptase polymerase chain reaction. The relatedness of the detected norovirus strains was evaluated by phylogenetic analysis.

Results: Of the 3347 questionnaires distributed, 631 (attack rate: 18.9%) met the case definition. Among the consumed food items, kimchi products (i.e., cabbage and fresh kimchi) were significantly associated with illness. The kimchi products were supplied by food company X. Among stool samples from 95 students and 34 food handlers at the 3 schools, 39 (41.1%) and 14 (41.2%) samples, respectively, were positive for norovirus. The samples of groundwater and cabbage kimchi at food company X were positive for norovirus. The predominant genotype of norovirus detected in the patient, groundwater, and cabbage kimchi samples, GI.4, shared high nucleotide identity.

Conclusions: Kimchi products tainted with norovirus GI.4 from contaminated groundwater were linked to the acute gastroenteritis outbreaks. Therefore, kimchi manufacturers in South Korea should apply chlorine disinfection when using groundwater. Moreover, more stringent sanitation requirements and strict regulations for food companies are recommended.
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http://dx.doi.org/10.1089/fpd.2014.1879DOI Listing
March 2015

Molecular epidemiology of norovirus GII.4 variants in children under 5 years with sporadic acute gastroenteritis in South Korea during 2006-2013.

J Clin Virol 2014 Nov 1;61(3):340-4. Epub 2014 Sep 1.

Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Background: The global emergence of norovirus (NoV) GII.4 variants has raised public concerns in the world including South Korea since 1996.

Objective: We analyzed seasonality and genotypic pattern for sporadic cases by norovirus GII-4 variants.

Study Design: To determine the epidemic status of GII.4 variants in South Korea during 2006-2013, 7301 fecal specimens were collected from children who were younger than 5 years and had sporadic acute gastroenteritis (AGE).

Results: During the study period, NoVs were the most prevalent viral agent, detected in 877 (12.0%) of the 7301 fecal specimens from children with sporadic AGE. NoV GII strains predominantly accounted for 97.6% of all sporadic NoV infections. NoV GII.4 was the most prevalent genotype and comprised 67.6% of the NoV GII strains. However, seasonal prevalence of GII.4 strains varied depending on the spread of GII.4 variants. GII.4-2006b variant most predominantly circulated from 2006-2007 to 2009-2010 and persisted during other seasons. GII.4-2009 variant was first detected in January 2010 and predominant in 2011-2012. However, it was rapidly displaced by GII.4-2012 variant, which emerged in May 2012 and substantially circulated in 2012-2013.

Conclusions: The frequent emergence and rapid spread of GII.4 variants significantly affect the magnitude of sporadic NoV infections in children. Hence, to minimize the disease burden of NoV infections, GII.4 strains should be considered as a primary target for vaccine development against NoVs.
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http://dx.doi.org/10.1016/j.jcv.2014.08.018DOI Listing
November 2014

Availability of clean tap water and medical services prevents the incidence of typhoid Fever.

Osong Public Health Res Perspect 2013 Apr;4(2):68-71

Division of Enteric Diseases, Korea National Institute of Health, Osong, Korea.

Objective: In this study, the factors that induced a decrease in the incidence of typhoid fever were analyzed. Based on the study results, we propose a quantitative and concrete solution to reduce the incidence of typhoid fever.

Methods: We analyzed the incidence and fatality rate of typhoid fever in Korea. Tap water service rate and the number of pharmacies, which affect the incidence rate of typhoid fever, were used as environmental factors.

Results: To prevent typhoid fever in the community, it is necessary to provide clean tap water service to 35.5% of the population, with an individual requiring 173 L of clean water daily. Appropriate access to clean water (51% service coverage, 307 L) helped the population to maintain individual hygiene and food safety practices, which brought about a decrease in the incidence of typhoid fever, and subsequently a decrease in fatality rate, which was achieved twice. During the 8-year study period, the fatality rate decreased to 1% when the population has access to proper medical service.

Conclusion: The fatality rate was primarily affected by the availability of medical services as well as by the incidence of typhoid fever. However, an analysis of the study results showed that the incidence of typhoid fever was affected only by the availability of clean water through the tap water system.
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http://dx.doi.org/10.1016/j.phrp.2013.03.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767100PMC
April 2013

Molecular serotyping of Salmonella enterica by complete rpoB gene sequencing.

J Microbiol 2012 Dec 30;50(6):962-9. Epub 2012 Dec 30.

Laboratory of Avian Diseases, College of Veterinary Medicine and BK21 for Veterinary Science, Seoul National University, Seoul 151-742, Republic of Korea.

Serotyping has been the gold standard for identifying Salmonella, but it requires large amounts of standard antisera. Multilocus sequence typing (MLST) has been applied to identify Salmonella serovars, but the recombination of 4-7 housekeeping genes and multiple analytic steps diminish its applicability. In the present study, we determined the complete sequences of the RNA polymerase beta subunit gene (rpoB) and 7 housekeeping genes (aroC, dnaN, hemD, hisD, purE, sucA, and thrA) for 76 strains of 33 Salmonella enterica serovars and conducted phylogenetic analyses together with the corresponding gene sequences of 24 reference strains registered in the GenBank database. Based on the phylogenetic analyses, 100 strains from 40 serovars and 91 strains from 37 serovars were classified into 60 rpoB (RST) and 49 multilocus sequence types (ST), respectively. The nucleotide similarities were 98.8-100% and 96.9-100% for the complete rpoB gene and the seven concatenated housekeeping genes, respectively. The strains of 35 and 30 serovars formed serovar-specific branches or clusters in the rpoB and housekeeping gene phylogenetic trees, respectively. Therefore, complete rpoB gene sequencing and phylogenetic analysis may be a useful method for identifying Salmonella serovars that is a simpler, more cost-effective, and less time-consuming alternative or complementary method to MLST and conventional serotyping.
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http://dx.doi.org/10.1007/s12275-012-2547-xDOI Listing
December 2012

Infection status of hospitalized diarrheal patients with gastrointestinal protozoa, bacteria, and viruses in the Republic of Korea.

Korean J Parasitol 2010 Jun 17;48(2):113-20. Epub 2010 Jun 17.

Department of Malaria and Parasitic Diseases, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Korea.

To understand protozoan, viral, and bacterial infections in diarrheal patients, we analyzed positivity and mixed-infection status with 3 protozoans, 4 viruses, and 10 bacteria in hospitalized diarrheal patients during 2004-2006 in the Republic of Korea. A total of 76,652 stool samples were collected from 96 hospitals across the nation. The positivity for protozoa, viruses, and bacteria was 129, 1,759, and 1,797 per 10,000 persons, respectively. Especially, Cryptosporidium parvum was highly mixed-infected with rotavirus among pediatric diarrheal patients (29.5 per 100 C. parvum positive cases), and Entamoeba histolytica was mixed-infected with Clostridium perfringens (10.3 per 100 E. histolytica positive cases) in protozoan-diarrheal patients. Those infected with rotavirus and C. perfringens constituted relatively high proportions among mixed infection cases from January to April. The positivity for rotavirus among viral infection for those aged < or = 5 years was significantly higher, while C. perfringens among bacterial infection was higher for > or = 50 years. The information for association of viral and bacterial infections with enteropathogenic protozoa in diarrheal patients may contribute to improvement of care for diarrhea as well as development of control strategies for diarrheal diseases in Korea.
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http://dx.doi.org/10.3347/kjp.2010.48.2.113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892565PMC
June 2010

Isolation, characterization, and evaluation of wild isolates of Lactobacillus reuteri from pig feces.

J Microbiol 2009 Dec 4;47(6):663-72. Epub 2010 Feb 4.

Department of Infectious Diseases, College of Veterinary Medicine, KRF Zoonotic Priority Research Institute and Brain Korea 21 Program for Veterinary Science, Seoul National University, Seoul, 151-742, Republic of Korea.

Lactic acid bacteria (LAB) are a well-used probiotics for health improvements in both humans and animals. Despite of several benefits, non-host-specific LAB showed poor probiotics effects due to difficulty in colonization and competition with normal flora. Therefore, the feasibility of porcine LAB isolates was evaluated as a probiotics. Ten of 49 Lactobacillus spp. isolates harbored 2 approximately 10 kb plasmid DNA. Seven strains were selected based on the safety test, such as hemolytic activity, ammonia, indole, and phenylalanine production. After safety test, five strains were selected again by several tests, such as epithelial adherence, antimicrobial activity, tolerance against acid, bile, heat, and cold-drying, and production of acid and hydrogen peroxide. Then, enzyme profiles (ZYM test) and antibiotics resistance were analyzed for further characterization. Five Lactobacillus reuteri isolates from pig feces were selected by safety and functional tests. The plasmid DNA which was able to develop vector system was detected in the isolates. Together with these approaches, pig-specific Lactobacillus spp. originated from pigs were selected. These strains may be useful tools to develop oral delivery system.
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http://dx.doi.org/10.1007/s12275-009-0124-8DOI Listing
December 2009

Poly-gamma-d-glutamic acid and protective antigen conjugate vaccines induce functional antibodies against the protective antigen and capsule of Bacillus anthracis in guinea-pigs and rabbits.

FEMS Immunol Med Microbiol 2009 Nov 6;57(2):165-72. Epub 2009 Aug 6.

Center for Infectious Diseases, Division of High-Risk Pathogen Research, Korea National Institute of Health, Seoul, Korea.

Anthrax is a lethal infectious disease caused by the spore-forming Bacillus anthracis. The two major virulence factors of B. anthracis are exotoxin and the poly-gamma-d-glutamic acid (PGA) capsule. The three components of the exotoxin, protective antigen (PA), lethal factor and edema factor act in a binary combination, which results in massive edema and organ failure in the progress of anthrax disease. The antiphagocytic PGA capsule disguises the bacilli from immune surveillance and allows unimpeded growth of bacilli in the host. Because PA can elicit a protective immune response, it has been a target of the anthrax vaccine. In addition to PA, efforts have been made to include PGA as a component of the anthrax vaccine. In this study, we report that PA-PGA conjugates induce expressions of anti-PA, anti-PGA and toxin-neutralizing antibodies in guinea-pigs and completely protect guinea-pigs against a 50 x LD(50) challenge with fully virulent B. anthracis spores. Polyclonal rabbit antisera produced against either PA or ovalbumin conjugated to a PGA-15mer offer a partial passive protection to guinea-pigs against B. anthracis infection, indicating that anti-PGA antibodies play a protective role. Our results demonstrate that PA-PGA conjugate vaccines are effective in the guinea-pig model, in addition to the previously reported mouse model.
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http://dx.doi.org/10.1111/j.1574-695X.2009.00595.xDOI Listing
November 2009

Analysis of gene expression in mouse alveolar macrophages stimulated with quorum-sensing mutants of Vibrio vulnificus.

Jpn J Infect Dis 2008 Sep;61(5):402-6

Department of Infectious Diseases, College of Veterinary Medicine, Seoul National University, Seoul, Korea.

Bacterial pathogens manipulate host cells to promote pathogen survival and dissemination. In this study, microarray technology was used to identify the genes that are affected by the Vibrio vulnificus quorum-sensing genes, luxS and smcR. By comparing the expression profiles of mouse macrophage cell lines stimulated with either the parent strains or a luxS smcR mutant, differentially expressed genes were identified. The genes included those that affect host cell death, stress, signaling transduction, inflammation, and immune response. Macrophages stimulated with the luxS smcR mutant differentially expressed genes associated with removal of toxins, the complement pathway, regulation of cytokine expression, and antigen presentation, indicating that macrophages stimulated with the luxS smcR mutant induced an appropriate inflammation reaction and immune response for removal of bacteria. In summary, quorum-sensing in V. vulnificus could contribute to bacterial survival and increased pathogenesis by inducing a changed expression profile in macrophages.
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September 2008

Chitosan microspheres containing Bordetella bronchiseptica antigens as novel vaccine against atrophic rhinitis in pigs.

J Microbiol Biotechnol 2008 Jun;18(6):1179-85

Department of Infectious Diseases, College of Veterinary Medicine, KRF Zoonotic Disease Priority Research Institute and BK21 Program for Veterinary Science, Seoul National University, Seoul, Korea.

The immune-stimulating activities of Bordetella bronchiseptica antigens containing dermonecrotoxin (BBD) loaded in chitosan microspheres (CMs) have already been reported in vitro and in vivo with a mouse alveolar macrophage cell line (RAW264.7) and mice. Therefore, this study attempted to demonstrate the successful induction of mucosal immune responses after the intranasal administration of BBD loaded in CMs (BBD-CMs) in colostrum-deprived pigs. The BBD was introduced to the CMs using an ionic gelation process involving tripolyphosphate (TPP). Colostrum-deprived pigs were then directly immunized through intranasal administration of the BBD-CMs. A challenge with a field isolate of B. bronchiseptica was performed ten days following the final immunization. The BBD-specific IgG and IgA titers, evident in the nasal wash and serum from the vaccinated pigs, increased with time (p<0.05). Following the challenge, the clinical signs of infection were about 6-fold lower in the vaccinated pigs compared with the nonvaccinated pigs. The grades for gross morphological changes in the turbinate bones from the vaccinated pigs were also significantly lower than the grades recorded for the nonvaccinated pigs (p<0.001). Therefore, the mucosal and systemic immune responses induced in the current study would seem to indicate that the intranasal administration of BBD-CMs may be an effective vaccine against atrophic rhinitis in pigs.
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June 2008

Characterization of TEM-, SHV- and AmpC-type beta-lactamases from cephalosporin-resistant Enterobacteriaceae isolated from swine.

Int J Food Microbiol 2008 May 27;124(2):183-7. Epub 2008 Mar 27.

Department of Infectious Diseases, College of Veterinary Medicine, KRF Zoonotic Disease Priority Research Institute, Brain Korea 21 for Veterinary Science, Seoul National University, San 56-1, Shilim 9 dong, Kwanak-Ku, Seoul, Republic of Korea.

Extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacteriaceae are an increasing problem in human medicine and an emerging problem in the veterinary field. Our study, therefore, focused on assessing the prevalence of beta-lactamases isolated from swine. Sixty-six Salmonella enterica serovar Typhimurium (S. Typhimurium), 33 Salmonella enterica serovar Enteritidis (S. Enteritidis), 26 Klebsiella pneumonia (K. pneumoniae) and 130 Escherichia coli (E. coli) pig isolates collected from 1999-2006 were screened for beta-lactam resistance by the disk diffusion test (DDT) and micro-broth dilution. Among the isolates, five E. coli and five K. pneumoniae exhibited reduced susceptibility to the cephalosporins tested. PCR, plasmid profiling and Southern blot hybridization showed the presence of multiple beta-lactamases in these isolates of animal origin. Hybridization patterns of the DHA-1 specific probe indicated that dissemination of DHA-1 related beta-lactamases could be attributed to plasmids of one common size among the enteric microbes of animal origin. To the best of our knowledge, this study reports the first identification of SHV-28 and DHA-1 from microbes of animal origin.
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http://dx.doi.org/10.1016/j.ijfoodmicro.2008.03.009DOI Listing
May 2008
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