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654 PUBLIC HEALTH WEEKLY REPORT, KCDC 제 7 권제 3 호 세계간염의날 World Hepatitis Day, 28 July : Think Again 질병관리본부감염병관리센터감염병감시과최수영 세계보건기구 (World Health Organization, WHO)

1 654 PUBLIC HEALTH WEEKLY REPORT, KCDC 제 7 권제 3 호 세계간염의날 World Hepatitis Day, 28 July : Think Again 질병관리본부감염병관리센터감염병감시과최수영 세계보건기구 (World Health Organization, WHO) 와협력단체는바이러스성간염과이로인해발생되는질병의인식및이해를높이기위해매년 7월 28일을 세계간염의날 로정하고있습니다. A형, B형, C형, D형및 E형바이러스성간염은전세계수억명의사람들에게영향을미쳐급성 만성간질환을일으키고이로인해매년 14 만명의사람들이사망하고있지만이러한심각성은간과되고있고잘알려져있지않고있습니다. WHO 는 년 4월 C형간염치료에대한새로운가이드라인을발표하였고, 5월에는, 194 개의회원국이참여한 WHO 총회에서바이러스성간염의예방, 진단및치료를향상시킬수있는개선안을의결하여통과시켰습니다. 또한 7월 28일 세계간염의날 을맞아각국의정책결정자, 보건의료종사자및일반인들에게이침묵의살인자 (silent killer) 에대해재고 (Think again) 해볼것을강력히촉구하고있습니다. Think again 캠페인은다음의사항들에대해초점을두고있습니다. 바이러스성간염및그와관련된질병들의예방, 선별검사및관리강화 B형간염백신의보장성확대및국가예방접종프로그램으로의통합 바이러스성간염에대한전세계적대응의조정 간염환자를유발하고약 5만명을사망에이르게하는 C형간염의관리를위한본가이드라인은최신과학적근거를기반으로하여각국가들이 C형간염의치료및관리를개선하여간암과간경화로인한사망자를감소하는데그목적이있다고 WHO 간염프로그램의책임자인 Dr. Stefan Wiktor 는밝혔습니다. 또한, 이가이드라인은저소득국가및중소득국가의 C형간염환자를관리하는관리자를위한핵심권고사항및이행사항들을제공함과더불어 C형간염환자를위한임상서비스의확대를이끌수있는기본틀을제공하고있습니다. 년 4 월에 WHO 에서발간한 WHO Guidelines for the screening, care and treatment of persons with hepatitis C infection 은 C 형간염에대한 WHO 의첫번째가이드라인으로 이글은세계보건기구 (World Health Organization, WHO. 의 World Hepatitis Day, 의내용을번역한것입니다. 기존의 C 형간염가이드라인을포함한혈행성바이러스전파예방 가이드라인을보완한것입니다. 한해약 1 억 5 천만명의만성

2 주간건강과질병 PUBLIC HEALTH WEEKLY REPORT, KCDC 655 안전한혈액관리를통한 C 형간염관리 Control of Hepatitis C Viral Infection through Safe Blood Management 질병관리본부장기이식관리센터혈액안전감시과 이동한, 최영실, 나경인, 조현정 Abstract As for the transmission route of the hepatitis C virus, post-transfusion hepatitis is known to be the major cause. In order to promote safe transfusion, a variety of blood management activities, such as screening of donated blood and assessment on transfusion-transmission, are being executed in Korea in accordance to The Act of Blood Management. For example, test equipment with high sensitivity is utilized for the inspection of donated blood and in case of a positive test result, the donated blood is discarded while verifying the donors infection status through further inspection on previous donated blood of the suspicious donors. Moreover when a donee is suspicious about post-transfusion hepatitis C, the investigation system is constructed to verify any transfusion reactions. Henceforth, a person who reports or is reported to have hepatitis C according to the national infectious disease monitoring system will be excluded from the blood donors through the screening at the medical interview of potential donors while sharing information with the Blood Center. Such effort will reinforce blood control as it prevents in advance the blood donation from those with hepatitis C. 우리나라의 C형간염유병율은 B형간염보다훨씬낮지만만성화되거나간경변증 (liver cirrhosis), 간암 (hepatoma) 으로진행될가능성은 C형간염에서현저히높은것으로알려져있다. C형간염의감염경로는주사기공동사용, 수혈, 혈액투석, 성접촉, 모자간수직감염등으로전파되는데, 수혈후의감염이주요원인으로알려져있다. 국내의안전한혈액공급을위해서 1991 년부터모든헌혈혈액에서 C형간염에대한선별검사를도입해왔으며, 초기에는 C-1-3단백을이용한효소면역검사법 (EIA) 으로 C형간염바이러스항체검사를실시하였다. 이후 C형간염바이러스항체검사법은 C-1-3 이외에새로운단백을추가하여민감도와특이도를높인제3세대효소면역검사법으로대치되었고이결과를바탕으로양성혈액을폐기시키고있다. 또한, 효소면역검사상반복양성을보인혈액은면역블롯검사 (Recombinantimmunoblot assay, RIBA Ⅱ) 를시행하여그결과를헌혈자에게통보하고있다. 25 년 2월부터 C형간염바이러스유전자를동시에검출할수있는핵산증폭검사 (Pooled nucleic acid test, NAT) 를시행하여효소면역검사상음성인헌혈자양성자를찾는데기여하고있다. 효소면역검사는 C형간염항체를측정하는것으로감염후항체가생기기전까지 2개월은윈도우기 (Window period) 로써항체를검출할수없지만감염후 3주면검출이가능하여매년 1-2 명의헌혈자가효소면역검사는음성이면서핵산증폭검사만양성으로나타나고있으며, 핵산증폭검사를시행한이래수혈을통한 C형간염사례는보고되지않고있다. 212년 6월부터는핵산증폭검사장비를교체하여개별검체를대상으로핵산증폭검사를시행하게되어윈도우기가 4일정도로더단축되었다 [1]. 우리나라의혈액에서의 C형간염관리는혈액관리법시행규칙별표1에 부적격혈액의범위및혈액 혈액제제의적격여부판정기준 에따라, 항체검사 (anti-hcv 검사 ), 핵산증폭검사에서모두음성이나와야적격판정을받을수있다. 매년헌혈자중.1-.2% 정도의혈액이 C형간염선별검사결과혈액부적격으로판정되어해당혈액을폐기함으로서수혈감염을예방하고있다 (Table)[2]. 또한, C형간염은혈액관리법시행규칙 7조및별표1의 2에따라환자및병력자로확인된경우영구적으로채혈금지되는감염병으로정해져있으며, 이에따라혈액원에서헌혈자문진시에 C형간염에이환된경험이있다고답변했을경우와헌혈후에라도헌혈자자신이 C형간염에감염된사실에대하여혈액원에자진배제신고를한경우에헌혈이제한되고있다. 년하반기부터국가감염병감시체계에 C형간염으로신고 보고되는환자의경우에도혈액원과정보공유를실시하여헌혈문진당시에부적격자로분류하여사전에채혈되지않도록함으로써헌혈에서의 C형간염감염자관리를강화할계획이다. 위의과정들을통해 C형간염의전파를막아수혈자에게안전한혈액을공급하고있지만보다안전한혈액관리를위하여두가지경로의수혈부작용조사를통해수혈로인한위험요인을차단하고있다. 첫째, 수혈자가수혈후 C형간염이의심될경우

3 656 PUBLIC HEALTH WEEKLY REPORT, KCDC 제 7 권제 3 호 Table 1. Incompetency status of HCV antibody test at blood donor in Korea, unit: person (%) Characteristics Year Total number of blood donor 2,25,63 2,28,684 2,265,592 2,461,88 2,514,699 2,448,516 2,542,495 Proton number of antibody test 4,499(.2) 3,177(.2) 2,213(.1) 2,58(.1) 2,15(.1) 3,771(.2) 3,928(.2) Proton number of NAT 216(.) 163(.) 148(.) 153(.) 144(.) 113(.) 86(.) Abbreviation: NAT= Pooled nucleic acid test, 수혈된혈액및헌혈자를조사하는특정수혈부작용조사와둘째로, 선별검사결과 C형간염양성자의과거헌혈기록을조회하여과거헌혈혈액의수혈자를추적하는수혈감염역추적조사를실시하고있다. 특정수혈부작용조사는혈액관리법제1 조 ( 특정수혈부작용에대한조치 ), 동법시행규칙제13조 ( 특정수혈부작용의신고 ) 에근거하여, 수혈자의신고를접수한의료기관이소재지보건소에신고하면시 도를통해질병관리본부로최종접수된다. 질병관리본부는특정수혈부작용조사지침에따라수혈자에대한수혈관련정보 ( 수혈혈액번호등수혈관련의무기록 ), 헌혈자의과거헌혈기록, 건강보험심사평가원및의료기관을통한헌혈자및수혈자의관련진료내역또는검사기록조회, 헌혈혈액의보관검체검사, 헌혈자방문채혈검사등을시행하여헌혈자의혈액을통해수혈자가감염되었는지여부를조사하며, 조사가완료되면수혈부작용소위원회와혈액관리위원회의심의를거친최종심의결과를수혈자에게통보하게된다.[3] 26년부터 년현재까지특정수혈부작용으로신고된 C형간염접수건은총 131 건이고조사대상헌혈자는 2,79 명이다. 이중 26 년 2건, 27 년 1건이수혈부작용으로인한 C형간염발생사례로확인되었지만, 이들모두 25 년핵산증폭검사도입이전수혈받은사례로 25년핵산증폭검사도입이후에는수혈부작용사례가발생하지않고있다. 수혈감염역추적조사는혈액관리법제8조의 2( 혈액사고발생시조치등 ) 에근거하여헌혈혈액선별검사결과 C형간염양성자의과거헌혈혈액을추적하여수혈자의감염여부를조기에파악함으로써타인에게로의전파차단및조기치료시행을목적으로실시하고있다. 수혈감염역추적조사지침에따라선별검사양성일로부터가장가까운과거헌혈혈액을대상으로해당혈액의보관검체검사를시행하고의료기관의수혈장부를통해수혈자의인적사항및생존여부를파악하게된다. 생존한수혈자의경우조사에동의하는자에한해채혈조사를실시하여수혈에의한감염여부를조사하며, 사망한수혈자는건강보험심사평가원정보조회를통해 수혈감염으로인한사망여부를확인하게된다. 수혈감염역추적조사도마찬가지로수혈부작용소위원회및혈액관리위원회심의를통해최종적으로수혈감염여부를판정하게된다.[4] 26 년부터 년현재까지수혈감염역추적조사로신고된 C형간염접수건은총 858 건으로조사대상인수혈자는 2,393 명이다. 이중 24 년헌혈된해당혈액의보관검체검사결과와수혈자의채혈검사결과양성이었으나, 수혈전 후로 C형간염에대한수혈자의진단및검사기록이없는것으로 28년조사되어 수혈감염추정으로 최종심의된건이있었다. 그러나특정수혈부작용과마찬가지로 25년핵산증폭검사도입이후수혈감염사례는발생하지않고있다. C형간염은감염이확인되면페그인터페론알파와리바비린및항바이러스제로최소 6개월간치료해야하므로치료기간이길고약물에대한부작용들도문제가되고있다. 또한감염된바이러스의유전자형에따라치료예후도다르며아직효과적인백신도없어예방관리가중요하다.[5] C형간염의전파경로중, 수혈에의한전파를막기위해우리나라에서는혈액관리법에근거하여헌혈자문진및정보조회를통해감염위험요인을차단하고, 민감도가높은검사장비들을도입하여헌혈혈액선별검사를통해혈액의안전성을확보하고있다. 또한수혈에의한 C형간염이의심될경우수혈부작용인과관계를확인하는조사체계를구축 운영하고있다. 그러나우리나라 C형간염환자는지속적으로보고되고있기때문에보다정확한역학정보를통한폭넓은 C형간염관리가필요하며이를바탕으로한지속적인혈액관리도이루어져야할것이다. < 참고자료 > 1. 한규섭외 1명,, 수혈의학 ( 제4판 ), 고려의학 2. 대한적십자사 혈액사업통계연보 3. 질병관리본부 특정수혈부작용조사지침 4. 질병관리본부 HCV 수혈감염역추적조사지침 5. 대한간학회 C형간염진료가이드라인

4 주간건강과질병 PUBLIC HEALTH WEEKLY REPORT, KCDC 657 status of selected infectious diseases 1. Hand, Foot and Mouth Disease(HFMD) Republic of Korea, s ending July 19, (29th Week)* 년도제 29 주수족구병의사환자분율은외래환자 1, 명당 24.2 명이며, 213 년동기간수족구병의사환자분율 14.4 명보다높음. 주별통계는잠정통계이므로변동가능 족구병은 29년 6월법정감염병으로지정되어표본감시체계로운영되고있음 No. of HFMD per 1, consultation Figure 1. The status of HFMD sentinel surveillance, Ophthalmologic, Republic of Korea, s ending July 19, (29th ) 년도제29주유행성각결막염의외래환자 1, 명당분율은 18.1 명으로지난주 16.9 명보다증가하였음. 동기간급성출혈성결막염의환자분율은 1.2 명으로지난주 1.5 명보다감소하였음. 주별통계는잠정통계이므로변동가능 EKC per 1, Case//sentinel AHC per 1, Case//sentinel (36~) Case//sentinel(1~35) 1years 213(36~) 213 Case//sentinel(1~35) 27, ~213 Figure 1. The mean of outpatients to Epidemic keratoconjunctivitis for a Figure 2. The mean of outpatients to Acute hemorrhagic conjunctivitis for a 3. Influenza, Republic of Korea, s ending July 19, (29th ) 년도제 29 주인플루엔자의사환자분율은외래환자 1, 명당 2.2 명으로지난주 (2.1) 보다증가하였으며유행판단기준 (12.1/1, 명 ) 보다낮은수준임..5.1일자인플루엔자유행주의보해제 인플루엔자표본감시체계가변경됨에따라 213-절기유행기준은 12.1명 (/1,) 으로변경 ILI per 1, baseline(12.1) ILI per 1, (past seasons) Figure 1. The ly proportion of Influenza-Like Iliness per 1, outpatients, to 213- seasons

5 658 PUBLIC HEALTH WEEKLY REPORT, KCDC 년제 29 주 ( ) Table 1. Provisional cases of reported notifiable diseases-republic of Korea, s ending July 19, (29th Week)* Disease ly Total cases reported for previous years 213* Unit: reported case Imported cases of current : Country (reported case) Cholera Typhoid fever Cambodia(1), Philippines(1), Taiwan(1) Paratyphoid fever Shigellosis Philippines(1) EHEC Viral hepatitis A ,197 5, India(1), Philippines(1) Pertussis Tetanus Measles Philippines(1) Mumps 68 12, ,24 7,492 6,137 6,94 6,399 Rubella Viral hepatitis B ** 94 2, ,394 2,753 1, Japanese encephalitis Varicella 6 23, ,361 27,763 36,249 24,4 25,197 Malaria ,772 1,345 Bangladesh(1), Pakistan(1), Philippines(1) Scarlet fever 13 3, , Meningococcal meningitis Legionellosis Vibrio vulnificus sepsis Murine typhus Scrub typhus ,365 8,64 5,151 5,671 4,995 Leptospirosis Brucellosis Rabies HFRS Syphilis CJD/vCJD Dengue fever Philippines(4), Cambodia(3), Thailand(3), Indonesia(2), Laos(1) Q fever West Nile fever Lyme Borreliosis Melioidosis Chikungunya fever SFTS Tuberculosis 36,89 39,545 39,557 36,35 35,845 HIV/AIDS , : No reported cases. Cum: Cumulative counts of the year from 1st to current. EHEC: Enterohemorrhagic Escherichia coli. HFRS: Hemorrhagic fever with renal syndrome. CJD/vCJD: Creutzfeldt-Jacob Disease / variant Creutzfeldt-Jacob Disease. SFTS: Severe fever with thrombocytopenia syndrome. * Incidence data for reporting year is provisional, whereas data for 29, 21, 211, 212 and 213 are finalized(except for HIV/AIDS). Reported cases contain all case classifications(confirmed, Suspected, Asymptomatic carrier) of the disease respectively. Excluding Hansen's disease, diseases reported through the Sentinel Surveillance System(Data for Sentinel Surveillance System are available in Table III), and diseases no case reported(diphtheria, Poliomyelitis, Epidemic typhus, Anthrax, Plague, Yellow fever, Viral hemorrhagic fever, Smallpox, Botulism, Severe Acute Respiratory Syndrome, Avian influenza infection and humans, Novel Influenza, Tularemia, Newly emerging infectious disease syndrome, Tick-borne Encephalitis) Surveillance system for Viral hepatitis A, Viral hepatitis B, Syphilis, CJD/vCJD, West Nile fever was altered from Sentinel Surveillance System to National Infectious Disease Surveillance System as of December 3,21. Calculated by summing the incidence counts for the current, the 2 s preceding the current, and the 2 s following the current, for a total of 5 preceding years(for Viral hepatitis A, Viral hepatitis B, Syphilis, CJD/vCJD, West Nile fever, Lyme Borreliosis, Melioidosis, this calculation used 3 year data(211, 212, 213) only, because of being designated as of December 3,21). ** Viral hepatitis B comprises acute Viral hepatitis B, HBsAg positive maternity, Perinatal hepatitis B virus infection. Scarlet fever's case classifications contain confirmed cases to confirmed and suspected cases since September 27, 212.

6 주간건강과질병 PUBLIC HEALTH WEEKLY REPORT, KCDC 659 Table 2. (continued) Provisional cases of selected notifiable diseases, Republic of Korea, s ending July 19, (29th Week)* Unit: reported case Reporting area Cholera Typhoid fever Paratyphoid fever Shigellosis Enterohemorrhagic Escherichia coli Viral hepatitis A Pertussis Tetanus 3-year Total , Seoul Busan Daegu Incheon Gwangju Daejeon Ulsan Sejong Gyonggi Gangwon Chungbuk Chungnam Jeonbuk Jeonnam Gyeongbuk Gyeongnam Jeju : No reported cases. Cum: Cumulative counts of the year from 1st to current. * Incidence data for reporting year is provisional, whereas data for 29, 21, 211, 212 and 213 are finalized Reported cases contain all case classifications (Confirmed, Suspected, Asymptomatic carrier) of the disease, respectively. Surveillance system for Viral hepatitis A was altered from Sentinel Surveillance System to National Infectious Disease Surveillance System as of December 3,21. Calculated by averaging the cumulative counts from 1st to current, for a total of 5 preceding years.

7 66 PUBLIC HEALTH WEEKLY REPORT, KCDC 년제 29 주 ( ) Table 2. (continued) Provisional cases of selected notifiable diseases, Republic of Korea, s ending July 19, (29th Week)* Unit: reported case Measles Mumps Rubella Viral hepatitis B Japanese encephalitis Varicella Malaria Scarlet fever Reporting area 4-year Total ,395 4, ,612 1, ,56 18, , Seoul , ,94 1, Busan , ,84 1, Daegu ,697 1, Incheon ,539 1, Gwangju , Daejeon Ulsan Sejong Gyonggi ,258 1, ,194 4, Gangwon , Chungbuk Chungnam , Jeonbuk , , Jeonnam Gyeongbuk , Gyeongnam , Jeju : No reported cases. Cum: Cumulative counts of the year from 1st to current. * Incidence data for reporting year is provisional, whereas data for 29, 21, 211, 212 and 213 are finalized Reported cases included all classification (Confirmed, Suspected, Asymptomatic carrier) of the diseases, respectively. Surveillance system for Viral hepatitis B was altered from Sentinel Surveillance System to National Infectious Disease Surveillance System as of December 3,21. The cumulative counts are calculated by averaging from 1st to current, for a total of 5 preceding years. Scarlet fever s case classifications contain confirmed cases to confirmed and suspected cases since September 27, 212.

8 주간건강과질병 PUBLIC HEALTH WEEKLY REPORT, KCDC 661 Table 2. (continued) Provisional cases of selected notifiable diseases, Republic of Korea, s ending July 19, (29th Week)* Unit: reported case Reporting area Meningococcal meningitis Legionellosis Vibrio vulnificus sepsis Murine typhus Scrub typhus Leptospirosis Brucellosis Rabies Total Seoul Busan Daegu Incheon Gwangju Daejeon Ulsan Sejong Gyonggi Gangwon Chungbuk Chungnam Jeonbuk Jeonnam Gyeongbuk Gyeongnam Jeju : No reported cases. Cum: Cumulative counts of the year from 1st to current. * Incidence data for reporting year is provisional, whereas data for 29, 21, 211, 212 and 213 are finalized Reported cases contain all case classifications (Confirmed, Suspected, Asymptomatic carrier) of the disease, respectively. Calculated by averaging the cumulative counts from 1st to current, for a total of 5 preceding years

9 662 PUBLIC HEALTH WEEKLY REPORT, KCDC 년제 29 주 ( ) Table 2. (continued) Provisional cases of selected notifiable diseases, Republic of Korea, s ending July 19, (29th Week)* Unit: reported case Reporting area Hemorrhagic fever with renal syndrome Syphilis CJD/vCJD Dengue fever Q fever Lyme Borreliosis Melioidosis Tuberculosis 3-year 3-year 3-year 3-year Total ,652 21,214 Seoul ,249 4,352 Busan ,569 1,772 Daegu ,5 1,167 Incheon ,96 1,92 Gwangju Daejeon Ulsan Sejong Gyonggi ,15 3,932 Gangwon Chungbuk Chungnam Jeonbuk Jeonnam Gyeongbuk ,423 1,495 Gyeongnam ,339 1,463 Jeju : No reported cases.cum: Cumulative counts of the year from 1st to current. * Incidence data for reporting year is provisional, whereas data for 29, 21, 211, 212 and 213 are finalized Reported cases contain all case classifications (Confirmed, Suspected, Asymptomatic carrier) of the disease, respectively. Calculated by averaging the cumulative counts from 1st to current, for a total of 5 preceding years.

10 주간건강과질병 PUBLIC HEALTH WEEKLY REPORT, KCDC 663 Table 3. Provisional cases of reported sentinel surveillance disease, Republic of Korea, s ending JULY 12, (28th Week)* Unit: case /sentinel Viral hepatitis Sexually Transmitted Diseases Hepatitis C Gonorrhea Chlamydia Genital herpes Condyloma acuminata 5 year 5 year 5 year 5 year 5 year Total : No reported cases. Cum: Cumulative counts of the year from 1st to current. Reported cases contain all case classifications (Confirmed, Suspected, Asymptomatic carrier) of the disease, respectively. Calculated by averaging the cumulative counts from 1st to current, for a total of 5 preceding years. 주요통계이해하기 <Table 1> 은법정감염병의지난 5년간발생과해당주의발생현황을비교한표로, 는해당주의보고건수를나타내며, 은 년 1주부터해당주까지의누계건수, 그리고 ly 는지난 5년 ( 년 ) 의해당주의보고건수와이전 2주, 이후 2주동안의보고건수 ( 총 25주 ) 평균으로계산된다. 그러므로 와 ly 에서의보고건수를비교하면주단위로해당시점에서의보고수준을예년의보고수준과비교해볼수있다. Total cases reported for previous years 는지난 5년간해당감염병의보고총수를나타내는확정통계이며연도별보고건수현황을비교해볼수있다. 예 ) 년 12 주의 ly (5 년간주평균 ) 는 29년부터 213 년의 1 주부터 14 주까지의보고건수를총 25주로나눈값으로구해진다. * ly (5 년주평균 )=(X1 + X2 + + X25)/25 1주 11주 12주 13주 14주 년 해당주 213년 X1 X2 X3 X4 X5 212년 X6 X7 X8 X9 X1 211년 X11 X12 X13 X14 X15 21년 X16 X17 X18 X19 X2 29년 X21 X22 X23 X24 X25 <Table 2, 3> 는 17 개시 도별로구분한법정감염병보고현황을보여주고있으며, 각감염병별로 Cum, 와 Cum, 를비교해보면최근까지의누적보고건수에대한이전 5년동안해당주까지의평균보고건수와의비교가가능하다. Cum, 는지난 5년 ( 년 ) 동안의동기간보고누계평균으로계산된다.

발간등록번호 11-1351159-2-3 PUBLIC HEALTH WEEKLY REPORT, 주간건강과질병 PHWR ISSN:25-811X PHWR Vol.7 NO.29 www.cdc.go.

주간건강과질병에서제공되는감염병통계는 감염병의예방및관리에관한법률 에의거한국가감염병감시체계를통해신고된자료를기초로집계된것이며, 당해년도자료는의사환자단계에서신고된것으로확진결과가나오거나다른병으로확인되는경우수정및변동가능한잠정통계입니다. 동간행물은인터넷 (http://www.cdc.go.

11 발간등록번호 PUBLIC HEALTH WEEKLY REPORT, 주간건강과질병 PHWR ISSN:25-811X PHWR Vol.7 NO.29 은질병관리본부가보유한각종감시및조사사업, 연구자료에대한종합, 분석을통하여근거에기반한질병과건강관련정보를제공하고자최선을다할것이며, 제공되는원고내용은질병관리본부의입장과는무관함을알립니다. 주간건강과질병에서제공되는감염병통계는 감염병의예방및관리에관한법률 에의거한국가감염병감시체계를통해신고된자료를기초로집계된것이며, 당해년도자료는의사환자단계에서신고된것으로확진결과가나오거나다른병으로확인되는경우수정및변동가능한잠정통계입니다. 동간행물은인터넷 ( 에주간단위로게시되며이메일을통해정기적인구독을원하시는분은이름, 이메일, 주소, 연락처, 직업을간단히기입하여 주간건강과질병에대하여궁금하신사항은 창발 간 : 28년 4월 4일행 : 년 7월 24일 발행인 : 양병국편집인 : 정충현편집위원 : 윤승기, 최혜련, 박영준, 김윤아, 최영실, 김기순, 정경태, 최병선, 조신형, 조성범, 김봉조, 구수경, 김용우, 조은희, 박선희, 유석현, 조승희, 최수영 편 집 : 질병관리본부감염병관리센터감염병감시과 충북청원군오송읍오송생명 2로 187 오송보건의료행정타운 ( 우 ) Tel. (43) , 7176 Fax. (43)

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°Ç°�°úÁúº´6-2È£ K O R E A C E N T E R S F O R D I S E A S E C O N T R O L & P R E V E N T I O N PHWR Vol. 6 No. 2 www.cdc.go.kr 2013 1 11 6 2 ISSN:2005-811X Flavivirus surveillance in mosquitoes collected from the quarantine