염준섭외 해외유입성인에대한대한감염학회예방접종권장안 1. 파상풍 - 디프테리아 - 백일해백신 < 파상풍 - 디프테리아 - 백일해백신접종권장안 > 노출전예방. Tdap Tdap 10 Td.. 3 Tdap 4~6 Td, 6-12 Td 10 Td.. - -, 1., 27-36

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Supplementary Infection & Chemotherapy 해외유입성인에대한대한감염학회예방접종권장안 염준섭 1, 권기태 2, 이재갑 3, 서유빈 3, 정혜숙 4, 권현희 5, 정희진 6 ; 대한감염학회성인예방접종위원회 1 성균관대학교의과대학내과학교실, 2 대구파티마병원감염내과, 3 한림대학교의과대학내과학교실, 4 건국대학교의과대학내과학교실, 5

1 Supplementary Infection & Chemotherapy 해외유입성인에대한대한감염학회예방접종권장안 염준섭 1, 권기태 2, 이재갑 3, 서유빈 3, 정혜숙 4, 권현희 5, 정희진 6 ; 대한감염학회성인예방접종위원회 1 성균관대학교의과대학내과학교실, 2 대구파티마병원감염내과, 3 한림대학교의과대학내과학교실, 4 건국대학교의과대학내과학교실, 5 대구가톨릭대학교의과대학내과학교실, 6 고려대학교의과대학내과학교실, ,576,000 3% [1]. (49.4%), (8.5%), (7.6%), (3.6%) (3.0%) [1] , (58.6%), (5.1%), (4.5%), (3.5%), (3.1%), (2.0%) [2] , [3].,.....,,. 3 ( 3 ) 예방접종대상질환선정과예방접종확인서 - -,, A, B, - -,,,,, [4]. - -, A, - -,,. ( 1). Received: May 19, 2015 Corresponding Author : Hee Jin Cheong, MD, PhD, Division of Infectious Disease, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul , Korea Tel: , Fax: , heejinmd@korea.ac.kr

2 염준섭외 해외유입성인에대한대한감염학회예방접종권장안 1. 파상풍 - 디프테리아 - 백일해백신 < 파상풍 - 디프테리아 - 백일해백신접종권장안 > 노출전예방. Tdap Tdap 10 Td.. 3 Tdap 4~6 Td, 6-12 Td 10 Td.. - -, 1., 노출후예방. Tdap Td DTP Td ( ). 표. 파상풍의예방적처치 백신접종력 깨끗하고작은상처기타다른상처 a Td b TIG Td b TIG 미상또는 3회미만 필요 불필요 필요 필요 3회이상마지막접종후 > 10년 필요 불필요 필요 불필요 마지막접종후 5-9년 불필요 불필요 필요 불필요 마지막접종후 <5년 불필요 불필요 불필요 불필요 a 토양, 분변, 오물, 타액등에오염된상처, 천자, 화상, 동상, 총상등에의한상처 b Tdap을접종받은적이없다면, Tdap을접종한다 (Tetanus-diphtheria-acellular pertussis; Tdap) Td/Tdap, Tdap [5] , , [6], 2012, 230 ( 167 ) [7]. Tdap, Tdap [8].. Tdap.,, 4~6 - - [9]. Tdap [10] A형간염백신 <A형간염백신접종권장안 >. A A.., A.. 2 ( ). 140 A, [11]., , [11] ,521, ,197, [12].. ( ) A,.,,, [13]. A,.

3 해외유입성인에대한대한감염학회예방접종권장안 염준섭외 표 1. 지역별, 연령별 A형간염항체양성률 (%) [13] 연령 지역 고소득아시아태평양 a 중앙아시아 동남아시아 남아시아 동남아시아 오스트레일리아 카리브해 중유럽 동유럽 서유럽 안데스라틴아메리카 중앙라틴아메리카 남라틴아메리카 열대라틴아메리카 북아프리카 / 중동 고소득북아메리카 b 오세아니아 중앙사하라이남아프리카 동사하라이남아프리카 동남사하라이남아프리카 서남서하라이남아프리카 a 일본, 대한민국, 싱가폴, 브루나이. 미국, 캐나다 18 1,, [14]. A IgG. 3. 홍역-볼거리-풍진백신 < 홍역-볼거리-풍진백신접종권장안 >. 12 MMR 2.,,,.. MMR 1., 2, 1..,..,, MMR 1 ( 4 ) (MMR ) [15], , 2. MMR 2 95%,.,, MMR 2, 2 [16]., MMR 2 MMR 9, [17, 18]., MMR, 2 MMR 1.,, MMR 1

4 염준섭외 해외유입성인에대한대한감염학회예방접종권장안. 4. 수두백신 < 수두백신접종권장안 >., ,. 15 ( 2) [19]., % [20] 일본뇌염백신 < 일본뇌염백신접종권장안 >. (8 ~11 ) : 0, 7, 30 3, 2~ : 0, :. 표 2. 수두의국가예방접종사업시행국가 (2013년 12월현재 ) 국가 접종일정 미국, 4-6세 캐나다, 4-6세 호주 18개월, 4-6세 ( 선택접종 ) 뉴질랜드 18개월, 4-6세 ( 선택접종 ) 독일 11-14개월 (MMRV), 4-6세 한국 그리스 리투아니아 ( 임의접종 ) 브라질 사이프러스 ( 임의접종 ) 우루과이 카타르 스페인 ( 마드리드 ) 타이완 일본 ( 임의접종 ) [21, 22].,,., [23],. 65% 1, 80% [24]

5 해외유입성인에대한대한감염학회예방접종권장안 염준섭외 표 3. 대륙별권장예방접종안 파상풍 - 디프테리아 - 백일해 A 형간염 홍역 - 볼거리 - 풍진 아시아북미유럽남미아프리카 자연감염에의한항체보유가능성높음 ( 일본제외 ) 접종고려 접종고려 자연감염에의한항체보유 가능성높음 자연감염에의한항체보유가능성높음 수두항체검사후선별접종항체검사후선별접종항체검사후선별접종항체검사후선별접종항체검사후선별접종 일본뇌염일본, 중국, 대만, 홍콩, 태국제외 접종고려접종고려접종고려접종고려 11 [24].,,,,, [9, 24].. 나. 백신접종전고려사항 3 (,, Vero ). Nakayama vero Beijing. vero SA Nakayama Vero SA [25],. 6. 요약 [26]..,.,,.,,,. ( 3).,. Acknowledgement The Committee of Adult Immunization, The Korean Society of Infectious Diseases: Chair Hee Jin Cheong, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Members Eu Suk Kim, Department of Internal Medicine, Seoul National University, Seoul, Korea Sang Hoon Han, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea Won Suk Choi, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Jung-Hyun Choi, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea Ki Tae Kwon, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea Jin-Soo Lee, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea Joon Young Song, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea Hee-Jung Choi, Department of Internal Medicine, Ewha Wom-

6 염준섭외 해외유입성인에대한대한감염학회예방접종권장안 an's University School of Medicine, Seoul, Korea Young-Hwa Choi, Department of Internal Medicine, Ajou University College of Medicine, Suwon, Korea Dong-Gun Lee, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea References 1. Korea immigraion service, ministry of justice. Korea immigration service statistics KEWAD; Ministry of Education. Statistics of foreign students in Korea Available at: board/view.do?bbsid=350&boardseq=50887&mode=view. Accessed 1 November Centers for Disease Control and Prevention, Department of Vaccine Control. Measles, strengthening of measures to prevent transmission and spread in schools. 27 May 2014 press release. 4. Korean Society of Infectious Diseases. Adult vaccination, 2nd ed. Seoul: Koonja Publishing; Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women--advisory Committee on Immunization Practices (ACIP), MMWR Morb Mortal Wkly Rep 2013;62: Korea Center for Disease Control and Prevention (KCDC). Disease web statistics system Available at: is.cdc.go.kr/nstat/jsp/observation/stat/tot/stattot- 0402List.jsp. Accessed 12 June Kwon HJ, Yum SK, Choi UY, Lee SY, Kim JH, Kang JH. Infant pertussis and household transmission in Korea. J Korean Med Sci 2012;27: Kim IS, Seo YB, Hong KW, Noh JY, Choi WS, Song JY, Cho GJ, Oh MJ, Kim HJ, Hong SC, Sohn JW, Kim WJ, Cheong HJ. Perceptions of Tetanus-diphtheria-acellular pertussis (Tdap) vaccination among Korean women of childbearing age. Infect Chemother 2013;45: World Health Organization (WHO). WHO vaccine-preventable diseases: monitoring system global summary. Available at: monitoring/globalsummary/schedules. Accessed 26 March Choi WS, Choi JH, Kwon KT, Seo K, Kim MA, Lee SO, Hong YJ, Lee JS, Song JY, Bang JH, Choi HJ, Choi YH, Lee DG, Cheong HJ; Committee of Adult Immunization; Korean Society of Infectious Diseases. Revised adult immunization guideline recommended by the korean society of infectious diseases, Infect Chemother 2015;47: Centers for Disease Control and Prevention (CDC). Hepatitis A. Available at: rcontentview.jsp?menuids=home001-mnu0001- MNU0746-MNU0750&cid= Accessed 2 November Centers for Disease Control and Prevention (CDC). Infectious Diseases Web-Statistics System. Accessed at stat.cdc.go.kr. Accessed 3 November Jacobsen KH. The global prevalence of hepatitis A virus infection and susceptibility: systematic review. Geneva, Switzerland: WHO; World Health Organization (WHO). Vaccine-preventable diseases: monitoring system global summary. Available at: globalsummary/schedules. Accessed 2 November Centers for Disease Control and Prevention (CDC). Elimination of measles--south Korea, MMWR Morb Mortal Wkly Rep 2007;56: Centers for Disease Control and Prevention (CDC). Progress toward measles elimination--western Pacific Region, MMWR Morb Mortal Wkly Rep 201;62: Martin R, Wassilak S, Emiroglu N, Uzicanin A, Deshesvoi S, Jankovic D, Goel A, Khetsuriani N. What will it take to achieve measles elimination in the World Health Organization European Region: progress from and essential accelerated actions. J Infect Dis 2011;204 (Suppl 1):S Centers for Disease Control and Prevention (CDC). Progress toward measles control - African region, MMWR Morb Mortal Wkly Rep 2009;58: Sadzot-Delvaux C, Rentier B, Wutzler P, Asano Y, Suga S, Yoshikawa T, Plotkin SA. Varicella vaccination in Japan, South Korea, and Europe. J Infect Dis 2008;197 (Suppl 2):S Ozaki T. Varicella vaccination in Japan: necessity of implementing a routine vaccination program. J Infect Chemother 2013;19: Fischer M, Lindsey N, Staples JE, Hills S; Centers for Disease Control and Prevention (CDC). Japanese encephalitis vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2010;59(RR-1): Erlanger TE, Weiss S, Keiser J, Utzinger J, Wiedenmayer K. Past, present, and future of Japanese encephalitis. Emerg

7 해외유입성인에대한대한감염학회예방접종권장안 염준섭외 Infect Dis 2009;15: Centers for Disease Control and Prevention (CDC) Annual Report on Infectious Disease Monitoring. Available at: Accessed 28 June World Health Organization (WHO). Japanese encephalitis vaccine. Available at: japanese_encephalitis/en/. Accessed 25 May Erra EO, Hervius Askling H, Rombo L, Riutta J, Vene S, Yoksan S, Lindquist L, Pakkanen SH, Huhtamo E, Vapalahti O, Kantele A. A single dose of Vero cell derived Japanese encephalitis (JE) vaccine (Ixiaro) effectively boosts immunity in travelers primed with mouse brain derived JE vaccines. Clin Infect Dis 2012;55: Leder K, Tong S, Weld L, Kain KC, Wilder-Smith A, von Sonnenburg F, Black J, Brown GV, Torresi J; GeoSentinel Surveillance Network. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 2006;43:

8 염준섭외 해외유입성인에대한대한감염학회예방접종권장안 부록 1. 예방접종확인서 (Vaccine Administration Checklist) Part 1. General Information ( 일반정보 ) Name ( 이름 ) (Last) (First) (Middle) Date of Birth ( 출생일 ) mm / dd / yy Age ( 연령 ) Gender ( 성별 ) Male ( 남성 ) Female ( 여성 ) Height ( 키 ) cm Weight ( 몸무게 ) kg Birthplace ( 출생지 ) Nationality ( 국적 ) Purpose of the Stay/Visit ( 체류 / 방문목적 ) Expected Date of the Stay/Visit ( 체류 / 방문기간 ) mm / dd / yy ~ mm / dd / yy City of the Stay/Visit ( 체류 / 방문도시 ) Part 2. Vaccination Status ( 백신접종상태 ) Vaccine ( 백신 ) Vaccination History ( 백신접종력 ) Vaccine Type ( 백신세부종류 ) Last Date Received ( 마지막접종일 ) Vaccination not required ( 접종이필요없는경우 ) Tetanus-Diphtheria-Pertussis ( 파상풍 - 디프테리아 - 백일해 ) Td DTwP/DTaP Tdap Unknown Influenza ( 인플루엔자 ) Hepatitis A (A 형간염 ) HepAHepB HepA History of hepatitis A infection (HAV 에걸렸던적이있음 ) Positive for hepatitis A antibodies (A 형간염항체가양성임 ) Hepatitis B (B 형간염 ) HepAHepB HepB HBV carrier or chronic hepatitis B state (B 형간염환자임 ) Positive for hepatitis B surface antibody (HBsAb (+)) (B 형간염항체가양성임 ) Measles-Mumps-Rubella (MMR) ( 홍역 - 볼거리 - 풍진 ) Series Times: Monovalent MM MR MMR MMRV Positive for MMR Ab ( 홍역, 볼거리, 풍진항체가모두양성 ) Two doses of MMR vaccine (MMR 2 회접종력 ) Varicella ( 수두 ) History of varicella infection ( 수두에걸렸던적이있음 ) Positive for varicella antibodies ( 수두항체가양성임 ) Meningococcus ( 수막구균 ) MenA MenAC MenACW MenACWY MenBC MenC-conj Japanese encephalitis a ( 일본뇌염 ) 2 nd dose 3 rd dose mm/dd /yy a Boosted dose will be administrated on all 2 nd dose series vaccinated person if potential for JE virus exposure continues (1 year after primary series).

Current update on immunization in cirrhosis

Current update on immunization in cirrhosis 연세대학교의과대학 내과학교실감염내과구남수 Cirrhosis Associated Immune Dysfunction Syndrome Bonnel et al. Clin Gastroenterol Hepatol 2011 백신으로예방가능한감염질환 파상풍-백일해-디프테리아 인플루엔자 A형간염