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,. 2013 1,576,000 3% [1]. (49.4%), (8.5%), (7.6%), (3.6%) (3.0%) [1]. 2007 4 9 2013 8 6, (58.6%), (5.1%), (4.5%), (3.5%), (3.1%), (2.0%) [2].. 2014, [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 152-703, Korea Tel: +82-2-2626-3050, Fax: +82-2-2626-1105, E-mail: heejinmd@korea.ac.kr
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. 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. 1990 1. - - (Tetanus-diphtheria-acellular pertussis; Tdap) Td/Tdap, 27-36 Tdap [5]. 2001 20, 2009 66, 2011 97 [6], 2012, 230 ( 167 ) [7]. Tdap, Tdap [8].. Tdap.,, 4~6 - - [9]. Tdap [10]. 1 27-36. 2. A형간염백신 <A형간염백신접종권장안 >. A A.., A.. 2 (1 6-12 2 ). 140 A, [11].,. 1970 1997. 2001 105 2006 1,937 20-30 [11]. 2011 5,521, 2012 1,197, 2013 867 [12].. ( ) A,.,,, [13]. A,.
해외유입성인에대한대한감염학회예방접종권장안 염준섭외 표 1. 지역별, 연령별 A형간염항체양성률 (%) [13] 연령 지역 1-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ 고소득아시아태평양 a 0 2 10 17 25 36 51 66 81 98 100 97 중앙아시아 42 60 68 72 76 81 85 89 91 94 96 100 동남아시아 24 44 56 63 69 75 82 87 91 94 97 100 남아시아 61 75 82 87 91 96 100 100 100 100 100 100 동남아시아 16 30 43 52 60 72 85 94 98 99 100 86 오스트레일리아 3 7 11 15 18 22 30 39 49 60 72 100 카리브해 14 31 42 50 57 65 76 86 95 100 100 96 중유럽 21 35 41 46 51 58 67 75 82 87 92 100 동유럽 20 33 10 47 54 64 76 86 95 100 100 94 서유럽 1 6 18 28 35 45 56 66 75 82 88 100 안데스라틴아메리카 54 69 78 85 91 97 100 100 100 100 100 100 중앙라틴아메리카 59 73 80 85 89 93 97 100 100 100 100 98 남라틴아메리카 36 53 62 68 73 78 83 87 91 94 96 100 열대라틴아메리카 28 51 64 72 79 86 93 99 100 100 100 100 북아프리카 / 중동 37 58 70 77 83 89 96 100 100 100 100 100 고소득북아메리카 b 0 2 6 9 13 20 30 41 54 69 83 100 오세아니아 17 45 61 71 78 87 96 100 100 100 100 100 중앙사하라이남아프리카 40 90 98 99 100 100 100 100 100 100 100 100 동사하라이남아프리카 73 86 91 95 98 100 100 100 100 100 100 100 동남사하라이남아프리카 67 84 94 100 100 100 100 100 100 100 100 100 서남서하라이남아프리카 59 75 84 95 95 100 100 100 100 100 100 100 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 ). 2001 - - (MMR ) 2 2006 [15], 2014. 2014, 2. MMR 2 95%,.,, MMR 2, 2 [16]., MMR 2 MMR 9, [17, 18]., MMR, 2 MMR 1.,, MMR 1
염준섭외 해외유입성인에대한대한감염학회예방접종권장안. 4. 수두백신 < 수두백신접종권장안 >.,...... 4-8 2...,. 15 ( 2). 4-6 2 2 [19].,. 20-40% [20].. 12-15.. 5. 일본뇌염백신 < 일본뇌염백신접종권장안 >. (8 ~11 ) - 1-1.. - : 0, 7, 30 3, 2~3 1. - : 0, 28 2 1 1. - :. 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 ) 100 1. 1973 2008 55 [21, 22].,,., 2000 2012 82 [23],. 65% 1, 80% [24]. 1 1. 8
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 14-14-2.. Nakayama Vero SA 14-14-2 1 [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-
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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).