ISSN:2005-811X www.cdc.go.kr PUBLIC HEALTH WEEKLY REPORT, PHWR Vol.9 No.11 CONTENTS 190 국민건강영양조사구강검사질관리소개 194 병의원기반심폐소생술확대방안소개 197 주요통계 : 인플루엔자발생현황 호흡기바이러스유전자검출현황
주간건강과질병 제 9 권제 11 호 국민건강영양조사구강검사질관리소개 질병관리본부질병예방센터건강영양조사과이혜린, 오경원 * * 교신저자 : kwoh27@korea.kr / 043-719-7460 Abstract Quality control of oral health examination for Korea National Health and Nutrition Examination Survey(KNHANES) Division of Health and Nutrition Survey, Center for Disease Prevention, CDC. Lee Hye-Rin, Oh Kyung-Won The oral health component of KNHANES obtained data to assess the oral health status of Koreans, monitor trends in risk factors, and determine the prevalence of dental caries and periodontitis. The oral health data quality control of KNHANES was composed of three parts: Education Program and Field Training Program for quality control of oral health examiners (dentist) by professional academy, and Data management by CDC. Through these efforts, the data were obtained and optimum quality level was maintained. 들어가는말 국민건강영양조사는우리나라국민의건강수준을파악하기위해만 1세이상약 10,000 명을대상으로매년시행되고있는전국규모의조사이다. 2007년부터구강검사를도입하여매년 국민건강영양조사구강검사에참여하고있다. 위와같은이유로다른조사항목에비해체계적인질관리가중요하여대한예방치과 구강보건학회와공동으로질관리를실시하고있다. 이글에서는국민건강영양조사구강검사질관리방법에대해자세히기술하고자한다. 만 1 세이상을대상으로치아및보철물, 치주조직을포함한 구강건강상태와칫솔질실천, 구강위생용품사용등을포함한 구강건강관련행태에관한자료를수집하고있다. 국민건강영양조사구강검사는국민의구강건강상태를측정하는대표적인역학조사로, 국민건강증진종합계획 (HP2020) 의구강보건목표달성여부를평가하는중요한자료이다. 현재구강검사는치과의사가치경 (dental mirror) 과탐침 (probe) 기구를사용하여시진과촉진에의해치아우식및치주질환유병등주요구강질환을측정하고있다. 구강검사조사원은질병관리본부소속공중보건치과의 2인과시 도에서지원받은 몸말 국민건강영양조사구강검사는 WHO 구강조사지침 [1] 을바탕으로구성한 국민건강영양조사구강조사지침 을근거로수행하고있다. 학회에서는 교육훈련프로그램 과 현장정도관리프로그램 에참여하여구강검사조사원의질관리를수행하고있으며, 내부에서는수집된자료의질관리를수행하고있다 [2] (Figure 1). 공중보건치과의약 30 인으로구성되어, 다수의구강검사조사원이 190
PUBLIC HEALTH WEEKLY REPORT, KCDC Figure 1. Quality control process of oral health survey in KNHANES 1. 교육훈련교육훈련은구강검사조사원인공중보건치과의의배치일정을반영하여상반기와하반기, 연간총 2회로나누어실시하고있다. 교육훈련은학회소속역학조사위원 ( 치과대학교수진 ) 들이진행하며, 1일차이론교육, 2일차사진및모형교육을실시하며, 3일차부터 5일차까지는모의검진을반복하도록구성되어있다. 1일차이론교육에서는국민건강영양조사구강검사의의의, 조사결과의활용등조사개요에대한설명과구강검사항목별세부지침 ( 치아우식증을포함한치아상태및치료필요, 임플란트및틀니 ( 의치 ) 등보철물상태, 치주조직상태, 반점치 ) 을교육한다. 2일차사진교육에서는서울대학교치의학대학원에서개발한조사자교육훈련프로그램 (w w w.snudentistr y.com) 에접속하여이론교육결과를평가한다. 사전검사 (16 문항 ) 후정답확인및지침에대한자가학습을하며, 사전검사와동일한항목을포함한사후검사 (23문항 ) 후정답확인및지침에대한재점검을수행한다. 교육결과는사전검사및사후검사의 정답률과사전 / 사후검사간일치도확인을통해평가한다. 사진교육후, 다양한치아우식증과보철물이재현되어있는 20악의구강모형 ( 상 하악각각 10개 ) 을이용하여모형교육을수행한다. 정답과검사결과를비교하여조사자간신뢰도를 kappa 지수를이용하여평가한다. 구강검사중, 치주조직검사는구강내치주낭 (periodontal pocket) 에탐침 (probe) 기구를삽입하여측정한길이를근거로치주질환여부를평가함에따라조사자숙련도특히, 탐침시압력을일정하게유지하는것이중요하다. 이에치주낭측정이가능한구강모형과전자저울을이용하여탐침가압훈련 (1일 2회씩 4일간, 총 8회이상반복시행 ) 을시행하여치주탐침적정압력인 15~20g 압력수준을유지할수있도록교육한다. 3일차모의검진은다양한연령으로구성된 5~6인의피검자를대상으로국민건강영양조사구강검사에서사용하는기록지를이용하여검사를실시한다. 교육결과는 gold standard( 학회소속역학조사위원 1인 ) 의검사결과와비교하여조사자간신뢰도를 kappa 지수를이용하여평가한다. 조사자간 www.cdc.go.kr 191
주간건강과질병 제 9 권제 11 호 오차를확인하여다수의오차가발생하는구강상태에대해 논의하고, 피검자의상태를재확인하여결과를환류한다. 동일한모의검진을 4 회반복실시하여최종 20 인이상의 피검자에대한모의검진을실시한다 (Figure 2). 1. Lecture 2. Picture review 3. Model review 4-1. Practice simulation 4-2. Discussion after practice simulation 5. Probing force measuring Figure 2. Education program process of oral health survey in KNHANES 192
PUBLIC HEALTH WEEKLY REPORT, KCDC Figure 3. KNHANES system for oral health survey 2. 현장정도관리교육훈련에참여한학회소속역학조사위원들은교육훈련을이수한구강검사조사원이국민건강영양조사구강조사에참여하는 1일차검진일에맞춰현장정도관리를진행한다. 학회에문의하여필요시자료를수정한다. 검독이완료된자료를바탕으로이상치확인등구강검사자료를최종정제한후, 이자료를활용하여구강건강통계를산출하고원시자료를공개하고있다. 구강검사조사원들의교육훈련일치도평가결과를참고하여 맞춤형정도관리를실시한다. 현장정도관리당일국민건강영양조사에참여하는대상자최소 5인이상을대상으로중복검사를시행하여조사항목별일치도를평가한다. 각조사항목별일치도가낮은경우 (kappa 기준 : 치아상태 0.6 미만, 치주상태 0.5 미만 ), 현장에서구강검사조사원에게결과를환류하고, 해당조사원이다음조사에참여할경우추가현장정도관리를실시한다. 3. 자료검독구강검사조사원이현장에서시스템에잘못된값을입력하거나 맺는말 국민건강영양조사구강조사는우리나라국민의구강건강상태를측정하는대표적인역학조사로, 구강검사조사원 ( 공중보건치과의 ) 에대한교육훈련과현장정도관리를통해외부질관리를수행하며, 자료검독을통해내부질관리를수행하고있다. 향후에도구강건강통계의정확도를유지하기위해학회와공동으로질관리과정을지속적으로수정 보완할계획이다. 논리적으로오류가있는값을기재하는경우, 시스템상에서 일차적으로오류에대한경고창을띄워바로오류를확인하여수정할수있도록한다 (Figure 3). 현장에서조사가완료된이후, 본부소속공중보건치과의는현장에서검토한자료를모두재검독한다. 기술적인입력오류를확인하고, 구강검사지침에근거하여치료필요및보철필요에대한학문적, 임상적판단오류를확인하여수정한다. 수정한내용은조사표에기록하고, 시스템에변경사유를기재한다. 본부구강검사담당자는본부소속공중보건치과의가수정한내용의오류를재확인하며, 임상적판단오류가모호한경우 참고문헌 1. World Health Organization. 2013. Oral Health Surveys;Basic Method. 5th edition. 2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. 2015. The sixth Korea National Health and Nutrition Examination Survey(2013-2015) Guideline. Cheongju:Korea centers for Disease Control and Prevention. www.cdc.go.kr 193
주간건강과질병 제 9 권제 11 호 병의원기반심폐소생술확대방안소개 질병관리본부질병예방센터만성질환관리과최정아, 윤성옥, 홍성옥, 김영택 * * 교신저자 : ruyoung@korea.kr / 043-719-7380 Abstract Introduction of Cardiopulmonary resuscitation training focused on the family members of high-risk patient and the primary care workers Division of Chronic Disease Control, Center for Disease Prevention, CDC Jung-ah Choi, Sung-ock Yoon, Sung-ok Hong, Young-taek Kim To increase cardiac arrest survival rate, bystanders should be able to recognize the onset of cardiac arrest and initiate CPR. The study developed hospital-based CPR training program and education of target population to increase effectivity of the training through proper motivation. Because more than 50% of cardiac arrest cases occur in homes, target population was the family members of high-risk patients and primary care workers. The education program was operated by Tertiary hospital. A total of 207 family members were enrolled in 25 CPR training sessions, while 258 primary care workers were enrolled in 25 CPR training sessions. The outcome of the education/training has improved and the trainees were highly satisfied. Willingness to help a stranger who needs CPR increased in both high-risk patient family members (71.0% 97.1%) and primary care workers (69.0 100.0%). 심장정지환자발생시병원에도착하기전환자를목격한 일반인의신속하고적극적인심폐소생술은심장정지생존율 향상을위한효과적인방안이지만, 우리나라의일반인 심폐소생술시행률은 3.3%( 10 년 ) 6.5%( 12 년 ) 12.1%( 14 년 ) 로매 2 년간약 2 배씩향상했음에도스웨덴 (55%), 미국 (30.8%), 일본 (27%) 등다른나라와비교했을때여전히 55 14 12 10 11.7 8 7.8 27 30.8 6 6 6.2 4.8 4 8.7 2 Korea Japan Sweden USA 0 Seattle Sweden Taiwan Japan Korea Figure 1. Regional bystander CPR rate and out of hospital cardiac arrest survival rate 194
PUBLIC HEALTH WEEKLY REPORT, KCDC Table 1. Cardiac arrest high-risk disease Middle Classification ICD-10 Small Classification Valvular Heart Disease Ischemic Heart Disease Cardiomyopathy Heart Failure Conduction disorders and arrythmia Cardiac Arrest Stroke Chronic Kidney Disease I01.1 Acute rheumatic endocarditis I05 Rheumatic mitral valve disease I06 Rheumatic aortic valve disease I07 Rheumatic tricuspid valve disease I08 Multiple Valve disease I33 Acute and subacute endocarditis I34 Nonrheumatic mitral valve disorders I35 Nonrheumatic aortic valve disorders I36 Nonrheumatic tricuspid valve disorders I37 Pulmonary valve disorders I38 Endocarditis, valve unspecified I39 Endocarditis and heart valve disorders in disease classified elsewhere Q22 Congenital malformations of pulmonary and tricuspid valves Q23 Congenital malformations of aortic and mitral valves I20 Angina Pectoris I21 Acute myocardiac infarction I22 Subsequent myocardial infarction I23 Certain current complications following acute myocardial infarction I24 Other acute ischemic heart disease I25 Chronic ischemic heart disease I42 Cardiomyopathy I43 Cardiomyopathy in disease classified elsewhere I11.9 Hypertensive heart disease without heart failure I50 Heart failure I11.0 Hypertensive heart disease with congestive heart failure I44 Atrioventricular and left bundle-branch block I45 Other conduction disorders I47 Paroxysmal tachycardia I49 Other cardiac arrythmias I46 Cardiac Arrest R09.2 Respiratory Arrest I60 Subarachnoid hemorrhage I61 Intracerebral hemorrhage I62 Other nontraumatic intracerebral hemorrhage I63 Cerebral infarction I64 Stroke, not specified as hemorrhage or infarction N18 Chronic Kidney disease N19 Unspecified kidney failure I12.0 Hypertensive renal disease with renal failure I13 Hypertensive heart and renal disease 낮은수준이다. 생존율은미국시애틀 (11.7%), 스웨덴 (7.8%), 일본 (6.2%) 이우리나라 (4.8%) 보다월등히높은데, 이는우수한 응급의료체계등다양한요소가영향을주지만, 우리나라보다 높은목격자심폐소생술시행률에기인한다 [1](Figure 1). 목격자심폐소생술시행률이낮은지역의경우그지역 구성원의특성을잘파악하여이에맞는심폐소생술교육과 www.cdc.go.kr 195
주간건강과질병 제 9 권제 11 호 응급의료체계를구축하는것이목격자심폐소생술을향상시키는데필요하며 [2], 지역내보건관련단체및기관의유기적협조는교육에서시작하여환자를위한바람직한의료전달체계확립의기초가될수있다. 따라서연구를통해 1~3차의료기관이함께참여할수있도록 3차의료기관이교육을운영하고, 1, 2차의료기관이교육을받는교육과정을개발하였다. 정확한교육효과측정을위해강사양성교육과정프로그램을개설하여기존에심폐소생술강사자격증을보유한 18명의의사및간호사를대상으로재교육하였다. 또한우리나라심장정지의 50% 이상이집에서발생하는현실을고려할때, 심장정지발생고위험질환을가진환자의가족 ( 이하 A 그룹 ) 과상대적으로심폐소생술교육의기회가적은 1 2 차의료기관종사자중간호사, 간호조무사및사무직원등 ( 이하 B 그룹 ) 을교육생으로선정하였다. 심장정지발생고위험질환은한국표준질병및사인분류에속하는질환군중총 8개중분류와각중분류에속하는하위 40개의소분류질환군을 심폐소생술효과비교시가족군에서는신경학적회복에미치는영향이미미했는데, 이는심장정지발생가족의경우심폐소생술교육에대한경험이적은경우가많기때문으로알려져있다 [3]. 방법을알면훨씬더잘할수있는집단이교육을받지못해서목격자심폐소생술을제대로시행하지못하는것이다. 당뇨를가진환자및보호자에게당뇨교육을실시하는것과마찬가지로고위험질환을가진환자는심장정지발생가능성이높으므로최초목격자가될가능성이높은그가족에게심폐소생술교육을실시하는것은환자안전의측면에서매우중요하다. 해당연구에서의고위험질환상병의추출은기존문헌을바탕으로하여향후변경될여지가있으나, 현재까지알려진고위험질환군관련사업과연계하는등병의원기반심폐소생술교육모델을지속확대해야할것이다. 또한지역사회심장정지예방및생존향상을위한협의체구성등기존지역사회심폐소생술교육프로그램과연계가필요할것으로사료된다. 심장정지고위험질환군으로선정하고, 5 년이내해당 질환군으로진단된환자의가족은모두심폐소생술교육대상으로선정하였다 (Table 1). 그룹별성과지표를개발하여모든교육생을대상으로교육전 / 후설문지를통해교육욕구및동기, 재교육의지, 교육효과등을확인하고, 이수증교부시연락처를기입한교육생을대상으로전화설문을통해교육생의교육효과지속여부를확인하였다. A 그룹은총 50회 207명의원내심폐소생술교육을시행했으며이중 85.5% 가 2년내심폐소생술교육경험이없었고, 심장정지환자발생시초기대응정답률은교육전 18.4% 교육후 91.8% 로나타났다. B 그룹중 95% 가교육이필요하나실습기회가없었다고답했으며, 심장정지환자발생시초기대응정답률은교육전 64.7% 교육후 96.5% 로두그룹모두교육이매우필요하다고느끼는것으로나타났으며, 교육효과도높게나타났다. 또한심폐소생술이필요한사람에게시행한다는답변은교육전후로확인했을때 A 그룹 71.0% 97.1%, B 그룹 69.0 100.0% 로나타났고교육과정의만족도역시각각 92.0%, 96.2% 로두그룹모두높았다. 목격자를가족군과비가족군으로분류하여전화지도 참고문헌 1. 질병관리본부. 일반인심폐소생술확산기반구축민간경상보조사업결과보고서. 2015. 2. Sasson C et al. on behalf of the American Heart Association Council on Quality of Care and Outcomes Research, Emergency Cardiovascular Care Committee; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Clinical Cardiology; and Council on Cardiovascular Surgery and Anesthesia. Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for Healthcare providers, policy makers, public health departments, and community leaders. Circulation 2013;127:1342-50. 3. Fujie K, Nakata Y, Yasuda S, Mizutani T, Hashimoto K. Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders. Resuscitation 2014;85:315-319. 196
10th (2.28-3.5) status of selected infectious diseases 1. Influenza, Republic of Korea, ending March 5, (10th ) 년도제 10 주인플루엔자의사환자분율은외래환자 1,000 명당 32.1 명으로지난주 (43.0) 보다감소 10 주에의뢰된 217 건중 99 건 [A(H1N1)pdm09 형 47 건, A(H3N2) 형 9 건, B 형 43 건 ] 검출 (45.6%).1.14. 인플루엔자유행주의보발령 2015- 절기유행기준은 11.3 명 (/1,000) ILI per 1,000 80 70 60 50 40 30 20 10 0 36 38 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 2015-2014-2015 2013-2014 2012-2013 Figure 1. The ly proportion of Influenza-Like Illness per 1,000 outpatients, 2012-2013 to 2015- flu seasons No. of Positive 130 120 110 100 90 80 70 60 50 40 30 20 10 0 36 38 40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 70.0 65.0 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0 Percent positive(%) A/H3N2 A(not subtyped) A/H1N1pdm09 B percent positive Figure 2. Number of specimens positive for influenza by subtype, 2015- season 2. Respiratory viruses, Republic of Korea, ending March 5, (10th ) 년도제10주호흡기검체에대한유전자검사결과 64.5% 의호흡기바이러스가검출되었음 ( 최근 4주평균 206개의호흡기검체에대한유전자검사결과를나타내고있음 ) 주별통계는잠정통계이므로변동가능 2015- () Weekly total Detection rate (%) HAdV HPIV HRSV IFV HCoV HRV HBoV HMPV 7 66.7 2.5 0.8 0.0 55.8 2.5 0.8 0.8 3.3 8 56.0 2.1 0.8 0.8 44.4 2.9 1.2 0.0 3.7 9 63.7 5.3 1.6 1.2 39.6 4.5 4.1 0.8 6.5 10 64.5 1.8 0.9 0.5 45.6 2.8 3.7 1.4 7.8 58.9 6.4 1.8 4.8 29.2 5.9 5.8 0.9 4.1 2015 52.6 4.9 6.2 3.0 14.4 2.1 17.9 2.3 1.8 - HAdV : human Adenovirus, HPIV : human Parainfluenza virus, HRSV : human Respiratory syncytial virus, IFV : Influenza virus, HCoV : human Coronavirus, HRV : human Rhinovirus, HBoV : human Bocavirus, HMPV : human Metapneumovirus : the rate of detected cases between Dec. 27. 2015 - Mar. 5. (Average No. of detected cases is 206 in last 4 s) 2015 : the rate of detected cases between Dec. 28. 2014 - Dec. 26. 2015. www.cdc.go.kr 197
10th (2.28-3.5) Table 1. Reported cases of national infectious diseases in Republic of Korea, ending March 5, (10th )* Group Ⅰ Group Ⅱ Group Ⅲ Group Ⅳ Classification of disease Abbreviation: 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, MERS-CoV= Middle East Respiratory Syndrome Coronavirus. Cum: Cumulative counts from 1st to current in a year. * The reported data for year 2015, are provisional data but the data for years 2011 2012, 2013 and 2014 are finalized data. According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. The reported surveillance data excluded Hansen s disease and no incidence data such as Diphtheria, Poliomyelitis, Haemophilus influenzae type b, Epidemic typhus, Anthrax, Plague, Yellow fever, Viral hemorrhagic fever, Smallpox, Severe Acute Respiratory Syndrome, Animal influenza infection in humans, Novel Influenza, Tularemia, Newly emerging infectious disease syndrome and Tick-borne Encephalitis. Data on scarlet fever included both cases of confirmed and suspected since September 27, 2012. 문의 : (043) 719-7176 ly average Total no. of cases by year 2015* 2014 2013 2012 2011 Cholera - - - - - 3-3 Typhoid fever 1 30 3 122 251 156 129 148 Paratyphoid fever 2 5 2 45 37 54 58 56 Shigellosis 1 19 2 88 110 294 90 171 unit: no. of cases Imported cases of current : Country(no. of cases) EHEC 2 6-71 111 61 58 71 Laos(1) Viral hepatitis A 73 582 58 1,804 1,307 867 1,197 5,521 Pertussis 2 32 1 205 88 36 230 97 Tetanus - 3-22 23 22 17 19 Measles 3 27 2 7 442 107 3 42 Mumps 204 2,329 165 23,447 25,286 17,024 7,492 6,137 Rubella 2 24 1 12 11 18 28 53 Viral hepatitis B (Acute) 7 70 5 157 173 117 289 462 Japanese encephalitis - - - 40 26 14 20 3 Varicella 611 11,223 472 46,327 44,450 37,361 27,763 36,249 India(1) Streptococcus pneumoniae 15 107 4 229 36 - - - Malaria - 13 1 705 638 445 542 826 Scarlet fever 139 2,016 62 7,002 5,809 3,678 968 406 Meningococcal meningitis - 3-6 5 6 4 7 Legionellosis - 23-45 30 21 25 28 Vibrio vulnificus sepsis - - - 38 61 56 64 51 Murine typhus - - - 15 9 19 41 23 Scrub typhus 9 181 4 9,513 8,130 10,365 8,604 5,151 Leptospirosis - 12-105 58 50 28 49 Brucellosis - 10-23 17 16 17 19 Rabies - - - - - - - - HFRS 5 70 3 385 344 527 364 370 Syphilis 15 249 15 1,006 1,015 799 787 965 CJD/vCJD 1 14 1 32 65 34 45 29 Tuberculosis 620 5,931 691 32,181 34,869 36,089 39,545 39,557 HIV/AIDS 14 130 15 1,019 1,081 1,013 868 888 Dengue fever 13 92 2 255 165 252 149 72 Botulism - - - - 1 - - - Q fever - 9-28 1 11 10 8 West Nile fever - - - - 11-1 - Lyme Borreliosis - 2-11 - 11 3 2 Melioidosis - 1-4 13 2-1 Chikungunya fever - 2-2 2 2 - - SFTS - - - 79 1 36 - - MERS - - - 186 - - - - Philippines(6), Indonesia(2), Guam(1), India(1), Sri Lanka(1), Unknown(1), Vietnam(1) 198
10th (2.28-3.5) Table 2. Reported cases of national infectious diseases in Republic of Korea, ending March 5, (10th )* unit: no. of cases Provinces Cholera Typhoid fever Paratyphoid fever Shigellosis Enterohemorrhagic Escherichia coli Viral hepatitis A Pertussis Tetanus 4-year average Total - - - 1 30 31 2 5 8 1 19 30 2 6 3 73 582 340 2 32 40-3 - Seoul - - - - 3 8 1 1 2-2 5-1 1 18 101 63-5 3 - - - Busan - - - - 3 1 - - - - 1 3-1 - 2 24 13-4 1 - - - Daegu - - - - 1 - - - - 1 1-1 - 1 15 4-1 14 - - - Incheon - - - 1 5 2 1 1 1-2 6 - - - 7 31 39 - - 2 - - - Gwangju - - - - - 1-1 - - - 1 - - 1 2 19 12 - - 2 - - - Daejeon - - - - 2 2 - - - - - - - - - 3 24 10-1 14 - - - Ulsan - - - - 1 1 - - - - - - - - - - 6 2-2 - - - - Sejong - - - - - - - - - - - - - - - - 3 1 - - - - - - Gyonggi - - - - 6 5 - - 1 1 4 6-1 1 15 180 115-2 1-1 - Gangwon - - - - - - - - - - - - - - - 2 14 11 - - - - - - Chungbuk - - - - - 1-1 1-1 1 - - - - 25 16 - - - - - - Chungnam - - - - 4 1 - - 1-3 2 1 1-12 45 14 - - 1 - - - Jeonbuk - - - - 1 - - 1 - - - 1 1 1-6 28 18 - - - - - - Jeonnam - - - - 2 2 - - - - 5 1 - - - - 14 8 1 3 - - 1 - Gyeongbuk - - - - 1 1 - - 1 - - 1 - - - 2 16 7-7 1-1 - Gyeongnam - - - - 2 5 - - 1 - - 1 - - - 3 33 5-3 1 - - - Jeju - - - - - - - - - - - 1 - - - - 4 2 1 4 - - - - Cum: Cumulative counts from 1st to current in a year * The reported data for year 2015, are provisional data but the data for years 2011, 2012, 2013 and 2014 are finalized data. According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. average is mean value calculated by cumulative counts from 1st to current for 5 preceding years. www.cdc.go.kr 199
10th (2.28-3.5) Table 2. Reported cases of national infectious diseases in Republic of Korea, ending March 5, (10th )* unit: no. of cases Provinces Measles Mumps Rubella Viral hepatitis B (Acute) 4-year average Japanese encephalitis Varicella Malaria Scarlet fever Total 3 27 6 204 2,329 1,996 2 24 3 7 70 40 - - - 611 11,223 7,673-13 14 139 2,016 475 Seoul 2 5 1 20 164 213-3 1-11 6 - - - 68 1,368 787-5 3 17 252 70 Busan - 1-14 159 160-1 1 1 4 4 - - - 56 831 661 - - - 5 118 54 Daegu - - - 10 67 61 1 2 - - - 1 - - - 29 539 521-1 - 4 75 30 Incheon - 1-9 61 112 - - - - 4 5 - - - 30 532 515 - - 3 11 102 28 Gwangju - - - 9 137 148 - - - 1 2 1 - - - 20 258 208 - - - 13 175 21 Daejeon - 2 2 7 52 114-2 - - 3 1 - - - 25 458 184-1 - 7 67 22 Ulsan - 1-4 72 72 - - - - 2 1 - - - 26 362 281 - - - 5 112 21 Sejong - - - 1 2 6 - - - - 1 - - - - 5 72 9 - - - 1 5 - Gyonggi - 9 3 43 513 408 1 5 1 3 18 8 - - - 126 3,028 2,045-5 5 34 537 19 Gangwon 1 3-2 43 69-1 - - 4 2 - - - 20 391 445-1 1 1 11 10 Chungbuk - - - 3 33 37 - - - - 1 1 - - - 11 220 176 - - 1-29 13 Chungnam - - - 7 118 57-8 - 1 2 2 - - - 21 418 310 - - 1 10 110 27 Jeonbuk - - - 9 102 228 - - - - 7 3 - - - 24 384 292 - - - 5 41 34 Jeonnam - 1-12 90 106 - - - - 4 1 - - - 34 567 304 - - - 2 83 17 Gyeongbuk - 1-11 133 45 - - - - 3 1 - - - 39 373 260 - - - 6 125 45 Gyeongnam - 3-42 557 105-2 - 1 3 3 - - - 46 1,044 490 - - - 16 150 56 Jeju - - - 1 26 55 - - - - 1 - - - - 31 378 185 - - - 2 24 8 Cum: Cumulative counts from 1st to current in a year * The reported data for year 2015, are provisional data but the data for years 2011, 2012, 2013 and 2014 are finalized data. According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. average is mean value calculated by cumulative counts from 1st to current for 5 preceding years. Data on scarlet fever included both cases of confirmed and suspected since September 27, 2012. 200
10th (2.28-3.5) Table 2. Reported cases of national infectious diseases in Republic of Korea, ending March 5, (10th )* unit: no. of cases Provinces Meningococcal meningiti Legionellosis Vibrio vulnificus sepsis Murine typhus Scrub typhus Leptospirosis Brucellosis Hemorrhagic fever with renal syndrome Total - 3 - - 23 5 - - - - - 1 9 181 66-12 2-10 1 5 70 36 Seoul - 2 - - 8 2 - - - - - - 1 6 3 - - - - 1 - - 5 2 Busan - - - - - 1 - - - - - - - 14 5 - - - - - - - 1 1 Daegu - 1 - - - - - - - - - - - 1 1 - - - - 1 - - - - Incheon - - - - 2 - - - - - - - - 9 3 - - - - 1 - - 1 1 Gwangju - - - - - - - - - - - - - 3 1-1 - - - - - - - Daejeon - - - - 1 - - - - - - - - 5 4 - - - - - - - - 1 Ulsan - - - - - - - - - - - - - 9 1 - - - - - - - 1 - Sejong - - - - - - - - - - - - - 1 - - - - - - - - - - Gyonggi - - - - 5 1 - - - - - 1 1 28 9-3 1-1 - 3 35 11 Gangwon - - - - - 1 - - - - - - 3 13 2-1 - - - - - 3 4 Chungbuk - - - - 2 - - - - - - - - - 1 - - - - - - - 3 2 Chungnam - - - - 2 - - - - - - - - 7 2-2 - - - - - 5 2 Jeonbuk - - - - - - - - - - - - - 13 6-2 - - - 1-1 3 Jeonnam - - - - 1 - - - - - - - 2 30 12-1 - - - - - 3 2 Gyeongbuk - - - - 1 - - - - - - - 1 13 3 - - - - 2-1 9 5 Gyeongnam - - - - 1 - - - - - - - 1 23 10-1 1-2 - 1 3 2 Jeju - - - - - - - - - - - - - 6 3-1 - - 2 - - - - Cum: Cumulative counts from 1st to current in a year * The reported data for year 2015, are provisional data but the data for years 2011, 2012, 2013 and 2014 are finalized data. According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. Calculated by averaging the cumulative counts from 1st to current, for a total of 5 preceding years www.cdc.go.kr 201
10th (2.28-3.5) Table 2. Reported cases of national infectious diseases in Republic of Korea, ending March 5, (10th )* unit: no. of cases Syphilis CJD/vCJD Dengue fever Q fever Lyme Borreliosis Melioidosis SFTS Tuberculosis Provinces 4-year average 4-year average 4-year average 4-year average 2-year average Total 15 249 126 1 14 10 13 92 17-9 1-2 - - 1 - - - - 620 5,931 6,314 Seoul 4 46 17-2 1 6 36 4-1 - - - - - - - - - - 100 1,133 1,324 Busan - 5 9-2 - - 4 1 - - - - - - - - - - - - 47 461 508 Daegu 2 14 5-1 1 1 10 - - - - - - - - - - - - - 38 297 338 Incheon 2 23 11-2 - - 2 1 - - - - - - - - - - - - 43 279 330 Gwangju 1 10 4 - - 1 - - - - - - - - - - - - - - - 21 166 158 Daejeon 1 10 3 - - - - 1 1-1 - - 1 - - - - - - - 16 127 157 Ulsan - 3 2 - - - 1 2 - - - - - - - - - - - - - 14 123 135 Sejong - 3 - - - - - - - - - - - - - - - - - - - 1 18 12 Gyonggi 3 69 35-2 2 2 24 5-1 - - - - - - - - - - 127 1,278 1,254 Gangwon - 13 5 - - 1 1 3 - - - - - 1 - - - - - - - 20 246 245 Chungbuk - 6 4 1 1 - - - - - - - - - - - - - - - - 27 197 184 Chungnam - 8 5-1 1 1 2 1-1 - - - - - - - - - - 27 237 252 Jeonbuk 1 8 3-1 1-2 1-3 - - - - - - - - - - 30 251 226 Jeonnam 1 14 3 - - - - - - - 1 - - - - - - - - - - 30 276 288 Gyeongbuk - 3 6-2 2 1 2 1-1 1 - - - - 1 - - - - 47 409 428 Gyeongnam - 6 9 - - - - 4 2 - - - - - - - - - - - - 28 388 409 Jeju - 8 5 - - - - - - - - - - - - - - - - - - 4 45 70 Cum: Cumulative counts from 1st to current in a year * The reported data for year 2015, are provisional data but the data for years 2011, 2012, 2013 and 2014 are finalized data. According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. average is mean value calculated by cumulative counts from 1st to current for 5 preceding years. 202
10th (2.28-3.5) Table 3. Reported cases of national sentinel surveillance disease in the Republic of Korea, ending March 5, (10th )) unit: no. of cases/sentinels Viral hepatitis Sexually Transmitted Diseases Hepatitis C Gonorrhea Chlamydia Genital herpes Condyloma acuminata Total 2.1 8.9 10.8 1.9 4.2 4.1 1.9 7.8 6.8 2.3 8.0 7.2 1.5 5.3 5.7 Cum: Cumulative counts from 1st to current in a year According to surveillance data, the reported cases may include all of the cases such as confirmed, suspected, and asymptomatic carrier in the group. average is mean value calculated by cumulative counts from 1st to current for 5 preceding years. 문의 : (043) 719-7168, 7178 주요통계이해하기 <Table 1> 은지난 5년간발생한법정감염병과 년해당주발생현황을비교한표로, 는 년해당주의신고건수를나타내며, 은 년 1주부터해당주까지의누계건수, 그리고 ly average 는지난 5년 (2011-2015 년 ) 해당주의신고건수와이전 2주, 이후 2주의신고건수 ( 총 25주 ) 평균으로계산된다. 그러므로 과 ly average 의신고건수를비교하면해당주단위시점과예년의신고수준을비교해볼수있다. Total no. of cases by year 는지난 5년간해당감염병현황을나타내는확정통계이며연도별현황을비교해볼수있다. 예 ) 2015 년 12 주의 ly average(5 년간주평균 ) 는 2011 년부터 2015 년의 10 주부터 14 주까지의신고건수를 총 25 주로나눈값으로구해진다. * ly average(5 년주평균 )=(X1 + X2 + + X25)/25 10주 11주 12주 13주 14주 2015년 해당주 2014년 X1 X2 X3 X4 X5 2013년 X6 X7 X8 X9 X10 2012년 X11 X12 X13 X14 X15 2011년 X16 X17 X18 X19 X20 2010년 X21 X22 X23 X24 X25 <Table 2> 는 17 개시 도별로구분한법정감염병보고현황을보여주고있으며, 각감염병별로 Cum, average 와 Cum, 을비교해보면최근까지의누적신고건수에대한이전 5년동안해당주까지의평균신고건수와비교가가능하다. Cum, average 는지난 5년 (2011-2015 년 ) 동안의동기간신고누계평균으로계산된다. <Table 3> 은표본감시감염병에대한신고현황으로, 최근발생양상을신속하게파악하는데도움이된다. www.cdc.go.kr 203
PHWR Vol.9 No.11 발간등록번호 11-1351159-000002-03 PUBLIC HEALTH WEEKLY REPORT, PHWR Vol.9 N0.11 주간건강과질병, PHWR 은질병관리본부에서시행되는조사사업을통해생성된감시및연구자료를기반으로근거중심의건강및질병관련정보를제공하고자최선을다할것이며, 제공되는정보는질병관리본부의특정의사와는무관함을알립니다. 본간행물에서제공되는감염병통계는 감염병의예방및관리에관한법률 에의거, 국가감염병감시체계를통해신고된자료를기반으로집계된것으로집계된당해년도자료는의사환자단계에서신고된것이며확진결과시혹은다른병으로확인될경우수정될수있는잠정통계임을알립니다. 주간건강과질병, PHWR 은질병관리본부홈페이지를통해주간단위로게시되고있으며, 정기적구독을원하시는분은 madin@korea.kr로신청가능합니다. 이메일을통해보내지는본간행물의정기적구독요청시구독자의성명, 연락처, 직업및이메일주소가요구됨을알려드립니다. 주간건강과질병 발간관련문의 : madin@korea.kr/ 043-719-7175 창 발 간 : 2008 년 4 월 4 일 행 : 년 3 월 10 일 발행인 : 정기석 편집인 : 조은희 편집위원 : 박영준, 김윤아, 최영실, 김기순, 정경태, 최병선, 조신형, 조성범, 김봉조, 구수경, 김용우, 이동한, 박선희, 임도상 편 집 : 질병관리본부감염병관리센터감염병감시과 충북청주시흥덕구오송읍오송생명 2 로 187 오송보건의료행정타운 ( 우 )28159 Tel. (043) 719-7175 Fax. (043) 719-7189