서울지역 급성호흡기 환자들로부터 분리한 인플루엔자 바이러스와 다른 급성호흡기 바이러스 감염의 역학적 특성 :Epidemiological characterization on viral infection of influenza viruses and other respiratory viruses isolated from acute respiratory patients in Seoul

함희진

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자료유형: 학위논문

저자정보: 함희진 (강원대학교, 강원대학교 대학원)

지도교수: 박선일

발행연도: 2016

저작권: 강원대학교 논문은 저작권에 의해 보호받습니다.

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이 논문의 연구 히스토리 (3)

2016

서울지역 급성호흡기 환자들로부터 분리한 인플루엔자 바이러스와 다른 급성호흡기 바이러스 감염의 역학적 특성

함희진 수의 2016.01 학위논문

2013

서울지역 급성호흡기 환자들로부터 분리한 인플루엔자 바이러스의 유행양상 (2010-2012)

함희진 , 장정임 , 최성선 외 4명 한국환경보건학회지 2013.01 학술저널

서울지역 급성 호흡기 환자들로부터 분리한 호흡기 바이러스의 유행양상

함희진 , 장정임 , 최성선 외 4명 Annals of Clinical Microbiology 2013.01 학술저널

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서울지역에서 매년 겨울철에 유행하는 급성호흡기질환의 주요원인 바이러스들 중 하나인 인플루엔자 바이러스와 다른 급성호흡기 바이러스들의 검츌율을 알아볼 목적으로 연구를 수행하였다.

서울시내 6개 병의원으로부터 2010년부터 2012년까지 3년간 2,544건의 인후도말 검체들을 채취하여 인플루엔자 바이러스를 검사한 결과, 19.1%(486/2,544)의 인플루엔자 바이러스를 분리하였다. 인플루엔자의 연도별 검출율은 2010년 23.0%(212/923), 2011년 6.4%(47/738) 그리고 2012년 25.7%(227/883)이었고, 유형별로는 A형이 10.8%(275/ 2,544), B형이 8.3%(211/2,544)로 나타났으며, 연령별로는 20-49세의 성인층 환자수가 51.6%로 가장 많았다.

또한, 2,544건의 동일 검체들로부터 32.0%(813/2,544)의 급성호흡기 질병의 원인바이러스를 검출하였는데, human rhinovirus가 40.7%(331/ 813)로 가장 많았고, 그 다음으로 adenovirus 23.9%(194/813), respiratory syncytial virus 14.1%(115/813), para influenza virus 12.3%(100/813), human coronavirus 8.7%(71/813) 순이었다.

바이러스별 임상증상을 분석한 결과, H1N1 pdm09에 의한 인플루엔자 의 경우 발열 100%(14/14), 기침 57.1% (8/14), H3N2인플루엔자 바이러스의 경우 발열 87.2%(75/86), 기침 72.1%(62/86), 인후염 59.3%(51/86), 근육통 55.8%(48/86), 콧물 58.1%(50/86)으로 나타 났다. 파라인플루엔자 바이러스는 발열 61.1%(22/36), 호흡기 세포융합 바이러스는 발열 52.8%(19/36), 기침 55.6%(20/36), 아데노 바이러스 는 발열 87.1%(81/93), 코로나 바이러스는 발열 89.2%(33/37)을 나타냈다.

인플루엔자와 다른 호흡기 바이러스에 의한 급성호흡기 질환은 사망률 자체는 높지 않았지만, 그 발생 규모가 커서 막대한 사회경제적 손실을 초래할 수 있으므로 지속적 감시체계가 필요하였다.

ABSTRACT

For the survey of the detection of influenza viruses and other respiratory viruses in respiratory infections in Seoul, the author evaluated the detection rate among patients diagnosed as acute respiratory viral infections in Seoul from 2010 to 2012, with regular surveillance.

For respiratory virus detection, the author conducted reverse transcription (RT)-polymerase chain reaction (PCR) analyses on total 2,544 throat specimens collected from patients.

19.1%(486/2,544) of the total throat specimens were determined to be positive for influenza viruses, among those results, it were shown by 23.0%(212/923) in 2010, 6.4%(47/738) in 2011, and 25.7%(227/883) in 2012. By each viral type, 10.8%(275/2,544) in type A, and 8.3%(211/2,544) in type B influenza viruses, also, the most likely was 20-49 age groups(51.6%), which shows that influenza viruses were a major causative agent of acute respiratory viral infections.

For other respiratory viruses, RNA viruses (hRV, PIV, RSV, hCoV, and hMPV) and DNA viruses (ADV, and bocavirus) were detected. 32%(813/2,544) of specimens were positive for other acute respiratory viruses; 31.9%(294/923) in 2010, 31.4%(232/738) in 2011, and 32.5%(287/883) in 2012. The most frequently detected virus was hRV (40.7%, 331/813), followed by ADV (23,9%, 194/813), RSV (14.1%, 115/813), PIV (12.3%, 100/813), and hCoV (8.7%, 71/813).

In the symptoms, adenovirus made 87.1%(81/93) fever in the pateints, coronavirus made 89.2%(33/37) fever, 62.2%(23/37) cough, and 51.4%(19/37) sneezing, rhinovirus made 67.0%(69/103) fever, influenza virus (H1N1pdm09) made 100%(14/14) fever, 57.1%(8/14) cough, influenza virus (H3N2) made 87.2%(75/86) fever, 72.1%(62/86) cough, 59.3%(51/86) pharyngitis, 55.8% (48/86) muscle pain, 58.1%(50/86) sneezing. And parainfluenza virus made 61.1%(22/36) fever, respiratory syncythial virus made 52.8% (19/36) fever, and 55.6%(20/36) cough.

The distributions of influenza viruses and other acute respiratory viruses from patients may give potentially valuable data for epidemiological studies of human and animal part in Korea.

Key words; Influenza viruses, type A, type B, RT-PCR, respiratory viruses, Seoul

#인플루엔자 바이러스 #A형(H1N1) #A형(H3N2) #B형 #다른 급성호흡기 바이러스 #혼합감염 #RT-PCR #서울

국문초록························································ iii
LIST OF ABBREVIATIONS···································v
LIST OF TABLES············································vii
LIST OF FIGURES······································xi
1 장. 총설············································1
1. 인플루엔자 바이러스·······································1
1) 발생역학··········································1
2) 특성··········································8
3) 병인론·············································13
4) 배양 및 동정방법·····································16
5) 분자생물학적 진단····································17
6) 백신················································19
2. 다른 급성호흡기 바이러스·································23
1) 발생역학 ··········································23
2) 특성··········································30
3) 병인론·············································36
4) 배양 및 동정방법···································44
5) 분자생물학적 진단···································47
6) 백신··········································49
3. 연구목적··········································50
2 장. 급성 호흡기 환자들로부터 분리한 인플루엔자 바이러스의 유행 양상··············································53
1. 서론················································53
2. 재료 및 방법··········································55
3. 결과·············································60
4. 고찰·············································86
3 장. 급성 호흡기 환자들로부터 분리한 다른 호흡기 바이러스의 유행
양상················································92
1. 서론·············································92
2. 재료 및 방법··········································94
3. 결과················································98
4. 고찰················································105
4 장. 급성 호흡기 바이러스 감염빈도, 혼합감염 및 바이러스별 임상 증상 분석·········································113
1. 서론················································113
2. 재료 및 방법··········································115
3. 결과················································118
4. 고찰················································127
5 장. 종합고찰·············································132
6 장. 종합결론·············································137
7 장. 참고문헌·············································140
ABSTRACT·············································157

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