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Study on the Epidemiological Features of Lyme Disease in Korea between 2011 and 2018

2011~2018년 라임병의 역학적 특성 연구

  • Seo, Choong Won (Division of Control for Zoonotic and Vector Borne Disease, Korea Centers for Disease Control and Prevention)
  • 서충원 (질병관리본부 인수공통감염병관리과)
  • Received : 2019.11.02
  • Accepted : 2019.11.15
  • Published : 2019.12.31

Abstract

Lyme disease is a national notifiable infectious disease as of September 2018. The number of cases of Lyme disease has recently been increasing. This study analyzed the epidemiological features and clinical symptoms of domestic and imported. From 2011 to December 31, 2018, of the 119 cases, 48 confirmed cases, 63 probable cases, and 8 suspected cases. 70 cases (58.8%) were reported in Korea and 49 cases (41.2%) of imported. In addition, 91 cases (76.5%) were reported during the summer~autumn season (June~November). In 2017, the highest number of 31 cases. The time needed to make a diagnosis was 2.8±14.7 days for domestic occurrences versus 1.4±4.5 days for those cases that infection occurred imported. Among the clinical symptoms, fever and rash were statistically significant (P<0.001). Clinical trials included early localized 31 cases (52.1%), early disseminated 43 cases (35.3%), and late disseminated 15 cases (12.6%). The estimated regions of infection in Korea were Chungnam 12 cases (17.1%), Gyeonggi 12 cases (17.1%), and Gangwon 8 cases (11.4%), Patient care is also considered to be very important as this disease occurs of all ages. Therefore, the promotion of preventive education and identification of epidemiological features are of paramount importance and should be implemented. The study's findings can be used as basic data for the prevention and management of patients with lyme disease.

라임병은 2010년 법정감염병 지정 이후 환자발생이 지속적으로 증가하고 있다. 첫 환자가 보고된 2011년부터 2018년 12월 31일까지 신고된 환자 119명의 신고 자료 및 역학조사서를 국내발생과 해외유입으로 구분하여 분석하였고, ArcGIS Pro를 이용하여 추정 감염 지역에 대한 공간분석을 하였다. 2011년부터 2018년 12월 31일까지 국내발생은 70명(58.8%) 해외유입은 49명(41.2%)이다. 환자 발생은 2017년에 31명(26.0%), 계절은 여름~가을(6~11월)이 91명(76.5%)으로 가장 많았다. 진단일_신고일은 국내발생이 2.8±14.7일, 해외유입이 1.4±4.5일로 차이를 보였고, 임상 증상 중 발열과 발진은 국내발생과 해외유입이 통계적으로 유의하였다(P<0.001). 임상 경과는 초기 국소성 감염 61명(52.1%), 초기 파종성 감염 43명(35.3%), 만성 감염 15명(12.6%)이었다. 국내 추정 감염 지역은 충남 12명(17.1%), 경기 12명(17.1%), 강원 8명(11.4%), 경남 7명(10.0%)으로 지역적인 차이를 보였고, 해외유입은 미국이 21명(42.9%), 유럽이 17명(34.7%)으로 가장 많았다. 라임병 환자는 2016~2018년이 환자수가 증가 하여 발생 지역이 확대된 것으로 추정된다. 해외유입도 증가하고 있어 환자 관리는 더욱 중요할 것으로 판단되며 전 연령에서 환자가 발생하고 있어 홍보 및 예방교육과 역학적 특성 파악은 꾸준히 실시되어야 할 것이다.

Keywords

References

  1. Aguero-Rosenfeld ME, Wang G, Schwarts I, Wormser GP. Diagnosis of Lyme borreliosis. Clin Micobiol Rev. 2005;18:484-509. https://doi.org/10.1128/CMR.18.3.484-509.2005
  2. Wang G, van Dam A, Schwarts I Dankert J. Molecular typing of Borrelia burgdorferi sensu lato: toxomic, epidemiological, and clinical implications. Clin Micobiol Rev. 1999:12:633-653.
  3. Burgdorfer W, Barbour AG, Hayes SF, Benach JL, Grunwaldt E, Davis JP. Lyme disease-a tick-borne spirochetosis? Science. 1982;216:1317-1319. https://doi.org/10.1126/science.7043737
  4. Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ. Surveillance of Lyme disease-United States, 2008-2015. MMWR Morb Mortal Wkly Rep. 2017;66:1-12. https://doi.org/10.15585/mmwr.mm6601a1
  5. Kim TH, Choi EH, Lee MG, Ahn SK. Serologically diagnosed Lyme disease manifesting erythema migrans in Korea. J Korean Med Sci. 1999;14:85-88. https://doi.org/10.3346/jkms.1999.14.1.85
  6. Lee CN, Mo HJ, Kim JE, Park HJ, Lee JY, Jo BG, et al. A case of Lyme disease presenting with erythema migrans. Korean J Dermatol. 2003;41:1202-1205.
  7. Kim JW, Kim JS. A case of Lyme disease with unusual cutaneous manifestations. Korean J Dermatol. 2005;43:501-506.
  8. Lee D, Kim SH, Hong SK, Seo JK, Sung HS, Hwang SW, et al. A case of Lyme disease with various general symptoms. Korean J Dermatol. 2008;46:1112-1116.
  9. Park KH, Lee SH, Won WJ, Park MY. Isolation of Borrelia burgdorferi, the causative agent of Lyme disease, from Ixodes ticks in Korea. J Korean Soc Microbiol. 1992;27:307-312.
  10. Kee SH, Hwang KJ, Oh HB, Kim MB, Shim JC, Ree HI, et al. Isolation and identification of Borrelia burgdorferi in Korea. J Korean Soc Microbiol. 1994;29:301-309.
  11. Lee MG, Chung KY, Choi YS, Cho SN. Lyme disease. Korean J Dermatol. 1993;31:601-605.
  12. Moon S, Gwack J, Hwang KJ, Kwon DH, Kim SY, Noh YT, et al. Autochthonous Lyme borreliosis in humans and ticks in Korea. Osong Public Health Res Perspect. 2013;4:52-56. https://doi.org/10.1016/j.phrp.2012.12.001
  13. Jung EK. 2017 Case definitions for national notifiable infectious diseases [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2017 [cited by 2019 Nov 10]. Available from: http://cdc.go.kr.
  14. Jung EK. 2017 Guideline for vector borne disease prevention and control [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2017 [cited by 2019 Nov 10]. Available from: http://cdc.go.kr.
  15. Allen CS. Lyme disease. N Engl J Med. 2001;345:115-125. https://doi.org/10.1056/NEJM200107123450207
  16. Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the infectious disease society of America. Clin Infect Dis. 2006;43:1089-134. https://doi.org/10.1086/508667
  17. Allen CS. Lyme disease. N Engl J Med. 1989;321:586-596. https://doi.org/10.1056/NEJM198908313210906
  18. Lee MG, Cho YH. Lyme disease. J Korean Med Assoc. 2004;47:1063-1069. https://doi.org/10.5124/jkma.2004.47.11.1063
  19. Ai CX, Wen YX, Zhang YG, Wang SS, Qiu QC, Shi ZX, et al. Clinical manifestations and epidemiological characteristics of Lyme disease in Hailin county, Heilongjiang Province, China. Ann N Y Acad Sci. 1988;539:302-313. https://doi.org/10.1111/j.1749-6632.1988.tb31864.x
  20. Hao Q, Hou X, Geng Z, Wan K. Distribution of Borrelia burgdorferi sensu lato in China. J Clin Microbiol. 2011;49:647-650. https://doi.org/10.1128/JCM.00725-10
  21. Masuzawa T. Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia. Jpn J Infect Dis. 2004;57:229-235.
  22. Murase Y, Konnai S, Githaka N, Hidano A, Taylor K, Ito T, et al. Prevalence of Lyme borrelia in Ixodes persulcatus ticks from an area with a confirmed case of Lyme disease. J Vet Med Sci. 2013;75:215-218. https://doi.org/10.1292/jvms.12-0211