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일본뇌염백신: 국제적 현황과 우리나라 현황

The Japanese Encephalitis Vaccine: Worldwide and Korean Status

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Japanese encephalitis is the leading cause of viral encephalitis in Asia, where it accounts for up to 50,000 cases. Approximately 20% of affected patients die, and 30-50% of survivors have significant neurological sequelae. Inactivated mouse-brain derived Japanese encephalitis vaccines has been effectively implemented to control the disease effectively in Korea and several other Asian countries. However, the vaccine is expensive and difficult to produce, requires multiple doses, and has been associated with hypersensitivity reactions and rare adverse neurologicale events. The live-attenuated SA14-14-2 vaccine derived from primary hamster kidney (PHK) cells was developed in China and has been used there since 1988. Outside China, it has been licensed and used in Korea and several other Asian countries. This vaccine is effective and inexpensive. However, the lack of precedence for using a PHK cell substrate in a live-attenuated vaccine is a special issue of concern. The WHO working group has recommended additional safety studies in selected high-risk groups, as well as ongoing post-marketing studies to ensure long-term safety. Recently, a new inactivated vaccine and live-attenuated chimeric vaccine have been developed from vero cells. With this background, this article summarized the current status of Japanese encephalitis vaccination worldwide and in Korea. (Korean J Pediatr Infect Dis 2008;15:108-114)

Abstract

Japanese encephalitis is the leading cause of viral encephalitis in Asia, where it accounts for up to 50,000 cases. Approximately 20% of affected patients die, and 30-50% of survivors have significant neurological sequelae. Inactivated mouse-brain derived Japanese encephalitis vaccines has been effectively implemented to control the disease effectively in Korea and several other Asian countries. However, the vaccine is expensive and difficult to produce, requires multiple doses, and has been associated with hypersensitivity reactions and rare adverse neurologicale events. The live-attenuated SA14-14-2 vaccine derived from primary hamster kidney (PHK) cells was developed in China and has been used there since 1988. Outside China, it has been licensed and used in Korea and several other Asian countries. This vaccine is effective and inexpensive. However, the lack of precedence for using a PHK cell substrate in a live-attenuated vaccine is a special issue of concern. The WHO working group has recommended additional safety studies in selected high-risk groups, as well as ongoing post-marketing studies to ensure long-term safety. Recently, a new inactivated vaccine and live-attenuated chimeric vaccine have been developed from vero cells. With this background, this article summarized the current status of Japanese encephalitis vaccination worldwide and in Korea. (Korean J Pediatr Infect Dis 2008;15:108-114)

참고문헌 (10)

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  2. WHO Expert Committee on Biological Standardization, "Guidelines for the production and control of Japanese encephalitis vaccine(live) for human use", WHO Tech Rep Ser, 910, pp.1~104 (2002)
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  4. "Global Advisory Committee on Vaccine Safety, 12-13 December 2007", Wkly Epidemiol Rec, 83, pp.37~44 (2008)
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  6. Takahashi H, "Adverse events after Japanese encephalitis vaccination: review of post-marketing surveillance data from Japan and the United States", Vaccine, 18, pp.2963~2969 (2000)
  7. Japanese encephalitis, "Infectious Agents Surveillance Report", 24, pp.149~150 (2003)
  8. Sohn YM, "Primary and booster immune responses to SA 14-14-2 Japanese encephalitis vaccine in Korean infants", Vaccine, 17, pp.2259~2264 (1999)
  9. Sohn YM, "The background and changes of inactivated Japanese encephalitis vaccine schedule", Korean J Pediatr Infect Dis, 7, pp.56~70 (2000)
  10. Hong YJ, "Immunogenicity and protective efficacy after Japanese encephalitis vaccination", pp.58~66 (2007), KCDC

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