국내에서 1989년부터 2001년 사이에 세 번 돌발 유행한 홍역의 역학 및 임상적 비교

Abstract

Purpose : We evaluated and compared clinical and laboratory characteristics of patients with measles in three epidemics(1989～90, 1993～94, and 2000～01) in Daejeon, Korea. Methods : Retrospective analyses were performed using medical records of 520 patients with measles at the Catholic University of Korea, Daejeon St. Mary's Hospital during three epidemics. We divided the subjects into three groups, i.e., those who admitted during 1989～ 1990(group I, 116 patients), those during 1993～1994(group II, 127 patients), and those during 2000～2001(group III, 277 patients). We compared clinical, demographic and laboratory characteristics among these 3 groups. Results : In age distribution, ratios of under 2 years of age in three groups were 61%, 58% and 57%, respectively with no statistical differences. However there are differences in age distribution above 2 years of age, as 21% in 2～5 years of group I, 28% in 6～9 years of group II, and 21% above 10 years of group III. No statistical differences were present between 3 groups in the male to female ratio, MMR vaccination rate in above 2 years of age, duration of fever, incidence of hepatitis. Hospitalization days(P=0.019) and rate of complications( P=0.012) were longer and higher in group I than in group III . Conclusion : In three epidemics, the second peak age group(except 0～1 year) of children above 2 years of age who had mostly received MMR vaccination showed a trend for increased age with increasing time(statistical difference). This result suggest that secondary vaccine failure may have a role in each epidemics. So, if measles outbreaks is happened in the future, we will have consideration in this aspect