Sage Journals: Discover world-class research

Abstract

A new clinical syndrome, epidemic pulmonary haemorrhagic fever, which is characterized by malaise, fever, myalgia and nausea or vomiting at the onset of the illness and chest pain, haemoptysis and dyspnoea with pneumonia-like X-ray shadow in the later stage, has been occurring sporadically in Korea since October 1975 as a disease of unknown aetiology. Upon the massive occurrence of the same syndrome again in the autumn of 1984 after a flood, the government commissioned an analytic epidemiological investigation that was conducted by the author. The objective of the investigation was to identify the aetiological agent of the syndrome by testing the hypothesis that the cause of the new syndrome is leptospiral infection, which had been formulated by the author on the basis of 1975 materials, a few years prior to the 1984 epidemic. Patients with a diagnosis of the syndrome (cases) and patients' families and/or villagers (controls) were interviewed and specimens to isolate leptospires, ie blood and urine, were collected. In addition, rodents and water from the paddy fields in the same areas that the patients came from were collected to be examined for leptospiral organisms. Spiral organisms were isolated from most of the specimens inoculated, from guinea pigs and mice. These organisms were reported by the microbiologists to have characteristics of Leptospira interrogans in every aspect examined. Subsequent community studies on a healthy population revealed 2.3-16% subclinical leptospiral infection rates on whole blood cultures in artificial media. Over 90% of rodents examined harboured leptospires. The results of this study served to confirm the endemicity of leptospirosis in Korea.

Keywords

A disease of unknown aetiology Causal hypothesis Epidemic pulmonary haemorrhagic fever Leptospira interrogans Subclinical infection of leptospires

Get full access to this article

View all access options for this article.

References

1. Park SC , Lee JH , Kim M et al: An epidemiological study on the epidemic pneumonitis, which occurred in Ryeo-Ju and I-Cheon, central area of Korea, 1975. J Korean Med Assoc 1976; 19: 263–68.

2. Nam SD : Epidemiological pattern of acute endemic respiratory diseases. J Korean Med Assoc 1976; 19: 269–73.

3. Kim KH , Hong SJ , Lee HK et al: Clinical pictures of the haemorrhagic pneumonia-like disease, which occurred epidemically in the central area of Korea in autumn, 1975. J Korean Med Assoc 1976; 19: 274–85.

4. Chae IS , Shim BS , Chin CJ et al: An epidemiological, clinical and radiological study on the epidemic pneumonitis, which occurred in the central area of Korea in autumn, 1975. J Korean Med Assoc 1976; 19: 287–92.

5. Kim KS : On the radiologic findings (of pneumonia-like disease). J Korean Med Assoc 1976; 19: 298–302.

6. Han WS , Kim DS : Autopsy and postmortem needle biopsy findings of pneumonia-like disease. J Korean Med Assoc 1975; 19: 303–6.

7. Moon GJ : The gross and histopathological findings (of pneumonia-like disease). J Korean Med Assoc 1976; 19: 307–9.

8. Bahk YW , Kim CY , Park SH et al: Radiologic manifestation of pneumonia-like disease which occurred epidemiologically in the central area of Korea in autumn, 1975. J Korean Med Assoc 1976; 19: 293–97.

9. Shim YH , Shim BS , Choe KH et al: Epidemic pulmonary hemorrhagic fever-1. Epidemiological and clinical observation. J Korean Med Assoc 1980; 23: 131–43.

10.

10. Choe KH : Epidemic pulmonary hemorrhagic fever-2. Retrospective study (1970–1974). J Korean Med Assoc 1980; 23: 145–50.

11.

11. Cho MK , Paik SB , Oh HB et al: Bacteriological studies on leptospira in Korea. Korean J Epidemiol 6: 16–35.

12.

12. Lee WY , Lee BK , Kim JD et al: Leptospira interrogans “Korea” isolated from patients with epidemic pulmonary hemorrhagic fever. Korean J Epidemiol 1984; 6: 30–46.

13.

13. Kim JS , Lee CW , Lee WY et al: An analytic epidemiological study to test the hypothesis, leptospirosis as the cause of the epidemic pulmonary hemorrhagic fever in Korea. Korean J Epidemiol 1984; 6: 8–15.

14.

14. Kim JS , Lee CW et al: An epidemiological study on identification of cause for epidemic pulmonary hemorrhagic fever. J Korean Med Assoc 1985; 28: 77–87.

15.

15. Kim JS : Derivation of Leptospirosis hypothesis on 1984 epidemic of epidemic pulmonary haemorrhagic fever and its proof. Proceedings on Leptospirosis, 11th International Symposium of Korean Academy of Medical Science. June 20, 1985.

16.

16. Kim JS , Lee JK , Chung HW , Yang SJ , Lim HS , Lee WY : An epidemiological study on subclinical leptospiral infection among rural Koreans by leptospires isolation in blood culture. Korean J Epidemiol 1985; 7: 253–58.

17.

17. Kim JS , Chung HK , Lee WY et al: A study on leptospiral infection among healthy young men, a special group by leptospires isolation from blood culture in an endemic area of Korean haemorrhagic fever. Korean J Epidemiol 1986; 8: 174–81.

Leptospirosis: A Newly Identified Disease in Korea

Abstract

Keywords

Get full access to this article

References