목 적 : 한국인의 해외여행이 지속적으로 증가함에 따라 해외 유행 질병의 유입 및 해외 감염 가능성이 점점 증가하고 있다. 특히 뎅기열은 동남아시아 등의 해외여행 및 거주 한국인이 증가함에 따라 감염기회가 점차 증가할 것으로 예상되고 있다. 따라서 뎅기열 유행지역의 여행 및 체류 한국인 가운데 뎅기열 의심증상을 보인 환자의 검체를 수집하여 혈청학적 및 역학적 상황을 확인함으로서 현재까지 확인되지 않았던 한국인의 뎅기 바이러스 감염 실태를 파악하여 국가의 보건지표를 확립하고자 하였다. 재료 및 방법 : 해외여행 후 뎅기열 의심증세를 보이는 환자의 혈청을 수집하여 상업용 진단 kit인 MAC-ELISA 및 ICA법을 사용하여 뎅기 바이러스에 대한 항체시험을 실시하고 성별, 연령, 방문국 등 뎅기 감염에 영향을 미치는 요인들을 분석하였다. 상업용 진단 kit에 의해 혈청학적 결과가 확인된 99건의 검체 가운데 25건의 검체에 대하여 본 실험실에서 제작한 IFA 슬라이드로 확인시험을 실시하고 그 결과를 상업용 진단 kit와 비교 분석하였다. 결 과 : 99건의 뎅기열 유사증상 환자의 검체는 상업용 진단 kit에 의해 33.3%의 뎅기 항체 양성으로 확인되었으며 이들 환자의 해외 방문국의 조사 결과 타일랜드 등 4개국 여행자에서 절반 이상의 양성자가 확인되었다. 또한 진단법 비교시험을 위해 25개 검체를 상업용 진단 kit와 자체 제작한 IFA법으로 시험한 결과 진단 kit에서 양성 9명, IFA에서 양성 13명으로 나타나 결과의 차이가 있었다. 결 론:한국인의 뎅기 바이러스 감염자가 국내에서 처음으로 확인되었으며 환자 발생의 원인과 지역, 환자의 발생을 확인할 수 있었다. 이에 따라 뎅기열에 대한 실험실적 감시체계 구축과 진단시험체계의 확립이 필요함을 확인하였다. 또한 상업용 진단 kit를 사용함에 따라 발생하는 고가의 비용을 최소화 할 수 있는 민감도와 특이도 등 효능이 높은 진단법 개발이 요구되었다.

Background:Recently, dengue fever has increased throughout tropical regions and emerged as the most important vector borne viral disease in human. 4 serotypes of viruses are circulating concurrently in these regions and thus it may be anticipated to increase risk of dengue hemorrhagic fever. Even though dengue fever is still not endemic in Korea, it is necessary to test antibodies against dengue viruses because the number of Koreans who have visited these regions is continuously increasing. Materials and methods:Serum specimens from persons with suspected dengue fever had been collected. Commercial kit, immunochromatographic test (ICA), and the IgM capture enzyme-linked immunosorbent assay (MAC-ELISA) were employed for dengue fever detection in these studies. For confirmation randomized 25 specimens among total of 99 specimens were selected and compared with those results from commercial kit and IFA. Results:33 (33.3%) among 99 specimens showed positive antibody against dengue virus by commercial kit. Positive rate of traveller who have visited Indonesia, Philippines, Malaysia, Thiland was 54.5%. To compare the efficiency of test methods, 25 randomly selected specimens were tested by the MAC-ELISA and IFA simultaneously. 9 specimens showed postive results with the MAC-ELISA method whereas 13 speciments were positive with the IFA methods. Conclusion:Confirming the diagnosis of dengue fever with antibody against dengue virus was attempted for the first time in Korea. The results from our study indicate that establishing a national surveillance and/or laboratory diagnostic system in Korea are necessary. In addtion, antibody test strategies for national surveillance system should be carefully considered.

Background:Recently, dengue fever has increased throughout tropical regions and emerged as the most important vector borne viral disease in human. 4 serotypes of viruses are circulating concurrently in these regions and thus it may be anticipated to increase risk of dengue hemorrhagic fever. Even though dengue fever is still not endemic in Korea, it is necessary to test antibodies against dengue viruses because the number of Koreans who have visited these regions is continuously increasing. Materials and methods:Serum specimens from persons with suspected dengue fever had been collected. Commercial kit, immunochromatographic test (ICA), and the IgM capture enzyme-linked immunosorbent assay (MAC-ELISA) were employed for dengue fever detection in these studies. For confirmation randomized 25 specimens among total of 99 specimens were selected and compared with those results from commercial kit and IFA. Results:33 (33.3%) among 99 specimens showed positive antibody against dengue virus by commercial kit. Positive rate of traveller who have visited Indonesia, Philippines, Malaysia, Thiland was 54.5%. To compare the efficiency of test methods, 25 randomly selected specimens were tested by the MAC-ELISA and IFA simultaneously. 9 specimens showed postive results with the MAC-ELISA method whereas 13 speciments were positive with the IFA methods. Conclusion:Confirming the diagnosis of dengue fever with antibody against dengue virus was attempted for the first time in Korea. The results from our study indicate that establishing a national surveillance and/or laboratory diagnostic system in Korea are necessary. In addtion, antibody test strategies for national surveillance system should be carefully considered.

Dengue virus, dengue fever, MAC-ELISA, ICA test, IFA test