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Lee, Park, Kim, Oh, Yu, Choi, Lee, Kim, Jang, and Lee: Surveillance of Acute Gastroenteritis in Seoul, Korea, During May 2004 and June 2007
Original Article

J Bacteriol Virol 2009;39(4):363-371.

Published online: 18 January 2009

DOI: https://doi.org/10.4167/jbv.2009.39.4.363

Surveillance of Acute Gastroenteritis in Seoul, Korea, During May 2004 and June 2007

Jae In Lee1, Sang Hun Park1, Moo Sang Kim1, Young Hee Oh1, In Sil Yu1, Byung Hyun Choi1, Gyu Cheol Lee2, Mi Suk Kim3, So Young Jang3, Chan Hee Lee∗, 3, ∗∗

1Seoul Metropolitan Institue of Public Health & Environment, Seoul, Korea

2Water Analysis and Research Center, K-water, Daejeon, Korea

3Department of Microbiology, Chungbuk National University, Cheongju, Korea

∗Corresponding author: Chan Hee Lee. Department of Microbiology, Chungbuk National University, 410 Seongbong-Ro, Heungduk-Gu, Cheongju, Chungbuk 361-763, Korea. Phone: +82-43-261-2304, Fax: +82-43-273-2451 e-mail: chlee@cbu.ac.kr

∗∗ This work was supported by the Korea Research Foundation Grant funded by the Korean Government (Ministry of Education, Science and Technology). (The Regional Research Universities Program/Chungbuk BIT Research-Oriented University Consortium)

      Revised 17 July 200921 September 2009       Accepted 30 September 2009

Copyright © 2009 Korean Society for Legal Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute gastroenteritis (AGE), which is one of the most common diseases worldwide, primarily occurs in infants and young children in both developed and developing countries. To investigate the prevalence of AGE in Korea, 6,788 stool specimens collected from hospitalized patients with AGE in Seoul, Korea from March 2004 to June 2007 were analyzed by enzyme immunoassay, reverse transcription-PCR, DNA sequencing and phylogenetic analysis. Enteric viruses and bacteria were detected in 2,955 (43.5%) and 1,389 (20.5%) specimens, respectively. Among the enteric viruses detected, rotavirus (19.7%) and norovirus (18.9%) were the predominant causative agents, followed by adenovirus (2.5%) and astrovirus (2.4%). Staphylococcus aureus was the most commonly observed bacteria (8.0~19.2%). The epidemic peaks of the enteric viruses were October to December for norovirus, January to May for rotavirus, and August to October for adenovirus. The seasonal activity of rotavirus was shifted from winter to late spring. However, astrovirus did not display seasonal activity in this study. Although viral AGE primarily occurred in patients younger than 5 years of age, the incidence of viral AGE in children aged 6 to 14 years was significant. The results of this study will contribute to the currently available epidemiological data and improve public health and hygiene via amelioration of diagnostic methods and longitudinal surveillance.

Keywords: Acute gastroenteritis, Rotavirus, Norovirus, Adenovirus, Astrovirus

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Figure 1.
Prevalence of bacterial gastroenteritis in Seoul, Korea, 2004~2007. A) Yearly prevalence of bacterial gastroenteritis. B) Monthly average prevalence of bacterial agents isolated from acute gastroenteritis patients.
(∗), Total bacteria detected; (○), Staphylococcus aureus; (□), Escherichia coli; (Δ), Clostridium perfringens; (◇), Salmonella spp.
jbv-39-363f1.tif
Figure 2.
Prevalence of viral gastroenteritis in Seoul, Korea, 2004~2007. A) Yearly prevalence of bacterial gastroenteritis. B) Monthly average distribution of viral agents isolated from acute gastroenteritis patients.
(∗), Total viruses detected; (○), Norovirus; (□), Rotavirus; (◇), Adenovirus; (Δ) Astrovirus
jbv-39-363f2.tif
Table 1.
Etiologic agents of gastroenteritis in Seoul, Korea, 2004~2007
Etiologic agents Number of samples (%)
2004 (n=1,836) 2005 (n=1,338) 2006 (n=2,213) 2007 (n=1,401) To tal (n=6,788)
S. aureus 166 (9.0) 107 (8.0) 424 (19.2) 162 (11.6) 859 (12.7)
E. coli 0 (0.0) 75 (5.6) 130 (5.9) 70 (5.0) 275 (4.1)
Salmonella spp. 6 (0.3) 11 (0.8) 29 (1.3) 10 (0.7) 56 (0.8)
C. perfringens 0 (0.0) 0 (0.0) 144 (6.5) 17 (1.2) 161 (2.4)
Othersa 0 (0.0) 4 (0.3) 21 (0.9) 13 (0.9) 38 (0.6)
Sum of Bacteria 172 (9.4) 197 (14.7) 748 (33.8) 272 (19.4) 1,389 (20.5)
Norovirus 176 (9.6) 48 (3.6) 638 (28.8) 420 (30.0) 1,282 (18.9)
Rotavirus 206 (11.2) 372 (27.8) 445 (20.1) 316 (22.6) 1,339 (19.7)
Adenovirus 64 (3.5) 19 (1.4) 71 (3.2) 16 (1.1) 170 (2.5)
Astrovirus 73 (4.0) 47 (3.5) 36 (1.6) 8 (0.6) 164 (2.4)
Sum of Viruses 519 (28.3) 486 (36.3) 1,190 (53.8) 760 (54.2) 2,955 (43.5)

a Others means detection number of Bacillus subtilus, Yersinia enterocolitica, Listeria monocytogenes, Vibrio spp., Campylobacter spp. and Shigella spp.

Table 2.
Detection of known etiologic agents of gastroenteritis in different age groups in Seoul, Korea, 2004~2007
Age No. of Samples Viruses (%) Bacteria (%)
NV RV AdV AstV Sum
< 1 2,853 501 (17.6) 496 (17.4) 69 (2.4) 95 (3.3) 1,161 (40.7) 699 (24.5)
1 1,132 312 (27.6) 317 (28.0) 50 (4.4) 8 (0.7) 687 (60.7) 177 (15.6)
2 471 129 (27.4) 127 (27.0) 14 (3.0) 14 (3.0) 284 (60.3) 83 (17.6)
3 281 63 (22.4) 69 (24.6) 6 (2.1) 3 (1.1) 141 (50.2) 48 (17.1)
4 202 32 (15.8) 38 (18.8) 7 (3.5) 1 (0.5) 78 (38.6) 47 (23.3)
5 134 29 (21.6) 18 (13.4) 4 (3.0) 3 (2.2) 54 (40.3) 23 (17.2)
6~14 375 63 (16.8) 40 (10.7) 8 (2.1) 8 (2.1) 119 (31.7) 75 (20.0)
15~30 79 3 (3.8) 0 (0.0) 0 (0.0) 1 (1.3) 4 (5.1) 7 (8.9)
31~60 236 6 (2.5) 3 (1.3) 1 (0.4) 5 (2.1) 15 (6.4) 28 (11.9)
> 61 195 6 (3.1) 1 (0.5) 0 (0.0) 5 (2.6) 12 (6.2) 17 (8.7)
Sum 5,958 1,144 (19.2) 1,109 (18.6) 159 (2.7) 143 (2.4) 2,555 (42.9) 1,204 (20.2)

Abbreviation; NV (norovirus), RV (rotavirus), AdV (adenovirus), AstV (astrovirus)

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