2023-08-09 07:14:11
Lee Kun-soo, former president of the Korean Academy of Pediatrics and professor emeritus at Kyungpook National University
Japanese encephalitis (Japanese encephalitis) is a disease transmitted by the Japanese encephalitis virus as a medium, the red house mosquito, and causes disease to other animals such as humans and livestock. The outbreak of patients began in July, when mosquitoes were most active, and at this time, the first patient occurred in each region, and it was competitively published in the newspaper to raise awareness. Before vaccination against this disease began in 1971, it was the most feared disease for children in summer and early fall. According to records, there was a pandemic in 1949 with 5,616 outbreaks and 2,729 deaths, and in 1958, 6,897 outbreaks and 2,177 deaths. There would have been no infectious disease with such a high mortality rate other than this disease. In addition, there are sequelae, so it is no different from the grim reaper that appears in the hot summer and autumn. It is particularly prevalent in Asia, and the disease was discovered by the Japanese, and the disease was named Japanese encephalitis. After vaccination, it decreased rapidly, resulting in 1,197 cases and 10 deaths in the 1982 pandemic. Since then, it has occurred every year, with 103 confirmed cases and 14 deaths for 5 years from 2011. Most of the cases of human infection pass asymptomatically, but 1 in 250 people show symptoms of acute encephalopathy, which causes sudden high fever, consciousness change, headache, diarrhea, vomiting, general weakness, movement disorder, convulsions, and loss of consciousness. Among survivors, central nervous system sequelae may persist in up to 45%. The age of onset was 5 to 9 years old before vaccination, but after vaccination to some extent, it was mainly in the middle-aged, who were vulnerable because there was no antibody.
Currently, the vaccine distributed by NIP is the Beijing-1 strain Vero cell culture inactivated vaccine, and there are inactivated inactivated vaccine and live attenuated vaccine as vaccination vaccines. The inactivated vaccine is 1st at 12 to 23 months, 2nd at 4 weeks, 3rd at 24 to 35 months, 4th at 6 years of age, and 5th at 12 years of age. The injection volume is 0.25 ml for children under 3 years of age and 0.5 ml for children over 3 years of age and is administered subcutaneously. Live vaccines are given first at 12 to 23 months and second at 12 months. The volume is 0.5 ml and is injected subcutaneously. It is contraindicated in the presence of an allergic reaction to a previous vaccination, and both vaccines are contraindicated in pregnant women.
Until now, the concept of vaccination has been to prevent the occurrence of infectious diseases. However, the human papilloma virus (HPV) vaccine prevents the development of cervical cancer. Ordinary people may think of it as a cancer vaccination, but HPV has been identified as the cause of cervical cancer, and the logic is that preventing this virus infection ultimately prevents cancer. This is the same concept as the hepatitis B virus vaccination. If one of the causes of liver cancer is hepatitis B virus infection, some of them progress to chronic hepatitis and progress to liver cancer through liver cirrhosis, so in the end, hepatitis B virus vaccination has the effect of preventing both hepatitis and liver cancer at the same time. .
HPV infection is a common cause of skin diseases, including warts on the hands, various proliferative diseases of the mucous membranes, anogenital lesions, oropharyngeal cancer, and rarely life-threatening respiratory papilloma (during delivery, the virus enters the respiratory tract of newborns and causes repeated warts). Mandeum) causes This disease only causes disease in humans, spreads only from person to person, and appears in both men and women. Therefore, the majority of children and sexually inexperienced adolescents do not have HPV-associated infections. There are more than 200 different types of HPV, of which more than 40 are found in the genital tract, and HPV types 16 and 18 are the main types found in cervical cancer, accounting for 70%.
Most HPV infections are asymptomatic, and 70% within 1 year and 90% within 2 years disappear spontaneously, but 5-10% persist and progress to premalignant lesions over several months to years, and a small number develop cancer. do. The period from HPV infection to the development of cervical cancer takes 15 to 20 years. According to the analysis of the Health Insurance Review and Assessment Service, 55,000 people are receiving treatment for cervical cancer in 2015, and 96.1% are over the age of 30, but more than 2,000 people under the age of 30 are receiving treatment every year. Cancer occurring in women in their 30s and 20s accounted for more than 10% of all cancer treatment, respectively, and since 2016, the subject of free national examinations has been expanded to those over 20 years of age, and cervical smears are performed once every two years. is needed Among the obstetrics and gynecology lectures I took as a student, the professor said that this disease occurs frequently in young women and is often beautiful. Later, when I was an intern, a young woman with this disease came to the emergency room, and unfortunately it had metastasized to the lungs (several round shadows were found on the chest X-ray), which made it even more unforgettable. At that time, there was no vaccination, and unlike today, it was difficult to treat cancer that had metastasized to the lungs, so it was helpless. As with all cancers, prevention of cervical cancer comes first, followed by early detection. The national early cancer screening program includes five major cancers: stomach cancer (40 years of age or older), liver cancer (40 years of age or older), colorectal cancer (50 years of age or older), breast cancer (40 years of age or older), cervical cancer (20 years of age or older), and lung cancer (for those with a long-term smoking history). 54 years of age or older) were included.
There are three types of vaccines: HPV2 (types 16 and 18), HPV4 (types 6, 11, 16, and 18), and HPV9 (types 6, 11, 16, 18, 31, 33, 45, 52, and 58). The vaccine is HPV2 and HPV4, and it is free for women aged 11 to 12 years, and is injected intramuscularly twice at 6-month intervals. If you try to get paid for a fee instead of getting it for free at this time, the price is quite expensive, so we recommend that you get the free vaccination within the due date. Adverse reactions may include local pain, redness, and swelling, similar to other vaccinations, and may include fever, fatigue, nausea, and fainting (psychogenic). The vaccine is contraindicated in cases of latex or yeast anaphylaxis. In 2013, with the news of ‘paralysis after vaccination’ from Japan, there was a strong rejection among parents in the early days of free vaccination, and the vaccination rate was low at around 50%, but it is rising these days. I realize that unbelievable news even in the medical world can lead to harm to the people’s health. Men can be vaccinated, and it is necessary, but there is a fee.
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