(Dengue Fever) 5294 242 21 1. 2. 3. 4. 5. 6. 1
1.1 (Dengue Fever) 1944 1 1950 2 1953 Philipines hemorrhagic fever 1956 15 Thai hemorrhagic fever Dengue hemorrhagic DHF 3 1 2 3 4 1956 Graham 1903 Bancroft 1906 1.2 1942 40 1981 80 2 1987 1387 500 5 2 1 1988 4389 1988 1 2 3 4 2
3 1870 1889 1902 1915 25-50 1922 20-30 1927 1931 1942 80 1981 80 2 1987 1123 527 5 2 1 2.9 1988 10,420 4389 3534 1 3 1989 594 35 16 19 5 2 1 1990 136 10 1 1 1991 804 175 26 16 4 1992 23 4 19 2 2 1993 13 1994 244 222 22 158 20 38
4 3 1 1 1 26 7 1995 369 329 40 179 1 3 3 69 8 6 51 6 1996 42 16 14 2 26 1997 76 19 57 1998 348 238 135 64 24 6 4 3 1 1 110 1999 49 20 29 2000 140 113 2 109 27 2001 218 2002 17 5294 2819 1958 377 66 18 1 2 2003 2/28 49 26 9 12 2 1.3
1. 2001 2002 2002 2001 2002 0-9 3 1.4 106 2.0 10-19 16 7.3 339 6.4 20-29 22 10.1 609 11.5 30-39 25 11.5 599 11.3 40-49 50 22.9 975 18.4 50-59 44 20.2 1144 21.6 60-69 40 18.3 1080 20.4 70 18 8.3 442 8.3 218 5294 1.4 5
1.5 25 25 1 1. 6
2.1 Dengue Fever Aedes aegypti Aedes albopictus " " ( ) 8 15 15-50% 2.2 1907 Craig (Family Togavirdae) Flavivirus (enveloped, single-stranded RNA viruses) I II III IV 7
2 9 (typespecific immunity) (primary infection) (homotypic immunity) (secondary infection) (anamnestic antibody response) (secondary-type immune response) (dengue hemorrhagic fever, DHF) (dengue shock syndrome, DSS) (arbovirus) 2.3 1 2 3 2 8
polynesiensis modirittatus polynesiensis 2. 2.4 3-14 viremia 8-12 3 9
3. 4 1 5 ) -1 5 7 17 8-12 -1 0 5 10 20 30 10 31 4. 10
2.5 1. (1) 3~8 (2) 12 (3) 39 40 3-6 3 1-2 2-3 (4) breakbone fever (5) 4 7 5 (6) (7) 1% (8) 1987 1988 250 98% 3 6 98% 95% 97% 22.4% 78% 62.6% 11
1.3% 7 14 9-10 5. 2. (1) 3~8 (1~10 ) (2) 3~6 (3) 6 (4) Confluent convalescent rash) 7 (5) (plasma leakage) (hypovolemic shock) 20mmHg (Dengue shock syndrome) DSS 1-2 12
DIC 10~50% 6 7. 3. (1) (2) (3) 13
4. (1) (2) (3) 14
3.1 1. 1500 N W S E 8. 2. 15
9 10 5-6 3-4 5-6 1-2 1 3-4 6-8 2-3 1 9. 3. 16
12 25-30 35 51% 2. 1993 12 6 1 2 10 4 34.3 17.1 2.9 5.7 28.6 11.4 2 0 0 0 1 2 40 0 0 0 20 40 3. 1993 24 43 42 22 0 131 400 18.3 32.8 32.1 16.8 0 100 19 3 27 0 0 49 400 38.8 6.1 55.1 0 0 100 17
4. 1993 2 23 18 2 4 0.5-2 96 76 43 81 0.5 8 6 8 15 5. 10 125 125 0.0 0.0 12 130 12 2 1.5 15 55 53 2 3.6 20 131 82 49 37.4 25 53 12 41 77.4 30 30 4 26 86.6 35 292 143 149 51 4. 85.2% 50 367 488 6. 50 90 161 165 265 287 347 395 488 179 15 5 3 1 2 1 1 1 209 22 0 4 0 0 1 1 0 0 28 201 15 9 3 1 3 2 1 1 237 85.2 6.4 3.8 1.3 0.4 1.3 0.8 0.4 0.4 100 1.3 2-3 20560 18
3.2 1960 3.3 1. (1) 19
(2) (3) 2. (1) (2) 7 7. 1 2 3 4 5 6 7 8 9 1-3 4-7 8-17 18-28 29-37 37-49 50-59 60-76 41 1-2 3-5 6-9 10-14 15-20 21-27 28-31 32-40 78 1-4 5-9 10-19 20-34 35-49 50-74 79-99 100-199 200 1-3 4-10 11-30 31-100 101-300 301-1000 1001-30003001-10000 10001 * 100 / 100 50 10 20% 4 20
21 * 100 / 100 50 5 10 4 * 100 / 100 50 10 20 4 * 100 / 100 50 60 120 5 (3) / 50 10 0.2 3.4
50 35% 20% 5% 4% 3% 22
4.1 4.2 1. 23
24 ( ) ULV ULV --- --- --- --- --- 2. (1) (2) A.
B. C. 3. (1) (2) 25
(3) (4) (5) 4. (1) A. B. C. 26
D. E. (2) A. B. C. D. E. F. G. H. I. (3) A. B. C. (4) A. B. C. D. 27
E. (5) A. B. C. D. E. F. G. H. (6) A. B. C. D. E. F. (7) A. B. C. 5. 28
? 1. (1) (2) 2. (1) ( ) (2) 29
(3) (4) 3. (1) (2) 4. / / 30
5. (1) (2) 6. 31
(1) (2) 6. (1) (2) (3) (4) 30 30 (5) 7. 32
33
91 5294 1. 2. 3. 4. 5. 34
35