SUMMARY: Adenovirus often causes respiratory disease outbreaks in military training soldiers. Compared with adenovirus pneumonia in young military adults, symptoms arising from febrile respiratory illness (FRI) caused by adenovirus have not been previously evaluated in Korean soldiers. We conducted an event-based outbreak investigation involving 712 male soldiers aged 19 to 21 years from March 14 to 30, 2012 to evaluate the epidemiological and clinical characteristics of patients with pneumonia and FRI caused by adenovirus. We described the laboratory and radiological characteristics of patients with adenovirus pneumonia. Among these, 407 cases of FRI and 15 cases of pneumonia were identified through active surveillance (attack rate of FRI, 57.16z; attack rate of pneumonia, 2.11z). Fire training and march training may present environmental risk factors for adenovirus-associated outbreaks. Most symptoms were mild. The most frequent symptom in patients with pneumonia and FRI was cough. Patients with pneumonia were associated with an increased incidence of dizziness (crude odds ratio [cOR], 9.65; 95z confidence interval [CI], 2.38-37.15) and a decreased incidence of rhinorrhea (cOR, 0.15; 95z CI, 0.04-0.53) during adenovirus-associated outbreaks. Differential leukocyte count revealed high monocytes, low lymphocytes, and low eosinophils, and chest computed tomography revealed a consolidation pattern and right lobar pneumonia. These findings warrant a high level of suspicion for adenovirus pneumonia.

BackgroundThe trend of military patients becoming infected with vivax malaria reemerged in the Republic of Korea (ROK) in 1993. The common explanation has been that infective Anopheles mosquitoes from the Democratic People’s Republic of Korea have invaded Republic of Korea’s demilitarized zone (DMZ). The aim of this study was to verify the relationship between meteorological factors and the number of malaria patients in the military in this region.MethodsThe authors estimated the effects of meteorological factors on vivax malaria patients from the military based on the monthly number of malaria cases between 2006 and 2011. Temperature, precipitation, snow depth, wind velocity, relative humidity, duration of sunshine, and cloud cover were selected as the meteorological factors to be studied. A systematic pattern in the spatial distribution of malaria cases was assessed using the Moran’s Index. Granger causality tests and cross-correlation coefficients were used to evaluate the relationship between meteorological factors and malaria patients in the military.ResultsSpatial analysis revealed significant clusters of malaria patients in the military in Republic of Korea in 2011 (Moran’s I = 0.136, p-value = 0.026). In the six years investigated, the number of malaria patients in the military in Paju decreased, but the number of malaria patients in the military in Hwacheon and Chuncheon increased. Monthly average, maximum and minimum temperatures; wind velocity; and relative humidity were found to be predicting factors of malaria in patients in the military in Paju. In contrast, wind velocity alone was not able to predict malaria in Hwacheon and Chuncheon, however, precipitation and cloud cover were able to predict malaria in Hwacheon and Chuncheon.ConclusionsThis study demonstrated that the number of malaria patients in the military is correlated with meteorological factors. The variation in occurrence of malaria cases was principally attributed to differences in meteorological factors by regions of Republic of Korea.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-016-0111-3) contains supplementary material, which is available to authorized users.

The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.

There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.