PHWR Public Health Weekly Report

Vol.14 No.50, December 09, 2021 Article TypeEpidemiology and Surveillance

• Epidemiology and Surveillance 2021-12-09

  0 658 188

  Smallpox vaccine and Vaccinia virus

  Hwachul Shin, Hwajung Yi, Myung-Min Choi, Gi-Eun Rhie

  Public Health Weekly Report 2021; 14(50): 3559-3565

  Abstract

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  Vaccinia viruses have been used as vaccine strains for smallpox vaccines. They belong to the Orthopoxvirus genus and Poxviridae, which are enveloped and have a double-stranded DNA genome. In Republic of Korea, the smallpox vaccine was included in the national vaccination program and the vaccination was started at the national level in 1954. World Health Organization (WHO) coordinated a global smallpox eradication campaign in 1967 with the aim of promoting the vaccination. After widespread immunization and surveillance, the incidence of smallpox dropped dramatically. In 1980, the WHO declared the eradication of smallpox worldwide, and large-scale vaccination of the vaccine was discontinued. To date, smallpox vaccines are classified into four generations, from the 1st to the 4th generation with differences of manufacturing method and the degree of attenuation of vaccine strains (vaccinia viruses). The vaccinia viruses used for smallpox vaccines have a large-sized genome, so it can be inserted and manipulated by foreign genes of large sizes such as genes coding antigens of viruses and bacteria. The vaccinia virus DNA genome is stable with low incidence of mutations. Therefore, it is generally accepted that since vaccinia viruses act as a vector they can be used for vaccine development of other infectious diseases or anti-cancer vaccines. Thus, this article described the history of smallpox vaccines and uses of vaccinia viruses as a viral vector.

• Epidemiology and Surveillance 2021-12-09

  0 329 287

  Importance and current status of standardization of creatinine test for the management of kidney disease

  Jinyoung Hong, Hyunjung Gu, Woochang Lee, Sail Chun, Won-Ki Min, Eun-Jung Cho, Tae-Dong Jeong

  Public Health Weekly Report 2021; 14(50): 3566-3572

  Abstract

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  The kidneys are essential organs for maintaining homeostasis in the body. Decreases in renal function increase the risk of morbidity and mortality and often result in high medical expenses. Since most kidney diseases are often asymptomatic during clinical progress, tests that can evaluate the presence and extent of renal function abnormalities should be appropriately used. The best single indicator used for overall renal function evaluation is glomerular filtration rate (GFR), which cannot be measured directly, so it must be measured indirectly using exogenous substances or estimated using endogenous substances. Currently, creatinine is the most widely used substance for calculating the estimated glomerular filtration rate (eGFR).
  According to the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline, it is recommended that eGFR be reported using the 2009 CKD-EPI creatinine equation in addition to the serum creatinine concentration in adults. The currently used creatinine test methods include those based on the traditional Jaffe reaction and the enzymatic method that measures creatinine using several enzymatic reactions. Since the diversity of creatinine measurement methods can affect the eGFR, quality control of the creatinine test and standardization between the test methods plays an important role in the accurate prediction of renal function.
  International creatinine standardization programs have been established and operated in cooperation with various international organizations to reduce differences among clinical laboratories reporting creatinine and to more accurately estimate GFR. The creatinine standardization recommendations recommend that clinical laboratories should use creatinine methods that has calibration traceable to IDMS and validated IDMS-traceable equations.
  The Korea Disease Control and Prevention Agency (KDCA) established the National Medical Reference Laboratory to improve the standardization of tests. To standardize creatinine tests, accuracy-based proficiency test and in-vitro diagnostic product quality assurance are implemented to evaluate the status of creatinine standardization and encourage each entity participating in the test to make efforts for standardization. In order to improve the standardization of creatinine tests in the Republic of Korea in the future, active cooperation from related professional academic organizations and support and efforts at the national level will be continuously needed.