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9 Articles
Early Trend of Imported COVID-19 Cases in South Korea
Osong Public Health Res Perspect. 2020;11(3):140-145.   Published online May 4, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.01
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  • 130 Download
  • 2 Citations
AbstractAbstract PDF

This study aimed to observe the initial trend of imported COVID-19 cases in South Korea since the beginning of the outbreak. All imported cases were classified into 5 regions (China, Asia, Europe, Africa, and America) according to travel history and potential exposure to the COVID-19. The list of countries for which confirmed cases had a travel history (single visit, multiple visits) and presented, were used to estimate the potential “exposure countries” of confirmed cases. For better understanding of the overall imported cases, time differences (day) among 3 major steps (symptom onset, entry to South Korea, laboratory confirmation) were measured based on available data. From the first importation of a COVID-19 case on January 20th, a total of 171 imported cases have been officially reported in South Korea as of March 23rd 2020. The overall trend of importation has significantly changed during this period. Importation of confirmed cases were initially from China, and subsequently from other Asian countries. After that, importation from Europe rapidly increased, with importation from America also increasing. One hundred fifteen (81%) were confirmed within 7 days of symptom onset. One Hundred forty three (84.1%) imported cases were confirmed within a week after entry into South Korea. One hundred seven imported cases (75.9%) developed symptoms within 5 days before or after, entry to South Korea. Streamlined processes of detection, subsequent testing, isolation, and treatment by public health authority, was key in minimizing the risk of secondary transmission.

Coronavirus Disease-19: Quarantine Framework for Travelers Entering Korea
Osong Public Health Res Perspect. 2020;11(3):133-139.   Published online May 8, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.04
  • 5,036 View
  • 154 Download
  • 6 Citations
AbstractAbstract PDF

South Korea is operating a flexible quarantine management system which is based on the results of epidemiological investigations of patients arriving from overseas with coronavirus disease-19 (COVID-19), and closely monitoring COVID-19 outbreaks. South Korea has designated countries with a localized, high prevalence of infection as “quarantine inspection required areas” and has reinforced quarantine measures by applying special immigration procedures for people entering South Korea. Furthermore, South Korea also provides information on international travel history of entrants (who are South Korean citizens and foreign nationals) to all medical institutions, through the smart quarantine information system. On March 11th 2020, the World Health Organization characterized COVID-19 as a pandemic. Inevitably, the number of patients from overseas with COVID-19 (based on 10,000 people entering South Korea), increased to 10 cases in the second week of March, 37 cases in the third week, and 67.7 cases in the fourth week. However, after enforcing quarantine strengthening measures, and with a decrease in the number of people entering the country, the number of cases decreased to 52.0 in the first week of April.

Coronavirus Disease-19: Summary of 2,370 Contact Investigations of the First 30 Cases in the Republic of Korea
Osong Public Health Res Perspect. 2020;11(2):81-84.   Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.04
  • 10,047 View
  • 404 Download
  • 45 Citations
AbstractAbstract PDF

Between January 24th and March 10th, a total of 2,370 individuals had contact with the first 30 cases of COVID-19. There were 13 individuals who contracted COVID-19 resulting in a secondary attack rate of 0.55% (95% CI 0.31–0.96). There were 119 household contacts, of which 9 individuals developed COVID-19 resulting in a secondary attack rate of 7.56% (95% CI 3.7–14.26).

Coronavirus Disease-19: The First 7,755 Cases in the Republic of Korea
Osong Public Health Res Perspect. 2020;11(2):85-90.   Published online April 30, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.2.05
Correction in: Osong Public Health Res Perspect 2020;11(3):146
  • 17,963 View
  • 675 Download
  • 76 Citations
AbstractAbstract PDF

We report the first 7,755 patients with confirmed COVID-19 in Korea as of March 12th, 2020. A total of 66 deaths have been recorded, giving a case fatality proportion of 0.9%. Older people, and those with comorbidities were at a higher risk of a fatal outcome. The highest number of cases of COVID-19 were in Daegu, followed by Gyeongbuk. This summary may help to understand the disease dynamics in the early phase of the COVID-19 outbreaks, and may therefore, guide future public health measures.

Early Epidemiological and Clinical Characteristics of 28 Cases of Coronavirus Disease in South Korea
Osong Public Health Res Perspect. 2020;11(1):8-14.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.03
  • 20,093 View
  • 736 Download
  • 79 Citations
AbstractAbstract PDF
Objectives

The first confirmed case of coronavirus disease 2019 (COVID-19) in South Korea was reported in January 2020, with 28 confirmed cases reported as of February 14th, 2020. The epidemiological and clinical characteristics of all 28 cases were analyzed in response to this disease.

Methods

The epidemiological characteristics and early clinical features of the 28 patients from Korea with confirmed COVID-19 were analyzed using COVID-19 reporting and surveillance data and the epidemiological investigation reports prepared by the rapid response team.

Results

There were 16 patients that entered Korea from foreign countries: Wuhan, China (11 patients), Zhuhai, China, (1 patient), Singapore (2 patients), Japan (1 patient), and Thailand (1 patient). The early symptoms were fever, sore throat, cough or sputum production, chills, and muscle ache. Three patients were asymptomatic, however, 18 developed pneumonia. Of the 28 cases, 16 were index cases imported from abroad, with 10 cases of secondary infection originating in Korea, and the route of transmission still under investigation for 2 patients. The 10 patients with secondary infection were infected from contact with family members or acquaintances of primary patients, and the suspected sites of transmission were mostly at home.

Conclusion

COVID-19 in Korea was spread by 16 infected individuals traveling from other countries, leading to second-generation cases. The initial symptoms were mostly minor, but the disease was infectious at this stage, resulting from close contact, particularly at home. Establishing an early detection strategy for COVID-19 is crucial for managing the transmission of the disease.

Contact Transmission of COVID-19 in South Korea: Novel Investigation Techniques for Tracing Contacts
Osong Public Health Res Perspect. 2020;11(1):60-63.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.09
  • 37,458 View
  • 1,016 Download
  • 103 Citations
AbstractAbstract PDF

In the epidemiological investigation of an infectious disease, investigating, classifying, tracking, and managing contacts by identifying the patient’s route are important for preventing further transmission of the disease. However, omissions and errors in previous activities can occur when the investigation is performed through only a proxy interview with the patient. To overcome these limitations, methods that can objectively verify the patient’s claims (medical facility records, Global Positioning System, card transactions, and closed-circuit television) were used for the recent ongoing coronavirus disease 2019 contact investigations in South Korea.

Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015
Osong Public Health Res Perspect. 2015;6(4):269-278.   Published online August 31, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.08.006
Correction in: Osong Public Health Res Perspect 2016;7(2):138
  • 2,757 View
  • 55 Download
  • 166 Citations
AbstractAbstract PDF
Objectives
The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the Republic of Korea started from the index case who developed fever after returning from the Middle East. He infected 26 cases in Hospital C, and consecutive nosocomial transmission proceeded throughout the nation. We provide an epidemiologic description of the outbreak, as of July 2015.
Methods
Epidemiological research was performed by direct interview of the confirmed patients and reviewing medical records. We also analyzed the incubation period, serial interval, the characteristics of superspreaders, and factors associated with mortality. Full genome sequence was obtained from sputum specimens of the index patient.
Results
A total of 186 confirmed patients with MERS-CoV infection across 16 hospitals were identified in the Republic of Korea. Some 44.1% of the cases were patients exposed in hospitals, 32.8% were caregivers, and 13.4% were healthcare personnel. The most common presenting symptom was fever and chills. The estimated incubation period was 6.83 days and the serial interval was 12.5 days. A total of 83.2% of the transmission events were epidemiologically linked to five superspreaders, all of whom had pneumonia at presentation and contacted hundreds of people. Older age [odds ratio (OR) = 4.86, 95% confidence interval (CI) 1.90–12.45] and underlying respiratory disease (OR = 4.90, 95% CI 1.64–14.65) were significantly associated with mortality. Phylogenetic analysis showed that the MERS-CoV of the index case clustered closest with a recent virus from Riyadh, Saudi Arabia.
Conclusion
A single imported MERS-CoV infection case imposed a huge threat to public health and safety. This highlights the importance of robust preparedness and optimal infection prevention control. The lessons learned from the current outbreak will contribute to more up-to-date guidelines and global health security.

PHRP : Osong Public Health and Research Perspectives