Hazlienor Mohd Hatta, Kamarul Imran Musa, Suhaily Mohd Hairon, Nik Mohd Hafiz Mohd Fuzi, Normaizura Mokhter, Norfaizah Sulaiman, Amutha Ayasamy, Rohani Ismail, Rohaidah Hashim, Jason Wei Jian Ng
Received March 25, 2026 Accepted August 9, 2026 Published online October 13, 2026
Objectives Nontyphoidal Salmonella (NTS) is a major cause of foodborne illness in Malaysia. Time-series modeling can characterize temporal patterns, although structural disruptions, nonlinear dynamics, and regional variability may affect model performance. This study aimed to characterize NTS seasonality in Malaysia, assess temporal stability, and explore model-based approaches for surveillance.
Methods Monthly laboratory-confirmed human NTS cases from national laboratory surveillance databases for 2018–2024 were analyzed using time-series models, including autoregressive integrated moving-average (ARIMA) models with Fourier terms and an exploratory hybrid ARIMA–long short-term memory (LSTM) model. Interrupted time-series analysis was used to assess structural stability. Anomalies were identified using 95% prediction intervals, and stratified modeling assessed regional heterogeneity.
Results NTS cases showed recurring annual seasonal patterns of moderate strength, with temporal variation over the study period. A significant decline occurred in March 2020 (β=−62.24 cases, p=0.001), followed by gradual recovery (β=2.71 cases/month, p<0.001), suggesting a marked coronavirus disease 2019 pandemic-related disruption and a subsequent positive post-intervention trend. The ARIMA(0,1,1)–Fourier (K=1) model outperformed conventional ARIMA, benchmark, and exponential smoothing models (root mean squared error, 42.9 vs. 51.37–108.79). The hybrid ARIMA–LSTM model provided modest additional improvement, particularly during high-case periods. Model-based anomaly detection identified deviations from expected patterns that coincided with documented outbreak-associated months. Regional heterogeneity in temporal dynamics suggested the need for surveillance strategies tailored to local epidemiological patterns.
Conclusion Parsimonious models captured most temporal patterns in NTS cases, with only modest gains from more complex approaches. Context-specific modeling strategies, model-based anomaly detection, and tiered surveillance frameworks may support more proactive NTS surveillance in Malaysia.
Objectives This study assessed changes in the visibility of the National Health Information Portal (NHIP), operated by the Korea Disease Control and Prevention Agency, across conventional search portals and generative artificial intelligence (AI) platforms.
Methods We analyzed 150 health-related keywords derived from NHIP traffic data, Daum search logs, and chronic disease categories across 7 platforms: Naver, Google, Bing, Daum, ChatGPT, Perplexity, and Gemini. Searches were conducted in September 2025 and February 2026; Gemini was assessed only in the second survey. NHIP exposure was defined as appearance within the top 10 organic search results, whereas AI citation was defined as explicit source attribution. Changes were tested using McNemar's test.
Results Organic search exposure for the NHIP increased on Naver (64.0% to 73.3%, p=0.018) and decreased on Bing (72.0% to 61.3%, p=0.021). AI-summary citation rates increased more substantially on Naver AI Briefing (8.0% to 62.7%, p<0.001), Bing AI Summary (6.7% to 44.7%, p<0.001), Google AI Overview (30.0% to 48.0%, p=0.001), and ChatGPT (16.7% to 38.0%, p<0.001). Gemini cited the NHIP for 96.0% of keywords. For dyslipidemia-related keywords (n=10), Google and ChatGPT showed no NHIP exposure, whereas Gemini cited the NHIP for all keywords.
Conclusion AI citation represents a new dimension of health information accessibility. To address visibility gaps and marked platform divergence, public health portals should implement a 3-level optimization strategy encompassing machine-readable infrastructure, AI-friendly content formatting, and continuous multi-platform monitoring.
Objectives This study described 10-year trends in the prevalence of 5 metabolic syndrome (MetS) components and examined age- and sex-specific patterns in the Republic of Korea using aggregated national health screening statistics from 2014 to 2023.
Methods This repeated cross-sectional study used publicly available aggregated data from the National Health Screening Statistical Yearbook of the National Health Insurance Service. Annual prevalence estimates were summarized overall and by age group and sex. Linear regression descriptively summarized temporal trends. Because of a marked reduction in examinees in 2018 and a discontinuity around the 2018–2019 transition, sensitivity analyses excluding 2018 were performed.
Results From 2014 to 2023, the prevalence of abdominal obesity increased from 21.0% to 25.5%, hyperglycemia from 34.7% to 40.1%, and hypertension from 42.3% to 45.1%. Hypertriglyceridemia and low high-density lipoprotein (HDL) cholesterol appeared to decrease over the same period but showed a marked discontinuity between 2018 and 2019. Prevalence generally increased across older age groups, particularly for hypertension and hyperglycemia. Men had a higher prevalence of 4 MetS components, whereas women had a higher prevalence of low HDL cholesterol.
Conclusion MetS components showed heterogeneous temporal, age-specific, and sex-specific patterns in Korean national health screening statistics. Increases in abdominal obesity and hyperglycemia support the need for earlier age- and sex-tailored cardiometabolic prevention, whereas apparent declines in lipid-related indicators should be interpreted cautiously due to the 2018–2019 discontinuity. Because this study used aggregated repeated cross-sectional data, individual-level longitudinal studies are needed to clarify cardiometabolic risk trends in the Republic of Korea.
Objectives The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare systems and may have influenced the direction of cancer research, particularly epidemiology and prevention research. However, empirical evidence regarding changes in research topics during the COVID-19 era remains limited.
Methods We analyzed 8,694 articles published from 2016 to 2025 in 3 journals using PubMed bibliographic data. Latent Dirichlet allocation topic modeling identified 10 thematic clusters. Differences in topic distributions between the pre-pandemic (2016–2019) and post-pandemic-onset (2020–2025) periods were assessed using the Pearson chi-square test and logistic regression. Interaction models assessed whether temporal changes differed among journals.
Results The overall distribution of topics differed significantly between the 2 periods (χ²=21.42, p=0.011). Logistic regression indicated modestly higher odds of classification as Topic 7, the representative topic of interest, during the 2020–2025 period (β=0.168, p=0.013; odds ratio≈1.18). Interaction analysis showed that this temporal change differed by journal: the interaction was significant for Cancer Epidemiology, Biomarkers & Prevention relative to the reference journal (British Journal of Cancer; β=−0.959, p<0.001) but not for European Journal of Cancer Prevention (p=0.269). Collectively, these findings indicate selective thematic reorientation rather than wholesale transformation of cancer research agendas, with changes varying according to journal scope and disciplinary focus.
Conclusion Cancer research topics shifted modestly during the COVID-19 era, with heterogeneous patterns among journals. These findings suggest that major global health crises may be associated with shifts in research agendas, although these changes may vary according to journal scope and disciplinary context.
Objectives To systematically review and meta-analyze the prevalence and genetic diversity of rotavirus A (RVA) in humans, animals, and environmental water samples in West Africa and to describe its geographic distribution and circulation patterns.
Methods PubMed, Scopus, Web of Science, African Journals Online, ScienceDirect, SpringerLink, JSTOR, clinical trial registries, and global health libraries were searched for observational studies published from January 1, 2010, to December 20, 2025, reporting molecular RVA genotyping data from West Africa. Two reviewers independently screened studies, extracted data, assessed risk of bias using the Joanna Briggs Institute and SYRCLE tools, and summarized genotype distributions narratively. Random-effects meta-analyses were used to estimate pooled prevalence by source category.
Results Fifty-four studies were included, comprising 21,532 samples and 2,080 RVA-positive cases. The overall pooled prevalence was 12.6% (95% confidence interval [CI], 9.9%–15.6%). Prevalence was highest in animals (19.77%; 95% CI, 5.4%–40.1%), followed by environmental water samples (14.81%; 95% CI, 3.5%–31.1%) and humans (11.37%; 95% CI, 9.0%–14.0%). Overall heterogeneity was very high (I²=97.1%). In human studies, G1P[8], G9P[8], and G2P[4] were among the most frequently detected and geographically widespread genotype combinations.
Conclusion RVA circulates widely in humans, animals, and environmental water samples across West Africa, although evidence is characterized by substantial heterogeneity, uneven geographic representation, and limited animal and environmental water data. These findings support integrated One Health surveillance, monitoring for genotype shifts, and stronger water, sanitation, and hygiene interventions.
Objectives Adequate physical activity is essential for promoting healthy life expectancy among older adults. Park accessibility is an important environmental determinant of physical activity and may support multimorbidity management in this population. However, evidence on the association between park accessibility and multimorbidity remains limited, particularly in nationally representative Korean samples. This study examined the association between park accessibility and multimorbidity among older Korean adults.
Methods This cross-sectional study analyzed data from 10,078 individuals aged ≥65 years who participated in the 2023 National Survey of Older Koreans. Multiple logistic regression was used to examine the association between park accessibility and multimorbidity after adjustment for covariates. Stratified analyses assessed this association by physical activity level, and additional logistic regression analyses evaluated associations between park accessibility and common chronic diseases.
Results The prevalence of multimorbidity among older adults was 64.8%. After adjustment for all covariates, older adults living 30–59 minutes’ walking distance from a park had higher odds of multimorbidity than those living <15 minutes from a park (adjusted odds ratio, 1.33; 95% confidence interval, 1.12–1.59). Among the common chronic diseases examined, hypertension was significantly associated with park accessibility.
Conclusion Greater park accessibility may support physical activity and green-space exposure and may thereby contribute to multimorbidity management and healthy life expectancy among older adults.
Objectives Cervical cancer remains a major public health challenge in India despite advances in prevention through human papillomavirus (HPV) vaccination and screening. Although national estimates indicate gradual declines, marked regional disparities persist, and coronavirus disease 2019–related disruptions may have affected recent disease trajectories. This study assessed long-term trends, post-pandemic deviations, and progress toward World Health Organization (WHO) elimination targets in South India.
Methods This population-based observational analysis used Global Burden of Disease Study 2023 estimates for women aged 30–69 years in South India from 1990 to 2023. Pre-pandemic trends and counterfactual projections were evaluated, and age-standardized incidence rates (ASRs) were descriptively compared with the WHO elimination threshold of ≤4 cases per 100,000 woman-years.
Results Age-standardized cervical cancer incidence and mortality declined until the early 2010s but remained above national and global rates. Thereafter, declines stagnated and reversed. In 2023, incidence ranged from 26.1 per 100,000 women in Kerala to 65.8 in Telangana; all states exceeded the WHO threshold based on these ASRs. Observed rates exceeded counterfactual projections, but uncertainty envelopes included zero for every location and outcome. Thus, the findings are consistent with possible post-pandemic disruption to cervical cancer services rather than statistically demonstrated excess burden, and this ecological comparison cannot establish causality. Disability-adjusted life-year rates were highest among women aged 50–69 years.
Conclusion South India appears to have experienced a recent loss of momentum in cervical cancer control. Strengthening HPV vaccination coverage, expanding screening, and improving the resilience of cancer prevention services are essential for accelerating progress toward elimination targets.
Objectives This study aimed to develop prevalence-informed post-release dengue control strategies for settings in which Wolbachia-carrying Aedes aegypti mosquitoes have become established through population replacement and to quantify how optimal supplementary intervention intensity and duration vary with adult Wolbachia prevalence, pW. Methods: A deterministic human–mosquito model was formulated that included Wolbachia-free and Wolbachia-carrying mosquitoes and incorporated cytoplasmic incompatibility, maternal transmission, and reduced vector competence. Two bounded supplementary controls were optimized over a 3-year horizon: reduction of effective human–mosquito contact and conventional adult mosquito suppression, represented by increased adult mortality. A quadratic-cost optimal-control problem was solved numerically using the Pontryagin maximum principle and a forward/backward sweep algorithm. Outcomes were compared across representative pW scenarios and prevalence scans. Results: The optimal policies applied high-intensity supplementary control early in the planning horizon and then relaxed control as infection pressure declined. Higher pW reduced the uncontrolled infection burden, decreased the incremental benefit of additional intervention, and shortened the duration of maximum control. In coarse scans with umax=0.30, the terminal dengue infection near-elimination indicator, defined as IH (T)≤10–4 at T=3 years, changed between pW=0.45 and pW=0.50 for all tested cost-weight combinations. A separate refined continuation example demonstrated non-monotonic mean control use and a sharp decrease in cumulative incidence. Conclusion: Adult Wolbachia prevalence measured through entomological surveillance may represent an actionable index for post-release dengue management. The identified transition band is a model-based planning indicator, not a universal field threshold or evidence of mosquito population elimination.
Objectives Chikungunya poses an increasing threat to people living in endemic areas and to travelers from non-endemic regions. This study descriptively characterized imported chikungunya cases in Japan and explored the relationship between local incidence in destination areas and infection risk among Japanese travelers.
Methods First, the descriptive features of imported chikungunya cases in Japan from 2011 to 2023 were examined. Second, monthly and yearly trends in the incidence of imported chikungunya cases among Japanese travelers were compared by destination with incidence in the corresponding destination country. Third, destination-specific incidence among Japanese travelers was compared between high- and low-transmission seasons in each destination country.
Results Of 155 imported chikungunya cases in Japan during 2011–2023, 112 (72.3%) were associated with travel to Myanmar, India, Indonesia, the Philippines, or Thailand. The yearly chikungunya importation rate among Japanese travelers returning from Indonesia and Thailand was correlated with the corresponding rate among local residents. The monthly incidence of imported cases during the high-transmission season was 12.3, 7.4, 12.0, and 4.0 times higher than that during the low-transmission season among travelers returning from Myanmar, India, Indonesia, and the Philippines, respectively.
Conclusion The risk of imported chikungunya infection among Japanese travelers reflected the local epidemiology of chikungunya in destination countries, including both seasonal and long-term patterns. Imported-case data may support risk assessment in destination countries and contribute to traveler-specific prevention, improved diagnosis, and a reduced risk of autochthonous outbreaks.
Objectives This study assessed the economic value of 2 major initiatives within the national infectious disease response system of the Korea Disease Control and Prevention Agency (KDCA): the Training Programs for Public Health Workforce (TPPHW) and the Infectious Disease Information System (IDIS). Methods: We developed a structured estimation model to quantify the economic benefits of pandemic preparedness investments and applied it to the KDCA’s TPPHW and IDIS. The model incorporated parameters elicited from 29 senior officials into a cost-benefit analysis (CBA) framework, from which we calculated the net present value (NPV) and benefit-cost ratio (BCR) over a 10-year period, with sensitivity analyses. Results: Both initiatives yielded positive net benefits under baseline assumptions, although the margin was substantially greater for workforce training than for the information system. At the assumed discount rate of 4.5%, the CBA yielded a BCR of 2.120 and an NPV of 27.2 billion Korean won (KRW) for TPPHW. For IDIS, the corresponding values were a BCR of 1.071 and an NPV of 2.7 billion KRW. Sensitivity analysis showed that workforce training remained economically justified across all scenarios, whereas the information system remained viable only under more favorable assumptions. Conclusion: This study contributes to the literature by systematically applying CBA to infectious disease preparedness in the Republic of Korea. The findings support continued investment in skilled workforce training and integrated information infrastructure for future pandemic preparedness. The study is limited by its reliance on expert-elicited parameters and its focus on monetary benefits, excluding health outcomes such as disability-adjusted life years and quality-of-life improvements.
Objectives This study investigated associations between building structure and managers’ knowledge, attitudes, and practices (KAP) regarding indoor air quality in welfare facilities for persons with disabilities, comparing facilities with and without coronavirus disease 2019 (COVID-19) cluster outbreaks. Methods: A web-based survey was conducted among managers of 242 welfare facilities for persons with disabilities in the Republic of Korea. Facilities were recruited from a national sampling frame of approximately 3,000 facilities, yielding a response rate of 8.1%. The 80-item questionnaire assessed building characteristics and air quality-related KAP scores. Logistic regression was used to identify factors associated with cluster outbreaks. Results: Of the 242 facilities, 50.8% had experienced cluster outbreaks. Facilities in complex/multi-use buildings had higher odds of outbreaks than those in detached buildings did (adjusted odds ratio, 2.21; 95% confidence interval, 1.25–3.91; p=0.006). For managerial factors, facilities with outbreaks tended to have lower attitude scores (p=0.02); however, this association did not remain statistically significant after Bonferroni correction (adjusted α=0.0083). No significant differences were observed in knowledge or practice scores. Conclusion: Building structure, particularly complex/multi-use configuration, was associated with COVID-19 cluster outbreaks. Managerial KAP scores were not definitively associated with outbreaks under the conservative significance threshold, but the observed trends suggest that institutional support, ventilation guidance, and practical training for facility managers may help strengthen future infection-prevention efforts.
Objectives Medication adherence remains a major challenge in the management of type 2 diabetes (T2D), especially in middle-income countries such as Morocco. With the rapid development of artificial intelligence, large language models, including ChatGPT, may offer new opportunities for clinical research through simulated patient profiles. This study examined the feasibility of using ChatGPT to generate culturally contextualized virtual profiles of Moroccan patients with T2D and to apply the validated Moroccan Arabic dialect version of the general medication adherence scale (GMAS). Methods: This exploratory pilot simulation study used ChatGPT-4 to generate 11 virtual profiles based on representative sociodemographic and clinical characteristics of Moroccan patients with T2D. Each profile was administered the validated Moroccan Arabic dialect version of the GMAS. Results: Four profiles (36.4%) showed high adherence, 6 (54.5%) displayed moderate adherence, and 1 (9.1%) exhibited low adherence. Expert evaluations were consistent, with all ratings ≥3 on a 4-point scale, supporting the credibility and cultural appropriateness of the profiles. The simulated patterns reflected real-world trends, with higher adherence among profiles treated with oral antidiabetic drugs, covered by health insurance, and having shorter disease duration, and lower adherence among profiles using insulin, lacking insurance, and having longer disease duration. Conclusion: ChatGPT generated credible, culturally adapted patient profiles that enabled application of a validated psychometric tool in a simulated environment. This rapid, low-cost approach may support exploratory research, healthcare training, and intervention design. Comparative studies using real patient data are needed to confirm validity.
Objectives This review aimed to synthesize recent advances in the understanding of emerging contaminants (ECs), including per- and polyfluoroalkyl substances, pharmaceuticals, personal care products, microplastics and nanoplastics, endocrine-disrupting chemicals, and engineered nanomaterials. It critically assessed their sources, environmental pathways, transformation mechanisms, and ecological and human health impacts, while identifying knowledge gaps and future research priorities.
Methods A systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Peer-reviewed research articles and critical reviews were retrieved from Scopus, Web of Science, and PubMed. Emphasis was placed on studies that used advanced analytical techniques, including high-resolution mass spectrometry, nuclear magnetic resonance spectroscopy, Fourier-transform infrared spectroscopy, and biosensor-based detection methods.
Results The findings indicated that ECs are characterized by high environmental persistence, complex transformation pathways, bioaccumulation, and trophic transfer potential. Reported impacts included endocrine disruption, genotoxicity, antimicrobial resistance, and ecological imbalance. Across global environmental compartments, these pollutants pose long-term risks to ecosystems and human health. Their distinctive partitioning behavior and environmental persistence challenge standard ecological assessment frameworks and underscore the need for comprehensive toxicological evaluations and robust regulatory oversight to mitigate long-term biological accumulation and adverse physiological effects in aquatic and terrestrial wildlife.
Conclusion This review highlights the urgent need for improved regulatory frameworks, standardized monitoring approaches, and sustainable remediation strategies for ECs. By integrating advanced analytical methods, computational tools, and circular economy principles, the review provides a timely contribution to environmental science and policy and supports informed decision-making for environmental protection and public health.
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Micro- and nanoplastic pollution in wetland ecosystems: Ecological risks, health implications, and mitigation strategies toward a One Health future Van Giang Le, Minh-Ky Nguyen Environmental Pollution.2026; : 129329. CrossRef
Objectives This study examined associations between indoor total volatile organic compound (TVOC) concentrations and urinary volatile organic compound (VOC) metabolites in Korean adults, focusing on potential sex-specific differences. We hypothesized that higher indoor TVOC exposure would be associated with higher urinary VOC metabolite concentrations and that these associations would differ by sex.
Methods We conducted a cross-sectional analysis of the 2020–2021 Korea National Health and Nutrition Examination Survey, which included the Republic of Korea’s first population-based indoor air quality survey. The analysis included 1,859 adults aged ≥19 years who participated in the indoor air quality survey from July 2020 to August 2021. Indoor TVOC concentrations (µg/m³) were measured using standardized protocols. Nine urinary VOC metabolites were quantified, creatinine-adjusted, and log-transformed. Multivariable linear regression, sex-stratified analyses, and subgroup analyses among unemployed adults were performed to reduce potential confounding from occupational exposure.
Results Indoor TVOC concentrations were positively associated with urinary 2-methylhippuric acid (2-MHA; β=0.041; 95% confidence interval [CI], 0.029–0.052) and 3,4-MHA (β=0.040; 95% CI, 0.027–0.052), with no evident sex difference in the overall sample. However, among unemployed adults, sex-by-TVOC interaction terms were statistically significant for both metabolites, and associations were stronger in males for both 2-MHA (β=0.110 vs. 0.024) and 3,4-MHA (β=0.130 vs. 0.031) than in females.
Conclusion Indoor TVOC concentrations were associated with urinary VOC metabolites, particularly 2-MHA and 3,4-MHA. These findings support considering sex-specific patterns in VOC-related risk assessment and indoor air quality surveillance, interventions, and management.
The health care community has moved from emergency response models to sustained recovery models for the rehabilitation of post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection, commonly referred to as long COVID. This study aimed to provide a comprehensive bibliometric visualization and thematic analysis of global research output from 2020 to 2025 on rehabilitation interventions for long COVID and related post-viral disorders. The PubMed database was systematically searched to retrieve bibliometric records. VOSviewer and Biblioshiny were used to conduct a multidimensional analysis. Key metrics included annual scientific production, Lotka’s law for author productivity, Bradford’s law for core source identification, and country collaboration mapping. The life-cycle model (R2=0.929) indicated that the field evolved in a predictable pattern, with continuous and accelerated development. However, the projected stabilization should be interpreted as a description of initial growth rather than as definitive evidence of disciplinary maturity. Scientific output in this area increased sharply and peaked in 2024. Thematic visualization identified 3 broad thematic groupings. Lotka’s law indicated a dispersed and fragmented research community, with approximately 90% of authors contributing only 1 document. Physiotherapy research for long COVID has shifted from early pulmonary-centered approaches toward more interdisciplinary models focused on cognitive health and fatigue.
Objectives This study characterized multidrug-resistant (MDR) bacteria in sewage, river, and marine ecosystems in South Gujarat, India.
Methods Water samples were collected from 25 hospital drainage, sewage treatment/pumping, Tapi River, and coastal marine sites at multiple time points. From 270 screened colonies, 166 morphologically and biochemically distinct nonduplicate isolates were retained. Antimicrobial susceptibility was assessed, and isolates were classified as MDR, extensively drug-resistant (XDR), or pan-drug-resistant (PDR). Biofilm formation, metabolic activity, extracellular polymeric substance protein, heavy metal tolerance, extended-spectrum β-lactamase production, carbapenemase production, and metallo-β-lactamase activity were assessed phenotypically. Tapi River estuary water was used for taxonomic profiling and antibiotic resistance gene (ARG) detection.
Results The 166 isolates comprised 45 bacterial species, with clinically significant Gram-negative pathogens predominating, including Pseudomonas aeruginosa (n=24, 14.5%), Ochrobactrum intermedium (n=16, 9.6%), Stenotrophomonas maltophilia (n=15, 9.0%), and Escherichia coli (n=12, 7.2%). MDR phenotypes were detected in 80.1% of isolates; 18.1% were XDR, and 1.8% were PDR, with PDR isolates confined to river water samples. Biofilm formation was observed in 86.1% (n=143) of isolates, including 28.3% (n=47) strong, 24.7% (n=41) moderate, and 32.5% (n=54) weak producers. Extended-spectrum β-lactamase production was confirmed in 13.4% of Gram-negative isolates, and carbapenemase activity was detected in 11 isolates. Zinc and copper tolerance were significantly higher in XDR than in MDR isolates (p<0.05). Metagenomics identified efflux pumps as the dominant ARG class (36.2%), followed by target-site mutations (21.3%) and β-lactamases (14.9%), and detected blaCTX-M-15, blaTEM-207, gyrA, and parC.
Conclusion These interconnected aquatic systems represent important reservoirs for community-level antimicrobial resistance transmission.
Objectives This study investigated a large-scale foodborne outbreak caused by Staphylococcus aureus during a local festival in the Republic of Korea and performed genomic and molecular epidemiological analyses using whole-genome sequencing (WGS).
Methods Microbiological identification was performed using clinical, food, and environmental samples. Molecular characterization included pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, and spa typing. WGS was conducted to evaluate clonal relatedness, virulence factors, and antimicrobial resistance genes.
Results A total of 141 suspected cases and 18 laboratory-confirmed cases were identified, and 24 S. aureus isolates were recovered (18 from patients, 3 from food samples, and 3 from environmental samples). All 17 isolates included in the genomic analysis carried the sea and sec genes and belonged to ST1-t321, with pairwise differences of 8–33 SNPs, supporting a clonal origin. These isolates exhibited a previously unreported PFGE pattern (STAS16.170) in the Republic of Korea. Virulence profiling identified hemolysin genes (hlgA, hlgB, hlgC), leukocidin genes (lukD, lukE), and immune evasion genes (sak, scn). In addition, all isolates were methicillin-susceptible and lacked mecA and mecC.
Conclusion This large-scale foodborne outbreak demonstrated that a single contaminated food source can result in widespread illness during mass gatherings. Genomic analysis clarified the clonal relatedness of the outbreak strains and highlighted the value of genomic surveillance for the early detection and prevention of S. aureus outbreaks.
Determining exactly what the next pandemic will be is complex, However, by studying some common characteristics of previous viral pandemics, we can predict the general characteristics of the next pandemic. Here, we will explore next pandemic features, reviewing the past pandemics that have afflicted humanity and the factors that might make one viral pathogen more likely than others to cause a future pandemic. There are many factors that accelerate the occurrence of pandemics, including climate change, intensive human interaction in our modern world, and the threat to natural environments of viral reservoirs. By studying a set of requirements, the most important of which is that the virus be transmitted through respiration and air, and that it be able to be transmitted between humans, as well as its ability to undergo genetic mutations, we have identified a specific set of viruses that could potentially turn into future pandemics.
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