<b>Objectives</b><br/>Subacute sclerosing panencephalitis (SSPE) is a rare but fatal neurodegenerative disease caused by persistent measles virus infection. After a significant measles outbreak in 2000–2001, the Republic of Korea implemented a nationwide measles elimination program, which led to a dramatic reduction in measles incidence. This study aimed to evaluate the impact of these measles elimination efforts on the incidence of SSPE in the Republic of Korea.
<br/><b>Methods</b><br/>This nationwide, population-based retrospective cohort study identified patients newly diagnosed with measles and SSPE between 2007 and 2022, registered in the Health Insurance Review and Assessment Service (HIRA) and Korea Disease Control and Prevention Agency (KDCA) databases. Population-based incidence rates of measles and SSPE were calculated and compared annually.
<br/><b>Results</b><br/>A total of 236 measles cases (HIRA data) and 1,168 measles cases (KDCA data), along with 2,736 SSPE cases, were diagnosed during the study period. Measles incidence significantly declined, reaching zero cases in 2021, while SSPE incidence displayed an upward trend, peaking in 2014. The mean age at SSPE onset was 21.2 years, with a marked male-to-female ratio of 13.0:1.
<br/><b>Conclusion</b><br/>SSPE incidence was remarkably low in the post-outbreak period, likely attributable to successful measles control. This study underscores the critical importance of maintaining low measles incidence through sustained vaccination efforts, preventing SSPE and other measles-related complications.
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The Republic of Korea’s health system at a turning point: from infectious disease threats to comprehensive reform Jong-Koo Lee Osong Public Health and Research Perspectives.2025; 16(3): 193. CrossRef
<b>Objectives</b><br/>No study has yet analyzed risk factors to determine whether students with confirmed coronavirus disease 2019 (COVID-19) infections may affect students at neighboring schools. Therefore, this study aimed to determine risk factors for COVID-19 transmission among schools within a community in the Republic of Korea.
<br/><b>Methods</b><br/>An epidemiological investigation was conducted among 696 students and school staff members at 3 schools where COVID-19 clusters began on October 15, 2021. Interviews, visit history surveys, a facility risk assessment, and closed-circuit television were used to identify risk factors. The statistical significance of risk factors was also evaluated.
<br/><b>Results</b><br/>We confirmed 129 cases (18.5%) among the individuals exposed to COVID-19 at the 3 schools, many of whom had a history of visiting the same multi-use facilities. The odds ratio of having visited multi-use facilities such as karaoke rooms was 1.90 (95% confidence interval, 1.03–3.50); the number of visits to a karaoke room and the visit durations were significantly higher among confirmed cases than non-confirmed cases (p=0.02 and p=0.03, respectively).
<br/><b>Conclusion</b><br/>Having a history of visiting karaoke rooms often and spending a long time there were risk factors for COVID-19 infection and inter-school transmission. Thus, it is necessary to investigate the status of multi-use facilities frequently visited by adolescents and consider incorporating them into the scope of school quarantine to prevent infectious diseases at schools in a community.
<b>Objectives</b><br/>In March 2023, an alternative school in the Republic of Korea reported 12 cases of shigellosis. This study aims to analyze the epidemiological characteristics in order to determine the cause of the cluster outbreak of shigellosis and to develop prevention strategies. Methods: This study focused on 12 patients with confirmed Shigella infection and investigated their demographics, clinical features, epidemiology, diagnostics, and antimicrobial susceptibility. Following the identification of Shigella, we conducted follow-up rectal smear cultures to manage patients, implementing isolation and control measures. Results: This study investigated the emergence of multidrug-resistant Shigella following missionary activities in Cambodia, documenting a cluster infection within an alternative school in Daejeon, the Republic of Korea. The outbreak affected 56 participants, resulting in the confirmation of 12 cases. The incidence rates varied by gender and occupation, with higher rates among males and teachers. All 12 cases demonstrated multidrug resistance. Challenges included delayed pathogen confirmation and suboptimal adherence to isolation criteria. The incident prompted revisions in the criteria for isolation release, focusing on symptom resolution. The study underscores the necessity for strengthened surveillance, educational initiatives focusing on prevention in endemic areas, and improved oversight of unlicensed educational establishments. Conclusion: Successful response strategies included swift situation assessment, collaborative efforts, effective infection control measures, and modified criteria for isolation release. Continued surveillance of multidrug-resistant strains is recommended, especially in regions with a high prevalence.
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Shigella flexneri Outbreak at a Rehabilitation Center: First Report from Saudi Arabia Khalifa Binkhamis, Sarah Alangari, Fatema Juma, Sahar Althawadi, Ahmed A. Al-Qahtani, Marie Fe F. Bohol, Fatimah S. Alshahrani, Fawzia Alotaibi Healthcare.2025; 13(9): 971. CrossRef
<b>Objectives</b><br/>We aimed to describe the epidemiological characteristics of carbapenemase-producing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022.
<br/><b>Methods</b><br/>Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022.
<br/><b>Results</b><br/>Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p<0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p<0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p<0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p=0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p=0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks.
<br/><b>Conclusion</b><br/>In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.
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Comparison of clinical outcomes of patients with serial negative surveillance cultures according to a subsequent polymerase chain reaction test for carbapenemase-producing Enterobacterales H. Seo, S. Kim, Y.W. Lee, H.S. Oh, H-S. Kim, Y.K. Kim Journal of Hospital Infection.2024; 146: 93. CrossRef
Identifying Contact Time Required for Secondary Transmission ofClostridioides difficileInfections by Using Real-Time Locating System Min Hyung Kim, Jaewoong Kim, Heejin Ra, Sooyeon Jeong, Yoon Soo Park, Dongju Won, Hyukmin Lee, Heejung Kim Emerging Infectious Diseases.2024;[Epub] CrossRef
Antimicrobial activity of ceftazidime-avibactam against KPC-2-producing Enterobacterales: a cross-combination and dose-escalation titration study with relebactam and vaborbactam Min Seo Kang, Jin Yang Baek, Jae-Hoon Ko, Sun Young Cho, Keon Young Lee, Young Ho Lee, Jinyoung Yang, Tae Yeul Kim, Hee Jae Huh, Nam Yong Lee, Kyungmin Huh, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Bobby G. Warren Microbiology Spectrum.2024;[Epub] CrossRef
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<b>Objectives</b><br/>The goal of this study was to help prevent and control the spread of coronavirus disease 2019 (COVID-19) by identifying transmission routes and risk factors in livestock slaughtering and processing facilities (SPFs) and establishing an optimal intervention strategy for outbreaks.
<br/><b>Methods</b><br/>This case series study was a demographic analysis of patients with confirmed COVID-19 associated with 5 SPFs in Korea between January and June 2021. Additionally, in a retrospective cohort study, the association between COVID-19 infection and risk factors was analyzed for SPFs at which outbreaks occurred.
<br/><b>Results</b><br/>The COVID-19 attack rates were 11.2%, 24.5%, and 6.8% at 3 poultry SPFs (PSPFs) and 15.5% and 25.2% at 2 mammal SPFs (MSPFs). Regarding spatial risk factors, the COVID-19 risk levels were 12.1-, 5.2-, and 5.0-fold higher in the refrigeration/ freezing, by-product processing, and carcass cutting areas, respectively, than in the office area. The risk of COVID-19 infection was 2.1 times higher among employees of subcontractors than among employees of contractors. The COVID-19 risk levels were 5.3- and 3.0-fold higher in foreign workers than in native Korean workers in the PSPFs and MSPFs, respectively.
<br/><b>Conclusion</b><br/>As the COVID-19 pandemic continues, a detailed policy for infectious disease prevention and control intervention is needed, without interrupting economic activities. Thus, we propose an ideal intervention plan to prevent COVID-19 through disinfection and preemptive testing and to block its transmission through effective contact management during outbreaks at SPFs.
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Mitigating COVID-19 in meat processing plants: what have we learned from cluster investigations? Pauline Kooh, Yvonnick Guillois, Michel Federighi, Mathilde Pivette, Anne-Laure Maillard, Ngoc-Du Martin Luong, Estelle Chaix Frontiers in Public Health.2024;[Epub] CrossRef
<b>Objectives</b><br/>This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness.
<br/><b>Methods</b><br/>An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness.
<br/><b>Results</b><br/>The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for transmission. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%).
<br/><b>Conclusion</b><br/>This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.
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<b>Objectives</b><br/>We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population. Methods: The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR. Results: The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the nonpatients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest. Conclusion: The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers.
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COVID-19 Vaccination in Korea: Past, Present, and the Way Forward Eliel Nham, Joon Young Song, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim Journal of Korean Medical Science.2022;[Epub] CrossRef
<b>Objectives</b><br/>We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).
<br/><b>Methods</b><br/>This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic.
<br/><b>Results</b><br/>TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003).
<br/><b>Conclusion</b><br/>TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.
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Il-Hwan Kim, Jun Hyeong Jang, Su-Kyoung Jo, Jin Sun No, Seung-Hee Seo, Jun-Young Kim, Sang-Oun Jung, Jeong-Min Kim, Sang-Eun Lee, Hye-Kyung Park, Eun-Jin Kim, Jun Ho Jeon, Myung-Min Choi, Boyeong Ryu, Yoon Suk Jang, Hwami Kim, Jin Lee, Seung-Hwan Shin, Hee Kyoung Kim, Eun-Kyoung Kim, Ye Eun Park, Cheon-Kwon Yoo, Sang-Won Lee, Myung-Guk Han, Gi-Eun Rhie, Byung Hak Kang
Osong Public Health Res Perspect 2020;11(5):280-285. Published online October 22, 2020
<sec>
<b>Objectives</b>
<p>The Korea Centers for Disease Control and Prevention has published “A Guideline for Unknown Disease Outbreaks (UDO).” The aim of this report was to introduce tabletop exercises (TTX) to prepare for UDO in the future.</p></sec>
<sec>
<b>Methods</b>
<p>The UDO Laboratory Analyses Task Force in Korea Centers for Disease Control and Prevention in April 2018, assigned unknown diseases into 5 syndromes, designed an algorithm for diagnosis, and made a panel list for diagnosis by exclusion. Using the guidelines and laboratory analyses for UDO, TTX were introduced.</p></sec>
<sec>
<b>Results</b>
<p>Since September 9<sup>th</sup>, 2018, the UDO Laboratory Analyses Task Force has been preparing TTX based on a scenario of an outbreak caused by a novel coronavirus. In December 2019, through TTX, individual missions, epidemiological investigations, sample treatments, diagnosis by exclusions, and next generation sequencing analysis were discussed, and a novel coronavirus was identified as the causal pathogen.</p></sec>
<sec>
<b>Conclusion</b>
<p>Guideline and laboratory analyses for UDO successfully applied in TTX. Conclusions drawn from TTX could be applied effectively in the analyses for the initial response to COVID-19, an ongoing epidemic of 2019 – 2020. Therefore, TTX should continuously be conducted for the response and preparation against UDO.</p></sec>
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Use of a pathogen X tabletop exercise to assess the operational response preparedness of an emerging infectious diseases research network Rachael Lee, Jennifer Hemingway-Foday, Nefer Batsuli, L. Danielle Wagner, Aaron Macoubray, Robert F. Garry, Christine K. Johnson, Kathryn A. Hanley, Nikos Vasilakis, Souleymane Mboup, Hongying Li, Cecilia A. Sánchez, Peter M. Rabinowitz, Robert F. Breiman Frontiers in Public Health.2025;[Epub] CrossRef
<b>Objectives</b><br/>
Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed.<br/><b>Methods</b><br/>
We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period.<br/><b>Results</b><br/>
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.<br/><b>Conclusion</b><br/>
If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.
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