Objectives This study investigated a cluster of secondary human-to-human transmission of severe fever with thrombocytopenia syndrome (SFTS) in a hospital setting, focusing on infection risk factors and the role of personal protective equipment (PPE).
Methods A descriptive epidemiological investigation was conducted following the death of an index patient with laboratory-confirmed SFTS. A total of 27 close contacts, including healthcare workers and a funeral director, were monitored for symptoms. Suspected cases underwent real-time reverse transcription polymerase chain reaction testing. Clinical features, PPE use, and exposure histories were analyzed. The Fisher exact test was used to assess associations between PPE use and infection. Viral genotyping and sequence analyses were performed to evaluate transmission routes.
Results The index patient deteriorated rapidly and died after repeated cardiopulmonary resuscitation (CPR), during which 8 secondary cases occurred. Most infections were identified among individuals involved in CPR or postmortem care without adequate PPE. Although not statistically significant, infection rates were higher among those who did not wear masks or who used low-filtration masks. Proper use of gloves, gowns, and goggles was associated with lower infection rates. Cycle threshold values in secondary cases (range, 34–39) were higher than in the index case (14.07), suggesting lower viral loads. Sequence analysis demonstrated 99.6%–100% homology between the index and secondary cases; all isolates were genotype B, indicating direct transmission.
Conclusion This study provides molecular and epidemiological evidence of nosocomial SFTS transmission. Inadequate PPE use during aerosol-generating procedures likely facilitated infection, underscoring the importance of strict adherence to PPE protocols and reinforced infection control practices.
Objectives This study aimed to examine the correlations between the regional characteristics of counties in Gangwon Province, Republic of Korea and the ratio of intracounty to extracounty sources of coronavirus disease 2019 (COVID-19) infection.
Methods The region of the infectious contact was analysed for each COVID-19 case reported in Gangwon Province between February 22, 2020 and February 7, 2022. The population, population density, area, the proportion of urban residents, the proportion of older adults (>65 years), financial independence, and the number of adjacent counties were assessed for each of the 18 counties in Gangwon Province. Correlation coefficients between regional characteristics and the ratio of intracounty to extracounty infections were calculated.
Results In total, 19,645 cases were included in this study. The population, population density, proportion of older adults, and proportion of urban residents were significantly correlated with the ratio of intracounty to extracounty infections. A stratified analysis with an age cut-point of 65 years showed that the proportion of older adults had a significant negative correlation with the ratio of intracounty to extracounty infections. In other words, the proportions of extracounty infections were higher in countries with higher proportions of older adults.
Conclusion Regions with ageing populations should carefully observe trends in infectious disease outbreaks in other regions to prevent possible transmission.
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<sec><title>Objectives</title><p>The objective of this review is to propose an appropriate course of action for improving the guidelines followed by food handlers for control of infection. For this purpose, previous epidemiological reports related to acute gastroenteritis in food service businesses mediated by food handlers were intensively analyzed.</p></sec><sec><title>Methods</title><p>Relevant studies were identified in international databases. We selected eligible papers reporting foodborne infectious disease outbreaks. Among primary literature collection, the abstract of each article was investigated to find cases that absolutely identified a causative factor to be food handlers’ inappropriate infection control and the taxon of causative microbial agents by epidemiological methodologies. Information about the sites (type of food business) where the outbreaks occurred was investigated.</p></sec><sec><title>Results</title><p>A wide variety of causative microbial agents has been investigated, using several epidemiological methods. These agents have shown diverse propagation pathways based on their own molecular pathogenesis, physiology, taxonomy, and etiology.</p></sec><sec><title>Conclusion</title><p>Depending on etiology, transmission, propagation, and microbiological traits, we can predict the transmission characteristics of pathogens in food preparation areas. The infected food workers have a somewhat different ecological place in infection epidemiology as compared to the general population. However, the current Korean Food Safety Act cannot propose detailed guidelines. Therefore, different methodologies have to be made available to prevent further infections.</p></sec>
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