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Original Article
COVID-19 outbreak response at a nursing hospital in South Korea in the post-vaccination era, including an estimation of the effectiveness of the first shot of the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1-S)
Chanhee Kim, Geon Kang, Sun Gu Kang, Heeyoung Lee
Osong Public Health Res Perspect. 2022;13(2):114-122.   Published online April 26, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0262
  • 1,327 View
  • 54 Download
AbstractAbstract PDF
Objectives
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.
Short Communication
COVID-19 outbreak and risk factors for infection in a taekwondo gym in the Republic of Korea
Seung Hwan Shin, Eonjoo Park, Sookhyun Kim, Minji Jang, Subin Park, Dong-Hwi Kim, Tae Jong Son, Ji-Hyuk Park
Osong Public Health Res Perspect. 2022;13(2):162-170.   Published online March 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0295
  • 923 View
  • 58 Download
AbstractAbstract PDF
Objectives
Relatively few studies have assessed risk factors for coronavirus disease 2019 (COVID-19) in public facilities used by children and adolescents. This study presents an analysis of a COVID-19 outbreak that occurred in a taekwondo gym in Korea, predominantly among children and adolescents, with the aim of providing insights on managing COVID-19 outbreaks in similar facilities. Methods: All 108 taekwondo gym students and staff received COVID-19 tests. A survey and closed-circuit television analyses were used to identify risk factors. A univariate analysis was conducted, followed by multivariate logistic regression analysis with backward elimination for variables with a significance level <0.10 in the univariate analysis. Results: COVID-19 was confirmed in 30 of 108 subjects at the taekwondo gym (attack rate, 27.8%). The outbreak started in an adult class student. This student transmitted the virus to the staff, who consequently transmitted the virus to adolescent students. In the univariate analysis, the relative risk for younger age (≤9 years) was 2.14 (95% confidence interval [CI], 1.01–4.54; p=0.054), and that for food consumption inside the gym was 2.12 (95% CI, 1.04–4.30; p=0.048). In the multivariate logistic regression analysis, the odds ratio for younger age was 2.96 (95% CI, 1.07–8.20; p=0.036), and that for food consumption inside the gym was 3.00 (95% CI, 1.10–8.17; p=0.032). Conclusion: Food consumption inside the facility and young age were significant risk factors for COVID-19 transmission in this taekwondo gym. Food consumption should be prohibited in sports facilities, and infection prevention education for young students is also required.
Original Articles
Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020
Jiyeon Yang, Yunhyung Kwon, Jaetae Kim, Yoojin Jang, Jiyeon Han, Daae Kim, Hyeran Jeong, Hyekyung Park, Eunhye Shim
Osong Public Health Res Perspect. 2021;12(5):293-303.   Published online September 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0063
  • 3,700 View
  • 134 Download
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).
Methods
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.
Results
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).
Conclusion
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.
Trends in recent waterborne and foodborne disease outbreaks in South Korea, 2015–2019
Sang Hyuk Lee, Jae-Won Yun, Ji Hee Lee, Yeon Haw Jung, Dong Han Lee
Osong Public Health Res Perspect. 2021;12(2):73-79.   Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.04
  • 3,192 View
  • 115 Download
  • 4 Citations
AbstractAbstract PDF
Objectives
This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019.
Methods
The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention (KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study.
Results
The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years.
Conclusion
The steady number of patients and decreasing number of cases per outbreak, even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.
2019 Tabletop Exercise for Laboratory Diagnosis and Analyses of Unknown Disease Outbreaks by the Korea Centers for Disease Control and Prevention
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
DOI: https://doi.org/10.24171/j.phrp.2020.11.5.03
  • 3,297 View
  • 85 Download
AbstractAbstract PDF
Objectives

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.

Methods

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.

Results

Since September 9th, 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.

Conclusion

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.

Brief Report
Enhancing ‘Whole-of-Government’ Response to Biological Events in Korea: Able Response 2014
Sangwoo Tak, Anton Jareb, Suon Choi, Marvin Sikes, Yeon Hwa Choi, Hyeong-wook Boo
Osong Public Health Res Perspect. 2018;9(1):32-35.   Published online December 31, 2017
DOI: https://doi.org/10.24171/j.phrp.2018.9.1.06
  • 3,111 View
  • 34 Download
  • 1 Citations
AbstractAbstract PDF

Since 2011, the Republic of Korea (ROK) and United States (U.S.) have been collaborating to conduct inter- and intra-governmental exercises to jointly respond to biological events in Korea. These exercises highlight U.S. interest in increasing its global biosurveillance capability and the ROK’s interest in improving cooperation among ministries to respond to crises. With Able Response (AR) exercises, the ROK and U.S. have improved coordination among US and ROK government and defense agencies responding to potential bio-threats and identified additional areas on which to apply refinements in policies and practices. In 2014, the AR exercise employed a Biosurveillance Portal (BSP) to facilitate more effective communication among participating agencies and countries including Australia. In the present paper, we seek to provide a comprehensive assessment of the AR 2014 (AR14) exercise and make recommendations for future improvements. Incorporating a more realistic response in future scenarios by integrating a tactical response episode in the exercise is recommended.

Original Article
Emerging Pathogens and Vehicles of Food- and Water-borne Disease Outbreaks in Korea, 2007–2012
Shinje Moon, Il-Woong Sohn, Yeongseon Hong, Hyungmin Lee, Ji-Hyuk Park, Geun-Yong Kwon, Sangwon Lee, Seung-Ki Youn
Osong Public Health Res Perspect. 2014;5(1):34-39.   Published online February 28, 2014
DOI: https://doi.org/10.1016/j.phrp.2013.12.004
  • 1,606 View
  • 16 Download
  • 14 Citations
AbstractAbstract PDF
Objectives
Food- and water-borne disease outbreaks (FBDOs) are an important public health problem worldwide. This study investigated the trends in FBDOs in Korea and established emerging causal pathogens and causal vehicles.
Methods
We analyzed FBDOs in Korea by year, location, causal pathogens, and causal vehicles from 2007 to 2012. Information was collected from the FBDOs database in the Korean Centers for Disease Control and Prevention.
Results
During 2007–2012, a total of 1794 FBDOs and 48,897 patients were reported. After 2007, FBDOs and patient numbers steadily decreased over the next 2 years and then plateaued until 2011. However, in 2012, FBDOs increased slightly accompanied by a large increase in the number of affected patients. Our results highlight the emergence of norovirus and pathogenic Escherichia coli other than enterohemorrhagic E. coli (EHEC) in schools in 2012. We found that pickled vegetables is an emerging causal vehicle responsible for this problem.
Conclusion
On the basis of this study we recommend intensified inspections of pickled vegetable manufacturers and the strengthening of laboratory surveillance of relevant pathogens.
Invited Original Article
Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire
Martin Eichner, Scott F. Dowell, Nina Firese
Osong Public Health Res Perspect. 2011;2(1):3-7.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.001
  • 2,199 View
  • 14 Download
  • 39 Citations
AbstractAbstract PDF
Objectives
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.
Methods
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.
Results
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.
Conclusion
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.

PHRP : Osong Public Health and Research Perspectives