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Brief Report
Isolation and identification of monkeypox virus MPXV-ROK-P1-2022 from the first case in the Republic of Korea
Jin-Won Kim, Minji Lee, Hwachul Shin, Chi-Hwan Choi, Myung-Min Choi, Jee Woong Kim, Hwajung Yi, Cheon-Kwon Yoo, Gi-Eun Rhie
Osong Public Health Res Perspect. 2022;13(4):308-311.   Published online August 31, 2022
DOI: https://doi.org/10.24171/j.phrp.2022.0232
  • 549 View
  • 39 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
Monkeypox outbreaks in nonendemic countries have been reported since early May 2022. The first case of monkeypox in the Republic of Korea was confirmed in a patient who traveled to Europe in June 2022, and an attempt was made to isolate and identify the monkeypox virus (MPXV) from the patient’s specimens.
Methods
Clinical specimens from the patient were inoculated in Vero E6 cells. The isolated virus was identified as MPXV by the observation of cytopathic effects on Vero E6 cells, transmission electron microscopy, conventional polymerase chain reaction (PCR), and sequencing of PCR products.
Results
Cytopathic effects were observed in Vero E6 cells that were inoculated with skin lesion swab eluates. After multiple passages from the primary culture, orthopoxvirus morphology was observed using transmission electron microscopy. In addition, both MPXV-specific (F3L and ATI) and orthopoxvirus-specific genes (A39R, B2R, and HA) were confirmed by conventional PCR and Sanger sequencing.
Conclusion
These results indicate the successful isolation and identification of MPXV from the first patient in the Republic of Korea. The isolated virus was named MPXV-ROK-P1-2022.
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
  • 1,328 View
  • 72 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.
Review Article
Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis
Saber Soltani, Milad Zandi, Samireh Faramarzi, Ramin Shahbahrami, Mohebat Vali, Sara Akhavan Rezayat, Reza Pakzad, Pooneh Malekifar, Iraj Pakzad, Neda Jahandoost, Jalal Moludi
Osong Public Health Res Perspect. 2022;13(1):15-23.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0293
  • 5,158 View
  • 82 Download
AbstractAbstract PDFSupplementary Material
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
Original Article
Laboratory investigations of herpes simplex virus-1 and -2 clinical samples in Korea
Eun Ju Oh, Young Sam Yuk, Jae Kyung Kim
Osong Public Health Res Perspect. 2021;12(6):385-389.   Published online December 1, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0146
  • 2,441 View
  • 49 Download
AbstractAbstract PDF
Objectives
Herpes simplex virus (HSV) infections have been reported in 60% to 95% of the adult population worldwide, making them one of the most common infectious conditions globally. HSV-1 and HSV-2 cause severe disease in immunocompromised patients. Therefore, the aim of this study was to provide information that could be used to reduce the incidence of genital herpes caused by HSV-1 and HSV-2.
Methods
From September 2018 to December 2020, 59,381 specimens were collected from outpatients across primary and secondary hospitals in Korea who requested U2Bio (Seoul, Korea) to conduct molecular biological testing of their samples for sexually transmitted infections. In this study, the positivity rates of HSV-1 and HSV-2 were analyzed according to age, sex, and specimen type.
Results
In the age-specific analysis of HSV-1, the highest positivity rate (0.58%) was observed in patients under 19 years of age, whereas the lowest positivity rate (0.08%) was observed in patients aged over 70 years. In the age-specific analysis of HSV-2, the highest positivity rate (2.53%) was likewise observed in patients under 19 years of age.
Conclusion
Our study identified differences in the infection rates of HSV-1 and HSV-2 depending on patients’ sex and age. These differences will be useful for improving disease prevention and control measures for HSV-1 and HSV-2.
Review Articles
The role of lipids in the pathophysiology of coronavirus infections
Milad Zandi, Parastoo Hosseini, Saber Soltani, Azadeh Rasooli, Mona Moghadami, Sepideh Nasimzadeh, Farzane Behnezhad
Osong Public Health Res Perspect. 2021;12(5):278-285.   Published online October 15, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0153
  • 2,787 View
  • 139 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Coronaviruses, which have been known to cause diseases in animals since the 1930s, utilize cellular components during their replication cycle. Lipids play important roles in viral infection, as coronaviruses target cellular lipids and lipid metabolism to modify their host cells to become an optimal environment for viral replication. Therefore, lipids can be considered as potential targets for the development of antiviral agents. This review provides an overview of the roles of cellular lipids in different stages of the life cycle of coronaviruses.
Severe acute respiratory syndrome coronavirus 2 and respiratory syncytial virus coinfection in children
Milad Zandi, Saber Soltani, Mona Fani, Samaneh Abbasi, Saeedeh Ebrahimi, Ali Ramezani
Osong Public Health Res Perspect. 2021;12(5):286-292.   Published online October 1, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0140
  • 3,342 View
  • 130 Download
  • 2 Citations
AbstractAbstract PDF
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has infected many people around the world. Children are considered an important target group for SARS-CoV-2, as well as other viral infections such as respiratory syncytial virus infection. Both SARS-CoV-2 and respiratory syncytial virus can affect the respiratory tract. Coinfection of SARS-CoV-2 and respiratory syncytial virus can pose significant challenges in terms of diagnosis and treatment in children. This review compares the symptoms, diagnostic methods, and treatment of COVID-19 and respiratory syncytial virus infection in children.
Brief Report
The laboratory test procedure to confirm rotavirus vaccine infection in severe complex immunodeficiency patients
Su-Jin Chae, Seung-Rye Cho, Wooyoung Choi, Myung-Guk Han, Deog-Yong Lee
Osong Public Health Res Perspect. 2021;12(4):269-273.   Published online August 13, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0079
  • 2,272 View
  • 63 Download
AbstractAbstract PDF
The rotavirus vaccine is a live vaccine, and there is a possibility of infection by the virus strain used in the vaccine. We investigated the process of determining whether an infection was caused by the vaccine strain in a severe complex immunodeficiency (SCID) patient with rotavirus infection. The patient was vaccinated with RotaTeq prior to being diagnosed with SCID. The testing process was conducted in the following order: confirming rotavirus infection, determining its genotype, and confirming the vaccine strain. Rotavirus infection was confirmed through enzyme immunoassay and VP6 gene detection. G1 and P[8] were identified by multiplex polymerase chain reaction for the genotype, and G3 was further identified using a single primer. By detecting the fingerprint gene (WC3) of RotaTeq, it was confirmed that the detected virus was the vaccine strain. Genotypes G1 and P[8] were identified, and the infection was suspected of having been caused by rotavirus G1P[8]. G1P[8] is the most commonly detected genotype worldwide and is not included in the recombinant strains used in vaccines. Therefore, the infection was confirmed to have been caused by the vaccine strain by analyzing the genetic relationship between VP4 and VP7. Rotavirus infection by the vaccine strain can be identified through genotyping and fingerprint gene detection. However, genetic linkage analysis will also help to identify vaccine strains.
Review Article
Scrutiny of COVID-19 response strategies among severely affected European nations
Shine Stephen, Alwin Issac, Rakesh Vadakkethil Radhakrishnan, Jaison Jacob, VR Vijay, Sam Jose, SM Azhar, Anoop S. Nair, Nadiya Krishnan, Rakesh Sharma, Manju Dhandapani
Osong Public Health Res Perspect. 2021;12(4):203-214.   Published online July 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0068
  • 6,943 View
  • 112 Download
  • 3 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Although the health care systems in Europe are considered the global benchmark, European nations were severely affected by the coronavirus disease 2019 (COVID-19) pandemic. This manuscript aimed to examine the strategies implemented to combat the COVID-19 pandemic by France, the United Kingdom, Spain, Italy, Germany, and Russia and their outcomes in terms of the number of cases, testing, and deaths. This is the first review of its kind that extensively analyzes the preparedness, mitigation, and response strategies against the COVID-19 pandemic adopted by these nations. This paper further suggests a strategic preparedness model for future pandemics. From the analysis, we found that a decentralized approach, prompt decision-making and timely execution, coordination between local health authorities, and public participation in the implementation of strategies could substantially reduce the case fatality rate. Nations with a high percentage of gross domestic product invested in the health sector, as well as more nurses, physicians, hospital beds, intensive care unit beds, and ventilators, better managed the pandemic. Instead, nations that postponed their pandemic response by delaying tracking, tracing, testing, quarantine, and lockdown were badly affected. The lessons learned from the present pandemic could be used as a guide to prepare for further pandemics.
Original Articles
Global variation of COVID-19 mortality rates in the initial phase
Saman Hasan Siddiqui, Azza Sarfraz, Arjumand Rizvi, Fariha Shaheen, Mohammad Tahir Yousafzai, Syed Asad Ali
Osong Public Health Res Perspect. 2021;12(2):64-72.   Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.03
  • 3,425 View
  • 137 Download
  • 5 Citations
AbstractAbstract PDFSupplementary Material
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused devastation in over 200 countries. Italy, Spain, and the United States (US) were most severely affected by the first wave of the pandemic. The reasons why some countries were more strongly affected than others remain unknown. We identified the most-affected and less-affected countries and states and explored environmental, host, and infrastructure risk factors that may explain differences in the SARS-CoV-2 mortality burden.
Methods
We identified the top 10 countries/US states with the highest deaths per population until May 2020. For each of these 10 case countries/states, we identified 6 control countries/states with a similar population size and at least 3 times fewer deaths per population. We extracted data for 30 risk factors from publicly available, trusted sources. We compared case and control countries/states using the non-parametric Wilcoxon rank-sum test, and conducted a secondary cluster analysis to explore the relationship between the number of cases per population and the number of deaths per population using a scalable EM (expectation–maximization) clustering algorithm.
Results
Statistically significant differences were found in 16 of 30 investigated risk factors, the most important of which were temperature, neonatal and under-5 mortality rates, the percentage of under-5 deaths due to acute respiratory infections (ARIs) and diarrhea, and tuberculosis incidence (p<0.05)
Conclusion
Countries with a higher burden of baseline pediatric mortality rates, higher pediatric mortality from preventable diseases like diarrhea and ARI, and higher tuberculosis incidence had lower rates of coronavirus disease 2019-associated mortality, supporting the hygiene hypothesis.
A Healthcare-Associated Outbreak of HCV Genotype 2a at a Clinic in Seoul
Siwon Choi, Hyerim Lee, Hyungmin Lee, Yoon-Seok Chung
Osong Public Health Res Perspect. 2021;12(1):3-12.   Published online February 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.1.02
  • 3,508 View
  • 208 Download
AbstractAbstract PDF
Objectives

An epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.

Methods

A retrospective study of the outpatients and health care workers (n = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1st, 2006 and March 25th, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.

Results

The rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (p < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (n = 56) or 2 clusters (n = 25). This result indicated exposure to a high-association infection source.

Conclusion

Anti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.

Brief Reports
Operating a National Hotline in Korea During the COVID-19 Pandemic
Rok Song, Yuh Seog Choi, Jae Young Ko
Osong Public Health Res Perspect. 2020;11(6):380-382.   Published online December 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.6.06
  • 3,644 View
  • 79 Download
  • 3 Citations
AbstractAbstract PDF

The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the up-to-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.

A Public-Private Partnership Model to Build a Triage System in Response to a COVID-19 Outbreak in Hanam City, South Korea
Seong Su Ku, Young June Choe
Osong Public Health Res Perspect. 2020;11(5):339-342.   Published online October 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.5.11
  • 4,015 View
  • 82 Download
  • 3 Citations
AbstractAbstract PDF

A substantial, immediate healthcare burden for screening of Coronavirus disease 2019 (COVID-19) is created when large-scale outbreaks occur. There have been a series of measures to strengthen the screening process through robust public-private partnerships between Hanam City Public Health Center (PHC), the local medical association, and central/provincial government. A partnership between PHC and the local physician’s group in Hanam City established the Respiratory Clinic. The PHC provided the infrastructure for the Respiratory Clinic including medical facilities, supplies (i.e. personal protective equipment), and administrative support. A total of 11 registered physicians from the local physicians group agreed to participate in clinical service provided at the Respiratory Clinic. Any citizens with COVID-19 suspected respiratory symptoms call the COVID-19 hotline and visit the Respiratory Clinic if required. Responding to COVID-19 outbreaks will be a continual process, and the screening system is essential support to public health interventions, and crucial in the response to a surge in COVID-19 cases.

Original Article
COVID-19 in Nursing Facilities: Experience in Republic of Korea
Rok Song, Hee-Sook Kim, Seok-Ju Yoo, Kwan Lee, Ji-Hyuk Park, Joon Ho Jang, Gyoung-Sook Ahn, Jun-Nyun Kim
Osong Public Health Res Perspect. 2020;11(4):164-169.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.04
  • 4,700 View
  • 131 Download
  • 5 Citations
AbstractAbstract PDF
Objectives

Coronavirus disease 2019 (COVID-19) outbreaks in nursing facilities can easily lead to a high rate of infection and fatality. A surge in newly infected cases in the first quarter of 2020 in Gyeongsan-si, in the Republic of Korea, was followed by several outbreaks in nursing facilities in the same area. The aim of this study is to report on the epidemiological investigation and the management to reduce the infection rate in nursing facilities for older adults.

Methods

The municipal government and the Korea Centers for Disease Control and Prevention performed an epidemiological investigation into 5 nursing facilities that reported a high number of COVID-19 infection cases from February to May 2020. COVID-19 infected cases in the facilities were investigated to identify the infection routes, and the fatality rate of the 5 facilities.

Results

The 5 facilities had a combined fatality rate of 12.2% (9 deceased among the 74 infected cases). The median age of the deceased was 87 years old (range: 82–91). The infection was first identified on February 27th, 2020, peaked on March 6th, and was last detected on March 24th, 2020.

Conclusion

Difficulties specific to such facilities included the delay in the recognition of symptoms and limitation in distancing. Tailored strategies such as daily monitoring of symptoms and proactive COVID-19 screening of quarantined residents, contributed to a decline in the infections in the facilities.

Review Article
COVID-19: Weighing the Endeavors of Nations, with Time to Event Analysis
Shine Stephen, Alwin Issac, Jaison Jacob, VR Vijay, Rakesh Vadakkethil Radhakrishnan, Nadiya Krishnan
Osong Public Health Res Perspect. 2020;11(4):149-157.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.02
  • 4,060 View
  • 100 Download
  • 8 Citations
AbstractAbstract PDF

The cataclysmic COVID-19 pandemic erupted silently causing colossal impact worldwide, the repercussions of which indicated a lackadaisical vigilance in preparation for such a pandemic. This review assessed the measures taken by nations to contain this pandemic. A literature review was conducted using Medline, Google Scholar, Science Direct, Scopus, and WHO website. There were 8 nations (selected from the GHS index list) appraised for containment strategies. This was achieved by using mortality rate (per million) as the primary endpoint. The nations which were proactive, initiated scientific strategies earlier with rigor, appeared to have succeeded in containing the pandemic, although it is still too early to arbitrate a verdict. The so called “pandemic war” mandates international, interdisciplinary, and interdepartmental collaboration. Furthermore, building trust and confidence between the government and the public, having transparent communication, information sharing, use of advanced research-technology, and plentiful resources are required in the fight against COVID-19.

Editorial
The Impact of Social Distancing on the Transmission of Influenza Virus, South Korea, 2020
Young June Choe, Jong-Koo Lee
Osong Public Health Res Perspect. 2020;11(3):91-92.   Published online June 1, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.07
  • 5,324 View
  • 244 Download
  • 14 Citations
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PHRP : Osong Public Health and Research Perspectives