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2 "In Hee Kim"
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Epidemiologic investigation
Workplace outbreak of enterotoxigenic Escherichia coli O159 enteritis linked to kimchi consumption in Daejeon, Republic of Korea, 2024
Ji Hae Hwang, Eun Mi Song, Eun Ho Jeong, Joo Yeon Kim, Jin Hee Kim, Hyun Jin Kim, Soyeon Nam, Jiyeon Cheon, Eun kyung Shin, Woo ju Kang, Jun young Kim, Hae-Sung Nam
Epidemiol Health. 2026;e2026031.   Published online June 22, 2026
DOI: https://doi.org/10.4178/epih.e2026031    [Accepted]
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AbstractAbstract
Abstract
OBJECTIVES
In August 2024, a large outbreak of gastrointestinal illness was reported among workers at a workplace in Daejeon, Republic of Korea, where bulk meals were served. This study investigated the epidemiological and microbiological characteristics of the outbreak to identify the causative pathogen, the infection source, and possible contamination routes.
METHODS
A comprehensive epidemiological investigation was conducted, including case identification, retrospective cohort analysis, laboratory confirmation, and pulsed-field gel electrophoresis (PFGE). Attack rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated. Environmental and distribution chain assessments were also performed to trace the sources and transmission pathways.
RESULTS
A total of 75 individuals developed gastrointestinal symptoms, of whom 27 had laboratory-confirmed enterotoxigenic Escherichia coli (ETEC) O159 infection. The mean and median incubation periods were 70.5 and 72.0 hours, respectively. The attack rate was significantly higher among kimchi consumers than among non-consumers (RR, 1.47; 95% CI, 1.08 to 2.00). PFGE identified ETCX01.332 as the predominant pattern among patient and kimchi isolates. Distribution tracing indicated that the implicated kimchi was produced at a factory in Gyeonggi Province and supplied to multiple catering facilities, leading to additional outbreaks in Seoul and Gyeonggi Province. However, the exact contamination point(s) during production or distribution remained undetermined.
CONCLUSIONS
This outbreak was attributed to ETEC O159, with kimchi suspected as the infection source. These findings provide rare evidence implicating non-heated fermented foods in ETEC transmission and highlight the need for strengthened hygiene standards and real-time monitoring throughout the production, distribution, and handling of fermented foods.
Summary
Original Article
Epidemiology and treatment status of hepatitis C virus infection among people who have ever injected drugs in Korea: a prospective multicenter cohort study from 2007 to 2019 in comparison with non-PWID
Kyung-Ah Kim, Gwang Hyun Choi, Eun Sun Jang, Young Seok Kim, Youn Jae Lee, In Hee Kim, Sung Bum Cho, Moran Ki, Hwa Young Choi, Dahye Paik, Sook-Hyang Jeong
Epidemiol Health. 2021;43:e2021077.   Published online October 6, 2021
DOI: https://doi.org/10.4178/epih.e2021077
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  • 279 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Injection drug use is a major risk factor for hepatitis C virus (HCV) infection; however, limited data on this topic are available in Korea. Thus, this study aimed to investigate the epidemiological and clinical characteristics, treatment uptake, and outcomes of HCV infection among people who inject drugs (PWID).
METHODS
We used the data from the Korea HCV cohort, which prospectively enrolled patients with HCV infection between 2007 and 2019. Clinical data and results of a questionnaire survey on lifetime risk factors for HCV infection were analyzed according to a self-reported history of injection drug use (PWID vs. non-PWID group).
RESULTS
Among the 2,468 patients, 166 (6.7%) were in the PWID group, which contained younger patients (50.6±8.2 vs. 58.2±13.1 years) and a higher proportion of male (81.9 vs. 48.8%) than the non-PWID group. The distribution of PWID showed significant regional variations. Exposure to other risk factors for HCV infection was different between the groups. The proportion of patients with genotype non-2 infection was higher in the PWID group. Treatment uptake was higher in the PWID group in the interferon era; however, it was comparable between the groups in the direct-acting antiviral era. The rate of sustained virological response did not significantly differ between the groups.
CONCLUSIONS
As of 2019, PWID constituted a minority of HCV-infected people in Korea. The epidemiological characteristics, but not treatment uptake and outcomes, were different between the PWID and non-PWID groups. Therefore, active HCV screening and treatment should be offered to PWID in Korea.
Summary
Korean summary
1. 국내 C형간염 환자 중 정맥주사 사용자의 비율은 6.7%로 서구에 비하면 낮은 편이며, 지역별로 차이가 있다. 2. C형간염 환자 중 정맥주사 사용자는 비사용자에 비하여 연령, 성별 및 C형간염 위험 요인 노출 등에서 상이한 역학적 특성을 보인다. 3. 정맥주사 사용자의 C형간염 치료 수용률이나 치료 성공률은 비사용자와 비슷하다.
Key Message
As of 2019, PWID comprised a minority (6.7%) of all HCV-infected people in South Korea. The epidemiological features of the PWID group were different from those of the non-PWID group in terms of age, sex and exposure to risk factors of HCV infection. However, the treatment uptake and outcomes were not significantly different between these 2 groups in DAA era. Therefore, considering the global and national increase in the number of PWID and the contribution of PWID to new cases of HCV infection, active screening and treatment should be offered to PWID in Korea.

Citations

Citations to this article as recorded by  
  • 2025 KASL clinical practice guidelines for management of hepatitis C
    Eun Sun Jang, Nae Yun Heo, Jae Yoon Jeong, Jung Gil Park, Do Seon Song, Eun Ju Cho, Chang Hun Lee, Jae Seung Lee, Jae Hyun Yoon, Seul Ki Han, Young Kul Jung
    Clinical and Molecular Hepatology.2026; 32(1): 1.     CrossRef
  • Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
    Hwa Young Choi, Kyung-Ah Kim, Bo Young Park, Bo Youl Choi, Moran Ki
    Journal of Infection and Public Health.2025; 18(3): 102662.     CrossRef
  • Universal self-testing as a cost-effective weapon to eliminate hepatitis C virus in the Republic of Korea: Editorial on “Self-testing strategy to eliminate hepatitis C as per World Health Organization’s goal: Analysis of disease burden and cost-effectiven
    Eun Sun Jang
    Clinical and Molecular Hepatology.2025; 31(2): 596.     CrossRef
  • 한국 마약류 사용자의 C형 간염 현황
    광현 최, 영훈 천, 도훈 권, 성남 조, 옥진 장, 다혜 백, 은선 장, 민경 박, 외욱 정, 민진 고, 정연 김, 숙향 정
    Public Health Weekly Report.2025; 18(33): 1236.     CrossRef
  • Prevalence, Clinical Characteristics, and Treatment Status of Hepatitis C Virus Infection among People Who Use Drugs in South Korea: A Prospective Multicenter Study
    Gwang Hyeon Choi, Young-Hoon Chon, Do Hoon Kwon, Sung Nam Jo, Og-Jin Jang, Kyung-Ah Kim, Dahye Baik, Eun Sun Jang, Sook-Hyang Jeong
    Gut and Liver.2025; 19(5): 725.     CrossRef
  • Prevalence and factors associated with hepatitis C among pregnant women in China: a cross-sectional study
    Sun He, Gao Shuang, Wu Yinglan, Wang Lan, Wang Wei, Wang Ailing, Wang Changhe, Wang Xiaoyan, Gao Qun, Lu Zechun, Huang Dongxu, Wang Yu, Mo Phoenix Kit Han, Chen Zhongdan, Polin Chan, Wang Qian
    Scientific Reports.2023;[Epub]     CrossRef
  • Hepatitis C Virus Seroprevalence in Persons Who Inject Drugs in Korea, 2012–2022: A Multicenter, Retrospective Study
    Jihye Kim, Gwang Hyeon Choi, Og-Jin Jang, Younghoon Chon, Sung Nam Cho, Dohoon Kwon, Sook-Hyang Jeong
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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