Epidemiology and Health

Original Article

Asymptomatic Middle East Respiratory Syndrome coronavirus infection using a serologic survey in Korea: Yeong-jun Song, Jeong-Sun Yang, Hee Jung Yoon, Hae-Sung Nam, Soon Young Lee, Hae-Kwan Cheong, Woo-Jung Park, Sung Han Park, Bo Youl Choi, Sung Soon Kim, Moran Ki; Epidemiol Health. 2018;40:e2018014. Published online April 15, 2018; DOI: https://doi.org/10.4178/epih.e2018014

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Abstract

OBJECTIVES
The rates of asymptomatic infection with Middle East Respiratory Syndrome (MERS) coronavirus vary. A serologic study was conducted to determine the asymptomatic MERS infection rate in healthcare workers and non-healthcare workers by exposure status.

METHODS

Study participants were selected from contacts of MERS patients based on a priority system in 4 regions strongly affected by the 2015 MERS outbreak. A sero-epidemiological survey was performed in 1,610 contacts (average duration from exposure to test, 4.8 months), and the collected sera were tested using an enzyme-linked immunespecific assay (ELISA), immunofluorescence assay (IFA), and plaque reduction neutralization antibody test (PRNT). Among the 1,610 contacts, there were 7 ELISA-positive cases, of which 1 exhibited positive IFA and PRNT results.

RESULTS

The asymptomatic infection rate was 0.060% (95% confidence interval, 0.002 to 0.346). The asymptomatic MERS case was a patient who had been hospitalized with patient zero on the same floor of the hospital at the same time. The case was quarantined at home for 2 weeks after discharge, and had underlying diseases, including hypertension, angina, and degenerative arthritis.

CONCLUSIONS

The asymptomatic infection was acquired via healthcare-associated transmission. Thus, it is necessary to extend serologic studies to include inpatient contacts who have no symptoms.

Summary

Korean summary
2015년 국내 MERS 유행시에 자가격리를 시행하였던 접촉자 약 15,000명 (의료인과 비의료인 포함) 중에서 주요 유행지역, 노출 강도 등을 고려하여 선별된 3,291명을 대상으로 무증상 감염여부를 확인하기 위한 혈청 역학조사를 수행하였다. 최종 검사에 참여한 1,610명 중에서 7명이 ELISA 양성 반응을 보였고, 그 중 1명이 IFA와 PRNT에서도 양성 반응을 보여 무증상 감염률은 0.060%(95% CI: 0.002-0.346)로 기존 연구에 비하여 낮았다. 최종 양성을 보인 1명은 노출 당시 1번환자와 가까운 병실에 입원하였던 환자였다.

Citations

Citations to this article as recorded by

MERS-CoV seroconversion amongst Malaysian Hajj pilgrims returning from the Middle East, 2016–2018: results from the MERCURIAL multiyear prospective cohort study
Jefree Johari, Robert D. Hontz, Brian L. Pike, Tupur Husain, Norhayati Rusli, Rozainanee Mohd-Zain, Vunjia Tiong, Hai-Yen Lee, Boon-Teong Teoh, Sing-Sin Sam, Chee-Sieng Khor, Shih-Keng Loong, Juraina Abd-Jamil, Siti-Sarah Nor'e, Hasmawati Yahaya, Naim Che
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Rapid diagnostics of coronavirus disease 2019 in early stages using nanobiosensors: Challenges and opportunities
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Talanta.2021; 223: 121704. CrossRef
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Dong Zhao, Mengmei Wang, Ming Wang, Yang Zhao, Zhishui Zheng, Xiaochen Li, Yunting Zhang, Tao Wang, Shaolin Zeng, Weihua Hu, Wenzhen Yu, Ke Hu
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MERS-Original Article

Mental health status of people isolated due to Middle East Respiratory Syndrome: Hyunsuk Jeong, Hyeon Woo Yim, Yeong-Jun Song, Moran Ki, Jung-Ah Min, Juhee Cho, Jeong-Ho Chae; Epidemiol Health. 2016;38:e2016048. Published online November 5, 2016; DOI: https://doi.org/10.4178/epih.e2016048

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Isolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months.

METHODS

Of 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS.

RESULTS

Of 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss.

CONCLUSIONS

Mental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.

Summary

Korean summary
메르스 환자와의 밀착접촉으로 격리되었던 1,692명을 대상으로 격리 당시와 격리해제 후 4-6개월 시점의 불안증상과 분노감 유병율을 파악하고 격리 해제 후 4-6개월 시점에 불안증상과 분노감 유병과 연관된 격리기간 동안의 위험요인을 알아보고자 하였다. 메르스 격리자에서 격리시점의 불안증상 유병율은 7.6% (95%CI: 6.3-8.9%), 분노감 유병율은 16.6% (95%CI: 14.8-18.4%) 였고, 4-6개월 시점이 불안증상 유병율은 3.0% (95%CI: 2.2-3.9%), 분노감 유병율은 6.4% (95%CI: 5.2-7.6%) 이였다. 성별과 연령을 보정한 후 격리해제 4-6개월 지난 시점에서 불안증상 및 분노감 유병의 위험요인은 격리 당시 메르스 증상이 있었거나 구호품 보급이 충분하지 않았거나, 정신과 질환의 과거력이 있었던 경우, 재정 손실이 있었던 사람이었다.

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