Epidemiology and Health

COVID-19: Original Article

Clinical symptom profile of hospitalized COVID-19 Brazilian patients according to SARS-CoV-2 variants: Natália Satchiko Hojo-Souza, Vander Luis de Souza Freitas, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza; Epidemiol Health. 2023;45:e2023079. Published online August 28, 2023; DOI: https://doi.org/10.4178/epih.e2023079

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Abstract

OBJECTIVES
The aim of this study was to investigate the prevalence of the main symptoms in Brazilian coronavirus disease 2019 (COVID-19) patients hospitalized during 4 distinct waves, based on their infection with different severe acute respiratory disease coronavirus 2 (SARS-CoV-2) variants.

METHODS

This study included hospitalized patients who tested positive for SARS-CoV-2 during 15 weeks around the peak of each of 4 waves: W1, ancestral strain/B.1 lineage (May 31 to September 12, 2020); W2, Gamma/P.1 variant (January 31 to May 15, 2021); W3, Omicron variant (December 5, 2021 to March 19, 2022); and W4, BA.4/BA.5 subvariants (May 22 to September 3, 2022). Symptom data were extracted from the Brazilian Severe Acute Respiratory Syndrome Database. Relative risks were calculated, and an analysis of symptom networks was performed.

RESULTS

Patients who were hospitalized during the prevalence of the Gamma/P.1 variant demonstrated a higher risk, primarily for symptoms such as fatigue, abdominal pain, low oxygen saturation, and sore throat, than patients hospitalized during the first wave. Conversely, patients who were hospitalized during the predominance of the Omicron variant exhibited a lower relative risk, particularly for symptoms such as loss of smell, loss of taste, diarrhea, fever, respiratory distress, and dyspnea. Similar results were observed in COVID-19 patients who were hospitalized during the wave of the Omicron subvariants BA.4/BA.5. A symptom network analysis, conducted to explore co-occurrence patterns among different variants, revealed significant differential profiles across the 4 waves, with the most notable difference observed between the W2 and W4 networks.

CONCLUSIONS

Overall, the relative risks and patterns of symptom co-occurrence associated with different SARS-CoV-2 variants may reflect disease severity.

Summary

Key Message
The study highlights the varying prevalence and distinct symptom profiles among Brazilian COVID-19 patients hospitalized during different waves linked to specific SARS-CoV-2 variants. It suggests that the manifestation of symptoms differs significantly across variant-driven waves, signifying potential shifts in disease severity. Specifically, patients during the Gamma/P.1 variant wave showed higher risks for symptoms like fatigue, abdominal pain, and respiratory impairment, while those during the Omicron wave exhibited lower risks for certain symptoms like loss of smell and taste, indicating changing symptomatology and potentially evolving disease impact linked to different variants.

Citations

Citations to this article as recorded by

Gastrointestinal symptoms in COVID-19 and disease severity: a Japanese registry-based retrospective cohort study
Yuta Matsubara, Hiroki Kiyohara, Yohei Mikami, Kosaku Nanki, Ho Namkoong, Shotaro Chubachi, Hiromu Tanaka, Shuhei Azekawa, Shinya Sugimoto, Yusuke Yoshimatsu, Tomohisa Sujino, Kaoru Takabayashi, Naoki Hosoe, Toshiro Sato, Makoto Ishii, Naoki Hasegawa, Yuk
Journal of Gastroenterology.2024; 59(3): 195. CrossRef
Prevalence and Factors Associated with Olfactory Dysfunction in Individuals with COVID-19 in Brazil: A Study of 20,669 Cases from 2020 to 2021
Carlos Dornels Freire de Souza, Amanda Júlia de Arruda Magalhães, Yasmin Vitória Silva Nobre, Carlos Alberto Souza, André Luis Oliveira do Nascimento, Luísa Robalinho de Faria, Márcio Bezerra-Santos, Anderson da Costa Armstrong, Jandir Mendonça Nicácio, O
Medical Principles and Practice.2024; : 1. CrossRef
Risks of Adverse Outcomes for Hospitalized COVID-19 Patients during the Four Waves in Brazil According to SARS-CoV-2 Variants, Age Group, and Vaccine Status
Natália Satchiko Hojo-Souza, Waasila Jassat, Daniel Ludovico Guidoni, Fernanda Sumika Hojo de Souza
Viruses.2023; 15(10): 1997. CrossRef

Epidemiologic Investigations

Epidemiological investigation of a food-borne outbreak in a kindergarten, Jeju Province, Korea: Kyoung Mi Kim, Eun Suk Cho, Seong Bae Ahn, Eun Ok Kang, Jong-Myon Bae; Epidemiol Health. 2023;45:e2023047. Published online April 17, 2023; DOI: https://doi.org/10.4178/epih.e2023047

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
On Monday, September 6, 2021, at a kindergarten in Jeju Province, a large number of children vomited and developed food poisoning symptoms, and this necessitated an epidemiological investigation.
METHODS
The team surveyed symptoms and food intake history of kindergarten children, teachers, and workers who ate lunch between September 2 (Thursday) and September 6 (Monday), excluding weekends. In addition to rectal swabs, environmental samples from preserved foods, cooking utensils, drinking water, and refrigerator handles were collected. Pulsed field gel electrophoresis (PFGE) for genetic fingerprint analysis was also performed.
RESULTS
There were 19 cases among 176 subjects, which indicated an attack rate of 10.8%. The epidemic curve showed a unimodal shape, and the average incubation period was 2.6 hours. While no food was statistically significant in food intake history, the analysis of 35 rectal smear samples detected Bacillus cereus in 7 children, 4 teachers, and 1 cooking staff. Enterotoxins were also detected in 12 samples. Out of 38 environmental samples, B. cereus and enterotoxins were detected in the morning snack cereal, lunch bean sprouts, and afternoon snack steamed potatoes on Monday, September 6th. The result of the PFGE test on 10 isolates of B. cereus showed that there was no genetic homology.
CONCLUSIONS
Our results indicated that this outbreak was simultaneously caused by various strains of B. cereus from the environment.; Summary

Korean summary
모 유치원에서 제공한 급식 취식아동에서 발열이 없고 구토형의 주증상인 식중독이 발생되었다. 평균 잠복기 2.6시간 (최소 0.8, 최대 4.5시간)이며, 인체 및 환경 검체에서 바실러스 세레우스 균이 분리되었다. 이에 해당 집단발생은 구토형 바실러스 세레우스 감염증에 의한 식중독을 결론지었다.

Key Message
A large number of children in a kindergarten vomited suddenly. The average incubation period was 2.6 hours (min 0.8, max 4.5 hours) with uni-modal shape in the epidemic curve. Bacillus cereus and entertoxin were detected in rectal smear and environmental samples.

An outbreak of neurologic symptoms among patients exposed to an unknown stench in a high school near an industrial complex: an epidemiological investigation: Kiook Baek, Seongmin Jo, Chulyong Park, Joon Sakong; Epidemiol Health. 2022;44:e2022105. Published online November 9, 2022; DOI: https://doi.org/10.4178/epih.e2022105

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Seven students at a high school in Korea visited the emergency room with non-specific neurological symptoms after a stench was noticed during a school entrance ceremony. In relation to this incident, 105 patients visited medical institutions over 5 days. A team of environmental and epidemiological experts was assembled to investigate the incident.
METHODS
Our team of experts participated in the investigation 1 month post-incident. Previously, only air samples had been analyzed. We received results of air samples analyzed by other investigators, medical records of some students, and data from police interviews of patients. Additional investigation and interviews were conducted, and the events were reconstructed in spatial and temporal order.
RESULTS
A cluster of patients was observed on the south side and parts of the north side of the upper floor. A stench like that reported during the incident had been noticed for about 2 years near the school. Students consistently described a similar stench occurring frequently in the vicinity of the school. According to student statements, the odor mainly resembled something burning. The carboxyhemoglobin levels of some students were observed to be >1.5%.
CONCLUSIONS
In the investigation, 2 suspected sources were identified: a science room storing chemicals downstairs from the auditorium and various industrial facilities near the school. Combining the scattered evidence, we considered a toxic puff of gas, perhaps from brief incineration or leakage in a specific area, to be the likely cause of the incident. We describe our approach and the limitations encountered during the investigation.; Summary

Korean summary
본 논문은 일개 고등학교에서 원인미상의 악취와 함께 100명 이상의 환자가 발생한 사건에 대한 조사과정을 담은 문헌이다. 본 연구진은 사건 발생 후 약 1달 후에 조사진에 합류하였으며, 발생 당시 환자 분포 점지도 작성, 인근 지역 사업장 및 악취발생 장소 점지도 작성, 사건 전후 시계열적 사건분석, 기상자료, 관계자 인터뷰 자료 분석 등의 역학적 기법을 동원하여 원인을 인근 지역에서 발생한 퍼프 가스의 유입으로 추정하였다. 본 사건의 원인은 결국 미제로 종결되었지만 추후 유사 사례 발생시 본 조사의 방법론을 참고할 수 있을 것이며, 의료진의 조기 개입을 수행하지 못함으로 인한 초기 상세 인터뷰 자료 확보, 생체 시료 수집 등이 이루어지지 못한 본 조사 과정의 한계점을 반면교사로 삼을 수 있을 것이다.

Key Message
This paper presents an investigation of an outbreak of over 100 patients experiencing an unexplained odor in a high school. The research team utilized epidemiological methods, including dot mapping, temporal analysis of events, and interview data analysis. The source of the odor was estimated to be the inflow of puff gas from surrounding areas. Although the toxic puff gas discharge facility was not identified, sharing the experience from this investigation could help with future investigations of similar incidents.

Experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea: Chanhee Kim, Gawon Choi, Shin Young Park, Jieun Kim, Young Joon Park, Kyungnam Kim; Epidemiol Health. 2021;43:e2021083. Published online October 18, 2021; DOI: https://doi.org/10.4178/epih.e2021083

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Abstract Summary PDF

Abstract

OBJECTIVES
Coronavirus disease 2019 (COVID-19) outbreaks in general hospitals are particularly risky because they not only overburden the regional healthcare delivery system, but also increase the possibility of community transmission. This study shares an experience of a COVID-19 outbreak response in a general hospital in Gyeonggi Province, Korea.

METHODS

Since the first COVID-19 confirmed case was recognized in Hospital A on March 29, 2020, the Immediate Response Team of Gyeonggi Province and Korea Disease Control and Prevention Agency devised a plan to conduct an epidemiological investigation and minimize the paralysis of hospital functions. Apart from the epidemiological investigation, a risk assessment of the hospital and management of contacts, including patients and workers, were also undertaken.

RESULTS

In total, 72 confirmed cases were identified, including 26 hospitalized patients, 16 healthcare personnel, 7 visitors, and 22 cases identified externally. The majority of the confirmed cases were exposed in Ward B or were contacts of people exposed in Ward A (58.3% of 72 cases). Among healthcare personnel, caregivers were found to be the most vulnerable to COVID-19 in this outbreak.

CONCLUSIONS

Preparation for all possible situations in medical facilities is important because it is difficult to find alternative resources. The findings of this study provide information on controlling the further transmission of COVID-19 and furnish evidence of the importance of ordinary management skills to be prepared for COVID-19.

Summary

Korean summary
본 연구에서는 2020년 경기도 소재 한 종합병원에서 발생한 코로나19 유행 대응 사례 경험을 공유한다. 병원 외 지역사회 전파 사례를 포함하여 총 72명의 확진자가 이 유행에서 확인되었다. 종합병원은 지역 의료전달체계에서 중요한 역할을 하고 있기 때문에 코로나19로 인해 그 기능이 마비되지 않도록 예방하는 것이 가장 바람직하며, 이를 위해서는 평상 시에 적절한 대비 체계를 갖추어 두어야 한다.

Key Message
This study shares the experience of responding to the COVID-19 outbreak at a general hospital in Gyeonggi-do, 2020. A total of 72 confirmed cases were identified, including cases of community based transmission outside the hospital. Since general hospitals play an important role in the medical delivery system, it is most desirable to prevent the function from being paralyzed by COVID-19 situation, and for this, and appropriate preparedness should be established.

Citations

Citations to this article as recorded by

Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea
Seonhee Ahn, Tae Jong Son, Yoonsuk Jang, Jihyun Choi, Young Joon Park, Jiseon Seong, Hyun Hee Kwon, Muk Ju Kim, Donghyok Kwon
Osong Public Health and Research Perspectives.2023; 14(3): 188. CrossRef
Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
Chul Young Yoon, Junhun Lee, Tae Hoon Kong, Young Joon Seo
Frontiers in Neurology.2023;[Epub] CrossRef

COVID-19 outbreak in a military unit in Korea: Chanhee Kim, Young-Man Kim, Namwoo Heo, Eunjung Park, Sojin Choi, Sehyuk Jang, Nayoung Kim, Donghyok Kwon, Young-Joon Park, Byeongseop Choi, Beomman Ha, Kyounghwa Jung, Changbo Park, Sejin Park, Heeyoung Lee; Epidemiol Health. 2021;43:e2021065. Published online September 8, 2021; DOI: https://doi.org/10.4178/epih.e2021065

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Abstract Summary PDF

Abstract

OBJECTIVES
This study presents the response of a military unit to an outbreak of coronavirus disease 2019 (COVID-19) in Gyeonggi Province. As soon as 2 soldiers were identified as index cases, the infectious disease investigators of the Gyeonggi Provincial Government, Korea Disease Control and Prevention Agency, and the Armed Forces Epidemiologic Investigation Center discussed the investigation and response plan for an imminent massive outbreak.

METHODS

The joint immediate response team (IRT) conducted interviews with confirmed COVID-19 patients, reviewed their medical records, performed contact tracing using global positioning system data, and undertook a field investigation. For risk assessment, the joint IRT visited all 8 sites of the military units and the army chaplain’s church to evaluate the transmission risk at each site. The evaluation items included the size of the site, the use of air conditioning, whether windows were opened, and whether masks were worn. Pooled testing was used for the low-risk population to quickly detect the spread of COVID-19 in the military base.

RESULTS

One day before the symptom onset of the index case, the lecturer and >50% of the attendees were infected with COVID-19 while attending a lecture that lasted 2 hours and 30 minutes. Attendees were not wearing masks and were in a poorly ventilated room.

CONCLUSIONS

Since COVID-19 can be spread before symptom onset, contact tracing must be performed to investigate potential exposures prior to symptom onset and to manage any exposed persons.

Summary

Korean summary
본 연구는 경기도 군부대에서 발생한 코로나19 대응 경험을 공유하는 국내 최초의 연구 결과이다. 본 연구를 통해 정리된 역학조사 과정은 군부대, 기숙사, 교정시설 등 집단 시설의 방역 대책 수립에 도움이 될 것으로 기대한다. 또한, 이번 사례는 집단 감염 발생 시 여러 유관 기관의 협조 체계가 신속한 대응과 추가 전파 예방에 중요하다는 점을 시사한다.

Key Message
This study is the first research in South Korea to share the experience of responding to COVID-19 at the military unit in Gyeonggi-do. The epidemiological investigation process organized through this study is expected to help establish response measures for group facilities such as military units, dormitories, and correctional facilities. In addition, this case suggests that the cooperative system of various related organizations in the event of a mass infection is important for rapid response and prevention of further transmission.

Citations

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Evaluation of diagnostic performance of SARS-CoV-2 infection using digital droplet polymerase chain reaction in individuals with or without COVID-19 symptoms
Yoonjung Kim, Eunyoung Lee, Boyeon Kim, Jinhee Cho, Sook-Won Ryu, Kyung-A Lee
Clinica Chimica Acta.2024; 554: 117759. CrossRef
Trends in Confirmed COVID-19 Cases in the Korean Military Before and After the Emergence of the Omicron Variant
Dong Hoon Shin, Haebong Jang, Sangho Lee, Byung Seop Choi, Donghoon Kim, Hong Sang Oh
Journal of Korean Medical Science.2022;[Epub] CrossRef
Characteristics of COVID-19 outbreaks and risk factors for transmission at an army training center in South Korea from June to August 2021
U Jin Cho, Seongjin Wang, Seonju Yi, Yeon Hwa Choi, Eun-Young Kim, Jin A Kim, Sanghwan Bae, Jungyeon Yu, Jangkyu Choi, Young-Joon Park
Osong Public Health and Research Perspectives.2022; 13(4): 263. CrossRef

COVID-19: Original Article

Epidemiological characteristics of a COVID-19 outbreak caused by religious activities in Daegu, Korea: Jong-Yeon Kim, Yu-Mi Lee, Hwajin Lee, Jung-Whan Kim, Shin-Woo Kim; Epidemiol Health. 2021;43:e2021024. Published online April 14, 2021; DOI: https://doi.org/10.4178/epih.e2021024

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. This outbreak spread rapidly to the community through high-risk groups. This study describes the characteristics of COVID-19 cases based on S religious group membership and summarizes the Daegu municipal government’s processes and responses to control the outbreak.

METHODS

The epidemiological characteristics of confirmed cases were obtained through basic and in-depth epidemiological surveys. General characteristics, the proportion of asymptomatic cases, the case-fatality rate, and the time-to-event within each group were presented after stratifying confirmed cases according to S religious group membership.

RESULTS

Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and 61.5% (n= 4,309) were S religious group members. Compared with non-members, members had a higher proportion of female (p< 0.001) and younger age (p< 0.001), as well as lower disease prevalence. At the time of the investigation, 38.4% of cases in members were asymptomatic versus 23.7% of cases in non-members (p< 0.001). The case-fatality rate of non-members aged ≥ 60 years was significantly higher than that of members (p< 0.001). Compared with non-members, members had longer intervals from symptom onset to diagnosis (p< 0.001) and from diagnosis to admission (p< 0.001), and a shorter interval from admission to discharge (p< 0.001).

CONCLUSIONS

The epidemiological features of S religious group members, including the proportion of asymptomatic cases, case-fatality rate, and time-to-event, differed from non-members. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.

Summary

Korean summary
2020년 2월 대구에서는 종교활동에 의한 코로나바이러스감염증-19(COVID-19) 유행이 발생하였다. 2020년 2월 18일부터 6월 30일까지 대구에서 7,008명이 확진되었으며, 이 중 약 61.5%가 S 종교집단의 신도였다. 비신도인 확진자에 비하여 S 종교집단의 신도인 확진자는 높은 여성 비율, 낮은 연령, 낮은 기저질환 유병률, 높은 무증상 감염율, 동일 연령대에 비하여 낮은 치명률을 보였다. 대구시 보건당국은 S 종교집단의 모든 회원에 대한 즉각적인 격리와 적극적인 선별검사를 통해 지역사회 내 더욱 광범위한 COVID-19 확산을 막을 수 있었다.

Key Message
A coronavirus disease 2019 (COVID-19) outbreak triggered by religious activities occurred in Daegu, Korea in February 2020. Overall, 7,008 COVID-19 cases were confirmed in Daegu from February 18, 2020 to June 30, 2020, and approximately 61.5% were S religious group members. Compared with non-members, members had a higher proportion of women, younger age, and lower disease prevalence, higher proportion of asymptomatic cases and lower case-fatality rate within the same age group. The Daegu authorities prevented further COVID-19 spread through immediate isolation and active screening tests of all S religious group members.

Citations

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Achieving COVID-19 zero without lockdown, January 2020 to March 2022: The Taiwan model explained
Yi-Hsuan Chen, Chi-Tai Fang
Journal of the Formosan Medical Association.2024; 123: S8. CrossRef
Estimation of the Effectiveness of a Tighter, Reinforced Quarantine for the Coronavirus Disease 2019 (COVID-19) Outbreak: Analysis of the Third Wave in South Korea
Marn Joon Park, Ji Ho Choi, Jae Hoon Cho
Journal of Personalized Medicine.2023; 13(3): 402. CrossRef
COVID-19 outbreak in a religious village community in Republic of Korea and risk factors for transmission
Jiae Shim, Eunju Lee, Eunyoung Kim, Yeonhwa Choi, Giseok Kang, Bryan Inho Kim
Osong Public Health and Research Perspectives.2023; 14(2): 110. CrossRef
Factors Related to the Transmission of COVID-19 within Households from Pediatric Initial Cases
Da Hye Lee, Jong Yeon Kim, Youn Joo Kim, Seung Soo Lee, Won Kee Lee
Journal of Health Informatics and Statistics.2023; 48(3): 203. CrossRef
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 and Research Perspectives.2022; 13(2): 162. CrossRef
Preventive Measures Against COVID-19 in Small- and Mid-sized Enterprises from an Early Stage of the Epidemic in Daegu and Gyeongsangbuk-do
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Safety and Health at Work.2022; 13(3): 294. CrossRef
An Experience of the Early Stage of COVID-19 Outbreak in Nursing Homes in Gyeonggi Province, Korea
Gawon Choi, Na-young Kim, Seon-young Lee, Hae Deun Noh, Heeyoung Lee
Korean Journal of Clinical Geriatrics.2022; 23(1): 27. CrossRef
Evaluation of a Follow-Up Health Consultation Program for Patients with Coronavirus Disease 2019 in Korea: Using the Context–Input–Process–Product Model
Keun-Mi Lee, Hae-Jin Ko, Geon Ho Lee, Yun-A Kim, Seung-Pil Jung, A-Sol Kim
International Journal of Environmental Research and Public Health.2022; 19(13): 7996. CrossRef
Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu, Korea During the First Half of 2020
Hwajin Lee, Keon-Yeop Kim, Jong-Yeon Kim, Sin Kam, Kyeong Soo Lee, Jung Jeung Lee, Nam Soo Hong, Tae-Yoon Hwang
Journal of Preventive Medicine and Public Health.2022; 55(4): 360. CrossRef
COVID-19 Outbreak in Daegu City, Korea and Response to COVID-19: How Have We Dealt and What Are the Lessons?
Shin-Woo Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef

Original Article

Ebola virus disease outbreak in Korea: use of a mathematical model and stochastic simulation to estimate risk: Youngsuk Ko, Seok-Min Lee, Soyoung Kim, Moran Ki, Eunok Jung; Epidemiol Health. 2019;41:e2019048. Published online November 24, 2019; DOI: https://doi.org/10.4178/epih.e2019048

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
According to the World Health Organization, there have been frequent reports of Ebola virus disease (EVD) since the 2014 EVD pandemic in West Africa. We aim to estimate the outbreak scale when an EVD infected person arrives in Korea.

METHODS

Western Africa EVD epidemic mathematical model SEIJR or SEIJQR was modified to create a Korean EVD outbreak model. The expected number of EVD patients and outbreak duration were calculated by stochastic simulation under the scenarios of Best case, Diagnosis delay, and Case missing.

RESULTS

The 2,000 trials of stochastic simulation for each scenario demonstrated the following results: The possible median number of patients is 2 and the estimated maximum number is 11 when the government intervention is proceeded immediately right after the first EVD case is confirmed. With a 6-day delay in diagnosis of the first case, the median number of patients becomes 7, and the maximum, 20. If the first case is missed and the government intervention is not activated until 2 cases of secondary infection occur, the median number of patients is estimated at 15, and the maximum, at 35.

CONCLUSIONS

Timely and rigorous diagnosis is important to reduce the spreading scale of infection when a new communicable disease is inflowed into Korea. Moreover, it is imperative to strengthen the local surveillance system and diagnostic protocols to avoid missing cases of secondary infection.

Summary

Korean summary
본 연구는 수학적 모델과 확률 시뮬레이션 기법을 이용하여 국내에 유입되지 않았던 에볼라바이러스병(EVD)의 확산 위험도를 정량적으로 예측하는 첫 번째 연구이다. 또한 이 연구를 통해 에볼라바이러스병 환자의 유입 시 발생 가능한 진단 지연 혹은 유입 미인지 상황을 가정하여 발생할 수 있는 2차 감염자 수 및 감염 종식까지의 기간을 계산했고 에볼라바이러스 유입 대비 실시간모니터링의 중요성과 확산 시 상황에 따른 최대 일일 환자수를 합리적으로 제시할 수 있다.

Citations

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Estimating the Transmission Risk of COVID-19 in Nigeria: A Mathematical Modelling Approach
Irany FA, Akwafuo SE, Abah T, Mikler AR
Journal of Health Care and Research.2020; 1(3): 135. CrossRef

Epidemiologic Investigation

Epidemiologic research on lung damage caused by humidifier disinfectants: Moo-Song Lee, Hwa Jung Kim; Epidemiol Health. 2016;38:e2016031. Published online July 20, 2016; DOI: https://doi.org/10.4178/epih.e2016031

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Abstract Summary PDF Supplementary Material

Abstract

In April 2011 a tertiary hospital located in Seoul, Korea reported several cases of severe respiratory distress of unknown origin in young adults. To find the route of transmission, causative agent and patient risk factors of the outbreak, an investigation of the epidemic was initiated. A hospital based case-control study was conducted to indicate that humidifier detergent use was the cause of the outbreak. This information led the Ministry of Health and Welfare of Korea issued an order that humidifier detergents should be withdrawn from the market. Here, we describe the major events of planning, execution, and interpretation of the study, and discussions between researchers and public authorities following the decision to perform an epidemiologic study, chronologically.

Summary

Korean summary
본 역학조사는 일개 병원에서 신고한 질병 유행에 대해 다학제적 연구 결과로써, 질병의 임상적 특성과 역학적 원인 파악 후 정책적 대책으로 이어진 사례이다. 향후 가습기 살균제 이외에도 일반국민의 건강에 영향을 미칠 수 있는 다양한 생활환경요인에 관심을 가지고, 필요 시 적극적인 조사와 대응이 필요할 것이다.

Citations

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Evaluation of polyhexamethylene guanidine-induced lung injuries by chest CT, pathologic examination, and RNA sequencing in a rat model
Cherry Kim, Sang Hoon Jeong, Jaeyoung Kim, Ki Yeol Lee, Jaehyung Cha, Chang Hyun Lee, Eun-Kee Park, Ju-Han Lee
Scientific Reports.2021;[Epub] CrossRef
Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury
Soyeoun Lim, Jong Han Leem, Young-Seoub Hong, Jungwon Kim, Soyoung Park, Joon-Sung Joh, Woon-Jung Kwon, Yangho Kim
Journal of Korean Medical Science.2020;[Epub] CrossRef
Guanidine-based disinfectants, polyhexamethylene guanidine-phosphate (PHMG-P), polyhexamethylene biguanide (PHMB), and oligo(2-(2-ethoxy)ethoxyethyl guanidinium chloride (PGH) induced epithelial-mesenchymal transition in A549 alveolar epithelial cells
Yong Joo Park, Mi Ho Jeong, In Jae Bang, Ha Ryong Kim, Kyu Hyuck Chung
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Original Article

A cholera outbreak in Alborz Province, Iran: a matched case-control study: Ghobad Moradi, Mohammad Aziz Rasouli, Parvin Mohammadi, Elham Elahi, Hojatollah Barati; Epidemiol Health. 2016;38:e2016018. Published online May 14, 2016; DOI: https://doi.org/10.4178/epih.e2016018

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Abstract

OBJECTIVES
A total of 229 confirmed cholera cases were reported in Alborz Province during an outbreak that lasted from June 2011 to August 2011. This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In other words, the lessons learned from this retrospective study can be utilized to manage future similar outbreaks.

METHODS

An age-matched and sex-matched case-control study was conducted during the outbreak. For each case, two control subjects were selected from the neighborhood. A case of cholera was defined as a bacteriologically confirmed case with signs and symptoms of cholera. This study was conducted from June 14, 2011 through August 23, 2011. The data were analyzed by calculating odds ratios (ORs) using the logistic regression method.

RESULTS

In this outbreak, 229 confirmed cholera cases were diagnosed. The following risk factors were found to be associated with cholera: consumption of unrefrigerated leftover food (OR, 3.05; 95% confidence interval [CI], 1.72 to 5.41), consumption of vegetables and fruits in the previous three days (OR, 2.75; 95% CI, 1.95 to 3.89), and a history of traveling in the previous five days (OR, 5.31; 95% CI, 2.21 to 9.72).

CONCLUSIONS

Consumption of vegetables and fruits has remained an unresolved risk factor in cholera outbreaks in Iran in recent years. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Summary

Citations

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Cholera outbreak at a city hotel in Kenya, 2017: a retrospective cohort study
Philip Ngere, Elvis Oyugi, Alexis Niyomwungere, Scolastica Wabwire, Adi Dahabo, Daniel Langat, Raphael Muli, Maurice Owiny
Journal of Interventional Epidemiology and Public Health.2022;[Epub] CrossRef
Cholera outbreak investigation report in Mille woreda, Afar region, Ethiopia, 2019
Hana Mekonen, Kefyalew Amene, Dr Samrawit Bisrat, Tesfahun Abye
MOJ Women s Health.2022; 11(2): 63. CrossRef
Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader
JMIR Public Health and Surveillance.2021; 7(7): e27627. CrossRef
Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines
Lauren D’Mello-Guyett, Karin Gallandat, Rafael Van den Bergh, Dawn Taylor, Gregory Bulit, Dominique Legros, Peter Maes, Francesco Checchi, Oliver Cumming, Andrew S. Azman
PLOS ONE.2020; 15(1): e0226549. CrossRef
Risk factors associated with the recent cholera outbreak in Yemen: a case-control study
Fekri Dureab, Albrecht Jahn, Johannes Krisam, Asma Dureab, Omer Zain, Sameh Al-Awlaqi, Olaf Müller
Epidemiology and Health.2019; 41: e2019015. CrossRef
Individual and household exposures associated with cholera transmission in case–control studies: a systematic review
Matthew D. Phelps, Lone Simonsen, Peter K. M. Jensen
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Govha Emmanuel, Paul Musarurwa, Christine Gabaza, Taurai Masango, Shambira Gerald, Gombe Tafara Notion, Juru Tsitsi Patience, Tshimanga Mufuta
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Francisca B.M. Sousa, Luan K.M. Souza, Nayara A. Sousa, Thiago S.L. Araújo, Simone de Araújo, Dvison M. Pacífico, Irismara S. Silva, Renan O. Silva, Lucas A.D. Nicolau, Fabiana M. Souza, Marcelo C. Filgueiras, Jefferson S. Oliveira, Marcellus H.L.P. Souza
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Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-analysis
Aaron Richterman, Duarxy Rodcnel Sainvilien, Lauren Eberly, Louise C Ivers
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Vaccine.2017; 35(43): 5819. CrossRef

MERS-Epidemiologic Investigation

Epidemiological investigation of the 119th confirmed Middle East Respiratory Syndrome coronavirus case with an indefinite mode of transmission during the Pyeongtaek outbreak in Korea: Jong Hyuk Choi, Byoungin Yoo, Soon Young Lee, Eun Gyu Lee, Moran Ki, Woncheol Lee, Jong Rak Jung, Kyujin Chang; Epidemiol Health. 2015;37:e2015054. Published online December 10, 2015; DOI: https://doi.org/10.4178/epih/e2015054

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Abstract

Since the first case was diagnosed on May 20, 2015, there were 186 confirmed cases of Middle East Respiratory Syndrome (MERS) until the end of outbreak in South Korea. Although medical institutions were the most identifiable sources of MERS transmission in South Korea, similar to other countries, in-depth epidemiological investigation was required for some confirmed cases with indefinite contact history or hospital visit records. The subject of epidemiological investigation in the present study was a 35 year-old male patient diagnosed with MERS (#119) who lived in Asan-city and worked in Pyeongtaek-city. Various potential sources of transmission were carefully investigated. While he could have been exposed to MERS through a friend from Saudi Arabia or confirmed MERS cases in his workplace, neighboring areas, and medical institutions, as well as contacts in his home, the chances of transmission were low; however, the potential for transmission through his local community could not be excluded. Practically, it was difficult to determine the modes of transmission for all outbreak cases in communicable disease that occurred in this short period of time. The investigation to identify the mode of transmission in this case was ultimately unsuccessful. However, the various data collected and analyzed to reveal modes of transmission provided detailed information that could not be collected using only interview surveys.

Summary

Korean summary
2015년 한국에서 유행한 메르스 환자들 중, 감염 경로가 불분명한 119번째 환자에 대한 심층 역학조사를 통해 다양한 감염경로의 가능성을 검토하였다. 감염경로를 명확하게 밝혀내지 못한 한계점이 있지만, 지역사회 전파에 대한 가능성을 제시하였다. 감염병 대유행시 효율적인 감염경로 파악을 위해서는 다방면의 자료에 대한 확보체계와 이를 신속히 분석하고 판단할 수 있는 전문 인력 확충이 필요하다.

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A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences
Rebecca E. Ramshaw, Ian D. Letourneau, Amy Y. Hong, Julia Hon, Julia D. Morgan, Joshua C. P. Osborne, Shreya Shirude, Maria D. Van Kerkhove, Simon I. Hay, David M. Pigott
Scientific Data.2019;[Epub] CrossRef

Case Report

In-Flight Transmission of Novel Influenza A (H1N1): Joon Hyung Kim, Dong-Han Lee, Sang-Sook Shin, Chun Kang, Jin Seok Kim, Byung Yool Jun, Jong-Koo Lee; Epidemiol Health. 2010;32:e2010006. Published online May 31, 2010; DOI: https://doi.org/10.4178/epih/e2010006

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Abstract

<p>The Korea Centers for Disease Control and Prevention confirmed two patients, who had taken the same plane from Los Angeles to Seoul, with novel influenza A (H1N1). Through contact tracing, we concluded that the second patient was infected during the flight.</p>

Summary

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Original Articles

A Epidemic Survey of the Shigellosis in Jeju Island during the First Half of Year 2000.: Jong Myon Bae, Sang Won Lee, Byung Guk Yang, Seong Chul Hong, Geun Ryang Bae, Sung Hack Kang; Korean J Epidemiol. 2001;23(1):80-80.

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Abstract PDF: Abstract
PURPOSE
A field investigation was done to evaluate the level of the epidemic of Shigellosis in Jeju Island during the first half of year 2000.
METHODS
Confirming the Shigellosis was done by the structured questionnaire and the result of rectal swab for the residents having a diarrhea.
RESULTS
As the confirmed patients with Shigella sonnei were 933 from 25 April to 14 August 2000, the crude incidence rate was 174 per 100,000 persons. The highest incidence rate was shown in 5-9 year-old group. Especially the south area of Jeju Island, called as Namjejugun, had the major epidemic occurrence.
CONCLUSIONS
The huge and chronic epidemic of Shigellosis was confirmed. The nature of this epidemic suggested that the endemic occurrence had been existed in Jeju Island.; Summary

An Epidemiologic Investigation of Shigella Sonnei Outbreak at a Primary School in Taegu city.: Byung Yeol Chun, Keon Yeop Kim, Ki Soo Park, Sang Won Lee, Young Joo Hur, Sun Hee Park, Ki Sang Kim, Sang Won Lee, Soon Ja Kim, Young Sook Hong; Korean J Epidemiol. 2000;22(2):101-107.

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Abstract PDF: Abstract
PURPOSE
S: This study was conducted to determine the source of infection and mode of transmission of the shigellosis outbreak on March 27, 1998 at a primary school in Taegu city.
METHODS
On-site interview using a standard questionnaire and rectal swab were conducted to 1,629 peoples who ate lunch on March 26 and 1,389 peoples who contacted with suspected cases. And bacteriological examination for 91 environmental materials and 25 food items were performed.
RESULTS
Of the 1,629 persons who ate lunch on March 26, seventy three had culture-confirmed S. sonnei infection(first attack rate: 4.5%). And additional fifty four had shigellosis among those 1,389 persons who might be exposed to the suspected cases(second attack rate: 3.9%). A total of 730 persons who complained one of four typical symptoms or more were treated as suspected cases(first attack rate of suspected cases: 44.8%). S. sonnei was never isolated from water, foods, and other environmental materials. The median incubation period was estimated about two days. The common symptom reported were diarrhea(88.7%), fever(73.4%), abdominal pain(54.7%), and vomiting episode(38.4%) in order. The shorter duration of the outbreak and the large proportion of cases involving students who ate lunch on March 26 are consistent with fecal-oral transmission, although the limited epidemiologic data obtainable do not clearly define the route of transmission.
CONCLUSIONS
Thus the outbreak reported here appear to be related to the unsanitary conditions of food facility in this school.; Summary

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