MERS-Epidemiologic Investigation
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MERS epidemiological investigation to detect potential mode of transmission in the 178th MERS confirmed case in Pyeongtaek, Korea
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Kyujin Chang, Moran Ki, Eun Gyu Lee, Soon Young Lee, Byoungin Yoo, Jong Hyuk Choi
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Epidemiol Health. 2015;37:e2015036. Published online August 15, 2015
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DOI: https://doi.org/10.4178/epih/e2015036
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Abstract
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Abstract
Most cases of Middle East Respiratory Syndrome (MERS) infection in Korea (outbreak: May 11-July 4, 2015) occurred in hospital settings, with uncertain transmission modes in some cases. We performed an in-depth investigation epidemiological survey on the 178th case to determine the precise mode of transmission. A 29- year-old man living in Pyeongtaek presented on June 16 with a febrile sensation, chills, and myalgia. Upon confirmatory diagnosis on June 23, he was treated in an isolation room and discharged on July 2 after cure. An epidemiological investigation of all possible infection routes indicated two likely modes of transmission: exposure to MERS in Pyeongtaek St. Mary’s Hospital during a visit to his hospitalized father (May 18-29), and infection through frequent contact with his father between the latter’s referral to Pyeongtaek Good Samaritan Bagae Hospital for treatment without confirmatory diagnosis until his death (May 29-June 6). Although lack of clear proof or evidence to the contrary does not allow a definitive conclusion, all other possibilities could be excluded by epidemiological inferences. While it is impossible to trace back the modes of transmission of all cases in a large-scale outbreak, case-by-case tracking and isolation of infected individuals and those in close contact with them is important in preventing the spread. Efforts should be made to establish a methodology for rapid tracking of all possible contacts and elimination-based identification of the precise modes of transmission.
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Summary
Korean summary
이 논문은 2015년 한국에서 새롭게 발생한 감염병인 메르스 유행 중, 감염경로가 불분명하였던 178번째 환자에 대한 심층 역학조사 과정과 결과를 기술한 것이며, 조사를 통해 얻은 교훈을 학계 및 관계자들과 공유하고자 한다. 조사 결과, 다른 사례들과 마찬가지로 병원감염으로 볼 수 있음을 밝힌다.
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Citations
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