Epidemiology and Health

Epidemiologic Investigation

Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in Korea: Taeyoung Kim, Eonjoo Park, Jun Suk Eun, Eun-young Lee, Ji Won Mun, Yunsang Choi, Shinyoung Lee, Hansol Yeom, Eunkyoung Kim, Jongmu Kim, Jihyun Choi, Jinho Ha, Sookkyung Park; Epidemiol Health. 2023;45:e2023040. Published online March 23, 2023; DOI: https://doi.org/10.4178/epih.e2023040

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Abstract

OBJECTIVES
As few mpox cases have been reported in Korea, we aimed to identify the characteristics of mpox infection by describing our epidemiologic investigation of a woman patient (index patient, the third case in Korea) and a physician who was infected by a needlestick injury (the fourth case).

METHODS

We conducted contact tracing and exposure risk evaluation through interviews with these 2 patients and their physicians and contacts, as well as field investigations at each facility visited by the patients during their symptomatic periods. We then classified contacts into 3 levels according to their exposure risk and managed them to minimize further transmission by recommending quarantine and vaccination for post-exposure prophylaxis and monitoring their symptoms.

RESULTS

The index patient had sexual contact with a man foreigner during a trip to Dubai, which was considered the probable route of transmission. In total, 27 healthcare-associated contacts across 7 healthcare facilities and 9 community contacts were identified. These contacts were classified into high (7 contacts), medium (9 contacts), and low (20 contacts) exposure risk groups. One high-risk contact was identified as a secondary patient: a physician who was injured while collecting specimens from the index patient.

CONCLUSIONS

The index patient visited several medical facilities due to progressive symptoms prior to isolation. Although the 2022 mpox epidemic mainly affected young men, especially men who have sex with men, physicians should also consider mpox transmission in the general population for the timely detection of mpox-infected patients.

Summary

Korean summary
국내 엠폭스 3번환자는 전파 가능 시기에 7곳의 의료기관을 방문했으며, 접촉자로 분류된 27명의 의료기관 접촉자와 9명의 지역사회 접촉자 중 주사침 자상을 입은 의료인 1명이 추가 확진되었다. 적시에 엠폭스 환자를 발견하기 위하여 의료인들은 전파위험이 낮은 일반 인구의 감염 가능성에 대한 고려가 필요하다.

Key Message
As a result of contact tracing of a mpox patient in the early phase of epidemic, she visited 7 healthcare facilities to be diagnosed which infers diagnosing those who are statistically not at high risk is challenging. Yet the risk of contracting mpox seems relatively low as only one of 36 contacts was infected; a healthcare personnel who sustained a needlestick injury.

Citations

Citations to this article as recorded by

Clinical Features of Mpox Patients in Korea: A Multicenter Retrospective Study
So Yun Lim, Hyeon Jae Jo, Su-Yeon Lee, Miyoung Ahn, Yeonjae Kim, Jaehyun Jeon, Eu Suk Kim, BumSik Chin, Jae-Phil Choi, Nam Joong Kim
Journal of Korean Medical Science.2024;[Epub] CrossRef
Transmission potential of mpox in mainland China, June-July 2023: estimating reproduction number during the initial phase of the epidemic
Andrei R. Akhmetzhanov, Pei-Hsuan Wu
PeerJ.2024; 12: e16908. CrossRef
Mpox exposure and transmission in healthcare settings during the 2022 global outbreak
Kimon C Zachary, Lisa L Philpotts, Erica S Shenoy
Current Opinion in Infectious Diseases.2023; 36(4): 257. CrossRef

Original Article

Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran: Hamed Akbari, Fakhradin Ghasemi, Hesam Akbari, Amir Adibzadeh; Epidemiol Health. 2018;40:e2018042. Published online August 20, 2018; DOI: https://doi.org/10.4178/epih.e2018042

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21 Web of Science
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Abstract PDF Supplementary Material

Abstract

OBJECTIVES
Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries.

METHODS

This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended.

RESULTS

The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors’ attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed.

CONCLUSIONS

To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.

Summary

Citations

Citations to this article as recorded by

Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross‐sectional survey
Huimin Gao, Mengyuan Liu, Yanan Su, Yinglan Li, Lingyun Tian
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Shift work organization on nurse injuries: A scoping review
Christopher C. Imes, Nicole J. Barthel, Eileen R. Chasens, Jacqueline Dunbar-Jacob, Sandra J. Engberg, Christine A. Feeley, Laura A. Fennimore, Cassandra M. Godzik, Mary Lou Klem, Faith S. Luyster, Dianxu Ren, Lynn Baniak
International Journal of Nursing Studies.2023; 138: 104395. CrossRef
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BMC Health Services Research.2023;[Epub] CrossRef
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Hyeonmi Cho, Knar Sagherian, Linda D. Scott, Linsey M. Steege
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H. Borgheipour, G. M. Tehrani, T. Eskandari, O. C. Mohammadieh, I. Mohammadfam
International Journal of Environmental Science and Technology.2021; 18(11): 3613. CrossRef
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Cochrane Database of Systematic Reviews.2021;[Epub] CrossRef
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I Komang Widarma Atmaja, I Made Ady Wirawan, I Ketut Suarjana
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American Journal of Infection Control.2020; 48(7): 805. CrossRef
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Archives of Trauma Research.2020; 9(2): 47. CrossRef
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International Journal of Industrial Ergonomics.2020; 80: 103058. CrossRef
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