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Salmonellosis outbreaks linked to eggs at 2 gimbap restaurants in Korea
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Jun Suk Eun, Joohyun Han, Ji-Hyun Lim, Eunkyung Shin, Junyoung Kim, Da-Jung Ko, Jaeil Yoo, Sungil Kim, Jin Sook Kim, Jung Sub Park, Ji-Hyuk Park
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Epidemiol Health. 2024;46:e2024036. Published online March 7, 2024
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DOI: https://doi.org/10.4178/epih.e2024036
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Abstract
OBJECTIVES
Salmonellosis outbreaks occurred at 2 restaurants 2 days apart, and an epidemiological investigation was conducted to determine whether the outbreaks were connected.
METHODS Case studies were conducted for both outbreaks. Stool samples were collected from individuals, and food samples were collected from the restaurants. Pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing analyses were performed on outbreak-related <i>Salmonella enterica</i> serovar Enteritidis (<i>Salmonella Enteritidis</i>) isolates. Traceback investigations were also conducted for the ingredients from gimbap restaurants A and B.
RESULTS In total, 106 people from gimbap restaurant A and 5 from gimbap restaurant B met the case definition. Salmonella Enteritidis was detected in samples from 2 food handlers, 22 patients, and 1 food (iceberg lettuce) at gimbap restaurant A and from 1 patient at gimbap restaurant B. According to PFGE, all isolates were identified as SEGX01.089. The molecular typing of all isolates showed the same pattern, and the genetic distance was close according to phylogenetic analysis. Eggs were the only food ingredient that was supplied to both gimbap restaurants.
CONCLUSIONS The outbreaks were caused by <i>Salmonella</i> Enteritidis, and the source of infections was suspected to be contaminated eggs. To prevent foodborne outbreaks of <i>Salmonella</i>, restaurants should heat eggs sufficiently, and egg farms need to establish management systems that prevent <i>Salmonella</i> infections.
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Summary
Korean summary
동일한 도시의 두 식당에서 2일 간격으로 살모넬라감염증 유행이 발생하여, 원인을 확인하고 두 유행 간에 연관이 있는지를 규명하기 위해 역학조사를 시행하였다. 병원체에 대한 유전자형 분석과 식재료 역추적조사 결과를 바탕으로 두 유행은 Salmonella Enteritidis에 의해 발생하였고, 감염원은 동일한 농장에서 공급된 오염된 계란으로 추적하였다.
Key Message
Salmonellosis outbreaks occurred at 2 restaurants in the same city 2 days apart, and epidemiological investigations were conducted to identify the causes and determine whether the outbreaks were connected. Based on the genetic characterization of the pathogens and traceback investigation of the food ingredients, the outbreaks were caused by Salmonella Enteritidis and the source of infection was traced to contaminated eggs, which were supplied from the same farm.
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Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in Korea
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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
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Epidemiol Health. 2023;45:e2023040. Published online March 23, 2023
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DOI: https://doi.org/10.4178/epih.e2023040
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Abstract
Summary
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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.
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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.
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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 - Genomic Analysis of Monkeypox Virus During the 2023 Epidemic in Korea
Chi-Hwan Choi, Minji Lee, Sang Eun Lee, Jin-Won Kim, Hwachul Shin, Myung-Min Choi, Hwajung Yi, Min-Kyung Kim, Jaehyun Jeon, Jun-Sun Park, Yeonjae Kim, So Yun Lim, BumSik Chin, Yoon-Seok Chung
Journal of Korean Medical Science.2024;[Epub] 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
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