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Kyounghee Park 3 Articles
An outbreak of hepatitis A associated with salted clams in Busan, Korea
Hyunjin Son, Miyoung Lee, Youngduck Eun, Wonseo Park, Kyounghee Park, Sora Kwon, Seungjin Kim, Changhoon Kim
Epidemiol Health. 2022;44:e2022003.   Published online December 29, 2021
DOI: https://doi.org/10.4178/epih.e2022003
  • 6,802 View
  • 511 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Busan. The current study presents the results of an epidemiological investigation and outlines the supplementary measures that would help with hepatitis A control.
METHODS
A cohort study was conducted for all 2,865 customers who visited restaurant A from June to July. Using a standardized questionnaire, participants reported the presence of hepatitis A symptoms and whether they had consumed any of 19 food items. As for participants who had visited public health centers, their specimens were collected.
RESULTS
From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The epidemic curve was unimodal, and the median number of days from the restaurant visit to symptom onset was 31 days. A genotype analysis indicated that 89 of 90 tested patients had hepatitis A virus (HAV) genotype 1A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times (95% confidence interval [CI], 9.22 to 510.87). In an unopened package of salted clams found and secured through traceback investigation, HAV genotype 1A was detected.
CONCLUSIONS
To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams; the food sampling test standards for salted clams should also be expanded. Furthermore, a laboratory surveillance system based on molecular genetics should be established to detect outbreaks earlier.
Summary
Korean summary
2019년 7월, 부산시의 한 식당을 방문한 사람에서 다수의 A형간염 환자가 신고되었다. 2019년 6월 1일부터 7월 28일까지 해당 식당을 방문하여 카드 결제를 한 사람과 동반자 2,865명 전체를 대상으로 코호트 조사를 수행하였다. A형간염에 확진 된 사람은 총 155명으로 발병률은 5.4%였다. 다변량 로지스틱 회귀분석 결과 조개젓 섭취는 A형간염 발병 위험을 68.62배(95% CI, 9.22 to 510.87) 증가시키는 것으로 나타났다. 익히지 않은 조개류를 섭취하지 않도록 더욱 홍보를 강화해야 한다.
Key Message
In July 2019, there were multiple reports on patients with hepatitis A among the visitors of a restaurant in Bu¬san. A cohort study was conducted for all 2,865 customers who visited the restaurant from June to July. From the study cohort, 155 participants (5.4%) had confirmed hepatitis A. The results of a multivariate logistic regression analysis indicated that the ingestion of salted clams increased the risk of hepatitis A by 68.12 times. To prevent people from ingesting uncooked clams, there needs to be more efforts to publicize the dangers of uncooked clams.

Citations

Citations to this article as recorded by  
  • Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model
    Jaehong Jeong, Mijeong Kim, Jungsoon Choi
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Influence of temperature and precipitation on the incidence of hepatitis A in Seoul, Republic of Korea: a time series analysis using distributed lag linear and non-linear model
    Kiook Baek, Jonghyuk Choi, Jong-Tae Park, Kyeongmin Kwak
    International Journal of Biometeorology.2022; 66(9): 1725.     CrossRef
Epidemiological characteristics of and containment measures for COVID-19 in Busan, Korea
Hyunjin Son, Hyojung Lee, Miyoung Lee, Youngduck Eun, Kyounghee Park, Seungjin Kim, Wonseo Park, Sora Kwon, Byoungseon Ahn, Dongkeun Kim, Changhoon Kim
Epidemiol Health. 2020;42:e2020035.   Published online June 1, 2020
DOI: https://doi.org/10.4178/epih.e2020035
  • 13,080 View
  • 510 Download
  • 10 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Objectives
To describe and evaluate epidemiological investigation results and containment measures implemented in Busan, where 108 cases were confirmed with coronavirus disease 2019 (COVID-19) between February 21, 2020 and March 24, 2020.
Methods
Any individual who tested positive for COVID-19 was classified as a confirmed case. Measures were taken to identify the source of infection and trace and quarantine contacts. Serial intervals were estimated and the effective reproduction number was computed.
Results
Of the total 18,303 COVID-19 tests performed between January 16, 2020 and March 24, 2020 in Busan, 108 yielded positive results (positive test rate, 0.6%). All confirmed cases were placed in isolation at hospitals. Of the 108 confirmed cases, 59 (54.6%) were female. The most common age group was 20-29 years with 37 cases (34.3%). Regarding symptoms at the time of diagnosis, cough (n=38, 35.2%) and fever (n=34, 31.5%) were most common; 12 cases (11.1%) were asymptomatic. The source of infection was identified in 99 cases (91.7%). A total of 3,223 contacts were identified and quarantined. Household contacts accounted for 196, and the household secondary attack rate was 8.2% (95% confidence interval [CI], 4.7 to 12.9). The mean serial interval was estimated to be 5.54 days (95% CI, 4.08 to 7.01). After February 26, (Rt) remained below 1 in Busan.
Conclusions
The early containment strategy implemented in Busan shows that control is possible if outbreaks are of limited scope. In preparation for future outbreaks, public health and healthcare systems should be re-examined and put in a ready state.
Summary
Korean summary
2월 21일부터 3월 24일까지 부산시에서 보고된 108명의 코로나바이러스감염증-19 (코로나19) 확진 환자의 역학 조사 결과와 관리 조치를 기술하고 평가하였다. 초기에는 A 교회 클러스터와 다른 지역에서 유입된 사례로 인해 급격한 환자 증가가 있었고 이후 접촉자를 중심으로 2차 유행을 보였다. 2월 26일 이후 부산 지역의 Rt가 1보다 낮은 값을 보여 전파가 통제되고 있음을 알 수 있었다. 부산에서 초기 containment 전략을 시행한 결과 제한된 발생 규모인 경우 통제가 가능하다는 점을 확인하였다. 이후 발생할 유행에 대비해 적극적으로 공중보건 및 보건의료 체계를 정비하고 준비해야 할 것으로 생각된다
Key Message

Citations

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  • Serial Intervals and Case Isolation Delays for Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
    Sheikh Taslim Ali, Amy Yeung, Songwei Shan, Lin Wang, Huizhi Gao, Zhanwei Du, Xiao-Ke Xu, Peng Wu, Eric H Y Lau, Benjamin J Cowling
    Clinical Infectious Diseases.2022; 74(4): 685.     CrossRef
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    Jun Jiao, Leiyu Shi, Yuyao Zhang, Haiqian Chen, Xiaohan Wang, Manfei Yang, Junyan Yang, Meiheng Liu, Gang Sun
    International Journal for Equity in Health.2022;[Epub]     CrossRef
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    Jean-François Jusot
    4open.2022; 5: 16.     CrossRef
  • Subcritical Transmission in the Early Stage of COVID-19 in Korea
    Yong Sul Won, Jong-Hoon Kim, Chi Young Ahn, Hyojung Lee
    International Journal of Environmental Research and Public Health.2021; 18(3): 1265.     CrossRef
  • Constructing and adjusting estimates for household transmission of SARS-CoV-2 from prior studies, widespread-testing and contact-tracing data
    Mihaela Curmei, Andrew Ilyas, Owain Evans, Jacob Steinhardt
    International Journal of Epidemiology.2021; 50(5): 1444.     CrossRef
  • Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis
    Pratha Sah, Meagan C. Fitzpatrick, Charlotte F. Zimmer, Elaheh Abdollahi, Lyndon Juden-Kelly, Seyed M. Moghadas, Burton H. Singer, Alison P. Galvani
    Proceedings of the National Academy of Sciences.2021;[Epub]     CrossRef
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    Kelly Jean Thomas Craig, Rubina Rizvi, Van C Willis, William J Kassler, Gretchen Purcell Jackson
    JMIR Public Health and Surveillance.2021; 7(10): e32468.     CrossRef
  • Characteristics of COVID-19 Cases in Central Java as the 5th Most Populous Province in Indonesia
    Dwi Sutiningsih, Nur Azizah Azzahra, Yulianto Prabowo, Aris Sugiharto, Mufti Agung Wibowo, Istirochah, Endah Sri Lestari, Estri Aurorina, Eka Pratiwi Maharani, T.R. Soeprobowati, B. Warsito, T. Triadi Putranto
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    Stella Talic, Shivangi Shah, Holly Wild, Danijela Gasevic, Ashika Maharaj, Zanfina Ademi, Xue Li, Wei Xu, Ines Mesa-Eguiagaray, Jasmin Rostron, Evropi Theodoratou, Xiaomeng Zhang, Ashmika Motee, Danny Liew, Dragan Ilic
    BMJ.2021; : e068302.     CrossRef
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    Sofia K. Mettler, Jihoo Kim, Marloes H. Maathuis
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Follow-up investigation of asymptomatic COVID-19 cases at diagnosis in Busan, Korea
Miyoung Lee, Youngduck Eun, Kyounghee Park, Jeonghun Heo, Hyunjin Son
Epidemiol Health. 2020;42:e2020046.   Published online June 23, 2020
DOI: https://doi.org/10.4178/epih.e2020046
  • 11,220 View
  • 303 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The objective of the study was to conduct a follow-up investigation of 10 asymptomatic patients at diagnosis among the 98 confirmed coronavirus disease 2019 (COVID-19) cases reported in Busan between February 21, 2020 and March 13, 2020 to determine whether asymptomatic infection and transmission during asymptomatic period are possible.
METHODS
The study analyzed 10 asymptomatic, confirmed COVID-19 cases to determine whether asymptomatic infection is possible. We conducted in-depth interviews with patients and guardians; interviews with primary physicians; review of medical records and drug utilization review (DUR) reports; and base station-based location tracking.
RESULTS
Among the 98, confirmed COVID-19 cases reported in Busan, the study analyzed 10 (10.2%) asymptomatic patients at diagnosis. The results confirmed that two (2.0%) patients reported to be asymptomatic during the initial epidemiological investigation, but turned symptomatic before diagnosis as per the in-depth interview results. Four cases (4.0%) of early detection led to confirmed diagnosis during the incubation period and presentation of symptoms after diagnosis. In addition, the remaining four patients (4.0%), having no subjective symptoms nor specific findings on chest radiography and computed tomography, remained asymptomatic until the isolation order was lifted. With regard to whether transmission during the asymptomatic period is possible, it was found that one out of 23 household contacts of the confirmed patients was identified as an additional confirmed case after coming in close contact with an index patient during the presymptomatic period.
CONCLUSIONS
Among the 98 confirmed cases, asymptomatic infection was confirmed in four cases (4.0%). In addition, there was one additional confirmed case in which the patient was a family member who came in close contact with an index patient during the incubation period, thereby confirming that transmission during the asymptomatic period is possible. The possibility of transmission during the asymptomatic period has been confirmed; therefore, it is necessary to review the measures for expanding contact tracing that is currently being applied starting one day prior to the onset of symptoms.
Summary
Korean summary
본 연구는 부산광역시에서 무증상으로 COVID-19에 진단된 10명의 환자를 추적조사하여 무증상 감염이 가능한가, 무증상기에 전파가 가능한가에 대해 확인하였다. 조사결과 4명(4.0%)의 무증상 감염환자를 확인하였고, 환자의 무증상기에 밀접 접촉한 가족 중 1명의 추가 환자를 확인하여 무증상기 전파가 가능하다는 것을 확인하였다.
Key Message

Citations

Citations to this article as recorded by  
  • Asymptomatic Cases, the Hidden Challenge in Predicting COVID-19 Caseload Increases
    Brett Snider, Bhumi Patel, Edward McBean
    Infectious Disease Reports.2021; 13(2): 340.     CrossRef
  • Efficacy and safety of traditional Chinese medicine combined with routine western medicine for the asymptomatic novel coronavirus disease (COVID–19)
    Jiahao Wang, Xue Zhu, Yuying Sun, Xingcai Zhang, Wei Zhang
    Medicine.2020; 99(35): e21927.     CrossRef

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