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Original Article
Outbreak of carbapenem-resistant Enterobacterales at a long-term care facility in Seoul, Korea: surveillance and intervention mitigation strategies
Yoojin Park, Euncheol Son, Young June Choe, Cho Ryok Kang, Sangmi Roh, Young Ok Hwang, Sung-il Cho, Jihwan Bang
Epidemiol Health. 2023;45:e2023057.   Published online June 9, 2023
DOI: https://doi.org/10.4178/epih.e2023057
  • 4,769 View
  • 273 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Because effective decolonization options are not available, and treatment options are limited, carbapenem-resistant Enterobacterales (CRE) constitute increasingly threatening nosocomial pathogens. To prevent CRE-associated transmission and ensure patient safety, healthcare personnel and everyone in contact with CRE-infected patients must implement stringent infection control practices. This report describes a CRE outbreak, possibly related to a caregiver at a long-term care facility (LTCF), and presents a new surveillance model to improve the infection control of CRE in Seoul, Korea.
METHODS
The Seoul Metropolitan Government surveillance system identified an outbreak of CRE in an LTCF in 2022. We obtained data on the demographic characteristics and contact histories of the inpatients, medical staff, and caregivers. To isolate the inpatients and employees exposed to CRE, we used rectal swab samples and environmental sampling during the study period (May-December 2022).
RESULTS
We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE, and conducted a complete 197-day follow-up of all cases in the LTCF’s isolation wards.
CONCLUSIONS
This investigation demonstrated that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.
Summary
Korean summary
서울시 CRE 감시체계를 통해 2022년 한 요양병원의 집단발생을 인지하였다. 현장역학조사를 실시하여 18명의 집단발생 사례(1명 간병인, 17명 입원환자)와 12명의 산발적인 사례를 확인하였고 감염관리 컨설팅을 통해 유행을 확산을 방지하는 중재를 시행하였다.
Key Message
The Seoul Metropolitan Government surveillance system identified an outbreak of carbapenem-resistant Enterobacterales (CRE) in a long-term care facility (LTCF) in 2022. We identified 18 cluster cases (1 caregiver and 17 inpatients) and 12 sporadic cases with CRE. In the current study, we could demonstrate that our surveillance model and targeted intervention, based on the cooperation of the municipal government, public health center, and infection control advisory committee, effectively contained the epidemic at the LTCF. Measures to improve the compliance of all employees in LTCFs with infection control guidelines should also be adopted.

Citations

Citations to this article as recorded by  
  • Role of Probiotics in Preventing Carbapenem-Resistant Enterobacteriaceae Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study
    Jung-Hwan Lee, Jongbeom Shin, Soo-Hyun Park, Boram Cha, Ji-Taek Hong, Don-Haeng Lee, Kye Sook Kwon
    Microorganisms.2023; 11(12): 2970.     CrossRef
Epidemiologic Investigation
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
  • 5,058 View
  • 205 Download
AbstractAbstract AbstractSummary PDFSupplementary 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.
COVID-19: Perspective
Dengue and COVID-19 infections in the ASEAN region: a concurrent outbreak of viral diseases
Lowilius Wiyono, Ian Christoper N. Rocha, Trisha Denise D. Cedeño, Adriana Viola Miranda, Don Eliseo Lucero-Prisno III
Epidemiol Health. 2021;43:e2021070.   Published online September 16, 2021
DOI: https://doi.org/10.4178/epih.e2021070
  • 11,336 View
  • 281 Download
  • 18 Web of Science
  • 19 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Member countries of the Association of Southeast Asian Nations (ASEAN) have faced dengue outbreaks for decades, and the region has one of the highest rates of dengue globally. Outbreaks continue to occur concurrently with the coronavirus disease 2019 (COVID-19) pandemic in the 10 ASEAN countries. Both infectious diseases pose a tremendous burden in these countries related to both infection control and the economy. Increases in the number of dengue cases occurred in part due to disruptions in the pathogen-host-vector relationship caused by changes in human behaviour in response to the COVID-19 pandemic. The spread of dengue was further aggravated by the implementation of lockdowns and social distancing policies. These measures limited the coverage of dengue preventive programs and delayed the medical management of both diseases due to co-infection and misdiagnosis. It is of the utmost importance for the population to remain aware of both diseases, and dengue vector control strategies must be devised to properly address outbreaks using digitalization and remote surveillance. Similarly, critical triage algorithms and further research are also needed to combat co-infection and misdiagnosis. Controlling the spread of COVID-19 though vaccination should also be undertaken to reduce the impact of the pandemic.
Summary
Key Message
The rising dengue infection amidst the COVID-19 pandemic has indicated the need of response to mitigate the dangers of both dengue and COVID-19. Appropriate measurement from all ASEAN countries are needed to lower the number of cases and ease the burden of both dengue and COVID-19 management."

Citations

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  • Dengue Dynamics: A Global Update
    Rabeya Yousuf, Md Wasek Salam, Shaima Akter, Susmita Sinha, Mainul Haque
    Advances in Human Biology.2024; 14(1): 5.     CrossRef
  • Health System Preparedness, Response, and Incidence of Dengue in District Mianwali
    Fatima Naseem, Muhammad Iftikhar Khattak, Faisal Rashid, Samia Nasim, Mustafa Khalid Waheed, Javaria Mustafa
    Pakistan Journal of Health Sciences.2024; : 55.     CrossRef
  • Potential inhibitors isolated from Curcuma aeruginosa against dengue virus type 2 (DENV-2) NS2B-NS3 protease activity
    Siti Sarah Fazalul Rahiman, Mohammad Al-Amin, Noratiqah Mohtar, Iffah Izzati Zakaria, Ummirul Mukminin Kahar, Melati Khairuddean, Salizawati Muhamad Salhimi
    Journal of Biologically Active Products from Nature.2024; 14(1): 64.     CrossRef
  • Proceedings of the 6th Asia Dengue Summit, June 2023
    Nattachai Srisawat, Duane J. Gubler, Tikki Pangestu, Umaporn Limothai, Usa Thisyakorn, Zulkifli Ismail, Daniel Goh, Maria Rosario Capeding, Lulu Bravo, Sutee Yoksan, Terapong Tantawichien, Sri Rezeki Hadinegoro, Kamran Rafiq, Valentina Sanchez Picot, Eng
    PLOS Neglected Tropical Diseases.2024; 18(3): e0012060.     CrossRef
  • Analysis of temperature, humidity, rainfall, and wind velocity on dengue hemorrhagic fever in Bandung municipality
    A. Sutriyawan, N. Kurniati, Novianti Novianti, U. Farida, L. Yusanti, S.N. Destriani, M.K.F. Saputra
    Russian Journal of Infection and Immunity.2024; 14(1): 155.     CrossRef
  • Dengue fever coinfection in COVID‐19 era: A public health concern
    Soumya Jal, Sangeeta Chhotaray, Gurudutta Pattnaik, Snehasish Mishra, Ranjan K. Mohapatra, Venkataramana Kandi, Md. Kudrat‐E‐Zahan
    Health Science Reports.2024;[Epub]     CrossRef
  • Incidence and co-infection with COVID-19 of dengue during the COVID-19 pandemic
    Yuan-Pin Hung, Ching-Chi Lee, Ying-Wen Chen, Jen-Chieh Lee, Chun-Wei Chiu, Po-Ren Hsueh, Wen-Chien Ko
    Journal of the Formosan Medical Association.2024;[Epub]     CrossRef
  • Genomic Characterization of Dengue Virus Outbreak in 2022 from Pakistan
    Massab Umair, Syed Adnan Haider, Zaira Rehman, Zunera Jamal, Qasim Ali, Rabia Hakim, Shaheen Bibi, Aamer Ikram, Muhammad Salman
    Vaccines.2023; 11(1): 163.     CrossRef
  • Rapid Appraisals of the Transformation Strategy Required to Sustain Dengue Vector Control During and After the COVID-19 Pandemic in Indonesia
    Sulistyawati Sulistyawati, Herman Yuliansyah, Tri Wahyuni Sukesi, Arfiani Nur Khusna, Surahma Asti Mulasari, Fatwa Tentama, Bambang Sudarsono, Fanani Arief Ghozali
    Risk Management and Healthcare Policy.2023; Volume 16: 93.     CrossRef
  • Singapore’s Dengue Outbreak Amidst the COVID-19 Pandemic: Challenges, Responses, and Lessons
    Huzaifa Ahmad Cheema, Rustam Shariq Mujtaba, Amna Siddiqui, Laiba Imran Vohra, Abia Shahid, Jaffer Shah, Abdulqadir J Nashwan, Natasha Howard
    Infection and Drug Resistance.2023; Volume 16: 1081.     CrossRef
  • The Diagnostic Potential of RNA Aptamers against the NS1 Protein of Dengue Virus Serotype 2
    Ramesh Thevendran, Sivalingam Rogini, Glenn Leighton, Atherton Mutombwera, Sarah Shigdar, Thean-Hock Tang, Marimuthu Citartan
    Biology.2023; 12(5): 722.     CrossRef
  • Incidence and mortality trends of neglected tropical diseases and malaria in China and ASEAN countries from 1990 to 2019 and its association with the socio-demographic index
    Qiao Liu, Wenxin Yan, Chenyuan Qin, Min Du, Yaping Wang, Min Liu, Jue Liu
    Global Health Research and Policy.2023;[Epub]     CrossRef
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    Vanessa Chong, Jennifer Zi Ling Tan, Valliammai Jayanthi Thirunavuk Arasoo
    Tropical Medicine and Infectious Disease.2023; 8(2): 86.     CrossRef
  • The effects of the COVID-19 pandemic on dengue cases in Malaysia
    Nuur Hafizah Md Iderus, Sarbhan Singh Lakha Singh, Sumarni Mohd Ghazali, Asrul Anuar Zulkifli, Nur Ain Mohd Ghazali, Mei Cheng Lim, Lonny Chen Rong Qi Ahmad, Mohamad Nadzmi Md Nadzri, Cia Vei Tan, Ahmed Syahmi Syafiq Md Zamri, Chee Herng Lai, Nur Shuhada
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • The simultaneous crises of dengue and COVID-19 in Pakistan: a double hazard for the country’s debilitated healthcare system
    Govinda Khatri, Mohammad Mehedi Hasan, Somina Shaikh, Syeda Lamiya Mir, Abdul Moiz Sahito, Priya, Ian Christopher N. Rocha, Osman Kamal Osman Elmahi
    Tropical Medicine and Health.2022;[Epub]     CrossRef
  • Does COVID-19 lockdowns have impacted on global dengue burden? A special focus to India
    Hemlata Sharma, Ashal Ilyas, Abhiroop Chowdhury, Nitesh Kumar Poddar, Anis Ahmad Chaudhary, Sireen Abdul Rahim Shilbayeh, Alnada Abdalla Ibrahim, Shahanavaj Khan
    BMC Public Health.2022;[Epub]     CrossRef
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    Sayambhu Saita, Sasithan Maeakhian, Tassanee Silawan
    Tropical Medicine and Infectious Disease.2022; 7(8): 171.     CrossRef
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    Sazaly AbuBakar, Sharifa Ezat Wan Puteh, Randee Kastner, Louisa Oliver, Shi Hao Lim, Riona Hanley, Elaine Gallagher
    International Journal of Infectious Diseases.2022; 124: 240.     CrossRef
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    Basu Dev Pandey, Mya Myat Ngwe Tun, Kishor Pandey, Shyam Prakash Dumre, Pramananda Bhandari, Uttam Raj Pyakurel, Nayanum Pokhrel, Meghanath Dhimal, Pardip Gyanwali, Richard Culleton, Yuki Takamatsu, Anthony Costello, Kouichi Morita
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COVID-19: Original Article
Estimation of the number of working population at high-risk of COVID-19 infection in Korea
Juyeon Lee, Myounghee Kim
Epidemiol Health. 2020;42:e2020051.   Published online July 9, 2020
DOI: https://doi.org/10.4178/epih.e2020051
  • 15,418 View
  • 414 Download
  • 19 Web of Science
  • 15 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to identify occupational groups at high-risk of coronavirus disease 2019 (COVID-19) infection in Korea, to estimate the number of such workers, and to examine the prevalence of protective resources by employment status.
METHODS
Based on the sixth Standard Occupational Classification codes, 2015 census data were linked with data from the fifth Korean Working Conditions Survey, which measured how frequently workers directly come into contact with people other than fellow employees in the workplace.
RESULTS
A total of 30 occupational groups, including 7 occupations from the healthcare and welfare sectors and 23 from other sectors, were classified as high-risk occupational groups involving frequent contact with people other than fellow employees in the workplace (more than half of the working hours). Approximately 1.4 million (women, 79.1%) and 10.7 million workers (46.3%) are employed in high-risk occupations. Occupations with a larger proportion of women are more likely to be at a high-risk of infection and are paid less. For wage-earners in high-risk occupations, protective resources to deal with COVID-19 (e.g., trade unions and health and safety committees) are less prevalent among temporary or daily workers than among those with permanent employment.
CONCLUSIONS
Given the large number of Koreans employed in high-risk occupations and inequalities within the working population, the workplace needs to be the key locus for governmental actions to control COVID-19, and special consideration for vulnerable workers is warranted.
Summary
Korean summary
코로나바이러스감염증-19 (코로나19) 유행 상황에서 감염 고위험 직업군 종사자는 보건의료복지 업종에서 총 140만 명, 그 외 업종에서 총 1,073만 명으로 추정된다. 고위험 사업장에 대해 정부가 안전보건 관리·감독·규제 및 지원 체계를 수립하고, 방역대책의 중심에 노동자의 안전과 건강 보호를 두는 관점의 전환이 필요하다. 우선 당장 역학조사 과정에서 직업관련 요소를 자세히 확인하고, 직업관련 감염에 대한 모니터링과 그에 걸맞는 대책을 마련해야 한다.

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Case Report
Two cases of cholera O1 in South Batinah, Oman, April 2019: lessons learned
Zayid K. Al Mayahi, Nasser Al-Shaqsi, Hamid A. Elmutashi, Ali Al-Dhoyani, Azza Al Hattali, Khalid Salim, Issa S. Al Fulaiti, Mahmood S. Al Subhi
Epidemiol Health. 2019;41:e2019033.   Published online July 12, 2019
DOI: https://doi.org/10.4178/epih.e2019033
  • 11,870 View
  • 167 Download
  • 1 Crossref
AbstractAbstract PDF
Abstract
Cholera represents an ongoing threat to many low-income and middle-income countries, but some cases of cholera even occur in high-income countries. Therefore, to prevent or combat cholera outbreaks, it is necessary to maintain the capacity to rapidly detect cholera cases, implement infection control measures, and improve general hygiene in terms of the environment, water, and food. The 2 cases, 1 imported and 1 secondary, described herein are broadly indicative of areas that require improvement. These cases were missed at the primary health care stage, which should be the first detection point even for unusual diseases such as cholera, and the absence of strict infection control practices at the primary care level is believed to contribute to secondary cases of infection. This report also encourages countries to ensure that rapid diagnostic stool tests are available to enable quick detection, as well as to provide information to people travelling to areas where cholera is endemic.
Summary

Citations

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Epidemiol Health : Epidemiology and Health