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Epidemiologic investigation Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in the Republic of Korea
Taeyoung Kim2orcid , Eonjoo Park2orcid , Juk Suk Eun3orcid , Eun-young Lee3orcid , Ji Won Mun3orcid , Yunsang Choi4orcid , Sinyoung Lee2orcid , Hansol Yeom2orcid , Eunkyoung Kim2orcid , Jongmu Kim2orcid , Jihyun Choi2orcid , Jinho Ha2orcid , Sookkyung Park1orcid
Epidemiol Health 2023;e2023040
DOI: https://doi.org/10.4178/epih.e2023040 [Accepted]
Published online: March 23, 2023
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1Korea Disease Control and Prevention Agency, Cheongju, Korea
2Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul , Korea
3Disease Management Division, Deogyang-gu Public Health Center, Goyang, Korea
4Seoul National University Bundang Hospital, Seongnam, Korea
Corresponding author:  Sookkyung Park,
Email: monica23@korea.kr
Received: 31 January 2023   • Accepted: 10 March 2023
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Abstract

Objectives
As few mpox cases have been reported in the Republic of Korea, we aimed to identify the characteristics of mpox infection by describing our epidemiologic investigation of a female 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 male 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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