Osong Public Health and Research Perspectives

Original Articles

A Healthcare-Associated Outbreak of HCV Genotype 2a at a Clinic in Seoul: Siwon Choi, Hyerim Lee, Hyungmin Lee, Yoon-Seok Chung; Osong Public Health Res Perspect. 2021;12(1):3-12. Published online February 23, 2021; DOI: https://doi.org/10.24171/j.phrp.2021.12.1.02

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Abstract PDF: Objectives
An epidemiological investigation was conducted into a hepatitis C virus (HCV) outbreak at an outpatients clinic in Seoul (2011–2012). The aim of the study was to analyze the scale of infection, identify the source of infection, and route of transmission to prevent hepatitis C transmission in the future.
Methods
A retrospective study of the outpatients and health care workers (n = 7,285) in the target outpatient clinic during 2011–2012 was conducted. The history of the study population infection with hepatitis C, electronic medical records, field visits, and health care worker interviews were examined for the period between March 1^st, 2006 and March 25^th, 2016. The blood samples were collected and tested for anti-HCV antibodies, HCV RNA and HCV gene in 2016.
Results
The rate of anti-HCV positive results was 4.4% in the study population. The risk factors associated with an anti-HCV positive result were ≥ 10 clinic visits, and receiving an invasive procedure including a nerve block and a block of the peripheral branch of the spinal nerve (p < 0.05). There were 112 HCV RNA positive cases out of 320 anti-HCV positive test result cases, amongst which 100 cases had the dominant HCV genotype 2a which formed either 1 cluster (n = 56) or 2 clusters (n = 25). This result indicated exposure to a high-association infection source.
Conclusion
Anti-HCV antibodies and genotypic analysis showed an epidemiological association between the outbreak of HCV and invasive procedures performed (2011–2012) at an outpatients clinic in Seoul.

A Study on the Relapse Rate of Tuberculosis and Related Factors in Korea Using Nationwide Tuberculosis Notification Data: Hyungmin Lee, Jusang Kim; Osong Public Health Res Perspect. 2014;5(Suppl):S8-S17. Published online December 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.11.001

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Objectives
From the perspective of public health, tuberculosis (TB) remains an important issue that threatens health. Korea is an intermediate burden country with a TB incidence of 97/100,000 individuals. Among many TB control measures, a relapse rate of TB is one indicator that can be used to indirectly assess the level of TB control in countries and in communities. Relapse TB has an approximately 12% yearly incidence in Korea. This study aims to estimate the relapse rate of TB and to investigate the associated factors by using nationwide TB notification data in Korea.
Methods
The nationwide TB notification data in 2005 was used with the exclusion criteria of duplicated reporting, foreign-born patients, outcome–died, and outcome–diagnosis changed. The data were double-checked as to whether they were reported again during 2006–2010 and the estimated relapse rate of TB. Associated factors were analyzed by multivariate logistic regression with the variables of age, sex, registration type, results of sputum smear test, medication, and outcome of treatment.
Results
Among 45,434 TB patients in 2005, 4,371 patients were again reported as TB patients from 2006 to 2010. Five hundred and sixty-four patients were reported more than twice and the cumulative number of relapses was 5,072 cases. The 5-year relapse rate was estimated as 9.62%. The relapse rate decreased yearly: 4.8% in 2006, 2.4% in 2007, 1.6% in 2008, 1.4% in 2009, and 1.0% in 2010. Age, sex, registration type, tuberculosis type, and medication were independently associated with a relapse of TB. In the multivariate logistic regression analysis, the following factors were related: male sex, 40–49 years old; registration type, relapse, treatment after failure, treatment after default, transfer in, and other, the sputum smear-positive pulmonary TB, and medications (including individuals taking 2–5 drugs).
Conclusion
This study has estimated a 5-year relapse rate of TB in Korea that is slightly lower than the rate of relapse TB in the annual reports. This study could be conducted and cross-checked with data from the National Health Insurance in the future.

Citations

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Emerging Pathogens and Vehicles of Food- and Water-borne Disease Outbreaks in Korea, 2007–2012: Shinje Moon, Il-Woong Sohn, Yeongseon Hong, Hyungmin Lee, Ji-Hyuk Park, Geun-Yong Kwon, Sangwon Lee, Seung-Ki Youn; Osong Public Health Res Perspect. 2014;5(1):34-39. Published online February 28, 2014; DOI: https://doi.org/10.1016/j.phrp.2013.12.004

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Abstract PDF

Objectives
Food- and water-borne disease outbreaks (FBDOs) are an important public health problem worldwide. This study investigated the trends in FBDOs in Korea and established emerging causal pathogens and causal vehicles.
Methods
We analyzed FBDOs in Korea by year, location, causal pathogens, and causal vehicles from 2007 to 2012. Information was collected from the FBDOs database in the Korean Centers for Disease Control and Prevention.
Results
During 2007–2012, a total of 1794 FBDOs and 48,897 patients were reported. After 2007, FBDOs and patient numbers steadily decreased over the next 2 years and then plateaued until 2011. However, in 2012, FBDOs increased slightly accompanied by a large increase in the number of affected patients. Our results highlight the emergence of norovirus and pathogenic Escherichia coli other than enterohemorrhagic E. coli (EHEC) in schools in 2012. We found that pickled vegetables is an emerging causal vehicle responsible for this problem.
Conclusion
On the basis of this study we recommend intensified inspections of pickled vegetable manufacturers and the strengthening of laboratory surveillance of relevant pathogens.

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Brief Report

Trends in the Incidence of Scrub Typhus: The Fastest Growing Vector-Borne Disease in Korea: Mi Ae Jeong, Seung-Ki Youn, Young-Kwon Kim, Hyungmin Lee, Sun-Ja Kim, Aeree Sohn; Osong Public Health Res Perspect. 2013;4(3):166-169. Published online June 30, 2013; DOI: https://doi.org/10.1016/j.phrp.2013.04.007

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Abstract PDF

Scrub typhus, also called tsutsugamushi disease, is classified as a Group 3 disease in Korea according to the National Notifiable Diseases Surveillance Systems. It is an infectious disease transmitted to humans through the bite of mites that are infected with an intracellular parasite called Orientia tsutsugamushi (Family: Rickettsiaceae). This study aims to identify the demographic characteristics of the infected cases according to profession, region, gender, and onset period and provide a basic data for prevention and control of the disease in the infected patients. Between 2001 and 2010, 16,741 men (36.3%) and 29,373 women (63.7%) were reported to have been infected with scrub typhus, with men being 1.6 times less infected than women. When classified according to age, it was found that 4421 persons (9.6%) were under 40 years of age; 6601 (13.1%) in their 40s; 9714 (21.1%) in their 50s; 13,067 (28.3%) in 60s; 10,128 (22.0%) in their 70s; and 2723 (5.9%) aged 80 or more. The elderly (60 years or older) represented more than half of the infected cases. When the infections were classified according to region, it was found that the county residents had the major share of infection, with a total of 1583 infected cases (59.85).

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