Hazlienor Mohd Hatta, Kamarul Imran Musa, Suhaily Mohd Hairon, Nik Mohd Hafiz Mohd Fuzi, Normaizura Mokhter, Norfaizah Sulaiman, Amutha Ayasamy, Rohani Ismail, Rohaidah Hashim, Jason Wei Jian Ng
Received March 25, 2026 Accepted August 9, 2026 Published online October 13, 2026
Objectives Nontyphoidal Salmonella (NTS) is a major cause of foodborne illness in Malaysia. Time-series modeling can characterize temporal patterns, although structural disruptions, nonlinear dynamics, and regional variability may affect model performance. This study aimed to characterize NTS seasonality in Malaysia, assess temporal stability, and explore model-based approaches for surveillance.
Methods Monthly laboratory-confirmed human NTS cases from national laboratory surveillance databases for 2018–2024 were analyzed using time-series models, including autoregressive integrated moving-average (ARIMA) models with Fourier terms and an exploratory hybrid ARIMA–long short-term memory (LSTM) model. Interrupted time-series analysis was used to assess structural stability. Anomalies were identified using 95% prediction intervals, and stratified modeling assessed regional heterogeneity.
Results NTS cases showed recurring annual seasonal patterns of moderate strength, with temporal variation over the study period. A significant decline occurred in March 2020 (β=−62.24 cases, p=0.001), followed by gradual recovery (β=2.71 cases/month, p<0.001), suggesting a marked coronavirus disease 2019 pandemic-related disruption and a subsequent positive post-intervention trend. The ARIMA(0,1,1)–Fourier (K=1) model outperformed conventional ARIMA, benchmark, and exponential smoothing models (root mean squared error, 42.9 vs. 51.37–108.79). The hybrid ARIMA–LSTM model provided modest additional improvement, particularly during high-case periods. Model-based anomaly detection identified deviations from expected patterns that coincided with documented outbreak-associated months. Regional heterogeneity in temporal dynamics suggested the need for surveillance strategies tailored to local epidemiological patterns.
Conclusion Parsimonious models captured most temporal patterns in NTS cases, with only modest gains from more complex approaches. Context-specific modeling strategies, model-based anomaly detection, and tiered surveillance frameworks may support more proactive NTS surveillance in Malaysia.
Objectives This study assessed the economic value of 2 major initiatives within the national infectious disease response system of the Korea Disease Control and Prevention Agency (KDCA): the Training Programs for Public Health Workforce (TPPHW) and the Infectious Disease Information System (IDIS). Methods: We developed a structured estimation model to quantify the economic benefits of pandemic preparedness investments and applied it to the KDCA’s TPPHW and IDIS. The model incorporated parameters elicited from 29 senior officials into a cost-benefit analysis (CBA) framework, from which we calculated the net present value (NPV) and benefit-cost ratio (BCR) over a 10-year period, with sensitivity analyses. Results: Both initiatives yielded positive net benefits under baseline assumptions, although the margin was substantially greater for workforce training than for the information system. At the assumed discount rate of 4.5%, the CBA yielded a BCR of 2.120 and an NPV of 27.2 billion Korean won (KRW) for TPPHW. For IDIS, the corresponding values were a BCR of 1.071 and an NPV of 2.7 billion KRW. Sensitivity analysis showed that workforce training remained economically justified across all scenarios, whereas the information system remained viable only under more favorable assumptions. Conclusion: This study contributes to the literature by systematically applying CBA to infectious disease preparedness in the Republic of Korea. The findings support continued investment in skilled workforce training and integrated information infrastructure for future pandemic preparedness. The study is limited by its reliance on expert-elicited parameters and its focus on monetary benefits, excluding health outcomes such as disability-adjusted life years and quality-of-life improvements.
Objectives This study examined the social and behavioral factors influencing community leaders’ participation in community-based surveillance (CBS) of infectious diseases. We hypothesized that knowledge, attitudes, and perceptions significantly predict the behavioral likelihood of engaging in CBS activities. Methods: A cross-sectional study was conducted among 470 schoolteachers in Kelantan, Malaysia, from March to June 2024. Participants were selected using multistage sampling, with random selection of schools followed by convenience sampling of teachers. Data were collected using the validated KAP-CBS-ID questionnaire, which was based on the Theory of Reasoned Action and Health Belief Model. Structural equation modeling was used to analyze relationships among the study variables with the maximum likelihood robust estimator. Results: The final model demonstrated good fit (comparative fit index, 0.921; standardized root mean square residual, 0.071; root mean square error of approximation, 0.040 [90% confidence interval, 0.036–0.044]). Ten significant path relationships were identified, explaining 46.1% of the variance in behavioral likelihood. Knowledge of infectious diseases (β=0.419, p<0.001), subjective norms (β=0.235, p=0.038), and negative attitudes (β=–0.432, p<0.001) significantly influenced intention. Behavioral likelihood was directly predicted by intention (β =0.347, p<0.001), perceived susceptibility (β=0.310, p<0.001), perceived benefits (β=0.198, p=0.001), and perceived barriers (β=–0.132, p=0.008). Self-efficacy showed significant indirect effects through perceived benefits (β=0.785, p<0.001) and perceived susceptibility (β=0.765, p<0.001). Conclusion: Knowledge and psychosocial factors significantly inf luence community engagement in CBS of infectious diseases. Public health interventions should address these interconnected determinants to strengthen early disease detection and reporting systems.
Objectives This study aimed to examine the temporal dynamics of dengue cases in Malaysia from 2022 to 2024 using seasonal-trend decomposition and time-series modeling. Methods: Weekly dengue case counts from the national registry were analyzed across all states using seasonal-trend decomposition using LOESS (STL) to separate trend, seasonal, and irregular components. Autoregressive integrated moving average (ARIMA) and seasonal ARIMA (SARIMA) models were fitted to validate temporal structures, with model selection based on the Akaike information criterion (AIC), corrected AIC, and Bayesian information criterion. Diagnostic checks, including residual analysis and Ljung-Box testing, were performed to ensure model adequacy. Results: Dengue incidence showed marked heterogeneity across states. STL decomposition indicated that long-term trends contributed more strongly to case dynamics than seasonality in most states, although seasonal influences were significant in the states of Kedah and Kelantan. Seasonal peak timing varied between states, highlighting differences in epidemic cycles. ARIMA and SARIMA modeling confirmed that no single temporal structure could adequately represent all states; while some series were well fitted by simple ARIMA models, others required seasonal adjustments. Residual diagnostics demonstrated that the selected models were statistically adequate. Conclusion: Dengue dynamics in Malaysia are shaped by both trend and seasonal components, with considerable variation across states. Combining STL decomposition with ARIMA/SARIMA modeling strengthens the evidence base for state-specific forecasting and proactive vector control. Tailoring surveillance systems and interventions to local temporal patterns
Objectives
This study aimed to validate the psychometric properties of the recently developed knowledge, attitudes, and perceptions questionnaire for community-based surveillance of infectious diseases (KAP-CBS-ID questionnaire), using confirmatory factor analysis (CFA) and item response theory (IRT).
Methods
A cross-sectional study using multistage sampling recruited 470 schoolteachers from Kelantan, Malaysia. The self-administered KAP-CBS-ID questionnaire consists of 3 domains: knowledge (31 items), attitudes (23 items), and perceptions (21-items). Two-parameter logistic (2-PL) IRT analysis and CFA were performed to validate the knowledge section. For attitudes and perceptions sections, CFA proceeded using a 4-factor model to evaluate both model fit and construct validity.
Results
Two-PL IRT analysis of the knowledge section resulted in elimination of 14 items due to inadequate discrimination or difficulty parameters. The 3-factor CFA model demonstrated good fit indices for knowledge (root mean square error of approximation [RMSEA], 0.028; comparative fit index [CFI], 0.945; Tucker-Lewis index [TLI], 0.941) without any modifications. The attitudes section required re-specification, ultimately yielding 21 items across 4 factors with acceptable fit indices (standardized root mean square residual [SRMR], 0.067; RMSEA, 0.055; CFI, 0.937; TLI, 0.927). Similarly, the perceptions section was refined to 17 items across 4 factors, showing good model fit (SRMR, 0.055; RMSEA, 0.059; CFI, 0.962; TLI, 0.954). Factor loadings ranged from 0.33 to 0.98, while Raykov’s rho reliability estimates ranged from 0.71 to 0.93. Factor determinacy exceeded 80% for all factors.
Conclusion
The KAP-CBS-ID is a valid and reliable instrument for assessing community representatives’ knowledge, attitudes, and perceptions regarding community-based surveillance of infectious diseases.
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Objectives The study aimed to analyze the core capacities to implement World Health Organization International Health Regulations (IHR) in 6 countries: Indonesia, Cambodia, Vietnam, the Dominican Republic, Ghana, and the Republic of Korea. Methods: Secondary data from relevant databases and reports, including the electronic State Party Self-Assessment Annual Reporting mechanism and global health security index, were used to assess health security in these countries. Descriptive statistics summarized the basic features of the scores, and a strengths, weaknesses, opportunities, and threats (SWOT) analysis was subsequently performed to identify factors affecting health security scores while highlighting key similarities and differences between countries. Results: Early warning and event management emerged as the primary strength in most countries. Common opportunities included international commitments and immunization programs. In contrast, many countries shared weaknesses related to the policy, legal, and normative frameworks for IHR implementation, as well as challenges in human resources, chemical event management, and radiation emergency preparedness. Recurring threats involved issues such as biosafety, biosecurity, dual-use research and the culture of responsible science, infection control practices, coordination between public health and security authorities, laboratory supply chain vulnerabilities, and communication with healthcare workers during public health emergencies. Conclusion: In order to counter future global health threats, countries should prioritize enhancing surveillance capacity (early warning and event management) as well as the immunization indicator (vaccination rates for human and animal diseases, including the national vaccine delivery system).
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Methods This study assessed acute hepatitis B cases reported to the Korean Disease Control and Prevention Agency’s mandatory surveillance system over a 10-year period (2013–2022). It evaluated 5 factors from the Centers for Disease Control and Prevention’s Updated Guidelines for Evaluating Public Health Surveillance Systems: simplicity, positive predictive value, data quality, timeliness, and usefulness.
Results The nonspecific nature of acute hepatitis B symptoms, along with the complexity of diagnostic criteria, indicated a high potential for misreporting. The surveillance system demonstrated a high positive predictive value (94.4%), with data quality and timeliness also rated high. However, data following the onset of the coronavirus disease 2019 pandemic indicate the need for improvement. Moreover, given the relative importance of specific characteristics of chronic infectious diseases, only limited interventions are implementable through the current surveillance system.
Conclusion The evaluation of the Republic of Korea’s acute hepatitis B surveillance system revealed high positive predictive value, data quality, and timeliness. However, improvements can be made in the misreporting of chronic cases and the system’s usefulness. More accurate reflection of the characteristics of acute hepatitis B cases is essential for better management of viral hepatitis.
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Objectives Limited information is available concerning the epidemiology of stroke and acute myocardial infarction (AMI) in the Republic of Korea. This study aimed to develop a national surveillance system to monitor the incidence of stroke and AMI using national claims data. Methods: We developed and validated identification algorithms for stroke and AMI using claims data. This validation involved a 2-stage stratified sampling method with a review of medical records for sampled cases. The weighted positive predictive value (PPV) and negative predictive value (NPV) were calculated based on the sampling structure and the corresponding sampling rates. Incident cases and the incidence rates of stroke and AMI in the Republic of Korea were estimated by applying the algorithms and weighted PPV and NPV to the 2018 National Health Insurance Service claims data. Results: In total, 2,200 cases (1,086 stroke cases and 1,114 AMI cases) were sampled from the 2018 claims database. The sensitivity and specificity of the algorithms were 94.3% and 88.6% for stroke and 97.9% and 90.1% for AMI, respectively. The estimated number of cases, including recurrent events, was 150,837 for stroke and 40,529 for AMI in 2018. The age- and sex-standardized incidence rate for stroke and AMI was 180.2 and 46.1 cases per 100,000 person-years, respectively, in 2018. Conclusion: This study demonstrates the feasibility of developing a national surveillance system based on claims data and identification algorithms for stroke and AMI to monitor their incidence rates.
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Objectives We aimed to describe the epidemiological characteristics of carbapenemase-producing Enterobacteriaceae (CPE) outbreaks in healthcare settings in the Republic of Korea between 2017 and 2022.
Methods Under the national notifiable disease surveillance system, we obtained annual descriptive statistics regarding the isolated species, carbapenemase genotype, healthcare facility type, outbreak location and duration, and number of patients affected and recommended interventions. We used epidemiological investigation reports on CPE outbreaks reported to Korea Disease Control and Prevention Agency from June 2017 to September 2022.
Results Among the 168 reports analyzed, Klebsiella pneumoniae (85.1%) was the most frequently reported species, while K. pneumoniae carbapenemase (KPC, 82.7%) was the most common carbapenemase genotype. Both categories increased from 2017 to 2022 (p<0.01). General hospitals had the highest proportion (54.8%), while tertiary general hospitals demonstrated a decreasing trend (p<0.01). The largest proportion of outbreaks occurred exclusively in intensive care units (ICUs, 44.0%), and the frequency of concurrent outbreaks in ICUs and general wards increased over time (p<0.01). The median outbreak duration rose from 43.5 days before the coronavirus disease 2019 (COVID-19) pandemic (2017–2019) to 79.5 days during the pandemic (2020–2022) (p=0.01), and the median number of patients associated with each outbreak increased from 5.0 to 6.0 (p=0.03). Frequently recommended interventions included employee education (38.1%), and 3 or more measures were proposed for 45.2% of outbreaks.
Conclusion In the Republic of Korea, CPE outbreaks have been consistently dominated by K. pneumoniae and KPC. The size of these outbreaks increased during the COVID-19 pandemic. Our findings highlight the need for continuing efforts to control CPE outbreaks using a multimodal approach, while considering their epidemiology.
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Objectives We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated. Results: During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures. Conclusion: Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.
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<sec>
<title>Objectives</title>
<p>Pathogenic <italic>Vibrio</italic> species are widely distributed in warm estuarine and coastal environments, and can infect humans through the consumption of raw or mishandled contaminated seafood and seawater. For this reason, the distribution of these bacteria in South Korea was investigated.</p></sec>
<sec>
<title>Methods</title>
<p>Seawater samples were collected from 145 coastal area points in the aquatic environment in which <italic>Vibrio</italic> species live. Environmental data (i.e., water temperature, salinity, turbidity, and atmospheric temperature) was collected which may help predict the distribution of the species (data not shown). Seawater samples were filtered, and incubated overnight in alkaline peptone water, at 37°C. Using species-specific polymerase chain reaction methods, screening tests were performed for the <italic>hlyA, ctxA, vvhA</italic>, and <italic>tlh</italic> genes. Clones of pathogenic <italic>Vibrio</italic> species were isolated using 3 selective plating media.</p></sec>
<sec>
<title>Results</title>
<p>In 2017, total seawater isolation rates for <italic>Vibrio vulnificus</italic>, <italic>Vibrio cholerae</italic> (non-pathogenic, non-O1, non-O139 serogroups), and <italic>Vibrio parahaemolyticus</italic> were 15.82%, 13.18%, 65.80%, respectively. However, in 2018 isolation rates for each were 21.81%, 19.40%, and 70.05%, respectively.</p></sec>
<sec>
<title>Conclusion</title>
<p>The isolation rates of pathogenic <italic>Vibrio</italic> species positively correlated with the temperature of seawater and atmosphere, but negatively correlated with salinity and turbidity. From 2017 to 2018, the most frequent seawater-isolated <italic>Vibrio</italic> species were <italic>V. parahaemolyticus</italic> (68.10 %), <italic>V. vulnificus</italic> (16.54%), and non-toxigenic <italic>V. cholerae</italic> (19.58%). Comprehensive monitoring, prevention, and control efforts are needed to protect the public from pathogenic <italic>Vibrio</italic> species.</p></sec>
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<p>Since 2011, the Republic of Korea (ROK) and United States (U.S.) have been collaborating to conduct inter- and intra-governmental exercises to jointly respond to biological events in Korea. These exercises highlight U.S. interest in increasing its global biosurveillance capability and the ROK’s interest in improving cooperation among ministries to respond to crises. With Able Response (AR) exercises, the ROK and U.S. have improved coordination among US and ROK government and defense agencies responding to potential bio-threats and identified additional areas on which to apply refinements in policies and practices. In 2014, the AR exercise employed a Biosurveillance Portal (BSP) to facilitate more effective communication among participating agencies and countries including Australia. In the present paper, we seek to provide a comprehensive assessment of the AR 2014 (AR14) exercise and make recommendations for future improvements. Incorporating a more realistic response in future scenarios by integrating a tactical response episode in the exercise is recommended.</p>
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Objectives
Completeness and timeliness are key attributes of accurate disease surveillance. This study aimed to evaluate the completeness and timeliness of tuberculosis (TB) notification in the Republic of Korea, by comparing notification data from the Korean National Tuberculosis Surveillance System and reimbursement data from the National Health Insurance. Methods
We evaluated reimbursement data from 103,075 cases (2012–2014) and surveillance data from 215,055 cases (2011–2015); cases were matched using Resident Registration Numbers. Completeness was evaluated using notifications that were reported within 365 days of the corresponding insurance claim. Timeliness was evaluated using the delay between starting TB treatment and the corresponding notification. Multivariate logistic regression analysis was used to analyze factors that affected completeness (e.g., sex, age, institution type, and nationality). Results
The completeness values were 90.0% in 2012 (33,094/36,775), 93.0% in 2013 (31,445/33,803), and 94.0% in 2014 (30,537/32,497). The rates of notification within 7 days of the corresponding claim were 81.6% in 2012 (27,323/33,489), 79.8% in 2013 (25,469/31,905), and 80.4% in 2014 (24,891/30,978). Increases over time were observed in the sex-, age-, institution type-, and nationality-specific analyses. Multivariate analyses revealed that completeness was affected by institution type [hospitals: odds ratio (OR) = 1.82, <i>p</i> < 0.001; general hospitals: OR = 4.18, <i>p</i> < 0.001] and nationality (native Korean status: OR = 1.48, <i>p</i> < 0.001). Conclusion
Notification completeness exhibited a 4.0% increase during 2012–2014 in Korea, and institution type and nationality significantly affected the completeness of TB notifications.
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Objectives
The aim of this study was to characterize the pathogens responsible for causing diarrhea according to season, region of isolation, patient age, and sex as well as to provide useful data for the prevention of diarrheal disease. Methods
Stool specimens from 14,886 patients with diarrhea were collected to identify pathogenic bacteria from January 2014 to December 2014 in Korea. A total of 3,526 pathogenic bacteria were isolated and analyzed according to season, region of isolation, and the age and sex of the patient. Results
The breakdown of the isolated pathogenic bacteria were as follows: <i>Salmonella</i> spp. 476 (13.5%), pathogenic <i>Escherichia coli</i> 777 (22.0%), <i>Vibrio parahaemolyticus</i> 26 (0.74%), <i>Shigella</i> spp. 13 (0.37%), <i>Campylobacter</i> spp. 215 (6.10%), <i>Clostridium perfringens</i> 508 (14.4%), <i>Staphylococcus aureus</i> 1,144 (32.4%), <i>Bacillus cereus</i> 356 (10.1%), <i>Listeria monocytogenes</i> 1 (0.03%), and <i>Yersinia enterocolitica</i> 10 (0.3%). The isolation rate trend showed the highest ratio in the summer season from June to September for most of the pathogenic bacteria except the Gram-positive bacteria. The isolation rate of most of the pathogenic bacteria by patient age showed highest ratio in the 0–19 year age range. For isolation rate by region, 56.2% were isolated from cities and 43.8% were isolated from provinces. Conclusion
Hygiene education should be addressed for diarrheal disease-susceptible groups, such as those younger than 10 years, aged 10–19 years, and older than 70 years, and monitoring for the pathogens is still required. In addition, an efficient laboratory surveillance system for infection control should be continued.
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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 <i>Escherichia coli</i> other than enterohemorrhagic <i>E. coli</i> (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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Objectives
To study the significance of entomological surveillance, the house index (HI), container index (CI), and Breteau index (BI) were determined to estimate the degree of a major dengue outbreak in Tirunelveli, Tamil Nadu, India (Latitude: 8°42′N; Longitude: 77°42′E) in May 2012. Methods
The HI, CI, and BI were determined in a primary health center (PHC) in the village of Maruthamputhur (Pappakudi taluk, Tirunelveli) by carrying out an antilarval (AL) work that involved door-to-door search for immature stages of <i>Aedes</i> spp. mosquitoes by trained field workers and volunteers. The work of field workers was evaluated by a junior and senior entomologist the following day. Results
Before the AL work, the reported numbers of fever cases from Week 1 to 5 in Maruthamputhur were 211, 394, 244, 222, and 144 with two deaths. By contrast, after the AL work, these numbers were considerably reduced and there was no fever-related death (the HI was reduced from 48.2% to 1.6%, the CI from 28.6% to 0.4%, and the BI from 48.2 to 1.6). Conclusion
Because no specific medicine and vaccines are available to treat dengue fever and dengue hemorrhagic fever, entomological surveillance and its significance can be used to halt the outbreak of dengue as shown in this study.
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Prion diseases, also called transmissible spongiform encephalopathies (TSEs), lead to neurological dysfunction in animals and are fatal. Infectious prion proteins are causative agents of many mammalian TSEs, including scrapie (in sheep), chronic wasting disease (in deer and elk), bovine spongiform encephalopathy (BSE; in cattle), and Creutzfeldt–Jakob disease (CJD; in humans). BSE, better known as mad cow disease, is among the many recently discovered zoonotic diseases. BSE cases were first reported in the United Kingdom in 1986. Variant CJD (vCJD) is a disease that was first detected in 1996, which affects humans and is linked to the BSE epidemic in cattle. vCJD is presumed to be caused by consumption of contaminated meat and other food products derived from affected cattle. The BSE epidemic peaked in 1992 and decreased thereafter; this decline is continuing sharply owing to intensive surveillance and screening programs in the Western world. However, there are still new outbreaks and/or progression of prion diseases, including atypical BSE, and iatrogenic CJD and vCJD via organ transplantation and blood transfusion. This paper summarizes studies on prions, particularly on prion molecular mechanisms, BSE, vCJD, and diagnostic procedures. Risk perception and communication policies of the European Union for the prevention of prion diseases are also addressed to provide recommendations for appropriate government policies in Korea.
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Objectives
Nosocomial outbreaks involve only a small number of cases and limited baseline data. The present study proposes a method to detect the nosocomial outbreaks caused by rare pathogens, exploiting score prediction interval of a Poisson distribution. Methods
The proposed method was applied to three empirical datasets of nosocomial outbreaks in Japan: outbreaks of (1) multidrug-resistant <i>Acinetobacter baumannii</i> (<i>n</i> = 46) from 2009 to 2010, (2) multidrug-resistant <i>Pseudomonas aerginosa</i> (<i>n</i> = 18) from 2009 to 2010, and (3) <i>Serratia marcescens</i> (<i>n</i> = 226) from 1999 to 2000. Results
The proposed method successfully detected all three outbreaks during the first 2 months. Both the model-based and empirically derived threshold values indicated that the nosocomial outbreak of rare infectious disease may be declared upon diagnosis of index case(s), although the sensitivity and specificity were highly variable. Conclusion
The findings support the practical notion that, upon diagnosis of index patient(s), one should immediately start the outbreak investigation of nosocomial outbreak caused by a rare pathogen. The proposed score prediction interval can permit easy computation of outbreak threshold in hospital settings among healthcare experts.
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Objective
Prediction of influenza incidence among outpatients from an influenza surveillance system is important for public influenza strategy. Methods
We developed two influenza prediction models through influenza surveillance data of the Korea Centers for Disease Control and Prevention (each year, each province and metropolitan city; total reported patients with influenza-like illness stratified by age) for 6 years from 2005 to 2010 and disease-specific data (influenza code J09-J11, monthly number of influenza patients, total number of outpatients and hospital visits) from the Health Insurance Review and Assessment service. Results
Incidence of influenza in each area, year, and month was estimated from our prediction models, which were validated by simulation processes. For example, in November 2009, Seoul and Joenbuk, the final number of influenza patients calculated by prediction models A and B underestimated actual reported cases by 64 and 833 patients, respectively, in Seoul and 6 and 9 patients, respectively, in Joenbuk. R-square demonstrated that prediction model A was more suitable than model B for estimating the number of influenza patients. Conclusion
Our prediction models from the influenza surveillance system could estimate the nationwide incidence of influenza. This prediction will provide important basic data for national quarantine activities and distributing medical resources in future pandemics.
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Objectives
The aim of this study was to review the epidemiologic data of rubella and congenital rubella syndrome (CRS) supplied by surveillance systems from 2001 to 2009 and to propose measures to improve the quality of the surveillance system in the Republic of Korea. Methods
The epidemiological data for rubella and CRS cases reported to the Korea Centers for Disease Control and Prevention from 2001 to 2009 were retrospectively reviewed, and insurance reimbursement data from the Korea National Health Insurance Review Agency were collected for comparison. Results
The number of yearly reported rubella cases to the Korea Centers for Disease Control and Prevention from 2001 to 2009 was 128, 24, 8, 24, 15, 12, 35, 30, and 36, respectively. The occurrence of rubella shifted to a slightly higher age group during the 9-year period, i.e. from 0–9 years to 10–19 years. Among the 309 reported rubella cases, three were confirmed cases of CRS. In addition, according to data sourced from Health Insurance Review Agency, 24, 19, 19, 9, and 5 CRS cases were reported for medical insurance reimbursement from 2005 to 2009, respectively. Conclusion
According to available surveillance data, the reported cases of rubella and CRS were not high, but a more detailed surveillance with emphasis on susceptible women of childbearing age is necessary for better monitoring and control of rubella and CRS in the Republic of Korea.
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