Objectives This study investigated a large-scale foodborne outbreak caused by Staphylococcus aureus during a local festival in the Republic of Korea and performed genomic and molecular epidemiological analyses using whole-genome sequencing (WGS).
Methods Microbiological identification was performed using clinical, food, and environmental samples. Molecular characterization included pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, and spa typing. WGS was conducted to evaluate clonal relatedness, virulence factors, and antimicrobial resistance genes.
Results A total of 141 suspected cases and 18 laboratory-confirmed cases were identified, and 24 S. aureus isolates were recovered (18 from patients, 3 from food samples, and 3 from environmental samples). All 17 isolates included in the genomic analysis carried the sea and sec genes and belonged to ST1-t321, with pairwise differences of 8–33 SNPs, supporting a clonal origin. These isolates exhibited a previously unreported PFGE pattern (STAS16.170) in the Republic of Korea. Virulence profiling identified hemolysin genes (hlgA, hlgB, hlgC), leukocidin genes (lukD, lukE), and immune evasion genes (sak, scn). In addition, all isolates were methicillin-susceptible and lacked mecA and mecC.
Conclusion This large-scale foodborne outbreak demonstrated that a single contaminated food source can result in widespread illness during mass gatherings. Genomic analysis clarified the clonal relatedness of the outbreak strains and highlighted the value of genomic surveillance for the early detection and prevention of S. aureus outbreaks.
Objectives Kudoa septempunctata is a marine myxosporean parasite implicated in seafood-borne acute gastroenteritis, predominantly associated with the consumption of raw olive flounder. This study aimed to characterize the molecular and genetic features of K. septempunctata-associated with foodborne outbreaks in the Republic of Korea from 2016 to 2024. Methods: We reviewed 415 suspected foodborne outbreaks reported through national surveillance between 2016 and 2024. Among these, 37 outbreaks with complete clinical, epidemiological, and laboratory data from 2020 to 2024—including K. septempunctata testing and genotyping—were analyzed in detail. Results: Diarrhea (88.8%) and vomiting (61.2%) were the most common symptoms. The detection rate of K. septempunctata was significantly higher in specimens collected ≤24 hours after raw fish consumption (69.8%) than in those collected > 24 hours after consumption (35.9%). Outbreak occurrence was higher during warmer months (May–October) than during other periods, although this difference was not statistically significant. All sequences obtained from patient specimens belonged to sequence type 3 (ST3) of K. septempunctata. Conclusion: Since 2020, the proportion of reported outbreaks associated with Kudoa has increased, indicating its continued public health relevance. The timing of specimen collection is a key determinant of K. septempunctata detection, as diagnostic yield declines significantly when specimens are collected more than 24 hours after exposure. These findings highlight the need for standardized rapid investigation protocols and an integrated surveillance system linking clinical data with seafood supply-chain information.
Objectives This study investigated the correlation between food insecurity and infectious diseases among toddlers in Indonesia.
Methods This research employed a cross-sectional study design using data from the 2021 Indonesian Nutrition Status Survey, which included a sample of 84,115 toddlers. Food insecurity levels were assessed using the food insecurity experience scale, developed by the Food and Agriculture Organization. The dependent variable, infectious disease, was defined as a toddler experiencing 1 or more of the following conditions: acute respiratory infections, diarrhea, pneumonia, measles, or worms. Multivariate analysis was conducted using multiple logistic regression to determine adjusted odds ratios (ORs).
Results The findings indicate that 23.78% of toddlers experienced at least 1 infectious disease. While more than half of the respondents were food secure, 26.5% faced mild food insecurity, 13.6% moderate food insecurity, and 6.5% severe food insecurity. Toddlers from households experiencing mild, moderate, and severe food insecurity had higher risks of infectious diseases compared to those from food-secure households, with adjusted ORs of 1.367 (95% confidence interval [CI], 1.308–1.428), 1.490 (95% CI, 1.399–1.588), and 1.500 (95% CI, 1.374–1.638), respectively.
Conclusion In conclusion, more severe food insecurity is correlated with an increased risk of toddlers suffering infectious diseases.
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Objectives
This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019.
Methods
The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention (KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study.
Results
The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years.
Conclusion
The steady number of patients and decreasing number of cases per outbreak, even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.
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<sec>
<title>Objectives</title>
<p>It was supposed to analyze status and affecting factors in water and food-borne communicable disease by screening entrants with diarrhea symptom at the point of entry in Korea</p></sec>
<sec>
<title>Methods</title>
<p>Symptomatic travelers with water and food-borne communicable diseases who entered Korea were diagnosed by a health declaration and detection of causative agents in water and food using laboratory tests. Among those entered in 2017, the affecting factors in the incidence of communicable diseases among those who had diarrhea at the entry into Korea, were analyzed, with frequency and chi-square test.</p></sec>
<sec>
<title>Results</title>
<p>The number of travel entrants with gastrointestinal communicable diseases increased by 40.19% from 2013 to 2017. The percentage of causative agents of water and food-borne communicable diseases was the highest at 69.2% from July to September. The rate of detection of causative agents of communicable disease pathogens in travelers from Southeast Asia entering Korea was 70.2%, which was higher than people arriving from East Asia and Central Asia (57.5%; <italic>p</italic> < 0.001).</p></sec>
<sec>
<title>Conclusion</title>
<p>The positive ratio of causative agents of water and food-borne communicable diseases was high among travelers that had entered Korea from July to September, with a high number among entrants from Southeast Asia. Based on the positive detection of causative agents, the entry period and countries visited were statistically significant affecting factors (<italic>p</italic> < 0.001).</p></sec>
<sec>
<title>Objectives</title>
<p>Investigations into foodborne illness, potentially caused by <italic>Kudoa septempunctata</italic>, has been ongoing in Korea since 2015. However, epidemiological analysis reporting and positive <italic>K septempunctata</italic> detection in feces in Korea has been limited. The aim of this study was to provide epidemiologic data analysis of possible food poisoning caused by <italic>K septempunctata</italic> in Korea.</p></sec>
<sec>
<title>Methods</title>
<p>This study reviewed 16 <italic>Kudoa</italic> outbreak investigation reports, including suspected cases between 2015 and 2016 in Gyeonggi province, Korea. Suspected <italic>Kudoa</italic> foodborne illness outbreak was defined as “evidence of <italic>K septempunctata</italic> in at least one sample.” The time and place of outbreak, patient symptoms and <italic>Kudoa</italic> (+) detection rate in feces was analyzed.</p></sec>
<sec>
<title>Results</title>
<p><italic>Kudoa</italic> foodborne illness outbreaks occurred in most patients in August (22.6%) and in most outbreaks in April (25%). The attack rate was 53.9% and the average attack rate in patients who had consumed olive flounder was 64.7%. The average incubation period was 4.3 hours per outbreak. Diarrhea was the most common symptom which was reported by 91.5% patients. The <italic>Kudoa</italic> (+) detection rate in feces was 69.2% of cases.</p></sec>
<sec>
<title>Conclusion</title>
<p>Monthly distribution of <italic>Kudoa</italic> foodborne illness was different from previous studies. The <italic>Kudoa</italic> (+) detection rate in feces decreased rapidly between 25.5 and 28.5 hours of the time interval from food intake to epidemiologic survey. To identify effective period of time of investigation, we believe additional study with extended number of cases is necessary.</p></sec>
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<sec><title>Objectives</title><p>The objective of this review is to propose an appropriate course of action for improving the guidelines followed by food handlers for control of infection. For this purpose, previous epidemiological reports related to acute gastroenteritis in food service businesses mediated by food handlers were intensively analyzed.</p></sec><sec><title>Methods</title><p>Relevant studies were identified in international databases. We selected eligible papers reporting foodborne infectious disease outbreaks. Among primary literature collection, the abstract of each article was investigated to find cases that absolutely identified a causative factor to be food handlers’ inappropriate infection control and the taxon of causative microbial agents by epidemiological methodologies. Information about the sites (type of food business) where the outbreaks occurred was investigated.</p></sec><sec><title>Results</title><p>A wide variety of causative microbial agents has been investigated, using several epidemiological methods. These agents have shown diverse propagation pathways based on their own molecular pathogenesis, physiology, taxonomy, and etiology.</p></sec><sec><title>Conclusion</title><p>Depending on etiology, transmission, propagation, and microbiological traits, we can predict the transmission characteristics of pathogens in food preparation areas. The infected food workers have a somewhat different ecological place in infection epidemiology as compared to the general population. However, the current Korean Food Safety Act cannot propose detailed guidelines. Therefore, different methodologies have to be made available to prevent further infections.</p></sec>
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Objectives
The purpose of this study was to develop an educational model regarding food safety and nutrition. In particular, we aimed to develop educational materials, such as middle- and high-school textbooks, a teacher’s guidebook, and school posters, by applying social cognitive theory. Methods
To develop a food safety and nutrition education program, we took into account diverse factors influencing an individual’s behavior, such as personal, behavioral, and environmental factors, based on social cognitive theory. We also conducted a pilot study of the educational materials targeting middle-school students (<i>n</i> = 26), high-school students (<i>n</i> = 24), and dietitians (<i>n</i> = 13) regarding comprehension level, content, design, and quality by employing the 5-point Likert scale in May 2016. Results
The food safety and nutrition education program covered six themes: (1) caffeine; (2) food additives; (3) foodborne illness; (4) nutrition and meal planning; (5) obesity and eating disorders; and (6) nutrition labeling. Each class activity was created to improve self-efficacy by setting one’s own goal and to increase self-control by monitoring one’s dietary intake. We also considered environmental factors by creating school posters and leaflets to educate teachers and parents. The overall evaluation score for the textbook was 4.0 points among middle- and high-school students, and 4.5 points among dietitians. Conclusion
This study provides a useful program model that could serve as a guide to develop educational materials for nutrition-related subjects in the curriculum. This program model was created to increase awareness of nutrition problems and self-efficacy. This program also helped to improve nutrition management skills and to promote a healthy eating environment in middle- and high-school students.
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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
The present study investigated associations between income and intake of nutrients and food in adults (n = 11,063) from the fourth Korea National Health and Nutrition Examination Survey 2007–2009. Methods
To examine relationships between individual dietary intake and anthropometric measures and family income, multiple linear regression models were constructed for each outcome variable. All models were adjusted for age, education, energy intake, smoking, body mass index, and physical activity. Results
For men, intakes of protein, calcium, phosphorus, potassium, and vitamin C were lower in low-income compared to high-income groups. For women, intakes of protein and niacin were lower in low-income groups. Lowest income group ate less dairy products in men and less fruits and fishes or shellfishes in women. Conclusion
Low-income groups had severe food insecurity and low diet quality compared to high-income groups. The study results will provide direction for public health efforts regarding dietary intakes according to economic status among Korean men and women.
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Objectives
In Korea, every outbreak of acute gastroenteritis in two or more patients who are epidemiologically related is investigated by local public health centres to determine causative agents and control the outbreak with the support of the Korean Centers for Disease Control and Prevention. The findings and conclusions of each outbreak investigation have been summarized annually since 2007 to make reports and statistics of water- and foodborne disease outbreaks. Methods
All outbreaks reported to Korean Centers for Disease Control and Prevention from 2007 to 2009 were included in the study. We analysed the trends and epidemiologic aspects of outbreaks by month, year, and location. Results
The total number of outbreaks decreased steadily each year for the period the study covered, whereas the number of patients per outbreak continued to increase resulting from a dramatic increase in the number of patients per outbreak in food service establishments. The outbreaks occurred in the period of June to September, when temperature and humidity are relatively high, which accounted for 44.3% of total outbreaks. The monthly number of outbreaks decreased steadily until November after peaking in May 2009. The most common causative agent was norovirus (16.5%) followed by pathogenic <i>Escherichia coli</i>. The rate of causative agent identification was 60.1%, with higher identification rates in larger outbreaks. Conclusions
Although a decreasing trend of outbreaks by year was observed in the study, the food services in schools and companies require more attention to hygiene and sanitation to prevent large outbreaks. The ability to establish the cause of an outbreak should be further improved.
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Global warming has various effects on human health. The main indirect effects are on infectious diseases. Although the effects on infectious diseases will be detected worldwide, the degree and types of the effect are different, depending on the location of the respective countries and socioeconomical situations.Among infectious diseases, water- and foodborne infectious diseases and vector-borne infectious diseases are two main categories that are forecasted to be most affected. The effect on vector-borne infectious diseases such as malaria and dengue fever is mainly because of the expansion of the infested areas of vector mosquitoes and increase in the number and feeding activity of infected mosquitoes. There will be increase in the number of cases with water- and foodborne diarrhoeal diseases.Even with the strongest mitigation procedures, global warming cannot be avoided for decades. Therefore, implementation of adaptation measures to the effect of global warming is the most practical action we can take. It is generally accepted that the impacts of global warming on infectious diseases have not been apparent at this point yet in East Asia. However, these impacts will appear in one form or another if global warming continues to progress in future. Further research on the impacts of global warming on infectious diseases and on future prospects should be conducted.
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