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Original Article
Epidemiological analysis and prevention strategies in response to a shigellosis cluster outbreak: a retrospective case series in an alternative school in the Republic of Korea, 2023
Yeongseo Ahn, Sunmi Jin, Gemma Park, Hye Young Lee, Hyungyong Lee, Eunkyung Shin, Junyoung Kim, Jaeil Yoo, Yuna Kim
Osong Public Health Res Perspect. 2024;15(1):68-76.   Published online February 7, 2024
DOI: https://doi.org/10.24171/j.phrp.2023.0298
  • 1,308 View
  • 63 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
In March 2023, an alternative school in the Republic of Korea reported 12 cases of shigellosis. This study aims to analyze the epidemiological characteristics in order to determine the cause of the cluster outbreak of shigellosis and to develop prevention strategies. Methods: This study focused on 12 patients with confirmed Shigella infection and investigated their demographics, clinical features, epidemiology, diagnostics, and antimicrobial susceptibility. Following the identification of Shigella, we conducted follow-up rectal smear cultures to manage patients, implementing isolation and control measures. Results: This study investigated the emergence of multidrug-resistant Shigella following missionary activities in Cambodia, documenting a cluster infection within an alternative school in Daejeon, the Republic of Korea. The outbreak affected 56 participants, resulting in the confirmation of 12 cases. The incidence rates varied by gender and occupation, with higher rates among males and teachers. All 12 cases demonstrated multidrug resistance. Challenges included delayed pathogen confirmation and suboptimal adherence to isolation criteria. The incident prompted revisions in the criteria for isolation release, focusing on symptom resolution. The study underscores the necessity for strengthened surveillance, educational initiatives focusing on prevention in endemic areas, and improved oversight of unlicensed educational establishments. Conclusion: Successful response strategies included swift situation assessment, collaborative efforts, effective infection control measures, and modified criteria for isolation release. Continued surveillance of multidrug-resistant strains is recommended, especially in regions with a high prevalence.
Short Communication
Epidemiological characteristics of carbapenemase-producing Enterobacteriaceae outbreaks in the Republic of Korea between 2017 and 2022
Hyoseon Jeong, Junghee Hyun, Yeon-Kyeng Lee
Osong Public Health Res Perspect. 2023;14(4):312-320.   Published online August 21, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0069
  • 1,513 View
  • 152 Download
  • 4 Web of Science
  • 4 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Comparison of clinical outcomes of patients with serial negative surveillance cultures according to a subsequent polymerase chain reaction test for carbapenemase-producing Enterobacterales
    H. Seo, S. Kim, Y.W. Lee, H.S. Oh, H-S. Kim, Y.K. Kim
    Journal of Hospital Infection.2024; 146: 93.     CrossRef
  • Identifying Contact Time Required for Secondary Transmission of Clostridioides difficile Infections by Using Real-Time Locating System
    Min Hyung Kim, Jaewoong Kim, Heejin Ra, Sooyeon Jeong, Yoon Soo Park, Dongju Won, Hyukmin Lee, Heejung Kim
    Emerging Infectious Diseases.2024;[Epub]     CrossRef
  • Antimicrobial activity of ceftazidime-avibactam against KPC-2-producing Enterobacterales: a cross-combination and dose-escalation titration study with relebactam and vaborbactam
    Min Seo Kang, Jin Yang Baek, Jae-Hoon Ko, Sun Young Cho, Keon Young Lee, Young Ho Lee, Jinyoung Yang, Tae Yeul Kim, Hee Jae Huh, Nam Yong Lee, Kyungmin Huh, Cheol-In Kang, Doo Ryeon Chung, Kyong Ran Peck, Bobby G. Warren
    Microbiology Spectrum.2024;[Epub]     CrossRef
  • Performance comparison of BD Phoenix CPO detect panel with Cepheid Xpert Carba-R assay for the detection of carbapenemase-producing Klebsiella pneumoniae isolates
    Nazmiye Ülkü Tüzemen, Uğur Önal, Osman Merdan, Bekir Akca, Beyza Ener, Halis Akalın, Cüneyt Özakın
    BMC Microbiology.2024;[Epub]     CrossRef
Original Articles
Risk factors for COVID-19 outbreaks in livestock slaughtering and processing facilities in Republic of Korea
Seongju Choi, Tae Jong Son, Yeon-Kyung Lee
Osong Public Health Res Perspect. 2023;14(3):207-218.   Published online June 8, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0035
  • 1,424 View
  • 51 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
The goal of this study was to help prevent and control the spread of coronavirus disease 2019 (COVID-19) by identifying transmission routes and risk factors in livestock slaughtering and processing facilities (SPFs) and establishing an optimal intervention strategy for outbreaks.
Methods
This case series study was a demographic analysis of patients with confirmed COVID-19 associated with 5 SPFs in Korea between January and June 2021. Additionally, in a retrospective cohort study, the association between COVID-19 infection and risk factors was analyzed for SPFs at which outbreaks occurred.
Results
The COVID-19 attack rates were 11.2%, 24.5%, and 6.8% at 3 poultry SPFs (PSPFs) and 15.5% and 25.2% at 2 mammal SPFs (MSPFs). Regarding spatial risk factors, the COVID-19 risk levels were 12.1-, 5.2-, and 5.0-fold higher in the refrigeration/ freezing, by-product processing, and carcass cutting areas, respectively, than in the office area. The risk of COVID-19 infection was 2.1 times higher among employees of subcontractors than among employees of contractors. The COVID-19 risk levels were 5.3- and 3.0-fold higher in foreign workers than in native Korean workers in the PSPFs and MSPFs, respectively.
Conclusion
As the COVID-19 pandemic continues, a detailed policy for infectious disease prevention and control intervention is needed, without interrupting economic activities. Thus, we propose an ideal intervention plan to prevent COVID-19 through disinfection and preemptive testing and to block its transmission through effective contact management during outbreaks at SPFs.
COVID-19 outbreak in a religious village community in Republic of Korea and risk factors for transmission
Jiae Shim, Eunju Lee, Eunyoung Kim, Yeonhwa Choi, Giseok Kang, Bryan Inho Kim
Osong Public Health Res Perspect. 2023;14(2):110-118.   Published online April 5, 2023
DOI: https://doi.org/10.24171/j.phrp.2023.0002
  • 1,669 View
  • 77 Download
  • 1 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness.
Methods
An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness.
Results
The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for transmission. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%).
Conclusion
This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.

Citations

Citations to this article as recorded by  
  • Trends of fear and anger on YouTube during the initial stage of the COVID-19 outbreak in South Korea
    Jae-Joon Lee, Jongwoo Kim, Soo-Kyoung Lee
    BMC Public Health.2024;[Epub]     CrossRef
COVID-19 outbreak response at a nursing hospital in South Korea in the post-vaccination era, including an estimation of the effectiveness of the first shot of the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1-S)
Chanhee Kim, Geon Kang, Sun Gu Kang, Heeyoung Lee
Osong Public Health Res Perspect. 2022;13(2):114-122.   Published online April 26, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0262
  • 4,617 View
  • 95 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Objectives
We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population. Methods: The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR. Results: The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the nonpatients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest. Conclusion: The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers.

Citations

Citations to this article as recorded by  
  • COVID-19 Vaccination in Korea: Past, Present, and the Way Forward
    Eliel Nham, Joon Young Song, Ji Yun Noh, Hee Jin Cheong, Woo Joo Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020
Jiyeon Yang, Yunhyung Kwon, Jaetae Kim, Yoojin Jang, Jiyeon Han, Daae Kim, Hyeran Jeong, Hyekyung Park, Eunhye Shim
Osong Public Health Res Perspect. 2021;12(5):293-303.   Published online September 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.0063
  • 7,804 View
  • 197 Download
  • 8 Web of Science
  • 8 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Objectives
We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).
Methods
This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic.
Results
TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003).
Conclusion
TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.

Citations

Citations to this article as recorded by  
  • A Review of the Impact of Patent Medicine Vendors in Driving Community Tuberculosis Case Finding in the COVID-19 Pandemic in Nigeria
    Arinze Emmanuel Ajogwu, Onwubiko Iheanyichukwu Samuel, Nnanyelugo Longinus Ochike, Uzoma Chidinma Ajegbo, Chinedu Paschal Maduka
    Matrix Science Medica.2024; 8(2): 33.     CrossRef
  • Tuberculosis: Republic of Korea, 2021
    Jinsoo Min, Hyung Woo Kim, Ju Sang Kim
    Tuberculosis and Respiratory Diseases.2023; 86(1): 67.     CrossRef
  • Prevalence and associated factors of diabetes mellitus among patients with tuberculosis in South Korea from 2011 to 2018: a nationwide cohort study
    Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeong Mi Seo, Hongjo Choi, Young Ae Kang
    BMJ Open.2023; 13(3): e069642.     CrossRef
  • Increased Healthcare Delays in Tuberculosis Patients During the First Wave of COVID-19 Pandemic in Korea: A Nationwide Cross-Sectional Study
    Jinsoo Min, Yousang Ko, Hyung Woo Kim, Hyeon-Kyoung Koo, Jee Youn Oh, Yun-Jeong Jeong, Hyeon Hui Kang, Kwang Joo Park, Yong Il Hwang, Jin Woo Kim, Joong Hyun Ahn, Yangjin Jegal, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Time trend prediction and spatial–temporal analysis of multidrug-resistant tuberculosis in Guizhou Province, China, during 2014–2020
    Wang Yun, Chen Huijuan, Liao Long, Lu Xiaolong, Zhang Aihua
    BMC Infectious Diseases.2022;[Epub]     CrossRef
  • Real-world association of adherence with outcomes and economic burden in patients with tuberculosis from South Korea claims data
    Sun-Hong Kwon, Jin Hyun Nam, Hye-Lin Kim, Hae-Young Park, Jin-Won Kwon
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini
    Hloniphile Victory Masina, I-Feng Lin, Li-Yin Chien
    International Journal of Public Health.2022;[Epub]     CrossRef
  • Trends in incidences of newly notified tuberculosis in Jeju Province, Korea, 2017-2021
    Jinhee Kim, Nam-Hun Kang, Jong-Myon Bae
    Journal of Medicine and Life Science.2022; 19(3): 103.     CrossRef
2019 Tabletop Exercise for Laboratory Diagnosis and Analyses of Unknown Disease Outbreaks by the Korea Centers for Disease Control and Prevention
Il-Hwan Kim, Jun Hyeong Jang, Su-Kyoung Jo, Jin Sun No, Seung-Hee Seo, Jun-Young Kim, Sang-Oun Jung, Jeong-Min Kim, Sang-Eun Lee, Hye-Kyung Park, Eun-Jin Kim, Jun Ho Jeon, Myung-Min Choi, Boyeong Ryu, Yoon Suk Jang, Hwami Kim, Jin Lee, Seung-Hwan Shin, Hee Kyoung Kim, Eun-Kyoung Kim, Ye Eun Park, Cheon-Kwon Yoo, Sang-Won Lee, Myung-Guk Han, Gi-Eun Rhie, Byung Hak Kang
Osong Public Health Res Perspect. 2020;11(5):280-285.   Published online October 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.5.03
  • 6,143 View
  • 110 Download
AbstractAbstract PDF
Objectives

The Korea Centers for Disease Control and Prevention has published “A Guideline for Unknown Disease Outbreaks (UDO).” The aim of this report was to introduce tabletop exercises (TTX) to prepare for UDO in the future.

Methods

The UDO Laboratory Analyses Task Force in Korea Centers for Disease Control and Prevention in April 2018, assigned unknown diseases into 5 syndromes, designed an algorithm for diagnosis, and made a panel list for diagnosis by exclusion. Using the guidelines and laboratory analyses for UDO, TTX were introduced.

Results

Since September 9th, 2018, the UDO Laboratory Analyses Task Force has been preparing TTX based on a scenario of an outbreak caused by a novel coronavirus. In December 2019, through TTX, individual missions, epidemiological investigations, sample treatments, diagnosis by exclusions, and next generation sequencing analysis were discussed, and a novel coronavirus was identified as the causal pathogen.

Conclusion

Guideline and laboratory analyses for UDO successfully applied in TTX. Conclusions drawn from TTX could be applied effectively in the analyses for the initial response to COVID-19, an ongoing epidemic of 2019 – 2020. Therefore, TTX should continuously be conducted for the response and preparation against UDO.

Invited Original Article
Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire
Martin Eichner, Scott F. Dowell, Nina Firese
Osong Public Health Res Perspect. 2011;2(1):3-7.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.04.001
  • 4,350 View
  • 18 Download
  • 47 Crossref
AbstractAbstract PDF
Objectives
Ebola hemorrhagic fever has killed over 1300 people, mostly in equatorial Africa. There is still uncertainty about the natural reservoir of the virus and about some of the factors involved in disease transmission. Until now, a maximum incubation period of 21 days has been assumed.
Methods
We analyzed data collected during the Ebola outbreak (subtype Zaire) in Kikwit, Democratic Republic of the Congo, in 1995 using maximum likelihood inference and assuming a log-normally distributed incubation period.
Results
The mean incubation period was estimated to be 12.7 days (standard deviation 4.31 days), indicating that about 4.1% of patients may have incubation periods longer than 21 days.
Conclusion
If the risk of new cases is to be reduced to 1% then 25 days should be used when investigating the source of an outbreak, when determining the duration of surveillance for contacts, and when declaring the end of an outbreak.

Citations

Citations to this article as recorded by  
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    Michael A Moso, Chuan K Lim, Eloise Williams, Caroline Marshall, James McCarthy, Deborah A Williamson
    The Lancet Infectious Diseases.2024; 24(2): e93.     CrossRef
  • Systems immunology of transcriptional responses to viral infection identifies conserved antiviral pathways across macaques and humans
    Kalani Ratnasiri, Hong Zheng, Jiaying Toh, Zhiyuan Yao, Veronica Duran, Michele Donato, Mario Roederer, Megha Kamath, John-Paul M. Todd, Matthew Gagne, Kathryn E. Foulds, Joseph R. Francica, Kizzmekia S. Corbett, Daniel C. Douek, Robert A. Seder, Shirit E
    Cell Reports.2024; 43(2): 113706.     CrossRef
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    Youngsuk Ko, Jacob Lee, Yubin Seo, Eunok Jung, Aleksandra Inic-Kanada
    PLOS Neglected Tropical Diseases.2024; 18(6): e0011955.     CrossRef
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    Zhenting Wei, Xiaowen Wang, Huhu Feng, Fanpu Ji, Dan Bai, Xiaoping Dong, Wei Huang
    Critical Reviews in Biotechnology.2023; 43(3): 415.     CrossRef
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    Aliou Bouba, Kristina Barbara Helle, Kristan Alexander Schneider, Jan Rychtář
    PLOS ONE.2023; 18(1): e0276351.     CrossRef
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    Amine Bernoussi
    International Journal of Biomathematics.2023;[Epub]     CrossRef
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    Yong Zhou, Yiming Ding, Minrui Guo
    Frontiers in Physics.2023;[Epub]     CrossRef
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    Andreas Eilersen, Bjarke Frost Nielsen, Kim Sneppen
    Physical Review Research.2023;[Epub]     CrossRef
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    Mohamed-Amine Chadi, Hajar Mousannif
    Applied Artificial Intelligence.2022;[Epub]     CrossRef
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    Kaitlyn Martinez, Grant Brown, Stephen Pankavich
    Spatial and Spatio-temporal Epidemiology.2022; 41: 100505.     CrossRef
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    Hossein Abouee Mehrizi, Arian Aminoleslami, Johnson Darko, Ernest Osei, Houra Mahmoudzadeh
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    Devika Dixit, Kasereka Masumbuko Claude, Lindsey Kjaldgaard, Michael T. Hawkes
    Paediatrics and International Child Health.2021; 41(1): 12.     CrossRef
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    Rachid Muleia, Marc Aerts, Christel Faes, Maria Vittoria Barbarossa
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    Frontiers in Physiology.2021;[Epub]     CrossRef
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    Journal of Nanobiotechnology.2021;[Epub]     CrossRef
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    Robin Burk, Laura Bollinger, Joshua C. Johnson, Jiro Wada, Sheli R. Radoshitzky, Gustavo Palacios, Sina Bavari, Peter B. Jahrling, Jens H. Kuhn, Urs Greber
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    Journal of the Formosan Medical Association.2015; 114(5): 384.     CrossRef
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    Maryam Keshtkar Jahromi, Batool Sharifi Mood
    International Journal of Infection.2015;[Epub]     CrossRef
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    Wayne M. Getz, Jean-Paul Gonzalez, Richard Salter, James Bangura, Colin Carlson, Moinya Coomber, Eric Dougherty, David Kargbo, Nathan D. Wolfe, Nadia Wauquier
    Computational and Mathematical Methods in Medicine.2015; 2015: 1.     CrossRef
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    R. A. Stein
    International Journal of Clinical Practice.2015; 69(1): 49.     CrossRef
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    Hiroshi Nishiura, Gerardo Chowell
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    Boris I Pavlin
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PHRP : Osong Public Health and Research Perspectives