<b>Objectives</b><br/>In the Republic of Korea, the previous surveillance system for zoonotic tuberculosis (TB) involved the X-ray testing of humans in contact with Mycobacterium bovis-infected livestock. In contrast, the updated surveillance system incorporates the genotyping of cultured Mycobacterium isolates for high-risk occupational groups. This study aimed to systematically document the detection, diagnosis, assessment, and response in the epidemic investigation of zoonotic TB in a laboratory worker in the Republic of Korea.
<br/><b>Methods</b><br/>M. bovis was confirmed using spoligotyping and whole genome sequencing. Clinical characteristics were reviewed through epidemiological investigation and interviews with the affected individual. Transmission routes and secondary spread were assessed via field epidemiological investigations and contact evaluations using chest X-ray and interferon gamma release assay for latent TB infection.
<br/><b>Results</b><br/>A 56-year-old laboratory worker presented with chest X-ray findings compatible with TB and subsequently tested positive for M. bovis. She had no clinical or family history of TB and remained asymptomatic. She completed a 6 month treatment regimen of isoniazid, rifampin, ethambutol, and pyrazinamide without hospitalization. Although no direct transmission pathways for zoonotic TB were identified, her work in a laboratory, processing specimens for zoonotic TB, indicated potential laboratory related exposure.
<br/><b>Conclusion</b><br/>This case underscores the importance of stringent use of personal protective equipment among high-risk occupational groups and the implementation of an enhanced surveillance system to report zoonotic TB. These findings highlight the need for a One Health approach and proactive surveillance, emphasizing the necessity of refining and strengthening surveillance systems for precise monitoring and an effective response.
<b>Objectives</b><br/>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).
<b>Objectives</b><br/>The main Brucella species causing human infections in the Republic of Korea is Brucella abortus, which uses cattle as its host. However, since 2014, Brucella melitensis, which uses sheep and goats as hosts, has also been identified. This study investigated whether a shift has occurred in the predominant species of Brucella pathogens.
<br/><b>Methods</b><br/>Brucellosis is a class 3 infectious disease requiring mandatory reporting and registration in the Korea Disease Control and Prevention Agency’s infectious disease surveillance system (http://is.kdca.go.kr). Cases from 2014 to 2023 were studied, and whole-genome sequencing analysis was conducted using BruMLSA21.
<br/><b>Results</b><br/>Out of 51 patients, males (45 patients, 88.2%) were predominantly affected. Twenty-five patients (49%) came from the livestock industry, and within the livestock sector group, the route of infection occurred exclusively through contact (25/25, 100%), whereas in other occupations, it was split between contact (9/26 patients, 34.6%) and ingestion (8/26 patients, 30.8%). Among the 31 patients who underwent Brucella culture tests, B. melitensis was found to be more prevalent than B. abortus (14 patients, 45.2% vs. 11 patients, 35.5%). In all cases where B. melitensis was isolated, the infections were of foreign origin, consistent with the results of BruMLSA21.
<br/><b>Conclusion</b><br/>Regular monitoring of the causative agent of brucellosis is necessary due to its varying host preferences and antibiotic resistance. Furthermore, given the increasing prevalence of B. melitensis worldwide, changes in dietary habits (e.g., increased lamb consumption), and the increase in foreign workers and Chinese immigrants, a multi-ministerial One Health response will be required.
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