Strengthening epidemiologic investigation of infectious diseases in Korea: lessons from the Middle East Respiratory Syndrome outbreak.

Changhwan Lee,Moran Ki

doi:10.4178/epih/e2015040

Abstract

The recent outbreak of Middle East Respiratory Syndrome (MERS) coronavirus infection in Korea resulted in large socioeconomic losses. This provoked the Korean government and the general public to recognize the importance of having a well-established system against infectious diseases. Although epidemiologic investigation is one of the most important aspects of prevention, it has been pointed out that much needs to be improved in Korea. We review here the current status of the Korean epidemiologic service and suggest possible supplementation measures. We examine the current national preventive infrastructure, including human resources such as Epidemic Intelligence Service officers, its governmental management, and related policies. In addition, we describe the practical application of these resources to the recent MERS outbreak and the progress in preventive measures. The spread of MERS demonstrated that the general readiness for emerging infectious diseases in Korea is considerably low. We believe that it is essential to increase society’s investment in disease prevention. Fostering public health personnel, legislating management policies, and establishing research centers for emerging infectious diseases are potential solutions. Evaluating international preventive systems, developing cooperative measures, and initiating improvements are necessary. We evaluated the Korean epidemiologic investigation system and the public preventive measures against infectious diseases in light of the recent MERS outbreak. We suggest that governmental authorities in Korea enforce preventive policies, foster the development of highly qualified personnel, and increase investment in the public health domain of infectious disease prevention.

Highlights

Korea recently experienced an unprecedented outbreak of Middle East Respiratory Syndrome (MERS), in which it became the country with the second most confirmed patients worldwide, after Saudi Arabia
We provide a chronological review of the epidemiologic investigation of the MERS outbreak as well as suggestions about how to strengthen epidemiologic investigations in the future
If an outbreak occurs in a hospital, as occurred in this MERS outbreak, it is very difficult for public health centers to implement quarantines or to track and manage contacts who are hospitalzed patients without the cooperation of hospitals and clinics, even though Epidemic Intelligence Service (EIS) officers officially determine the criteria used to designate persons subject to preventative measures based on the extent of their contact with the infected case

Summary

INTRODUCTION

Korea recently experienced an unprecedented outbreak of Middle East Respiratory Syndrome (MERS), in which it became the country with the second most confirmed patients worldwide, after Saudi Arabia. If an outbreak occurs in a hospital, as occurred in this MERS outbreak, it is very difficult for public health centers to implement quarantines or to track and manage contacts who are hospitalzed patients without the cooperation of hospitals and clinics, even though EIS officers officially determine the criteria used to designate persons subject to preventative measures based on the extent of their contact with the infected case. It is extremely difficult for EIS officers to make decisions alone in this context, since EIS officers have no legal power to order the temporary suspension of services in a hospital where cases occurred, even when it is necessary to take urgent measures to prevent an epidemic.

DISCUSSION

CONCLUSION