Middle East Respiratory Syndrome Outbreak In Korea Research Articles

How Can We Deal with Psychosocial Issues in an Emerging Infectious Disease Outbreak? Lessons from a Qualitative Study for the MERS Outbreak in Korea.

The 2015 Middle East respiratory syndrome (MERS) coronavirus outbreak in Korea led to profound emotional and social burdens, especially in patients and health care professionals. Focus group interviews were conducted with 2 patients, 1 family member and 6 health care professionals about psychological distress related to MERS in 2017 and analyzed the interview data using the consensual qualitative research method. Four domains and 17 core ideas were identified within three interview groups, including psychological distress during the outbreak, problems regarding the response to the outbreak, positive experiences, and future directions for enhancing intervention to improve mental health and prevent psychosocial problems during the outbreak. Psychological consequences were affected by the characteristics of the emerging infectious disease and the structure and process of institutional or governmental response to the MERS outbreak. Mental health services and psychosocial support reduced the negative impact on psychological distress. The MERS outbreak in 2015 gave rise to emotional and social injuries to patients and health care professionals, some of which can be long-lasting constraints in their lives. Preparedness in a society's response to a pandemic considering mental health in related parties can minimize negative psychological consequences and enhance resilience at the individual and society levels.

Workplace Response System Against Infectious Disasters based on the MERS Outbreak in Korea

Purpose: This study aimed to evaluate the workplace response system (WRS) against infectious disasters (IDs) based on the response attitudes and capacity of occupational health nurses (OHNs) who worked during the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea. Methods: Fifty-one participants who had worked as OHNs at the time of the 2015 MERS outbreak were surveyed from November 20 to December 10, 2016. Data were collected using a self-report questionnaire and analyzed using descriptive statistics and McNemaer's test. Results: According to the survey results, the following were lacking in the WRS: a dedicated ID-response team, manuals, related education programs for OHNs, and health education programs for workers. Results also confirmed that workers were vulnerable to new infectious diseases because of the lack of health checkups and support for workers before and after business trips abroad. Among the respondents, 98.0% answered affirmatively that an ID was important for health management in the workplace, but 64.7% answered that it was difficult to manage an ID. The perceived capacity items to respond to IDs ranged from 3.0 points to 3.3 points. This scores were generally high. Conclusion: As the WRS is currently insufficient, it is necessary to develop an adequate WRS to IDs by addressing the identified problems.

Investigation of nonlinear epidemiological models for analyzing and controlling the MERS outbreak in Korea

Much concern has arisen regarding serious epidemics due to the Middle East Respiratory Syndrome (MERS) coronavirus. The first MERS case of Korea was reported on 20 May 2015, and since then, the MERS outbreak in Korea has resulted in hundreds of confirmed cases and tens of deaths. Deadly infectious diseases such as MERS have significant direct and indirect social impacts, which include disease-induced mortality and economic losses. Also, a delayed response to the outbreak and underestimating its danger can further aggravate the situation. Hence, an analysis and establishing efficient strategies for preventing the propagation of MERS is a very important and urgent issue. In this paper, we propose a class of nonlinear susceptible-infectious-quarantined (SIQ) models for analyzing and controlling the MERS outbreak in Korea. For the SIQ based ordinary differential equation (ODE) model, we perform the task of parameter estimation, and apply optimal control theory to the controlled SIQ model, with the goal of minimizing the infectious compartment population and the cost of implementing the quarantine and isolation strategies. Simulation results show that the proposed SIQ model can explain the observed data for the confirmed cases and the quarantined cases in the MERS outbreak very well, and the number of the MERS cases can be controlled reasonably well via the optimal control approach.

Impact of Middle East respiratory syndrome outbreak on the use of emergency medical resources in febrile patients

ObjectiveOutbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources.MethodsAn ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea. All demographic and diagnostic data from patients presenting with febrile symptoms as a main complaint were collected. The data were compared to the equivalent period in the three years preceding the MERS outbreak in Korea.ResultsFollowing the MERS outbreak, there was an increase in overall ED visits by febrile patients and the proportion of visits by febrile patients, relative to total ED attendances. This effect was more prominent in the children under five years. The duration of the chief complaint before ED arrival and the length of ED stay were significantly increased among younger pediatric patients. Decreased body temperature on arrival was observed in younger pediatric patients.ConclusionMERS outbreak appears to have had a significant effects on ED use by febrile patients. The use of emergency care services by pediatric patients makes them more vulnerable to an outbreak of a transmissable disease. An effective strategy to control emergency center visits by non-urgent febrile patients and provide proper medical services is urgently needed.

Understanding and Modeling the Super-spreading Events of the Middle East Respiratory Syndrome Outbreak in Korea

Understanding and Modeling the Super-spreading Events of the Middle East Respiratory Syndrome Outbreak in Korea

Factors Affecting MERS-related Health Behaviors among Male High School Students

Purpose: The purpose of the study was to survey male high school students on their MERS(Middle East Respiratory Syndrome)-related knowledge, risk perception, and health behaviors and to identify the factors affect- ing health behaviors during the MERS outbreak in Korea. Methods: The subjects in this study were 144 students in a male high school. Data were collected through self-reported questionnaires in July, 2015. The collected data were analyzed by ANOVA, Pearson's correlation and multiple regression using SPSS/WIN 21.0. Results: The proportion of correct answers to questions testing MERS-related knowledge was 71.6% among male high school students; their health behaviors were rated at 48.9%; and their risk perception rate was 1.8 out of 4. There was a positive correlation between knowledge, risk perception, and health behaviors. Knowledge and risk perception explained 15.1% of the variance in health behaviors. Conclusion: To improve students' health behaviors, their risk perception and knowledge over MERS should be strengthened. Therefore, it is necessary to develop and implement efficient and feasible MERS education programs for high school students.

The first case of the 2015 Korean Middle East Respiratory Syndrome outbreak.

This study reviewed problems in the prevention of outbreak and spread of Middle East Respiratory Syndrome (MERS) and aimed to provide assistance in establishing policies to prevent and manage future outbreaks of novel infectious diseases of foreign origin via in-depth epidemiological investigation of the patient who initiated the MERS outbreak in Korea, 2015.Personal and phone interviews were conducted with the patient and his guardians, and his activities in Saudi Arabia were investigated with the help of the Saudi Arabian Ministry of Health. Clinical courses and test results were confirmed from the medical records.The patient visited 4 medical facilities and contacted 742 people between May 11, 2015, at symptom onset, and May 20, at admission to the National Medical Center; 28 people were infected and diagnosed with MERS thereafter.Valuable lessons learned included: (1) epidemiological knowledge on the MERS transmission pattern and medical knowledge on its clinical course; (2) improvement of epidemiological investigative methods via closed-circuit television, global positioning system tracking, and review of Health Insurance Review and Assessment Service records; (3) problems revealed in the existing preventive techniques, including early determination of the various people contacted; (4) experiences with preventive methods used for the first time in Korea, including cohort quarantine; (5) reconsideration of the management systems for infectious disease outbreaks across the country, such as this case, at the levels of central government, local government, and the public; (6) reconsideration of hospital infectious disease management systems, culture involving patient visitation, and emergency room environments.

Epidemiologic features of the first MERS outbreak in Korea: focus on Pyeongtaek St. Mary's Hospital.

OBJECTIVES:This study investigated the epidemiologic features of the confirmed cases of Middle East Respiratory Syndrome (MERS) in Pyeongtaek St. Mary’s Hospital, where the outbreak first began, in order to identify lessons relevant for the prevention and control of future outbreaks.METHODS:The patients’ clinical symptoms and test results were collected from their medical records. The caregivers of patients were identified by phone calls.RESULTS:After patient zero (case #1) was admitted to Pyeongtaek St. Mary’s Hospital (May 15-May 17), an outbreak occurred, with 36 cases between May 18 and June 4, 2015. Six patients died (fatality rate, 16.7%). Twenty-six cases occurred in the first-generation, and 10 in the second-generation. The median incubation period was five days, while the median period from symptom onset to death was 12.5 days. While the total attack rate was 3.9%, the attack rate among inpatients was 7.6%, and the inpatients on the eighth floor, where patient zero was hospitalized, had an 18.6% attack rate. In contrast, caregivers and medical staff showed attack rates of 3.3% and 1.1%, respectively.CONCLUSIONS:The attack rates were higher than those of the previous outbreaks in other countries. The outbreak spread beyond Pyeongtaek St. Mary’s Hospital when four of the patients were moved to other hospitals without appropriate quarantine. The best method of preventing future outbreaks is to overcome the vulnerabilities observed in this outbreak, such as ward crowding, patient migration without appropriate data sharing, and the lack of an initial broad quarantine.

2015 MERS outbreak in Korea: hospital-to-hospital transmission.

The distinct characteristic of the Middle East Respiratory Syndrome (MERS) outbreak in South Korea is that it not only involves intra-hospital transmission, but it also involves hospital-to-hospital transmission. It has been the largest MERS outbreak outside the Middle East, with 186 confirmed cases and, among them, 36 fatal cases as of July 26, 2015. All confirmed cases are suspected to be hospital-acquired infections except one case of household transmission and two cases still undergoing examination. The Korean health care system has been the major factor shaping the unique characteristics of the outbreak. Taking this as an opportunity, the Korean government should carefully assess the fundamental problems of the vulnerability to hospital infection and make short- as well as long-term plans for countermeasures. In addition, it is hoped that this journal, Epidemiology and Health, becomes a place where various topics regarding MERS can be discussed and shared.

Definition and management of the close contacts with Middle East respiratory syndrome cases: reflection and lessons in 2015 Korean outbreak

Middle East respiratory syndrome (MERS) is an emerging zoonosis caused by the novel MERS corona virus isolated in 2012. Most MERS cases have been reported from Arab countries of the Middle East, including Saudi Arabia, United Arab Emirates, Qatar, and Jordan. There have been a few imported cases in many countries, but the exception is Korea, which reported 186 confirmed cases originating from one imported case in a two-month outbreak in 2015. There are many lessons to be learned from the MERS outbreak in Korea, among them, management of contacts. The definition of "close contact" used by the Korean Centers for Disease Control and Prevention (KCDC) for MERS response was not clear and not compatible with the definition of the World Health Organization. This incorrect definition allowed the KCDC make serious mistakes in contact tracing and management in the early epidemic stage of MERS. After the rapid expansion of the outbreak, the KCDC redefined a "close contact" according to the definition of the US CDC. The total number of close contacts was 16,693 in this outbreak, and they were all forced to conduct a self-quarantine for 14 days after the last contact with a MERS patient. It was not clear whether self-quarantine of close contacts was effective to control the outbreak. Given the lack of prepared guidelines or a social support system for them, these measures for the massive number of asymptomatic contacts caused a great deal of confusion in the field A clear response guideline is needed for contact management based on robust evidence from this MERS epidemic in Korea.