Surveillance and public health response for travelers returning from MERS-CoV affected countries to Gyeonggi Province, Korea, 2016–2017
Identifieur interne : 000889 ( Pmc/Corpus ); précédent : 000888; suivant : 000890Surveillance and public health response for travelers returning from MERS-CoV affected countries to Gyeonggi Province, Korea, 2016–2017
Auteurs : Sukhyun RyuSource :
- Travel Medicine and Infectious Disease [ 1477-8939 ] ; 2018.
Url:
DOI: 10.1016/j.tmaid.2018.11.006
PubMed: 30419356
PubMed Central: 7128286
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Surveillance and public health response for travelers returning from MERS-CoV affected countries to Gyeonggi Province, Korea, 2016–2017</title><author><name sortKey="Ryu, Sukhyun" sort="Ryu, Sukhyun" uniqKey="Ryu S" first="Sukhyun" last="Ryu">Sukhyun Ryu</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30419356</idno><idno type="pmc">7128286</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128286</idno><idno type="RBID">PMC:7128286</idno><idno type="doi">10.1016/j.tmaid.2018.11.006</idno><date when="2018">2018</date><idno type="wicri:Area/Pmc/Corpus">000889</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000889</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Surveillance and public health response for travelers returning from MERS-CoV affected countries to Gyeonggi Province, Korea, 2016–2017</title><author><name sortKey="Ryu, Sukhyun" sort="Ryu, Sukhyun" uniqKey="Ryu S" first="Sukhyun" last="Ryu">Sukhyun Ryu</name></author></analytic><series><title level="j">Travel Medicine and Infectious Disease</title><idno type="ISSN">1477-8939</idno><idno type="eISSN">1873-0442</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Al Tawfiq, J A" uniqKey="Al Tawfiq J">J.A. Al-Tawfiq</name></author><author><name sortKey="Rabaan, A A" uniqKey="Rabaan A">A.A. Rabaan</name></author><author><name sortKey="Hinedi, K" uniqKey="Hinedi K">K. Hinedi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ki, M" uniqKey="Ki M">M. Ki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Korea Centers For Disease Control And Prevention Kcdc" uniqKey="Korea Centers For Disease Control And Prevention Kcdc">Korea Centers for Disease Control and Prevention (KCDC)</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="World Health Organization Who" uniqKey="World Health Organization Who">World Health Organization (WHO)</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Atabani, S F" uniqKey="Atabani S">S.F. Atabani</name></author><author><name sortKey="Wilson, S" uniqKey="Wilson S">S. Wilson</name></author><author><name sortKey="Overton Lewis, C" uniqKey="Overton Lewis C">C. Overton-Lewis</name></author><author><name sortKey="Workman, J" uniqKey="Workman J">J. Workman</name></author><author><name sortKey="Kidd, I M" uniqKey="Kidd I">I.M. Kidd</name></author><author><name sortKey="Petersen, E" uniqKey="Petersen E">E. Petersen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chowell, G" uniqKey="Chowell G">G. Chowell</name></author><author><name sortKey="Abdirizak, F" uniqKey="Abdirizak F">F. Abdirizak</name></author><author><name sortKey="Lee, S" uniqKey="Lee S">S. Lee</name></author><author><name sortKey="Lee, J" uniqKey="Lee J">J. Lee</name></author><author><name sortKey="Jung, E" uniqKey="Jung E">E. Jung</name></author><author><name sortKey="Nishiura, H" uniqKey="Nishiura H">H. Nishiura</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Travel Med Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Travel Med Infect Dis</journal-id><journal-title-group><journal-title>Travel Medicine and Infectious Disease</journal-title></journal-title-group><issn pub-type="ppub">1477-8939</issn><issn pub-type="epub">1873-0442</issn><publisher><publisher-name>Elsevier Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">30419356</article-id><article-id pub-id-type="pmc">7128286</article-id><article-id pub-id-type="publisher-id">S1477-8939(18)30405-8</article-id><article-id pub-id-type="doi">10.1016/j.tmaid.2018.11.006</article-id><article-id pub-id-type="publisher-id">101350</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Surveillance and public health response for travelers returning from MERS-CoV affected countries to Gyeonggi Province, Korea, 2016–2017</article-title></title-group><contrib-group><contrib contrib-type="author" id="au1"><name><surname>Ryu</surname><given-names>Sukhyun</given-names></name><email>gentryu@onehealth.or.kr</email><xref rid="cor1" ref-type="corresp">∗</xref></contrib></contrib-group><aff id="aff1">Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Republic of Korea</aff><aff id="aff2">WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region</aff><contrib-group><contrib contrib-type="author" id="au2"><name><surname>Kim</surname><given-names>Joon Jai</given-names></name></contrib></contrib-group><aff id="aff3">Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Republic of Korea</aff><contrib-group><contrib contrib-type="author" id="au3"><name><surname>Cowling</surname><given-names>Benjamin J.</given-names></name></contrib></contrib-group><aff id="aff4">WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region</aff><contrib-group><contrib contrib-type="author" id="au4"><name><surname>Kim</surname><given-names>Chulhee</given-names></name></contrib></contrib-group><aff id="aff5">Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Republic of Korea</aff><author-notes><corresp id="cor1"><label>∗</label>Corresponding author. <email>gentryu@onehealth.or.kr</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>9</day><month>11</month><year>2018</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub" iso-8601-date="2019-10-01"><season>September-October</season><year>2019</year></pub-date><pub-date pub-type="epub"><day>9</day><month>11</month><year>2018</year></pub-date><volume>31</volume><fpage>101350</fpage><lpage>101350</lpage><history><date date-type="received"><day>18</day><month>6</month><year>2018</year></date><date date-type="rev-recd"><day>5</day><month>11</month><year>2018</year></date><date date-type="accepted"><day>8</day><month>11</month><year>2018</year></date></history><permissions><copyright-statement>© 2018 Elsevier Ltd. All rights reserved.</copyright-statement><copyright-year>2018</copyright-year><copyright-holder>Elsevier Ltd</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><kwd-group id="kwrds0010"><title>Keywords</title><kwd>Middle east respiratory syndrome</kwd><kwd>Surveillance</kwd><kwd>Notification</kwd><kwd>Response</kwd><kwd>Korea</kwd></kwd-group></article-meta></front><body><p content-type="salutation">Dear Editor,</p><p id="p0010">A 2015–2016 surveillance study in Saudi Arabia on Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections showed that cases of influenza infections were much more common than those of MERS-CoV [<xref rid="bib1" ref-type="bibr">1</xref>]. These findings indicate that travelers planning to visit MERS-CoV affected countries should be vaccinated against influenza virus. Here, we describe the results from a 2016 and 2017 surveillance study in the most populous province in Korea, the Gyeonggi province (population: 25.5 million; area: 11,730 km<sup>2</sup>), and we demonstrate the Korean public health effort to prevent local transmission of MERS-CoV. In 2015, the Republic of Korea experienced a large outbreak of MERS-CoV with 186 laboratory-confirmed cases [<xref rid="bib2" ref-type="bibr">2</xref>]. In this outbreak, inter-hospital and intra-hospital transmission were determination factors of the MERS-CoV infections [<xref rid="bib2" ref-type="bibr">2</xref>]. After the outbreak, a Korean national surveillance program with virological testing for MERS-CoV and other respiratory viruses was implemented to rapidly identify infected travelers returning from MERS-CoV-affected countries.</p><p id="p0015">Each suspected case of MERS-CoV was defined as a person who had a lower respiratory tract illness (a cough, sputum or shortness of breath), fever (over 37.8 °C), and an epidemiological link to recent travel (within the past 14 days) to a MERS-CoV-affected country [<xref rid="bib3" ref-type="bibr">3</xref>]. The demographic and clinical information for suspected cases were collected through patient interviews [<xref rid="bib3" ref-type="bibr">3</xref>].</p><p id="p0020">Public health officers immediately transferred suspected cases by ambulance to a negative pressure room in an isolation ward of a designated hospital. The officers were equipped with personal protective equipment including disposable coveralls, nitrile gloves, N95 particulate half-masks with a two-strap design, unvented goggles, and boots. Upper and lower respiratory specimens (nasopharyngeal, oropharyngeal swab and sputum) and blood samples of individuals with a suspected infection were immediately collected and transported at 4 °C to the provincial public health laboratory [<xref rid="bib3" ref-type="bibr">3</xref>]. The delay from the report of the onset of symptoms and notification of the public health authority, to the quarantine time including self-isolation, was recorded.</p><p id="p0025">To identify MERS-CoV, qualitative Real-time Reverse Transcription-Polymerase Chain Reaction (rRT-PCR) testing was performed using the TaqMan method by targeting regions upstream of the envelope (UpE) and the open reading frame 1a gene [<xref rid="bib4" ref-type="bibr">4</xref>]. A cycle of threshold value ≤ 37 was regarded as positive [<xref rid="bib4" ref-type="bibr">4</xref>]. Additional rRT-PCR using respiratory swabs was conducted to identify other respiratory viruses including influenza (IFV; A, B), human respiratory syncytial virus (hRSV; A, B), human metapneumovirus (hMPV; A, B), human parainfluenza virus (hPIV; I, II, III), human adenovirus (hAdV), human bocavirus (hBoC), human rhinovirus (hRV), and human coronavirus (hCoV; 229E, OC43, NL63). <xref rid="tbl1" ref-type="table">Table 1</xref>shows the characteristics of the suspected cases. There were 56 male cases among 99 suspected cases. Seven of the suspected cases had underlying disease (either hypertension or diabetes, or both). The median age of the suspected case group was 43 years (range, 1 to 70; mean, 42.3); and the group had a median of 11 contacts (range, 1 to 33; mean, 21.2). The median delay between the onset of symptoms and the notification of the public health authority was 30 hours (range, 0–240 hrs; mean, 21 hrs). In addition, the median time interval was 1.0 hour (range, 0–63 hrs; mean, 3.4 hrs) between notification and patient quarantine of case, and it was 35 hours (range, 2–240 hrs; mean, 53 hrs) between the onset of symptoms and patient quarantine.<table-wrap position="float" id="tbl1"><label>Table 1</label><caption><p>Characteristics of suspected cases of Middle East Respiratory Syndrome Coronavirus infections (n = 99).</p></caption><alt-text id="alttext0010">Table 1</alt-text><table frame="hsides" rules="groups"><thead><tr><th></th><th>Number (%)</th></tr></thead><tbody><tr><td colspan="2" align="left">Sex</td></tr><tr><td align="left"> Male</td><td align="left">56 (56.6)</td></tr><tr><td align="left"> Female</td><td align="left">43 (43.4)</td></tr><tr><td colspan="2" align="left">Age groups, years</td></tr><tr><td align="left"> 0–18</td><td align="left">9 (9.1)</td></tr><tr><td align="left"> 19-65</td><td align="left">77 (77.8)</td></tr><tr><td align="left"> >65</td><td align="left">13 (13.1)</td></tr><tr><td colspan="2" align="left">Nationality</td></tr><tr><td align="left"> Korean</td><td align="left">94 (94.9)</td></tr><tr><td align="left"> Saudi Arabian</td><td align="left">2 (2.0)</td></tr><tr><td align="left"> UAE</td><td align="left">2 (2.0)</td></tr><tr><td align="left"> Pakistani</td><td align="left">1 (1.0)</td></tr><tr><td colspan="2" align="left">Interval of public health response<xref rid="tbl1fna" ref-type="table-fn">a</xref></td></tr><tr><td align="left"> <1 hours</td><td align="left">62 (62.6)</td></tr><tr><td align="left"> 1 ― < 2 hours</td><td align="left">11 (11.1)</td></tr><tr><td align="left"> 2 ― < 3 hours</td><td align="left">7 (7.0)</td></tr><tr><td align="left"> 3 ― < 4 hours</td><td align="left">4 (4.0)</td></tr><tr><td align="left"> >5 hours</td><td align="left">15 (15.2)</td></tr></tbody></table><table-wrap-foot><fn id="tbl1fna"><label>a</label><p id="ntpara0010">The time interval between notification of public health authority and the quarantine of suspected case.</p></fn></table-wrap-foot></table-wrap></p><p id="p0030">In comparison with the United Kingdom (UK), the delay in time between the initiation of symptoms and patient quarantine for the Republic of Korea was relatively shorter (median duration of symptoms and sample testing in UK: 5 days, range: 1–22 days) [<xref rid="bib5" ref-type="bibr">5</xref>]. In addition, the detection rate of other respiratory virus pathogens was 66.3%, which is higher than reported for the UK (50.3%) [<xref rid="bib5" ref-type="bibr">5</xref>]. All the specimens obtained during the study were confirmed as MERS-CoV negative. However, a viral etiology was detected in 66 (66%) of the cases as follows: Influenza A H3N2 (23 suspected patients, 23%), hRSV (12, 12%), Influenza B (11, 11%), Influenza A H1N1 (10, 10%), hMPV (7, 7%), hCoV (5, 5%), hAdV (3, 3%), hPIV II (1, 1%), and hBoC (1, 1%). Thus, influenza vaccination prior to travel may benefit individual travelers and save the public health resources.</p><p id="p0035">In addition to the above data, it has been found that a significant fraction of confirmed MERS-CoV cases in previous outbreaks has been linked to issues related to healthcare setting (99%; Republic of Korea in 2015, 43%; Jeddah, Saudi Arabia in 2014) [<xref rid="bib2" ref-type="bibr">2</xref>,<xref rid="bib6" ref-type="bibr">6</xref>]. Therefore, the continuous and immediate public health response after symptom onset in a suspected case prior to the patient's visit to a health-care facility is important.</p><p id="p0040">Since MERS-CoV infection has a wide spectrum of illness from asymptomatic to severe, some potential cases could have been missed. However, no additional cases from the Gyeonggi Province hospitals have been reported through the Severe Acute Respiratory Infection surveillance network.</p><p id="p0045">In this study, although no cases of MERS-CoV infection were identified in the Gyeonggi Province, Korea, cases of influenza infection were dominant. It remains important for the risk of the importation of MERS-CoV to be reduced through the continued surveillance of travelers returning from MERS-CoV affected countries combined with a rapid public health response. In addition, vaccination against influenza for the travelers prior to their travel should be considered.</p></body><back><ref-list id="cebib0010"><title>References</title><ref id="bib1"><label>1</label><element-citation publication-type="journal" id="sref1"><person-group person-group-type="author"><name><surname>Al-Tawfiq</surname><given-names>J.A.</given-names></name><name><surname>Rabaan</surname><given-names>A.A.</given-names></name><name><surname>Hinedi</surname><given-names>K.</given-names></name></person-group><article-title>Influenza is more common than Middle East Respiratory Syndrome Coronavirus (MERS-CoV) among hospitalized adult Saudi patients</article-title><source>Trav Med Infect Dis</source><volume>20</volume><year>2017</year><fpage>56</fpage><lpage>60</lpage></element-citation></ref><ref id="bib2"><label>2</label><element-citation publication-type="journal" id="sref2"><person-group person-group-type="author"><name><surname>Ki</surname><given-names>M.</given-names></name></person-group><article-title>MERS outbreak in Korea: hospital-to-hospital transmission</article-title><comment>2015</comment><source>Epidemiol Health</source><volume>37</volume><year>2015</year><fpage>e2015033</fpage><pub-id pub-id-type="pmid">26212508</pub-id></element-citation></ref><ref id="bib3"><label>3</label><element-citation publication-type="book" id="sref3"><person-group person-group-type="author"><name><surname>Korea Centers for Disease Control and Prevention (KCDC)</surname></name></person-group><chapter-title>Infection prevention and Control guideline for Middle East respiratory Syndrome coronavirus</chapter-title><edition>fourth ed.</edition><year>2016</year><publisher-name>KCDC</publisher-name><publisher-loc>Osong</publisher-loc></element-citation></ref><ref id="bib4"><label>4</label><element-citation publication-type="book" id="sref4"><person-group person-group-type="author"><name><surname>World Health Organization (WHO)</surname></name></person-group><chapter-title>Laboratory testing for Middle East respiratory Syndrome coronavirus (MERS-CoV). Interim guidance</chapter-title><year>2015</year><publisher-name>WHO</publisher-name><publisher-loc>Geneva</publisher-loc></element-citation></ref><ref id="bib5"><label>5</label><element-citation publication-type="journal" id="sref5"><person-group person-group-type="author"><name><surname>Atabani</surname><given-names>S.F.</given-names></name><name><surname>Wilson</surname><given-names>S.</given-names></name><name><surname>Overton-Lewis</surname><given-names>C.</given-names></name><name><surname>Workman</surname><given-names>J.</given-names></name><name><surname>Kidd</surname><given-names>I.M.</given-names></name><name><surname>Petersen</surname><given-names>E.</given-names></name></person-group><article-title>Active screening and surveillance in the United Kingdom for Middle East respiratory syndrome coronavirus in returning travellers and pilgrims from the Middle East: a prospective descriptive study for the period 2013-2015</article-title><source>Int J Infect Dis</source><volume>47</volume><year>2016</year><fpage>10</fpage><lpage>14</lpage><pub-id pub-id-type="pmid">27117200</pub-id></element-citation></ref><ref id="bib6"><label>6</label><element-citation publication-type="journal" id="sref6"><person-group person-group-type="author"><name><surname>Chowell</surname><given-names>G.</given-names></name><name><surname>Abdirizak</surname><given-names>F.</given-names></name><name><surname>Lee</surname><given-names>S.</given-names></name><name><surname>Lee</surname><given-names>J.</given-names></name><name><surname>Jung</surname><given-names>E.</given-names></name><name><surname>Nishiura</surname><given-names>H.</given-names></name></person-group><article-title>Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study</article-title><source>BMC Med</source><volume>13</volume><year>2015</year><fpage>210</fpage><pub-id pub-id-type="pmid">26336062</pub-id></element-citation></ref></ref-list><ack id="ack0010"><title>Acknowledgement</title><p>Ethical clearance of this study is exempted as an emergency response. Informed written consent was taken from all suspected cases. We would like to thank the colleagues at the Division of Infectious Disease Control, Gyeonggi Provincial Government, and Division of Infectious Disease Research, Gyeonggi Province Institute of Health and Environment for assistance in the data collection.</p></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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