• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.274-276
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• 2015

Since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (hereafter Korea) began on May 11, 2015, a total of 186 persons have been infected by the MERS coronavirus, 38 of whom have died. With this number, Korea becomes second only to the Kingdom of Saudi Arabia in the ranking of cumulative MERS cases. In this paper Korea's unique experience of an outbreak of MERS will be summarized and discussed briefly.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.1-9
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• 2015

Objectives: The purpose of this article was to assess epidemiological characteristics and recommendations for strengthening national response and preparedness after MERS-CoV outbreak in Korea, 2015. Methods: The author reviewed epidemiological reports and policy recommendations on MERS-CoV outbreak in Korea, 2015. Results: There was no evidence that genetical difference between the MERS viruses in the Republic of Korea and recent viruses in the Middle East. From the index case to last laboratory-confirmed case, there were 186 laboratory-confirmed cases that included 36 deaths(19.4%), all of whom appear epidemiologically linked to the index cases or subsequent secondary, tertiary, and quaternary cases. This outbreak spread to hospitals through nosocomial transmission. At least, three large clusters were investigated. However, there was at least one case of community transmission of MERS-CoV. Several factors had contributed to the MERS outbreak in Korea, 2015 that including epidemiological characteristics, and infrastructure of national healthcare system for preventing and controlling emerging infectious diseases. Conclusions: It is very important that to share experiences and identify underlying causes of this outbreak for prevention and control of emerging infectious disease in the future; including epidemiology, clinical features, and public health response and preparedness.

• Journal of Contemporary Eastern Asia
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• v.16 no.1
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• pp.69-81
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• 2017

This study examines how South Korean governments responded to the outbreak of Middle East Respiratory Syndrome Coronavirus (MERS) using the adaptive governance framework. As of November 24, 2015, the MERS outbreak in South Korea resulted in the quarantine of about 17,000 people, 186 cases confirmed, and a death of 38. Although the national government had overall responsibility for MERS response, there is no clear understanding of how the ministries, agencies, and subnational governments take an adaptive response to the public health crisis. The paper uses the adaptive governance framework to understand how South Korean governments respond to the unexpected event regarding the following aspects: responsiveness, public learning, scientific learning, and representativeness of the decision mechanisms. The framework helps understand how joint efforts of the national and subnational governments were coordinated to the unexpected conditions. The study highlights the importance of adaptive governance for an effective response to a public-health related extreme event.

• Journal of Korean Neuropsychiatric Association
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• v.56 no.1
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• pp.28-34
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• 2017

Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

• Korean Security Journal
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• no.52
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• pp.145-162
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• 2017

In 2005, the Republic of Korea suffered from the outbreak of MERS(Middle East respiratory syndrome), leaving 186 infectees and 38 casualties. Responding to this crisis, Korean government revealed many problems in emergency management policies and was widely criticized. A similar case in emergency management and infectious disease control is the 1999 outbreak of West Nile Virus(WNV) outbreak in the United States. During this period, the state of Oregon effectively responded to WNV through collaboration between state and local government, being considered as a model case of emergency management. This article aims to find insights in emergency management and infectious disease control by analyzing and comparing the responses of Korean MERS outbreak and Oregon's WNV outbreak focusing on interorganizational collaboration. Insights found in this study include the role of control tower, the importance of information sharing and disclosure, the role of existing systems and social networks, and sustainable intergovernmental collaboration.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• v.21 no.3
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• pp.143-154
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• 2017

This paper presents the mathematical model for the MERS-CoV outbreak in South Korea, and the optimal control for two intervention strategies (contact, hospitalization) is implemented. After the MERS-CoV outbreak, hospitalizing infected individuals did not help to prevent the spread of infection. However, the intervention to control contact was effective. It was effective the intervention to controlling both of contact and hospitalization of infection population.

• Research in Community and Public Health Nursing
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• v.29 no.1
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• pp.65-75
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• 2018

Purpose: This study aims to examine how elementary, middle and high school health teachers in Gyeonggi province react to infectious disease like MERS. Methods: This is a descriptive study using a convenience sample of 1,267 school health teachers. Results: When MERS was an epidemic, school health teachers who took the 'leading' role were 92.4%. A school heath teacher's countermeasures against infectious diseases showed a high score during MERS outbreak (3.81) compared to regular days (3.59). Conclusion: Based on such results, it has been determined that schools need to keep two types of procedures manual, such as 'countermeasures on a regular basis' and 'countermeasures in the event of a pandemic disease outbreak' manual in the staff offices so that anyone can view them at any time. It is necessary to prepare regulations to strengthen their authority so that school health teachers can take the role of control tower, in a professional capacity, when communicable disease is spreading. In order to prevent any confusion and chaos, there should be a unitary reporting system at each school when dealing with an epidemic. School health teachers need to get continuous training to reinforce their abilities to react to communicable diseases.

• Korean Journal of Clinical Pharmacy
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• v.26 no.4
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• pp.330-340
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• 2016

Objective: The outbreak of Middle East Respiratory Syndrome (MERS) started in South Korea in May 2015 and the end of crisis was declared in December 2015 by Korea Centers of Disease Control and Prevention (KCDC). However, Zika virus emerged in less than 2 months following MERS and showed higher mortality than other countries. This study is to assess the current prevention system of overseas infectious diseases, based on MERS and Zika virus outbreak and to suggest effective response system for the future. Methods: We conducted two surveys on medical specialists working at tertiary general hospitals regarding the effectiveness of responding system by KCDC against MERS and Zika virus and education in individual medical institutions using 5-Likert points. Response system was examined in three different periods as initial period, spreading period, and post disease period. Results: Although medical specialists received the notifications in initial period, no practical prevention was proven to be placed in responding stage by medical facilities (averagely 3.5/5 points in total and sub-analyses). During spreading period, there were several academic seminars conducted, which were evaluated as helpful. In post disease period, all answered that there were changes on patient treatment in all medical facilities, with mainly report system and the treatment regulations in case of suspicious patients for infection. Only 49% respondents answered positive on the possibility of initial responses. For questionnaire items regarding Zika virus, all answered that there were notifications prior to the first outbreak of the infected patient. Eighty% of respondents were aware of 'the Guideline system for traveling to dangerous areas', and answered that the system was moderately effective (averagely 3.8/5 points in total). For the effectiveness of prevention measures for foreign novel disease by KCDC, the average point was 3.0 in both of total and sub-analyses. Conclusion: There is not enough response system to prevent infectious disease in medical institutional and governmental levels in Korea. It would warrant the modification of overall medical system to improve preventive measures for initial spread of such diseases.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.179-188
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• 2017

Purpose: This study examined post-traumatic stress (PTS) and the factors affecting it among general hospital nurses after the MERS(Middle East Respiratory Syndrome) epidemic. Methods: Data were collected from 170 nurses who worked at general hospitals since the first reported MERS outbreak. The IES-R-K assessed PTS. Data were analyzed using SPSS. Results: The mean PTS level was 7.80 points (range: 0~88); 7.1% of the participants were at a high risk. Nurses who had been in contact with patients suspected or diagnosed with MERS had high post-traumatic levels; those who had been quarantined during the MERS outbreak had relatively higher PTS levels. Shift-work nurses had higher PTS levels than those with fixed working hours. Above charge' nurses stress levels were higher than staff nurses' stress levels. The results showed that factors including contact with an MERS-suspected or diagnosed patient, position at work, and working status of MERS-affected nurses explained 16% of the PTS. Among the main variables, nurses' above charge position was the greatest factor affecting PTS. Discussion: It is necessary to develop intervention studies and programs considering these variables. Furthermore, development and implementation of differentiated programs should be done considering the position of above charge nurses.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.265-270
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• 2015

The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system's weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of "control tower" in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.