• Title/Summary/Keyword: Outbreak investigation

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Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006 (2006년 인천의 한 유치원에서 발생한 홍역 유행 역학조사)

  • So, Jae-Sung;Go, Un-Yeong;Lee, Dong-Han;Park, Koang-Suk;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.153-158
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    • 2008
  • Objectives : This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. Methods : The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measles-specific IgM was preformed. Results : Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. Conclusions : High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

Investigation on an epidemic of tuberculosis in dairy cattle farms In Jeongeup, Korea (전북 정읍지역 젖소농장 결핵병 집단 발생에 대한 역학조사)

  • Yoon, Hachung;Moon, Oun-Kyong;Kim, Youn-Ju;Cho, Bum-Joon;Lee, Soo-Doo;Lee, Jeong-Won;Lee, Sang-Jin
    • Korean Journal of Veterinary Research
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    • v.49 no.4
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    • pp.309-317
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    • 2009
  • The present study describes an investigation on an epidemic of Tuberculosis (TB) which has been occurred among dairy cattle farms in Jeongeup, Jeollabuk-do since 2007. The investigation was performed in three ways as follows: 1. Collecting information about bovine TB outbreaks using investigation reports, an on-the-spot and tracing-back investigations; 2. Analyzing the outbreak pattern; 3. Establishing hypothesis and performing statistical analysis on potential risk factors. In the early 2000s, TB outbreaks were sporadically reported in beef cattle, and only a small number ($1{\sim}2$) of reactors was confirmed in each of outbreak farms. The number of TB outbreaks has been suddenly increased from 2007, mainly in dairy cattle farms. And these outbreaks were temporarily clustered during the period, from March 2007 to April 2009 (relative risk, RR = 13.7, p < 0.001). And two spatial clusters of which radiuses were 0.3 km (RR = 6.9, p < 0.001) and 0.9 km (RR = 3.6, p < 0.01). The analysis to find risk factors was performed on 99 dairy farms (21 outbreaks), which are located in the most seriously affected village during 2007-2009. Middleman (odds ratio, OR = 47.4, p < 0.05) and raw milk collecting system (OR = 6.9, p < 0.05) were recognized as with the highest association. Considering the fact that all the outbreak farms except one had their own manure composting tank, it might be that the manure containing pathogen was leaked from tank and transmitted to other farms by fomites such as middleman or raw milk collecting system.

Epidemiologic Investigation to Identify the Cause of an Infant Methemoglobinemia (서울 S지역에서 발생한 영아 메트헤모글로빈혈증 1례의 원인구명을 위한 역학조사)

  • Kim, Young-Yeul;Choi, Bo-Youl;Park, Hang-Bae;Kim, Min-Young;Yeo, In-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.192-201
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    • 1993
  • Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained On analyzing the quality of the ground water on patient's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analysing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with their distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.

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Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011

  • Lim, Hyun-Sul;Choi, Kumbal;Lee, Saerom
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.2
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    • pp.62-73
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    • 2013
  • Objectives: An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease. Methods: A field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested. Results: Three cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases. Conclusions: The initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.

Epidemiological Investigation on an Outbreak of Enterotoxigenic E. coli among the Baseball Club Students of High School in Ulsan City, 2014 (2014년 울산시 일개 고등학교 야구부원들에서 발생한 장독소생성대장균의 유행에 관한 역학조사)

  • Kang, Young-Eun;Lim, Hyun-Sul;Lee, Kwan;Kim, Byung-Seok
    • Journal of agricultural medicine and community health
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    • v.40 no.2
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    • pp.53-61
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    • 2015
  • Objectives: An outbreak of food poisoning occurred among the baseball club students at a high school in Ulsan city in 2014. An epidemiological investigation was carried out to examine the infection source and the transmission route of pathogen, and to prevent a recurrence. Methods: A questionnaire survey was conducted for 26 male students and 2 food handlers. Rectal swabs were examined in 7 students and the 2 food handlers, and an environmental investigation was performed. A retrospective cohort study was used to evaluate the association between risk factors and disease. Results: The attack rate was 35.7% (10 persons/28 persons) from June 9 to 14, and Enterotoxigenic E. coli ST/LT was isolated from 7 among 28 persons. The study revealed that no food was a significant risk factor for the outbreak. There were no connection between environmental factors and the outbreak. Conclusions: The major risk factors for this outbreak were presumed to be the contaminated ice cube and ice making machines and eating ice cube from the machines. More strict personal and environmental hygiene need to be enforced to prevent such outbreaks.

Hepatitis A Outbreak in a Facility for the Disabled, Gyeonggi Province, Korea: An Epidemiological Investigation

  • Chang, Yeonhwa;Kim, Chanhee;Kim, Nayoung;Kim, Joon Jai;Lee, Heeyoung
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.5
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    • pp.370-375
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    • 2021
  • Objectives: The number of cases of hepatitis A virus (HAV) infections has sharply increased in Korea, especially among young adults. In this study, an HAV outbreak in a facility for disabled people was investigated, and we found epidemiological differences both between 2 different generations and between generally abled and disabled groups. Methods: We analyzed the incubation period and attack rate of an HAV outbreak and investigated the prevalence of HAV antibodies among the staff and residents of a facility for the disabled. We performed a retrospective cohort study during the HAV outbreak, which lasted from February 8 to 25, 2019, including examinations of HAV antibody tests and post-exposure HAV vaccination for the staff or residents of the facility. Results: There were 9 confirmed cases in 2 staff members and 7 residents. Among 53 people (30 staff and 23 residents), except for the 9 confirmed cases and 1 staff member with a known history of HAV infection, HAV seroprevalence was seen in 16.7% of the staff under 40 years of age and 95.2% of those over 40 years of age, while the corresponding rates in the residents were 0.0% and 58.8%, respectively. Conclusions: This result implies that it is necessary to prioritize HAV vaccination for vulnerable groups and workers of residential care facilities.

Fifteen Years After the Gozan-Dong Glass Fiber Outbreak, Incheon in 1995

  • Cho, Soo-Hun;Sung, Joo-Hon;Kim, Jong-Hoon;Ju, Young-Su;Han, Min-Ji;Jung, Kyu-Won
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.4
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    • pp.185-189
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    • 2011
  • Objectives: In 1995, an outbreak survey in Gozan-dong concluded that an association between fiberglass exposure in drinking water and cancer outbreak cannot be established. This study follows the subjects from a study in 1995 using a data linkage method to examine whether an association existed. The authors will address the potential benefits and methodological issues following outbreak surveys using data linkage, particularly when informed consent is absent. Methods: This is a follow-up study of 697 (30 exposed) individuals out of the original 888 (31 exposed) participants (78.5%) from 1995 to 2007 assessing the cancer outcomes and deaths of these individuals. The National Cancer Registry (KNCR) and death certificate data were linked using the ID numbers of the participants. The standardized incidence ratio (SIR) and standardized mortality ratio (SMR) from cancers were calculated by the KNCR. Results: The SIR values for all cancer or gastrointestinal cancer (GI) occurrences were the lowest in the exposed group (SIR, 0.73; 95% CI, 0.10 to 5.21; 0.00 for GI), while the two control groups (control 1: external, control 2: internal) showed slight increases in their SIR values (SIR, 1.18 and 1.27 for all cancers; 1.62 and 1.46 for GI). All lacked statistical significance. All-cause mortality levels for the three groups showed the same pattern (SMR 0.37, 1.29, and 1.11). Conclusions: This study did not refute a finding of non-association with a 13-year follow-up. Considering that many outbreak surveys are associated with a small sample size and a cross-sectional design, follow-up studies that utilize data linkage should become standard procedure.