On March 19, 2021, the Korean Bioethics Association and related academic circles published a joint statement criticizing the partial revision of Infectious Disease Control And Prevention Act. However, according to the Bioethics And Safety Act of Korea, research conducted by the state or local governments for public welfare is excluded from human subjects research project. In addition, since the Korean legal system is not based on the dichotomy between research and surveillance, the discussion of the US Common Rule cannot be directly applied to Korea. For the harmonious operation of the state's duty to manage infectious diseases and the Institutional Review Boards, institutional alternatives should be prepared in consideration of the following issues. First, the related academic community should first pay attention to the problems of the current laws in Korea. Second, it should be understood that the state is carrying out many tasks without the consent of the parties in order to fulfill its duty to manage infectious diseases. Third, when presenting institutional alternatives, it is necessary to consider the feasibility of implementation in Korea. An in-depth discussion of the institutional alternatives by the Medical Law Society and other related academic circles is necessary.
Kim, Eun Young;Ryu, Boyeong;Kim, Eun Kyoung;Park, Young-Joon;Choe, Young June;Park, Hye Kyung;Jeong, Eun Kyeong
Pediatric Infection and Vaccine
/
v.27
no.3
/
pp.180-183
/
2020
Purpose: To describe pediatric coronavirus disease 2019 (COVID-19) cases after the reopening of schools in the Republic of Korea and their transmission routes. Methods: All case report forms and epidemiologic investigation forms for children aged 3-18 years reported as COVID-19 cases to the National Notifiable Disease Surveillance System from May 1 to July 12, 2020, were reviewed. Results: After the schools were reopened in May 2020, a total of 127 pediatric COVID-19 cases were confirmed until July 12. Of these, 59 children (46%) were exposed to severe acute respiratory syndrome coronavirus 2 through family and relatives, followed by 18 children (14%) through cram schools or private lessons, 8 children (6%) through multi-use facilities, and 3 children (2%) through school. Conclusions: The present data do not suggest an increased risk of COVID-19 transmission in the context of stringent school-based infection prevention measures introduced across the country.
Background: In the absence of a vaccine or treatment, the most pragmatic strategies against an infectious disease pandemic are extensive early detection testing and social distancing. This study aimed to summarize public and workplace responses to Coronavirus Disease-19 (COVID-19) and show how the Korean system has operated during the COVID-19 pandemic. Method: Daily briefings from the Korean Center for Disease Control and the Central Disaster Management Headquarters were assembled from January 20 to May 15, 2020. Results: By May 15, 2020, 11,018 COVID-19 cases were identified, of which 15.7% occurred in workplaces such as health-care facilities, call centers, sports clubs, coin karaoke, and nightlife destinations. When the first confirmed case was diagnosed, the Korean Center for Disease Control and Central Disaster Management Headquarters responded quickly, emphasizing early detection with numerous tests and a social distancing policy. This slowed the spread of infection without intensive containment, shut down, or mitigation interventions. After entering the public health blue alert level, a business continuity plan was distributed. After entering the orange level, the Ministry of Employment and Labor developed workplace guidelines for COVID-19 consisting of social distancing, flexible working schedules, early identification of workers with suspected infections, and disinfection of workplaces. Owing to the intensive workplace social distancing policy, workplaces remained safe with only small sporadic group infections. Conclusion: The workplace social distancing policy with timely implementation of specific guidelines was a key to preventing a large outbreak of COVID-19 in Korean workplaces. However, sporadic incidents of COVID-19 are still ongoing, and risk assessment in vulnerable workplaces should be continued.
Carbapenem-resistant Enterobacteriaceae (CRE) infections have increased rapidly over the past decade and are recognized as a severe health threat in Korea and worldwide. This study aimed to identify the status and characteristics of CRE infection in Jeju province and provide important basic data for the prevention and management of CRE infection. A descriptive epidemiological analysis was performed on reported cases of CRE infection in Jeju Province between 2018 and 2021 using the integrated management system for disease, an infectious disease reporting system from the Korea Disease Control and Prevention Agency. The annual difference and distribution trends of CRE infection were analyzed using CRE isolates, carbapenemase-producing CREs (CP-CRE) and their genotypes, and the type of medical institution in Jeju Province. CRE infections steadily increased in Jeju from 2018 to 2021, and the proportion of CP-CRE among the CREs also showed a statistically significant increase each year. Among the CRE isolates, Klebsiella pneumoniae (KPC, 62.13%) was the most common, and among the CP-CRE genotypes, KPC (81.62%) showed the highest distribution and increased each year. As the distribution of CP-CRE in have increased over the past 4 years, measures to prevent the spread and outbreak of CRE infections are warranted. The results of this study are expected to be used as basic data for prevention and management of CRE infections in the province.
The crowded environment of a domestic pig farm is highly vulnerable to the spread of infectious diseases such as foot-and-mouth disease, and studies have been conducted to automatically analyze behavior of pigs in a crowded pig farm through a video surveillance system using a camera. Although it is required to correctly separate occluding pigs for tracking each individual pigs, extracting the boundaries of the occluding pigs fast and accurately is a challenging issue due to the complicated occlusion patterns such as X shape and T shape. In this study, we propose a fast and accurate method to separate occluding pigs not only by exploiting the characteristics (i.e., one of the fast deep learning-based object detectors) of You Only Look Once, YOLO, but also by overcoming the limitation (i.e., the bounding box-based object detector) of YOLO with the test-time data augmentation of rotation. Experimental results with two-pigs occlusion patterns show that the proposed method can provide better accuracy and processing speed than one of the state-of-the-art widely used deep learning-based segmentation techniques such as Mask R-CNN (i.e., the performance improvement over Mask R-CNN was about 11 times, in terms of the accuracy/processing speed performance metrics).
Lee, Hong Jue;Sohn, Young Mo;Kim, Joung Soon;Kim, Young Taek;Lee, Jong Gu;Choi, Bo Youl
Pediatric Infection and Vaccine
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v.8
no.2
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pp.135-149
/
2001
Purpose : To describe the characteristics of the claims for compensation and the methodology of investigations concerning adverse events following immunization(AEFI) and epidemiologic characteristics of the AEFI. From these results, to give a suggestion for improving AEFI surveillance system, consequently to stabilize National Immunization Program. Methods : Totally 61 cases were reported to the National Compensation Program and surveillance system of AEFI from 1995 to 2000. Documents from National Compensation Program, medical records and epidemiologic investigation reports of the cases were collected and analyzed. Results : The number of reported cases was 12 in 1995, 3 in 1996, 12 in 1998, 5 in 1999, and 29 in 2000, respectively. That of deaths was 24(39.3%) and 16 cases among them were autopsied(66.7%). That of claims for compensation was 36 and 17 cases among them were compensated(47.2%). The proportion of claim was lower in 1999~2000 than in 1995~1998, but proportion of compensation increased. Although proportion of investigation was lower in 1999~2000 than in 1995~1998, cases which were not epidemiologically investigated, decreased. The epidemiologic investigation launched within 24 hours after report increased from 25% in 1995~1998 to 48.3% in 1999~2000. Among reported cases, the number of boys was 31(50.8%), and 75.4% of subjects were from 2 months to 24 months old. 78.4% of adverse events occurred within one week after immunization. Conclusion : We can find that surveillance system of AEFI and quality of epidemiologic investigation has been somewhat improved. But, it seems that severe cases were more frequently reported than moderate or mild cases, and reporting rate was lower than that of other developed countries. We could not identify the detailed epidemiologic characteristics of AEFI due to these limitation of data. To achieve the stabilization of National Immunization Program, reporting rate and the quality of investigation should be improved.
Highly pathogenic avian influenza (HPAI) is among the top infectious disease priorities in Korea and the leading cause of economic loss in relevant poultry industry. An understanding of the spatial epidemiology of HPAI outbreak is essential in assessing and managing the risk of the infection. Though previous studies have reported the majority of outbreaks occurred clustered in what are preferred to as densely populated poultry regions, especially in southwest coast of Korea, little is known about the spatial distribution of risk areas vulnerable to HPAI occurrence based on geographic information system (GIS). The main aim of the present study was to develop a GIS-based risk index model for defining potential high-risk areas of HPAI outbreaks and to explore spatial distribution in relative risk index for each 252 Si-Gun-Gu (administrative unit) in Korea. The risk index was derived incorporating seven GIS database associated with risk factors of HPAI in a standardized five-score scale. Scale 1 and 5 for each database represent the lowest and the highest risk of HPAI respectively. Our model showed that Jeollabuk-do, Chungcheongnam-do, Jeollanam-do and Chungcheongbuk-do regions will have the highest relative risk from HPAI. Areas with risk index value over 4.0 were Naju, Jeongeup, Anseong, Cheonan, Kochang, Iksan, Kyeongju and Kimje, indicating that Korea is at risk of HPAI introduction. Management and control of HPAI becomes difficult once the virus are established in domestic poultry populations; therefore, early detection and development of nationwide monitoring system through targeted surveillance of high-risk spots are priorities for preventing the future outbreaks.
The transmissible spongiform encephalopathies (TSEs) disease group are fatal neurodegenerative disorders affecting a wide range of hosts. The group includes kuru and Creutzfeldt-Jakob disease (CJD) in humans, scrapie in sheep and goats and Bovine spongiform encephalopathy (BSE) in cattle. The exact nature of the infectious agent involved in the transmission of these diseases remains controversial. However, a central event in their pathogenesis is the accumulation in infected tissues of an abnormal form of a host-encoded protein, the prion protein (PrP). Whereas the normal cellular protein is fully sensitive to protease ($PrP^{sen}$), the disease-associated prion protein ($PrP^d$) is only partly degraded ($PrP^{res}$), its amino-terminal end being removed. BSE was first reported in the mid-80s in the UK. Ten years later, a new form of human prion disease, variant CJD (vCJD) developed in the wake of the BSE epidemic, and there is now strong scientific evidence that vCJD was initiated by the exposure of humans to BSE-infected tissues, thus indicating a zoonotic disease. However, the ban on the feeding of animal-derived proteins to ruminants, and the apparent lack of vertical transmission of BSE, have led to a decline in the incidence of the disease within cattle herd and therefore, an assumed decreased risk for human contacting vCJD. The origin of the original case(s) of BSE still remains an enigma even though three hypotheses have been raised. Hypotheses are i) sheep- or goat-derived scrapie-infected tissues included in meat and bone meal fed to cattle, ii) a previously undetected sporadic or genetic bovine TSE contaminating cattle feed or iii) originating from a human TSE through animal feed contaminated with human remains. A host cellular membrane protein ($PrP^C$), which is abundant in central nervous system tissue, appear to be conformationally altered in the diseased host into a prion protein ($PrP^{Sc}$). This $PrP^{Sc}$ is detergent insoluble and partially protease-resistant ($PrP^{res}$). The term $PrP^{res}$ is normally used to describe the protein detected after protease treatment, in techniques such as Western immunoblotting, and enzyme-linked immunosorbant assay using fresh/frozen tissue. Immunohistochemistry may performed with formalin-fixed tissues. Also, clinical signs of the BSE are one of the major diagnostic indicators. Recently, atypical forms (known as H- and L-type) of BSE have appeared in several European countries, Japan, Canada and the United States. An unusual case was also reported in a miniature zebu. The atypical BSE fall into two groups based on the relative molecular mass (Mm) of the unglycosylated $PrP^{res}$ band relative to that of classical BSE, one of the higher Mm (H-type) and the other lower (L-type). Both types have been detected worldwide as rare cases in older animals, at a low prevalence consistent with the possibility of sporadic forms of prion diseases in cattle. This raises the unwelcome possibility that vCJD could increase in the human population. Now, active surveillance program against BSE is going on in Korea. In regional veterinary service lab, ELISA is applied to screen the BSE in slaughter and confirmatory tests by Western immunoblotting and immunohistochemisty are carried out if there are positive or suspect in the screening test. Also, the ruminant feed ban is rigorously enforced. Removal of specified risk materials such as brain and spinal cord from cattle is mandatory process at slaughter to prevent the infected material from entering the human food chain.
Health is a fundamental human right and a sine qua non for happiness of people and for national development. Government has a responsibility for the provision of health services for their people. Recent changes of disease pattern, i.e. decrease of Infectious diseases and increase of chronic and degenerative diseases Including cancer and cardiovascular diseases, together with universal coverage of health insurance and improved living standard have prompted medical care utilization and skyrocketed the national health expenses. The goal of national health policy is improving the quality of life through the betterment of health level. To achieve this goal it is necessary to establish a healthcare system for lifetime, to improve the efficiency of healthcare delivery system, and to strengthen the public health services for disease prevention and health promotion. The current public health service programs are Inefficient due to an inconsistent policy for health service program, lack of health information system, irrational health program planning and evaluation, and Inadequate training of health workers. Local government has a legal responsibility for health service program planning and promoting the competence of health workers. Thus, municipal and provincial health departments should expand their roles and strengthen their function. The strategies for developing public health service programs at local level are ${\circled}1$ stipulating the goals of health policy, ${\circled}2$ promoting the ability for health program planning and evaluation, ${\circled}3$ establishing health information and surveillance system, ${\circled}4$ training of health workers, ${\circled}5$ establishing an institution for health information management and training of health workers, and ${\circled}61$ collaboration with local universities.
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