COVID-19 in Nursing Facilities: Experience in Republic of Korea

ObjectivesCoronavirus disease 2019 (COVID-19) outbreaks in nursing facilities can easily lead to a high rate of infection and fatality. A surge in newly infected cases in the first quarter of 2020 in Gyeongsan-si, in the Republic of Korea, was followed by several outbreaks in nursing facilities in the same area. The aim of this study is to report on the epidemiological investigation and the management to reduce the infection rate in nursing facilities for older adults.MethodsThe municipal government and the Korea Centers for Disease Control and Prevention performed an epidemiological investigation into 5 nursing facilities that reported a high number of COVID-19 infection cases from February to May 2020. COVID-19 infected cases in the facilities were investigated to identify the infection routes, and the fatality rate of the 5 facilities.ResultsThe 5 facilities had a combined fatality rate of 12.2% (9 deceased among the 74 infected cases). The median age of the deceased was 87 years old (range: 82–91). The infection was first identified on February 27th, 2020, peaked on March 6th, and was last detected on March 24th, 2020.ConclusionDifficulties specific to such facilities included the delay in the recognition of symptoms and limitation in distancing. Tailored strategies such as daily monitoring of symptoms and proactive COVID-19 screening of quarantined residents, contributed to a decline in the infections in the facilities.

Operating a National Hotline in Korea During the COVID-19Pandemic

The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the upto-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.

Operating a National Hotline in Korea During the COVID-19Pandemic

The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the upto-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.

A 6-year Prospective, Observational, Multi-Center Post-Marketing Surveillance of the Safety of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccine in Korea

BACKGROUND: Incidence of whooping cough is increasing in Korea. Since 2011, occurrence among adolescents and adults has risen putting vulnerable neonates at risk. National immunization guidelines now include Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during pregnancy and as a cocooning strategy (i.e., vaccinating adults and adolescents in contact with neonates). This study assessed post-marketing Tdap (Boostrix®, GSK, Belgium) vaccine safety in subjects ≥ 10 years. METHODS: This open, non-comparative multi-center study was conducted over six years at 10 hospitals in Korea. Subjects received Tdap in normal clinical practice according to local prescribing information. All adverse events (AEs) were recorded, classified as expected or unexpected, and severity and relationship to Tdap were assessed. RESULTS: The analysis included 672 Korean subjects (mean age, 44 years; range, 11–81), 451 were women and 211 were pregnant. Ninety subjects experienced 124 AEs (incidence 13.39%) of which six were serious AEs (SAEs) assessed as not related to vaccination, and 51 were non-SAEs related to vaccination (mostly administration site reactions). Overall 65/124 AEs were unexpected; the most common were 14 constipation, 5 dyspepsia, 4 common cold and 4 premature labor cases. One case of common cold was assessed as possibly related to vaccination. Pregnancy outcome was ‘live infant, no apparent congenital anomaly’ in 195 subjects (92.42%) or ‘lost to follow-up’ in 16 subjects. CONCLUSION: Tdap administration to Korean subjects ≥ 10 years, including pregnant women, for the prevention of diphtheria, tetanus and pertussis was shown to have a well-tolerated safety profile. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01929291

Relationship between work loss due to oral diseases and self-perceived oral health status among workers / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the work loss caused by oral diseases of workers and their subjective self-perceived oral health status. The study focused on the relationship between work loss due to oral diseases and self-perceived oral health status. METHODS: A cross-sectional survey was conducted. The sample consisted of 550 workers who resided in Ansan City and Gwacheon City. The data were collected from a self-reported questionnaire survey. RESULTS: The percentage of workers that were absent from the workplace due to oral diseases in the past year was 4.8%, and the average of days of absence from the workplace per worker was 0.1 day. Most of the workers (41.1%) answered “average” for the self-perceived oral health status. However, there were more workers that answered “not healthy” than workers that answered “healthy” for the self-perceived oral health status. The percentage of workers that felt the need for dental treatment because of the presence of oral diseases was 59.5%. There was a statistically significant relationship between the work loss due to oral diseases and the subjective self-perceived oral health status. CONCLUSIONS: Work loss due to oral diseases and subjective self-perceived oral health status should be periodically assessed for use as basic data for the development of oral health-promotion policies for workers.

Treatment of an omental cyst by laparoscopic surgery / 대한산부인과학회지

Mesenteric cysts are uncommon, and they are histopathologically classified as pseudocyst, mesothelial cyst, lymphangioma and omental cyst. We report a case of a 27-year-old female with a huge cystic mass arising from greater omentum. Patient complained the symptoms of abdominal distention due to massive ascites and intermittent pelvic discomfort. The diagnostic examinations including ultrasonography and computed tomography were performed and identified a huge, intraabdominal cyst. Laparoscopic resection of cyst was done with no clinical and symptomatic evidence of adverse event till 12 months. The diagnostic role of sonography and CT in ascites with unknown etiology is emphasized. Minimal invasive surgery showed comparable result to open exploration.

A case of cystolithiasis after intravesical migration of Copper T intrauterine device / 대한산부인과학회지

An intrauterine device (IUD) is one of the most commonly used contraceptive method in the world. One of the major complications of intrauterine contraception is the perforation through the uterine wall into the pelvic or abdominal cavity. The incidence is 0.9 people per 1000. However, bladder perforation is even more rare. It happens mostly at the time when it was inserted. The symptom varies from no symptom at all to low abdominal pain, massive bleeding, et cetera. We report a case with displaced intrauterine device in bladder, producing the bladder stone which was managed with cystoscopic lithotripsy and intrauterine device removal, followed by a review of the literature.

Magnetic resonance imaging in the evaluation of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis: a case report / 대한산부인과학회지

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly. Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis usually presents after menarche with progressive abdominal pain during menses secondary to hematocolpos. The method of choice for diagnosis is magnetic resonance imaging (MRI). MRI can do much for the early diagnosis and the prevention against further complications of this condition because it can demonstrate the mullerian duct anomaly complicated with obstructed hemivagina in detail and even ipsilateral renal agenesis. A greater awareness of the syndrome of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis should lead to its prompt diagnosis, allowing for early and appropriate surgical intervention as well as decreased long-term morbidity. Early accurate diagnosis after menarche followed by excision and marsupialization of the blind hemivagina offers complete relief of symptoms and preserves reproductive potential. We report a case of uterine didelphys with obstructed hemivagina and ipsilateral renal agensis with a brief review of the literature.