ABSTRACT
The role that children play in the transmission of the omicron variant is unclear. Here we report an outbreak that started in young children attending various pediatric facilities, leading to extensive household transmission that affected 75 families with 88 confirmed case-patients in 3 weeks. Tailored social and public health measures directed towards children and pediatric facilities are warranted with the emergence of highly transmissible omicron variant to mitigate the impact of coronavirus diseases 2019 (COVID-19).
ABSTRACT
Prolonged viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in an immunocompromised host is a challenge as the treatment and infection control for chronic coronavirus disease 2019 infection is not well established and there is a potential risk of new variants emerging. A 48-year-old woman who underwent chemotherapy, including rituximab and steroid, had reactivation of SARS-CoV-2 68 days after the virus was first detected. She successfully recovered after receiving convalescent plasma and intravenous immunoglobulin. Genomic analysis demonstrated that viruses collected from the nasopharyngeal specimens at day 0 and day 68 had 18 different nucleotide mutations, implying within-host evolution after in-depth epidemiologic investigation.
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Since October 2021, severe acute hepatitis of unknown etiology in pediatric patients has been observed in many countries around the world. Adenovirus (mainly enteric adenovirus) was detected in more than 50% of the cases. Nationwide surveillance on acute hepatitis of unknown etiology in pediatric patients was started in May 2022 in Korea. Taking into account the severity of the illness and the urgency of the epidemiological situation worldwide, we report a summary of changes in adenovirus epidemiology during the past five years and six months in Korea.
ABSTRACT
Objectives@#This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness. @*Methods@#An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness. @*Results@#The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for infection. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%). @*Conclusion@#This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.
ABSTRACT
Background@#Nonpharmacological interventions (NPIs) reduce the incidence of respiratory infections. After NPIs imposed during the coronavirus disease 2019 pandemic ceased, respiratory infections gradually increased worldwide. However, few studies have been conducted on severe respiratory infections requiring hospitalization in pediatric patients.This study compares epidemiological changes in severe respiratory infections during pre-NPI, NPI, and post-NPI periods in order to evaluate the effect of that NPI on severe respiratory infections in children. @*Methods@#We retrospectively studied data collected at 13 Korean sentinel sites from January 2018 to October 2022 that were lodged in the national Severe Acute Respiratory Infections (SARIs) surveillance database. @*Results@#A total of 9,631 pediatric patients were admitted with SARIs during the pre-NPI period, 579 during the NPI period, and 1,580 during the post-NPI period. During the NPI period, the number of pediatric patients hospitalized with severe respiratory infections decreased dramatically, thus from 72.1 per 1,000 to 6.6 per 1,000. However, after NPIs ceased, the number increased to 22.8 per 1,000. During the post-NPI period, the positive test rate increased to the level noted before the pandemic. @*Conclusion@#Strict NPIs including school and daycare center closures effectively reduced severe respiratory infections requiring hospitalization of children. However, childcare was severely compromised. To prepare for future respiratory infections, there is a need to develop a social consensus on NPIs that are appropriate for children.
ABSTRACT
Objectives@#Although it is widely used as a measure for mortality, the case fatality rate (CFR) of coronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons other than viral characteristics. To compare the CFRs of different countries in equal measure, we estimated comparable CFRs after adjusting for multiple covariates and examined the main factors that contributed to variability in the CFRs among 21 countries. @*Methods@#For statistical analysis, time-series cross-sectional data were collected from Our World in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated by pooled generalized linear squares regression models for the panel data. Covariates included the predominant virus variant, reproduction rate, vaccination, national economic status, hospital beds, diabetes prevalence, and population share of individuals older than age 65. In total, 21 countries were eligible for analysis. @*Results@#Adjustment for covariates reduced variation in the CFRs of COVID-19 across countries and over time. Regression results showed that the dominant spread of the Omicron variant, reproduction rate, and vaccination were associated with lower country-level CFRs, whereas age, the extreme poverty rate, and diabetes prevalence were associated with higher country-level CFRs. @*Conclusion@#A direct comparison of crude CFRs among countries may be fallacious, especially in a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over time for a more proper comparison. In addition, our findings suggest that comparing CFRs among different countries without considering their context, such as the epidemic phase, medical capacity, surveillance strategy, and socio-demographic traits, should be avoided.
ABSTRACT
Objectives@#We conducted a comparative analysis of the differences in the incidence of 8 acute respiratory viruses and the changes in their patterns before and during the coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#Three sentinel surveillance systems of the Korea Disease Control and Prevention Agency and data from the Health Insurance Review and Assessment Service were analyzed. The average numbers of reported cases and the related hospital admissions and outpatient data were compared between April 2018–2019 and 2020–2021. Changes in the disease burden and medical expenditures between these 2 time periods were evaluated. @*Results@#During the COVID-19 pandemic, the number of reported cases of all acute respiratory viral infections, except for human bocavirus, decreased significantly. Data from the Health Insurance Review and Assessment Service also showed decreases in the actual amount of medical service usage and a marked reduction in medical expenditures. @*Conclusion@#Non-pharmacological interventions in response to COVID-19 showed preventive effects on the transmission of other respiratory viruses, as well as COVID-19. Although COVID-19 had a tremendous impact on society as a whole, with high social costs, there were also positive effects, such as a reduction in the incidence of acute respiratory viral infections.
ABSTRACT
Antimicrobial resistance and emerging infectious diseases, including avian influenza, Ebola virus disease, and Zika virus disease have significantly affected humankind in recent years. In the premodern era, no distinction was made between animal and human medicine. However, as medical science developed, the gap between human and animal science grew deeper. Cooperation among human, animal, and environmental sciences to combat emerging public health threats has become an important issue under the One Health Initiative. Herein, we presented the history of One Health, reviewed current public health threats, and suggested opportunities for the field of public health through better understanding of the One Health paradigm.