Seroprevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) in public health workers responding to a MERS outbreak in Seoul, Republic of Korea, in 2015

@#The first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in the Republic of Korea was confirmed in May 2015 after a traveller returned from the Middle East. There were 186 cases, including 38 deaths, within two months. The potential of a single MERS-confirmed patient to result in such a large MERS outbreak constitutes a serious global health concern.

Associations Between Hand Hygiene Education and Self-Reported Hand-Washing Behaviors Among Korean Adults During MERS-CoV Outbreak.

BACKGROUND: Hand washing is an effective way to prevent transmission of infectious diseases. Education and promotional materials about hand washing may change individuals' awareness toward hand washing. Infectious disease outbreak may also affect individuals' awareness. AIMS: Our study aimed to examine associations between hand-washing education and self-reported hand-washing behaviors among Korean adults during the year of the Middle East respiratory syndrome (MERS) outbreak. METHODS: Data from the 2015 Community Health Survey were used for this study. The total study population comprised 222,599 individuals who were older than 20 years of age. A multiple linear regression model was used to investigate associations between hand hygiene education and self-reported hand-washing behaviors. Subgroup analyses stratified by age, sex, income, and MERS outbreak regions were also performed. RESULTS: Individuals who received hand-washing education or saw promotional materials related to hand washing had significantly higher scores for self-reported use of soap or sanitizer (ß = 0.177, P < .0001) and self-reported frequency of hand washing (ß = 0.481, P < .0001) than those who did not have such experiences. The effect of hand-washing education on self-reported behavior change was greater among older adults, women, and lower income earners. The effect of hand hygiene education on self-reported use of soap or sanitizer was similar regardless of whether the participants lived in MERS regions. CONCLUSION: Our findings emphasize the importance of education or promotions encouraging hand washing, especially for older adults, women, and lower income earners. In addition, MERS outbreak itself affected individuals' awareness of hand-washing behaviors. Well-organized campaigns that consider these factors are needed to prevent infectious diseases.

Effects of operational decisions on the diffusion of epidemic disease: A system dynamics modeling of the MERS-CoV outbreak in South Korea.

We evaluated the nosocomial outbreak of Middle East Respiratory Syndrome (MERS) Coronavirus (CoV) in the Republic of Korea, 2015, from a healthcare operations management perspective. Establishment of healthcare policy in South Korea provides patients' freedom to select and visit multiple hospitals. Current policy enforces hospitals preference for multi-patient rooms to single-patient rooms, to lower financial burden. Existing healthcare systems tragically contributed to 186 MERS outbreak cases, starting from single "index patient" into three generations of secondary infections. By developing a macro-level health system dynamics model, we provide empirical knowledge to examining the case from both operational and financial perspectives. In our simulation, under base infectivity scenario, high emergency room occupancy circumstance contributed to an estimated average of 101 (917%) more infected patients, compared to when in low occupancy circumstance. Economic patient room design showed an estimated 702% increase in the number of infected patients, despite the overall 98% savings in total expected costs compared to optimal room design. This study provides first time, system dynamics model, performance measurements from an operational perspective. Importantly, the intent of this study was to provide evidence to motivate public, private, and government healthcare administrators' recognition of current shortcomings, to optimize performance as a whole system, rather than mere individual aspects.

Healthcare reform after MERS outbreak: progress to date and next steps

To avoid a future catastrophic event like the recent Middle East respiratory syndrome (MERS) outbreak, we must reform our health system based on an objective and thorough review of the outbreak. A little over a year after the outbreak, this paper aims to evaluate the current status of the government's effort to reform our health system across the three following areas: 1) infectious disease emergency preparedness and response; 2) an organized healthcare system for infectious diseases; and 3) hospital preparedness for healthcare-associated infections. In spite of the substantial organizational changes of the Korea Centers for Disease Control (CDC) responsible for infectious disease emergency preparedness and response, the Korea CDC has not shown significant improvement in its competence and organizational commitment in the face of recent infectious disease threats such as Zika virus and cholera. So far, the Korean government has not announced an implementation plan for establishing an organized healthcare system for infectious diseases. To reduce healthcare associated infections, the Korean government implemented major changes in the hospital infection control system, emergency medical service system, and enhanced nursing system. Because the most extensive reform occurred around reducing healthcare-associated infections in hospitals, we need to evaluate the impact of the entire reform effort in a near future. Because the effort to reform our health system remains ongoing, we also need to continue to observe the progress of reform to ensure the avoidance of a future catastrophic event like the recent MERS outbreak.

Communicating about the Middle East respiratory syndrome outbreak to the international community and in-country foreigners, Republic of Korea, 2015

During the Middle East respiratory syndrome (MERS) outbreak in 2015, the Ministry of Health and Welfare (MOHW) of the Republic of Korea provided outbreak information targeting international visitors and foreign residents through multiple channels. The MOHW created a MERS portal website in Korean and English on 10 June 2015; in addition, the existing MOHW website provided English-language press releases beginning 28 May. A toll-free telephone hotline also started service in English on 12 June; it expanded to include 18 other foreign languages on 15 June. This report describes the usage of these multi-language communication channels during this MERS outbreak.