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Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications.
J Hosp Infect. 2017 Feb; 95(2):207-213.JH

Abstract

BACKGROUND

Since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea was reported on 20th May 2015, there have been 186 confirmed cases, 38 deaths and 16,752 suspected cases. Previously published research on South Korea's MERS outbreak was limited to the early stages, when few data were available. Now that the outbreak has ended, albeit unofficially, a more comprehensive review is appropriate.

METHODS

Data were obtained through the MERS portal by the Ministry for Health and Welfare (MOHW) and Korea Centres for Disease Control and Prevention, press releases by MOHW, and reports by the MERS Policy Committee of the Korean Medical Association. Cases were analysed for general characteristics, exposure source, timeline and infection generation. Sex, age and underlying diseases were analysed for the 38 deaths.

FINDINGS

Beginning with the index case that infected 28 others, an in-depth analysis was conducted. The average age was 55 years, which was a little higher than the global average of 50 years. As in most other countries, more men than women were affected. The case fatality rate was 19.9%, which was lower than the global rate of 38.7% and the rate in Saudi Arabia (36.5%). In total, 184 patients were infected nosocomially and there were no community-acquired infections. The main underlying diseases were respiratory diseases, cancer and hypertension. The main contributors to the outbreak were late diagnosis, quarantine failure of 'super spreaders', familial care-giving and visiting, non-disclosure by patients, poor communication by the South Korean Government, inadequate hospital infection management, and 'doctor shopping'. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors.

Links

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Authors+Show Affiliations

Kim KH
Institute for Occupational and Environmental Health, Korea University, Seoul, Korea.
Tandi TE
Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea; Ministry of Public Health Yaounde, Yaounde, Cameroon.
Choi JW
Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea; MERS Policy Committee of the Korean Medical Association, Seoul, Korea. Electronic address: shine@korea.ac.kr.
Moon JM
Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea.
Kim MS
Institute for Occupational and Environmental Health, Korea University, Seoul, Korea; Graduate School of Public Health, Korea University, Seoul, Korea.

MeSH

AdolescentAdultAge DistributionAgedAged, 80 and overCoronavirus InfectionsCross InfectionDisease OutbreaksDisease Transmission, InfectiousFemaleHumansInfection ControlMaleMiddle AgedMiddle East Respiratory Syndrome CoronavirusMortalityRepublic of KoreaSex FactorsYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28153558

Clinical Trial Links

Primary Prevention of Infection by COVID-19 in Workers

Citation

Kim, K H., et al. "Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Outbreak in South Korea, 2015: Epidemiology, Characteristics and Public Health Implications." The Journal of Hospital Infection, vol. 95, no. 2, 2017, pp. 207-213.
Kim KH, Tandi TE, Choi JW, et al. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. J Hosp Infect. 2017;95(2):207-213.
Kim, K. H., Tandi, T. E., Choi, J. W., Moon, J. M., & Kim, M. S. (2017). Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. The Journal of Hospital Infection, 95(2), 207-213. https://doi.org/10.1016/j.jhin.2016.10.008
Kim KH, et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Outbreak in South Korea, 2015: Epidemiology, Characteristics and Public Health Implications. J Hosp Infect. 2017;95(2):207-213. PubMed PMID: 28153558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, 2015: epidemiology, characteristics and public health implications. AU - Kim,K H, AU - Tandi,T E, AU - Choi,J W, AU - Moon,J M, AU - Kim,M S, Y1 - 2016/10/14/ PY - 2016/08/24/received PY - 2016/10/07/accepted PY - 2017/2/6/pubmed PY - 2017/3/3/medline PY - 2017/2/4/entrez KW - Epidemiology KW - MERS-CoV outbreak KW - Public health KW - South Korea SP - 207 EP - 213 JF - The Journal of hospital infection JO - J Hosp Infect VL - 95 IS - 2 N2 - BACKGROUND: Since the first case of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea was reported on 20th May 2015, there have been 186 confirmed cases, 38 deaths and 16,752 suspected cases. Previously published research on South Korea's MERS outbreak was limited to the early stages, when few data were available. Now that the outbreak has ended, albeit unofficially, a more comprehensive review is appropriate. METHODS: Data were obtained through the MERS portal by the Ministry for Health and Welfare (MOHW) and Korea Centres for Disease Control and Prevention, press releases by MOHW, and reports by the MERS Policy Committee of the Korean Medical Association. Cases were analysed for general characteristics, exposure source, timeline and infection generation. Sex, age and underlying diseases were analysed for the 38 deaths. FINDINGS: Beginning with the index case that infected 28 others, an in-depth analysis was conducted. The average age was 55 years, which was a little higher than the global average of 50 years. As in most other countries, more men than women were affected. The case fatality rate was 19.9%, which was lower than the global rate of 38.7% and the rate in Saudi Arabia (36.5%). In total, 184 patients were infected nosocomially and there were no community-acquired infections. The main underlying diseases were respiratory diseases, cancer and hypertension. The main contributors to the outbreak were late diagnosis, quarantine failure of 'super spreaders', familial care-giving and visiting, non-disclosure by patients, poor communication by the South Korean Government, inadequate hospital infection management, and 'doctor shopping'. The outbreak was entirely nosocomial, and was largely attributable to infection management and policy failures, rather than biomedical factors. SN - 1532-2939 UR - https://www.unboundmedicine.com/medline/citation/28153558/Middle_East_respiratory_syndrome_coronavirus__MERS_CoV__outbreak_in_South_Korea_2015:_epidemiology_characteristics_and_public_health_implications_ DB - PRIME DP - Unbound Medicine ER -