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We analyzed reports for 59,073 contacts of 5,706 coronavirus disease (COVID-19) index patients reported in South Korea during January 20-March 27, 2020. Of 10,592 household contacts, 11.8% had COVID-19. Of 48,481 nonhousehold contacts, 1.9% had COVID-19. Use of personal protective measures and social distancing reduces the likelihood of transmission.

OBJECTIVES: The first confirmed case of coronavirus disease 2019 (COVID-19) in South Korea was reported in January 2020, with 28 confirmed cases reported as of February 14th, 2020. The epidemiological and clinical characteristics of all 28 cases were analyzed in response to this disease. METHODS: The epidemiological characteristics and early clinical features of the 28 patients from Korea with confirmed COVID-19 were analyzed using COVID-19 reporting and surveillance data and the epidemiological investigation reports prepared by the rapid response team. RESULTS: There were 16 patients that entered Korea from foreign countries: Wuhan, China (11 patients), Zhuhai, China, (1 patient), Singapore (2 patients), Japan (1 patient), and Thailand (1 patient). The early symptoms were fever, sore throat, cough or sputum production, chills, and muscle ache. Three patients were asymptomatic, however, 18 developed pneumonia. Of the 28 cases, 16 were index cases imported from abroad, with 10 cases of secondary infection originating in Korea, and the route of transmission still under investigation for 2 patients. The 10 patients with secondary infection were infected from contact with family members or acquaintances of primary patients, and the suspected sites of transmission were mostly at home. CONCLUSION: COVID-19 in Korea was spread by 16 infected individuals traveling from other countries, leading to second-generation cases. The initial symptoms were mostly minor, but the disease was infectious at this stage, resulting from close contact, particularly at home. Establishing an early detection strategy for COVID-19 is crucial for managing the transmission of the disease.

Between January 24th and March 10th, a total of 2,370 individuals had contact with the first 30 cases of COVID-19. There were 13 individuals who contracted COVID-19 resulting in a secondary attack rate of 0.55% (95% CI 0.31–0.96). There were 119 household contacts, of which 9 individuals developed COVID-19 resulting in a secondary attack rate of 7.56% (95% CI 3.7–14.26).

Since 1993, vivax malaria has been recognized as a public health burden in Korea. Despite of pan-governmental malaria-control efforts and the dramatic reduction in the burden of this disease over the last 10 years, vivax malaria has not been well controlled and has remained continuously endemic. We focused interviewed and examined the charts of 28 confirmed vivax malaria patients given malarial therapy for whom daily records were kept from Gimpo-si, Gyeonggido of Korea. Various epidemiological characteristics of vivax malaria, including the incubation period, medication used, and recurrence, and an evaluation of the parasitic characteristics from the focused interviews of patients from this region are described here. Most of the participants indicated the 3 most common symptoms of malaria (headache, chills and fever). Of the 28 cases, 2 experienced a second attack and there were 17 and 11 cases with short- and long-term incubation periods, respectively, yielding a short-term to long-term ratio of 1.5. Based on the parasitemia stages, most of the participants were tested at 5 to 7 days (11 cases) and 7 to 15 days (11 cases) after initial wave of asexual parasites. In conclusion, public health authorities should consider developing management measures to decrease the time lag for diagnosis and drafting unified and robust guidelines for drug use for malaria and drawing up unified and robust guidelines on the use of medication for malaria. It also suggests that routine monitoring, surveillance, and precise medical surveys in high-risk vivax malaria endemic areas are pivotal to controlling this persistent public disease and finally eliminating it from Korea.

In the epidemiological investigation of an infectious disease, investigating, classifying, tracking, and managing contacts by identifying the patient’s route are important for preventing further transmission of the disease. However, omissions and errors in previous activities can occur when the investigation is performed through only a proxy interview with the patient. To overcome these limitations, methods that can objectively verify the patient’s claims (medical facility records, Global Positioning System, card transactions, and closed-circuit television) were used for the recent ongoing coronavirus disease 2019 contact investigations in South Korea.

Background Exposure to air pollution aggravates symptoms of atopic dermatitis (AD) in children in the population studies. Variability in individual patient's response from individual susceptibility is needed to be explored. Objective This study aimed to investigate spectrum of individual variability in the associations between AD symptoms and air quality. Methods We enrolled 89 children aged 0-6 years with AD (22 890 person-days). Daily manifestation of symptoms was recorded for an average of 257 days (range 100-499). Both an individual analysis using logistic regression models and an overall analysis using a generalized estimating equation were performed. Results The odds ratios of an individual ranged 0.24-8.11 for particulate matter Conclusion Responses of AD children to air pollution and weather variable were considerably variable among individuals. An individualized model would be useful to forecast and manage AD symptoms in patients.

Objectives: This study was conducted to evaluate the prevalence rate of multiple chemical sensitivity/idiopathic environmental intolerance(MCS/IEI) among workers in the Gumi industrial complex around the region of accidental release of hydrogen fluoride in 2012. Materials: We evaluated MCS/IEI using the Korean version of the Quick Environmental Exposure and Sensitivity Inventory(QEESI). A total of 535 workers at six manufacturing companies in the Gumi industrial complex were investigated using self-administered questionnaires from February to March 2015. After exclusion of incompletely answered questionnaires, 271 were analyzed. Results: The prevalence rate and proved positive rate of MCS/IEI were 5.9%(16 out of 271) and 3.7%(10 out of 271), respectively. The scores of chemical intolerance, other intolerance, symptom severity and life impact were significantly higher(p

Background Diarrheal and intestinal infectious disease caused by inadequate drinking water, sanitation, and hygiene (WASH) is not only a great concern in developing countries but also a problem in low-income populations and rural areas in developed countries. In this study, we assessed the exposure to inadequate WASH in Korea and estimated the burden of disease attributable to inadequate WASH. Methods We used observational data on water supply, drinking water, sewage treatment rate, and hand washing to assess inadequate WASH conditions in Korea, and estimated the level of exposure in the entire population. The disease burden was estimated by applying the cause of death data from death registry and the morbidity data from the national health insurance to the population attributable fraction (PAF) for the disease caused by inappropriate WASH. Results In 2013, 1.4% of the population were exposed to inadequate drinking water, and 1.0% were living in areas where sewerage was not connected. The frequency of handwashing with soap after contact with excreta was 23.5%. The PAF due to inadequate WASH as a cluster of risk factors was 0.353 (95% confidence interval [CI], 0.275–0.417), among which over 90% were attributable to hand hygiene factors that were significantly worse than those in American and European high-income countries. Conclusion The level of hand hygiene in Korea has yet to be improved to the extent that it shows a significant difference compared to other high-income countries. Therefore, improving the current situation in Korea requires a continuous hand washing campaign and a program aimed at all people. In addition, continuous policy intervention for improvement of sewage treatment facilities in rural areas is required, and water quality control monitoring should be continuously carried out., Graphical Abstract

Introduction Studies on the associations between phthalate exposures and respiratory outcomes are limited. We investigated the association of phthalates exposure with pulmonary function and airway inflammation in asthmatic children. Methods Fifty-six children with asthma living in Seoul Metropolitan Area, Korea aged 6-16 years were enrolled. Their pulmonary function including forced expiratory volume in 1 sec (FEV1) and peak expiratory flow rate (PEFR) were measured, and the fractional exhaled nitric oxide (FeNO) as a marker of airway inflammation was examined repeatedly up to four times during the study period. Urinary levels of mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), metabolites for di-(2-ethylhexyl) phthalate (DEHP), and mono-n-butyl phthalate (MnBP), a metabolite of di-n-butyl phthalate (DnBP), were also measured on the same days. The effects of phthalate metabolites on the respiratory symptoms were analyzed using linear mixed effect models with adjustment for potential cofounders. Results An increase in phthalate metabolites was associated with a decrease in pulmonary function and an increase in FeNO in asthmatic children. As one natural log-unit (ln-unit) levels of urinary MEHHP and MEOHP increased, FeNO levels on the same day increased by 19.47 ppb [95% confidence interval (CI): 9.28, 29.67] and 17.93 ppb (95% CI: 5.86, 30.01), respectively. An increases in the urinary level of MEHHP, MEOHP, and MnBP by one ln-unit was associated with a decrease in PEFR on the next day by 12.17 L/min (95% CI: 2.59, 21.74), 10.80 L/min (95% CI: 0.29, 21.32), and 13.65 L/min (95% CI: 5.07, 22.24), respectively. Conclusion Phthalates, especially DEHP, may worsen pulmonary function and airway inflammation in asthmatic children. To control asthma symptoms, exposure to phthalates needs to be avoided.

We used a survey about the need for an educational training of infectious disease response staff in Korea Centers for Disease Control and Prevention (KCDC) and officer in metropolitan cities and provincial government to conduct field epidemiological investigation. The survey was conducted from January 25 to March 15, 2016. A total of 173 participants were selected from four different groups as follows: 27 clinical specialists, 22 Epidemic Intelligence Service (EIS) officers, 82 KCDC staff, and 42 local health department officials. Results revealed that 83% of KCDC staff and 95% of local health department officials agreed on the need for educational training to strengthen capability of personnel to conduct epidemic research and investigation. The level of their need for training was relatively high, while self-confidence levels of individuals to conduct epidemic research and investigation was low. It was concluded that there was a need to develop training programs to enhance the ability of public health officials, EIS officers, KCDC staff, and local health department personnel to conduct epidemic research and investigation.

Background Despite increasing evidence on the relationship between exposure to phthalates and bisphenol A with allergies and asthma, reports on atopic dermatitis (AD) with these chemicals are few. We assessed the association between AD symptoms and the exposure to phthalates and bisphenol A and in children. Methods We surveyed 18 boys with AD (age 3–7 years) in a day care center in Seoul between May 2009 and April 2010. AD symptoms were recorded by using a daily symptom diary. We collected 460 series of pooled urine twice a day, in the morning and afternoon, over 230 working days and measured the concentrations of mono–2–ethyl-5-oxohexyl phthalate (5-oxo-MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate (5-OH-MEHP), mono-isobutyl phthalate (MnBP) and bisphenol A glucuronide (BPAG) in the pooled urine. Logistic regression was used for statistical analysis. Results Most phthalate metabolite levels were higher in the morning than in the afternoon (p

Introduction: In Korea, first estimation of environmental burden of disease was first conducted on 2009. This study aimed to estimate the environmental burden of disease in Korea while adopting the...

We estimated the exposure to ambient air pollutants and analyzed the associations with allergic diseases. We enrolled 177 children with atopic dermatitis (AD) and 70 asthmatic adults living in Seoul Metropolitan Area, Korea, and followed for 17months between August 2013 and December 2014. Parents or patients recorded symptom scores on a daily basis. Exposure to particulate matter with a diameter

Introduction The effects of weather and air pollution on the severity and persistence of atopic dermatitis (AD) are important issues that have not been investigated in detail. The objective of our study was to determine the short-term effects of meteorological variables and air pollution on AD symptoms in children. Methods We enrolled 177 AD patients with 5 years or younger from the Seoul Metropolitan Area, Korea, and followed for 17 months between August 2013 and December 2014. Symptoms records of 35,158 person-days, including itching, sleep disturbance, erythema, dry skin, oozing, and edema, were obtained. We estimated the effect of meteorological variables including daily mean temperature, relative humidity (RH), diurnal temperature range (DTR), rainfall and air pollutants including particulate matter with an aerodynamic diameter 14 degrees C. An increase in PM10, NO2, and O3 by 10 units increased the risk of AD symptoms on the same day by 3.2% (95% CI: 1.5, 4.9), 5.0% (95% CI: 1.4, 8.8), and 6.1% (95% CI: 3.2, 9.0), respectively. Conclusion Exposure to meteorological variables and air pollutants are associated with AD symptoms in young children.

Objectives: This study is a cross-sectional study to investigate the frequency of humidifier and humidifier disinfectant usage in the general population. Methods: A questionnaire was applied to 94 subjects (46 male, 48 female) from the general population of Gyeonggi Province. The questionnaire consisted of 3 scales (general characteristics, 5 items about humidifier usage, 5 items about humidifier disinfectant usage). Results: Thirty-five (37.2%) of the 94 subjects use a humidifier and humidifier disinfectant usage was found to be 18.1%. The frequency of humidifier usage is 4.8 times per a week and the humidifier disinfectant usage is 2.4 times per a week. Humidifier usage rate was highest in January. and then tended to rise gradually from October. Conclusions: Although this study population was not representative, we can say that approximately 50 percent of the humidifier users use a humidifier disinfectant and the trend of using a humidifier has shown seasonality.