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Healthcare personnel (HCP) are vulnerable to COVID-19 infection due to their higher risk of contact with infected persons. The numbers of cases and deaths among HCP in Korea were divided into four periods associated with different major variants of SARS-CoV-2: GH clade, Alpha, Delta, and Omicron. To evaluate the implication of HCP infection in Korea, we overviewed the pandemic status in Korea and in other countries: the cases, deaths, excess mortality, and vaccination rates in Germany, Israel, Italy, Japan, the United Kingdom, and the United States. In about two years, there were 10,670 HCP cases among all COVID-19 cases (1.15% of 925,975 cases). HCP cases had a lower death rate (%) compared to that for all cases (0.14 versus 0.75). Nurses were the most infected (55.3%), followed by HCP of other categories (28.8%) and doctors (15.9%), while deaths were mostly reported among doctors (9 out of 15, 60%). Cases among HCP gradually increased, but the death rate decreased as the pandemic progressed. Compared to five of the other countries examined, Korea had a higher incidence of cases but a lower mortality, lower excess mortality, and a higher vaccination rate.

Since a novel beta-coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019, there has been a rapid global spread of the virus. Genomic surveillance was conducted on samples isolated from infected individuals to monitor the spread of genetic variants of SARS-CoV-2 in Korea. The Korea Disease Control and Prevention Agency performed whole genome sequencing of SARS-CoV-2 in Korea for 1 year (January 2020 to January 2021). A total of 2,488 SARS-CoV-2 cases were sequenced (including 648 cases from abroad). Initially, the prevalent clades of SARS-CoV-2 were the S and V clades, however, by March 2020, GH clade was the most dominant. Only international travelers were identified as having G or GR clades, and since the first variant 501Y.V1 was identified (from a traveler from the United Kingdom on December 22nd, 2020), a total of 27 variants of 501Y.V1, 501Y.V2, and 484K.V2 have been classified (as of January 25th, 2021). The results in this study indicated that quarantining of travelers entering Korea successfully prevented dissemination of the SARS-CoV-2 variants in Korea.

Socioeconomic disparities have been reported as the main risk factors contributing to the spread of coronavirus disease 2019 (COVID-19) at the community level. We conducted an epidemiological study on the risk of COVID-19 incidence using area deprivation indices (DIs) depending on the characteristics of the susceptible population.The database of the confirmed COVID-19 cases in eight metropolitan cities, the Republic of Korea, from January 20, 2020 to December 31, 2021, was combined with the area DIs and standardized prevalence of diabetes and hypertension from the community health survey. The relative risk (RR) was estimated using a generalized linear model with Poisson distribution by age group.The risk of COVID-19 incidence increased with the increasing age group, especially in patients aged ≥75 years. The RR per interquartile range increment of total social deprivation index (total SDI) was 1.54 (95% confidence interval [CI]: 1.34-1.70) in the COVID-19 incidence. Especially, the risk of COVID-19 incidence in the first wave was about three times higher in the region belonging to the lowest socioeconomic status than in the region with the highest socioeconomic status. The risk was 3.08 (95% CI: 2.42 to 3.78) based on the total SDI and 3.13 (95% CI: 2.53 to 3.83) based on the social deprivation index.This study provides scientific evidence that socioeconomic inequity is an important risk factor for the spread of COVID-19. This finding suggests that a mid-to-long-term strategy is needed for the susceptible population to reduce the burden of COVID-19 in the community.

Our study indicates sustained transmission (effective reproduction number, 1.3; serial interval, 4.2 days; regional doubling times, 3.3–11.4 days) of the severe acute respiratory syndrome coronavirus 2 Omicron (B.1.1.529) variant (N = 2351) in South Korea (25 November 2021–8 January 2022), implicating insufficient protection through vaccination and supporting nonpharmaceutical control measures.

BACKGROUND Understanding the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be a useful tool when studying spread of the disease. This study aimed to compare the prevalence of antibodies to SARS-CoV-2 in 9954 recruits in the Korean Army Training Center with the general Korean population age30 years between September and November, 2020. MATERIAL AND METHODS At the Korean Army Training Center, samples were taken from 9954 men from September to November, 2020. Participants were randomly enlisted healthy adult men. The data were compared with 4,205,265 samples from the Korean general population. Men age30 years were used, as this is similar to the age range of the military recruits. RESULTS Among military recruits, 31 subjects (0.31%) were positive for the antibody, while the Korean male population had 3757 (0.09%) positive individuals. Among these 31 men, 13 were previously diagnosed by PCR, while 18 (58.06%) had no history related to the disease. Positive military recruits were mostly from 2 regional clusters. The first cluster was Daegu and Gyeongbuk areas (1.97% and 0.80%, respectively), which had an outbreak in March, 2020. The second cluster was Gyeonggi and Seoul, or capital areas (0.23% and 0.20%, respectively), which currently has high PCR positivity. Overall, seroprevalence was 3.49 times higher in study subjects. CONCLUSIONS The high seroprevalence of antibodies to SARS-CoV-2 between September and November 2020 in a densely populated military academy in Korea may have been an indicator for the resulting outbreak of COVID-19 in winter 2020-21, which highlights the importance of asymptomatic spread from the young and healthy to the general population.

BackgroundThe most recent variant of concern, Omicron (B.1.1.529), has caused numerous cases worldwide including the Republic of Korea due to its fast transmission and reduced vaccine effectiveness.MethodsA mathematical model considering age-structure, vaccine, antiviral treatment, and influx of the Omicron variant was developed. We estimated transmission rates among age groups using maximum likelihood estimation for the age-structured model. The impact of nonpharmaceutical interventions (in community and border), quantified by a parameter μin the force of infection, and vaccination were examined through a multi-faceted analysis. A theory-based endemic equilibrium study was performed to find the manageable number of cases according to Omicron-and healthcare-related factors.ResultsBy fitting the model to the available data, the estimated values of μ ranged from 0.31 to 0.73, representing the intensity of nonpharmaceutical interventions such as social distancing level. If μ < 0.55 and 300,000 booster shots were administered daily from February 3, 2022, the number of severe cases was forecasted to exceed the severe bed capacity. Moreover, the number of daily cases is reduced as the timing of screening measures is delayed. If screening measure was intensified as early as November 24, 2021 and the number of overseas entrant cases was contained to 1 case per 10 days, simulations showed that the daily incidence by February 3, 2022 could have been reduced by 87%. Furthermore, we found that the incidence number in mid-December 2021 exceeded the theory-driven manageable number of daily cases.ConclusionNonpharmaceutical interventions, vaccination, and antiviral therapy influence the spread of Omicron and number of severe cases in the Republic of Korea. Intensive and early screening measures during the emergence of a new variant is key in controlling the epidemic size. Using the endemic equilibrium of the model, a formula for the manageable daily cases depending on the severity rate and average length of hospital stay was derived so that the number of severe cases does not surpass the severe bed capacity.

Jinhwa Jang,1 Myung-Jae Hwang,1 Yoo-Yeon Kim,1 Shin Young Park,1 Myeongsu Yoo,1 Seong-Sun Kim,1 Sangwon Lee,2 Donghyok Kwon1 1Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, Republic of Korea; 2Director General for Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Cheongju-si, Chungcheongbuk-do, Republic of KoreaCorrespondence: Donghyok Kwon, Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, 187, OsongSaengmyeong 2-ro, Osong-eup, Heungdeok-gu, Cheongju-si, Chungcheongbuk-do, 28159, Republic of Korea, Tel +82-43-719-7730, Fax +82-43-719-7749, Email vethyok@korea.krBackground: In South Korea, the epidemiological characteristics of children and adolescents infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have not been reported to date. The purpose of this study was to identify major epidemiological characteristics and transmission patterns of coronavirus disease 2019 (COVID-19) in children and adolescents.Methods: This study was conducted through a system integrated in an epidemiological investigation by the Korea Disease Control and Prevention Agency from January 20, 2020, to June 5, 2021. We analyzed the epidemiological characteristics of 14,967 children and adolescents with COVID-19 according to the age groups and transmission age patterns of 3721 infector-infectee pairs in South Korea.Results: Among the total confirmed COVID-19 cases, 14,967 patients were aged 0– 18 years. The most affected age group among children and adolescents were those aged 16– 18 years (3589, 24.0%). For all age groups, the infection route through friends and family members (31.9%) was the highest. For the contact age pattern analysis, infection from infectors aged 30– 49 years to infectees aged 0– 12 years showed a statistically significant relation (p < 0.001) compared to that in other age groups. On the other hand, among the infectees aged 13– 15 years and 16– 18 years were significantly related with adolescents aged 10– 19 years (p < 0.05).Conclusion: These results suggest that adolescents aged 13– 18 years were more infected with COVID-19 than those aged 0– 12 years. Furthermore, they are particularly more likely to be infected by friends and family members. Besides, in patients aged 13– 18 years, transmission of SARS-CoV-2 was more common from adolescents to adolescents than from adults to adolescents. This research will provide scientific evidence for school policies and vaccine strategies for COVID-19 prevention in children and adolescents.Keywords: coronavirus disease-2019, severe acute respiratory syndrome coronavirus-2, incidence rate, mortality

The most recent variant of concern, omicron (B.1.1.529), has caused numerous cases worldwide including the Republic of Korea due to its fast transmission and reduced vaccine effectiveness.A mathematical model considering age-structure, vaccine, antiviral drugs, and influx of the omicron variant was developed. We estimated transmission rates among age groups using maximum likelihood estimation for the age-structured model. The impact of non-pharmaceutical interventions (NPIs; in community and border), quantified by a parameter μ in the force of infection, and vaccination were examined through a multi-faceted analysis. A theory-based endemic equilibrium study was performed to find the manageable number of cases according to omicron- and healthcare-related factors.By fitting the model to the available data, the estimated values of μ ranged from 0.31 to 0.73, representing the intensity of NPIs such as social distancing level. If μ0.55 and 300,000 booster shots were administered daily from February 3, 2022, the number of severe cases was forecasted to exceed the severe bed capacity. Moreover, the number of daily cases is reduced as the timing of screening measures is delayed. If screening measure was intensified as early as November 24, 2021 and the number of overseas entrant cases was contained to 1 case per 10 days, simulations showed that the daily incidence by February 3, 2022 could have been reduced by 87%. Furthermore, we found that the incidence number in mid-December 2021 exceeded the theory-driven manageable number of daily cases.NPIs, vaccination, and antiviral drugs influence the spread of omicron and number of severe cases in the Republic of Korea. Intensive and early screening measures during the emergence of a new variant is key in controlling the epidemic size. Using the endemic equilibrium of the model, a formula for the manageable daily cases depending on the severity rate and average length of hospital stay was derived so that the number of severe cases does not surpass the severe bed capacity.

BackgroundEarly vaccination efforts and non-pharmaceutical interventions were insufficient to prevent a surge of coronavirus disease 2019 (COVID-19) cases triggered by the Delta variant. This study aims to understand how vaccination and variants contribute to the spread of COVID-19 so that appropriate measures are implemented.MethodsA compartment model that includes age, vaccination, and infection with the Delta or non-Delta variants was developed. We estimated the transmission rates using maximum likelihood estimation and phase-dependent reduction effect of non-pharmaceutical interventions (NPIs) according to government policies from 26 February to 8 October 2021. We extended our model simulation until 31 December considering the initiation of eased NPIs. Furthermore, we also performed simulations to examine the effect of NPIs, arrival timing of Delta variant, and speed of vaccine administration.ResultsThe estimated transmission rate matrices show distinct pattern, with the transmission rates of younger age groups (0 39 years) much larger than non-Delta. Social distancing (SD) level 2 and SD4 in Korea were associated with transmission reduction factors of 0.64 to 0.69 and 0.70 to 0.78, respectively. The easing of NPIs to a level comparable to SD2 should be initiated not earlier than 16 October to keep the number of severe cases below the capacity of Korea’s healthcare system. Simulation results also showed that a surge prompted by the spread of the Delta variant can be prevented if the number of people vaccinated daily was larger.ConclusionsSimulations showed that the timing of easing and intensity of NPIs, vaccination speed, and screening measures are key factors in preventing another epidemic wave.2Key MessagesMaximum likelihood estimation can be utilized to determine the transmission rates of the Delta and non-Delta variants.The phase-dependent NPIs implemented by the Korean government were effectively quantified in the modelling study.Even with fast vaccination, resurgence of cases is still possible if NPIs are eased too early or screening measures are relaxed.The model can be used as a guide for policy makers on deciding appropriate SD level that considers not only disease control, but also the socio-economic impact of maintaining strict measures.

(1) Background: The vaccine supply is likely to be limited in 2021 due to constraints in manufacturing. To maximize the benefit from the rollout phase, an optimal strategy of vaccine allocation is necessary based on each country’s epidemic status. (2) Methods: We first developed a heterogeneous population model considering the transmission matrix using maximum likelihood estimation based on the epidemiological records of individual COVID-19 cases in the Republic of Korea. Using this model, the vaccine priorities for minimizing mortality or incidence were investigated. (3) Results: The simulation results showed that the optimal vaccine allocation strategy to minimize the mortality (or incidence) was to prioritize elderly and healthcare workers (or adults) as long as the reproductive number was below 1.2 (or over 0.9). (4) Conclusion: Our simulation results support the current Korean government vaccination priority strategy, which prioritizes healthcare workers and senior groups to minimize mortality, under the condition that the reproductive number remains below 1.2. This study revealed that, in order to maintain the current vaccine priority policy, it is important to ensure that the reproductive number does not exceed the threshold by concurrently implementing nonpharmaceutical interventions.

Summary Objectives An outbreak of joint and cutaneous infections among patients who had been injected at a single clinic in South Korea was investigated. Methods In this retrospective case–control study, 61 cases were diagnosed based on symptoms and signs of septic arthritis or cutaneous infection that developed after injections at the clinic between April and September 2012; 64 controls were investigated by administering questionnaires on risk factors and analyzing the clinic medical records. An environmental investigation was performed, and clinical specimens of the cases were analyzed by pulsed-field gel electrophoresis. Results All cases were injected with triamcinolone. A greater number of triamcinolone injections (adjusted odds ratio 4.3, 95% confidence interval 1.5–12.1 for six or more visits, compared with one or two visits) was associated with the development of an infection. In the clinic, only the triamcinolone injection was prepared by mixing with lidocaine and normal saline, and an alcohol swab was prepared using boiled tap water by members of the clinic staff. Although injected medications and environmental cultures were not found to be responsible, a single strain of Mycobacterium massiliense was isolated from the affected sites of 16 cases. Conclusions Repeated injection of triamcinolone contaminated with NTM from the clinic environment may have caused this post-injection outbreak.

Lyme borreliosis is one of the most common tick-borne infections in the northern hemisphere. However, the epidemiological features and clinical manifestations of this disease in Korea are unknown. The present study is the first to investigate the characteristics of Lyme borreliosis in Korea. We traced suspected cases of Lyme borreliosis during the period 2005-2012. Of the 16 identified patients with the disease, 11 had acquired autochthonous infection within Korea, while 5 patients were infected outside Korea. The history of past exposure was investigated in 8 of the 11 patients with autochthonous infection; 5 of these 8 patients (62.5%) were suspected to have acquired the infection in the northeastern alpine region. Clinically, of 11 patients with autochthonous infection, 6 (54.5%) showed early skin manifestations, 4 (36.4%) showed neurological manifestations, and 1 (9.1%) showed acrodermatitis chronica atrophicans. In conclusion, Lyme borreliosis could be endemic in the northeastern alpine region of Korea, and neurological and early skin manifestations are likely to be the major clinical characteristics of autochthonous Lyme borreliosis in Korea.

Objectives The aim of this study was to develop an immunochromatographic assay (ICA) for the detection of influenza A (H1N1) pdm09 virus infection. Materials and methods Several monoclonal antibodies against influenza A (H1N1) pdm09 virus were generated and an ICA (pdm09-ICA) was developed for the rapid and specific detection of influenza A (H1N1) pdm09 virus infection. The specificity and sensitivity of the developed assay were compared with that of hemagglutination assay and real-time reverse-transcription polymerase chain reaction (rRT-PCR). Results The detection limit was estimated to be 1/2 (8) hemagglutinating unit; the sensitivity and specificity rates of pdm09-ICA were 75.86% (110/145) and 100% (43/43), respectively, compared with rRT-PCR. The cross-reactivity for 20 influenza viruses, including seasonal H1N1 viruses, was found to be negative except for the H1N1 virus (A/Swine/Korea/GC0503/2005). Conclusion These results indicate that the proposed method can be easily used for rapid and specific detection of the pdm09 infection. The assay developed in this study would be a useful tool for distinguishing the pdm09 infection from seasonal influenza A and B infections.

Summary We evaluated the epidemiological risk factors for MERS-CoV transmission during the recent South Korean outbreak. MERS-CoV transmission was determined by host infectivity and the number of contacts, whereas super-spreading events were determined by the number of contacts and hospital visits., Background. Transmission heterogeneity was observed during the 2015 Korean outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Only 22 of 186 cases transmitted the infection, and 5 super-spreading events caused 150 transmissions. We investigated the risk factors for MERS-CoV transmission. Methods. Epidemiological reports were used to classify patients as nonspreaders, spreaders, or those associated with a super-spreading event (5 or more transmissions). Logistic regression analyses were used to evaluate the factors for MERS-CoV transmission. Results. Compared to nonspreaders, spreaders exhibited a longer interval from symptom onset to isolation (7 days vs 3 days) and more frequent pre-isolation pneumonia diagnoses (68.2% vs 17.1%). Spreaders also exhibited higher values for pre-isolation contacts (149 vs 17.5), pre-isolation hospitalization (68.2% vs 16.5%), and emergency room (ER) visits (50% vs 7.3%). Spreaders exhibited lower cycle thresholds for the upE and ORF1a genes (22.7 vs 27.2 and 23.7 vs 27.9, respectively). In multivariate analysis, transmission was independently associated with the cycle threshold (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.75–0.96) and pre-isolation hospitalization or ER visits (OR, 6.82; 95% CI, 2.06–22.84). The super-spreading events exhibited higher values for pre-isolation contacts (777 vs 78), pre-isolation ER visits (100% vs 35.3%), and doctor shopping (100% vs 47.1%) compared to non-super-spreading events. Conclusions. These findings indicate that transmission is determined by host infectivity and the number of contacts, whereas super-spreading events were determined by the number of contacts and hospital visits. These relationships highlight the importance of rapidly enforcing infection control measures to prevent outbreaks.

This study aimed to characterize the replication and pathogenic properties of a Korean pandemic (H1N1) 2009 influenza virus isolate in ferrets and mice. Ferrets infected with A/Korea/01/2009 (H1N1) virus showed mild clinical signs. The virus replicated well in lungs and slightly in brains with no replication in any other organs. Severe bronchopneumonia and thickening of alveolar walls were detected in the lungs. Viral antigens were detected in the bronchiolar epithelial cells, in peribronchial glands with severe peribronchitis and in cells present in the alveoli. A/Korea/01/2009 (H1N1) virus-infected mice showed weight loss and pathological lung lesions including perivascular cuffing, interstitial pneumonia and alveolitis. The virus replicated highly in the lungs and slightly in the nasal tissues. Viral antigens were detected in bronchiolar epithelial cells, pneumocytes and interstitial macrophages. However, seasonal H1N1 influenza virus did not replicate in the lungs of ferrets, and viral antigens were not detected. Thus, this Korean pandemic (H1N1) 2009 isolate infected the lungs of ferrets and mice successfully and caused more pathological lesions than did the seasonal influenza virus.

Surveillance for this emerging disease should be expanded to the outpatient setting., In South Korea, nationwide surveillance for severe fever with thrombocytopenia syndrome (SFTS) began during 2013. Among 301 surveillance cases, 35 hospitalized case-patients in 25 areas were confirmed by using virologic testing, and 16 (46%) case-patients subsequently died. The SFTS cases occurred during May–November and peaked during June (9 cases, 26%). The incidence of SFTS was higher in the southern regions of South Korea. Age and neurologic symptoms, including decreased level of consciousness and slurred speech, were heavily associated with death; neurologic symptoms during the first week after disease onset were also associated with death. Although melena was common among patients who died, no other hemorrhagic manifestations were substantively more common among those who died. No effective treatments, including ribavirin, were identified. Expansion of SFTS surveillance to include the outpatient sector and development of an antibody test would enhance completeness of SFTS detection in South Korea.

Transmission of influenza (H5N1) virus from birds to humans is a serious public health threat. In South Korea, serologic investigation among 2,512 poultry workers exposed during December 2003–March 2004 to poultry with confirmed or suspected influenza (H5N1) virus infection found antibodies in 9. Frequency of bird-to-human transmission was low.

In situ hybridization techniques that employed a nonradioactive digoxigenin-labeled probe were used to detect and localize ApxI, II and III genes in tissue sections of pneumonic lung naturally infected with Actinobacillus pleuropneumoniae. In pigs infected with either serotype 2 or 6, a hybridization signal for apxIICA, apxIIICA, apxIBD, and apxIIIBD was detected, and in pigs infected with serotype 5, a hybridization signal for apxICA, apxIICA, and apxIBD was detected in the pneumonic lesions. A hybridization signal for apxIICA and apxIBD was detected in pigs infected with serotype 7. A strong hybridization signal for apx genes was seen in streaming degenerate alveolar leukocytes bordering zones of coagulative necrosis. Simultaneous detection of hybridization signals for the apxCA and apxBD genes provided scientific evidence that the expression of the apx genes could be potential indicators of the production of corresponding Apx toxins. This study demonstrates the expression of ApxI, II, and III genes in pneumonic lesions caused by A. pleuropneumoniae.

A retrospective study was made of natural infections with Isospora suis in nursing piglets, recorded from April 1994 to May 1997, to determine the prevalence, microscopical lesions and other microorganisms associated with coccidiosis. One hundred and five (17.3 per cent) of the 605 nursing piglets submitted from 304 pig farms were diagnosed positive for coccidiosis. The affected piglets were from seven to 20 days old, with a mean age of 11.1 days. Coccidiosis occurred in each year but the incidence peaked in July (15 cases, 14.3 per cent), September (15 cases, 14.3 per cent), October (16 cases, 15.2 per cent) and November (18 cases, 17.1 per cent) and was lowest in May (no cases), August (two cases, 1.9 per cent) and June (four cases, 3.8 per cent). Histopathologically, villous atrophy resulting from the necrosis and sloughing of epithelial cells was a prominent feature of infection with I suis. In 49.5 per cent of the nursing piglets, other enteropathogens were identified, Escherichia coli (47.6 per cent) and transmissible gastroenteritis virus (3.8 per cent) being the most commonly diagnosed. Forty-five of 50 E coli isolates associated with coccidiosis tested negative by polymerase chain reaction for enterotoxigenic virulence factors, such as fimbriae and enterotoxins.

Oseltamivir, a neuraminidase (NA) inhibitor, has been widely used for the treatment of patients infected with the pandemic (H1N1) 2009 influenza virus. With the increasing use of oseltamivir, drug-resistant mutants emerged rapidly and 11 cases of resistant viruses were detected during the 2009 H1N1 pandemic in South Korea. To better understand the differences between oseltamivir-susceptible and oseltamivir-resistant virus, we compared the replication and pathogenesis of the NA H275Y mutant virus, A/Gyeongnam/1820/2009, in ferrets and mice with those of oseltamivir-susceptible A/Korea/01/2009 virus. Oseltamivir-resistant virus infected ferrets showed mild clinical signs and the virus replicated well in the upper respiratory tract and slightly in the lower respiratory tract. No virus was detected in the extrapulmonary organs. Severe bronchopneumonia and thickening of alveolar walls were detected in the lungs. Viral antigens were detected mainly in the bronchiolar epithelial cells, cells present in the interstitial septa, pneumocytes and peribronchial glands with severe peribronchitis. A/Gyeongnam/1820/2009 virus-infected mice showed weight loss and the virus replicated in lungs with high titer. Histopathologically, the mice showed mild to moderate alveolitis, interstitial pneumonia and perivascular lymphoid tissue hyperplasia. In lungs, bronchiolar epithelial cells, pneumocytes and interstitial inflammatory cells were infected by influenza virus and trachea epithelial cells were the sites of infection. When compared with the results of A/Korea/01/2009 oseltamivir-susceptible pandemic influenza virus, an oseltamivir-resistant virus isolated in South Korea showed fewer pathogenic properties in ferrets and similar fitness in mice.

During the influenza pandemic of 2009-2010, rapid influenza diagnostic tests (RIDTs) were used to detect influenza viral infections because they are quick and simple to use. However, retrospective studies showed that RIDTs performed poorly when used to diagnose pandemic viral infections. Determining how amino acid sequence changes in pandemic or epidemic influenza viral antigens impact clinical value of RIDTs has not been possible, because the viral epitopes recognized by RIDTs have been not mapped. In this study, the effect of escape-variations or mutations in influenza viral antigens upon the sensitivity and specificity of an RIDT was investigated by characterizing the immunological properties of the antibodies used in the RIDT. Escape-mutants were generated by cultivating A/Korea/01/2009 in the presence of an excess of the same antibodies used in the RIDT. Escape-mutants not recognized by the RIDT were selected. Epitopes recognized by the RIDT were mapped by comparing the sequence and immunological analysis of the escape-variants and wild-type isolates. The RIDT antibodies recognized epitopes on the Sa antigenic site and in the F subdomain in hemagglutinin. Variants bearing mutations in these epitopes were not detected by the RIDT. The frequency of escape-variants emerging since the 2009-2010 pandemic was calculated as 1.27% using in silico surveillance of influenza sequence databases. These results suggest that mapping the relevant epitopes of RIDTs and making such information available to clinics would be helpful for determining whether RIDTs match newly emergent strains and subtypes prior to retrospective re-evaluation of the RIDTs using clinical specimens.

The in vitro susceptibilities of 285 isolates of Escherichia coli from preweaned and postweaned pigs with diarrhea and edema disease were tested with the 15 commonly used antimicrobial drugs by an agar dilution minimal inhibitory concentration procedure according to National Committee for Clinical Laboratory Standards (NCCLS) guidelines. All E. coli isolates tested in this study belonged to enterotoxigenic E. coli, attaching and effacing E. coli, or Shiga toxin-producing E. coli. Field isolates had low MIC90 for ceftiofur (1 microg/ml). No correlation in antimicrobial resistance was found in three types of E. coli.

We evaluated a new rapid influenza diagnostic test for the pandemic (H1N1) 2009 influenza virus by using real-time reverse transcription-PCR (rRT-PCR) and viral culture. The sensitivities were 68.5% and 64.5%, and the specificities were 98.4% and 97.6%, respectively. This kit should be used with caution, and negative results should be verified by a confirmative test.