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Detecting mpox infection in the early epidemic: an epidemiologic investigation of the third and fourth cases in Korea
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Taeyoung Kim, Eonjoo Park, Jun Suk Eun, Eun-young Lee, Ji Won Mun, Yunsang Choi, Shinyoung Lee, Hansol Yeom, Eunkyoung Kim, Jongmu Kim, Jihyun Choi, Jinho Ha, Sookkyung Park
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Epidemiol Health. 2023;45:e2023040. Published online March 23, 2023
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DOI: https://doi.org/10.4178/epih.e2023040
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Abstract
OBJECTIVES As few mpox cases have been reported in Korea, we aimed to identify the characteristics of mpox infection by describing our epidemiologic investigation of a woman patient (index patient, the third case in Korea) and a physician who was infected by a needlestick injury (the fourth case).
METHODS We conducted contact tracing and exposure risk evaluation through interviews with these 2 patients and their physicians and contacts, as well as field investigations at each facility visited by the patients during their symptomatic periods. We then classified contacts into 3 levels according to their exposure risk and managed them to minimize further transmission by recommending quarantine and vaccination for post-exposure prophylaxis and monitoring their symptoms.
RESULTS The index patient had sexual contact with a man foreigner during a trip to Dubai, which was considered the probable route of transmission. In total, 27 healthcare-associated contacts across 7 healthcare facilities and 9 community contacts were identified. These contacts were classified into high (7 contacts), medium (9 contacts), and low (20 contacts) exposure risk groups. One high-risk contact was identified as a secondary patient: a physician who was injured while collecting specimens from the index patient.
CONCLUSIONS The index patient visited several medical facilities due to progressive symptoms prior to isolation. Although the 2022 mpox epidemic mainly affected young men, especially men who have sex with men, physicians should also consider mpox transmission in the general population for the timely detection of mpox-infected patients.
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Summary
Korean summary
국내 엠폭스 3번환자는 전파 가능 시기에 7곳의 의료기관을 방문했으며, 접촉자로 분류된 27명의 의료기관 접촉자와 9명의 지역사회 접촉자 중 주사침 자상을 입은 의료인 1명이 추가 확진되었다. 적시에 엠폭스 환자를 발견하기 위하여 의료인들은 전파위험이 낮은 일반 인구의 감염 가능성에 대한 고려가 필요하다.
Key Message
As a result of contact tracing of a mpox patient in the early phase of epidemic, she visited 7 healthcare facilities to be diagnosed which infers diagnosing those who are statistically not at high risk is challenging. Yet the risk of contracting mpox seems relatively low as only one of 36 contacts was infected; a healthcare personnel who sustained a needlestick injury.
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Citations
Citations to this article as recorded by
- Clinical Features of Mpox Patients in Korea: A Multicenter Retrospective Study
So Yun Lim, Hyeon Jae Jo, Su-Yeon Lee, Miyoung Ahn, Yeonjae Kim, Jaehyun Jeon, Eu Suk Kim, BumSik Chin, Jae-Phil Choi, Nam Joong Kim Journal of Korean Medical Science.2024;[Epub] CrossRef - Transmission potential of mpox in mainland China, June-July 2023: estimating reproduction number during the initial phase of the epidemic
Andrei R. Akhmetzhanov, Pei-Hsuan Wu PeerJ.2024; 12: e16908. CrossRef - Genomic Analysis of Monkeypox Virus During the 2023 Epidemic in Korea
Chi-Hwan Choi, Minji Lee, Sang Eun Lee, Jin-Won Kim, Hwachul Shin, Myung-Min Choi, Hwajung Yi, Min-Kyung Kim, Jaehyun Jeon, Jun-Sun Park, Yeonjae Kim, So Yun Lim, BumSik Chin, Yoon-Seok Chung Journal of Korean Medical Science.2024;[Epub] CrossRef - Mpox exposure and transmission in healthcare settings during the 2022 global outbreak
Kimon C Zachary, Lisa L Philpotts, Erica S Shenoy Current Opinion in Infectious Diseases.2023; 36(4): 257. CrossRef
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Trends of liver cancer and its major risk factors in Korea
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Eun-Young Lee, Tran Thi Xuan Mai, Yoonjung Chang, Moran Ki
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Epidemiol Health. 2015;37:e2015016. Published online March 11, 2015
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DOI: https://doi.org/10.4178/epih/e2015016
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26,404
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268
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17
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Abstract
The Republic of Korea (hereafter Korea) is one of the countries with high incidence of liver cancer and there is great difference in incidence of liver cancer between male and female. We investigated the sex-specific trends of three major risk factors of liver cancer, which are hepatitis B virus(HBV) infection, hepatitis C virus(HCV) infection, and alcoholic liver cirrhosis. The incidence of liver cancer was obtained from the Cancer Registration Statistics of the National Cancer Center of Korea. Hepatitis B surface antigen (HBsAg) seropositivity was based on data from the 2011 Korea National Health and Nutrition Examination Survey. Disease statistics from the Health Insurance Review and Assessment Service of Korea were used to evaluate trends in HCV infection and alcoholic liver cirrhosis. The prevalence of these risk factors were compared with the incidence of liver cancer. Males had a three to four times higher incidence of liver cancer than females did from 1999 to 2011. This gap between the incidence for males and females increased with age and males aged 50 to 59 showed a five times higher incidence than females of the same age did. In general, HBsAg seropositivity decreased from 1998 to 2011. The prevalence of HCV infections was 96.2 and 90.3 per 100,000 females and males, respectively in 2013. The prevalences of HCV infections from 2009 to 2013 did not substantially differ. The annual average prevalence of alcoholic liver cirrhosis from 2009 to 2013 was 77.22 and 8.90 per 100,000 males and females, respectively; the prevalence among males was 8.7 times higher than that among females. The prevalence rapidly increased with age in males, and males aged 60 to 69 peaked with a 19.2 times higher prevalence than that among females of the same age group. We found that the incidence of alcoholic liver cirrhosis, a major risk factor of liver cancer, exhibited a trend similar to that of liver cancer incidence in males, and this trend also differed remarkably by sex.
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Summary
Korean summary
한국의 간암 발생 추세에서 나타나는 큰 남녀차이와 관련하여 간암의 주요 위험요소로 평가되는 만성 간염, 음주, 간경변과 관련한 B형간염, C형간염, 알코올성 간경변의 유병률 추세를 살펴본 결과 알코올성 간경변의 유병률 추세에서 간암발생에서와 유사한 큰 남녀차이가 발견되었다.
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Citations
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- Hepatocellular carcinoma incidence is decreasing in Korea but increasing in the very elderly
Young Eun Chon, Seong Yong Park, Han Pyo Hong, Donghee Son, Jonghyun Lee, Eileen Yoon, Soon Sun Kim, Sang Bong Ahn, Soung Won Jeong, Dae Won Jun Clinical and Molecular Hepatology.2023; 29(1): 120. CrossRef - Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis
Xuanxuan Niu, Lin Zhu, Yifan Xu, Menghan Zhang, Yanxu Hao, Lei Ma, Yan Li, Huichun Xing BMC Public Health.2023;[Epub] CrossRef - Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study
Chang Hun Lee, Gwang Hyeon Choi, Hwa Young Choi, Sojung Han, Eun Sun Jang, Young Eun Chon, Young Chang, Kyung-Ah Kim, Do Young Kim, Hyung Joon Yim, Hye-Lin Kim, Sook-Hyang Jeong, In Hee Kim Clinical and Molecular Hepatology.2023; 29(3): 779. CrossRef - Global pattern of trends in incidence, mortality, and mortality-to-incidence ratio rates related to liver cancer, 1990–2019: a longitudinal analysis based on the global burden of disease study
Maedeh Amini, Mehdi Azizmohammad Looha, Elaheh Zarean, Mohamad Amin Pourhoseingholi BMC Public Health.2022;[Epub] CrossRef - Association of the presence of allergic disease with subsequent risk of liver cancer in a nationwide retrospective cohort among Koreans
Ji Ah Kim, Sun Jae Park, Seulggie Choi, Jooyoung Chang, Seogsong Jeong, Joseph C.Ahn, Gyeongsil Lee, Joung Sik Son, Sang Min Park Scientific Reports.2022;[Epub] CrossRef - Decrease in liver cancer incidence rates in Bamako, Mali over 28 years of population-based cancer registration (1987-2015)
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Hye-Eun Lee, Masayoshi Zaitsu, Eun-A Kim, Ichiro Kawachi International Journal of Environmental Research and Public Health.2020; 17(1): 303. CrossRef - Elevated fasting serum glucose levels increase the risk of hepatocellular carcinoma
Tong Liu, Wanchao Wang, Haozhe Cui, Miaomiao Sun, Yiming Wang, Xining Liu, Liying Cao, Hai Liu, Siqing Liu Medicine.2019; 98(30): e16369. CrossRef - Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea
Sang‐Wook Yi, Ja‐Sung Choi, Jee‐Jeon Yi, Yong‐ho Lee, Ki Jun Han Cancer.2018; 124(13): 2748. CrossRef - Trend analysis of major cancer statistics according to sex and severity levels in Korea
Minsu Ock, Woong Jae Choi, Min-Woo Jo, Antonio Palazón-Bru PLOS ONE.2018; 13(9): e0203110. CrossRef - Clustering Asian Countries According to the Trend of liver cancer Mortality Rates: an Application of Growth Mixture Models
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