PHWR Public Health Weekly Report

Vol.13 No.14, April 02, 2020 Article TypeCOVID-19 Special ReportEpidemiology and Surveillance

• COVID-19 Special Report 2020-04-02

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  Weekly report on the COVID-19 situation in the Republic of Korea (As of March 28, 2020)

  Kim Miyoung, Kweon Sanghui, Lee Jung Hyun, Baek Soojin, Jeon Byoung-Hak, Yoo Hyosoon, Park Young Joon, Gwack Jin, Park Ok

  Public Health Weekly Report 2020; 13(14): 792-806

  

  

  Abstract

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  This is a weekly report on the COVID-19 situation in the Republic of Korea based on the confirmed cases reported through the Integrated System to Korea Centers for Disease Control and Prevention according to the INFECTIOUS DISEASE CONTROL AND PREVENTION ACT and based on the epidemiological investigation by central and local health authorities.
  As of March 28, 2020, there have been 9,645 confirmed cases in total, including 154 deaths. Confirmed cases have been reported in all 17 provinces/cities in Korea, with highest number of cases from Daegu, Gyeongbuk, Seoul, and Gyeonggi. Women accounted for slightly higher proportion (60.3%, n=5,818) of total confirmed cases than men. The median age was 45 years old (range: 0 to 104 years old).
  Current epidemiological investigation shows several major clusters related with COVID-19. Of the total cases, the proportion of the imported cases (and cases related to the imported cases) is 4.8% (n=465); 53.6% (n=5,171) are Shincheonji (and related); 31.6% (n=3,046) are small clusters and contacts of confirmed cases (other than Shincheonji); and 10.0% (n=963) are currently under investigation.

• Epidemiology and Surveillance 2020-04-02

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  Surveillance of tick density in the Republic of Korea, 2019

  Noh Byung-Eon, Lee Wook-Gyo, Lee Hee il, Cho Shin-Hyeong

  Public Health Weekly Report 2020; 13(14): 807-816

  

  

  Abstract

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  Ticks are infectious agent vectors that transmit various pathogens such as viruses, bacteria, rickettsia and parasites. Tick-borne diseases in the Republic of Korea (ROK) include severe fever with thrombocytopenia syndrome (SFTS) virus, Lyme disease, tick-borne encephalitis (TBE), arthropod-associated bacteria and parasites. To prevent the spread of tick-borne diseases, a nationwide surveillance of ticks was monitored. To conduct the surveillance, 16 regions and 4 environments (grave sites, grasslands, copses, and mountain trails) were selected from 16 centers for vector surveillance in climate change and surveyed from April to November 2019. In this survey, 107,863 ticks, comprising three genera and five species, were collected. The results that Haemaphysalis longicornis was the most predominant species at all collection sites (97.9%). Successively, H. flava ranked second at 2,081, (1.9%), followed by Ixodes nipponensis (163, 0.2%), Amblyomma testudinarium (32, <0.1%), and H. japonica (10, <0.1%). In terms of environmental density, 44,008 ticks were collected in grasslands (40.8%), 22,409 were collected at grave sites (20.8%), 20,732 were collected in copses (19.2%), and 20,714 were collected on mountain roads (19.2%). This survey found that tick density correlated with changes in the number of SFTS patients after one month (R² = 0.4043). As tick-borne diseases increase in the ROK, continuous surveillance of geological and climatic factors is critical for public health. Therefore, this study recommended expanding the number of collection sites and periods of investigation for ticks.

• Epidemiology and Surveillance 2020-04-02

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  Geographical Distribution of Chigger Mites as Scrub Typhus Vectors in the Republic of Korea, 2019

  Song Bong Goo, Lee Wook-Gyo, Lee Hee Il, Cho Shin-Hyeong

  Public Health Weekly Report 2020; 13(14): 817-831

  

  

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  Scrub typhus is an acute infectious febrile disease caused by Orientia tsutsugamushi with increased cases observed in autumn. Scrub typhus is spread to people through bites of infected chiggers (larval mites). The symptoms are fever, body ache, headache, and sometimes rash. Annually, more than 4,000 scrub typhus cases are reported in Korea. Therefore, it is important to recognize any nationwide changes in the density and prevalence of chigger mites. To that end, this study conducted a survey. The survey was conducted in 32 regions (160 locations) across Korea in April and November. A total of 49,301 mites representing 6 genera and 18 species were collected from 515 trapped rodents. Among the rodents, the majority were Apodemus agrarius (striped field mouse) (85%, n=437), The predominant chigger species was Leptotrombidium pallidum (53.9%, n=13,278), followed by L. orientale (13.2%, n=3,239), and L. scutellare (9.5%, n=2,348). Leptotrombidium pallidum, confirmed as the dominant species, showed similar density in spring (April) and autumn (November) at 55.1% and 53.1%, respectively. However, L. scutellare showed a relatively high share of 16.1% (n=2,341) in autumn. In particular, the distribution of L. scutellare, known as the main vector for scrub typhus, expanded northward to the central region of Korea, which was highly correlated with the cases of Scrub typhus patient occurrence in 2019. Thus, the results required monitoring of chigger mites and further epidemiological analysis between patients and vectors.

• Epidemiology and Surveillance 2020-04-02

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  Characteristics of the Notified Tuberculosis — Republic of Korea, 2019

  Kim Jinsun, Shin JeeYeon, Kong Insik

  Public Health Weekly Report 2020; 13(14): 832-850

  

  

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  In 2019, the overall notification rate of new tuberculosis (TB) cases was 46.4 per 100,000 population, with an reduction of 9.9% from the previous year rate, and decreasing patterns observed in almost all age groups and in all provinces. Also, 47.1% of new TB cases involved elderly patients aged 65 years or older and the new TB notification rate of the elder was 145.3 per 100,000 population, with an reduction of 10.7% from the previous year rate. The crude incidence in foreign-born TB patients decreased from 1,801 in 2018 to 1,597 in 2019. Beneficiaries of the Medical Aid, known as socio-economically vulnerable population, had 3.6 times higher rate of new TB notification compared to those of the Health Insurance. The number of Multidrug-resistant TB cases dropped from 618 in 2018 to 580 in 2019. The number of TB deaths decreased from 1,816 in 2017 to 1,800 in 2018.
  In 2020, to reduce the TB burden, the Korea Centers for Disease Control and Prevention has been implementing the ‘Measures to Strengthen TB Prevention Management’, established in 2019 based on ‘the Second National TB Control Plan, 2018-2022’ applied in recent situation in the Republic of Korea and resolution from the first UN high-level meeting on TB.

• Epidemiology and Surveillance 2020-04-02

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  Surveillance of Acute Flaccid Paralysis in the Republic of Korea, 2018

  Lee Yong-Pyo, Kang Hae Ji, Choi Wooyoung, Han Myung-Guk

  Public Health Weekly Report 2020; 13(14): 851-861

  

  

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  Background: Acute flaccid paralysis (AFP) is described as sudden onset of flaccid paralysis in one or more limbs in children may be caused by poliovirus. As Polio national-laboratory was undertaken by World Health Organization (WHO) in 1991, the Korea Center for Diseases Control and Prevention has conducted its surveillance system to monitor the progress of poliomyelitis eradication since 1998. One of WHO’s indicators for polio elimination is strengthening of surveillance by maintaining the number of reported non-polio AFP cases per 100,000 children aged less than 15 years equivalent.
  Methods: The AFP surveillance was conducted through repor ting and laborator y testing according to WHO recommendations. Conventional tube cell culture method was used for virus isolation and the isolates were identified by ITD (Intratypic differentiation) kit. For viral detection, clinical specimens were tested, using both real-time reverse transcription polymerase reaction (Real-time RT-PCR) and nested RT-PCR to amplify part of 5’NCR and VP1 gene respectively.
  Results: Non-polio AFP rate was 1.04 in 2018. 70 cases were reported from nine provinces in 2018. A total of 142 clinical specimens were collected from 70 patients, 6 cases were positive for non-polio enterovirus (NPEV) which were identified as Echovirus 3, Echovirus 13, Echovirus 30, Enterovirus 71 and Coxsackievirus B5. In 2018, among the total of 70 cases, Guillain-Barré Syndrome (38.6%, 27/70) was the major leading cause of AFP.
  Conclusion: This surveillance represented a national-based survey of AFP and could provide evidence that Korea continues to maintain polio-free status.