Sukhyun Ryu

The new Korean action plan for containment of antimicrobial resistance

BACKGROUND The Korean national action plan on antimicrobial resistance (AMR) was established on 11 August 2016 by the Korean Ministry of Health and Welfare. METHODS AND RESULTS This article briefly describes the current status of AMR in Korea and introduces six objectives of the action plan, including the prudent use of antimicrobial medicines, prevention of the spread of AMR, strengthening surveillance programmes, awareness improvement, strengthening research and development, and enhancement of international collaboration. CONCLUSIONS Integrated multisectoral principles are applied to fight AMR more effectively. This 5-year national AMR action plan will be the cornerstone of public health in Korea.

Are we investing wisely? A systematic analysis of nationally funded antimicrobial resistance projects in Republic of Korea, 2003-2013.

From 2003 to 2013, South Korea has conducted the National Antimicrobial Resistance Safety Control Program (NARSCP). The purpose of the current study was to systematically review national antimicrobial resistance (AMR) research trends and to provide guidance on future allocation of research funding to enable a comprehensive approach in AMR control. This study collected project reports related to AMR published by the Ministry of Food and Drug Safety, the Ministry of Health and Welfare and the Korea Centers for Disease Control and Prevention between 2003 and 2013. These reports were analysed by topics based on the AMR action plan of the World Health Organization (WHO), period of study, categories along the research pipeline and types of receiving institution. A total of 198 project reports were included, with total funding of US

Serosurveillance of avian influenza A/H5N6 virus infection in poultry farmers, Gyeonggi Province, Republic of Korea, 2016–2017

18.3 million. Mean funding per award was US

Investigation of scarlet fever outbreak in a kindergarten

92,750, with a median of US

Community-acquired Legionnaires’ Disease in a Newly Constructed Apartment Building

71,714. Among the WHO-suggested criteria, the basic microbial research and surveillance sector accounts for 143 (72.2%) of all awards. Yearly project funding increased from US

One Health Perspectives on Emerging Public Health Threats

961,476 in 2003 to US

Foodborne Illness Outbreaks in Gyeonggi Province, Korea, Following Seafood Consumption Potentially Caused by Kudoa septempunctata between 2015 and 2016

1,553,294 in 2013. Operational research was 61.5% and product development was 0.7% of the basic microbial research and surveillance sector. By institution, academia received 145 awards (73.2%). During progress of the NARSCP, total research funding increased significantly, but most awards were focused on understanding the overall picture of the nationwide AMR status. More balanced funding is needed, and encouraging active participation of private and international sectors is also required in reducing AMR.

Low risk of avian influenza A (H5N6) transmission to depopulation workers in Korea

OBJECTIVES Between November 20, 2016 and April 17, 2017, outbreaks of highly pathogenic avian influenza (HPAI) A/H5N6 occurred on poultry farms in Gyeonggi Province in the Republic of Korea. A serosurvey was conducted among poultry farmers to identify the transmission of HPAI A/H5N6 virus to humans. METHODS A descriptive study of 870 poultry farmers in Gyeonggi Province in Korea was conducted during the 2016-2017 outbreaks. Serological testing was performed using a microneutralization (MN) assay for antibodies against influenza A/duck/ES2/Korea/2016 virus, which has antigenic properties similar to those of the HPAI A/H5N6 virus that caused this poultry outbreak. RESULTS Overall, 523 exposed poultry farmers were assessed by serological testing. Consequently, all tested negative for HPAI A/H5N6 virus via MN assay. CONCLUSIONS Based on serological assays, no transmission of HPAI A/H5N6 to humans was identified in this study cohort. Additional studies should be conducted to determine the possibility of poultry-to-human transmission of HPAI A/H5N6.

Outbreak investigation of pertussis in an elementary school: a case-control study among vaccinated students

Background Scarlet fever is caused by a group A streptococcal (GAS) infection. On April 3, 2017, an outbreak among children in a kindergarten was reported to the local health department. An epidemiologic investigation was conducted to identify the possible transmission route of this outbreak and to recommend appropriate control measures. Materials and Methods A retrospective cohort study was conducted using questionnaires including age, sex, the classroom attended at a kindergarten, and date and type of symptoms developed. A case-patient is defined as a child having sore throat, fever, skin rash, or strawberry tongue with or without laboratory confirmation of GAS infection between March 28 and April 28, 2017. Results The index case-patients developed symptoms on March 28, 2017, and this outbreak persisted over a period of 16 days. The outbreak affected 21 out of 158 children (13.3%) in the kindergarten, with the mean age of 4.2 (range 3–5) years; 12 (57.1%) of them were boys. The common symptoms reported were fever (71.4%), sore throat (71.4%), reddened tonsil (57.1%), and skin rash (52.4%). The epidemiologic analysis showed that children attending one of the classrooms in the kindergarten were 14.12 times affected than the other classrooms (relative risk, 14.12; 95% confidence interval, 4.99–33.93; P <0.01). All case-patients were recommended to stay away from the kindergarten and its social activities for >24 hours after starting appropriate antibiotic treatment, and all the children in the kindergarten were instructed to keep strict personal hygiene practices. Conclusion Our results suggest that the outbreak likely affected from the index case-patients who attended to one of the classrooms in the kindergarten. This highlights the importance of immediate notification of outbreak to prevent large number of patients.

Temporal association between antibiotic use and resistance in Klebsiella pneumoniae at a tertiary care hospital

Objectives Legionnaires’ disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection. Methods To identify the source of LD, we interviewed the patient’s husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient’s symptoms first appeared to 14 days after the implementation of environmental control measures. Results Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient’s residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests. Conclusions The likely source of infection was the building’s potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.