• Kidney Research and Clinical Practice
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• v.36 no.2
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• pp.111-116
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• 2017

The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of 'the clinical practice guideline for hemodialysis facilities dealing with MERS patients' built upon our previous experience.

• Journal of Korean Public Health Nursing
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• v.33 no.1
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• pp.33-46
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• 2019

Purpose: Individuals suspected Middle East Respiratory Syndrome (MERS) are continuously surfacing in Korea. study the Korean public's knowledge, attitude, and preventive behaviors related to MERS as well as the factors that affect preventive behaviors for MERS. Methods: The study used a descriptive research design, and included 196 men and women aged 20 to 65 years. Data were collected through Internet surveys and self-reported questionnaires from December 1 to 30, 2017. Results: Among the participants, 88.7 percent knew cough etiquette, 84.7 percent had education about cough etiquette, and 52.6 percent had received education on MERS. The average scores for knowledge of MERS was $73.60{\pm}18.78$; attitude of MERS, $2.22{\pm}0.92$; and preventive behaviors for MERS, $62.43{\pm}16.11$. egression analysis showed that higher knowledge of MERS (${\beta}=.34$, p<.001) and higher attitude of MERS (${\beta}=.05$, p=<.001) resulted in increased preventive behaviors, people with MERS education increased preventive behaviors (${\beta}=.21$, p=.003). Conclusion: the awareness and knowledge of MERS for promoting related preventive behaviors. Therefore, education content that considers the characteristics of the target population should be organized and expanded multiple channels.

• Journal of Korean Neuropsychiatric Association
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• v.56 no.1
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• pp.28-34
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• 2017

Objectives The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. Methods After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. Results The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. Conclusion The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

• Genomics & Informatics
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• v.18 no.3
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• pp.30.1-30.7
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• 2020

The novel coronavirus pandemic that has originated from China and spread throughout the world in three months. Genome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) predecessor, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) play an important role in understanding the concept of genetic variation. In this paper, the genomic data accessed from National Center for Biotechnology Information (NCBI) through Molecular Evolutionary Genetic Analysis (MEGA) for statistical analysis. Firstly, the Bayesian information criterion (BIC) and Akaike information criterion (AICc) are used to evaluate the best substitution pattern. Secondly, the maximum likelihood method used to estimate of transition/transversions (R) through Kimura-2, Tamura-3, Hasegawa-Kishino-Yano, and Tamura-Nei nucleotide substitutions model. Thirdly and finally nucleotide frequencies computed based on genomic data of NCBI. The results indicate that general times reversible model has the lowest BIC and AICc score 347,394 and 347,287, respectively. The transition/transversions bias for nucleotide substitutions models varies from 0.56 to 0.59 in MEGA output. The average nitrogenous bases frequency of U, C, A, and G are 31.74, 19.48, 28.04, and 20.74, respectively in percentages. Overall the genomic data analysis of SARS-CoV-2, SARS-CoV, and MERS-CoV highlights the close genetic relationship.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.143-146
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• 2015

Since 2012, outbreaks of the Middle East respiratory coronavirus (MERS-CoV) have been reported, including the Republic of Korea. To date, most of the people infected with the virus are adults. Herein we describe the clinical characteristics of cases of MERS-CoV infection among children. As of October 29, 2015, MERS-CoV has caused 34 pediatric infections, which accounts for 2.1% of all cases. The median age was 13 years (range 9 months to 17 years) and where gender has been reported (n=33), 57.6% cases were male. About half of the patients were asymptomatic and the majority of the symptomatic patients had respiratory symptoms. In general, the clinical outcome in children was favorable. Among the four patients who died of progressive pneumonia, three had documented comorbidities. MERS-CoV infection in children has a lower incidence and mortality compared to adults.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.179-179
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• 2015

• Journal of Korean Medical Science
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• v.33 no.53
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• pp.348.1-348.6
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• 2018

We report a case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in a 61-year-old businessman returning from Kuwait. The patient arrived there on August 16, 2018, developed watery diarrhea on August 28 (day 0), and came back to Korea on September 7 (day 10) as his condition worsened. Upon arrival, he complained of diarrhea and weakness, but denied any respiratory symptoms, and he directly went to visit an emergency room. Chest radiography revealed interstitial infiltrates in the lungs, and he was immediately transferred to an isolation unit. Quantitative real-time PCR analysis of sputum samples taken on day 11 returned positive for MERS-CoV. No secondary MERS-CoV infection was identified among people who had close contact with him. This case underscores the importance of a high index of suspicion of MERS-CoV infection in any febrile patients who present after a trip to the Middle East.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.1-9
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• 2015

Objectives: The purpose of this article was to assess epidemiological characteristics and recommendations for strengthening national response and preparedness after MERS-CoV outbreak in Korea, 2015. Methods: The author reviewed epidemiological reports and policy recommendations on MERS-CoV outbreak in Korea, 2015. Results: There was no evidence that genetical difference between the MERS viruses in the Republic of Korea and recent viruses in the Middle East. From the index case to last laboratory-confirmed case, there were 186 laboratory-confirmed cases that included 36 deaths(19.4%), all of whom appear epidemiologically linked to the index cases or subsequent secondary, tertiary, and quaternary cases. This outbreak spread to hospitals through nosocomial transmission. At least, three large clusters were investigated. However, there was at least one case of community transmission of MERS-CoV. Several factors had contributed to the MERS outbreak in Korea, 2015 that including epidemiological characteristics, and infrastructure of national healthcare system for preventing and controlling emerging infectious diseases. Conclusions: It is very important that to share experiences and identify underlying causes of this outbreak for prevention and control of emerging infectious disease in the future; including epidemiology, clinical features, and public health response and preparedness.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.131-135
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• 2015

Since April 2012, more than 1,600 laboratory-confirmed human infections with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) have been reported, occurring primarily in countries in the Arabian Peninsula; the majority in Saudi Arabia. The MERS outbreak in Korea, which began in May 2015 through the importation of a single case who had recently traveled to Bahrain, the United Arab Emirates, Saudi Arabia, and Qatar. As of November 28th, 186 secondary and tertiary cases had been reported; 38 deaths, mainly associated with underlying chronic illnesses, were reported. One case was exported to China and has been recorded as the first MERS case in China. Thirty-seven confirmed cases were associated with the index case, who was hospitalized from May 15 to May 17. Emergency room at one of the nation's largest hospitals had been affected by hospital-to-hospital and intra-hospital transmissions of MERS-CoV, resulting in an outbreak of 90 infected patients. The vast majority of 186 confirmed cases are linked to a single transmission chain associated with health facilities. The median age of patients is 55 years, with a range of 16 to 87 years. The majority (61%) of patients are men. Twenty-five (14%) of the cases involve healthcare workers. The overall median incubation period was six days, but it was four days for secondary cases and six days for tertiary cases. There has been no evidence of airborne transmission and sustained human-to-human transmission in communities. Intensified public health measures, including contact tracing, quarantine and isolation of all contacts and suspected cases, and infection prevention and control have brought the MERS-CoV under control in Korea. Since 4 July no new cases have been reported.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.252-260
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• 2018

Purpose: This study aimed to investigate the relationships between the level of knowledge, attitude and compliance of preventive behaviors of the Middle East respiratory syndrome (MERS) among nursing students. Methods: The study sample consisted of 219 nursing students. Through the use of a structured questionnaire, data collection was conducted from June 1st to June 30th 2015. The descriptive statistics, independent t-tests and Pearson's correlation coefficient were employed to analyze the data. Results: The score of the MERS-related knowledge was 9.15 out of 13. The participants had a positive attitude toward the MERS. The level of MERS-related knowledge was high in the case of temporary school closure or break in clinical practice because of the clinical training in hospitals that MERS occurred (t= 2.42, p= .016). The compliance level of the preventive behavior for MERS was high in female students (t= -2.11, p= .036), in the case of temporary school closure or break in clinical practice due to the clinical training in hospitals that MERS occurred (t = 3.29, p= .001), and in students that had MERS-related education for prevention (t = 2.80, p= .006). The MERS-related knowledge was positively correlated with the level of compliance for preventive behavior (r= .18, p= .009). Conclusion: To prevent MERS infection in nursing students, the level of knowledge on MERS should be enhanced so that they can practice preventive behaviors against it. Additionally, the MERS infection control education should include etiology and treatment products based on the MERS response guideline issued by the Centers for Korea Disease Control and Prevention.