New framework to assess tracing and testing based on South Korea's response to COVID-19.

South Korea's remarkable success in controlling the spread of COVID-19 during the pre-Omicron period was based on extensive contact tracing and large-scale testing. Here we suggest a general criterion for tracing and testing based on South Korea's experience, and propose a new framework to assess tracing and testing. We reviewed papers on South Korea's response to COVID-19 to capture its concept of tracing and testing. South Korea expanded its testing capabilities to enable group tracing combined with preemptive testing, and to conduct open testing. According to our proposed model, COVID-19 cases are classified into 4 types: confirmed in quarantine, source known, source unknown, and unidentified. The proportion of the first two case types among confirmed cases is defined as "traced proportion", and used as the indicator of tracing and testing effectiveness. In conclusion, South Korea successfully suppressed COVID-19 transmission by maintaining a high traced proportion (> 60%) using group tracing in conjunction with preemptive testing as a complementary strategy to traditional contact tracing.

Association of Deforestation With Severe Fever With Thrombocytopenia Syndrome.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) virus was first isolated in China in 2009 and has since spread to several Asian countries. SFTS is closely related to environmental factors that accelerate vector growth. We evaluated the associations of SFTS and deforestation with environmental variables. METHODS: For this observational study, we generated multiple Poisson models using national SFTS outbreak data (2013-2018) and official environmental data for Korea. We included established risk factors as variables. Deforestation was used as the main variable. All variables were analyzed according to their spatial characteristics using the R-INLA package. RESULTS: SFTS cases increased over time and peaked in 2017, at 272, followed by a decrease in 2018. Disease mapping showed a high incidence of SFTS nationwide, with particular risks in Gangwon and Gyeonggi Provinces in the north, and Jeju in the south of South Korea. Deforestation was significantly associated with a higher risk of SFTS in the final model (relative risk, 1.751 [95% confidence interval, 1.125-2.743]). CONCLUSIONS: SFTS outbreaks are associated with deforestation. Therefore, deforestation in Gyeonggi, Gangwon, and Jeju provinces of South Korea needs to be considered in vector-control strategies and active surveillance of SFTS occurrence.

Associations of symptom combinations with in-hospital mortality of coronavirus disease-2019 patients using South Korean National data.

BACKGROUND: There are various risk factors for death in coronavirus disease-2019 (COVID-19) patients. The effects of symptoms on death have been investigated, but symptoms were considered individually, rather than in combination, as predictors. We examined the effects of symptom combinations on in-hospital mortality. METHODS: Data from the Korea Disease Control and Prevention Agency were analyzed. A cohort of 5,153 patients confirmed with COVID-19 in South Korea was followed from hospitalization to death or discharge. An exploratory factor analysis was performed to identify symptom combinations, and the hazard ratios (HRs) of death were estimated using the Cox proportional hazard model. RESULTS: Three sets of symptom factors were isolated for symptom combination. Factor 1 symptoms were cold-like symptoms, factor 2 were neurological and gastrointestinal symptoms, and factor 3 were more severe symptoms such as dyspnea and altered state of consciousness. Factor 1 (HR 1.14, 95% confidence interval [95% CI] 1.01-1.30) and factor 3 (HR 1.25, 95% CI 1.19-1.31) were associated with a higher risk for death, and factor 2 with a lower risk (HR 0.71, 95% CI 0.71-0.96). CONCLUSIONS: The effect on in-hospital mortality differed according to symptom combination. The results are evidence of the effects of symptoms on COVID-19 mortality and may contribute to lowering the COVID-19 mortality rate. Further study is needed to identify the biological mechanisms underlying the effects of symptom combinations on mortality.

The Unequal Effects of Social Distancing Policy on Subway Ridership during the COVID-19 Pandemic in Seoul, South Korea.

In the Republic of Korea, social distancing policies relied on voluntary participation by citizens and exhibited short-term changes. In this situation, the effects of such policies varied depending on each community's capacity to comply. Here, we collected subway ridership data for 294 stations on nine Seoul Metro lines and aggregated the data for each station to the 184 smallest administrative areas. We found that the mean percent change in subway ridership was fitted by an additive model of the log-transformed percent ratio of the restaurant industry (estimated degrees of freedom (EDF) = 3.24, P < 0.001), the Deprivation Index (DI) (EDF = 3.66, P = 0.015), and the proportion of essential workers (ß = - 0.10 (95% confidence interval - 0.15 to - 0.05, P < 0.001). We found a distinct decrease in subway ridership only in the least deprived areas, suggesting that social distancing is costly.

Evaluation of microbiological quality and safety of fresh-cut fruit products at retail levels in Korea.

The risk of foodborne illnesses caused by pathogens could be increased in fresh-cut fruit products owing to contamination during processing. Therefore, this study was conducted to investigate the microbiological quality and safety of commercial fresh-cut fruit products in Korea. Additionally, the growth of Listeria monocytogenes in selected fresh-cut fruits was evaluated, and their growth curves were analyzed using predictive growth modeling. The mean count of total aerobic bacteria, coliforms, and yeast/mold was 3.67±1.73 log10 CFU/g, 1.54±1.01 log10 CFU/g, and 3.81±1.51 log10 CFU/g, respectively. Escherichia coli, Staphylococcus aureus, Escherichia coli O157:H7, L. monocytogenes, Salmonella spp., and Cyclospora spp. were not detected in any of the tested samples. Only Bacillus cereus was detected in a few samples at the mean level of 1.72±0.13 log10 CFU/g. The growth of L. monocytogenes varied depending on the type of fruit; they grew well in non-acidic fresh-cut fruit products during storage at 10 °C.

Optimization of resuscitation-promoting broths for the revival of Vibrio parahaemolyticus from a viable but nonculturable state.

This study was conducted to examine the effect of formulated resuscitation-promoting broths on the revival of viable but nonculturable Vibrio parahaemolyticus induced by cold and starvation stresses. Vibrio parahaemolyticus was incubated in artificial sea water at 4 °C for more than 8 months until this bacterium became undetectable, while retaining its intact cell count of more than 105 CFU/field over time. On day 250, V. parahaemolyticus was collected and enriched in tryptic soy broth supplemented with 3% NaCl, 10,000 U/mg catalase, 2% sodium pyruvate, 20 mM MgSO4, 5 mM EDTA, and a cell-free supernatant taken from V. parahaemolyticus ATCC 17802 in the stationary phase (pH 8). V. parahaemolyticus returned partially to a culturable state with a maximal cell density of 7.91 log CFU/mL in this formulated medium following 7 days of enrichment at 25 °C. In contrast, no V. parahaemolyticus was resuscitated when enriched in alkaline peptone water and tryptic soy broth.