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Epidemiol Health. 2015;37(1):e2015036. English. Case Report.
Chang K , Ki M , Lee EG , Lee SY , Yoo B , Choi JH .
Independent Health Consultant, Suwon, Korea.
Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
Divsion of Epidemiology and Health Index, Center for Genome Science, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea.

Most cases of Middle East Respiratory Syndrome (MERS) infection in Korea (outbreak: May 11-July 4, 2015) occurred in hospital settings, with uncertain transmission modes in some cases. We performed an in-depth investigation epidemiological survey on the 178th case to determine the precise mode of transmission. A 29-year-old man living in Pyeongtaek presented on June 16 with a febrile sensation, chills, and myalgia. Upon confirmatory diagnosis on June 23, he was treated in an isolation room and discharged on July 2 after cure. An epidemiological investigation of all possible infection routes indicated two likely modes of transmission: exposure to MERS in Pyeongtaek St. Mary's Hospital during a visit to his hospitalized father (May 18-29), and infection through frequent contact with his father between the latter's referral to Pyeongtaek Good Samaritan Bagae Hospital for treatment without confirmatory diagnosis until his death (May 29-June 6). Although lack of clear proof or evidence to the contrary does not allow a definitive conclusion, all other possibilities could be excluded by epidemiological inferences. While it is impossible to trace back the modes of transmission of all cases in a large-scale outbreak, case-by-case tracking and isolation of infected individuals and those in close contact with them is important in preventing the spread. Efforts should be made to establish a methodology for rapid tracking of all possible contacts and elimination-based identification of the precise modes of transmission.

Copyright © 2019. Korean Association of Medical Journal Editors.