- Seroreactivity to Q Fever Among Slaughterhouse Workers in South Korea
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Hyuk Chu, Seok-Ju Yoo, Kyu-Jam Hwang, Hyun-Sul Lim, Kwan Lee, Mi-Yeoun Park
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J Prev Med Public Health. 2017;50(3):195-200. Published online May 11, 2017
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DOI: https://doi.org/10.3961/jpmph.17.017
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Q fever is a zoonotic disease that occurs worldwide; however, little is known about its prevalence in South Korea. We attempted to determine the prevalence of Q fever seroreactivity among Korean slaughterhouse workers and the risk factors for seroreactivity according to the type of work.
Methods The study was conducted among 1503 workers at a total of 73 slaughterhouses and 62 residual-product disposal plants. During the study period, sites were visited and surveys were administered to employees involved in slaughterhouse work, and serological tests were performed on blood samples by indirect immunofluorescence assays. Serological samples were grouped by job classification into those of slaughter workers, residual-product handlers, inspectors and inspection assistants, and grading testers and testing assistants. Employee risk factors were analyzed according to the type of work.
Results Out of 1481 study subjects who provided a blood sample, 151 (10.2%) showed reactive antibodies. When these results were analyzed in accordance with the type of work, the result of slaughter workers (11.3%) was similar to the result of residual-product handlers (11.4%), and the result of inspectors and assistants (5.3%) was similar to the result of grading testers and assistants (5.4%). Among those who answered in the affirmative to the survey question, “Has there been frequent contact between cattle blood and your mouth while working?” the proportions were 13.4 and 4.6%, respectively, and this was identified as a risk factor that significantly varied between job categories among slaughterhouse workers.
Conclusions This study found a Q fever seroreactivity rate of 10.2% for slaughterhouse workers, who are known to be a high-risk population. Contact with cattle blood around the mouth while working was the differential risk factor between job categories among slaughterhouse workers.
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- Q Fever in Greece and Factors of Exposure: A Multiregional Seroprevalence Study
Magdalini K Christodoulou, Konstantinos Tsaras, Charalambos Billinis, Konstantinos I Gourgoulianis, Dimitrios Papagiannis Cureus.2024;[Epub] CrossRef - Prevalence and risk factors associated with Q fever infection in slaughterhouse workers in Fars province, Iran
Alireza Zakeri, Maryam Montaseri, Seyed Shahram Shekarforoush International Archives of Occupational and Environmental Health.2023; 96(4): 597. CrossRef - First report of an outbreak of “Q” fever IN an abattoir from Argentina
Natalia Marina Cardillo, Reginaldo Bastos, Araceli García, Rosendo Pérez, Ezequiel García, Susana Lloveras, Carlos Suarez Zoonoses and Public Health.2023; 70(8): 674. CrossRef - Seroepidemiologic evidence of Q fever and associated factors among workers in veterinary service laboratory in South Korea
Dilaram Acharya, Ji-Hyuk Park, Jeong-Hoon Chun, Mi Yeon Kim, Seok-Ju Yoo, Antoine Lewin, Kwan Lee, José Reck PLOS Neglected Tropical Diseases.2022; 16(2): e0010054. CrossRef - Exposure of South African Abattoir Workers to Coxiella burnetii
Liesl De Boni, Sumaya Mall, Veerle Msimang, Alex de Voux, Jennifer Rossouw, John Frean Tropical Medicine and Infectious Disease.2022; 7(2): 28. CrossRef - Seroprevalence of Coxiella burnetii in a dairy cattle herd from the Al Ain region, United Arab Emirates
Robert Barigye, Nabeeha Abdelgaleel D. Hassan, Ibrahim M. Abdalla Alfaki, Mike B. Barongo, Mohamed Elfatih H. Mohamed, Khaja Mohteshamuddin Tropical Animal Health and Production.2021;[Epub] CrossRef - Seroreactivity to Coxiella burnetii in an Agricultural Population and Prevalence of Coxiella burnetii Infection in Ticks of a Non-Endemic Region for Q Fever in South Korea
Jeong-Rae Yoo, Mi-Sun Kim, Sang-Taek Heo, Hyun-Joo Oh, Jung-Hwan Oh, Seo-Young Ko, Jeong-Ho Kang, Sung-Kgun Lee, Woo-Seong Jeong, Gil-Myeong Seong, Hyun-Jung Lee, Chul-Hoo Kang, Ji-Hyun Moon, Keun-Hwa Lee, Sung-Wook Song Pathogens.2021; 10(10): 1337. CrossRef - Isolation of Coxiella burnetii in patients with nonspecific febrile illness in South Korea
Seung Hun Lee, Jae Hoon Lee, Sungdo Park, Hae Kyung Lee, Seon Do Hwang, Hye Won Jeong, Jung Yeon Heo, Yeong Seon Lee BMC Infectious Diseases.2020;[Epub] CrossRef - Coxiella burnetiiinfection in humans: to what extent do cattle in infected areas free from small ruminants play a role?
M. Pouquet, N. Bareille, R. Guatteo, L. Moret, F. Beaudeau Epidemiology and Infection.2020;[Epub] CrossRef - Hepatitis in slaughterhouse workers
Hassan Tariq, Muhammad Umar Kamal, Jasbir Makker, Sara Azam, Usman Ali Pirzada, Vaniza Mehak, Kishore Kumar, Harish Patel World Journal of Hepatology.2019; 11(1): 37. CrossRef - Clinical characteristics of acute Q fever patients in South Korea and time from symptom onset to serologic diagnosis
Jung Yeon Heo, Young Wha Choi, Eun Jin Kim, Seung Hun Lee, Seung Kwan Lim, Seon Do Hwang, Ju Young Lee, Hye Won Jeong BMC Infectious Diseases.2019;[Epub] CrossRef - Serologic Survey and Risk Factors forCoxiella burnetiiInfection among Dairy Cattle Farmers in Korea
Ji-Hyuk Park, Hyuk Chu, Seok-Ju Yoo, Kyu-Jam Hwang, Hyun-Sul Lim Journal of Korean Medical Science.2018;[Epub] CrossRef - Seroreactivity and Risk Factors Associated with Coxiella burnetii Infection among Cattle Slaughterhouse Workers in South Korea
Ji-Hyuk Park, Seon Do Hwang, Dilaram Acharya, Seung Hun Lee, Kyu Jam Hwang, Seok-Ju Yoo, Kwan Lee International Journal of Environmental Research and Public Health.2018; 15(10): 2264. CrossRef
- A Survey on the Status of Hepatitis E Virus Infection Among Slaughterhouse Workers in South Korea
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Byung-Seok Kim, Hyun-Sul Lim, Kwan Lee, Young-Sun Min, Young-Sil Yoon, Hye-Sook Jeong
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J Prev Med Public Health. 2015;48(1):53-61. Published online January 15, 2015
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DOI: https://doi.org/10.3961/jpmph.14.048
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9,657
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The seroprevalence of hepatitis E virus (HEV) among high-risk groups overseas is high, but studies in these groups are rare in South Korea. We conducted the present study from April to November 2012 to obtain data on the seroprevalence and associated risk factors for HEV among slaughterhouse workers in South Korea.
Methods Slaughterhouse workers from 80 workplaces nationwide were surveyed in South Korea in 2012. The subjects comprised 1848 cases: 1434 slaughter workers and 414 residual products handlers. By visiting 80 slaughterhouses, which were mixed with 75 of which also performed residual products handling, we conducted a questionnaire survey for risk factors and obtained blood samples in order to determine the seropositivity and seroprevalence of HEV. Anti-HEV IgG and IgM were measured using HEV IgG and IgM enzyme-linked immunospecific assay kits and HEV antigen was measured by reverse transcription polymerase chain reaction (RT-PCR).
Results The seropositivity of anti-HEV IgG was 33.5% (slaughter workers 32.8% and residual products handlers 36.2%), and among the seropositive individuals the seroprevalence of anti-HEV IgM was 0.5% (slaughter workers 0.5%, residual products handlers 0.7%). The response rate of HEV-antigen as measured by RT-PCR was 0.2%. Risk factors significantly related to anti-HEV IgG seropositivity were age, sex , and working duration (slaughter workers only).
Conclusions There were significant risk factors (sex, age, and working duration) for HEV identified in our study. All three positive cases for HEV-antigen by RT-PCR were related to pig slaughter but without statistical significance. To prevent HEV, an educational program and working guidelines may be needed for high risk groups.
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- Epidemiological Aspects of Hepatitis E Virus Infections between South Korea and Japan
Myeong-Jin Lee, Won-Chang Lee, Young Hwan Kwon The Korean Journal of Aerospace and Environmental Medicine.2022; 32(1): 27. CrossRef - Hepatitis E virus in professionally exposed: A reason for concern?
Anna Mrzljak, Ivan Balen, Ljubo Barbic, Maja Ilic, Tatjana Vilibic-Cavlek World Journal of Hepatology.2021; 13(7): 723. CrossRef
- Analysis of the Change of Health Status Among the Republic of Korea Air Force Soldiers During Military Service
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Seok-Ju Yoo, Won-Ju Park, Kwan Lee, Hyun-Sul Lim, Hyun-Jin Kim, Suk-Ho Lee
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J Prev Med Public Health. 2014;47(4):230-235. Published online July 31, 2014
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DOI: https://doi.org/10.3961/jpmph.2014.47.4.230
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9,565
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The aim of this study was to investigate whether the health status of Republic of Korea Air Force (ROKAF) soldiers changed after one year of military service. Methods: We selected 483 ROKAF soldiers from the 11 749 recruits who participated in the 2011 physical examination. The selected soldiers underwent another physical examination in 2012 for advancement to senior airman. Data from 2011 and 2012 were merged. To collect data on lifestyle, a questionnaire was sent to all included subjects via the military intranet e-mail service. Results: The percentage of recruits with an abnormal alanine transaminase level (normal range <40 IU/L) decreased from recruitment (13.7%) to the following year (2.7%). Moreover, the percentage of obese soldiers (body mass index ≥25 kg/m2) decreased from recruitment (20.5%) to the following year (10.4%). There was a significant change in mean duration of exercise carried out each day before (0.8±1.3 hours) and after (1.0±0.7 hours) joining the ROKAF service. Conclusions: These ROKAF soldiers were generally in good health before and after joining the armed service. After one year of military service, the health status of most soldiers improved, especially with respect to body mass index and alanine transaminase level.
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- Behavioral impact of national health campaigns on healthy lifestyle practices among young adults in Singapore: a cross-sectional study
Yong Zhi Khow, Talia Li Yin Lim, Jarret Shoon Phing Ng, Jiaxuan Wu, Chuen Seng Tan, Kee Seng Chia, Nan Luo, Wei Jie Seow BMC Public Health.2021;[Epub] CrossRef - Strategic Priorities to Improve Effectiveness of Anti-smoking Interventions for the Korean Military: An Application of the Analytic Hierarchy Process
Yun-Kyoung Song, Jae Hyun Kim, Boyoon Choi, Nayoung Han, Myeong Gyu Kim, Jeongsam Lee, Handuk Lee, Jieun Yoon, Beom-Jin Lee, Jung Mi Oh Military Medicine.2018; 183(7-8): e223. CrossRef
- Epidemiological Investigation of an Outbreak of Salmonellosis in Gyeongju, Korea
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Seok-Ju Yoo, Hyun-Sul Lim, Kwan Lee
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J Prev Med Public Health. 2014;47(3):177-181. Published online May 30, 2014
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DOI: https://doi.org/10.3961/jpmph.2014.47.3.177
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A salmonellosis outbreak occurred within a community of Gyeongju residents who ingested catered food from a wedding in June 2009. We aimed to epidemiologically investigate the probable vehicle of the infection. MethodsWe conducted a retrospective cohort study on 34 local residents who ingested the wedding food. ResultsAmong the 34 residents, 31 (91.2%) reported symptoms of infection after eating the food. Among all of the wedding foods, pan-fried foods were highly associated with the diarrheal attack rate. On bacteriological examination, Salmonella species were detected in the pan-fried foods among the leftover foods and in 17 of the 31 stool specimens from the cases. There were five different types of pan-fried foods, but the onset of symptoms was independent of the ingredients used. We found that the pan-fried food was prepared at a food store in Seoul and that eggs were a common ingredient. ConclusionsThe major cause of the salmonellosis in this population was presumed to be the pan-fried food prepared with contaminated eggs. These food items might have been partially undercooked because of their irregular shape, which allowed the Salmonella species to survive and multiply before ingestion.
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- Prevalence of Salmonella spp. and Escherichia coli in the feces of free-roaming wildlife throughout South Korea
Rahman M. Mafizur, Lim Sangjin, Park Y. Chul, Csaba Varga PLOS ONE.2024; 19(2): e0281006. CrossRef - Phylogenetic Analysis Based on Whole Genome Sequences, Antibiotic Resistance, and Virulence of Salmonella enterica Clinical Isolates from South Korea
Jihyun Choi, Jong Hyun Shin, Suyeon Park, Ji Young Choi, Jin Yang Baek, Kyungmin Huh, Doo Ryeon Chung, Ki Tae Kwon, Mi-Ran Seo, Seung-Hyun Jung, Yeun-Jun Chung, Kwan Soo Ko Foodborne Pathogens and Disease.2024;[Epub] CrossRef - DISINFECTION OF MARKETABLE EGGS BY PLASMA-CHEMICALLY ACTIVATED AQUEOUS SOLUTIONS
О. Pivovarov, О. Kovalova, V. Koshulko Food Science and Technology.2022;[Epub] CrossRef - Salmonella in eggs: From shopping to consumption—A review providing an evidence‐based analysis of risk factors
Maria João Cardoso, Anca Ioana Nicolau, Daniela Borda, Line Nielsen, Rui Leandro Maia, Trond Møretrø, Vânia Ferreira, Susanne Knøchel, Solveig Langsrud, Paula Teixeira Comprehensive Reviews in Food Science and Food Safety.2021; 20(3): 2716. CrossRef - A dynamic predictive model for the growth of Salmonella spp. and Staphylococcus aureus in fresh egg yolk and scenario-based risk estimation
Jin Hwa Park, Mi Seon Kang, Kyung Min Park, Hee Young Lee, Gyeong Sik Ok, Min Seon Koo, Seok In Hong, Hyun Jung Kim Food Control.2020; 118: 107421. CrossRef - Nationwide surveillance on serotype distribution and antimicrobial resistance profiles of non-typhoidal Salmonella serovars isolated from food-producing animals in South Korea
Abraham Fikru Mechesso, Dong Chan Moon, Su-Jeong Kim, Hyun-Ju Song, Hee Young Kang, Seok Hyeon Na, Ji-Hyun Choi, Ha-Young Kim, Soon-Seek Yoon, Suk-Kyung Lim International Journal of Food Microbiology.2020; 335: 108893. CrossRef - Salmonella food-poisoning outbreak linked to the National School Nutrition Programme, North West province, South Africa
Thejane W. Motladiile, John M. Tumbo, Adrien Malumba, Bolaji Adeoti, Nozizwe J. Masekwane, Oleteng M.R. Mokate, Otsile C. Sebekedi Southern African Journal of Infectious Diseases.2019;[Epub] CrossRef - Molecular characterization of antimicrobial resistant non-typhoidal Salmonella from poultry industries in Korea
Jin Eui Kim, Young ju Lee Irish Veterinary Journal.2017;[Epub] CrossRef
- Airborne Nicotine Concentrations in the Workplaces of Tobacco Farmers
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Seok-Ju Yoo, Sung-Jun Park, Byoung-Seok Kim, Kwan Lee, Hyun-Sul Lim, Jik-Su Kim, In-Shik Kim
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J Prev Med Public Health. 2014;47(3):144-149. Published online May 30, 2014
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DOI: https://doi.org/10.3961/jpmph.2014.47.3.144
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10,596
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Nicotine is a natural alkaloid and insecticide in tobacco leaves. Green tobacco sickness (GTS) is known as a disease of acute nicotine intoxication among tobacco farmers. Until now, GTS has been recognized globally as a disease that results from nicotine absorption through the skin. However, we assumed that GTS might also result from nicotine inhalation as well as absorption. We aimed to measure the airborne nicotine concentrations in various work environments of Korean tobacco farmers. MethodsWe measured the nicotine concentrations in the tobacco fields, private curing barns, and joint curing barns of farmers from July to October 2010. All sampling and analyses of airborne nicotine were conducted according to the National Institute for Occupational Safety and Health manual of analytic methods. ResultsThe airborne nicotine concentrations (geometric mean [geometric standard deviation]) in the tobacco field were 83.4 mg/m3 (1.2) in the upper region and 93.3 mg/m3 (1.2) in the lower region. In addition, the nicotine concentration by personal sampling was 150.1 mg/m3. Similarly, the nicotine concentrations in the private curing barn, workers in curing barns, the front yard of the curing barn, and in the joint curing barn were 323.7 mg/m3 (2.0), 121.0 mg/m3 (1.5), 73.7 mg/m3 (1.7), and 610.3 mg/m3 (1.0), respectively. ConclusionsThe nicotine concentration in the workplaces of tobacco farmers was very high. Future studies should measure the environmental concentration of nicotine that is inhaled by tobacco farmers.
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- Perspectives of push-pull-mooring effects on a desire for
switching to alternative crops among tobacco farmers in
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Chakkraphan Phetphum, Artittaya Wangwonsin, Atchara Prajongjeep, Saksin Simsin Tobacco Induced Diseases.2024; 22(January): 1. CrossRef - Nicotine exposure from packaged cigarettes in tobacco retail settings
Myung-Bae Park, Jimi Huh, Byung Lyul Woo Drug and Alcohol Dependence.2024; 258: 111271. CrossRef - Obstructive Lung Disease Linked to Occupational Exposures in Malawian Tobacco Farmers
Yotam M Moyo, Mohamed F Jeebhay, Roslynn Baatjies, Sufia Dadabhai, Shahieda Adams Journal of Agromedicine.2023; 28(4): 867. CrossRef - Deteriorating Quality of Life and a Desire to Stop Growing Tobacco Among Virginia and Burley Tobacco Farmers in Thailand
Chakkraphan Phetphum, Atchara Prajongjeep, Orawan Keeratisiroj, Saksin Simsin, Kanyarat Thawatchaijareonying JCO Global Oncology.2022;[Epub] CrossRef - Dor na coluna torácica e fatores associados em fumicultores
Maitê Peres de Carvalho, Nadia Spada Fiori, Rodrigo Dalke Meucci, Neice Muller Xavier Faria, Anaclaudia Gastal Fassa Revista Brasileira de Saúde Ocupacional.2020;[Epub] CrossRef - Dolor cervical entre agricultores que producen tabaco en el sur de Brasil
Anaclaudia Gastal Fassa, Nadia Spada Fiori, Rodrigo Dalke Meucci, Neice Müller Xavier Faria, Maitê Peres de Carvalho Salud Colectiva.2020; 16: e2307. CrossRef - Green tobacco sickness: mecamylamine, varenicline, and nicotine vaccine as clinical research tools and potential therapeutics
Lance R. McMahon Expert Review of Clinical Pharmacology.2019; 12(3): 189. CrossRef - Molecular mechanisms for nicotine intoxication
Tursun Alkam, Toshitaka Nabeshima Neurochemistry International.2019; 125: 117. CrossRef - Intelligent Control of Bulk Tobacco Curing Schedule Using LS-SVM- and ANFIS-Based Multi-Sensor Data Fusion Approaches
Juan Wu, Simon X. Yang Sensors.2019; 19(8): 1778. CrossRef - Socio-environmental risks associated with the green tobacco sickness in farmers: a case-control study
Marcia Casaril dos Santos Cargnin, Marta Regina Cezar-Vaz, Caroline Ottobelli Getelina, Clarice Alves Bonow Revista Brasileira de Enfermagem.2019; 72(6): 1670. CrossRef - Uso de biomarcador cotinina em trabalhadores para detecção da doença da folha verde do tabaco
Marta Regina Cezar-Vaz, Marcia Casaril dos Santos Cargnin Revista Latino-Americana de Enfermagem.2019;[Epub] CrossRef - How to prevent and manage green tobacco sickness?
Dilaram Acharya, Kwan Lee Indian Journal of Occupational and Environmental Medicine.2018; 22(2): 115. CrossRef - CULTURA DO TABACO VERSUS SAÚDE DOS FUMICULTORES
Marcia Casaril dos Santos Cargnin, Carolina de Castilhos Teixeira, Vanessa Monteiro Mantovani, Amália de Fátima Lucena, Isabel Cristina Echer Texto & Contexto - Enfermagem.2016;[Epub] CrossRef
- Epidemiological Investigation of an Outbreak of Hepatitis A at a Residential Facility for the Disabled, 2011
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Hyun-Sul Lim, Kumbal Choi, Saerom Lee
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J Prev Med Public Health. 2013;46(2):62-73. Published online March 28, 2013
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DOI: https://doi.org/10.3961/jpmph.2013.46.2.62
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An outbreak of hepatitis A occurred at a residential facility for the disabled in July 10, 2011. This investigation was carried out to develop a response plan, and to find the infection source of the disease. MethodsA field epidemiologist investigated the symptoms, vaccination histories, living environments, and probable infection sources with 51 residents and 31 teachers and staff members. In July 25, 81 subjects were tested for the hepatitis A virus antibody, and specimens of the initial 3 cases and the last case were genetically tested. ResultsThree cases occurred July 10 to 14, twelve cases August 3 to 9, and the last case on August 29. Among the teachers and staff, no one was IgM positive (on July 25). The base sequences of the initial 3 and of the last case were identical. The vehicle of the outbreak was believed to be a single person. The initial 3 patients were exposed at the same time and they might have disseminated the infection among the patients who developed symptoms in early August, and the last patient might have, in turn, been infected by the early August cases. ConclusionsThe initial source of infection is not clear, but volunteers could freely come into contact with residents, and an infected volunteer might have been the common infection source of the initial patients. Volunteers' washing their hands only after their activity might be the cause of this outbreak. Although there may be other possible causes, it would be reasonable to ask volunteers to wash their hands both before and after their activities.
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- Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020
Noele P. Nelson, Mark K. Weng, Megan G. Hofmeister, Kelly L. Moore, Mona Doshani, Saleem Kamili, Alaya Koneru, Penina Haber, Liesl Hagan, José R. Romero, Sarah Schillie, Aaron M. Harris MMWR. Recommendations and Reports.2020; 69(5): 1. CrossRef - Outbreak of Hepatitis A Virus Infection Among Adult Patients of a Mental Hospital — Los Angeles County, 2017
Curtis Croker, Susan Hathaway, Amy Marutani, Margilane Hernandez, Crystal Cadavid, Shobita Rajagopalan, Bessie Hwang, Moon Kim Infection Control & Hospital Epidemiology.2018; 39(07): 881. CrossRef - Estimating human-to-human transmissibility of hepatitis A virus in an outbreak at an elementary school in China, 2011
Xu-Sheng Zhang, Giovanni Lo Iacono, Eric HY Lau PLOS ONE.2018; 13(9): e0204201. CrossRef - Source identification through social networks in an epidemiological investigation of a hepatitis A outbreak at an elementary school in Anhui province, China
J. B. WU, X. L. LI, J. ZHANG, D. XU, J. J. ZHU, B. S. ZHOU Epidemiology and Infection.2014; 142(7): 1450. CrossRef
- Vaccine Storage Practices and the Effects of Education in Some Private Medical Institutions
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Saerom Lee, Hyun-Sul Lim, Ohyon Kim, Jeonggyeong Nam, Yeongsun Kim, Hyungrae Woo, Woojin Noh, Kyenam Kim
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J Prev Med Public Health. 2012;45(2):78-89. Published online March 31, 2012
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DOI: https://doi.org/10.3961/jpmph.2012.45.2.78
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10,698
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Although vaccination rates have increased, problems still remain in the storage and handling of vaccines. This study focused on inspecting actual vaccine storage status and awareness, and comparing them before and after education was provided. MethodsIn the primary inspection, a status survey checklist was completed by visual inspection. A questionnaire on the awareness of proper vaccine storage and handling was also administered to vaccine administrators in private medical institutions in 4 regions in Gyeongsangbuk-province. One-on-one education was then carried out, and our self-produced manual on safe vaccine storage and management methods was provided. In the secondary inspection, the investigators visited the same medical institutions and used the same questionnaire and checklist used during the primary inspection. The results before and after education were compared, by treating each appropriate answer as 1 point. ResultsThe average checklists score was 9.74 (out of 15 points), which increased significantly after education was provided (by 0.84, p<0.001). The participants demonstrated improved practices in recording storage temperatures (p=0.016), storing vaccines in the center of the refrigerator (p=0.004), storing vaccines with other medication and non-medical items (p=0.031) after education. The average score calculated from the questionnaires was 10.48 (out of 14 points), which increased after education (by 1.03, p<0.001). ConclusionsThis study suggests that vaccine storage practices and awareness are inadequate, but can be partially improved by providing relevant education. Repetitive education and policy-making are required to store vaccines safely because one-off education and unenforced guidelines offer limited efficacy.
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Anika Thielmann, Marie-Therese Puth, Christine Kersting, Johannes Porz, Birgitta Weltermann, Sanjai Kumar PLOS ONE.2019; 14(11): e0224972. CrossRef - Visual inspection of vaccine storage conditions in general practices: A study of 75 vaccine refrigerators
Anika Thielmann, Marie-Therese Puth, Birgitta Weltermann, Abhijit P. Pakhare PLOS ONE.2019; 14(12): e0225764. CrossRef - Safety of vaccines that have been kept outside of recommended temperatures: Reports to the Vaccine Adverse Event Reporting System (VAERS), 2008–2012
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