The Internet is becoming increasingly important and essential in medicine. The number of health-related web sites and medical portal sites is rising exponentially in recent years. Now, ensuring that the Internet becomes a suitable and comfortable medium for supporting medical applications is a challenging task. Internet in medicine has changed the health and illness behavior of e-health consumers and the traditional doctor-patient relationship. The patients now can get more health information online and take more responsibilities for their own care (consumer empowerment). E-communication using e-mails between doctors and patients has become popular, but this kind of practice needs a proper standard guideline. Implementation of point-of-care(telemedicine), e-consultation and Internet prescription evokes ethical, medicolegal, and social issues and threatens the treaditional medical practice. It is highly recommended that the Korean doctors be familiar with the e-health and e-medicine.
Electronic Mail ; Humans ; Illness Behavior ; Internet* ; Medical Informatics ; Prescriptions ; Telemedicine

No abstract available.
Occupational Diseases*

BACKGROUND: Influenza is a highly infectious viral illness. The epidemics of influenza occur from the late fall to the early spring nearly every year and are responsible for several hundred thousand death per year all over the world. Influenza vaccine is the primary method for preventing influenza and its more severe complications. The efficacy of influenza vaccination have been well known in developed countries. The influenza vaccination has been recommended as one of the tentative immunization schedule for indicated persons since 1997 in Korea. But there are still no available data about them, even though nearly 5 - 8 million doses of influenza vaccine were used in a winter season. PURPOSE: To assess the clinical efficacy of influenza vaccine against influenza-like illness(ILI) among Korean elderly(age over 65). METHODS: Primary study design - a prospective field trial. Study subjects and method - We prospectively observed the 1,488 vaccinee and 1,425 non-vaccinee in a community(Nonsan city) from November 1 1998 to March 31 1999. The vaccinee were those who randomly selected 100-200 per 13 sub-region(Myon) in Nonsan city, and the non-vaccinee were those who had not vaccinated until January 1999 among the Nonsan city elderly cohort. This cohort was consisted of 5,787 elderly(over 1/3 of total elderly population) who had ever visited the community health center or 13 public health offices in Nonsan city in 1998. We followed up these two groups two times-in January and April 1999 - by telephone survey. The questionnaire included the questions about the health behaviors, medical history, socioeconomic condition, medical security type, physical function status, medical facility utilization in the season, symptom and signs of influenza-like illness, number and type of the flu, hospitalization or not. We did throat swap to isolate the virus of 490 patient who had influenza -like symptoms in the same period. RESULTS: Influenza vaccination was significantly reduced the incidence of influenza -like illness(fever or chilling sensation and cough or sore throat) in the vaccinated. The preventive effect of influenza-like illness among influenza risk group was about 32%(95% CI, 20%-44%). The illness duration of main symptoms of influenza-like illness(fever, cough) was significantly shorter in the vaccinee. The consistency of the survey was noted quite high from the analysis of the result of test-retest(104 person). CONCLUSION: Influenza vaccination significantly reduced the incidence of influenza-like illness(32%) among elderly.
Aged ; Chungcheongnam-do ; Cohort Studies ; Community Health Centers ; Cough ; Developed Countries ; Health Behavior ; Hospitalization ; Humans ; Immunization Schedule ; Incidence ; Influenza Vaccines ; Influenza, Human* ; Korea ; Pharynx ; Prospective Studies ; Public Health ; Seasons ; Sensation ; Telephone ; Vaccination* ; Surveys and Questionnaires

Middle East respiratory syndrome (MERS) is an emerging zoonosis caused by the novel MERS corona virus isolated in 2012. Most MERS cases have been reported from Arab countries of the Middle East, including Saudi Arabia, United Arab Emirates, Qatar, and Jordan. There have been a few imported cases in many countries, but the exception is Korea, which reported 186 confirmed cases originating from one imported case in a two-month outbreak in 2015. There are many lessons to be learned from the MERS outbreak in Korea, among them, management of contacts. The definition of "close contact" used by the Korean Centers for Disease Control and Prevention (KCDC) for MERS response was not clear and not compatible with the definition of the World Health Organization. This incorrect definition allowed the KCDC make serious mistakes in contact tracing and management in the early epidemic stage of MERS. After the rapid expansion of the outbreak, the KCDC redefined a "close contact" according to the definition of the US CDC. The total number of close contacts was 16,693 in this outbreak, and they were all forced to conduct a self-quarantine for 14 days after the last contact with a MERS patient. It was not clear whether self-quarantine of close contacts was effective to control the outbreak. Given the lack of prepared guidelines or a social support system for them, these measures for the massive number of asymptomatic contacts caused a great deal of confusion in the field A clear response guideline is needed for contact management based on robust evidence from this MERS epidemic in Korea.
Centers for Disease Control and Prevention (U.S.) ; Contact Tracing ; Coronavirus Infections ; Humans ; Jordan ; Korea ; Middle East* ; Qatar ; Saudi Arabia ; United Arab Emirates ; World Health Organization

Travel medicine is an interdisciplinary specialty concerned not only with prevention of infectious diseases during travel but also with personal safety and prevention of environmental risk. Travel medicine focuses primarily on pre-travel preventive care of persons and less on the diagnosis and treatment of illness acquired in the tropics. To provide optimal pre-travel preventive service, it is needed for the travel health provider to be aware of the epidemiology of the many travel-related health risks. But still the knowledge of the precise risks for a specific disease in a specific location has proved elusive and the application of evidence-based standards to travel medicine is a challenge. The GeoSentinel, a worldwide communication and data collection network for the surveillance of travel related morbidity and mortality was initiated in 1995, and provides various epidemiologic features needed in pre-travel risk assessment. The three essential elements of pre-travel health service are risk assessment, risk management and risk communication. The risk assessment includes both assessing the health problem of the traveler and the risk of travel itself. Hence the health risks of a specific destination is changeable over time, they should be evaluated with last informations provided from World Health Organizations or other professional institutes for travel health. The essential services for risk management include vacccination, chemoprophylaxis (e.g.,malaria), and education the risk and prevention of insetborne, foodborne, animal-related diseases, behavioral safety, and any other known risks. The of travel-related diseases of Korean travelers are not quite clear yet. It is recommended that the travel-related disease surveillance system for Korean travelers should be improved so as to provide evidences needed to assess the risks and to prescribe preventive services.
Academies and Institutes ; Chemoprevention ; Communicable Diseases ; Data Collection ; Health Services ; Humans ; Risk Assessment ; Risk Management ; Travel Medicine ; World Health

Food poisoning is one of the major public health problems. Prevention is better than cure. Prevention of food poisoning is a hardly achievable goal, if we misunderstand the complex causality of food poisoning. For example, food hygiene and food safety are essential components of prevention of food poisoning, but not all of the components. Especially a viewpoint of public health is needed to the prevention of food poisoning. I described the conceptual model of prevention of food poisoning; the primary, secondary, and tertiary prevention of food poisoning at the individual level and at the population level. In case of primary prevention strategy, I applied the epidemiologic triangle model to explore the causality of food poisoning. I found that the both secondary and tertiary prevention activities at the population level had been very poor. However, these activities are enormously important to the prevention and control of food poisoning. We should develop an integrated strategy for the prevention of food poisoning at the multi-disciplinary level, especially public health.
Food Safety ; Foodborne Diseases* ; Hygiene ; Primary Prevention ; Public Health ; Tertiary Prevention

Understanding the spread of infections is of vital importance in the control of epidemics and the development of proper policies toprevent infectious diseases. Theory and techniques have been developed for the study of both the evolution of diseases with individual people and the transmission of infections through populations. From broad theoretical issues to specific practical problems, the mathematical modeling studies of infectious diseases have provided great insight to solve the mechanisms of disease spread and to predict the course of epidemics. Emerging and reemerging infectious diseases have attracted widespread concern in Korea. While preparing the influenza pandemic plan in 2004, we developed a model of the new influenza pandemic to estimate the number of cases and deaths, the shortage of medical resources, and the effect of interventions such as isolation and vaccination. Based on this model, we constructed a possible pandemic scenario of the emerging virus, and designed a table-top exercise for public health officials and related administration staff. On March 30th, 2005, the exercise was performed and the results were evaluated as successful. In the case of bioterrorism, a model of small pox epidemic was developed in 2005 to examine the speed of the disease spread in the population and to evaluate the intervention effects in a Korean city. The simulation results were also helpful to form a guideline to prepare for a small pox epidemic. These two experiments confirmed the usefulness of epidemic modeling in Korea.
Bioterrorism ; Communicable Diseases ; Communicable Diseases, Emerging* ; Influenza, Human ; Korea* ; Models, Theoretical ; Pandemics ; Public Health ; Vaccination

The history of modern infectious disease control in Korea could be divided into 4 era by its characteristics; the Opening and Korean Empire era (1896-1910), Japanese Colonial Rule and US military government era (1910-1948), Korean government era before 2000 (1948-2000) and After 2000 (2000-present). In the Opening and Korean Empire era, the first form of communicable disease prevention act was issued in 1899, including the first 6 notifiable communicable diseases in Korea; cholera, smallpox, dysentery, diphtheria and epidemic typus. Before establishment of administrative department for infectious disease, Japanese Colonial Empire took the police power away and set the colonial sanitary police system in 1907. During the Japanese Colonial Rule, the sanitary police system was forcefully active not only to control the epidemics but also fortify the colonial governmentalism. But during the colonial era, the incidence of water-borne diseases like typhoid fever and dysentery had increased, and the respiratory diseases both diphtheria and tuberculosis also had increased. This forceful sanitary police system had influenced the communicable prevention act and health policy for over 50 years after the colonial era. In 1954 the Korean government proclaimed the communicable prevention act. Since then the government increased the number of national notifiable diseases and refined the related acts by public needs. In 2000, the communicable prevention act was fully amended to satisfy the modern public health principles not the sanitary policy rules. And the revised act named 'Infectious Diseases Control and Prevention Act' was proclaimed in 2010. The globalization, emerging and re-emerging infectious disease, climate change, change of health behavior, development information technology, unification of Korean peninsula would be the next challenges of infectious disease control and prevention in Korea.
Asian Continental Ancestry Group ; Cholera ; Climate Change ; Communicable Diseases ; Communicable Diseases, Emerging ; Diphtheria ; Dysentery ; Health Behavior ; Health Policy ; Humans ; Incidence ; Internationality ; Jurisprudence ; Korea ; Military Personnel ; Police ; Public Health ; Public Policy ; Smallpox ; Tuberculosis ; Typhoid Fever

No abstract available.
Coronavirus Infections* ; Korea* ; Middle East*

BACKGROUND: Hospital-wide surveillance showed an up to 9% increase in the incidence rate of the nasal transmission of methicillin-resistant Staphylococcus aureus (MRSA) among health care workers (HCWs) in a tertiary care hospital where MRSA is endemic. The purpose of this study was to investigate the knowledge of and attitude towards nasal transmission of MRSA and hand-washing practice among HCWs and determine the behavioral factors associated with the nasal transmission of MRSA. METHODS: In a 750-bed tertiary care hospital, nasal swabs from HCWs were obtained, and questionnaires with 25 questions were distributed to HCWs who were divided into 2 different groups: MRSA carriers and non-carriers. The questionnaires focused on the HCWs' knowledge about the mode of MRSA transmission and precautions against MRSA infection and their self-reported compliance for hand hygiene. RESULTS: The total number of respondents for the surveillance culture and survey were 253 (51 MRSA carriers and 202 non-carriers). There was significant difference between the 2 groups on the knowledge of precautionary measures used for the MRSA patients in the hospital (P=0.026). Compared to the MRSA carriers, the non-carriers washed their hands significantly more frequently after ventilator care (P=0.004) and used more alcohol sanitizers (P=0.023). However, no significant difference was observed in hand-washing practices of both the groups before the medical procedures, their knowledge about the mode of transmission of MRSA, and the duration of hand washing. CONCLUSION: Non-carriers replied more accurately to the questions on knowledge about the management and treatment of MRSA, and they considered interventions such as surveillance cultures and questionnaires to be an effective method in lowering the incidence of nosocomial infections. Compared to the MRSA carriers, the non-carriers showed higher hand-washing compliance.
Compliance ; Cross Infection ; Cross-Sectional Studies ; Surveys and Questionnaires ; Delivery of Health Care ; Drug Resistance ; Hand ; Hand Disinfection ; Humans ; Incidence ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Tertiary Healthcare ; Ventilators, Mechanical