Sunday, November 01, 2015

Korean Respiratory Outbreak Investigation – Day 4

 

# 10,681

 

The cause of the unidentified respiratory outbreak linked to the Konkuk University Animal Life Sciences building remains a mystery - with the number of suspect cases now raised to  68 - of which 49 are currently showing radiological signs of pneumonia.  

 

This represents an increase of 8 pneumonia cases over yesterday’s report, and a jump in the total number of cases by 24

 

The additional 19 `suspect cases’ are exhibiting minor flu-like symptoms (fever, cough,muscle aches), and will be monitored for any progression of their illness.

 

Despite extensive testing for a viral, bacterial, or fungal cause (including some fairly obscure zoonotics, like Q fever and Brucellosis), the source of this outbreak remains undetermined. 

 

A handful have tested positive for Rhinovirus, but this is viewed as an incidental finding. Testing (and re-testing) continues. 


So far, all of the confirmed pneumonia cases have had direct exposure to the Life Sciences building – most on floors 4 through 7 (1 on floor 3) - raising hopes that this may be an environmental exposure of some sort (mold, fungi, chemical or toxins, etc.), rather than a viral disease.

 

If that turns out to be true, it would likely limit the size and scope of this outbreak. But just as no plausible viral, bacterial, or fungal cause has yet been isolated in these patients, no obvious environmental contamination has been identified in the building.  Testing on both fronts continues.

 

Of course, lab tests generally requires knowing what you are looking for. And if it is something obscure, or previously unidentified - this process could take days, weeks, or even years.

 

Back in 2013, in mBio: A Strategy To Estimate The Number Of Undiscovered Viruses, we looked at an attempt by researchers at Columbia University's Mailman School of Public Health, EcoHealth Alliance, the NIH, and universities and research centers around the world to estimate the number of  yet to be identified viruses in the wild.

 

Their best estimate was there are a minimum of 320,000 mammalian viruses awaiting discovery.  The vast majority are benign to humans, but viruses continually evolve, and `bad actors’ can emerge at any time.

 

Whether due a  viral, bacterial, fungal, or chemical  agent - the Korean CDC has announced plans to conduct a case-control study where epidemiologists will compare `confirmed cases’  to a large number of healthy controls, matched for age, sex, and by work area in the building.

 

By examining their respective exposures against their outcomes, the source of infection may be revealed.

 

Meanwhile, the  Korean CDC continues to monitor at least 1,400 people – who either had access to the Life Sciences building in recent weeks, or who are contacts of patients – for any signs of illness. 

 

Although the translations are somewhat syntax challenged, the  Korean CDC quite admirably continues to provide us with extensive daily updates, with the latest one below:

 

 

Konkuk University research related respiratory disease occurred in four primary

□ Centers for Disease Control (General Manager Yang byeongguk) is Konkuk University associated with respiratory disease caused by 11.1 il 0 until a total of 68 cases (cumulative) received your report in the, of which 49 patients chest X Award pneumonia findings are confirmed suspected cases * and classified into 7 gae medical groups to distribute the tubes said that under the quarantine treatment.

- Suspected: 10.8 days after the founding of the University of Life Sciences building have visited animal characters 37.5 & lt; 0 & gt; C on the chest radiograph with at least if you have fever suspected pneumonia findings

* Chest radiography results cases classified as suspected cases do not meet the definition: 19 myeong

Mild symptoms and chest radiography unclassified pending cases without 0 myeong

○ suspected patients being hospitalized are initially fever, mild, such as muscle symptoms usually showed, respiratory symptoms are relatively rare pneumonia findings seem not a serious case such as, later admitted six showed improvement in the patients symptoms rest without deterioration It is maintained .

 image

 

 

□ (epidemiology) suspected patients 49 patients all animal life science university buildings within regular working character, one myeong * except for 48 people all 4-7 layers and the lab workers,

image

○ suspicious symptoms first occur in patients thing 10.19 days, 10.25 il ~ 27 intensive occurred in sayi il,

○ 49 living with people suspected 83 cases exhibiting fever or respiratory symptoms among patients is the absence so far.

○ Centers for Disease Control are patients with a life science university entrant animal-control survey * conducted by plans to investigate the risk factors and the onset of the propagation path.

* Patient-control investigation (case-control study): groups with specific diseases (group) and those without the disease group (control group) epidemiological studies to investigate how to compare selected

- Patients: suspected

- Control: the same building permanent workers (mainly laboratory) asymptomatic state party as a

□ (clinical) symptoms, and proceeds relatively lightly, chest X Awards are nonspecific findings and pneumonia appears as a common,

○ some lung CT for abnormal findings being presented to confirm the pathology of lung tissue were collected.

□ (pathogen tests) 10.31 conducted by germs and viruses pathogenic to be 16 species human specimens for tests, specific findings were not found.

* Total 4 confirmed Rhino virus in people, but that is popular in the domestic cold is a viral respiratory illness and Konkuk University this one kinds relevance Low

□ On the other hand, Centers for Disease Control has a call center (109) to expand the range of symptoms caused monitored through,

○ existing animal and Life Sciences students and staff 964. In addition to regular people with access to the building (lecture courses, etc.) other college students, including 508 by adding the name of a total 1,472, and monitoring the patients,

○ Until now, the monitor has not confirmed the specific case jittering results.

* SK Group adopted Candidates 527 patients symptoms occurred 109 maintains the call center reported that the system of induction

□ Centers for Disease Control are investigating and taking the necessary steps as possible for the attribution and management of respiratory disease caused this,

○ relevant ministries and academics to them ‧ collaboration with medical experts and actively, the progress from time to time planning to inform the public and the media.