Government takes thorough action against Zika

In line with the WHO's declaration of PHEIC, the Korean government has decided to look at the domestic situation and review countermeasures.

- The World Health Organization (WHO) held an emergency meeting about the recent Zika virus oubreak* around South America at 9:00 p.m. on February 1, 2016, Korean standard time, and declared "Public Health Emergency of International Concern (PHEIC)" over the Zika virus on February 2.

Consequently, the Ministry of Health and Welfare (Minister Chung Chin-youb) held a meeting on February 2, to assess its crisis response capabilities and make preventive measures against the Zika virus, and has announced that its alert level remains at ATTENTION now that none of any infected cases has come to Korea from overseas and mosquitoes carrying the virus were not yet active in the countries.

- However, the Ministry said that despite keeping the alert level at ATTENTION, it would strengthen its countermeasures against the Zika virus, to prevent its influx and transmission.

It has also developed and announced guidelines on infection prevention targeting citizens, pregnant women and medical organizations, advising people to actively follow them. The Korean government has announced that a vice-ministerial meeting presided over by the Minister of the Office for Government Policy Coordination would be held with relevant ministries on February 3, to review prevention measures planned by each of ministries and discuss collective prevention and control measures against the Zika virus.

1. Assessment of the potential influx and spread of the Zika virus

- An expert meeting was held to evaluate the potential introduction of an infected case into the country and the potential transmission of infection. The results are as follows:

[Assessment of potential influx]

Increasing people-to-people exchanges between the Republic of Korea and Central and South America or between the Republic of Korea and Southeast Asia allow the possibility of the imported case of Zika.

* Brazil → Korea : nearly 40,000 people per year
Thailand → Korea : nearly 1.7 million people per year
Indonesia → Korea : nearly 400,000 people per year

[Assessment of potential transmission]

The risk of the Zika virus spreading across the Republic of Korea through mosquitoes, in the case of the introduction of an infected case into the country, is low, because it is now not the mosquito season.

Of course, transmission of infection is possible in the summer, the mosquito season. However, the risk is assessed to be low due to the limited habitats for Aedes albopictus, a carrier of the Zika virus, and its low population density.

* As for dengue fever, although more than 200 infected cases come to the Republic of Korea a year, the virus have never been transmitted by mosquitoes in the country.

* The Zika virus has never been detected among mosquitoes in the country.

[Assessment of settling]

The risk is low because under the country's current climate condition, all of adult mosquitoes disappear during the winter*, stopping the possibility of transmission through mosquito.

* In the winter, mosquitoes are only in the water as eggs and all of adults die.
* The Zika virus has never been detected among the mosquitoes living in the countries.

It is required to constantly monitor any changes in infection-carrying mosquitoes, influenced by global warming, and the potential occurrence of infected cases.

2. KCDC's Prevention & Control Measures

- As the Zika virus was designated as a legal infectious disease on January 29, a quick monitoring system is carried out.

a. Medical organizations are required to report if they identify a suspected case.

* Guidelines on diagnosis and report have been offered to local governments and medical organizations.

b. The Korea Centers for Disease Control and Prevention (KCDC) promptly takes its prevention and control measures including epidemiological investigation, regulated by the Infectious Disease Prevention Act.

- The KCDC sets up a virus diagnosis system and a standard for submitting specimens to the laboratory for testing.

a. Medical organizations should submit serum samples from suspected cases to the Korea National Institute of Health (the department of virus infection of nervous system) for laboratory testing.

* RT-PCR testing of serum is performed for genetic analysis of viruses.
* Differential diagnoses of mosquito-borne viruses such as dengue fever or chikungunya are carried out at the same time.

b. As for those who visit the regions affected by the Zika virus within two months and have symptoms related to the virus, such as a fever, rash, muscle pain and conjunctivitis, within two weeks after returning home, they need to have their specimen tested. Those who are suspected to be infected with the Zika virus by their doctors also need to undergone the laboratory testing.

* Those with no symptoms are not advised to undergone the laboratory testing.

- The KCDC intensifies its monitoring and control of virus carriers.

a. The population density of infection-carrying mosquitoes is investigated, and the Zika virus is considered when performing testing for viruses transmitted by mosquitoes.

b. If infection-carrying mosquitoes are found in an aircraft entering the Republic of Korea from South America or Southeast Asia, disinfection should be promptly carried out and then mosquito control measures should be taken within quarantine area.

- The KCDC strengthens border quarantine measures against returning travelers, and sets up more detailed prevention guidelines for those who will leave the country.

a. For those who will travel to the affected countries, the KCDC delivers test messages about ways to prevent the Zika virus, distributes a leaflet on prevention guidelines, and requires the Incheon Airport to constantly make a related announcement.

b. As for those who show suspected symptoms such as a fever among the travelers returning from the affected countries, they need to be put under epidemiological investigation, and, if necessary, have their specimens collected and tested.

- Protection measures for pregnant women is strengthened.

a. They are advised to delay travel to the countries where patients infected with the Zika virus have occurred.

b. The KCDC develops educational and promotional materials on the Zika virus for pregnant women in collaboration with the Korean Society of Obstetrics and Gynecology, distributes them through delivery institutions and provide counseling programs, and offers related information through Internet community sites for them.

c. Pregnant women exposed to the affected regions need to undergone tests for the virus, and have their fetus checked regularly.
- The KCDC continues timely communication and sharing of information.

a. The KCDC constantly shares important information, such as prevention guidelines and characteristics of infectious diseases, with the public in collaboration with risk communication experts.

b. The KCDC constantly monitors the status of infected cases occurring in foreign countries including Central and South America, studies Microcephaly which affects the fetus's growth, and promptly and transparently discloses related information.

3. Prevention Guidelines

- Prevention guidelines for citizens

a. [Before travel] They are advised to constantly check the countries where patients infected with the Zika virus have occurred within two months through the KCDC's website, fully know ways to prevent Zika infection, and prepare a mosquito repellent, and long-sleeved tops and long pants in bright colors to avoid getting bitten by mosquitoes.

b. [During travel] They are advised to use air-conditioned accommodations with screens on windows or mosquito nets, wear long-sleeved tops and long pants in bright colors when going outside, and spray a mosquito repellent after checking directions for use.

c. [After travel] They are advised to avoid blood transfusions for at least a month after returning home, use a condom for at least a month regardless of symptom appearance if they are males, and report their overseas travel to a doctor and undergo tests if they have symptoms within two weeks after returning home.

- Prevention guidelines for pregnant women

a. They are advised to delay travel to the countries where cases of Zika infection have occurred within two months, and consider it after delivery. If the travel is inevitable, they should consult a doctor.

* Guidelines before and during travel are the same as citizens.

b. Those who show symptoms related to the virus within two weeks after returning from the affected countries should report overseas travel to a doctor, and have their fetus checked regularly.

- Prevention guidelines for medical organizations

a. When treating patients with symptoms such as a fever and rash, they are advised to ask if they have traveled to foreign countries, and check whether their symptoms are related to the Zika virus if the patients have traveled to the countries where cases of Zika infection have occurred within two weeks.

b. They are advised to report suspected cases to the public health center, and submit their specimen to the laboratory for testing.