==== Front Online J Public Health InformOnline J Public Health InformOJPHIOnline Journal of Public Health Informatics1947-2579University of Illinois at Chicago Library ojphi-10-e8810.5210/ojphi.v10i1.8655ISDS 2018 Conference AbstractsA provincial Acute Febrile Illness Surveillance Network (GAFINet), South Korea Sung Yeon-Hee 1 Yi Seon-Ju * 1 Song Kyoung-Ho 2 Kim Yang Lee 3 Kim Jeong Yeon 4 Kim Jieun 5 Kim Hong Bin 2 Kim Eu Suk 2 Lee Heeyoung 1 Jo Soo-nam 1 kyung-nam Kim 1 Kim Na-young 1 Park Eun-jung 1 Lee Yu-ra 1 Jeong Hye-jin 1 Choi Sungyong 6 Choi Won Suk 7 1 GIDCC(Gyeonggi Infectious Disease Control Center), Seongnam-si, Korea (the Republic of); 2 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea (the Republic of); 3 The Catholic Univ. of Korea Uijeongbu Mary’s hospital, Uijeongbu-si, Korea (the Republic of); 4 GPMC(Gyeonggi Provincial Medical Center, Suwon-si, Korea (the Republic of);5 Department of Internal Medicine, Hanyang University College of Medicine, Seongdong-gu, Korea (the Republic of); 6 ICDC(Incheon Center for Infectious Diseases Control), Namdong-gu, Korea (the Republic of);7 Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Ansan-si, Korea (the Republic of)* Seon-Ju Yi E-mail: yiseonju@gidcc.or.kr30 5 2018 2018 10 1 e88ISDS Annual Conference Proceedings 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Keywords acute febrile illnessSouth Koreaemergency department based surveillancecommunicable disease surveillancesyndomic surveillance ==== Body Objective The objectives are to introduce a provincial level surveillance system, which has been initiated in response to the MERS-CoV outbreak of South Korea, and describe findings from systematic investigation of individual admissions attributed to acute febrile illness for the first year. Introduction In May 2015, the MERS-CoV outbreaks in South Korea was sparkled from a hospital of Gyeonggi-do province (1). In response to this outbreak, the provincial government and infectious disease control center (GIDCC) initiated an emergency department (ED) based Gyeonggi-do provincial acute febrile illness (AFI) surveillance network (GAFINet) to monitor for a subsequent outbreak of emerging or imported infectious diseases since September 2016. Gyeonggi-do province is located in the North-West of South Korea, surrounds the capital city Seoul, and borders North Korea (Figure 1). Considering the geographical coverage, GAFINet Initiative involves ten hospitals, consisted of four university-affiliated hospitals and six provincial medical centers in Gyeonggi-do province. These hospitals participated in this network voluntarily, and most staffs including five infectious diseases specialists had direct or indirect experiences in dealing with MERS-CoV patients. Methods Periodic surveillance for finding AFI patients in ED of participating hospitals was performed prospectively (Figure 2). AFI was defined as 1) fever: body temperature ≥38 °C at admission, or 2) chief complaint of febrile or chilling sensation. Demography of patients and chief complaints were investigated in this first step (CRF #1). Cases were classified into six categories based on their clinical diagnoses: 1) respiratory AFI [AFRI], 2) gastroenteric AFI [AFGI], 3) exanthematic AFI [AFEI], 4) other infectious AFI, 5) non-infectious AFI, and 6) unclassified AFI. Participating infectious diseases specialists regularly reviewed and reformed this classification. Because the aim of GAFINet is primarily monitoring community- or aboard-acquired infection, nosocomial AFI cases or the patients transferred from another hospital were excluded. When a patient had a history of international travel or he/she were undiagnosed in three days after ED admission, more comprehensive information (CRF#2 & #3) including history and final diagnosis were obtained. For a baseline data, age- and sex-stratified ED visits were also gathered weekly. The proportion of AFI cases per 1000 visits was determined for one week period and analyzed by febrile diseases categories with age-stratification. Characteristics of cases with international travel histories or undiagnosed cases were also described separately. Results Between 30 September and 3 December 2016, about 6,000 of patients visited ED of ten hospitals a week, and 10% of them were AFI cases. The proportion of AFRI was the largest, 33.64 to 71.96 per 1000 visits/week, and the second-largest was the other infectious AFI. The proportion of AFRI showed the highest rate at the age 1-9 years, while those of AFGI and AFEI were the highest at the age under 19 year and 70-79 years, respectively. 31 cases with international travel history were reported, and the majority of them traveled China and South East Asian counties. Some of them were suspected cases of Zika viral infection, MERS-CoV, or viral hemorrhagic fever. 3 cases undiagnosed until discharge were also reported. Conclusions Gyeonggi-do province was the most affected region in the 2015 MERS-CoV outbreak, 67 of 185 cases were residents of this province. GAFINet Initiative is a meaningful step for rapid detection of emerging or overseas imported infectious diseases at the provincial level. To validate data and co-analysis with pre-existing surveillance data, we need a more long-term of continuous operation of GAFINet. As a next step, we are preparing the additional lab-based surveillance system to detect new or re-emerging pathogens. Figure 1 Locations of sentinel hospitals participating in GAFINet (Blue dots: University affiliated hospitals; Red dots: Provincial medical centers) Figure 2 Flow diagram showing patient flow and collection of clinical data in GAFINet Acknowledgments This study was supported by the Korea Centers for Disease Control and Prevention (KCDC) and Gyeonggi-do Provincial Government. ==== Refs References 1 Park H 2015 . Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015 . Euro Surveill . 20 (25 ), 1 -6 . 10.2807/1560-7917.ES2015.20.25.21169 26132766