We investigated public health emergency management networks during the recent outbreak of Middle East respiratory syndrome coronavirus that affected more than 17 000 people in South Korea. We administered a survey to 169 organizations in order to map the pattern of communication and response networks during the Middle East respiratory syndrome outbreak. We also conducted 11 semistructured interviews with national, regional, and local government officials to comprehend inhibiting and facilitating factors in risk communication and response to the system. National ministries or agencies play central roles in coordinating and supporting the overall response, and local and regional governments or agencies interact with other governments and agencies. Governmental agencies coordinating and/or supporting the outbreak response had difficulties in communicating with other agencies because of the ambiguity of the nature of the infectious disease, slow information disclosure, differences in the organizational priorities, different information standards, and the limitations of the information system. To better respond to a virus outbreak, government agencies need to improve hierarchical communication among different levels of governments, horizontal communication and cooperation between same types or different types of agencies, and information systems.
Probable transmission chains of Middle East respiratory syndrome coronavirus and the multiple generations of secondary infection in South Korea
