Did poor etiquette lead to Korea's worst flu outbreak?

In the face of the worst seasonal flu sweeping the nation, Kim’s complaint seems to be shared by an increasing number of South Koreans.
PHOTO: The Straits Times

For Kim Su-yeon, a 36-year-old self-proclaimed germophobe, Seoul at this time of a year is a nightmare.

Before stepping outside, she always makes sure she has a sufficient supply of antibacterial wipes and hand sanitizers in her bag.

But such precautions still seem inadequate in keeping her germ-free, especially when strangers near her start to cough without covering their mouth.

"I saw a lady who clearly had a contagious cold, coughing, sneezing and wiping her nose with her hand in the subway. I immediately stood up and moved to a different part of the subway," Kim said, expressing frustration at ignorance about etiquette in public places.

In the face of the worst seasonal flu sweeping the nation, Kim's complaint seems to be shared by an increasing number of South Koreans.

Doctors, too, stress that simple etiquette can be most effective in preventing the spread of the contagious seasonal flu virus. The failure to properly educate students and follow preventive steps may have been behind the worst flu outbreak in decades, they said.

Natural remedies for cold and flu

  • The classic symptoms of a cold are a blocked nose, sneezing and a hacking cough.
  • The flu is usually caused by very contagious viruses. A person who has caught the flu is usually confined to the bed with a bad fever, severe headaches, bad cough, sore throat and body aches.
  • Eucalyptus oil has powerful medicinal properties such as anti-inflammatory, antiseptic, antiviral, antibacterial and it is also a decongestant.
  • Inhaling steam with eucalyptus oil can offer instant relief from a blocked nose and also kill harmful microorganisms so you can heal faster.
  • 5 / 16 Alternatively you also can put 10 drops in a diffuser in your bedroom before going to bed so you get a good night's sleep and also reap the healing benefits while you snooze.
  • Sea salt water is very good for internal cleansing.
  • Spraying salt water into your nose or gargling with it can loosen up mucus, helping you to get rid of it.
  • It also has anti-inflammatory properties that help to alleviate the swelling of the throat and promote healing.
  • The active compound in garlic which is known as allicin has demonstrated antibacterial and antiviral properties.
  • You should crush or chop the garlic before consuming it so that the cells will rupture and cause the creation of allicin. It is best eaten raw.
  • Echinacea has been used for centuries in a variety of forms to prevent colds and fight respiratory infections.
  • It is best to take it at the first sign of a cold or flu. You can consume it in the form of a tea, or you also can buy them in supplement form from your local pharmacy.
  • While Vitamin C is best known as a powerful antioxidant, it is also a vitamin that is very important for the immune system. It has antiviral activity, boosting our immune system.
  • When inflammation or infection occurs such as cold or flu, our level of vitamin C drops just when your body needs it to combat the infection, which is why it only makes perfect sense that you need to increase your intake of Vitamin C when sick.
  • Take 500mg every hour, up to 3-5g per day, and ease back to your usual dose as symptoms improve.

Read also: 5 natural remedies for the cold and flu

According to the Korea Centres for Disease Control and Prevention, a record high number of young patients were diagnosed with flu last week -- 152 flu cases per 1,000 students aged 7-18. The government began monitoring the flu in 1997.

Dr. Kim Yang-hyun of the Anam Hospital of Korea University Medical Center said flu etiquette is relatively less known or followed by Koreans, compared to people in other countries.

"Did you know that you should sneeze into your elbow, not your hand?" he asked.

"Also, not many in South Korea can decide for themselves whether or not they should go to work or school when they sneeze and cough," he added.

Last year, South Korea had a major outbreak of the Middle East respiratory syndrome that caused 38 deaths.

The state-run KCDC, in response, came up with antiviral treatment guidelines that include educating children and adults to sneeze into their elbows.

But such information is still not well known among the public or taught at schools, experts highlighted.

Sneezing into one's elbow can prevent some 3,000 infectious droplets from being sprayed onto hands, which could spread germs by holding or passing frequently touched surfaces such as door handles and tables.

Read also: Singapore's first painless flu vaccine

"Koreans tend to campaign or follow health care steps only when a serious disease outbreaks," a medical resident at Seoul National University Hospital told the Korea Herald on condition of anonymity.

"Simple but fundamental preventive steps can keep colds away. All we need to do is to follow simple manners on a daily basis, which takes on a whole new meaning when their intent is to protect your health and the health of those around you," he added.

In other developed countries like the US, health authorities have been campaigning since 2009 to teach elementary school students to properly cover their mouths when they cough through the distribution of flyers and posters about health care, under the slogan "Cough = Elbow."

South Korean health authorities said Tuesday that they had suggested schools start their winter vacation earlier than scheduled and immediately stop students from attending school.

Doctors said the disease, the influenza A virus subtype H3N2, is unlikely to develop serious complications, such as pneumonia, if patients receive timely treatment.

"Although the flu virus this time is accompanied by symptoms such as headaches and muscle pain -- rare for other types of seasonal flu -- the disease can be cured when the patients visit the doctor immediately and take antiviral drugs like Tamiflu," said Dr. Kim Gyu-yeon of The Severance Hospital of the Yonsei University Health System.

Getting a vaccination, either a flu shot or a nasal-spray type vaccination, is another simple method to reduce chances of catching cold.

"Those who study or work in confined spaces are particularly susceptible to the highly contagious illness, since people with the flu can spread it to others up to about 2 meters away, mainly by droplets made when they cough, sneeze or talk," said Kim.

While vaccines show efficacy after two weeks, it is still not too late to get a vaccination now, as the cold weather is to continue until February next year, he added.

South Korea confirms highly pathogenic bird flu outbreaks

  • South Korea's agriculture ministry said it will issue a temporary nationwide ban on the transportation of poultry to contain the spread of bird flu, with 43 outbreaks recorded in Asia's fourth-largest economy.
  • Since the first outbreak of a severe strain of bird flu known as H5N6 was reported on Nov.18., South Korea has ramped up quarantine measures to stop a wider spread of the virus, including issuing a 48-hour nationwide standstill order three weeks ago.
  • To prevent the spread of bird flu, the ministry said at least 8.8 million farm birds were culled and plans to slaughter 1.5 million more. That would be over 10 per cent of the country's poultry population of nearly 85 million.
  • Although cases of human infections from the H5N6 virus have previously been reported elsewhere including China, no cases of human infection have been found in South Korea.
  • South Korean health officials disinfect a stream which migratory birds stay in winter temporarily, to prevent spread of bird flu
  • A South Korean health official disinfects a vehicle to prevent spread of bird flu in Pohang, South Korea