ISDS 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. ISDS 2018 Conference Abstracts A provincial Acute Febrile Illness Surveillance Network (GAFINet), South Korea Yeon-Hee Sung1, Seon-Ju Yi*1, Kyoung-Ho Song2, Yang Lee Kim3, Jeong Yeon Kim4, Jieun Kim5, Hong Bin Kim2, Eu Suk Kim2, Heeyoung Lee1, Soo-nam Jo1, kyung-nam Kim1, Na-young Kim1, Eun-jung Park1, Yu-ra Lee1, Hye-jin Jeong1, Sungyong Choi6 and Won Suk Choi7 1GIDCC(Gyeonggi Infectious Disease Control Center), Seongnam-si, Korea (the Republic of); 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea (the Republic of); 3The Catholic Univ. of Korea Uijeongbu Mary’s hospital, Uijeongbu-si, Korea (the Republic of); 4GPMC(Gyeonggi Provincial Medical Center, Suwon-si, Korea (the Republic of); 5Department of Internal Medicine, Hanyang University College of Medicine, Seongdong-gu, Korea (the Republic of); 6ICDC(Incheon Center for Infectious Diseases Control), Namdong-gu, Korea (the Republic of); 7Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Ansan-si, Korea (the Republic of) 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) ISDS 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. ISDS 2018 Conference Abstracts Figure 2. Flow diagram showing patient flow and collection of clinical data in GAFINet Keywords acute febrile illness; South Korea; emergency department based surveillance; communicable disease surveillance; syndomic surveillance Acknowledgments This study was supported by the Korea Centers for Disease Control and Prevention (KCDC) and Gyeonggi-do Provincial Government. References 1. Park H et al. Epidemiological investigation of MERS-CoV spread in a single hospital in South Korea, May to June 2015. Euro Surveill. 2015;20(25):1-6. *Seon-Ju Yi E-mail: yiseonju@gidcc.or.kr Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 10(1):e88, 2018