Infectious Deseases
Basic Research
Surveillance
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- Category: Infectious Agents Surveillance Report (IASR)
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Measles and Rubella/Congenital Rubella Syndrome in Japan, as of March 2016
(IASR 37: 59-61, April 2016)
The World Health Organization (WHO) proposed to achieve regional measles and rubella/congenital rubella syndrome (CRS) elimination goals by the end of 2015, and achieve measles and rubella elimination in at least five of the six WHO regions by 2020 (Global Measles and Rubella Strategic Plan, WHO, 2012). These measles and rubella elimination goals were included in the global vaccine action plan (GVAP) endorsed at the 65th World Health Assembly in 2012. Here, “elimination” is defined as the absence of endemic transmission of measles or that of rubella/CRS in a defined geographical area (e.g. region or country) for ≥12 months in the presence of a well performing surveillance system. WHO’s Western Pacific Regional Office started the measles elimination program in 2003, and verified the elimination status of Australia, Macao SAR (China), Mongolia and the Republic of Korea in 2014, and that of Brunei Darussalam, Cambodia and Japan in 2015 (see p. 62 of this issue). Japan, while maintaining measles elimination status under the “Guidelines for the Prevention of Specific Infectious diseases: Measles (Ministry of Health, Labour and Welfare notice No. 442, December 28, 2007; http://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou21/dl/241214a.pdf)”, now targets attaining rubella elimination status by FY2020 under the “Guidelines for the Prevention of Specific Infectious diseases: Rubella (Ministry of Health, Labour and Welfare notice No. 122, March 28, 2014; http://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000041928.pdf.pdf)”(see p. 81 of this issue).
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- Category: Infectious Agents Surveillance Report (IASR)
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Enterohemorrhagic Escherichia coli infection, as of April 2016, Japan
(IASR 37: 85-86, May 2016)
Enterohemorrhagic Escherichia coli (EHEC) infection is a systemic infection of pathogenic E. coli that produces Verotoxin/Shiga toxin (VT/Stx) or possesses the VT encoding genes. Main signs and symptoms consist of abdominal pain, watery diarrhea, and bloody diarrhea. High fever (38°C) and/or vomiting are occasionally observed. Hemolytic uremic syndrome (HUS), which can be fatal for the young and the elderly, can be caused by VT that causes thrombocytopenia, hemolytic anemia and/or acute renal failure.
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- Category: Infectious Agents Surveillance Report (IASR)
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Leptospirosis in Japan, January 2007-April 2016
(IASR 37: 103-104, June 2016)Leptospirosis is a zoonotic infectious disease caused by Leptospira spp. (IASR 29: 5-7, 2008). The bacteria colonize the renal tubules of rodents and other mammals and are excreted in urine. Humans are infected by the bacteria through direct contact with the urine of the carrier animal or indirectly through contact with contaminated water and/or soil; occasionally, infection may occur through ingestion of contaminated food and/or water.
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- Category: Infectious Agents Surveillance Report (IASR)
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Mosquito-borne viral infections: Zika virus infection, Chikungunya fever and Dengue fever, 2011 to June 2016, Japan
(IASR 37: 119-120, July 2016)All mosquito-borne infectious diseases are classified as category IV infectious diseases under the Infectious Diseases Control Law (Table 1). This article focuses on Zika virus infection, Chikungunya fever and Dengue fever. As these are associated with acute febrile illness and clinically similar in manifesting syndromes such as fever, rash, and arthralgia, and as there are many asymptomatic cases, differential diagnosis solely based on clinical information is difficult (see notification criteria for each disease described below). In Japan, majority of the reported cases for these three diseases have been acquired abroad (i.e. imported cases), but an autochthonous dengue fever outbreak was confirmed in Japan in 2014 for the first time in nearly 70 years (IASR 36: 33-35, 2015).
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- Category: Infectious Agents Surveillance Report (IASR)
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Acute hepatitis B, April 2006-December 2015
(IASR 37: 147-148, August 2016)Acute hepatitis B is caused by infection with hepatitis B virus (HBV) of Hepadnaviridae. After an incubation period of approximately 3 months, the disease starts with general malaise, flu-like symptoms, anorexia, chills, and vomiting, often followed by brown urine or jaundice. Infection among infants is usually symptomless but often lapses into a carrier state. Infection among adults generally resolves within 1-2 months. However, fulminant hepatitis occurs in 1% of adult cases and approximately 60-70% among them are fatal. A proportion of infants and adult cases who are carriers can develop chronic hepatitis; adults with competent immunity rarely become carriers (see p. 157 of this issue).
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- Category: Infectious Agents Surveillance Report (IASR)
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HIV/AIDS in Japan, 2015
(IASR 37: 167-168, September, 2016)HIV/AIDS surveillance in Japan started in 1984. It was conducted under the AIDS Prevention Law from 1989 to March 1999 and since April 1999, has been operating under the Infectious Diseases Control Law. Physicians who have made a diagnosis of HIV/AIDS are required to notify all such cases (see http://www.niid.go.jp/niid/images/iasr/34/403/de4031.pdf for the reporting criteria). The data used in this article were derived from the annual report of the National AIDS Surveillance Committee for the year 2015 (released by the Tuberculosis and Infectious Diseases Control Division, the Ministry of Health, Labour and Welfare (MHLW), http://api-net.jfap.or.jp/status/2015/15nenpo/15nenpo_menu.html). HIV/AIDS cases are classified into two categories: as an “HIV case” if HIV infection was detected before clinical manifestation of AIDS, and as an “AIDS case” if the infection was detected after manifes-tation of AIDS symptoms*.
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- Category: Infectious Agents Surveillance Report (IASR)
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Mumps (infectious parotitis) in Japan, as of September 2016
(IASR 37: 185-186, October, 2016)Mumps is a common viral infection frequent among children. The causative agent is mumps virus (MuV) belonging to the family Paramyxoviridae, genus Rubulavirus. While there is only one serotype, there are 12 genotypes from A to N (E and M are lacking) based on the variation of the SH gene (IASR 34: 224-225, 2013).
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Influenza 2015/16 season, Japan
(IASR 37: 211-212, November, 2016)The 2015/16 influenza season (from week 36 in September 2015 to week 35 in August 2016) was characterized by the return of A/H1pdm09 as the predominant strain after being relatively absent in the previous season. Influenza virus B, consisting of both Yamagata and Victoria lineages, started increasing from week 2 of 2016.
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- Category: Infectious Agents Surveillance Report (IASR)
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Amebiasis in Japan, week 1 of 2007-week 43 of 2016
(IASR 37: 239-240, December, 2016)Amebiasis is caused by the protozoan parasite Entamoeba histolytica, transmitted through the fecal-oral route. The parasite is released in the feces as cysts, which may contaminate drinking water or foods. Once the cysts are ingested and reach the small intestine, they undergo excystation and become trophozoites. Trophozoites migrate to the colon and cause mucosal ulcers in 5-10% of infected persons, resulting in “intestinal amebiasis”. This condition is associated with dysenteric signs or symptoms, such as mucous and bloody stool, diarrhea, tenesmus (feeling of incomplete defecation) and abdominal pain. Occasionally, the trophozoites migrate hematogenously further to the liver, lung, brain or skin and produce local abscesses resulting in “extraintestinal amebiasis”, which is clinically more serious. The World Health Organization estimates that globally several tens of thousands of people die of amebiasis annually.
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- Category: Infectious Agents Surveillance Report (IASR)
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Measles in Japan, 2016
(IASR Vol. 38 p45-47: March, 2017)
Measles is a highly transmissible acute systemic infectious disease caused by measles virus. Its transmission mode is airborne, droplet or contact. Main clinical manifestations are fever, rash and catarrh. Approximately 40% of the patients require hospitalized treatment. Complications such as pneumonia or encephalitis may lead to death. In 2015, an estimated 134,200 people, mainly children in developing countries, died of measles [World Health Organization (WHO) fact sheet, November 2016, http://who.int/mediacentre/factsheets/fs286/en/].