Genomic characterization of clinical Enterobacter roggenkampii co-harbouring bla- and bla-encoding IncP6 and mcr-9-encoding IncHI2 plasmids isolated in Japan.

Objectives: The spread of carbapenemase-producing Enterobacterales (CPE) with colistin resistance is a critical public health issue. We genetically characterized the clinical isolate Enterobacter roggenkampii OIPH-N260, which harboured carbapenemase genes bla and bla with multiple resistance genes, including mcr-9 and bla.

Methods: This isolate was characterized by whole-genome sequencing, comparative analysis of resistance plasmids, susceptibility tests, bacterial conjugation, S1-nuclease digested pulsed-field-gel electrophoresis, and Southern blot hybridization.

Immune thrombocytopenic purpura risk by live, inactivated and simultaneous vaccinations among Japanese adults, children and infants: a matched case-control study.

This case-control study investigated immune thrombocytopenic purpura (ITP) risk following live, inactivated, and simultaneous vaccination, with a focus on infants aged < 2 years. We matched case patients with ITP to one or two control patients with other diseases by institution, hospital visit timing, sex, and age. We calculated McNemar's pairwise odds ratios (ORs [95% confidence interval]) with 114 case-control pairs.

Description of hospitalized cases of influenza A(H1N1)pdm09 infection on the basis of the national hospitalized-case surveillance, 2009-2010, Japan.

This study reports the epidemiological characteristics of hospitalized cases of influenza A(H1N1)pdm09 infection analyzed on the basis of surveillance data collected from July 24, 2009, the date on which the hospital-based surveillance of influenza cases was implemented in Japan, to September 5, 2010. During the study period, 13,581 confirmed cases were reported. Among those cases with information regarding the reason for hospitalization, 39% were admitted to hospitals for non-therapeutic purposes such as medical observation and laboratory testing.

National surveillance of influenza-associated encephalopathy in Japan over six years, before and during the 2009-2010 influenza pandemic.

Influenza-associated encephalopathy (IAE) is a serious complication of influenza and is reported most frequently in Japan. This paper presents an assessment of the epidemiological characteristics of influenza A (H1N1) 2009-associated encephalopathy in comparison to seasonal IAE, based on Japanese national surveillance data of influenza-like illness (ILI) and IAE during flu seasons from 2004-2005 through 2009-2010. In each season before the pandemic, 34-55 IAE cases (mean 47.

Geographic trends and spread of the pandemic (H1N1) 2009 in the metropolitan areas of Japan studied from the national sentinel data.

The identification of geographic trends of an influenza pandemic is important for analyzing its social epidemic factors. We performed spatiotemporal analyses focusing on the metropolitan areas in Japan by using the influenza-like illness (ILI) sentinel surveillance data for the pandemic (H1N1) 2009 and seasonal influenza. The epidemic curves and spread features expressed by the kriging method of geographic information system (GIS) and correlations between reported cases and demographic data were analyzed.

Pandemic (H1N1) 2009 transmission during presymptomatic phase, Japan.

During an epidemiologic investigation of pandemic influenza (H1N1) 2009 virus infection in May 2009 in Osaka, Japan, we found 3 clusters in which virus transmission occurred during the presymptomatic phase. This finding has public health implications because it indicates that viral transmission in communities cannot be prevented solely by isolating symptomatic case-patients.

Sex- and age-related differences in morbidity rates of 2009 pandemic influenza A H1N1 virus of swine origin in Japan.

Background: The objective of the present study was to determine whether the morbidity rates of the 2009 pandemic influenza A H1N1 virus (pdmH1N1) varied by age and/or sex.

Methods And Findings: Retrospective analysis of 2,024,367 cases of pdmH1N1 was performed using the national surveillance data from influenza sentinel points in Japan. The male-to-female morbidity ratios (M/F ratios) in nineteen age groups were estimated as the primary outcome.

[Epidemiology of acute encephalitis or encephalopathy in Japan].

Epidemiological situation on acute encephalitis in Japan from 2004 to 2009 are described. Acute encephalopathy suspected infectious disease origin such as influenza encephalopathy are involved. Data are based on the National Epidemiological Surveillance of Infectious Diseases (NESID) under Infectious Disease Control Law.

Molecular evolutionary analysis of the influenza A(H1N1)pdm, May-September, 2009: temporal and spatial spreading profile of the viruses in Japan.

Background: In March 2009, pandemic influenza A(H1N1) (A(H1N1)pdm) emerged in Mexico and the United States. In Japan, since the first outbreak of A(H1N1)pdm in Osaka and Hyogo Prefectures occurred in the middle of May 2009, the virus had spread over 16 of 47 prefectures as of June 4, 2009.

Methods/principal Findings: We analyzed all-segment concatenated genome sequences of 75 isolates of A(H1N1)pdm viruses in Japan, and compared them with 163 full-genome sequences in the world.

[Tsutsugamushi disease and Japanese spotted fever recognition among medical seminar participants for the general public in epidemic and non-epidemic areas].

Questionnaires on Tsutsugamushi disease (TD) and Japanese spotted fever (JSF) recognition, were distributed at lectures to the general public held in Sakai, Osaka (Lecture A), and Sumoto, Hyogo (Lecture B). Questions included knowledge of transmission routes, symptoms, and seeing physicians after having suspected symptoms. Hyogo had more reported cases of both diseases than Osaka.

[2008 G8 Hokkaido Toyako Summit Meeting Syndrome Surveillance].

We conducted syndromic surveillance for the Hokkaido, Japan, Toyako Group of Eight (G8) summit meeting in July 2008 as a counter-measure to bioterrorism attacks and other health emergencies. Surveys were conducted from June 23, two weeks before the summit, to July 23 two weeks after it, with part of those for prescription drugs fully automated, and part by manual input over the World-Wide-Web. Those for ambulance transfer were done similarly.

Seasonal influenza surveillance using prescription data for anti-influenza medications.

Surveillance is critical for both early detection and a timely public health response to infectious diseases. Electronic information systems have been widely adopted by pharmacies in Japan. The aim of this study is to evaluate the feasibility of using prescription data for influenza surveillance in Japan to facilitate the development of a daily reporting system.

Serological survey of avian H5N2-subtype influenza virus infections in human populations.

To investigate the distribution of antibodies against H5N2 influenza virus in humans living in Ibaraki prefecture, Japan, 266 single serum samples were collected to perform serological tests. Results were compared to investigate the relationship between positive results and several factors. The number of positive serum neutralization antibody titers (> or = 40) against avian influenza virus A/H5N2 was significantly greater (P < 0.

Diarrhea as a minor adverse effect due to oral polio vaccine.

Using the adverse events monitoring system of Japan, we observed diarrhea cases in approximately 10% of patients who received oral poliovirus vaccine (OPV). This study was conducted to investigate whether diarrhea among children aged 0 to 1 is caused by OPV or by other factors such contact at the doctor's office and/or with others outside the home. We conducted a survey of the health of children after regular health check-ups and after the administration of the OPV.

Human H5N2 avian influenza infection in Japan and the factors associated with high H5N2-neutralizing antibody titer.

Background: H5N2 avian influenza virus infection of humans has not been reported thus far. The first H5N2 avian influenza infection of poultry in Japan occurred in Ibaraki.

Methods: The subjects were workers at 35 chicken farms in Ibaraki Prefecture, where the H5N2 virus or antibody was isolated from chickens.

Epidemics of vector-borne diseases observed in infectious disease surveillance in Japan, 2000-2005.

Background: Observing the epidemics of vector-borne diseases is important. One or more cases of 6 vector-borne diseases were reported to the National Epidemiological Surveillance of Infectious Diseases in Japan in 2000-2005.

Methods: The reports of those cases were available.

Epidemics of drug-resistant bacterial infections observed in infectious disease surveillance in Japan, 2001-2005.

Background: Drug-resistant bacteria have been increasing together with advancement of antimicrobial chemotherapy in recent years. In Japan, the target diseases in the National Epidemiological Surveillance of Infectious Diseases (NESID) include some drug-resistant bacterial infections.

Methods: We used the data in the NESID in Japan, 2001-2005.

Annual and weekly incidence rates of influenza and pediatric diseases estimated from infectious disease surveillance data in Japan, 2002-2005.

Background: The method for estimating incidence of infectious diseases from sentinel surveillance data has been proposed. In Japan, although the annual incidence rates of influenza and pediatric diseases estimated using the method were reported, their weekly incidence rates have not.

Methods: The weekly sex- and age-specific numbers of cases in the sentinel medical institutions in the National Epidemiological Surveillance of Infectious Diseases in Japan in 2002-2005 were used.

Overview of infectious disease surveillance system in Japan, 1999-2005.

Background: In 1999 the Communicable Disease Prevention Law of Japan was completely revised into the "New" Infectious Disease Control Law, which reiterated the importance of surveillance and information dissemination and re-organized the surveillance system. This paper is an attempt to illustrate the potential impact of the new surveillance system through a description of the existing surveillance system and data before and after the revision.

Methods: After a historical review of surveillance system in Japan, the current surveillance system is described.

Wide-area epidemics of influenza and pediatric diseases from infectious disease surveillance in Japan, 1999-2005.

Background: Epidemics of infectious diseases usually start in small areas and subsequently become widespread widely. Although a method for detecting epidemics in public health center (PHC) areas has been proposed and used in the National Epidemiological Surveillance of Infectious Diseases in Japan, wide-area epidemics have not been fully investigated.

Methods: Using the abovementioned method, we defined an epidemic as that occurring for a week in at least one PHC area in a prefecture and a wide-area epidemic as that when the number of people living in epidemic PHC areas exceeds 30% of the prefectural population.

Epidemics of influenza and pediatric diseases observed in infectious disease surveillance in Japan, 1999-2005.

Background: A method for determining epidemics in small areas from the sentinel surveillance data has been proposed and applied in the National Epidemiological Surveillance of Infectious Diseases (NESID) in Japan. We observed epidemics of influenza and 11 pediatric diseases by the method in the NESID in Japan during 1999-2005.

Methods: We assumed that an epidemic in a public health center area began in a week when the number of cases reported to the NESID per sentinel clinic and hospital in the area in the week exceeded a given value, and that the epidemic ended when the number was lower than another given value.