Naohide Takayama

Tokyo Metropolitan Komagome Hospital, Edo, Tōkyō, Japan

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Publications (34)49.14 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In the present study, we evaluated the immunogenicity of intradermal vaccination of Japanese purified chick embryo cell rabies vaccine (PCEC-K) for preexposure immunization (PEI). A total of 39 healthy subjects were administered a single 0.1-ml dose of PCEC-K intradermally at the antebrachial region on days 0, 7, and 28. To assess immunogenicity, rabies neutralizing antibody (NA) titers were measured on days 7, 28, and 42 post vaccination. By day 42, all subjects developed NA titers ≥0.5 IU/ml (geometric mean titer, 2.7 IU/ml), a level that is considered protective. The vaccine was well tolerated; vaccinated subjects displayed minimal redness and pruritus. Although a 1.0-ml dose of PCEC-K administered subcutaneously is considered the standard method, the intradermal regimen using a 0.1-ml dose of PCEC-K is immunogenic, safe, and highly recommended for situations of vaccine shortage.
    Journal of Infection and Chemotherapy 08/2011; 18(1):66-8. DOI:10.1007/s10156-011-0286-2 · 1.38 Impact Factor
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    ABSTRACT: We evaluated the immunogenicity and safety of the influenza A (H1N1) 2009 monovalent vaccine in HIV-infected Japanese subjects. A total of 182 HIV-infected and 42 HIV-uninfected subjects were enrolled, and antibody (ab) titers were measured by hemagglutination-inhibition assay at baseline and 32.3±10.4 and 29.7±3.3 days after vaccination, respectively. In the HIV-infected cohort, ab titers ≥ 1:40 at baseline and post-vaccination were 12.6% and 49.5%, respectively. The seroconversion rate, defined as either an ab titer ≤ 1:10 before and ≥ 1:40 after or ≥ 1:10 before and ≥ 4-fold increase in ab titer, was only 38.5% in the HIV-infected cohort, whereas the rate was 85.7% in the HIV-uninfected cohort. Multivariate logistic regression analysis showed that the CD4 cell count was the only significant predictor of a positive vaccine response. There were no serious adverse events in any of the subjects receiving the vaccine. Additional study is warranted to identify a more effective method of vaccinating HIV-infected Japanese subjects.
    Vaccine 06/2011; 29(34):5694-8. DOI:10.1016/j.vaccine.2011.06.003 · 3.49 Impact Factor
  • Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 07/2010; 84(4):474-5.
  • Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 05/2010; 84(3):313-4.
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    ABSTRACT: We examined the efficacy and safety of the Japanese purified chick embryo cell rabies vaccine (PCEC-K) when administered on days 0, 7, and 28, as recommended by the WHO. Post-vaccination serum samples were obtained from 53 human subjects, and rabies antibody titers were determined by a combination of enzyme-linked immunosorbent assay (ELISA) and neutralizing antibody (NA) assay. By day 42 of the experiment, which was 2 weeks after the third dose, all subjects had developed NA titers of 0.5 IU/ml or higher. The geometric mean titers of ELISA antibody and NA were 3.8 EU/ml and 5.7 IU/ml, respectively. Overall, the vaccine was well tolerated by all subjects. These results suggest that PCEC-K used for pre-exposure immunization according to the WHO schedule is as immunogenic and effective as the current pre-exposure immunization regimen in Japan, which consists of vaccines administered on days 0, 28, and 180. An accelerated schedule would be of great advantage to Japanese travelers, who could complete the required three doses for primary immunization in 1 month.
    Journal of Infection and Chemotherapy 02/2010; 16(1):38-41. DOI:10.1007/s10156-009-0019-y · 1.38 Impact Factor
  • Naoki Yanagisawa, Naohide Takayama, Akihiko Suganuma
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    ABSTRACT: The wide spread use of Diphteria-Pertussis-Tetanus (DPT) vaccination has made pertussis rare among infants, but reports have noted the rise in adult pertussis in the United States and in Japan. Adult pertussis vaccination in the US has been approved and is becoming widely disseminated, but not in Japan, where only way to prevent adult pertussis is vaccination using infantile DPT vaccine. Reducing the Japanese DPT vaccine dose to 0.2 mL in the hope of minimizing adverse events, we studied its efficacy and safety. We nearly equalized diphteria and tetanus antigenic titers to a 0.1 mL dose of diphteria-tetanus bivalent vaccine--the booster dose regularly used in Japan--containing anti-FHA antibody titers similar to effective pertussis vaccines approved in the US. Subjects were 30 healthy volunteers who gave oral and written consent, testing anti-PT and anti-FHA antibody titers 4 weeks after vaccination. Of the 30, 29 showed a titer increase. Anti-tetanus toxoid titers tested showed increased titers in 28 subjects, the remaining 2 assumed to not have undergone previous tetanus vaccination. The incidence of local adverse effects was higher in adults than in children, but none were serious. A Japanese DPT vaccine dose of 0.2 mL thus proved effective against pertussis in adults.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 02/2009; 83(1):7-11.
  • Naoki Yanagisawa, Naohide Takayama, Akihiko Suganuma
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    ABSTRACT: After severe exposure to suspected rabid animal, WHO recommends a complete vaccine series using a potent effective vaccine that meets WHO criteria, and administration of rabies immunoglobulin (RIG). RIG is not available globally, and is not marketed in Japan. If pre-exposure prophylaxis for rabies is given, RIG is unnecessary even after severe exposure. It is thus important to give pre-exposure prophylaxis for rabies to people who plan to go to rabies-endemic areas. In Japan, pre-exposure prophylaxis for rabies consists of 3 doses of cell-culture rabies vaccine. The first two doses are given 4 weeks apart, and the third dose is given 6-12 months after the first dose, all of which are injected subcutaneously (standard regimen). People who plan to travel abroad to rabies-endemic areas may know of their destinations only 1 or 2 months in advance at best. Therefore, it is virtually impossible to complete the 3 dose regimen for rabies in Japan. Pre-exposure prophylaxis recommended by WHO consists of 3 doses given intramuscularly on days 0, 7, and 28, making it possible to complete pre-exposure prophylaxis in one month. This WHO recommended pre-exposure prophylaxis using Japanese cell-cultured rabies vaccine (PCEC-K) has not been studied, so we elected to fill the gap using PCEC-K, administered based on the WHO recommendation and examined its efficacy and safety. Subjects were 26 healthy volunteers with no previous rabies vaccination giving oral and written consent. Vaccine was administered on days 0, 7, and 28, and rabies antibody levels were tested on days 7, 28, and 42. On day 7, every antibody level was negative. On day 28, antibody levels were between 0.7-3.5 EU/ mL, with the exception of 3 cases still negative. On day 42, all cases, including the 3 negative cases, exceeded 1.6 EU/mL, providing sufficient protection against rabies. This result was not inferior compared to the standard regimen. Local adverse effects such as erythema and pain were noted, but none were serious. In conclusion, WHO recommended pre-exposure prophylaxis for rabies using PCEC-K is considered effective and safe.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 10/2008; 82(5):441-4. DOI:10.11150/kansenshogakuzasshi1970.82.441
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    Naohide Takayama
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    ABSTRACT: Rabies is a typical zoonotic disease which has been known for more than 4300 years. To date, no effective medical therapy has been established for overt rabies. The rabies post-exposure prophylaxis (PEP), which is a serial vaccination against rabies starting as soon as possible after the patient was bitten by a suspected rabid animal, is the only way to prevent death. In Japan, no rabies case has been reported for about 50 years. However, rabies is epizootic in many Asian countries, where more than 50% of the rabies deaths in the world occur. The Japanese travelers who visit these countries every year may not be aware of this fact since no rabies occurs in their own country. Therefore, the risk of being bitten by a rabid animal abroad and developing rabies after returning to Japan seems to be high. All medical staff should keep in mind that imported rabies cases can occur at any time. In addition, pre-exposure vaccination against rabies should be recommended to international travelers in order to ensure the preventative effect of PEP.
    Journal of Infection and Chemotherapy 03/2008; 14(1):8-14. DOI:10.1007/s10156-007-0573-0 · 1.38 Impact Factor
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    Emerging infectious diseases 01/2008; 13(12):1954-5. DOI:10.3201/eid1312.070422 · 7.33 Impact Factor
  • Michiko Takayama, Naohide Takayama
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    ABSTRACT: A new method was developed to distinguish accurately wild-type varicella-zoster virus (VZV) strains from the Oka vaccine strain. Several DNA fragments covering open reading frame (ORF) 1-37 were amplified from wild-type VZV strains including the Oka parent strain and from the Oka vaccine strain. Restriction fragment length polymorphisms of these regions were compared, and nucleotide differences between the vaccine virus and other wild-type VZV strains were noted in ORFs 6, 10, and 35. In addition, variations of the R2 and R4 reiterated structures of the vaccine and its parent strains were examined. The Oka vaccine strain used in Japan was shown to be a mixture of viruses with different nucleotide sequences that had variations in at least three nucleotide positions in ORF 1-37 and had variable polymorphisms at R2 and R4 repeat regions (two and three patterns, respectively). The Oka parent strain on the other hand showed a single sequence and had only one reiterated structure at these regions. When VZV ORF 6 was amplified and its product was digested with AluI, the Oka vaccine strain could be precisely differentiated from its parent and from 56 other Japanese clinical isolates.
    Journal of Clinical Virology 03/2004; 29(2):113-9. DOI:10.1016/S1386-6532(03)00112-4 · 3.47 Impact Factor
  • Naohide Takayama, Akihiko Suganuma
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    ABSTRACT: Age distribution, history of vaccination against measles, clinical signs and symptoms were investigated among a total of 113 adult measles patients admitted in our hospital between January, 2000 and December, 2002. The maximum body temperature, duration of fever, presence of Koplik spot and exanthema among these adult inpatients were compared with those among 1-to-5-year-old inpatients having measles. Concerning age distribution, the peak was found at the age of 20-24 years. Most of adult inpatients had not contracted measles until then and had not been vaccinated against measles. The infection route was unknown except a small number of inpatients. Clinical signs and symptoms among adult inpatients were about the same of those in pediatric inpatients except a sore throat. Complications occurred in 17 cases out of 113 adult inpatients, 4 of them had encephalitis or acute disseminated encephalomyelitis and the other 4 cases contracted pneumonia. Among the 45 child inpatients, whereas, 23 had complications, 13 of them had pneumonia, 3 contracted otitis media, and an additional 3 suffered from both pneumonia and otitis media. From the results it is reasonably concluded that clinical signs and symptoms among adults impatients with measles are comparable with those of pediatric measles inpatients or slightly severer.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 11/2003; 77(10):815-21.
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    ABSTRACT: Chronic pneumonitis of infancy (CPI) is a very rare lung disease in infants and young children. We report a 33-day-old infant with CPI, focusing on the radiologic aspects of the disease. Chest radiographs showed variable and non-specific appearances including ground-glass shadowing, consolidation, volume loss, and hyperinflation. Dense alveolar opacities progressed as CPI advanced. The radiologic features of our case reflected pathologic changes.
    European Radiology 01/2003; 12 Suppl 3:S155-7. DOI:10.1007/s00330-002-1496-x · 4.34 Impact Factor
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    ABSTRACT: Recently travelers who were bitten by possibly rabid animals in rabies endemic regions and returned to Japan have increased in number. About half of them received rabies post-exposure prophylaxis (RPEP) with one or more doses of foreign-made rabies vaccines (FRV) in the local medical institutions. FRV, however, are not available in Japan so we have to continue the RPEP with Japanese rabies vaccine (JRV). It has not been demonstrated that an anti-rabies antibody induced with JRV following Vero cell rabies vaccine (PVRV) or chick embryo cell rabies vaccine (PCEC) could be high enough to prevent clinical rabies. We examined anti-rabies antibody (ARA) titers among the subjects visited our vaccine clinic to receive RPEP and obtained results as follows: the ARA titers after a total of 5 doses of PCEC or PVRV and JRV were high enough to prevent clinical rabies as after 5 doses of JRV. However, ARA titers obtained after receiving one dose of PVRV and 2 doses of JRV seemed lower than those produced after one dose of PCEC and 2 doses of JRV or 3 doses of JRV. To accelerate antibody production, consequently, the simultaneous intradermal and subcutaneous injection method of rabies vaccine may be applied to those who were bitten in their hands or head by possibly rabid animals and received only one dose of PVRV in rabies endemic regions.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 11/2002; 76(10):882-7. DOI:10.11150/kansenshogakuzasshi1970.76.882
  • Michiko Takayama, Naohide Takayama
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    ABSTRACT: Long PCR amplification of the 7.7 to 33.5 Kbp regions of varicella-zoster virus (VZV) genomic DNA was performed using template DNAs extracted from clinical specimens such as vesicle fluid and crusts which had been obtained from varicella or herpes zoster patients. PCR products of 7.7-14.4 Kbp in length were efficiently amplified from all of the 14 template DNAs of crust specimens. Targets of 18.6-20.0 Kbp DNA could be also amplified from 14 crust samples except one. From all of the 7 samples derived from infected cells, the DNA targets up to 27.2 Kbp in length could be amplified. Whereas, the efficiency of amplification of 27.2 Kbp DNAs from crust samples was somewhat lower (9/14,64%) than that of DNAs from infected cells. In 83% (5/6) of target DNAs from infected cells, amplification of DNA as long as 33.5 Kbp was possible, while only in 40% (2/5) of these from crust specimens. From crust samples, the efficiency of amplification of DNA longer than 20 Kbp tended to decline. We also confirmed that long target DNA was amplifiable directly from vesicle fluid specimens as effective as from crust specimens. Restriction fragment length polymorphism (RFLP) analyses combined with R2-nested PCR of the long PCR products allowed classification of the 14 clinical specimens into 9 groups. Long PCR derived from clinical specimens was demonstrated to be applicable to RFLP analyses and sequencing without laborious test of virus isolation. Furthermore, the long PCR method described here will be useful for studies of the molecular epidemiology of VZV and for investigating variations among VZV isolates.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 06/2002; 76(5):347-54. DOI:10.11150/kansenshogakuzasshi1970.76.347
  • Naohide Takayama, Michiko Takayama
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    ABSTRACT: Four cases of the Ramsay Hunt syndrome were admitted to our hospital during the two years from February 1997 to January 1999. Though one of the 4 patients had been immunized with varicella vaccine, the causative virus was not a vaccine strain but a wild-type strain. These patients were not suffering from underlying diseases. Because the number of pediatric zoster patient without underlying diseases who visited our clinic between 1981 and 1999 was 35 cases, the Ramsay Hunt syndrome turned out not to be extremely rare even among children having no underlying diseases. The prognosis of the Ramsay Hunt syndrome is assumed to be good if the treatment begins at the early stage. To begin the treatment at the early stage, it is necessary to confirm the diagnosis with virological examinations.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 04/2002; 76(3):216-9. DOI:10.11150/kansenshogakuzasshi1970.76.216
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    ABSTRACT: We collected blood samples from 70 HIV-1-infected pregnant women and 76 babies born to HIV-1-infected women in Japan, from 1989 to 1999. To analyze the genetic diversity of HIV-1 among mothers and children, we sequenced the C2-V3 regions of HIV-1 gp120. Phylogenetic tree analysis of these regions revealed that multiple HIV-1 subtypes, A, B, D, E, and G, were circulating among mothers and children in Japan. Thus, the genetic heterogeneity of HIV-1 among mothers and children in Japan is steadily increasing, although the number of cases remains small. Perhaps the longest term survivor, an 11-year-old child with a vertical HIV-1 subtype G infection in Japan, is one of our subjects.
    AIDS Research and Human Retroviruses 05/2001; 17(6):569-75. DOI:10.1089/08892220151126706 · 2.46 Impact Factor
  • Naohide Takayama, Michiko Takayama, Junko Takita
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    ABSTRACT: A 5-year-old boy had zosteriform vesicular lesions 4 years after immunization with varicella vaccine. PCR analyses of DNA extracted from the crusts revealed herpes simplex virus type 1 infection. Virologic examinations should be performed before the vesicular lesion is attributed to the varicella-zoster virus vaccine strain.
    The Pediatric Infectious Disease Journal 03/2001; 20(2):226-8. DOI:10.1097/00006454-200102000-00025 · 3.14 Impact Factor
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    ABSTRACT: Two separate febrile Indian patients who reside in Japan and had recently returned from their country were diagnosed as suffering from typhoid fever. Fluoroquinolone therapy was clinically ineffective and the addition of a third-generation cephalosporin was required in each case. Each strain of Salmonella Typhi was resistant to nalidixic acid in vitro and also showed higher minimal inhibitory concentration to other quinolones than usual susceptible strains. Similar cases of typhoid fever responding poorly to quinolone treatment have been observed in the Indian subcontinent, south-east Asia and central Asia since the early 1990s, and potential spread by travelers into Japan is of serious concern. Although quinolones still remain the drugs of choice for treatment of typhoid fever, physicians should be aware of the possibility and implications of clinical treatment failure.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 02/2001; 75(1):48-52. DOI:10.11150/kansenshogakuzasshi1970.75.48
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    ABSTRACT: To confirm epidemiological features of herpes zoster among children with or without immunosuppression, herpes zoster patients who had presented to this hospital were retrospectively investigated. Medical records were reviewed for the 92 cases of pediatric herpes zoster patients diagnosed during the period from 1981 to 1998. The age at onset of herpes zoster and of varicella, the interval between varicella and zoster, the dermatomal distribution of herpes zoster and complications were compared between immunocompetent and immunocompromised children. The mean age at onset of zoster in immunocompetent children was 8.5 +/- 4.0 years and in immunosuppressed children was 9.7 +/- 3.8 years. The age at onset of varicella was significantly lower (1.6 +/- 1.8 years) in immunocompetent than in immunosuppressed children (4.6 +/- 2.7 years). The interval between varicella and zoster was 6.2 +/- 3.2 years in immunocompetent children. More than 80% of patients with acute leukemia or malignant lymphoma had herpes zoster within 2 years after diagnosis of malignancy. Lesions of herpes zoster were most frequently found in the thoracic nerve regions. Five of 11 zoster patients with cutaneous dissemination, three of five zoster patients having aseptic meningitis and three of four patients complicated facial palsy were children without underlying disease. The present study confirmed that varicella in the first year of life was a risk factor in immunocompetent children, as reported previously. Herpes zoster in children without immunosuppression was found not to be as mild as generally accepted.
    Pediatrics International 07/2000; 42(3):275-9. DOI:10.1046/j.1442-200x.2000.01227.x · 0.73 Impact Factor
  • Naohide Takayama, Michiko Takayama
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    ABSTRACT: A neonatal varicella case confirmed early to be infected with varicella-zoster virus (VZV) using PCR analysis was reported. The mother developed an eruption on the following day the patient's birth and was diagnosed as varicella at 3 day of age. The neonate received immunoglobulin and acyclovir (17.5 mg x twice). She was speculated to develop varicella on the 5 to 10 day of age. Eruptions were noted, however, on the 13 day of age, although she was confirmed to be infected with VZV using PCR on the 6 day of age, and her symptoms were much milder than that foreseen. Delay of development and mildness of her symptoms may be attributed to immunoglobulin and acyclovir given on the 3 day of age. PCR method was very useful in determining early that she was infected with VZV.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 05/2000; 74(4):392-4. DOI:10.11150/kansenshogakuzasshi1970.74.392