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ABSTRACT: The mean herpes zoster incidence in Japan was 4.15/1,000 person-years and was 5.23-7.84/1,000 person-years among those 50 years old and older. One in three persons experiences herpes zoster before age 80, indicating how common it is. The Oka varicella vaccine was developed to prevent varicella in healthy and immunocompromized children and is now used to prevent varicella in 20 million people worldwide. Contact with varicella patients and Oka varicella vaccine are reported to augment varicella-zoster virus immunity in adults and the elderly. Oxman et al. have shown that Oka varicella vaccine prevents herpes zoster and postherpetic neuralgia (PHN) in the elderly. Oka varicella vaccine is approved to prevent herpes zoster and PHN in the elderly in USA and Europe. We review the relationship between varicella/Oka varicella vaccine and herpes zoster, the study by Oxman et al., and the need to introduce this new application of Oka varicella vaccine in Japan.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 11/2010; 84(6):694-701.
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Hidemi Toyoda,
Masaru Ido,
Kyoichi Nakanishi, Takashi Nakano,
Hitoshi Kamiya,
Akihiko Matsumine,
Atsumasa Uchida,
Hitoshi Mizutani,
Ludovic de Beaucoudrey,
Guillaume Vogt,
Stéphanie Boisson-Dupuis,
Jacinta Bustamante,
Jean-Laurent Casanova,
Yoshihiro Komada
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ABSTRACT: Disseminated squamous cell carcinoma (SCC) of the skin is exceedingly rare in children. SCC occurs after immunodeficiency from immunosuppression in organ transplant recipients or patients with HIV infection or leukaemia, but has not been reported in primary immunodeficiencies other than epidermodysplasia verruciformis. Interferon gamma receptor 2 (IFN gamma R2) deficiency is an exceedingly rare primary immunodeficiency, conferring almost selective predisposition to mycobacterial diseases. A disseminated, cutaneous SCC is described that occurred in a patient homozygous for a novel frameshift deletion at positions 949 and 950 (949delTG) in the IFNGR2 gene. The patient first presented at 1 year of age with disseminated Mycobacterium avium infection, with later infections of atypical mycobacteria (Mycobacterium fortuitum and Mycobacterium porcium). At 17 years of age, the patient developed multifocal SCC lesions on the face and both hands. Histopathological examination revealed well differentiated SCC. Despite local tumour excision, multiple lesions occurred and a large SCC on the right arm required amputation. The patient died at 20 years of age of disseminated SCC. Inherited disorders of IFN gamma mediated immunity may predispose patients to SCC.
Journal of Medical Genetics 09/2010; 47(9):631-4. · 6.36 Impact Factor
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ABSTRACT: The incidence of reported cases with pertussis has increased in young adults in Japan and the lack of additional booster immunizations containing pertussis components is suspected to be one of the causal reasons. Instead of DT immunization at 11-12 years of age, safety and immunogenicity were investigated using 0.2 ml and 0.5 ml of DTaP. 176 subjects in DTaP 0.5ml, 178 in DTaP 0.2 ml, and 197 in DT 0.1 ml groups were enrolled in clinical trial. The relative risk of local reactions in the DTaP 0.2 ml group compared to the DT 0.1 ml group was 1.13 (95% CI: 0.97-1.30), and that of the DTaP 0.5 ml to the DT 0.1 ml group was 1.34 (95% CI: 1.18-1.53). The relative risks of local pain and heat were 1.62 (95% CI: 1.33-1.98) and 1.59 (95% CI: 1.19-2.13), respectively, in the DTaP 0.5 ml group compared to the DT 0.1 ml group. Sero-positive rates against PT and FHA were 54% and 82% before immunization and increased to >95% for both after vaccination with no significant difference in GMT. Instead of the scheduled DT program, 0.2 ml of DTaP was acceptable and demonstrated efficient immunogenicity.
Vaccine 09/2010; 28(48):7626-33. · 3.77 Impact Factor
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ABSTRACT: A 2-year-old boy developed acute myositis associated with rotavirus gastroenteritis. He had remarkable swelling and subcutaneous edema, mostly in the legs, 4 days after the onset of gastroenteritis. Marked elevation of creatine kinase was observed while serum albumin, immunoglobulin, and complement were decreased.
Pediatrics International 10/2007; 40(1):82 - 84. · 0.63 Impact Factor
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Tamie Sugawara,
Yasushi Ohkusa,
Keiko Taya,
Kaoru Oikawa,
Noriyuki Haneda,
Kiyoshi Kikuchi,
Fumihide Kato,
Seiji Yamaguchi,
Tetuji Yoshikawa, Takashi Nakano,
Toshiaki Ihara,
Hiroyuki Tutumi,
Yoshizo Asano,
Hitoshi Kamiya,
Nobuhiko Okabe
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ABSTRACT: Mumps immunization is not included in routine immunization in Japan. We measured the cost-effectiveness of routine immunization.
We surveyed outpatients prospectively from June 15, 2004, for 19 months in an area with a population of 100,000. Almost all of the 11 pediatric clinics and hospitals in this area cooperated. In 2006, we retrospectively surveyed all inpatients hospitalized for more than 24 hours and dying of mumps.
We collected data from 189 doctors who rated outpatients and 112 families. The disease burden for outpatients including family nursing was estimated to be 47.1 billion yen nationwide. We estimated the total number of inpatients as 4,596. The disease burden of inpatients including the cost of family nursing was estimated to be 1.35 billion yen. Adding cases of sequelae and death, the total disease burden was estimated to be 52.5 billion yen. The incremental benefit cost ratio for routine immunization is higher than 1 even in the lower bounds of the 95% confidence interval.
The incremental benefit cost ratio shows that the additional benefit due to routine immunization exceeds additional cost, emphasizing the benefits of routine mumps immunization.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 10/2007; 81(5):555-61.
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Masahiro Hirayama,
Eiichi Azuma,
Tadashi Kumamoto,
Shotaro Iwamoto,
Yuji Nashida,
Mariko Araki,
Hiroshi Yamada,
Francis Dida,
Shigehisa Tamaki,
Keiki Kawakami,
Shinichi Kageyama, Takashi Nakano,
Hatsumi Yamamoto,
Yoshihiro Komada
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ABSTRACT: Infections may coexist and in certain circumstances aggravate acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation. Early detection of aGVHD is often difficult in patients with concurrent infections. Using an enzyme-linked immunospot assay that reflects ongoing immune status in vivo, we enumerated spot-forming cells (SFCs) for interferon (IFN)-gamma, interleukin (IL)-4, and IL-12 in peripheral blood from 56 patients with hematological disorders. Eleven patients had viral, fungal, or bacterial systemic infections during first 10 weeks posttransplant. Of these, six patients with grade 0-I aGVHD showed normal levels of IFN-gamma SFCs. On the other hand, IFN-gamma SFCs were elevated in five patients with grade II-IV aGVHD. These data indicate that increased IFN-gamma SFCs seemed to be correlated with clinically significant aGVHD, but not with infection itself. IL-4 and IL-12 SFCs increased in some patients with infections, irrespective of the presence of aGVHD. Thus, IFN-gamma SFCs may be used to distinguish systemic infections from aGVHD.
Transplantation 03/2006; 81(4):632-5. · 4.00 Impact Factor
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Akira Sugiyama,
Yoshito Iwade,
Shigehiro Akachi,
Yoko Nakano,
Yukari Matsuno,
Takuya Yano,
Akinori Yamauchi,
Osamu Nakayama,
Haruko Sakai,
Ken-ichi Yamamoto,
Yuji Nagasaka, Takashi Nakano,
Toshiaki Ihara,
Hitoshi Kamiya
Japanese journal of infectious diseases 01/2006; 58(6):398-400. · 1.49 Impact Factor
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ABSTRACT: Following the re-emergence of polio in West Africa, an investigation was conducted on the occasion when transients gather for the festival in Niger, where the oral polio vaccine (OPV) and BCG coverage among children under the age of 5 years can be evaluated. A total of 259 children were investigated, including 186 from settled families and 73 from unsettled families. OPV coverage was found to be as low as 32.4%, and 61.8% of all participants in the study had not received both OPV and BCG. There were more children who had not received the OPV in unsettled families than in settled families. As there are still unvaccinated children in Niger, polio continues to occur among them. Moreover, outbreaks can transfer to more densely-populated areas, causing much larger outbreaks. To stop the chain of transmission, it is essential to reconsider the strategy of mass vaccination in order to cover all children thoroughly, including transients.
Japanese journal of infectious diseases 07/2004; 57(3):121-3. · 1.49 Impact Factor
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Hidemi Toyoda,
Masaru Ido,
Tatsuya Hayashi,
Esteban C Gabazza,
Koji Suzuki,
Jun Bu,
Shigeki Tanaka, Takashi Nakano,
Hitoshi Kamiya,
James Chipeta,
Rodrick R Kisenge,
Jian Kang,
Hiroki Hori,
Yoshihiro Komada
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ABSTRACT: We examined the immunological abnormality in a patient with recurrent Mycobacterium avium infection. T cells from the patient showed decreased ability both to produce IFN-gamma and to proliferate in response to IL-12. Despite decreased expression of IL-12R beta1 and beta2 chains in the patient's PHA-activated T cells, there was no difference in IL-12-induced tyrosine and serine phosphorylation of STAT4 in PHA-activated T cells between the patient and healthy subjects, suggesting that IL-12R signals are transmitted to STAT4 in the patient's PHA-activated T cells. Using EMSA, confocal laser microscopy, and Western blotting, we demonstrated that the nuclear translocation of STAT4 in response to IL-12 is reduced in PHA-activated T cells from the patient when compared with those from healthy subjects. Leptomycin B was used to examine whether nuclear export of STAT4 is increased in the patient's T cells. However, leptomycin B treatment did not reverse impaired IL-12-induced nuclear accumulation of STAT4. Although the exact mechanism responsible for the impaired STAT4 nuclear translocation in this patient remains unclear, the absence of mutation in the IL-12Rbeta1, IL-12Rbeta2, STAT4, and STAT4-binding sequence of the IFN-gamma gene and preservation of STAT4 tyrosine and serine phosphorylation suggest the existence of a defective STAT4 nuclear translocation. This defect is likely responsible for the impaired STAT4 nuclear translocation in IL-12-stimulated T cells, leading to impairment of both IFN-gamma production and cell proliferation. To the best of our knowledge, this is the first report of a patient with atypical mycobacterial infection associated with impairment of STAT4 nuclear translocation.
The Journal of Immunology 04/2004; 172(6):3905-12. · 5.79 Impact Factor
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ABSTRACT: In some nation states, sustained integrated global epidemiological surveillance has been weakened as a result of political unrest, disinterest, and a poorly developed infrastructure due to rapidly increasing global inequality. The emergence of severe acute respiratory syndrome has shown vividly the importance of sensitive worldwide surveillance. The Agency for Cooperation in International Health, a Japanese non-governmental organisation, has developed on a voluntary basis a sentinel surveillance system for selected target infectious diseases, covering South America, Africa, and Asia. The system has uncovered unreported infectious diseases of international importance including cholera, plague, and influenza; current trends of acute flaccid paralysis surveillance in polio eradication; and prevalence of HIV, syphilis, hepatitis B, and hepatitis C in individual areas covered by the sentinels. Despite a limited geographical coverage, the system seems to supplement disease information being obtained by global surveillance. Further development of this sentinel surveillance system would be desirable to contribute to current global surveillance efforts, for which, needless to say, national surveillance and alert system takes principal responsibility.
The Lancet Infectious Diseases 04/2004; 4(3):171-7. · 17.39 Impact Factor
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Tropical Doctor 11/2003; 33(4):252-3. · 0.66 Impact Factor
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Japanese journal of infectious diseases 09/2003; 56(4):175-7. · 1.49 Impact Factor
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Akira Sugiyama,
Kanako Nishi,
Takuya Yano,
Yoko Nakano,
Miwa Fukuta,
Yoshito Iwade,
Akinori Yamauchi,
Kazunobu Kawada,
Osamu Nakayama,
Norichika H Kumazawa, Takashi Nakano,
Toshiaki Ihara,
Hitoshi Kamiya
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ABSTRACT: The Norwalk virus(NV) is widely known as a cause of nonbacterial food poisoning, infant diarrhea, and acute gastroenteritis in the winter months between November and March. While it is strongly suspected that NV that is excreted by humans flows into coastal seawaters via rivers and wastewater treatment facilities to contaminate oysters that are grown in farms in the area, light has yet to be shed on the behavior of this virus in the natural environment. We therefore conducted a polymerase chain reaction (PCR) survey of NV levels in the aquatic environment of the oyster bed area of the Shima region in Mie Prefecture, whereupon the NV was detected in marine sediment, oysters, and mule clams even during the summer months, when food poisoning is infrequent. In order to assess their similarity to human-derived strains, the detected viruses and their human-derived counterparts were subjected to genetic analysis, whereupon some of the detected viruses were found to be remarkably similar to those that were previously detected in humans infected with NV. In the interests of examining methods for decontaminating NV-contaminated oysters, we also conducted an assessment on a system of virus decontamination that focuses on seawater temperature and oyster metabolism, using Poliovirus Sabin strain. The decontamination system mentioned above was a closed loop, water circulating system, built on the same principles as those actually in use at oyster farms. Our experiment indicated that at seawater temperatures of both 10 degrees C and 20 degrees C, virus placed into the water tank was rapidly incorporated into the midgut glands of the oysters. Thereafter, when seawater irradiated with UV was circulated, the virus count in the oysters fell from 1/1,000 to 1/10,000 within 6 hours. These results indicated the utility of this system for virus decontamination, suggesting the possibility of significantly alleviating the risk of NV infection in humans by using this system to maintain the seawater temperature within the decontamination tank above a certain temperature, and to perform decontamination with an adequate water flow.
Nippon rinsho. Japanese journal of clinical medicine 07/2002; 60(6):1214-21.
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Pediatrics International 03/2002; 44(1):106-8. · 0.63 Impact Factor
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ABSTRACT: We experienced an outbreak of measles in which our hospital played an unfortunate role as a vector for the transmission of the disease. Most patients had never been vaccinated and an investigation into the reasons for this revealed a need to more widely promote awareness of measles vaccination in Japan.
Scandinavian Journal of Infectious Diseases 02/2002; 34(6):426-9. · 1.72 Impact Factor
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ABSTRACT: Recent research has suggested that an association exists between moyamoya disease and fibromuscular dysplasia which involves systemic vessels, including renal arteries. We report a 3 year old girl with moyamoya disease associated with bilateral renal artery stenosis. This case may support the common etiology of these two clinical conditions. To our knowledge this is the youngest case of moyamoya disease associated with bilateral renal artery stenosis.
Pediatrics International 07/1993; 35(4):354 - 357. · 0.63 Impact Factor
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ABSTRACT: We studied the expression of interleukin-2 receptor α (CD25)+CD45RO+CD4+ T lymphocytes (T-cell activation) in response to the rubella virus (RV) antigen (Matsuura strain, Biken, Osaka, Japan) using three-color-staining flow cytometry. The subjects were 48 healthy children (3–14 years old, 31 boys and 17 girls), who had received either monovalent vaccine (n=5; mean age, 13.2 years) or measles–mumps–rubella (MMR) vaccine (n=21; mean age, 10.5 years), had been naturally infected (n=5; mean age, 11.4 years), or had been neither vaccinated nor naturally infected (n=17; mean age, 10.0 years) and 62 healthy adolescents and adults (15–37 years old; 19 males and 43 females), who had received monovalent vaccine (n=26, mean age, 27.4 years), had been naturally infected (n=8; mean age, 24.0 years), or had been neither vaccinated nor naturally infected (n=8; mean age, 16.5 years). Ninety-four of 110 subjects had HI titers≥1:16. T-cell activation in these subjects was significantly higher than that in 6 seronegative (HI titers<1:8) subjects (p<0.05). T-cell activation did not differ significantly with the history of exposure to RV. HI antibody titers≥1:16 and T-cell activation persisted in vaccinated subjects for ≥20 years and was similar to those in naturally infected subjects. Our results suggest that cell-mediated immunity and humoral immunity persist for at least 20 years after vaccination.
Vaccine.
