[show abstract][hide abstract] ABSTRACT: Evidence regarding the mortality rate after administration of the pandemic influenza A (H1N1) 2009 vaccine on patients with underlying diseases is currently scarce. We conducted a case-control study in Japan to compare the mortality rates of patients with idiopathic interstitial pneumonia after the vaccines were administered and were not administered.
Between October 2009 and March 2010, we collected clinical records in Japan and conducted a 1∶1 matched case-control study. Patients with idiopathic interstitial pneumonia who died during this period were considered case patients, and those who survived were considered control patients. We determined and compared the proportion of each group that received the pandemic influenza A (H1N1) 2009 vaccine and estimated the odds ratio. Finally, we conducted simulations that compensated for the shortcomings of the study associated with adjusted severity of idiopathic interstitial pneumonia.
The case and control groups each comprised of 75 patients with idiopathic interstitial pneumonia. The proportion of patients who received the pandemic influenza A (H1N1) 2009 vaccine was 30.7% and 38.7% for the case and control groups, respectively. During that winter, the crude conditional odds ratio of mortality was 0.63 (95% confidence interval, 0.25-1.47) and the adjusted conditional odds ratio was 1.18 (95% confidence interval, 0.33-4.49); neither was significant. The simulation study showed more accurate conditional odds ratios of 0.63-0.71.
In our study, we detected no evidence that the influenza A (H1N1) 2009 vaccine increased the mortality rate of patients with idiopathic interstitial pneumonia. The results, however, are limited by the small sample size and low statistical power. A larger-scale study is required.
PLoS ONE 01/2014; 9(2):e88927. · 3.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: Abstract DNA sequences encoding the GroES and GroEL proteins of Orientia tsutsugamushi were amplified by the PCR and sequenced. Pairwise alignment of full-length groES and groEL gene sequences indicated high sequence similarity (90.4-100% and 90.3-100%) in O. tsutsugamushi, suggesting that these genes are good candidates for the molecular diagnosis and phylogenetic analysis of scrub typhus. Comparisons of the 56-kD type-specific antigen (TSA) protein gene and the groES and groEL genes showed that genotypes based on the 56-kD TSA gene were not related to a cluster containing the groES and groEL genes in a dendrogram, suggesting that a gene rearrangement may be associated with homologous recombination in mites.
[show abstract][hide abstract] ABSTRACT: We conducted a nationwide survey of the present status of 10 representative mother-to-child infections in Japan. Congenital syphilis, vertical HTLV-1 infection, congenital rubella, and vertical HIV infection, for which effective preventative strategies have been established, were rare. CMV was the most common congenital pathogen in Japan, although most infants with congenital CMV infection may remain undiagnosed.
The Pediatric Infectious Disease Journal 02/2013; · 3.57 Impact Factor
[show abstract][hide abstract] ABSTRACT: Introduction Since the novel influenza A (H1N1) 2009 virus was identified in Mexico and the United States in April 2009, it has spread worldwide. In response to this situation, the World Health Organization raised the pandemic alert level to phase 6 . Since seasonal influenza vaccines were not expected to prevent influenza A (H1N1)2009 virus infection , the development of efficient and safe new influenza vaccines was an urgent need. The suspected side effects of the seasonal influenza vaccine include acute disseminated encephalomyelitis and Guillain-Barre syndrome [3-8]. After the dissemination of an estimated 82.4 million doses of A(H1N1)2009 vaccines, 48 fatal cases were reported to the Vaccine Adverse Event System in United States . When the new influenza A (H1N1) 2009 spread in Japan, beginning in September 2009, the new vaccines were administered to the Japanese population. One hundred thirty-one patients with underlying diseases, including 22 with chronic kidney diseases, 12 with chronic obstructive pulmonary diseases (COPD), and 11 interstitial pneumonias, were reported to have died after the vaccinations [9,10]. The cause of death was undetermined between adverse events resulting from the vaccinations, the effects of the underlying diseases, or exacerbation of the underlying diseases by the vaccination. To our knowledge, thus far, no studies have tested the safety of the influenza vaccine among COPD patients. To clarify the mortality risk associated with the vaccinations, we undertook a case-control study in which the patients who died with COPD (case) were matched with those who survived COPD (control). Patients with incurable COPD usually consult a respiratory physician throughout their lives in hospitals registered with the Japanese Respiratory Society in Japan. Our study was designed to determine the safety of the influenza A (H1N1) 2009 vaccine among COPD patients . We aimed at exploring whether the A (H1N1) 2009 vaccine increased the mortality in patients with COPD. Abstract Background: The safety of influenza A (H1N1) 2009 among chronic obstructive pulmonary disease (COPD) patients has not been investigated yet. Our objective was to investigate the safety of the A (H1N1) 2009 vaccine, especially for mortality after vaccination.
Journal of Vaccines & Vaccination. 09/2012; 3(5):1000148.
[show abstract][hide abstract] ABSTRACT: Young infants with influenza virus infection are frequently hospitalized, and are at risk of serious complications including death. With the emergence of pandemic influenza A/H1N1 2009, oseltamivir was approved for use in Europe and the USA, including use in infants aged < 3 months. However, few data are available regarding the safety of oseltamivir treatment for influenza in infants aged < 3 months.
The clinical data from Japanese infants aged < 3 months with laboratory-confirmed influenza virus infections, who were treated with oseltamivir between October 2009 and April 2011, were collected and analyzed.
Forty-four infants were included in the study. The median age was 1 month (range 4 days to 2 months) and median body weight was 4.5 kg (range 2.6-7.6 kg). Thirty-eight infants (86%) had no underlying diseases. The most common presenting symptom was fever (42 infants, 95%). There were no cases of influenza-associated encephalopathy or myocarditis. The median time between the onset of influenza symptoms and initiation of oseltamivir treatment was 0 days (range 0-7 days), with treatment initiated within 1 day in 40 infants (91%). The oseltamivir dose was 1.5-2 mg/kg twice daily in 98% of infants. No serious adverse events were identified during treatment. All infants recovered completely.
Treatment of influenza with oseltamivir 1.5-2 mg/kg twice daily may be safe in infants aged < 3 months.
[show abstract][hide abstract] ABSTRACT: Spurred by the recent isolation of a novel hantavirus, named Imjin virus (MJNV), from the Ussuri white-toothed shrew (Crocidura lasiura), targeted trapping was conducted for the phylogenetically related Asian lesser white-toothed shrew (Crocidura shantungensis). Pair-wise alignment and comparison of the S, M and L segments of a newfound hantavirus, designated Jeju virus (JJUV), indicated remarkably low nucleotide and amino acid sequence similarity with MJNV. Phylogenetic analyses, using maximum likelihood and Bayesian methods, showed divergent ancestral lineages for JJUV and MJNV, despite the close phylogenetic relationship of their reservoir soricid hosts. Also, no evidence of host switching was apparent in tanglegrams, generated by TreeMap 2.0β.
[show abstract][hide abstract] ABSTRACT: To assess the prevalence including asymptomatic infection, infection risk of exposure to patients, and effectiveness of personal protective equipment (PPE) among health care workers (HCWs) during the first pandemic (H1N1) 2009 (pH1N1) outbreak in Kobe, Japan in May 2009.
A cross-sectional seroepidemiological study was conducted on 268 HCWs in the two hospitals in Kobe to which all pH1N1 inpatients were directed. Participating HCWs completed a self-administrated questionnaire and provided a single serum sample which was analyzed using a hemagglutination-inhibition (HI) antibody test.
Of 268 subjects, 14 (5.2%) were found to have positive antibodies to the pH1N1 by HI assay; only 1 reported a febrile episode. Among the 14 seropositive cases, 8 received chemoprophylaxis. 162 HCWs (60.4%) had been exposed to patients. The seropositive rate (SPR) for pH1N1 of the exposed group was higher than that of the unexposed group, however not statistically significant (6.8% vs. 3.1%, p = 0.197). There were no statistically significant differences in SPR for any PPE.
The SPR for pH1N1 in the exposed group was higher than that of the unexposed group in HCWs; however, most of these individuals were asymptomatic. There was no statistically significant association between PPE implementation and pH1N1 seropositivity.
The Journal of infection 05/2011; 63(4):281-7. · 4.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: We studied measles outbreak in Ibaraki Prefecture in spring 2002 as members of Field Epidemiology Training Program Japan (FETPJ). Of 84 cases diagnosed by not laboratory test but clinically, 67 (79.8%) were junior high school students, 9 (10.7%) were other students, and 8 (9.5%) were ordinary adult and infant citizens. Of the 84, 46 (54.8%) had been vaccinated. Most did not show typical Koplik spots. The city in which the school was located promoted vaccinations for infants and children aged 7.5 years old to grade 1 in High school. Questionnaire given to junior high students were detected 86 cases, of whom 57 (66.3%) were male. Overall, 4 peaks of clusters were observed in an epidemic curve, among which graduates' farewell parties and graduation ceremonies were the most common opportunities for measles virus exposure. The overall vaccination rate at school was 82.2%, vaccine efficacy extremely low at 72.5%, and vaccine failure high at 15.2%. Symptoms among those vaccinated were significantly milder than those not vaccinated. Immunity of those vaccinated as infants may have been decreased due to scarcity of measles cases in the last 10 years. In such situations--much less in typical measles among susceptible non affected and non vaccinated subjects--atypical or mild measles may be difficult to diagnose. These findings may keep clarify the need to introduce two-dose measles immunization in Japan.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 05/2011; 85(3):256-62.
[show abstract][hide abstract] ABSTRACT: We performed questionnaire survey in 2005, just before the introduction of the MR vaccine, concerning child vaccination and/or infection history for measles, mumps, rubella, varicella, influenza, diphtheria-pertussis-tetanus (DPT), BCG, and Japanese encephalitis. The vaccination rate against measles and rubella did not exceed 95% at any age levels. As a result, children who had contracted measles and/or rubella were observed at all age levels. The vaccination rate was 95% or higher only for BCG and DPT. The vaccination rates for influenza, mumps, and varicella, although vaccination against which diseases was being performed voluntarily, were low, and outbreaks of these diseases were expected to persist. The vaccination rates at a low level for these infectious diseases might be one of the most possible risk factors to the high prevalence of the diseases in nursery schools (daycare centers), kindergartens, and elementary schools all over Japan.
[show abstract][hide abstract] ABSTRACT: The WHO Western Pacific Regional Office including Japan sets 2012 as the target year of the measles elimination. Japan notified "National Measles Elimination Plan in December 2007" aiming at being eliminate measles from the country by 2012. In 2009, total 741 cases (5.80 per 1,000,000 population) were reported (as of January 7, 2010). It was a remarkable decrease compared with 11,015 cases in 2008. However, the vaccination rate as of the end of 2008 fiscal year (the end of March) doesn't reach 95%. The first vaccination rate was 94%, and the second vaccinations for age groups of 5-6 years, 12-13 years and 17-18 years were 92%, 85%, and 77%, respectively. To prevent the spread of measles and eliminate in Japan, the whole nation recognizes that measles is a serious illness related to the life, and the department of the public health, the education, the medical units, and the research laboratories make an effort aiming at the goal for measles elimination is necessary.
[show abstract][hide abstract] ABSTRACT: We conducted an anti-varicella-zoster virus antibody seroepidemiologic survey comparing the pre- and postvaccine eras of 1977-1981 and 2001-2005. For each period, 828 samples were measured by enzyme immunoassay test and compared. The differences from 1-year-old to high-school aged children were statistically significant. The introductions of optional varicella immunization and lifestyle changes for children were considered influencing factors.
[show abstract][hide abstract] ABSTRACT: We report the case of a male infant born to a mother diagnosed as having measles before delivery. Although he was given standard immunoglobulin soon after delivery, he developed congenital measles. The diagnosis was confirmed by serology and PCR assay from the infant's pharyngeal secretions.
[show abstract][hide abstract] ABSTRACT: Japanese encephalitis (JE) surveillance has been conducted since 1965 as a part of the National Epidemiological Surveillance of Vaccine Preventable Diseases in Japan. Over 1,000 JE cases were reported annually in the late 1960s. The number of JE cases has since markedly decreased, with less than 10 cases reported annually from 1992 to 2004. A total of 361 JE cases were reported between 1982 and 2004. Prognosis was available for 320 cases; 58 (18%) died, 160 (50%) recovered with neuropsychiatric sequelae, and 102 (32%) completely recovered. Seventy-eight percent of these cases were 40 years old or over with a peak age group of 60-69 years old. JE predominantly occurred in unvaccinated populations. A high seroconversion rate among sentinel pigs was recorded every year. This suggests the presence of JE virus-infected mosquitoes during the summer in most areas of Japan, including the northern districts where no JE cases were reported from 1982 to 2004. Although JE cases have been reported in single figures since 1992, the risk of JE virus infection is still present. Thus, high immunization rates of JE vaccine should be maintained in Japan.
Japanese journal of infectious diseases 10/2008; 61(5):333-8. · 1.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the present study was to produce the first estimation in Japan of the basic reproduction number (R(0)) and the minimum level of vaccine coverage needed to prevent measles outbreaks (P(c)).
A questionnaire survey was conducted during two measles outbreaks among 12-15-year-old middle school students in one prefecture in spring, from the end of February to the beginning of May 2002, and a stochastic mathematical model was constructed to calculate vaccine effectiveness (VE) and the basic reproduction number (R(0)). P(c) was calculated from R(0) and VE.
In outbreak 1 (school A), 62 (94%) of 66 patients responded to the questionnaire. Of a total of 601 students, 534 (88.9%) responded. Of these, 82.6% (441/534) had previously received measles vaccine. In outbreak 2 (school B), 20 (99%) of 21 patients responded. Of a total of 375 students, 373 (99.5%) responded. Of these, 317 (85.0%) received measles immunization. Mathematical analysis was as follows: in outbreak 1 R(0) was 7.40 (95% confidence interval [CI]: 7.36-7.44) and VE was 76.55% (95%CI: 53.24-87.54). In outbreak 2, R(0) was 18.89 (95%CI: 18.88-18.90) and VE was 98.54% (95%CI: 94.89-99.73). Consequently, P(c) was 112.97% (95%CI: 92.29-145.52) in outbreak 1 and 96.11% (95%CI: 93.81-98.53) in outbreak 2.
Because of the lower VE in outbreak 1, measles virus transmission could not have been stopped even if all students received a single dose of vaccine. In outbreak 2, with higher VE, the outbreak could have been prevented by increasing the proportion of students who had been vaccinated.
Pediatrics International 09/2008; 50(4):464-8. · 0.88 Impact Factor