Teruo Okafuji

Hyogo Prefectural Institute of Public Health and Consumer Sciences, Kōbe, Hyōgo, Japan

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Publications (17)

  • Takao Okafuji · Teruo Okafuji · Tetsuo Nakayama
    [Show abstract] [Hide abstract] ABSTRACT: The Takahashi, Matsuura and TO-336 strains of live attenuated rubella vaccine have been used until now in Japan. Japan had implemented a single dose rubella vaccine program until 2006, but few reports are available on the persistence of immunity after the single dose of vaccination. We obtained 276 sera from January, 2009 to December, 2011 at Okafuji Pediatric Clinic and assessed the immune status against the rubella virus 1 to 10 years after vaccination with a single dose of the Takahashi strain of rubella vaccine. The regional outbreak of rubella didn't occur from 1999 to 2011. Sera were tested for rubella antibody by a standard hemagglutination inhibition (HI) method and all subjects maintained positive antibodies 10 years after vaccination. Geometric mean titers (GMT) of HI antibody was 1:180 and decreased to 1:68 ten years after immunization. HI antibodies decreased logarithmically with days after the administration of Takahashi strain vaccine. In conclusion, vaccine-acquired immunity after a single dose of the Takahashi strain of live attenuated rubella vaccine retained the immunity at least 10 years when rubella was under regional control.
    Article · Aug 2015
  • [Show abstract] [Hide abstract] ABSTRACT: Although anaphylaxis is an extremely rare vaccine-associated adverse event, it occurred in young children following administration of the 2011/12 seasonal split influenza vaccine, which contained 2-phenoxyethanol as the preservative. These children had high levels of IgE antibodies against influenza vaccine components. We herein investigated why these children were sensitized. One hundred and seventeen series of serum samples were obtained immediately before, and one month after the first and second immunizations with the HA split vaccine of 2011/12. Forty-two sequential serum samples were collected in the acute and convalescent phases (2 and 4 weeks) after natural infection with H1N1 Pdm in 2009. IgE antibodies developed following the vaccination of young children with seasonal split vaccines, whereas no significant IgE response was observed following natural infection with H1N1 Pdm 2009. The prevalence of IgE antibodies was not influenced by outbreaks of H1N1 Pdm. Repeated immunization with the HA split vaccine induced IgE sensitization against the influenza vaccine irrespective of the H1N1, H3N2, or B influenza subtypes. The reasons why anaphylaxis only occurred in recipients of the influenza vaccine containing 2-phenoxyethanol are still being investigated, and the size distribution of antigen particles may have shifted to a slightly larger size. Since the fundamental reason was IgE sensitization, current split formulation for the seasonal influenza vaccine needs to be reconsidered to prevent the induction of IgE sensitization. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Article · Jul 2015 · Vaccine
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    File available · Data · Nov 2014
  • [Show abstract] [Hide abstract] ABSTRACT: Abstract The 2009 pandemic H1N1 mainly affected adolescents and children, and most of the elderly in Japan escaped clinical illness. To clarify the role of humoral immunity in the infection, the time kinetics of hemagglutination inhibition (HI), neutralization (NT), and IgG subclass antibody response directed against influenza A(H1N1)pdm2009 were analyzed in three consecutive specimens obtained from 51 young adults and children (group 1) who contracted pandemic influenza and from 74 pediatric clinic employees (group 2) inoculated with pandemic monovalent vaccine. In group 1 patients, 6 and 30 patients had lower HI and NT antibody in the acute phase respectively. Thereafter, HI and NT antibody titers increased fourfold or more in 50 patients with peak response in the third specimens obtained four weeks after the onset. IgG1 in 45 patients, IgG3 in 18 patients, and IgG4 in 29 patients showed elevated responses. Forty (54%) and 70 (95%) subjects in group 2 had positive HI and NT antibodies in the prevaccination samples, with increased antibody responses in the follow-up peaking in the second specimens. Forty of those vaccinated had increased IgG1 responses peaking in the third specimens, whereas elevated IgG3 was observed in 22 recipients with the highest level in the second samples. IgG4 did not show any increase in subjects in group 2. A few participants showed an IgG2 response in both groups. An immunologically naive population contracted influenza with apparent clinical symptoms. However, already primed subjects through subclinical infection elicited the unique pattern of IgG subclass responses by vaccination, which differed from those of naive populations.
    Article · Sep 2014 · Viral Immunology
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    Miki Enomoto · Teruo Okafuji · Takao Okafuji · [...] · Tsuguto Fujimoto
    File available · Data · Jul 2013
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    Data: 65 457
    Miki Enomoto · Teruo Okafuji · Takao Okafuji · [...] · Tsuguto Fujimoto
    File available · Data · Jul 2013
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    Miki Enomoto · Teruo Okafuji · Takao Okafuji · [...] · Tsuguto Fujimoto
    [Show abstract] [Hide abstract] ABSTRACT: Since 2011, HAdV-56 has been included in reports to the National Epidemiological Surveillance of Infectious Disease (NESID) system in Japan. A total of 30 isolates were reported until April 2012, and 27 (90z) of these isolates came from the eye swabs of EKC patients. Following our isolation of HAdV-56 from PCF, another PCF case (detection from pharyngeal swab) and a ``fever of unknown origin'' (detection from feces) case associated with HAdV56 were reported (detailed data were not available). The tissue tropism of HAdV-56 has not yet been sufficiently resolved. This case underscores the necessity for continuous surveillance in order to understand the epidemiological nature of HAdV-56.
    Full-text available · Article · Sep 2012 · Japanese journal of infectious diseases
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    [Show abstract] [Hide abstract] ABSTRACT: Hand, foot, and mouth disease (HFMD) caused by enterovirus is one of the common pediatric diseases. A lot of HFMD cases were reported under the epidemiological surveillance of infectious diseases of Hyogo prefecture in 2010. The cases younger than five years occupied 72.7% of the whole HFMD reported from 2008 to 2010. Thirty strains of enterovirus 71 (EV71) were detected from 1,097 patients under the infectious agents surveillance for those three years and all of the EV71 strains were detected in 2010. Fourteen of them were detected from the HFMD patients including five patients with complications of central nervous system such as aseptic meningitis and encephalitis. According to the phylogenetic analysis of the VP4 region of the EV71 genome, the strains detected in Hyogo were similar to the C2 strain isolated in Netherlands in 2007, except for one strain which was similar to the C2-like strain isolated in Taiwan in 2008.
    Full-text available · Article · Jun 2011
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    [Show abstract] [Hide abstract] ABSTRACT: Clinically apparent mumps reinfection is considered extremely rare, but several cases have been suspected of reinfection in an out-patient clinic. In this study, virological examination, virus isolation, the reverse transcription loop-mediated isothermal amplification (RT-LAMP), and IgG and IgM EIA antibodies, were examined in order to identify mumps reinfection. Patients were divided into three categories; the reinfection group comprised 29 patients with a history of natural infection, the vaccine-failure group consisted of 37 patients with an immunization history, and two patients had histories of both immunization and mumps infection. Another 25 patients were enrolled as a primary infection group. Mumps virus was isolated in 5 (17%) and the genome was detected in 12 (41%) of 29 in the reinfection group. Reinfection was confirmed in 21/28, demonstrating high avidity of IgG EIA. Mumps virus was isolated in 15 (41%) and there was a higher positivity of genome amplification in 25 (68%) of 37 patients in the vaccine-failure group. Among these, 23 were confirmed as secondary vaccine failure by high avidity IgG EIA serology. In the primary infection group, the isolation rate and genome detection rate was higher in 16 (64%) and in 18 (72%) of 25 patients, respectively. There was no significant difference in virus load among the three groups but high mumps virus load was suspected in the IgM EIA-positive group based on the shorter amplification time on RT-LAMP. Mumps virus reinfection was confirmed by RT-LAMP and an IgG avidity test and was not a rare event.
    Full-text available · Article · Mar 2008 · Journal of Medical Virology
  • Takao Nagai · Teruo Okafuji · Chiaki Miyazaki · [...] · Tetsuo Nakayama
    [Show abstract] [Hide abstract] ABSTRACT: To compare the incidence of aseptic meningitis associated with symptomatic natural mumps infection and in mumps vaccine recipients, we conducted a prospective comparative study. Consecutive samples of 1051 children with mumps were enrolled by 10 pediatricians and 21,465 vaccine recipients by 143 pediatric primary care practitioners, from January 1, 2000 to January 1, 2003. Parents used a daily diary to record symptoms during the period of illness (15 days) or 30-day period following immunization. Mumps infection was confirmed by virus isolation and/or detection of mumps virus genome in salivary and CSF samples. The incidence of aseptic meningitis was 13/1051 (1.24%) in patients with symptomatic natural mumps infection and was estimated to be 0.7-1.1% of overall infection in considering asymptomatic infection, and 10/21,465 (0.05%) in vaccine recipients. Although aseptic meningitis is a clear side effect of the mumps vaccine, the incidence is considerably lower than among those with symptomatic natural infection. Our results provide an informative data for consideration to resume mumps vaccine as a part of routine immunization schedule for Japanese children.
    Article · Apr 2007 · Vaccine
  • [Show abstract] [Hide abstract] ABSTRACT: On account of the measles vaccination campaign, with vaccinations carried out on the first birthdays of children, the number of reported cases of measles was reduced to 545 in 2005, which is the lowest so far in Japan. We conducted a molecular epidemiological study of measles virus to determine the circulating measles virus genotypes in Japan since 1984. Different genotypes, C1, D3, D5, and H1, were the major strains isolated in outbreaks in 1984, 1987-1988, 1991-1993, and 2000, respectively. When measles was in the control phase, a sporadic outbreak was reported, but the causative virus was found to be of imported measles virus lineage. We also conducted a seroepidemiological study to investigate the persistence of vaccine-acquired immunity in Himeji City, Japan. Before 1990, vaccine coverage was 84.5% and it increased gradually, to 88.5% in 1991-1995, 92.7% in 1996-2000, and 94.6% after 2000. Measles outbreaks were observed annually before 1978 and in 1980, 1981, 1984, 1990, and 1996; there were no measles cases after 1997 in Himeji City. In 1994-1998, a serological study of 795 sera showed that measles neutralization test (NT) antibodies were sufficiently preserved, even 12 years after the first-dose immunization. In 1999-2003, 26 (3.7%) of 695 sera were negative for NT. The positive rate for measles NT decreased to approximately 90% as the elapsed time after the first-dose immunization increased to 6 or 7 years. The immunity obtained after receiving measles vaccine decays by 6-7 years after the first dose when the measles was controlled. A two-dose schedule of measles vaccine was implemented in Japan in 2006; we should continue molecular and serological surveillance.
    Article · Jan 2007 · Journal of Infection and Chemotherapy
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    [Show abstract] [Hide abstract] ABSTRACT: The aim of this study was to evaluate the applicability of diagnostic methods for dual-infected cases of human adenoviruses (AdVs) and coxsackieviruses type B (CBs). For this purpose, 100 nasopharyngeal samples from patients with acute exudative tonsillitis and clinically suspected AdV infection were analyzed. Using PCR and real-time PCR techniques for AdVs and CBs, we found 86 AdVs-only positive samples; we also found five dual-infected samples containing 5.4 x 10(5) to 7.1 x 10(8) copies/mL of AdV genomes and 1.4x104 to 1.3 x 10(9) copies/mL of CB genomes. By viral culture using A549 cells, two co-infected samples, which contained over 10(8) copies/mL of AdV genomes and <10(5) copies/mL of CB genomes, became AdV dominant, while three samples with less than 2.0 x 10(6) copies/mL of AdV genomes became CB dominant. An immunochromatography kit for diagnosing AdVs at the bedside was positive for 3/5 dual-infected patients, and PCR techniques for AdVs and CBs were both positive for 5/5. Viral culture is usually considered to be the gold standard for AdV diagnosis, but our results demonstrate the importance of PCR applications for the detection of AdV and CB genomes, particularly in clinical cases of suspected AdV infection. Even though the sample size of dual infection (n=5) is small, our results show the existence of dual infection cases which were difficult to diagnose by viral culture alone.
    Full-text available · Article · Jan 2007 · Clinical laboratory
  • [Show abstract] [Hide abstract] ABSTRACT: During the 2000/2001 influenza season in Japan, children ranging in age from 6 months to 13 years with fever exceeding 37.5 degrees C were recruited. Vaccine efficacy was evaluated by comparing the rates of pre-seasonal vaccination between groups stratified by fever severity. Seven hundred and sixty one patients (33.1%), culture positive for influenza were enrolled for analysis. The numbers of patients for A/H1N1 and A/H3N2 were insufficient for statistical analysis. For influenza B the odds ratio for vaccinated children to have a maximum fever exceeding 39.5 degrees C was 0.52 (95% CI, 0.30-0.92) Our findings suggest modest impact of influenza vaccination on limiting severity of disease symptoms.
    Article · May 2006 · Vaccine
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    Tsuguto Fujimoto · Teruo Okafuji · Takao Okafuji · [...] · Osamu Nishio
    [Show abstract] [Hide abstract] ABSTRACT: An immunochromatography (IC) kit for human adenovirus (HAdV) was evaluated with 138 patient nasopharyngeal samples. The samples were collected at a sentinel clinic in Japan from January through June 2003. Patients were diagnosed by clinical manifestation of pharyngoconjunctival fever (n = 38) or exudative tonsillitis (n = 100). The IC kit was positive for 84% (116 of 138) of patients diagnosed at bedside. The remaining extract solution of the IC kit test was transferred into maintenance medium and tested via laboratory diagnoses. The IC kit had 95% sensitivity (116 of 122 patients) with HAdV isolation (isolation) as the standard and 91% sensitivity (116 of 128 patients) with PCR as the standard. All of the IC kit-positive samples were isolation and PCR positive. Similarly, all the isolation-positive samples were PCR positive. Twenty-two IC kit-negative samples were evaluated by real-time PCR. Six samples were IC kit negative and isolation positive and contained 3.8 × 107 to 2.5 × 109 copies of the HAdV genome/ml. Five samples that were only PCR positive contained 3.0 × 104 to 3.8 × 105 copies of the HAdV genome/ml, but one sample was real-time PCR negative. We conclude that the IC kit is a useful bedside diagnostic tool for HAdV infections because it has 95% sensitivity (compared to isolation), but a negative result does not always rule out HAdV infection.
    Full-text available · Article · Jan 2005 · Journal of Clinical Microbiology
  • [Show abstract] [Hide abstract] ABSTRACT: We isolated 872 strains of mumps virus from naso-pharyngeal secretions in seven different districts of Japan from January 2000 to July 2001. Among them, 57 strains were geno-typed by nucleotide sequencing in part of the hemagglutinin-neuraminidase (HN) and small hydrophobic (SH) protein regions. Four different genotypes (B, G, K, and L) of mumps virus were co-circulating in Japan and the distribution of genotypes varied in geographically different districts. Two new clusters designated as genotypes K and L had more than 7% nucleotide variation in the SH gene. Among the 57 strains, 11 were classified as B, 35 as G, three as K, and eight as L, which was mainly isolated in Tokyo. We also examined 104 stains isolated in a clinic in Mie prefecture from 1993 to 2003. Genotype B was the indigenous strain and genotype K was introduced in 1994. Genotypes B and K co-circulated in the 1990s and were replaced by genotype G in 2000. There was no significant change in neutralizing test antibody titers against genotypes B, G, K, and L using seven post-vaccination sera with Hoshino strain (genotype B) and these four genotypes had a different antigenicity from genotype A. We should continue to watch on mumps virus molecular epidemiology.
    Article · May 2004 · Journal of Medical Virology
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    [Show abstract] [Hide abstract] ABSTRACT: We developed a new diagnostic method of subgenus (Sub) B adenovirus (Ad) in clinical samples using non-nested polymerase chain reaction (PCR). Sequences of the conserved hexon-coding region of representative strains of eight serotypes (3, 7, 11, 14, 16, 21, 34 and 35) of Sub B Ad were heterogeneous. In order to distinguish Ad serotype 3 (Ad 3) and Ad 7 from the other serotypes of Sub B Ad, and to differentiate Ad 3 and 7 from each other, 3 different downstream primers were designed based on the sequence heterogeneity. By a single-tube PCR method using a combination of 6 primers including the 3 new primers, Ads demonstrated to amplify 188, 206, 284, and 301 bp DNA fragments for Ad 3, Ad 7, other Sub B Ads, and non-Sub B Ads, respectively. A total of 114 clinical samples were selected to evaluate the direct applicability of our PCR. The results were compared with previous culture results. Sixty-seven out of 71 (94%) Sub B Ad culture-positive samples, and 15 out of 19 (79%) Sub C or E-positive samples amplified products of the expected size. Two of 20 (10%) culture-negative samples from pharyngoconjunctival fever patients were identified as Ad 3 by the PCR. Four samples, from which non-Ad viruses were isolated, were negative by the PCR. The present study might provide a rapid and sensitive diagnosis method for infections caused by Sub B Ads.
    Full-text available · Article · Feb 2000 · Microbiology and Immunology
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    Full-text available · Article · Nov 1998