[Effect of a provisional vaccination plan for students who did not previously receive a rubella vaccine in Japan--a fact of low vaccination rate].
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Adolescent↗
Biomedical subjects
Kihei Terada
Publications and source records attributed to Kihei Terada.
Rubella and congenital rubella syndrome in Japan: epidemiological problems.
Rubella virus infection can lead to problems with congenital rubella syndrome (CRS) in the next generation due to fetal infection, but these problems are preventable with vaccination. In other words, rubella epidemics and the occurrence of CRS can be eliminated by vaccination. In Japan, until recently, rubella epidemics occurred every 5 years, and there were at least 1,600 CRS cases between 1965 and 1985. Following the 1994 revision of the Preventive Vaccination Law, national surveillance from approximately 3,000 clinics has shown that the number of rubella cases has dramatically decreased to a few thousand and the occurrence of CRS has decreased to only a few cases. However, the vaccination rate during a transitional period from 1995 to 2003 has been unsatisfactory. This has been especially true for junior high school students, because individual vaccination has replaced mass immunization in urban areas. As a result, the negative antibody rate in females below 18 years of age has increased to approximately 27%. If this trend continues, there is likely to be an increase in rubella epidemics and occurrence of CRS in the near future. Vaccination is not compulsory under Japanese law, and vaccination campaigns alone have proved unsuccessful in promoting vaccination. Another system of motivating individuals to seek vaccination will be needed in order to maintain a high vaccination rate without such campaigns.
Antibodies, Viral↗
Responses of varicella zoster virus (VZV)-specific immunity in seropositive adults after inhalation of inactivated or live attenuated varicella vaccine.
To examine boostering of varicella zoster virus (VZV)-specific immunity in seropositive adults after nasal inhalation of heat-inactivated or live attenuated varicella vaccine, we determined specific cellular immunity, IgG antibody in sera and secretory IgA antibody in saliva before and after the inhalation. The mean titers in specific IgG antibody and skin test findings significantly increased following inhalation of both vaccines. However, the ratio of a two-fold or more increase in the levels of IgG antibody or skin test did not show significant difference after inhalation of the inactivated vaccine in comparison with those in the control. After inhalation of the live vaccine, the ratio showed significant difference but transmission of the live vaccine virus to others was suspected. No significant increase in VZV-secretory IgA antibody levels in saliva was noted following inhalation. The results of this study suggested that nasal inhalation of the live vaccine could increase specific immunity in adults. This method would be similar to the natural infection and simpler than subcutaneous injection.
Administration, Inhalation↗
Intrafamilial transmission of Salmonella oranienburg.
BACKGROUND: There were diffuse outbreaks of Salmonella oranienburg in Japan since March 1999 which included 1505 patients. The outbreak was caused through ingestion of a dried squid snack contaminated with S. oranienburg. Such a large number of cases has not been previously recorded in Japan or other countries. METHODS: A 9-month-old boy was admitted to our hospital with enteritis and bacteremia due to S. oranienburg. His older brother had eaten the contaminated snack. We detected S. oranienburg in the stools of five out of his six family members. RESULTS: With the exception of the index case's brother, no other family members had eaten the contaminated snack. The S. oranienburg strain detected in the family was confirmed to be the same strain by pulse field gel electrophoresis. Therefore, we presumed there had been a series of household transmissions. CONCLUSION: Our observation of intrafamilial transmission suggests that S. oranienburg may be highly infectious.
Animals↗
[Alterations in epidemics and vaccination for measles during a 20 year period and a strategy for elimination in Kurashiki City, Japan].
In Japan, an epidemic of measles occurs every few years. An estimated 100-200,000 people contract the disease each year and 50-100 patients die. Following the eradication of poliomyelitis, the World Health Organization made plans for global eradication of measles, and the Japanese Association of Pediatricians began advocating vaccination to eliminate measles in Japan by 2005. However, no big response has occurred nationwide. Therefore, we retrospectively look at changes in epidemics and measles vaccination during the past 20 years in Kurashiki City, Okayama Prefecture and developed a strategy for elimination through the results. The Japanese surveillance showed the numbers of measles patient in Okayama to be a few times higher than the mean number nationwide. The number of persons vaccinated was approximately 2,000-3,000 per year, while the number of births was about 6,000 per year. After passing a revised vaccination law in 1994, the number of vaccinations increased to more than 4,000, and the epidemic situation decreased to the nationwide level. However, the number of measles patients older than 15 years of age who were admitted to our hospital increased from 4% to 24% in the ratio to the whole. In the United States, school regulations require that children be vaccinated for MMR twice before admission to school, but the revised vaccination law in Japan was changed from a requirement to a recommendation. To eliminate measles, we should increase the vaccination rate for infants, and should vaccinate adolescents who have not been vaccinated or do not have a past history of measles. It is important to choose the subjects and then confirm their vaccination after the recommendation. We have developed a strategy that includes 1) advocacy for vaccination 2) selection for vaccination, 3) request for certification of vaccination, 4) convenience for vaccination. The goal after two years is for 1) a vaccination rate of more than 90% by end of one year of age, 2) a rate of vaccination and past history of measles in more than 90% of children before admission to kindergarten or public school.
Adolescent↗
[Practicability and reliability of a new rapid detection kit for rubella antibody].
We have investigated the practicability and reliability of a new rapid detection kit for rubella antibody by means of an immunochromatographic assay. This kit can measure 100 microliters of total blood or 50 microliters of serum or plasma in approximately 10 minutes. When a band appears in this kit, a sample is positive. The subjects of this investigation were 233 medical students or nursing students. Blood was also drawn from their fingertips of 71 of them. The blood was obtained with a lancet for measuring blood sugar. By an ELISA assay using IgG antibody for rubella, 188 samples (80.7%) were found to be positive, 1 sample (0.4%) was +/-, and 44 samples (18.9%) were negative. The positive IgG antibody titers deviated toward the lower levels since the median was lower than the mean. Therefore, the subjects were appropritate for evaluation of low titer samples. In comparison with the measurement of IgG antibody using the ELISA assay, the sensitivity and specificity levels of this new kit were 99.5% and 100%, respectively. The correlation index between the antibody titers and color concentration of the band was as weak as 0.5 (0.35-0.58 at 95% confident range). Seroconversion of the antibody in paired samples is necessary for diagnosis of rubella in this kit. However, if there is an uncertain past history of vaccination and/or rubella, this kit is useful for evaluating the need for vaccination in 10 minutes. It usually takes approximately one week to receive antibody results through a commercial laboratory.
Antibodies, Viral↗
[Vaccine development].
We reviewed vaccine development in the past, at present and possible future, and described new vaccines, which will be introduced in Japan in the near future. The introduction of gene technology has promoted advances in vaccines. A subunit vaccine of hepatitis B, a recombinant vaccine for rotavirus and an enhanced inactivated polio vaccine have been developed. DNA vaccines and mucosal vaccines with adjuvants have been studied recently. They are promising, but safety, cost and benefits should be taken into consideration for vaccine development. In Japan, we cannot use MMR vaccines, but MR or imported MMR vaccines have been tested and are awaiting approval. Hemophilus influenzae type b vaccine and inactivated polio vaccine are also awaiting approval in Japan.
Allergy and Immunology↗