Impact of COVID-19 vaccination status on hospitalization and disease severity: A descriptive study in Nagasaki Prefecture, Japan.

Coronavirus disease 2019 (COVID-19) was extraordinarily harmful, with high rates of infection and hospitalization. This study aimed to evaluate the impact of COVID-19 vaccination status and other factors on hospitalization and disease severity, using data from Nagasaki Prefecture, Japan. Confirmed cases of COVID-19 infection with vaccination status were included and the differences in characteristics between different vaccination statuses, hospitalization or not, and patients with varying levels of disease severity were analyzed. Furthermore, logistic regression was used to calculate odds ratio (ORs) and 95% confidence intervals (CI) to evaluate the association of various factors with hospitalization and disease severity. From March 14, 2020 to August 31, 2022, 23,139 patients were unvaccinated 13,668 vaccinated the primary program with one or two doses, and 4,575 completed the booster. Vaccination reduced the risk of hospitalization with an odd ratio of 0.759 (95% CI: 0.654-0.881) and the protective effect of completed booster vaccination was more pronounced (OR: 0.261, 95% CI: 0.207-0.328). Similarly, vaccination significantly reduced the risk of disease severity (vaccinated primary program: OR: 0.191, 95% CI: 0.160-0.228; completed booster vaccination: OR: 0.129, 95% CI: 0.099-0.169). Overall, unvaccinated, male, elderly, immunocompromised, obese, and patients with other severe illness factors were all risk factors for COVID-19-related hospitalization and disease severity. Vaccination was associated with a decreased risk of hospitalization and disease severity, and highlighted the benefits of completing booster.

Behavioural responses and anxiety symptoms during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A large scale cross-sectional study.

BACKGROUND: This study explored the behavioural responses and anxiety symptoms of the general adult population in Japan during the ongoing coronavirus disease 2019 (COVID-19) outbreak. METHODS: A web-based cross-sectional survey was conducted between 12th and May 13, 2020. Quota sampling was used to attain equal gender and age distributions representative of the Japanese population. RESULTS: A total of 4127 complete responses were analysed. Higher educational level (B = 0.045, p = 0.002) and household income (B = 0.04, p = 0.009) were associated with a higher increase in preventive measures when comparing before and after the state of emergency was declared. The highest reported social anxiety was a feeling of fear (65.6%), followed by embarrassment (43.8%), keeping infection a secret (41.3%), avoidance (41.3%), and stigma (25.5%). A total of 86.1% of the respondents reported moderate to severe anxiety. The partial least square-based structural equation modelling (PLS-SEM) revealed that being female has the greatest effect (B = 0.246, p < 0.0001) on higher current preventive measures, followed by social anxiety (B = 0.119; p = 0.001) and State-Trait Anxiety Inventory scores (B = 0.153; p < 0.001). Perceived susceptibility (B = 0.033, p = 0.020), knowing someone who have been diagnosed with COVID-19 (B = 0.097, p < 0.001), higher income (B = 0.079, p < 0.001) and educational level (B = 0.045; p = 0.004) all had a small but significant effect on influencing levels of preventive measures. CONCLUSIONS: A moderate level of preventive practices found in this study indicates the need to encourage behavioural change to limit the spread of the coronavirus. The provision of mental health services is warranted as anxiety symptoms are prevalent.

[Tetrodotoxin (TTX) Monitoring of Biological Specimens and Toxin Profile in a Food Poisoning Case Caused by the Scavenging Gastropod Nassarius (Alectrion) glans "Kinshibai"].

In November 2015, a patient presented with symptoms of toxicity after eating whole boiled samples of the scavenging gastropod Nassarius (Alectrion) glans "Kinshibai" in Nagasaki. This food poisoning case was the third recorded in Japan. The case was investigated by evaluation of the toxin profile of the gastropod, and monitoring of tetrodotoxin (TTX) levels in serum and urine sampled from the affected individual. One gastropod contained a harmful dose of TTX (2.5 mg/ individual in food residue sample 2). In biological samples, maximum TTX concentrations were 42.8 ng/mL in serum on the day after onset of symptoms. TTX urinary excretion was calculated to be 2.4 mg. From the measured TTX concentrations, it was estimated that a lethal dose had been ingested in this case. Moreover, it was found by LC-QqQ-MS/MS analysis and mouse bioassay that the toxicity of "Kinshibai" was not solely due to TTX. The remaining toxicity was thought to be due to 11-oxoTTX. As in previous poisoning cases, it was concluded that ingestion of this gastropod poses a high risk of food poisoning.

A rapid detection method using flow cytometry to monitor the risk of Legionella in bath water.

Legionella species are the causative agents of human legionellosis, and bathing facilities have been identified as the sources of infection in several outbreaks in Japan. Researchers in Japan have recently reported evidence of significant associations between bacterial counts and the occurrence of Legionella in bathing facilities and in a hot tub model. A convenient and quantitative bacterial enumeration method is therefore required as an indicator of Legionella contamination or disinfection to replace existing methods such as time-consuming Legionella culture and expensive Legionella-DNA amplification. In this study, we developed a rapid detection method (RDM) to monitor the risk of Legionella using an automated microbial analyzing device based on flow cytometry techniques to measure the total number of bacteria in water samples within two minutes, by detecting typical patterns of scattered light and fluorescence. We first compared the results of our RDM with plate counting results for five filtered hot spring water samples spiked with three species of bacteria, including Legionella. Inactivation of these samples by chlorine was also assessed by the RDM, a live/dead bacterial fluorescence assay and plate counting. Using the RDM, the lower limit of quantitative bacterial counts in the spiked samples was determined as 3.0×10(3)(3.48log)counts mL(-1). We then used a laboratory model of a hot tub and found that the RDM could monitor the growth curve of naturally occurring heterotrophic bacteria with 1 and 2 days' delayed growth of amoeba and Legionella, respectively, and could also determine the killing curve of these bacteria by chlorination. Finally, samples with ≥3.48 or <3.48log total bacterial counts mL(-1) were tested using the RDM from 149 different hot tubs, and were found to be significantly associated with the positive or negative detection of Legionella with 95% sensitivity and 84% specificity. These findings indicated that the RDM can be used for Legionella control at bathing facilities, especially those where the effectiveness of chlorine is reduced by the presence of Fe(2+), Mn(2+), NH(4)(+), skin debris, and/or biofilms in the water.

Comparison of ethidium monoazide and propidium monoazide for the selective detection of viable Legionella cells.

Ethidium monoazide (EMA) and propidium monoazide (PMA) have been utilized for selective PCR amplification of DNA from viable bacterial cells. In this study, we compared the abilities of EMA and PMA, together with real-time PCR, to specifically distinguish dead Legionella cells from viable cells. Several experiments showed that PMA or EMA treatment could specifically prevent the PCR amplification of DNA from dead Legionella cells in water samples. However, a 4-fold higher concentration of PMA than EMA was required to achieve this effect. EMA may therefore be more useful for practical environmental investigations of Legionella.

Isolation and characterization of Leptospira spp. from raccoons in Japan.

We investigated whether raccoons (Procyon lotor) carried leptospires in their kidneys in Japan. Leptospira was isolated from 2 of 71 raccoons captured in Kanagawa Prefecture and 1 of 53 raccoons at a zoological park in Nagasaki Prefecture. Anti-Leptospira antibodies were detected in 16 of 124 raccoons (12.9%) in Kanagawa and 33 of 53 raccoons (62.3%) in Nagasaki, respectively. The partial nucleotide sequences of their flaB genes suggested that the isolates belonged to L. interrogans. The serovars of the isolates were identified as Copenhageni/Icterohaemorrhagiae (1 strain in Kanagawa) and Hebdomadis (1 strain both in Kanagawa and Nagasaki) by reactivity with the reference antisera and restriction fragment length polymorphism (RFLP) analysis based on pulsed-field gel electrophoresis and cross-agglutination-absorption test, respectively. RFLP analysis on the serovars Hebdomadis strains revealed genetic diversity among serovar Hebdomadis. Although it is unclear if the raccoons carried leptospires in their kidneys at the time imported, there is no doubt that imported animals are a new reservoir animal of leptospires in Japan.

[Legionella contamination risk factors in non-circulating hot spring water].

We examined water from 182 non-circulating hot spring bathing facilities in Japan for possible Legionella occurrence from June 2005 to December 2006, finding Legionella-positive cultures in 119 (29.5%) of 403 samples. Legionellae occurrence was most prevalent in bathtub water (39.4%), followed by storage tank water (23.8%), water from faucets at the bathtub edge (22.3%), and source-spring water (8.3%), indicating no statistically significant difference, in the number of legionellae, having an overall mean of 66 CFU/100mL. The maximum number of legionellae in water increased as water was sampled downstream:180 CFU/100 mL from source spring, 670 from storage tanks, 4,000 from inlet faucets, and 6,800 from bathtubs. The majority--85.7%--of isolated species were identified as L. pneumophila : L. pneumophila serogroup (SG) 1 in 22%, SG 5 in 21%, and SG 6 in 22% of positive samples. Multivariate logistic regression models used to determine the characteristics of facilities and sanitary management associated with Legionella contamination indicated that legionellae was prevalent in bathtub water under conditions where it was isolated from inlet faucet/pouring gate water (odds ratio [OR] = 6.98, 95% confidence interval [CI] = 2.14 to 22.8). Risk of occurrence was also high when the bathtub volume exceeded 5 m3 (OR = 2.74, 95% CI = 1.28 to 5.89). Legionellae occurrence was significantly reduced when the bathing water pH was lower than 6.0 (OR = 0.12, 95% CI = 0.02 to 0.63). Similarly, occurrence was rare in inlet faucet water or the upper part of the plumbing system for which pH was lower than 6.0 (OR = 0.06, 95% CI = 0.01 to 0.48), and when the water temperature was maintained at 55 degrees C or more (OR = 0.10, 95% CI = 0.01 to 0.77). We also examined the occurrence of amoeba, Mycobacterium spp., Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus in water samples.

Specific detection of viable Legionella cells by combined use of photoactivated ethidium monoazide and PCR/real-time PCR.

Legionella organisms are prevalent in manmade water systems and cause legionellosis in humans. A rapid detection method for viable Legionella cells combining ethidium monoazide (EMA) and PCR/real-time PCR was assessed. EMA could specifically intercalate and cleave the genomic DNA of heat- and chlorine-treated dead Legionella cells. The EMA-PCR assay clearly showed an amplified fragment specific for Legionella DNA from viable cells, but it could not do so for DNA from dead cells. The number of EMA-treated dead Legionella cells estimated by real-time PCR exhibited a 10(4)- to 10(5)-fold decrease compared to the number of dead Legionella cells without EMA treatment. Conversely, no significant difference in the numbers of EMA-treated and untreated viable Legionella cells was detected by the real-time PCR assay. The combined assay was also confirmed to be useful for specific detection of culturable Legionella cells from water samples obtained from spas. Therefore, the combined use of EMA and PCR/real-time PCR detects viable Legionella cells rapidly and specifically and may be useful in environmental surveillance for Legionella.

Antibacterial spectrum of plant polyphenols and extracts depending upon hydroxyphenyl structure.

The relationship between the structure and antibacterial activity of 22 polyphenols was analyzed by using minimum inhibitory concentration (MIC) as a criterion against 26 species of bacteria which can grow in Mueller-Hinton medium. There was no clear correlation between Gram-staining and bacterial susceptibility to polyphenols, and the extent of the susceptibility was approximately dependent on the species of bacteria. In the same Gram-negative bacteria, the antibacterial activity of the polyphenols against Aeromonas hydrophila, Vibrio parahaemolyticus and Vibrio vulnificus was comparatively strong. On the other hand, the activity against 11 species of the Enterobacteriaceae was comparatively weak, and the activity against six species of aerobic bacteria causing plant disease was moderate. Polyphenols having pyrogallol groups showed strong antibacterial activity, and those with catechol and resorcinol rings showed lower activity. The structure-activity relationship was extended to 26 polyphenol-rich plant extracts which could have potent antibacterial activity suitable for commercial use.

Antimicrobial activity of 10 different plant polyphenols against bacteria causing food-borne disease.

The antibacterial activities of 10 different plant polyphenols were evaluated by comparing their minimum inhibitory concentrations (MICs) against several food-borne pathogenic bacteria, Staphylococcus aureus (20 strains), some serotypes of the genus Salmonella (26 strains), Escherichia coli (23 strains), and some species of the genus Vibrio (27 strains). The polyphenols examined were epigallocatechin (1), epigallocatechin-3-O-gallate (2), punicalagin (3), tannic acid (4), castalagin (5), prodelphinidin (6), geraniin (7), procyanidins (8), a theaflavin mixture of black tea (9), and green tea polyphenols treated with loquat polyphenol oxidase (10). The average MICs of all polyphenols against S. aureus and the genus Vibrio (192+/-91 and 162+/-165 microg/ml, respectively) were much lower than the values against the genus Salmonella and E. coli (795+/-590 and 1519+/-949 microg/ml, respectively) (p<0.01). The coefficient of variation of the MICs of all polyphenols against S. aureus was the least and that against the genus Vibrio was the greatest. The mean MICs of each plant polyphenol against S. aureus (98-389 microg/ml) and the genus Vibrio (68-488 microg/ml) were similar. The relatively lower mean MIC values of 1, 2, 5, and 6 suggest the importance of 3,4,5-trihydroxyphenyl groups in antibacterial activity.