Transition of Akabane virus genogroups and its association with changes in the nature of disease in Japan.

Akabane virus (AKAV) is teratogenic to the foetus of domestic ruminants and causes a significant reproduction loss in cattle in Japan. In several past epizootics in cattle, AKAV was also associated with post-natal encephalomyelitis, mainly in calves and young stock. Previously analysed AKAV isolates in East Asia form two major clusters, genogroups I and II, with isolates involved in encephalomyelitis belonging mainly to the former. Between 2007 and 2013, AKAV epizootics were regularly observed in Japan during the summer/autumn season, and abnormal deliveries and post-natal encephalomyelitis caused by the virus in cattle were reported. During this period, 30 AKAV isolates were obtained from diseased and sentinel cattle, a piglet and Culicoides biting midges throughout Japan and were subjected to genetic comparison and phylogenetic analysis with previous isolates. In 2007, 2011 and 2013, AKAV belonging to genogroup I was identified in the central nervous systems of calves showing neurological disorders. Notably, a total of 165 cases of bovine encephalomyelitis were reported in 2011 and the isolated viruses from affected animals shared high genetic identities with a South Korean isolate that was associated with a large outbreak in 2010, suggesting some epidemiological linkage between these epizootics. Epizootics of genogroup II were observed in 2008 and 2010, but bovine post-natal encephalomyelitis cases rarely occurred. Our findings suggest that the frequent incursion of genogroup I isolates has increased the frequency of post-natal encephalomyelitis cases in Japan in recent years. Infection by genogroup I virus was also identified in piglets with neurological disorders or congenital malformations in 2011 and 2013. The aetiological role of AKAV in pigs should be elucidated in the future.

An economic assessment of foot and mouth disease in Japan.

A large-scale foot and mouth disease (FMD) epidemic in Japan in 2010 caused severe economic losses for livestock and related industries. In this paper, the authors develop a clear and usable framework to estimate the economic impact of this FMD outbreak. An economic analysis is then conducted by combining this framework with an epidemiological model. The framework estimates the direct and indirect costs to livestock and related industries by applying an input-output model, as well as by addressing expenditure on disease control. The direct cost to the livestock industry was estimated at 51.2 billion Japanese yen (JPY), engendering an indirect cost to related industries of JPY 25.5 billion. The expenditure for disease control activities was estimated at JPY 8.2 billion. The total impact of the 2010 FMD epidemic was estimated at almost JPY 85 billion. Within the economic analysis, the authors evaluate several control measure scenarios: a baseline scenario, which assumes that the rapid disease spread observed in the early phase of the 2010 FMD epidemic would continue; prompt culling within 24 hours; early detection of the first case; and emergency vaccination within a radius of 10 km around the affected farms in either seven or 28 days. Prompt culling and early detection were superior from an economic point of view, reducing the total economic impact to 30% and 2% of that in the baseline scenario, respectively. Compared with these scenarios, vaccination was less cost effective. However, vaccination suppressed the speed of disease spread and shortened the duration of the epidemic, suggesting its potential effectiveness in curbing rapid disease spread in a densely populated area.

Une épizootie de fièvre aphteuse de grande envergure survenue au Japon en 2010 a entraîné de graves pertes économiques pour la filière de l'élevage et les secteurs connexes. Les auteurs proposent un cadre d'évaluation clair pour estimer l'impact économique de ce foyer de fièvre aphteuse. Ils effectuent ensuite une analyse économique dans laquelle ce cadre d'évaluation est relié à un modèle épidémiologique. Les coûts directs et indirects subis par la filière de l'élevage et par les secteurs connexes sont évalués dans ce cadre en appliquant un modèle entrées­sorties (input­output) et en prenant en compte les dépenses liées à la lutte contre la maladie. Le coût direct de la maladie pour la filière de l'élevage a été estimé à 51,2 milliards de yens japonais, auxquels s'ajoute le coût indirect pour les secteurs connexes estimé à 25,5 milliards de yens japonais. Les dépenses induites par la lutte contre la maladie s'élèvent à 8,2 milliards de yens japonais. L'impact total de l'épizootie de fièvre aphteuse de 2010 est estimé à près de 85 milliards de yens japonais. Dans leur analyse économique, les auteurs ont évalué plusieurs scénarios relatifs aux mesures de lutte appliquées : un scénario de base, qui suppose une propagation de la maladie au même rythme que durant la phase initiale de l'épidémie de 2010 ; l'abattage rapide des animaux en 24 heures ; la détection précoce du premier cas ; l'application de la vaccination d'urgence dans un périmètre de 10 km autour des exploitations affectées et dans un délai de sept ou de 28 jours. Par rapport au scénario de base, l'abattage rapide et la détection précoce sont les meilleurs scénarios du point de vue économique, réduisant l'impact économique total respectivement à 30 % et 2 % de celui du scénario de base. Comparativement à ces scénarios, la vaccination est la solution la moins efficiente économiquement. Néanmoins, la vaccination a freiné la propagation de la maladie et limité la durée de l'épidémie, ce qui laisse penser qu'elle permettrait d'infléchir la courbe de propagation de la maladie dans les zones à forte densité de bétail.

En 2010 se produjo en el Japón una epidemia de fiebre aftosa de grandes proporciones, que causó graves pérdidas económicas a la industria ganadera y demás sectores conexos. Los autores describen un método claro para estimar el impacto económico de dicho brote. Acto seguido, llevan a cabo un análisis económico combinando este método con un modelo epidemiológico. El método permite estimar los costos directos e indirectos que soportan la industria ganadera y demás sectores conexos aplicando un modelo de «insumoproducto ¼ (input­output) y teniendo también en cuenta los gastos ligados al control de la enfermedad. Según los cálculos, el costo directo para la industria ganadera fue de 51 200 millones de yenes japoneses y el costo indirecto para los sectores conexos fue de 25 500 millones de yenes. Se estimó que las actividades de lucha contra la enfermedad supusieron gastos por valor de 8 200 millones. En total, pues, según estas estimaciones, el impacto económico de la epidemia de fiebre aftosa de 2010 se cifra en casi 85 000 millones de yenes. Como parte del análisis económico, los autores evalúan varias hipótesis relativas a las medidas de control: una hipótesis básica, en la cual prosigue sin trabas la veloz propagación de la enfermedad observada en la primera fase de la epidemia de 2010; la rápida implantación, en un plazo de 24 horas, de medidas de sacrificio sanitario; la pronta detección del primer caso; y la vacunación de emergencia dentro de un radio de 10 km alrededor de las explotaciones afectadas, en un plazo de siete días o en un plazo de 28 días. Desde un punto de vista económico, el rápido sacrificio sanitario y la pronta detección ofrecían mejores resultados, pues reducían el impacto económico total hasta un 30% y un 2%, respectivamente, del registrado en la hipótesis básica. En comparación con esas dos hipótesis, la vacunación ofrecía menos eficacia en relación con el costo, aunque frenaba la rápida propagación de la enfermedad y abreviaba la epidemia, de donde se infiere que puede resultar eficaz para contener la rápida dispersión de la enfermedad en áreas densamente pobladas.

Injuries to staff engaged in foot-and-mouth disease eradication in Japan.

BACKGROUND: In April 2010, a large-scale outbreak of foot-and-mouth disease, a highly infectious disease affecting cloven-hoofed animals, was reported in Miyazaki prefecture in Japan. Many staff were dispatched to the epidemic area to undertake containment measures. Various injuries were reported among the dispatched staff. AIMS: To study the characteristics of injuries that occurred during containment measures and to identify the characteristics of those injured. METHODS: We analysed records of injuries that occurred among staff dispatched from national organizations and prefectures other than Miyazaki prefecture. Based on these records, a qualitative analysis was conducted for veterinarians and non-veterinarian support staff as each group played a different role during the outbreak. RESULTS: Forty-seven veterinarians and 183 support staff were injured. The injury risk was significantly higher for support staff (13%) than for veterinarians (5%; P < 0.001). The most frequently reported injury resulted from exposure to disinfectant and the next was abrasions caused by friction from protective clothing and rubber boots. Among veterinarians, needlestick accidents were also frequently reported. CONCLUSIONS: Applying a less hazardous disinfectant and improving protective equipment to prevent skin abrasion may be effective in reducing the risk of these injuries among staff conducting containment measures. Reducing injuries among staff in such circumstances will assist effective control measures.

Analysis of risk factors associated with bovine leukemia virus seropositivity within dairy and beef breeding farms in Japan: a nationwide survey.

This cross-sectional study evaluated risk factors associated with farm-level bovine leukemia virus (BLV) seropositivity in 563 dairy and 490 beef farms throughout Japan. Twenty randomly selected cattle on each farm were serologically tested, and farm epidemiologiocal information was obtained through face-to-face interviews. Due to the large number of zero-prevalence dairy and beef farms, data analysis was performed using a zero-inflated negative binomial model, which revealed that the common risk factors associated with higher within-farm seroprevalence were past detection of clinical leukemia and presence of blood-sucking insects. Loose housing on dairy farms and direct contact between calves and adult cattle on beef farms were also identified as risk factors. With regard to farm-level presence of BLV, the presence of purchased cattle was found to be a risk factor in both sectors. Sending heifers to a common ranch was identified as an additional risk factor for dairy farms.

Mathematical model of the 2010 foot-and-mouth disease epidemic in Japan and evaluation of control measures.

A large-scale foot-and-mouth disease (FMD) epidemic occurred in Japan in 2010. The epidemic arose in an area densely populated with cattle and pigs, continued for 3 months, and was contained by emergency vaccination. In this study, a mathematical simulation model of FMD transmission between farms was developed to generate the disease spread in the affected area. First, a farm-distance-based transmission kernel was estimated using the epidemic data. The estimated transmission kernel was then incorporated into the transmission model to evaluate the effectiveness of several control measures. The baseline model provided a good fit to the observed data during the period from imposition of movement restrictions until the implementation of vaccination. Our simulation results demonstrated that prompt culling on infected farms after detection could contribute to reducing the disease spread. The number of infected farms decreased to 30% of the baseline model by applying the 24-h prompt culling scenario. The early detection scenario resulted in a smaller-sized epidemic. However, the results of this scenario included a 35% chance of large-scale epidemic (more than 500 infected farms), even when the disease was detected 14 days earlier than in the baseline model. As additional options, preemptive culling could halt the epidemic more effectively. However, the preemptive culling scenario required substantial resources for culling operations. The 1-km preemptive scenario involved more than 50 farms remaining to be culled per day. Therefore, preemptive culling scenarios accompanied some difficulties in maintaining a sufficient capacity for culling in the affected area. A 10-km vaccination 7 days after the first detection of the disease demonstrated the potential to contain the epidemic to a small scale, while implementation of a 3-km vaccination on the same day could not effectively reduce epidemic size. In vaccination scenarios, the total number of farms that were either culled or vaccinated exceeded that of the baseline model. Vaccination scenarios therefore posed a problem of appropriate management of many vaccinated animals, whether these vaccinated animals would be culled or not. The present FMD transmission model developed using the 2010 FMD epidemic data in Japan provides useful information for consideration of suitable control strategies against FMD.

Risk factors for local spread of foot-and-mouth disease, 2010 epidemic in Japan.

To provide a basis for effective foot-and-mouth disease (FMD) prevention measures, factors associated with local spread were investigated in this study using data of the 2010 FMD epidemic in Japan. Thirty-eight local clusters within a 500-m radius from source farms were selected. In the clusters with pig source farms, more neighboring farms were infected in a short time compared with the clusters with cattle source farms. The influence of distance and wind upon local spread did not show a significant difference between infected and noninfected neighboring farms. Large-size pig farms posed a greater risk of inducing local spread; the odds ratio with reference to small-size cattle farms was 16.73. Middle-size and large-size cattle farms had a greater risk of infection; odds ratios with reference to small-size cattle farms were 15.65 and 25.52, respectively. The present results are useful for understanding features of local spread and prioritizing farms for control measures.

Prevalence and growth kinetics of Shiga toxin-producing Escherichia coli (STEC) in bovine offal products in Japan.

Recent epidemiological data suggest a link between the consumption of bovine offal products and Shiga toxin-producing Escherichia coli (STEC) infection in Japan. This study thus examined the prevalence of STEC in various types of these foods. PCR screened 229 bovine offal products for the presence of Shiga toxin (stx) gene. Thirty-eight (16·6%) samples were stx positive, of which eight were positive for rfbE(O157) and three were positive for wzy(O26). Four O157 and one O26 STEC isolates were finally obtained from small-intestine and omasum products. Notably, homogenates of bovine intestinal products significantly reduced the extent of growth of O157 in the enrichment process compared to homogenates of beef carcass. As co-incubation of O157 with background microbiota complex from bovine intestinal products in buffered peptone water, in the absence of meat samples, tended to reduce the extent of growth of O157, we reasoned that certain microbiota present in offal products played a role. In support of this, inoculation of generic E. coli from bovine intestinal products into the homogenates significantly reduced the extent of growth of O157 in the homogenates of bovine intestinal and loin-beef products, and this effect was markedly increased when these homogenates were heat-treated prior to inoculation. Together, this report provides first evidence of the prevalence of STEC in a variety of bovine offal products in Japan. The prevalence data herein may be useful for risk assessment of those products as a potential source of human STEC infection beyond the epidemiological background. The growth characteristic of STEC O157 in offal products also indicates the importance of being aware when to test these food products.

Simulation model for Campylobacter cross-contamination during poultry processing at slaughterhouses.

Broiler meat is regarded as the most common source of Campylobacter infection and risk management measures are required to reduce broiler meat contamination. Among the quantitative risk assessments for Campylobacter in broiler meat, evaluation of the poultry processing stage is particularly important for predicting the contamination level of broiler meat and the effects of control measures. In this study, we built a simulation model for cross-contamination during poultry processing focusing on Campylobacter contamination at the individual carcass level. Using this model, we examined changes in the prevalence of contaminated carcasses and the number of Campylobacter per carcass after processing. As a result, it was found that the prevalence and number of Campylobacter after processing were largely influenced by the number of Campylobacter on the contaminated carcasses before processing. In the baseline model, where it was assumed that the mean number of Campylobacter on contaminated carcasses before processing was 4.7 log10 cfu per carcass, the prevalence after processing was less than that before processing. Although the median value of Campylobacter on contaminated carcasses was reduced after processing, the distributions after processing became wider and the upper limit of the 95% credible interval of Campylobacter on contaminated carcasses remained elevated. The individual-based simulation model can trace individual level changes considering discrete interactions, while models tracing mean values cannot handle these interactions in detail. The individual-based approach is considered useful for modelling cross-contamination among individual carcasses during poultry processing.

Ectoparasites of the Pallas squirrel, Callosciurus erythraeus, introduced to Japan.

The squirrel Callosciurus erythraeus (Pallas) (Rodentia: Sciuridae) was intentionally introduced to Japan in 1935 and has become established throughout much of the country. Although they live mainly in forests, Pallas squirrels come into gardens and are frequently fed by people or kept as pets, so their ectoparasites could be of potential medical as well as veterinary importance. During 2001-2003 we conducted the first ectoparasite survey of Pallas squirrels in Japan. From 105 C. erythraeus captured in Kamakura District of Kanagawa Prefecture on Honshu Island, three types of ectoparasite were found: 52 specimens of the sucking louse Neohaematopinus callosciuri Johnson (Anoplura: Haematopinidae), 26 fleas Ceratophyllus (Monopsyllus) anisus Rothschild (Siphonaptera: Ceratophyllidae) and four nymphs of the tick Haemaphysalis flava Neumann (Acari: Ixodidae) on 22, 13 and one squirrels, respectively. Evidently in Japan C. erythraeus carries relatively few ectoparasite species; this may be a contributory factor to their invasive success. Further investigations are needed to assess risks of zoonotic transmission of plague or murine typhus by C. anisus, of louse-borne typhus by N. callosciuri and of tularaemia and especially Japanese spotted fever (Rickettsia japonica) by H. flava.

[Right thoracotomy for reoperative mitral valve replacement].

We report a case of 67-year-old male who underwent reoperative mitral valve replacement through the right thoracotomy. He had undergone primary double valve replacement with mechanical valve for aortic valve and tissue valve for mitral valve respectively, and tricuspid annular plasty 11 years ago. The second operation was performed through the right thoracotomy under moderately hypothermic cardiopulmonary bypass. The mechanical valve was replaced via right side of left atrium approach under ventricular fibrilation at 25 centigrade of bladder temperature. He recovered well without any major complications.

[The concept of caring applied to nursing education--based on Milton Mayeroff's work].

This paper is intended to explore the way to apply the concept of caring in nursing education. In particular, the authors examined the concept based on Mayeroff's work. During the past two decades in the United States, the "Curriculum Revolution" shifted the paradigm from a content-driven curriculum to one that emphasized transaction and interaction with caring as a core concept. M. Mayeroff asserts that the primacy of caring is to help the other grow. A teacher should know a student personally and adjust her/his behavior to response of the student. She/He can believe that the student will develop her/his potential. If faculty effectively, organized the curriculum to offer the environment of interaction students could learn caring as a nurse through their daily activities. Also a teacher is able to play a role model for caring.

[Analysis of the concept of care/caring-structure of attributes identified from qualitative and quantitative research].

The concept of care/caring has been recognized as the central component of nursing in the United States of America since the 1980s. Although caring is the essence and the central focus of clinical nursing, the term has several meanings, and there is no consensus regarding its definition. The concept of care/caring should be examined not only from the nurse's perspective, but also from the patient's perspective. The purpose of this research is to identify the common characteristics of the concept of care/caring from both the patient's and nurse's perspectives, and to clarify the structure of the concept of care/caring in the English articles. Thirty qualitative research papers written by 21 authors and 17 quantitative research papers written by 9 authors were sampled. From the analysis of the 47 articles, 5 categories and 13 sub-categories were identified as attributes of care/caring. The 5 categories were 1) Characteristics of Nurse, 2) Nursing Activities, 3) Patient-Nurse Relationship, 4) Caring Outcomes, and 5) Others. As the next stage of the research, the concept of care/caring in Japanese nursing should be analyzed. It must be determined whether the concept of care/caring is also the central component of nursing in Japan and if so can these identified characteristics of the concept be applied to the concept of care/caring in Japanese nursing.

Primary angiosarcoma of the right atrium detected by magnetic resonance imaging.

A 20-year-old woman with a primary angiosarcoma of the right atrium is reported. The patient had a cardiorespiratory arrest due to cardiac tamponade with bloody pericardial effusion. Magnetic resonance imaging (MRI) revealed a tumor, which was corroborated by selective coronary angiography. Open-heart surgery was performed. The tumor relapsed however, and she died four months after operation. The tumor was undetectable by echocardiography, but MRI demonstrated a heterogeneous mass with focal areas of high- and low-signal intensity in the right atrium, suggesting that MRI may allow characterization of cardiac tumors.

MRI of the gastroepiploic artery used as a bypass graft.

The right gastroepiploic artery (RGEA) is recognized for its long-term patency as a coronary artery bypass graft, a property shared with the internal thoracic artery. The usefulness of MRI for noninvasive visualization and evaluation of the RGEA graft was assessed using a spine coil as the surface coil in 14 patients with graft patency verified by postoperative angiography. The graft was visualized by spin-echo imaging as a signal-void surrounded by lipomatous tissue with high-signal intensity in all 14 cases. Cine MRI was also performed in 13 of the 14 patients; in each case the graft was confirmed to contain blood flow of high-signal intensity.

[Quality of life studies in nursing science (2). Community adjustment of chronic schizophrenics: effects on life satisfaction and self-esteem (2)].

The purpose of this study was to test two community adjustment models of the chronically mentally ill developed by this author. The study was to determine the effects of daily living, work, family, and social adjustment on life satisfaction and self-esteem as well as to determine the effects of chronicity and symptomatology on the four adjustments. Twenty schizophrenic inpatients and 120 schizophrenic outpatients from a psychiatric hospital in Tokyo participated in the study: the former group was used for a pilot study of the instruments and the latter for the model testing. Seven instruments were used; two self-administered questionnaires of the Life Satisfaction Scale and the Rosenberg Self-Esteem Scale, two structured interview schedules of the Adjustment Scales and a modified version of the Psychiatric Evaluation Form, the Demographic and Psychiatric History Form, the Cantril Ladder of Satisfaction, and the Global Assessment Scale. Two direct effects of family and social adjustment (beta = 0.326 and 0.262 respectively) explained 22.2% of the variance in life satisfaction. Two direct effects of symptomatology (beta = -0.216) and family adjustment (beta = 0.185) accounted for 10.6% of the variance in self-esteem. It was assumed that dropping of symptomatology as a direct effect on life satisfaction was a type two error. In addition, chronicity and social adjustment failed to enter into the equation of self-esteem due to the type two error as well. The culturally characteristic pattern that emerged was that relationship-oriented variables were directly effective on life satisfaction and self-esteem. However, task-oriented variables of daily living adjustment and work adjustment did not account for life satisfaction and self-esteem despite the hypothetical links in the models. It was concluded that interpersonal relationships were especially important for the well-being of Japanese schizophrenics living in the community. The lack of direct effects of daily living and work adjustment suggested that autonomy in living did not heighten the well-being of the subjects, a result that was different than the findings of American studies. It was probably because that Japanese people in general value interdependence among family members, therefore, relatives of the mentally ill tend to play more roles to take care for them.