[Hygienic maintenance of water mist-generating equipment that couples directly to the tap].

OBJECTIVES: Water mist is usually generated using equipment directly connected to the water tap, as its installation is relatively easy. However, there is no legal regulation regarding the maintenance of this equipment, and the quality of the mist has not been sufficiently well investigated. In this study, we sought to establish methods that allow the hygienic maintenance of this equipment. METHODS: We monitored the use of the mist generating equipment in five of the 61 institutions in the jurisdiction of Ichinomiya Health Center, examined the resulting water quality, and tested for Legionella bacteria in the mist. If equipment was found to contain bacteria, the contaminated part was identified by counting the number of bacteria in the water after sequentially washing and disinfecting parts of the equipment. We also identified the predominant bacterial species. RESULTS: In the water mists from three of 5 institutions, the number of bacteria greatly exceeded that permitted for drinking-water, even though the residual chlorine level was >0.1 mg/l. However, no Legionella bacteria were detected. Brevundimonas species were predominant in the water mists at each institute. The hose was found to be the contaminated component in each case. CONCLUSION: Our findings suggest that the number of bacteria in the water mist exceeded the drinking-water quality standard, even with a residual chlorine level of >0.1 mg/l. This study also revealed the importance of the continued drainage of water, following suitable cleaning and disinfection for maintenance of the mist-generating equipment.

Phylogenetic Clades 6 and 8 of Enterohemorrhagic Escherichia coli O157:H7 With Particular stx Subtypes are More Frequently Found in Isolates From Hemolytic Uremic Syndrome Patients Than From Asymptomatic Carriers.

BACKGROUND: Enterohemorrhagic Escherichia coli (EHEC) O157:H7 infection causes severe diseases such as bloody diarrhea and hemolytic uremic syndrome (HUS). Although EHEC O157:H7 strains have exhibited high genetic variability, their abilities to cause human diseases have not been fully examined. METHODS: Clade typing and stx subtyping of EHEC O157:H7 strains, which were isolated in Japan during 1999-2011 from 269 HUS patients and 387 asymptomatic carriers (ACs) and showed distinct pulsed-field gel electrophoresis patterns, were performed to determine relationships between specific lineages and clinical presentation. RESULTS: Clades 6 and 8 strains were more frequently found among the isolates from HUS cases than those from ACs (P = .00062 for clade 6, P < .0001 for clade 8). All clade 6 strains isolated from HUS patients harbored stx2a and/or stx2c, whereas all clade 8 strains harbored either stx2a or stx2a/stx2c. However, clade 7 strains were predominantly found among the AC isolates but less frequently found among the HUS isolates, suggesting a significant association between clade 7 and AC (P < .0001). Logistic regression analysis revealed that 0-9 year old age is a significant predictor of the association between clade 8 and HUS. We also found an intact norV gene, which encodes for a nitric oxide reductase that inhibits Shiga toxin activity under anaerobic condition, in all clades 1-3 isolates but not in clades 4-8 isolates. CONCLUSIONS: Early detection of EHEC O157:H7 strains that belonged to clades 6/8 and harbored specific stx subtypes may be important for defining the risk of disease progression in EHEC-infected 0- to 9-year-old children.

[Control of toxicity of Sarcocystis fayeri in horsemeat by freezing treatment and prevention of food poisoning caused by raw consumption of horsemeat].

More than 27 outbreaks per year of food poisoning caused by consuming horse meat were reported in Kumamoto Prefecture (including Kumamoto City) from January 2009 to September 2011. It was found that the causative agent of the outbreaks was a protein with a molecular weight of 15 kDa that had originated from bradyzoites of Sarcocystis fayeri parasitizing the horse meat. Rabit ileal loop tests showed that pepsin treatment of homogenates of frozen horse meat containing the cysts of S. fayeri induced loss of toxicity, presumably by digestion of the proteinous causative agent(s). Slices of horse meat containing the cysts were frozen at below -20°C for various periods. The cysts were collected after thawing the slices, then treated in an artificial stomach juice containing pepsin. The bradyzoites of the cysts kept at -20°C for 48 hr or more completely disappeared. Simultaneously, the 15 kDa protein also disappeared in the frozen cysts. After notifying the public and recommending freezing treatment of horse meat, no subsequent cases of food poisoning were reported. This indicates that freezing of horse meat is effective to prevent the occurrence of food poisoning caused by consuming raw horse meat containing S. fayeri.

Multiplex PCR assay for identification of three major pathogenic Vibrio spp., Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus.

A multiplex PCR assay was developed based on atpA-sequence diversification for molecular identification of 3 major pathogenic Vibrio species: Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus. It specifically identified them from among 133 strains of various Vibrio species and other genera, and was applicable for testing seawater, suggesting its usefulness.

[The effects of a practical diabetes prevention training course for public health care providers in Aichi Prefecture].

PURPOSE: Lifestyle intervention for high-risk people is one of the most important issues for reduction of diabetic patients. Public health care providers should update their knowledge and enhance their educational skills. The purpose of this study was to evaluate the effects of a diabetes prevention training course for public health care providers in Aichi Prefecture. METHODS: This course included not only lectures about up-to-date knowledge about diabetes but also many practical aspects such as lifestyle assessment and coaching methods. The participants were made aware of an adequate diet by choosing foods in nutrition sessions, and they experienced walking and aerobic exercise with heart-rate monitors and pedometers in an exercise program. They also learned how to interview and provide health guidance to impaired glucose tolerance (IGT) people through role play. There were 373 participants from 90% of municipal health care centers in Aichi Prefecture. We made inquiries about the effectiveness of this practical training course immediately after the training period and 6-months later for all participants. In follow-up inquiries, we asked if the knowledge obtained in this training course had been useful and had improved their services. RESULTS: The aim and methods were well-accepted by more than 90% of participants. The follow-up examination (6 month later) showed improvement with reference to teaching methods (60%), evaluation of the diabetes prevention service (53%), cooperation with other facilities (48%) and survey on municipal health problems related to diabetes (48%). New methods, which they experienced in this course, were adopted in their own services in many municipalities. Many municipal health care centers started the diabetes individual health promotion program, because the health care providers got aware of importance of diabetes prevention by attending this training course. DISCUSSION: In order to make effective interventions, public health care providers should obtain up-to-date knowledge about diabetics and educational skills. Administrative organ can play important roles in diabetes prevention by training public health care providers and setting up a network between related facilities.