Epidemiologic features of Kawasaki disease: Winter versus summer.

BACKGROUND: The epidemiology of Kawasaki disease (KD) shows seasonal variations, although the etiology of KD is unknown. In this study, we compared the clinical epidemiology of KD onset in winter versus that in summer to identify its etiology, that is, infectious agents. METHODS: Epidemiologic features of KD were compared between two seasons with high incidence (January [winter] and July [summer]) using a dataset of the 22nd nationwide survey in Japan. Data on patients who visited hospital during 2011-2012 in Japan were analyzed after adjusting for age differences. Subgroup analysis was carried out for day of illness at the day of first hospital visit. RESULTS: The total number of KD patients reported in the survey was 26 691. The number of patients who visited hospital with KD for the first time in January and July was 2,812 and 2,302, respectively. The proportion of patients in the age group 15 months-3 years was 38.8% in January and 33.5% in July. Mean serum albumin was significantly lower in January than in July (at days 2-5 of illness, P < 0.05). There were no between-group differences with respect to treatment, incidence of cardiac lesions, recurrence, or history of KD among the patients' siblings and parents. CONCLUSION: No significant differences were observed between KD with onset in January and July, although minor differences with respect to age distribution and serum albumin were observed.

[Training programs for staff at local Infectious Disease Surveillance Centers: the needs and usefulness].

OBJECTIVES: The objective of this study was to assess the need for and usefulness of training programs for Local Infectious Disease Surveillance Center (LIDSC) staff. METHODS: A structured questionnaire survey was conducted to assess the needs and usefulness of training programs. The subjects of the survey were participants of a workshop held after an annual conference for the LIDSC staff. Data on demographic information, the necessity of training programs for LIDSC staff, the themes and contents of the training program, self-assessment of knowledge on epidemiology and statistics were covered by the questionnaire. RESULTS: A total of 55 local government officials responded to the questionnaire (response rate: 100%). Among these, 95% of participants believed that the training program for the LIDSC staff was necessary. Basic statistical analysis (85%), descriptive epidemiology (65%), outline of epidemiology (60%), interpretation of surveillance data (65%), background and objectives of national infectious disease surveillance in Japan (60%), methods of field epidemiology (60%), and methods of analysis data (51%) were selected by over half of the respondents as suitable themes for training programs. A total of 34 LIDSC staff answered the self-assessment question on knowledge of epidemiology. A majority of respondents selected "a little" or "none" for all questions about knowledge. Only a few respondents had received education in epidemiology. CONCLUSION: The results of this study indicate that LIDSC staff have basic demands for fundamental and specialized education to improve their work. Considering the current situation regarding the capacity of LIDSC staff, these training programs should be started immediately.

Pathogens detected from patients with acute respiratory infections negative for SARS-CoV-2, Saitama, Japan, 2020.

Objective: During the coronavirus disease pandemic in Japan, all patients with respiratory symptoms were initially tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study describes the respiratory pathogens detected from patients who tested negative for SARS-CoV-2 at the Saitama Institute of Public Health from January to December 2020. Methods: We performed pathogen retrieval using multiplex real-time polymerase chain reaction on samples from patients with acute respiratory diseases who tested negative for SARS-CoV-2 in Saitama in 2020 and analysed the results by age and symptoms. Results: There were 1530 patients aged 0-104 years (1727 samples), with 14 pathogens detected from 213 patients (245 samples). Most pathogens were human metapneumovirus (25.4%, 54 cases), rhinovirus (16.4%, 35 cases) and Mycoplasma pneumoniae (13.1%, 23 cases). Human metapneumovirus, human coronavirus (but not NL63) and M. pneumoniae were detected in almost all age groups without any significant bias. Seasonal human coronaviruses, human metapneumovirus, M. pneumoniae and several other pathogens were detected until April 2020. Discussion: Multiple respiratory pathogens were circulating during 2020 in Saitama, including SARS-CoV-2 and influenza viruses. We suggest introducing a system that can comprehensively monitor the regional prevalence of all viruses that cause acute respiratory infections.

SARS-CoV-2 Genome Analysis of Japanese Travelers in Nile River Cruise.

Japan has reported 26 cases of coronavirus disease 2019 (COVID-19) linked to cruise tours on the River Nile in Egypt between March 5 and 15, 2020. Here, we characterized the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome of isolates from 10 travelers who returned from Egypt and from patients possibly associated with these travelers. We performed haplotype network analysis of SARS-CoV-2 isolates using genome-wide single-nucleotide variations. Our analysis identified two potential Egypt-related clusters from these imported cases, and these clusters were related to globally detected viruses in different countries.

Epidemiologic features of Kawasaki disease distinguished by seasonal variation: an age-specific analysis.

PURPOSE: The purpose of this study was to review the seasonal variation of Kawasaki disease (KD) by an age-specific analysis to clarify the distribution of infectious agents. METHODS: Data obtained from nationwide surveys of KD in Japan, which targeted patients for 12 years (2003-2014), were analyzed. The monthly numbers of patients were classified into the following age groups: 0-11 months, 1 year, 2-3 years 5 months, and 3 years 6 months-4 years. Factors associated with disease onset were analyzed using a 12-month moving average method. RESULTS: In winter, a sharp peak was observed in all age groups, but this was notably sharper in the 1-year age group. Plateaus in disease occurrence were observed in two periods: from March to May in the 2- to 4-year age group and from June to August in the 0- to 11-month age group. Seasonal index was analyzed into two factors that differed depending on the age group. CONCLUSIONS: The age-specific analysis of KD clearly identified age-related differences in the seasonal occurrence of this disease.

Seasonal patterns of legionellosis in Saitama, 2005-2009.

Sporadic cases of legionellosis have increased in Saitama Prefecture. This study aimed to understand the characteristics and incidence of legionellosis in Saitama Prefecture by studying the corresponding data from Tokyo and all over Japan. We analyzed cases of legionellosis registered from 2005 through 2009 in the annual reports of the Infectious Disease Surveillance Center. There were two peaks in the incidence of legionellosis in Japan between June and November, and a trough between February and May every year. Similar seasonal characteristics were observed in both Tokyo and Saitama. Proper management of risk factors-such as cooling towers and other aerosol-generating devices, before and during the seasonal increase in these incidences-is essential as a prophylactic measure against legionellosis.

Outbreak of hepatitis C virus infection in an outpatient clinic.

BACKGROUND: From January through September 2001, seven patients were admitted to Fukaya Red Cross Hospital with typical clinical manifestations of acute hepatitis. Six were outpatients of the clinic, which is located near the hospital. An extensive survey of clinic outpatients conducted by the local health department revealed six more new acute hepatitis cases during this period. METHODS: A case control study was carried out to identify potential risk factors for infection. In total, 1946 outpatients with clinic records were scheduled to undergo hepatitis C virus (HCV)-antibody testing. For the HCV-Ab positive patients, HCV-RNA was subtyped and quantified, and sequences of HCV hypervariable region 1 were determined. RESULTS: Ultimately, 12 patients with acute hepatitis and two asymptomatic subjects were found to be a part of this outbreak. HCV isolates were divided into three major groups using phylogenetic tree analysis. Only a past history of visiting the clinic was significantly associated with acute hepatitis. The timing of the parenteral medical procedure at the clinic and the onset of acute hepatitis strongly suggested association of the two events. CONCLUSIONS: Our findings suggest that nosocomial HCV infection can occur in an outpatient clinic, even in countries where post-transfusion hepatitis has been almost entirely eliminated.