Present Status and Its Control of Tsutsugamushi Disease in Japan

Abstract

Tsutsugamushi disease (TD) had been recognized as a serious disease in Japan for more than several hundreds years, while, over the years the number of reported cases has been steadily declining with only a few cases being reported during the years of 1965 to 1975. The disease seemed to have been nearly eliminated:
Since about 1976, however, the reported cases of the disease began to increase in many areas of the country even where the disease had never been identified previously.
This significant increase in the number of reported cases of TD in Japan might be supported by the regulation of Chloramphenicol and the intensive use of β-lactum antibiotics which are not effective in treating TD but used as the first choice for most febrile infectious diseases. The use of the latter antibiotics led to the occurrence of several fatal cases, and these unfavorable occurrence have served as a stimulus to develop an enlightenment with rapid diagnosis and rapid treatment.
Now, many prefectures have the authorized diagnostic laboratory using IP or IF technique. And the number of doctors who can identify the TD is much increasing, and resulted in the recent increase of the reported cases of TD in Japan. This will be rather valuable for the people who may suffer from this disease during the every incidental seasons. Because the patients will be easily cured by administration of the tetracycline group of antibiotics according to the correct diagnosis.
Thus we believe that the early diagnosis and early treatment is most important and most effective way to control TD at present time in Japan.