The aim of this study was to obtain information on the risk of companion-animal hospital staff members acquiring zoonotic diseases. We surveyed veterinary technicians to estimate the rate of acquisition of zoonoses from pets while working in companion-animal hospitals. About one in five veterinary technicians (19.4%) reported acquiring zoonotic infections in their small-animal practice. The rate of acquisition of zoonoses by those who had worked for more than 5 years was significantly higher than by those who had worked for less than 1 year (p<0.001, odds ratio: 6.74). The list of zoonoses included the flea bites (62.3%), dermatophytosis (26.9%), cat-scratch disease (16.0%), tick bites (9.0%), and pasturellosis (6.1%). A small number of veterinary technicians had been infected with Q fever, toxoplasmosis, parrot fever, salmonellosis, tetanus, campylobacteriosis, or scabies.
Cytotoxicity and effect on guinea pig wounds were compared with three kinds of 10% povidoneiodine solution (isodine, neojodine, J-iodine) and povidone-iodine. It gave the following results: 1. In the Chang conjunctiva cell where remarkable toxicity was observed in the used cell line, the toxicity emphasized was 10 times using povidone-iodine<J-iodine<neojodine<isodine. In addition, a toxic difference was recognized between cells, in the order of Chang conjunctiva>SIRC> FRSK>human fibroblast for isodine and neojodine. 2. As for the influence on cells achromatized in sodium thiosulfate, alteration was not recognized in isodine, J-iodine using half-maximum cytotoxicity concentrations (CC50), and, in neojodine and povidone-iodine, elimination of drug toxicity was recognized in Chang conjunctiva/FRSK cells. 3. Strong toxicity was seen in isodine and neojodine in the toxicity test using colony formation method, however on washing with PBS (-), an easing of the toxicity effect could be seen to 0.01%. 4. Polyoxythylene nonylphenyl ether, NP-10 was the most toxic in the used surfactants in this study, and the toxicity by 100 times when compared with sodium polyoxyethylene lauryl ether sulfate, SBL-2N. Prominent sensitivity was observed in Chang conjunctiva cells with regard to the cell line and subsequently showed toxicity in order of SIRC>FRSK>human fibroblast. Remarkably, the difference between solutions of isodine and J-iodine was made more clear from the 5th culture. 5. In this study, significantly guinea pig wounds, povidone-iodine blocked all examples significantly recognized as dallying by distance between epidermal cells. In addition, isodine was meaningful area. Although their ware not offer the significant differences, the solutions obstructed the sliding of epidermal cells in comparison with povidone-iodine, and a delaying tendency of inflammation was also recognized. The toxic difference between povidone iodine solutions was regarded as the influence of surfactants added to the povidone-iodine. Based on this foundation study, more detailed clinical testing is necessary in determine where sterilization to wounds/mucosa/eyes with solutions containing additive is a suitable panpractice or not.
National echinococcosis surveillance has been performed since April 1999 when it was stipulated as a Category IV Disease under the Infectious Diseases Prevention Law. During the last 4 years of surveillance, 7 cases of unilocular hydatid disease (age range 27-81 years; median age 56 years) and 43 cases of alveolar hydatid disease (age range 24-83 years; median age 64 years) have been reported. There was an increase in the number of reported cases of alveolar hydatid with age, and the greatest number of reported cases occurred in the age group≥70 years. Thirty-three of the reported echinococcosis cases had clinical symptoms. The greatest number of echinococcosis was reported from health centers in Hokkaido; 94% of all reported cases (47/50) were from this island. After classifying Hokkaido into six regional districts and analyzing cases by district, we found the greatest number of reported cases to be from the Nemuro-Abashiri-Kushiro region (16 cases) and the Ishikari-Shiribeshi-Iburi region (15 cases). However, the greatest number of reported cases per 100, 000 residents was found to be from the Souya-Rumoi region (2.05/100, 000) and the Nemuro-Abashiri-Kushiro region (2.00/100, 000). As the incubation period of echinococcosis is thought to be several years or more, the current data shows the infection rate from several years ago. In order to better understand the current infection rate of echinococcosis, we recommend implementing a seroepidemiological surveillance in addition to the present surveillance.
The incidence and prevalent types of Norwalk virus (NV), Sapporo virus (SV), and human astrovirus (HAstV) in pediatric gastroenteritis in Hiroshima Prefecture were investigated in 7 cold seasons, between 1995/96 and 2001/02. The incidences of NV, SV, and HAstV were 23.6% ranging from 16.3 to 34.4, 2.5% ranging from 1.5 to 4.7, and 3.2% ranging from 1.5 to 6.0, respectively. The peak of the incidence of NV was found in November and December. No accumulation of monthly incidence in SV or HAstV was noted. Most NVs detected belonged to genogroup II. A probe type of G2F, according to Fukuda et al., was predominant in NV, followed by G2E and G2B. The probe types of LON and SAP, according to Vinje et al., were predominant in SV. Serotype 1 was predominant in HAstV.
From January 2001 to July 2002, we investigated the duration of fever, the duration of hospitalization, the frequency of antipyretic use, and other clinical symtoms of 162 inpatients with influenza A virus infection, and compared them with oseltamivir-treated, amantadine-treated, and untreated groups. The duration of fever and the duration of hospitalization treated were significantly shortened in the oseltamivir-treated group than in the amantadine-treated group and untreated group. There was no difference in the duration of fever between patients treated by oseltamivir at 2mg/kg/day and those at 4mg/kg/day. The frequency of antipyretic use was lower in the oseltamivir-treated group than in the other group. No difference was observed in the duration of fever and the frequency of antipyretic use between patients treated by oseltamivir with antibiotics and those by oseltamivir alone. The complications such as vomiting, abdominal pain, irritability were observed in 9% of patients treated by oseltamivir. But those symptoms were not serious, and the rate of complications in the oseltamivir -treated group was lower than that in untreated group. In conclusion, oseltamivir is safe and effective in the treatment of influenza virus infection in children, and it may reduce the amount of antibiotics and antipyretic use.
A 47-case-year old male was admitted to our hospital because of high fever and general fatigue. He had no immune deficiency, and had no other disease in his past history. On admission, the white blood cell count and C-reacted protein were severely elevated (18, 700/μl, 27.7mg/dl, respectively) and abdominal CT revealed multiple low density, From these results, he was diagnosed as liver abscess. Intravenous MINO and SBT/CPZ injection were started. On the fifth hospital day, he suffered from headache and nuchal rigidity. The clinical data revealed the cerebro-spinal fluid (CSF) counting 8, 336cells/mm3 (mononuclear 8, 000, ) protein at 119mg/dl, and sugar 42mg/dl. CSF cultures were negative, but Klebsiella was recognized in the blood culture and drainage fluid in liver abscess. This condition was diagnosed as bacterial meningitis and antibiotics were changed to intravenous CTRX and MEPM. Furthermore we administered oral PSL and intravenous steroid-pulse therapy. After these combination therapies his condition improved gradually. After 40 hospital day, however, he suddenly had double vision, Axial FLAIR (SE6, 000/120) image revealed with high signal intensity at 4th ventricle. Intravenous MEPM was administered again. On the 60th hospital day, double vision was gradually improved and abnormal intensity at 4th ventricle was almost disappeared. This case may provide us a considerable suggestion on the treatment of bacterial meningitis.
We report a case of candidemia due to Candida krusei after subarachinoid hemorrage. A 51 yearold male patient consulted us for high fever and increase of CRP 10 days post operation against subarachinoid hemorrage. There was a temporary decrease in the CRP after administration of ceftazidime (CAZ) but it again when treatment with CAZ was stopped. Because of detected Candida sp. by blood culture, fluconazole was administered i. v for 5 days, but C. krusei was positive during the treatment. Therefore, fluconazole was replaced with micafungin. The patient became better after the administration with micafungin for 14 days without side effect. Micafungin is effective against candidemia due to C. krusei.
Two siblings with allergic purpura after Salmonella O9 infection were reported. A girl (patient 1) aged 4 years and 4 months started to have knee joint pain and abdominal pain followed by purpura of the lower extremities and was referred to us for treatment of allergic purpura. She had contracted enterocolitis one month before visiting our hospital and Salmonella enteritidis was identified. During the course of the illness she had nephritis associated with allergic purpura. However, she made a favorable progress and proteinuria and hematuria disappeared within 6 months. A boy (an elder brother of patient 1) aged 6 years was admitted to our hospital because of the allergic purpura. He similarly had contracted Salmonella enterocolitis. He had severe gastro-intestinal symptoms including abdominal pain, vomiting and bloody stool, which rapidly subsided after initiation of treatment with intravenous hyperalimentation combined with prednisolone. It is possible that allergic purpura in our patients was closely associated with Salmonella enteritidis infection. Further accumulation of cases is a requisite to clarify an association of Salmonella enteritidis infection with allergic purpura and pathogenesis of allergic purpura.
We report a 52 year-old patient with malignant lymphoma who developed necrotizing soft tissue infection in the left lower extremity by Aeromonas veronii biotype sobria during a neutropenic period after intensive chemotherapy. We decided to amputate the involved leg when signs and symptoms of necrotizing myositis were progressing despite administration of sensitive antibiotics. He survived with subsequent intensive supportive care. It is to note that even though the patient's neutrophil count is zero, he or she should be treated aggressively by drainaging the lesion or even amputation of the involved extremities in combination with proper antibiotics.