Epidemiological investigations were carried out with 87 cases of epidemic nephritis, having prevailed in autumn, 1957 in Kanagase, Okawara-machi, Miyagi prefecture.
The results were as follows:
1. The peak of epidemy extended from late summer to autumn. The infection ratewas 2.2%.
2. There was no difference in susceptibility by sex.
3. The highest incidence was seen between 3 and 11 years of age, showing its maximum in 8 years.
4. The family infection rate was 17.2%.
5. Out-of-the-way-places were frequented by the infection.
6. Hemolytic streptococci were isolated from the pharyngeal mucus membrane in 14.2% of patients.

View full abstract

Clinical Investigations were carried out with 110 cases of an epidemic nephritis which prevailed in autumn of 1955 Kanagase and it's vicinity in Miyagi prefecture.The following results were obtained:
They were divided into 2 groups: nephritic and non-nephritic.
They were furthermore subdivided into non-eruptive, eruptive and pustular. Out of 110 cases 100 were nephritic (90.9%) and 10 were non-nephritic (9.1%). Only one patient died out of the nephritic group, so that the mortality rate was calculated at 0.9%. Convalescent children after the severe infection must be put under strict clinical control for a long period, for a certain portion of the nephritic group showed a prolonged course with hypertension and had a tendency to turn chronic.

View full abstract

Clinical investigations were carried out with 28 patients of a mass incidence of Izumi fever which broke out on November 1954 in our nurse dormitory. The main clinical manifestations consisted of fever and exanthema. Furthermore, the following symptoms were experienced; headache, chill, perspiration, arthralgia, lumbago, anorexia, nausea, vomiting, stomachache, etc.
The fever curve showed mostly one or two peaks, however, in a few cases three peaks or an irregular type. The fever period lasted 9 to 36 days, the most frequent being 14 to 27 days. The exanthema was almost the same as the hitherto reported ones. They appeared namely as primary, secondary and tertiary eruption and showed erythematous, scarlatinar, measle-like or mixed form. The former two were particularly often encountered. The desquamation was observed in 2/3 of the cases. The liver was swollen in a half of the cases and went parallel with the exanthema.
The spleen was palpable only in a few cases, whereas the lymph nodes were palpable almost in a half. Uroblilinogen was positive in the urine in all cases and the blood sedimentation rate was moderately accelerated in general. Among liver function tests C. C. F. was positive in the beginning in all cases, but contrary to that the Takata reaction and the T. T. T. turned out positive only in a few cases. It is very interesting that in nearly one half of the cases the agglutination test against Proteus Ox K turned out positive in the course of the disease. Streptococcus hemolyticus, II type after Kobayashi was isolated from the larynx in a fairly high rate. A certain relationship might be suspected between this type of staphylococcus and this incidence. Intravenous injection of Tetracin seemed to be effective.

View full abstract

A mass incidence of mixed infection, paratyphus A (P.A.) and bacillary dysentery (D) was experienced in summer, 1956 in Yokohama city. According to the sanitary bureau, the dysentery infection from contaminated well water broke out explosively during the course of paratyphus A incidence. Ninety patients treated in this hospital consisted of 37 P. A., 8 carriers of P. A., 10 mixed infected, 20 D., and 15 carriers of D. Seventy-eight point eight percent of them were over 51 years of age.
Clinical symptoms of P.A. were relatively slight for the aged persons except for only one case with intestinal bleeding. Febrile period averaged 20.9 days with 38-39°C fever. Relapses were recorded in 21.7%. The lapse of time till relapse was on an average 20.9 days, the early being on the 6th day after the complete subsiding of fever, the latest on the 43rd day. P. A. bacilli were isolated in 61.8%. The Widal reaction reached the peak in a half of the patients in the 1st-2rd week. The chiefly used antibiotic, CM was administered in the dosis of 2.0gm a day till 3 or 4 days after the removal of fever. The fever subsided on an average in 3.6 days, so that the antibiotics were used only in 8 cases for more than 5 days. The manner of CM administration had nothing to do with the relapse. The combined nse of PVL with CM at the beginning of the disease, however, seemed to prevent the relapse and to shorten the duration of bacillary discharge with 3 exceptional cases in which the bacilli appear in the stool from time to time even now, one year after the infection.
Most of the dysentery patients likewise showed slight clinical symptoms. The bacilli were isolated in 65.7% and identified as Sh. dysenteriae II. None of 10 patients showed any aggravation as the result of mixed infection.
Isolated bacilli were confirmed as lysogenic and the lysogenicity is in a stable way transmitted to the subcolonies. The average amount of phage showed ca 240 in 35 minutes of incubation. It was completely inactivated by heating at 90°C for 10 minutes. This temperate phage demonstrated bacteriolytic specifity against 4 species of salmonella.

View full abstract