A mass incidence of acute enteritis broke out in September, 1957 in a kindergarten of Nagano prefecture, affecting an adult and 12 infants (including 2 asymptomatic cart iers)
The signs and symptoms common to all the patients were frequent severe diarrhea with abdominal pain and fever (38.5°-40.3°). Vomiting and convulsion were also seen in some infants. Sulfonamides however, were effective for a majority of patients, so that no mortal case was recorded.
The stools obtained from the patients in the acute stage were cultivated in S.S and E.M.B mediums, and a type no shigella, Salmonella, Arizona or other types of E. coli for routine examinations (0-25, -26, -44, -55, -75, -86, -111, -112, -119, -124-128) were recovered. This type of E. coli isolated commonly from the patients was examined biochemically and serologically in detail. As a result, this strain was identified as non-motile E. coli with an antigenic structure 0-28a, 28c: B18, a strain known under the name of Katwijk type of seeliger (See Tab. 2), by which no epidemic had been yet caused in Japan.
From the bacteriological and epidemiological studies, this type of E. coli 0-28a, 28c: B18 was decided as a pathogenic agent for this epidemic.

View full abstract

By the universal use of antibiotics in recent years, the treatment of bacillary dysentery has made great progress, but at the same time, the problem of resistance of he dysentery bacilli has come to assume an important aspect in the treatment of this disease.
The author made a study of the bacilli excretion of 868 cases of ysentery for the purpose of elucidating the behavior of such antibiotics, and a series of measuremens of the bacillar sensitivity against chloramphenicol (CM) in the acilli sampled form 196 CM-treated patients in every stage of the entire course of the disease, for the purpose of following up the change in the resistance of the acilli. The results obtained were as follows:
1. In 775 cases of dyentery and 93 cases of Ekiri (Severe dysentery form of children with a sudden onse) the rate of bacilli detection was found to be high at the earliest stage, rising to 40-48%, but to fall off with progress of the disease. The persistence of bacilli excretion is longer n the early stage of the disease, but shortens afterwards. When the patient recovered to excrete normal feces, the rate of bacilli detection was 16.2%.
2. The xtinction rate of bacilli following CM administration was 62 and 80, respectively within 24 and 48 hours.
3. Reappearance of bacilli following application of CM ccurred in 19.4% of the cases, and clinical relapse for once only in 22.6%, for twice in 2.8% and for three times in 0.4% of the cases.
4. By use of CM, most of the cases showed marked improvements in their complaints and the nature of their feces, and the frequency of defecation also decreased, even a tendency to onstipation being observed in many cases.
5. In the dysentery bacilli isolated from 196 patients on different days during the entire course of disease the CM γy/cc value showed the same level throughout in 29%, but fell gradually lower in 51%, the sum of the two above amounting to 80%. In 9.2% it rose from the initial stage to the middle and rose in 10.8% steadily up to the final end of the disease.
6. In the greatest majority of the isolated bacilli the CM γ/cc value remained within the range of 0.39-3.13 and in some cases reached the maximum of 25 γ/cc, but fell lower during the course of the disease.
7. The CM gamma;/cc value was not always found correlated with the extinction of bacilli, no delay in extinction being confirmed even with highly resitant bacilli.
8. Most of he bacilli excreted by the patients after CM also showed lowered CM γ/cc values with the lapse of time, so no data indicating lower sensitivity of CM-treated ases were obtained, compared with that of not CM-treated cases.
9. No dysentery bacilli with high resistance against CM could be found.

View full abstract

Complement fixation test (CF), hemagglutination inhibition test (HI), neutralisation test (NT) and complement fixation inhibition test (CFI) were carried out on the patients admitted in our hospital under suspicion of Japanese B encephalitis (JBE) in 1955 and 1956, in order to know the diagnostic value of CF in comparison with the other tests.
From these patients were naturally excluded the ones diagnosed as non-encephalitic diseases clinically and or bacteriologically. The CF was performed with 143 remaining cases (including 53 mortal cases). Diagnosis of JBE was established on the basis of a 4-fold rise and or a titer 1: 32 or greater in CF test. Eighty one cases were diagnosed in this way out of 95 recovered cases. The HI test, a 4-fold rise of HI antibody being required, was carried out on the sera of 68 patients (including 14 CF negative cases) with the result of 45 positive reactors. The results of both, CF and HI tests coincided in 43 cases except for 13 cases which consisted of 11 HI negative and 2 CF negative ones. The absence of obvious rising of HI antibody titer in many cases was explained from the fact that the titer rose more rapidly than CF. Needless to say, the serological tests were not so effective for mortal cases, although the HI was contrarily of more value than the CF due to the vicissitude of antibody. Namely, diagnosis was serologically established only in 7 of 53 mortal cases, 2 of them with both, 1 with CF and 4 with HI test. NT was carried out with the above mentioned 12 cases which were negative for both CF and HI tests. A rise of NT antibody titer over 1.5 log in convalescence was seen in no case. On the other hand, the rise of titer was found in 3 of 7 cases which were admitted during the same period and were positive reactors for CF. CFI test was also performed with the sera of the same negative reactors. The rise of antibody was not demonstrated.
The clinical aspects of those 12 cases were generally mild in comparison with those of JBE cases. Nine of them did not show any cerebral focus symptom, but might be designated as “aseptic meningitis.” Presumably, some other diseases were mixed in them. Consistently, the reliability of CF test for JBE was confirmed in comparison wtih the other serological tests except for mortal cases, for which HI should be used in combination. Among the recovered patients a negative result of CF would be almost unconceivable, if the sera were examined during a long period (4 weeks after onset)

View full abstract