Izumi fever and Kamikitazawa fever, belonging both to the food-born infections, occasionally cause explosive outbreaks in schools or factories.
Clinical and hematological investigations were carried out with the patients from those 12 mass incidences since 1952 in Tokyo, 4 of which were Izumi and 8 Kamikitazawa fever. The results were as follows:
1. Signs and symptoms differed between children and adults in both diseases.
a) In Kamikitazawa fever, systemic symptoms such as headache, fatigue, muscle and joint pain or chill appeared with more severity and frequency in adults than in children, who showed, on the contrary, disturbances of digestive organs such as nausea, vomiting and abdominal pain as major symptoms.
b) In Izumi fever, signs of so called ileitis terminalis were of more severity and frequencey in adults as compared with children.
The manifestation rate of the third exanthema demonstrated no significant sexual difference in children, whereas, in adults, females were more predisposed to this exanthema than males.
2. Both diseases showd characteristic shifts of blood picture.
a) Kamikitazawa fever demonstrated in the initial stage marked neutrophilia and monocytosis, which shifted from the second day on rapidly to neutropenia and lymphocytosis. Leucocyte count increased slowly and reached the maximum in the third week, which remained, however mostly, within the normal range. The average nuclear number of neutrophils was extremely low, the minimum being mostly on the second or third day. But it rose so rapidly, that almost half of the cases returned to: the normal range in the second week.
Atypical lymphocytes (Virocyte, LITWINS) were found in 0-2% of leucocytes all through the couse of illness, but no case showed over 3.0%
b) In Izumi fever, leucocyte count fluctuated parallel with the fever course. Leucocytosis was observed even in the monophasic group in the period corresponding to the second peak of the biphasic one.
The lymphocytie count rose consistently from the onset without fluctuation.
Atypical lymphocytes appeared in many cases from the second half of the first week, though in alow percentage, less than 3%.
In the bone marrow picture, neutrophils played the leading role, i. e. they demonstrated in the initial stage an active reaction and a temporal hindrance of ripening around the sixth day. Thus, the change of neutrophil corresponded well with the clinical course.
3. The hematologic findings, the fever curve and other clinical symptoms enabled the author to divide the couse of Izumi fever in initial infectious phase and organic phase and to discuss about developmental mechanism of various types of the disease.
4. It must be emphasized that the ASLO value of Izumi fever demonstrated no fluctuation in the course of disease in mass incidence as well as in sporadic cases and BSP which had risen markedly in the beginning, declined rapidly thereafter.
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