The epidemiologic study has been carrie d out on JBE in Japan during last 15 years (1946-1960), in which its secular variations in incidence, mortality and case fatality by age, sex and locality were observed.
One of the purposes of this study was to see some secular changes of the disease after the year when the vaccination has begun to be used for the mass immunization.
The results obtained in the study were as follows:
1) Three big epidemics of JBE have occurred in Japan during the last thirty seven years. After the last epidemic of 1950 the disease has indicated a little increase of incidence rate every two years without any big outbreak.
2) During the last fourteen years the incidence rate of the disease has been 2 to 5 100, 000 population, while the death, rate 1 to 3 and case fatality rate, ca 35%. The incidence rates of both the age groups of 5-9 years and more than 60 years old are higher than any other age groups, so that the incidence curve by age shows M-form. It is always higher in male than in female, while higher the case fatality rate is higher in female, and in older age groups than other age groups.
3) The case rate of the age group of 5-14 years old indicates remarkable decrease annually, since the year of 1956 when the vaccination has been widely used in this age group.
4) Before the year of 1935 JBE attacked mostly on the older aged persons than fifty and not on the younger, so that the incidence curve appeared as S-form. Since then, the age distribution of the disease has gradually changed, and recently, it shapes M-form as mentioned adove. This is the most interesting feature of JBE during past many years from the standpoint of epidemiology. Of this phenomenon there should be many factors to be concerned. The most reasonable factor is that, before the year of 1935, the prevalence and the epidemization of the disease was very little and locally limited and the host susceptibility played a big roll, while after that year the diease has spread all over the country and mass immunity and host resistance has been very much concerned about the occurrence of the disease.
5) It is certainly imagined that there are some foci of infection in accordance with the geographycal distribution of the disease in our country.
6) It was presumed, that 73.0% of children less than 14 years old were vaccinated in Tokyo, 57.1% in Nagoya and 1.7% in Kobe.
7) The incidence rate of the age group of 5-9 years old in Tokyo has apparently decreased after the period when the vaccination had been carried out. The same decrease, in more or less, was seen in each other city also.
8) The ratio of the cases of 0-14 years old to that of more than 14 years old has also decreased year by year. 9) The significant difference has been seen between the incidence rates of both vaccinated and unvaccinated groups in Tokyo during last four years (1956-1959) except year of 1957.
10) The number of all cases admitted to the infectious hospitals in Tokyo and Yoko-hama was 425, and 37.2% of them was diagnosed by virus isolation or CF-Reaction (32>) and the other 62.8% by clinical findings.
11) The prognosis of patients during last five years was as follows:
in 185 cases of 0-14 years old
56.8% Cured completely
16.7% Sequelae
26.5% Death
in 134 cases of more than 15 years old
63.4% Cured completely
9.0% Sepuelae
27.6% Death
13) Among the vaccinated patients, 12.1% of those were completely cured, 14.0% cured with sequelae and 9.3% were dead.
There was no significant difference of the prognosis between the vaccinated (37 cases) and the unvaccinated groups (282 cases).
14) It was estimated, that 17.7% of patients and 28.8% of control persons were vaccinated. The difference of vaccination status between the two groups was apparently significant. (X
2= 6.38)
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