The drive ‘extrerminate bacillary dysentery’ was conducted in Johana Town, Toyama prefecture during a 3-year period (1962-1964) with every possible measure to be taken at that time.
Notwithstanding such comprehensive countermeasures, an outbreak of bacillary dysentery took place in a creche belonging to town's authority in Feb. 1965.
Both bacteriological and epidemiological investigations were carried out on it. By means of colicine typing technique and drug-sensitivity test on the causative organisms, the source of epidemic was pursued successfully, and at the same time it was made almost clear that contact infections played the main role in disseminating the germs through the epidemic.
This report was submitted from such a viewpoint of the author that these findings would bear the great importance to the prophylaxis of epidemic of this kind of disease.
Results were summed up as follows:
1) An outbreak of bacillary dysentery, occurring in a creche of Johana Town, durated for 27 days from Feb. 5 to Mar. 3, 1965. The creche was, at that time, taking care of 224 infants. The patients involved were 126 in total, including infants of the creche and their families. The peak of incidence was at around 7th and 8th day of the outbreak, and a number of incidence were lingering until the end of epidemic.
Out of total, the majority (65, 53.1%) were infants of 4-5 years age. The second highest incidence was seen in 25-34 years age group of female, mostly the mothers of diseased infants.
Viewing above results, the mode of this epidemic should be appropriately described as ‘continuative lingering’ pattern rather than as ‘in a moment, massively explossive’ pattern. And the fact that the patients involved were mainly infants and their mothers, is suggestive of contact infection as the cause of germ dissemination. Water supply or meals provided by the creche would be almost deniable as a cause of epidemic.
2) The modified colicine typing teehnique by Abbott et al and drug-sensitivity test were applied to detect the route of infection.
Strains isolated through this epidemic were all Sh. sonnei of colicine type 12, and at the same time resistant to three drugs (streptomycin, tetracycline and chloramphenicol) without exception.
It happened to be that a mother, whose child was a patient in earliest incidence, was found to be a healthy carrier and, at the same time, in her past history she was diagnosed on Oct. 26, 1964, the previous year to this occasion, as a carrier of Sh. sonnei, its colicine type and drug-sensitivity pattern being identical to that of the causative strains of this time. No other patients' history revealed such one, then she was desided almost definitely to be an epidemic source of this outbreak. The germ would have been disseminated from her child, who was infected first from her, to the infants in creche, further to their families, possibly by contact.
3) It is surprising that Sh. sonnei were recovered from the dust clogging the connections of japanese style mats (tatami) of the creche that were considered to have already been completely disinfected.
It should be borne in mind that the usual procedures for disinfecting japanese house were not satisfactory at least to Shigella bacilli, considering that such dust could have played the role in some part of contact infections in this epidemic.

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An international study team relevant to type distribution of streptococcus pyogenes has been arranged by Dr. C.H. Williams and M.T. Parker in Streptotoccus & Staphylococcus Reference Laboratory in London and 11 countries co-operated during the period from May 1964 to June 1965. Data on 5148 strains collected were classified and analyzed according to each of several categories, e.g., such as country, kinds of disease and agglutination- and precipitation-types.
In many respects, Japan was found to be in an unique situation. In any countries except Japan the most prevalent type was either type 12, 11 or others, i.e., those represented by (5/11/12/27/44) complex, whereas only in Japan it was type 4. The frequency of type 6 which was the secondly ranked type in our country was also highest. Type 28 was not detected in Japan. Moreover, the percentage of untypable strains encountered was also highest in Japan. The preponderance of scarlet fever which is generally accepted as a lower-incidence disease in civilized countries was also most characteristic in Japan.
Referring to the comparative results of T versus M, it was found that each type T includes a fair number of variety of types M, i.e., each agglutination type Tcorresponds to a variety of heterologous type M besides homologous type M. However, it is of importance that the incidence of heterologous type M encountered was found lower in comparison with that of homlogous type M. That is, the rate of coincidence of both types, T and M, with a few exception, was found higher. This finding was that which we could only expect to obtain by such large-scale plan as international survey.

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Isolations of Staphylococcus aureus (St. aur.) were carried out from the sputa of 81 in-patients in the tuberculosis-wards of this institute and the anterior nares of 15 guinea-pigs. And, by means of the phage typing, its carrier state was investigated.
Although many reports on the St. aur. carrier state in the human nose and throat are available, the knowledge of the carrier state, especially of the long period, about St. aur. in the sputum is scarce. In this respect, the patients' sputa were investigated for as long as 12 months at longest, at intervals of a month, in this experiment.
The nasal carrier state of St. aur. in guinea-pigs was investigated as well for several months from immediately after the birth, at intervals of a week. And some comparisons were done between the carrier state in the nose and in the sputum.
The results were as follows:
1) Out of 81, the total number of in-patients examined, Staph. aureus carrier state was observed in 30 cases, in which 28 could be observed for 6 months-12 months. Others (51) were considered to be non-carriers.
2) In these 28 cases, 8 were found to be occasional non-carriers and 20 were persistent carriers.
3) Each carrier constantly harboured Staphylococci of the same phagepattern.
4) It was revealed in several cases where the nose and the sputum cultures were done at the same time that only the sputum culture gave positive result for Staphylococci, while the nose culture was negative.
5) There appeared a lower isolation rate for Staph aureus in cases of kanamycin treatment than in cases of streptomycin treatment.
6) Staphylococci were found to have colonized in the nose of guineapigs within 24 hours after birth and type of which tended to remain unchanged hereafter.
7) On artificial inoculations of the strain of phage-type different from those which had already naturally colonized in the nose of guinea-pigs, it was seen that such a superimposed strain survived there only several days, while the naturally colonized strains were persistently recovered through the experiment.
8) On the other hand, the strain inoculated immediately after birth in the nose of guineapig which had not been naturally colonized by Staphylococci yet, has been present for three weeks in average.

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