A culture of biologically peculiar variant of Shigella flexneri 2a, characterized by sorbitol fermenting property, was encountered at the routine carrier survey performed in this institute on Jan. 31, 1968.
Within supervening two months, there took place three dysentery epidemics in Osaka city, each in a different ward, all of which proved to be caused by the same type as mentioned above.
Positive cultures from these four occasions are totalled in number to 74; one from a carrier, 29 and 40 from two food-borne instances, respectively, and 4 from one intra-familial infection.
Both bacteriological and epidemiological observations were made on it with the following results:
1) Bacteriologically, all 74 cultures of Shigella flexneri 2a were proved to be identical in having. properties of fermenting sorbitol in Barsikows media within 24 hours and requiring cysteine for the growth in Simmons glucose. Further their drug-resistance patterns are all identical, being resistant to SM, and SA and sensitive to TC.
2) On above two epidemics, the authors could trail the sources of infection, a hotel in other prefecture and a restaurant in this city, respectively.
Viewing that incidence of this type of Shigella flexneri 2a, especially of this drug-resistant pattern, . has been very rare (1.3-7.0%), close causative relationship among these four instances and chain-style disseminations of the agents seemed to be highly suggestive.

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In contrast with abruptly dwindled Polio with the use of vaccines, Japanese encephalitis still remains a disease of considerably high incidence and high mortality. It is especially worth attention that those who had received the vaccines occupy 10% proportion to the total number of the victims each year.
Recently, it was made clear that immuno-globulin, built in the early stage of infection, . initiates in. 19S fraction and is sensitive to 2ME. This property has been utilized in the diagnosis of Japanese .encephalitis infection, especially in its early stage diagnosis.
In this report, immuno-chemical studies were made on the sera of 290 Japanese encephalitis patients: administrated to Osaka Municipal Momoyama Hospital during 1964-1968. The number of the sera. samples studied at the time of hospitalization totalled to 1, 200 and those studied after the hospitalization counted 90.
Long run fluctuations of immuno-globulin titers were pursued separately in vaccinated patients, in non-vaccinated patients, and in those who had high antibody titers. IgG, IgM, electrophoresis, immuno-electrophoresis, and long run fluctuations of antibody were also investigated. In some cases, the possibility of re-infection was discussed.
The results were summed-up. as follows:
1) Generally speaking, in non-vaccinated cases the antibody had remained sensitive to 2ME for a considerably long period from soon after the onset of illness and in vaccinized cases or aged persons, it had become resistant to 2ME in the early stage of illness.
2) Long term observations revealed that most HI antibody titers settled down to 1: 80-1: 20 one year after the onset of illness. Downward trend was slowest in Neutralization antibody titers.
3) Those were mostly aged persons whose antibody levels reached high at the very early stage. of illness.
4) There were a few patients in whom we found the antibody titers re-increased after passing over the summer without any vaccinations given after leaving hospital.
5). In patients who had received vaccines after leaving hospital, antibody titers against JaGAr# 01 strains were found higher than those against Nakayama strains, and HI and CF titers were higher than Neutralizing antibody titers.
6) A little active antibody was still recognized in 19S fraction in a patient's serum two years after leaving hospital.
7) Agar-electrophoresis analysis revealed that the increase of Alpha-2 and Gumma globulin fraction was prominent. Immuno-electrophoresis with agar was normal.
8) In both vaccinated and non-vaccinated patients, IgG was increased in the early stage of illness. IgM was found increased in non-vaccinated patients only in the early stage of illness, but not increased at all in vaccinated patients. Antibody titers were not related with IgG and IgM levels.

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There have been controversies as to which is more suitable as a remedy of Bacillary Dysentery between easily-absorbable drug such as CP, TC, NA, or BA-PC and hardly-absorbable drug such as KM, SM, PM, or Furan or Quinoline derivatives.
In a symposium at 16th medical meeting of Japanese Association for Infectious Diseases (Eastern. Japan Section), the author made public the results of clinical experiences with these drugs. In that, at. least in single use, easily-absorbable group was recognized as somewhat advantageous.
On the other hand, an idea that drug combinations, particularly of easily-absorbable one and hardly absorbable one would have synergistic effects and prevent the bacilli from getting drug-resistancy has come up in the field of dysentery, treatment.
In this regard, the author tried combination use of an easily-absorbable drug, AB-PC and a hardly absorbable drug, KM as well as their single use as comparison.
In a conclusion, the most satisfactory is a combination of the two drugs, followed by the single use of AB-PC and KM in that order. Another strong impression is that the early recognition and commencement of antibiotic therapy, as early as in the stage before theepustulations take place, is the best policy is the treatment of bacillary dysenteric diseases.

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