Kawasaki disease (KD) is an acute febrile illness in infants and children with systemic clinical symptoms, including coronary artery aneurysms. Findings seen in KD patients such as infiltration of T cells into vascular lesions, elevation of soluble interleukin 2 receptors in serum, an imbalance of T cell subsets, and transient depletion of T cells with CD11/CD18 suggest that the activation of T cells is involved in the pathogenesis of KD. In 1992, an interesting mechanism was proposed in which T cell activation by a certain superantigen is involved in the pathogenesis of KD. Examinations have been undertaken extensively to confirm the proposed hypothesis. We, however, still do not have reliable evidence supporting the above hypothesis. In the present paper we review the research papers which support or rule out the view described above. In addition, we discuss the relation between KD and systemic Yersinia pseudotuberculosis infection that manifests clinical symptoms quite similar to those in KD.

Since a laboratory network to eradicate poliomyelitis in the Western Pacific region started in 1991, the Department of Virology II, National Institute of Infectious Diseases, has been functioning as a regional reference laboratory. From 1992 to 1998, we examined 5453 stool samples collected from 3501 patients with acute flaccid paralysis in Cambodia, Vietnam and Laos, and isolated 392- type 1 and 10- type 3 wild polioviruses. As a result of the extensive immunization during this time in this area, the numbers of poliomyelitis cases by wild polioviruses have drastically decreased. In 1997, only nine type 1 wild polioviruses were isolated. Eight out of the nine cases were found in Cambodia, and one was in mid-Vietnam. Since then no wild polioviruses have been isolated in the Western Pacific Region for more than two years. A nucleotide sequence analysis of these 1997 isolates indicated that they all belonged to the same strain that has been prevailing in the Indochina area, suggesting the complete interruption of wild poliovirus transmission in the region.

Dengue virus infections are a major public health problem in most tropical and sub-tropical countries of the world. Dengue is occasionally imported by travelers who visit tropical areas and become infected with dengue virus. Laboratory diagnosis is essential for confirming the diagnosis of this virus. For purpose of confirmation, detection of specific IgM by IgM-capture enzyme-linked immunosorbent assay (ELISA) and of dengue virus genome by reverse transcriptase polymerase chain reaction (RT-PCR) have recently been used. In the present study, we tested serum specimens from dengue-suspected Japanese cases, by IgM-capture ELISA, RT-PCR, HI, and virus isolation. Serum samples collected before or on the day of defervescence were positive by RT-PCR, and though no PCR-positive samples were obtained after fever day 1. IgM capture ELISA was positive as early as disease day 4, and all samples but one were IgM-positive when collected on disease day 5 or later. In light of these findings, we recommend that both RT-PCR and IgM-capture ELISA be performed, irrespective of the stage of dengue illness. Combination of RT-PCR and IgM-capture ELISA increases the ability to diagnose dengue virus infection, even in the only that a single serum specimen from the patient is available.

To investigate the complexity of epitopes presented on Echinococcus multilocularis (E.m.) metacestode carbohydrates, a panel of monoclonal antibodies (MoAbs) was generated and characterized. Thirty of the clones were obtained and classified into three types (type I to III) based on Western blotting (WB) and dot-ELISA. One MoAb (type I) appeared to react with one of the carbohydrate antigens (C-antigens) located at 30-35 kDa, and was the most effective diagnostic antigen for human alveolar hydatid disease (AHD) in Hokkaido, Japan. The second group (15 clones) of MoAb (type II) reacted with another C-antigen; one which also induced antibody response in AHD patients. The third group (14 clones) of MoAb (type III) reacted with other C-antigens both in ELISA and dot ELISA, but did not react in WB. Cross-reaction to the antigens of Echinococcus granulosus was faintly observed in only the type I-MoAb by dot-ELISA. In the immunohistological studies, all of the MoAbs reacted strongly with the laminated layer though not with protoscoleces in metacestode tissue prepared from experimentally infected cotton rats. Tissue sections treated with sodium periodate lost their immunoreactivity, suggesting that these MoAbs recognized carbohydrate epitopes of the E.m. metacestode.

During 1997 to 1998, a nationwide epidemic of aseptic meningitis occurred in Japan. More than 4,500 isolates from patients with aseptic meningitis were identified as echovirus type 30. To investigate the character of these isolates, we examined the nucleotide sequences of thirty-seven geographical representatives and compared them with 50 strains isolated during the past 20 years. The phylogenic analysis used partial sequences from either the VP1 or VP4-VP2 region of the viral capsid. This analysis revealed that the isolates were divided into six genomic groups. All isolates identified during 1997-1998 belonged to only two genomic groups; these two groups are thought to be the causative viral agents involved in the recent epidemic.