The relationship between the number of measles patients (y) and the population size (x) was expressed by the equation y=ax^s, where a is a constant and s the slope of the plot; s was 2.04–2.17 for prefectures in Japan, i.e., the number of patients was proportional to the square of the population size of the prefecture. For European countries that joined the European Union (EU) no later than 2009, the slope was 1.43–1.87. The population dependency of measles found among prefectures in Japan was thus scalable to European countries. This was surprising because, unlike Japan, the population densities of EU countries were not uniform and not proportional to the population size. The population size dependency was not observed among Western Pacific and South-East Asian countries probably due to confounding from interacting socioeconomic factors. The correlation between measles incidence and birth rate, infant mortality or gross domestic product per capita was almost insignificant. The size distribution of local infection clusters (LICs) of measles and rubella in Japan followed a power law. For measles, although the population dependency remained unchanged after “elimination,” there were changes in the Zipf-type plots of LIC sizes. After “elimination,” LICs linked to importation-related outbreaks in less populated prefectures emerged as the top-ranked LICs.

Virucidal effects of chlorous acid on enveloped and non-enveloped viruses were characterized. The virucidal activity was prominent in enveloped viruses. However, among non-enveloped viruses, viruses such as human rhinovirus and feline calicivirus showed a significant sensitivity to the reagent, whereas others such as poliovirus and coxsackievirus showed a weak sensitivity to the reagent, suggesting the presence of 2 classes of sensitivity to the reagent, among non-enveloped viruses. In addition, characterization of the mode of inactivation by the reagent revealed that virus inactivation is strongly dependent on virus species, contaminated proteins, and solvent system composition. Comparison of the cytotoxic effects of chlorous acid with those of sodium hypochlorite or sodium dodecyl sulfate (SDS) revealed that chlorous acid was similar to SDS and remarkably weaker than sodium hypochlorite. These results indicate the unique nature of chlorous acid as a potent virucidal agent with tolerable tissue damage, and reveal the merits and limitations of chlorous acid as a disinfectant in food hygiene and sanitizer in healthcare.

While we previously detected anti-bornavirus antibodies via radioligand assay in psychiatric patients, we did not examine the viral pathogenicity in these individuals. Herein, we present 2 psychiatric patients who were seropositive for bornavirus and whose treatment-resistant symptoms improved after oral administration of ribavirin, a broad-spectrum antiviral agent. Cerebrospinal fluid analysis indicated that ribavirin affected the central nervous system of these patients. Ribavirin ameliorated intermittent involuntary head shaking, which is reminiscent of a symptom observed in bornavirus-infected animals. Using radioligand assays to examine the serial sera of these patients, we found a relationship between the titers of anti-bornavirus antibodies and the change in the patients’ symptoms. Our findings suggest there is a relationship between bornavirus infection and human symptoms and that ribavirin may be useful in suppressing chronic bornavirus infection in some neuropsychiatric patients. However, the possibility remains that some other known or unknown virus other than bornavirus that is sensitive to ribavirin may have caused the symptoms. Additional evidence that directly indicates the causative relationship between bornavirus infection and human symptoms is needed before establishing the pathogenesis and treatment for human bornavirus infection.

Several cases of herpes simplex encephalitis (HSE) caused by acyclovir (ACV)-resistant herpes simplex virus type 1 (HSV-1) have been reported. Amino acid substitutions of R41H, Q125H, and A156V in the viral thymidine kinase (vTK) gene have been reported to confer ACV resistance. Recombinant HSV-1 clones, containing each amino acid substitution in the vTK gene, were generated using the bacterial artificial chromosome system. A recombinant HSV-1 with the Q125H substitution showed ACV resistance while the R41H or A156V substitutions were ACV-sensitive. Furthermore, the Q125H recombinant HSV-1 was less virulent than the repaired virus, but it maintained neurovirulence in mice at relatively high levels. Substitution of Q125H, which was detected in the neonatal HSE patient, conferred ACV resistance, but the substitutions of R41H and A156V, which were detected in immunocompetent adult HSE patients, did not. This suggests that HSE caused by ACV-resistant HSV-1 might be a very rare event to occur during the course of ACV treatment in immunocompetent patients. Showing resistance to ACV treatment does not always indicate emergence of ACV-resistant HSV-1 in HSE patients.

Here, we used multilocus sequence typing (MLST) to evaluate 3 intergenic genes (16S rRNA, ospA, and 5S-23S IGS) in Borrelia isolated from South Korea to analyze the relationships between host, vector, and molecular background. We identified B. afzelii, B. yangtzensis, B. garinii, and B. bavariensis. This study is the first report for the identification of B. yangtzensis using MLST in South Korea.

This study involved epidemiological surveillance of the measles virus (MV) in the territory of the Republic of Kazakhstan during 2015–2016. We detected MV genotype D8 in this season of measles outbreak. A total of 2,341 cases were registered and 19 were identified by genotyping. Sixteen of these samples were attributed to subgroup A of genotype D8, while 3 imported cases were represented by genotypes B3 and H1. Analysis of vaccination coverage showed that a large group of infected people were not vaccinated or did not have a reliable report on their vaccination status. This issue might increase the morbidity rate among the healthy population in outbreak seasons. To prevent the incidence caused by this problem, we have successfully introduced epidemiologic measures for the control of measles.

Japanese encephalitis (JE) is an acute viral disease caused by the Japanese encephalitis virus (JEV). JEV strains are classified into 5 genotypes (I–V). JEV genotype V strains have never been detected in Japan to date, but they were recently detected in South Korea. In the present analysis, we tried to determine if a JEV genotype V strain caused any JE case in Japan in 2016. Serum and cerebrospinal fluid samples were collected from 10 JE patients reported in Japan in 2016. JEV RNA was not detected in any of the samples. Although JEV is a single-serotype virus, it can be expected that the neutralizing antibody titers against JEV genotype V strains are higher than those against genotype I and III strains in the serum of patients with JE in Japan whose causative JEV was the genotype V strain. The neutralizing antibody titers against the JEV genotype V strain were not higher than those against the genotype I or III strain in any serum samples. Therefore, the evidence that the JEV genotype V strain caused any JE case in Japan in 2016 was absent.

Fusobacterium necrophorum has recently been suggested to be associated with tonsillopharyngitis, peritonsillar abscess, and recurrent tonsillitis. Between the 2 subspecies of F. necrophorum, subsp. funduliforme is known to be a major human pathogen. To better understand the epidemiology of F. necrophorum subsp. funduliforme (FNSF), we studied the prevalence of FNSF in the tonsils of patients undergoing elective tonsillectomy (TE) for different indications. Adult patients who underwent elective TE from October 2014 to November 2015 were included. The tonsils were sent for aerobic and anaerobic tissue culture within 30 min of excision; the presence of FNSF was detected using PCR with gyrB primers and 16S rRNA. A total of 32 patients were enrolled. The prevalence of FNSF identified by either culture or gyrB PCR did not significantly differ between infectious and noninfectious TE indications. The constant presence of FNSF might not be associated with recurrent pharyngotonsillitis.

We report a case of murine typhus in a 4-year-old boy living in northern Greece. Although the illness started with mild symptoms, a maculopapular rash appeared by the end of the first week of illness followed by marked thrombocytopenia. The detection of IgM antibodies against Rickettsia typhi in the patient’s blood and a positive polymerase chain reaction result combined with sequencing confirmed the diagnosis of infection by Rickettsia typhi. Clinicians in northern Greece should be aware of the disease, even in cases presenting with no specific initial symptoms.

Cytomegalovirus (CMV) rarely causes disease in immunocompetent individuals but may cause severe disease in immunocompromised patients. We report the case of a young woman who had undergone multiple transfusions and splenectomy for homozygous β-thalassemia. She presented with prolonged fever and respiratory distress. Although broad-spectrum antibiotic therapy had initially been administered, the patient had clinically deteriorated. Serology and molecular blood testing established CMV infection and viremia. Computed tomography of the chest demonstrated pneumonitis and she was successfully treated with a 3-week administration of ganciclovir. In β-thalassemia patients who undergo splenectomy necessitating multiple blood transfusions, CMV infection should be considered as a differential diagnosis.

The level of Listeria monocytogenes contamination of domestic retail meat in Tokyo, Japan, was assessed by comparison of isolates from 2004 to 2007 with those isolated before 2003. The overall prevalence of L. monocytogenes among these samples significantly diminished over time (1998–2003, 28.0%; 2004–2007, 17.6%) reflecting a significant decrease in the frequency of contamination of beef. Serotype 1/2a was isolated most frequently, reflecting a change in the predominant serotype in pork from 1/2c to 1/2a. We performed a simple genetic subtyping method based on 3 genes, iap, sigB, and actA, as well as traditional multilocus sequence typing to classify the allele types (ATs). No extensive variation among sequence types was detected. However, increased genetic diversity among the ATs of the 3 genes in the 2004–2007 isolates was evident. We identified AT 26 of the iap gene, which was not previously reported in Japanese isolates, and 6 ATs of the sigB gene, including 4 with nonsense mutations not currently registered in L. monocytogenes DNA databases. sigB is an evolutionally conserved gene that plays a role in the stress response. Our results indicate that the sigB gene may be relatively unstable among L. monocytogenes strains circulating in Japan.

We analyzed reported dengue fever (DF) cases and DF-relevant characteristics in South Korea from 2006 to 2015. A total of 1,260 DF notifications were obtained during the study period that were presumably introduced from endemic foreign countries. The nationwide cumulative incidence rate (CIR) of DF was 0.25 per 100,000 population; CIR of DF among overseas travelers was 0.93. CIRs of overseas male and female travelers were 1.13 and 0.87, respectively. CIR of overseas travelers aged 20–39 years was the highest. More men (61.9%) were infected with the dengue virus than women (38.1%, P<0.01). Individuals aged 20–39 years were most infected than those of other ages (58.4%, P<0.01). About a third of reported DF cases occurred between June and November. Most of the imported DF cases were associated with traveling in Southeast Asia (86.1%). The incidence of DF was highly correlated with the total number of overseas travelers (Pearson correlation r=0.842, P<0.01). The number of reported patients with DF has been increasing in the last decade, and DF is associated with international travel. To prevent dengue virus infections, greater attention should be paid to individuals who are planning to travel to Southeast Asia.

The possible emergence of praziquantel (PZQ)-tolerant and/or -resistant schistosomes requires the study and development of new antischistosomal drugs as alternatives to PZQ. The present study investigates the capability of 3 dyes—methylene blue (MB), neutral red (NR), and trypan blue (TB)—to assess the in vitro antischistosomal effect of antimalarial drugs on Schistosoma mansoni adult worms. S. mansoni adult worms were incubated in the medium alone as the control or in the medium supplemented with 10 μg/ml primaquine (PQ), artesunate (AR), or amodiaquine (AQ) for 5 days. Viabilities of the worms were observed following staining with MB, NR, or TB. The disparity of MB and NR staining among male and female adult worms treated with PQ, AR, and AQ correlated with the various levels of damage to the male and female worms. Furthermore, the severity of the damage to the adult worms treated with the 3 drugs appeared to be reflected in the TB staining status. The results indicate that the 3 non-fluorescent dyes can serve as useful complementary tools to assess the antischistosomal effect of antimalarial drugs.