Urban epidemic of bubonic plague in Majunga, Madagascar: epidemiological aspects

After an absence of 62 years, an epidemic of plague occurred in the harbour city of Majunga (Madagascar) from July 1995 to March 1996, following sporadic cases in March and May 1995. By 15 March 1996, 617 clinically suspected cases of bubonic plague had been notified. Laboratory testing was carried out for 394 individuals: 60 (15.2%) were confirmed to have bubonic plague and 48 (12.2%) were considered as presumptive cases. The incidence was significantly higher in males in all age groups and in both sexes in the 5–19 age group. Twenty‐four deaths were related to plague, but early treatment with streptomycin has confirmed its effectiveness insofar as the case‐fatality ratio was only 8.7% among confirmed and presumptive cases admitted to hospital. The difficulty of clinically diagnosing bubonic plague was affirmed. The disease met favourable conditions through the poverty and low level of hygiene prevalent in most parts of Majunga.     

Current problems of amebiasis in Japan and recent advances in amebiasis research

Amebiasis is epidemic in two major populations in Japan: male homosexuals and institutionalized people. Currently available diagnostic, chemotherapeutic, and prophylactic measures and their problems are discussed. Recent advances in basic research on amebiasis are also described with new findings of unique metabolisms and intracellular structures and organization. Discoveries and analyses of the unique features presented by this parasitic protist help in our elucidation of the pathogenic mechanisms of the parasite and may eventually lead to the development of new drugs and vaccines against amebiasis.     

Lung cancer in Greenland-selected epidemiological,pathological, and clinical aspects

Summary One hundred and seven cases of lung cancer were first diagnosed among indigenous Greenlanders during the 25 years from 1955 to 1979. Compared with the Danish population, relative risk of lung cancer among male Greenlanders increased from 0.4 in 1955–1959 to 1.1 in 1975–1979. Relative risk among women increased from 0.7 to 2.1. The age-adjusted rate for women during the period 1975–1979 is one of the highest on record. This increase in lung-cancer risk followed a sharp rise in the use of cigarettes in the general population. An association with cigarette consumption was also suggested by tumor histology and location. A synergistic role of other risk hazards is possible. Local factors arising from previous tuberculosis involvement may have favored lung cancer development in men. More than 2/3 of the cases of lung cancer diagnosed between 1955 and 1974 were brought to medical attention because of clinical symptoms although most of the population was screened annually or biannually for tuberculosis. Intervention through screening had little impact on the overall very low survival rate.This work has been supported by Sygekassernes Helsefond (Grant no. H 11/51-76) and by Michaelsen Fonden     

日本 埃及和曼氏血吸虫病的寄生虫学特征及防治措施

血吸虫病是一种严重危害疫区人民健康, 阻碍社会经济发展的被忽略的热带病。经过积极防治, 一些国家和地区先后阻断了血吸虫病传播。近年来, 随着社会、 经济的发展, 全球人口流动日益频繁, 血吸虫病不但对已控制地区构成威胁, 而且可能形成新的流行区。本文对3种主要人体血吸虫病 （日本、 埃及、 曼氏血吸虫病） 的全球流行现况、 临床特征、防治方法进行阐述, 并且对3种人体血吸虫及其中间宿主的共性和特性进行描述, 为今后研究血吸虫病防治策略及措施提供参考。     

Comparative research on epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan

In order to compare the epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan, we analyzed the current state of tsutsugamushi disease outbreaks and related risk factors. The average prevalence rate of tsutsugamushi disease from 2001 to 2005 in Korea was higher than that in Japan (7.2 and 0.3 per 100,000 population, respectively) (P<0.01). The seasonal distribution in Korea showed that the incidence of tsutsugamushi disease in autumn (94.5% of total cases) was higher than in Japan (38.2%) (P<0.01), while the incidences of outbreaks in other seasons were much higher in Japan (P<0.01). In Korea, more females (64.8%) were infected than males (35.2%) (P<0.01), while there was no significant difference in Japan. The remarkable difference between the gender distribution in Korea and Japan is believed to reflect cultural differences between the two countries in terms of work, dress and ornamentation. In both countries, elderly people (over 60 years old), especially in rural areas, showed a very high prevalence rate (50%), which is possibly due to increased outdoor activities and a decreased number of young people in those areas. These differences in tsutsugamushi disease risk factors reflect the different influences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries.     

Measles outbreak in a suburb of Tokyo, Japan, in 1998-1999

A 1998-1999 outbreak of measles in Kawasaki City was studied to provide an up-to-date epidemiological understanding of the disease in Japan. 21 of the 69 total patients (30.4%) seen at the hospital were under 1 y of age. None of the 69 patients had received measles vaccine. 43 out of 50 nasopharyngeal swabs subjected to polymerase chain reaction assay (86%) were positive for the hemagglutinin (H) gene. The measles strain isolated from patients was classified as a D3 genotype. Such outbreaks are important epidemiologically, and these findings shed light on vaccination and immunity patterns in this urban population.     

Postprandial glycemia--review of current pathophysiological, epidemiological and clinical aspects

One of the most difficult current medical problems is the growing epidemics of diabetes mellitus. The contemporary treatment aims not only to secure the patients survival and to protect from the acute symptoms but also to avoid the occurrence of the chronic complications of the disease. This paper contains a review of the role that postprandial hyperglycemia plays in the treatment of diabetes mellitus especially type 2. Authors summarize findings of pathophysiological and epidemiological macroangiopathy studies that indicate the use of prandial glucose regulation in clinical practice. This review contains discussion of postulated mechanism in which short-lasting increases in plasma glucose concentration can damage vessel wall lead to atherosclerosis. Epidemiological studies showing the strong correlation between postprandial (and post-challenge) plasma glucose levels with cardiovascular endpoints are also discussed. Moreover, in this paper the reader may find a discussion on practical aspects of postprandial hyperglycemia monitoring in the treatment of diabetic patient, focusing at the relationship between prandial glycaemia and long term glycaemia control expressed by HbA(1c) measurements. The guidelines for monitoring postprandial glycaemia are also included. The modern therapeutic possibilities aiming post-prandial hyperglycaemia are also showed.     

Refractory anemia occurring in survivors of the atomic bombing in Nagasaki,Japan

In this paper the case histories of six Nagasaki atomic bomb survivors whodeveloped refractory anemia are presented. Four of these individuals receivedundoubted radiation injury. The fact that refractory anemia may occur as a latemanifestation of exposure to atomic radiation is pointed out.

Submitted on July 1, 1953 Accepted on August 15, 1954