Surveillance, recognition, and reporting of Tsutsugamushi disease (scrub typhus) and Japanese spotted fever by general practice clinics in Miyazaki Prefecture, determined by questionnaire survey in 2007

In June 2007, a questionnaire survey related to the surveillance, recognition, and reporting of Tsutsugamushi disease (TD) and Japanese spotted fever (JSF) — diseases considered endemic in Miyazaki Prefecture — was distributed to general practice clinics in the prefecture. The response rate was 40.9% (232/567). While 75.5% of the responding clinics knew TD to be a notifiable disease, only 41.8% knew JSF was notifiable. The recognition level of JSF surveillance was lower in the low-incidence areas of JSF within Miyazaki Prefecture. In 2006, 25 cases were clinically suspected as TD by the responding clinics; of the 25 cases, 9 were confirmed and 8 of these were reported to the National Epidemiological Surveillance of Infectious Diseases (NESID). Only 1 of 6 clinically suspected JSF cases from the responding clinics was confirmed in 2006, and it was not reported to NESID. The clinics located in the high-incidence areas for TD tended not to perform laboratory confirmation of the clinically suspected cases of either of the diseases. Considering that NESID requires laboratory confirmation of the reported cases of these diseases, their extent may be underestimated, especially in the high-incidence areas. For clinics in Miyazaki Prefecture, we need to publicize the existence of JSF surveillance and inform clinics about the laboratories available for confirmation of JSF and TD in the prefecture.