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Otsuka Y, Hagiya H, Fukushima S, Harada K, Koyama T, Otsuka F. Trends in the Incidence of Japanese Spotted Fever in Japan: A Nationwide, Two-Decade Observational Study from 2001-2020. Am J Trop Med Hyg 2023; 108:701-704. [PMID: 36746667 PMCID: PMC10076997 DOI: 10.4269/ajtmh.22-0487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/01/2022] [Indexed: 02/08/2023] Open
Abstract
The worldwide spread of tick-borne diseases (TBDs) has become a public health concern. Therefore, this study aimed to clarify trends in the incidence of Japanese spotted fever (JSF), one of Japan's most prevalent TBDs. Weekly infectious disease reports were used to calculate the annual incidence rates (AIRs) of JSF. Data were stratified by age and sex, and joinpoint regression analysis was performed to estimate the annual percentage change (APC). AIR and APC were geographically compared among the 47 prefectures. A total of 3,453 JSF cases were observed from 2001 to 2020. The AIR per 100,000 population was 0.03 in 2001, which increased approximately 10-fold to 0.33 in 2020. The average APC (AAPC) during the study period was 12.3% (95% CI: 10.7-13.9). By age group, the incidence of JSF increased more rapidly among the older population: 11.5% (95% CI: 10.1-12.9) in those aged ≥ 65 years and 8.9% (95% CI: 6.4-11.5) in those aged < 50 years. Although the AIR over the past two decades was higher in climatically warm regions located in southwestern Japan and on the Pacific coast, increases in the AAPC were notable in colder regions located in eastern Japan. The incidence of JSF continues to increase in Japan, especially among older populations and in eastern prefectures, where the disease has not been previously diagnosed.
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Affiliation(s)
- Yuki Otsuka
- Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Hideharu Hagiya
- Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Shinnosuke Fukushima
- Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Ko Harada
- Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York
| | - Toshihiro Koyama
- Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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Kobayashi KI, Utatsu N, Kanbe C, Niu T, Terasoma F, Ando S, Kubo K, Komiya N. A Cluster of Japanese Spotted Fever Cases Associated with Cemetery Visits in Wakayama City, Japan. Am J Trop Med Hyg 2023; 108:513-517. [PMID: 36716740 PMCID: PMC9978555 DOI: 10.4269/ajtmh.22-0563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/29/2022] [Indexed: 01/31/2023] Open
Abstract
Japanese spotted fever (JSF) is a tick-borne rickettsiosis caused by Rickettsia japonica. Although the number of JSF cases has been increasing, exceeding 300 per year since 2017, clusters of cases are rare. Here, we report a cluster of seven JSF cases, the first nonfamilial cluster of the disease documented in the Japanese literature, and describe the management of the outbreak through prompt investigation and control-and-prevention measures performed collaboratively by members from the clinical, laboratory, and public health fields. All seven cases in the cluster had visited a cemetery in September or October of 2019. R. japonica was detected in whole-blood and/or skin samples from six patients and in the larvae of Haemaphysalis hystricis collected in a field survey. The evidence suggested that this cluster of cases was caused by the conjunction of two circumstances within a short period of time: an increase in the number of visitors to a cemetery during a Buddhist event and an increase in the number of infectious tick larvae in the cemetery through hatching (vertical transmission from infected females). Delays in the treatment of JSF can lead to severe manifestations. Early interventions through collaborative efforts among members from the clinical, laboratory, and public health fields are important for controlling outbreaks, raising the awareness of the public, and diagnosing and treating patients.
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Affiliation(s)
- Ken-ichiro Kobayashi
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Nobuko Utatsu
- Section of Health Crisis Management, Wakayama City Public Health Center, Wakayama, Japan
| | - Chisa Kanbe
- Section of Health Crisis Management, Wakayama City Public Health Center, Wakayama, Japan
| | - Tetsuya Niu
- Section of Health Crisis Management, Wakayama City Public Health Center, Wakayama, Japan
| | - Fumio Terasoma
- Public Health Research Division, Wakayama Prefectural Research Center of Environment and Public Health, Wakayama, Japan
| | - Shuji Ando
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenji Kubo
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
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Kobayashi K, Shikino K, Sano H, Shibata T, Higuchi S, Miyamoto M, Ban T. Family cluster of Japanese spotted fever. QJM 2022; 115:169-170. [PMID: 35021228 DOI: 10.1093/qjmed/hcac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Kobayashi
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - K Shikino
- Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-city, Chiba 260-8677, Japan
| | - H Sano
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - T Shibata
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - S Higuchi
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - M Miyamoto
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - T Ban
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
- Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-city, Chiba 260-8677, Japan
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Silva-Ramos CR, Faccini-Martínez ÁA. Clinical, epidemiological, and laboratory features of Rickettsia africae infection, African tick-bite fever: A systematic review. LE INFEZIONI IN MEDICINA 2022; 29:366-377. [PMID: 35146341 DOI: 10.53854/liim-2903-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/27/2021] [Indexed: 11/03/2022]
Abstract
African tick-bite fever (ATBF), caused by Rickettsia africae, is the main tick-borne rickettsiosis and the second most frequent cause of fever after malaria in travelers returning from sub-Saharan Africa. General descriptions on ATBF were made in the first two decades after recognized as a new infectious entity, and since then, many authors have contributed to the knowledge of the disease by reporting clinical cases in scientific literature. We developed a systematic review that evaluated all available evidence in the literature regarding clinical, epidemiological, and laboratory features of confirmed R. africae rickettsiosis cases. We followed the recommendations made by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide. A total of 48 scientific publications (108 confirmed cases) were analyzed in order to extract data for developing this review. Overall, our results show that R. africae rickettsiosis is more frequent in males in the age group of 18-64 years, more than 80% of the cases occurred in European travelers, South Africa was the country where most infections were acquired, and almost 40% of cases occurred in clusters. Clinically, more than 80% of the cases had fever and eschar (55% developed multiple eschars), rash was present in less than the half of cases, and lymphangitis was not a common sign (11%). Headache, myalgia and regional lymphadenopathy were predominant nonspecific clinical manifestation (mean of 60%, 49% and 51%, respectively). Our results show that at least 70% of R. africae cases had altered laboratory parameters, most often showing an increase in transaminases and C-reactive protein. Tetracycline-class antibiotics, as monotherapy, were used in most (>90%) of the patients. Overall, only 4% of cases had complications, 12% required hospitalization, and there was a 100% rate of clinical recovery.
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Affiliation(s)
- Carlos Ramiro Silva-Ramos
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Álvaro A Faccini-Martínez
- Department of Pathology, University of Texas Medical Branch, Galveston, TX, USA.,Committee of Tropical Medicine, Zoonoses and Travel Medicine, Asociación Colombiana de Infectología, Bogotá, Colombia
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Takahashi M, Sasaki N. Japanese spotted fever exhibiting leukocytoclastic vasculitis. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2020. [DOI: 10.1002/cia2.12110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Masayuki Takahashi
- Department of Dermatology Kure‐Kyosai HospitalFederation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
| | - Naomi Sasaki
- Department of Pathology Kure‐Kyosai HospitalFederation of National Public Service Personnel Mutual Aid Associations Hiroshima Japan
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Affiliation(s)
- H Matsuura
- Department of General Internal Medicine, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki-city, Okayama, Japan, Department of General Internal Medicine, Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji-city, Kagawa, Japan
| | - K Yamauchi
- Department of Gastroenterology, Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji-city, Kagawa, Japan
| | - K Kagawa
- Department of Cardiology, Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji-city, Kagawa, Japan
| | - F Zheng
- Department of General Internal Medicine, Mitoyo General Hospital, 708, Himehama, Toyohama-cho, Kanonji-city, Kagawa, Japan
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