ABSTRACT
Japanese botulinum antitoxins have been used for more than 50 years; however, their safety and therapeutic efficacy are not clear. In order to analyze the available data on botulinum antitoxin therapy in Japan, we surveyed published reports about botulism cases in which botulinum antitoxins were used, and retrospectively analyzed the safety and efficacy of the therapy. A total of 134 patients administered botulinum antitoxins were identified from published reports. Two cases of side effects (1.5%) were detected after antitoxin administration, both not fatal. The fatality rate was 9.4%, and more than 70% of the patients showed improvement in their symptoms and better clinical conditions than those not treated with antitoxins. These data suggest that the therapy with Japanese antitoxins is safe and highly effective.
Subject(s)
Botulinum Antitoxin/therapeutic use , Botulism/drug therapy , Adolescent , Adult , Aged , Botulinum Antitoxin/adverse effects , Botulism/mortality , Botulism/physiopathology , Child , Female , Health Care Surveys , Humans , Japan/epidemiology , Male , Middle Aged , Public Health Informatics , Retrospective Studies , Severity of Illness Index , Survival Analysis , Young AdultABSTRACT
Tick-borne encephalitis virus (TBEV) is a zoonotic agent causing severe encephalitis in humans. A recent epizootiological survey indicated that endemic foci of TBEV have been maintained in the southern part of Hokkaido until recently. In this study, we sought to isolate TBEV from wild rodents in the area. One virus, designated Oshima 08-As, was isolated from an Apodemus speciosus captured in Hokuto in 2008. Oshima 08-As was classified as the Far Eastern subtype of TBEV and formed a cluster with the other strains isolated in Hokkaido from 1995 to 1996. Thirty-six nucleotide differences resulted in 12 amino acid changes between Oshima 08-As and Oshima 5-10 isolated in 1995. Oshima 08-As caused high mortality and morbidity in a mouse model compared with Oshima 5-10. Although similar transient viral multiplication in the spleen was observed in the mice infected with Oshima 08-As and Oshima 5-10, greater viral multiplication with an inflammatory response was noted in the brains of mice infected with Oshima 08-As than those infected with Oshima 5-10. These data indicate that a few naturally occurring mutations affect the pathogenicity of the Oshima strains endemic in the southern part of Hokkaido.
Subject(s)
Antigens, Viral/immunology , Encephalitis Viruses, Tick-Borne/isolation & purification , Encephalitis, Tick-Borne/veterinary , Murinae , Rodent Diseases/epidemiology , Animals , Animals, Suckling , Animals, Wild , Brain/pathology , Brain/virology , Cell Line , Cricetinae , Disease Models, Animal , Encephalitis Viruses, Tick-Borne/classification , Encephalitis Viruses, Tick-Borne/genetics , Encephalitis Viruses, Tick-Borne/pathogenicity , Encephalitis, Tick-Borne/epidemiology , Encephalitis, Tick-Borne/virology , Female , Humans , Japan/epidemiology , Mice , Mice, Inbred C57BL , Mutation , Phylogeny , Rodent Diseases/immunology , Rodent Diseases/virology , Rodentia , Spleen/pathology , Spleen/virology , Virus Replication , ZoonosesABSTRACT
Tick-borne encephalitis virus (TBEV) is a zoonotic agent causing severe encephalitis in humans. Rodent species that are potential hosts for TBEV are widely distributed in various regions in Japan. In this study, we carried out large-scale epizootiological surveys in rodents from various areas of Japan. A total of 931 rodent and insectivore sera were collected from field surveys. Rodents seropositive for TBEV were found in Shimane Prefecture in Honshu and in several areas of Hokkaido Prefecture. These results emphasize the need for further epizootiological and epidemiological research of TBEV and preventive measures for emerging tick-borne encephalitis in Japan.
