Rickettsioses in Japan and the Far East
Rickettsioses in Japan and the Far East
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DOI：
10.1196/annals.1374.007
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Mahara, Fumihiko
中科院分区：
文献类型：
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作者：
Mahara, Fumihiko
目前已知在日本存在三种立克次体疾病：日本斑点热（JSF）、恙虫病（TD;恙虫病）和Q热。自1999年4月以来，日本的感染控制和预防系统发生了巨大变化。JSF、Q热和TD作为新发传染病，被指定为国家法定报告疾病。JSF患者的地理分布是沿着日本中部和西南部的海岸，而TD和Q热几乎发生在全国各地。1984 - 1998年报告的JSF患者数量为216例，1999 - 2004年根据修订后的法律报告的JSF患者数量为268例。每年约有30万例TD发生，1999 - 04年发生Q热76例。JSF的病例数和流行面积都在逐渐增加。直到2003年，只有一名患者死于JSF，而2004年有两名患者死于JSF，因此JSF在日本仍然是一种危及生命的疾病。暴发性JSF的治疗包括及时给予四环素和喹诺酮的联合治疗。最近的蜱调查显示，JSF最可能的媒介是黄色血蜱和歇斯底里血蜱。除了R.日本的蜱中分离出两种斑点热群立克次体血清型或种，一种与R.另一个是一个未知基因型AT的新基因型，它与一个Helvetica基因型密切相关。这些血清型的临床意义尚不确定。简要介绍了远东地区立克次体病的流行病学。
Three rickettsial diseases are known to exist in Japan currently: Japanese spotted fever (JSF), Tsutsugamushi disease (TD; scrub typhus), and Q fever. Since April 1999, the system for infection control and prevention in Japan has changed drastically. JSF, Q fever, and TD, as emerging infectious diseases, are designated as national notifiable diseases. The geographic distribution of JSF patients is along the coast of central and southwestern Japan, whereas TD and Q fever occur almost all over the country. The number of JSF patients reported was 216 cases during 1984998 and 268 cases, under the revised law, in 1999004. About 300000 cases of TD occur every year, and 76 cases of Q fever in 1999004. The number of cases of JSF and its endemic area are gradually increasing. There was only one fatality due to JSF until 2003, whereas two patients died of JSF in 2004, so JSF is still a life-threatening disease in Japan. Treatment of fulminant JSF consists of prompt administration of a combination of tetracycline and quinolone. Recent tick surveys revealed that the most probable vectors of JSF are Haemophysalis flava and Haemophysalis hystericis. In addition to R. japonica, two serotypes or species of spotted fever group rickettsiae have been isolated from ticks in Japan; one is closely related to R. helvetica and the other is a new genotype of unknown genotype AT, which is closely related to a Slovakian genotype. These serotypes are of uncertain clinical significance. Epidemiology of rickettsioses in the Far East is mentioned briefly.