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Yoshinari T.,Japan National Institute of Health Sciences | Takeuchi H.,11 Health | Aoyama K.,Food and Agricultural Materials Inspection Center | Taniguchi M.,11 Health | And 10 more authors.
Journal of Food Protection | Year: 2014

A survey of the contamination of wheat, barley, and Japanese retail food by four Fusarium mycotoxins, deoxynivalenol (DON), zearalenone (ZEN), T-2 toxin (T-2), and HT-2 toxin (HT-2), was performed between 2010 and 2012. A method for the simultaneous determination of the four mycotoxins by liquid chromatography-tandem mass spectrometry was validated by a small-scale interlaboratory study using two spiked wheat samples (DON was spiked at 20 and 100 μg/kg and ZEN, T-2, and HT-2 at 6 and 20 μg/kg in the respective samples). The recovery of the four mycotoxins ranged from 77.3 to 107.2%. A total of 557 samples of 10 different commodities were analyzed over 3 years by this validated method. Both T-2 and HT-2 were detected in wheat, wheat flour, barley, Job's tears products, beer, corn grits, azuki beans, soybeans, and rice with mixed grains. Only T-2 toxin was detected in sesame seeds. The highest concentrations of T-2 toxin (48.4 μg/kg) and HT-2 toxin (85.0 μg/kg) were present in azuki beans and wheat, respectively. DON was frequently detected in wheat, wheat flour, beer, and corn grits. The contamination level of wheat was below the provisional standard in Japan (1,100 μg/kg). The maximum contamination level of DON was present in a sample of a Job's tears product (1,093 μg/kg). ZEN was frequently detected in Job's tears products, corn grits, azuki beans, rice with mixed grains, and sesame seeds. A sample of a Job's tears product presented the highest ZEN contamination (153 μg/kg). These results indicate that continuous monitoring by multiple laboratories is effective and necessary due to the percentage of positive samples detected. Source

Gu Y.,Tohoku University | Gu Y.,Japan National Institute of Infectious Diseases | Shimada T.,Japan National Institute of Infectious Diseases | Yasui Y.,Japan National Institute of Infectious Diseases | And 4 more authors.
PLoS ONE | Year: 2013

Influenza-associated encephalopathy (IAE) is a serious complication of influenza and is reported most frequently in Japan. This paper presents an assessment of the epidemiological characteristics of influenza A (H1N1) 2009-associated encephalopathy in comparison to seasonal IAE, based on Japanese national surveillance data of influenza-like illness (ILI) and IAE during flu seasons from 2004-2005 through 2009-2010. In each season before the pandemic, 34-55 IAE cases (mean 47.8; 95% confidence interval: 36.1-59.4) were reported, and these cases increased drastically to 331 during the 2009 pandemic (6.9-fold the previous seasons). Of the 331 IAE cases, 322 cases were reported as influenza A (H1N1) 2009-associated encephalopathy. The peaks of IAE were consistent with the peaks of the influenza epidemics and pandemics. A total of 570 cases of IAE (seasonal A, 170; seasonal B, 50; influenza A (H1N1) 2009, 322; unknown, 28) were reported over six seasons. The case fatality rate (CFR) ranged from 4.8 to 18.2% before the pandemic seasons and 3.6% in the 2009 pandemic season. The CFR of pandemic-IAE was 3.7%, which is lower than that of influenza A-/B-associated encephalopathy (12.9%, p<0.001; 14.0%, p = 0.002; respectively). The median age of IAE was 7 years during the pandemic, which is higher than that of influenza A-/B-associated encephalopathy (4, p<0.001; 4.5, p = 0.006; respectively). However, the number of pandemic-IAE cases per estimated ILI outpatients peaked in the 0-4-year age group and data both before and during the pandemic season showed a U-shape pattern. This suggests that the high incidence of influenza infection in the 0-4 year age group may lead to a high incidence of IAE in the same age group in a future influenza season. Further studies should include epidemiologic case definitions and clinical details of IAE to gain a more accurate understanding of the epidemiologic status of IAE. © 2013 Gu et al. Source

Saitoh A.,Niigata University | Saitoh A.,University of California at San Diego | Okabe N.,Japan National Institute of Infectious Diseases | Okabe N.,Kawasaki City Institute for Public Health
Vaccine | Year: 2012

The " vaccine gap" is a term which has been used in Japan to indicate that the current immunization program is behind compared to the programs in other developed countries. The current national immunization program (NIP) which was established under the Japanese Immunization Law includes only six vaccines (eight targeted diseases), and the rest of available vaccines have been categorized as voluntary vaccines, which require out-of-pocket expense in order for the patients to receive them. This has led the vaccination rates for the voluntary vaccines remaining low, and the incidence of the target diseases remaining high. In addition, there are a few domestic rules that exist for immunizations including (1) subcutaneous injection is the standard method of vaccination, (2) the thigh is not considered to be the common site of vaccination in infants, and (3) the intervals of administration of inactivated and live vaccines are strictly determined by law. Along with the " vaccine gap" and the domestic rules, some movements to improve our current NIP are underway; including increased calls to change the NIP from civilians and professionals, the establishment of a group by the representatives from 13 medical professional societies asking the government to consider the immunization policy a " national policy" and seeking the establishment of a new and reorganized national immunization technical advisory group (NITAG). In addition, the Vaccination Subcommittee of Health Sciences Council was formed in the government to reform the current Immunization Law and NIP, which established a new national program for three voluntary vaccines funded by a temporary budget. We hope these new movements will fill the " vaccine gap" and that the NITAG will help ensure that vaccine policy becomes a national policy, and will provide necessary vaccinations without out-of-pocket expense to protect children in Japan from vaccine preventable diseases. © 2012. Source

Sano T.,Nara Medical University | Akahane M.,Nara Medical University | Sugiura H.,Nara Medical University | Ohkusa Y.,National Institute of Infectious Disease | And 3 more authors.
International Journal of Environmental Health Research | Year: 2013

With increasing Internet coverage, the use of a web-based survey for epidemiological study is a possibility. We performed an investigation in Japan in winter 2008 using the web-based daily questionnaire for health (WDQH). The WDQH is a web-based questionnaire survey formulated to obtain information about the daily physical condition of the general public on a real-time basis, in order to study correlations between changes in physical health and changes in environmental factors. Respondents were asked whether they felt ill and had specific symptoms including fever. We analysed the environmental factors along with the health conditions obtained from the WDQH. Four factors were found to influence health: minimum temperature, hours of sunlight, median humidity and weekday or holiday. The WDQH allowed a daily health survey in the general population in real time via the Internet. © 2013 Taylor & Francis. Source

Saitoh A.,Niigata University | Saitoh A.,University of California at San Diego | Okabe N.,Kawasaki City Institute for Public Health
Vaccine | Year: 2014

Recent progress in the Japanese immunization program has partially closed the "vaccine gap," i.e., the deficiencies in that program relative to immunization programs in other developed countries. During the last several years, seven new vaccines (12 new products, excluding influenza vaccines) have been introduced in Japan. Five of these new vaccines are produced outside Japan and four are now included as routine vaccines in the National Immunization Program, which is a new development in the licensing and financial support of imported vaccines. However, along with this progress, important concerns have arisen regarding the Japanese immunization program. A rubella epidemic among adults, in 2012-2013, resulted in more than 40 cases of congenital rubella syndrome as of March 2014. In addition, the temporary withdrawal of the active governmental recommendation for human papilloma virus vaccines, in 2013-2014, highlighted challenges in the current Japanese immunization system. Furthermore, some important vaccines - including vaccines for hepatitis B virus, mumps, varicella, and rotavirus - are still not included in the National Immunization Program and have been categorized as voluntary vaccines since their introduction. The possibility of their inclusion in the National Immunization Program remains a matter for discussion. We hope that future initiatives will further address the vaccine gap and protect Japanese children from vaccine-preventable diseases. © 2014 Elsevier Ltd. Source

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