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Shiga Toxin (Verotoxin)-Producing in Japan

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  • Authors: Jun Terajima1, Sunao Iyoda2, Makoto Ohnishi3, Haruo Watanabe4
  • Editors: Vanessa Sperandio5, Carolyn J. Hovde6
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; 2: Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; 3: Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; 4: Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan; 5: University of Texas Southwestern Medical Center, Dallas, TX; 6: University of Idaho, Moscow, ID
    • Source: microbiolspec September 2014 vol. 2 no. 5 doi:10.1128/microbiolspec.EHEC-0011-2013
  • Received 18 June 2013 Accepted 23 July 2013 Published 19 September 2014
  • Haruo Watanabe, haruwata@nih.go.jp
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  • Abstract:

    A series of outbreaks of infection with Shiga toxin (verocytotoxin)-producing or enterohemorrhagic (EHEC) O157:H7 occurred in Japan in 1996, the largest outbreak occurring in primary schools in Sakai City, Osaka Prefecture, where more than 7,500 cases were reported. Although the reason for the sudden increase in the number of reports of EHEC isolates in 1996 is not known, the number of reports has grown to more than 3,000 cases per year since 1996, from an average of 105 reports each year during the previous 5-year period (1991–1995). Despite control measures instituted since 1996, including designating Shiga toxin-producing infection as a notifiable disease, and nationwide surveillance effectively monitoring the disease, the number of reports remains high, around 3,800 cases per year. Serogroup O157 predominates over other EHEC serogroups, but isolation frequency of non-O157 EHEC has gone up slightly over the past few years. Non-O157 EHEC has recently caused outbreaks where consumption of a raw beef dish was the source of the infection, and some fatal cases occurred. Laboratory surveillance comprised prefectural and municipal public health institutes, and the National Institute of Infectious Diseases has contributed to finding not only multiprefectural outbreaks but recognizing sporadic cases that could have been missed as an outbreak without the aid of molecular subtyping of EHEC isolates. This short overview presents recent information on the surveillance of EHEC infections in Japan.

  • Citation: Terajima J, Iyoda S, Ohnishi M, Watanabe H. 2014. Shiga Toxin (Verotoxin)-Producing in Japan. Microbiol Spectrum 2(5):EHEC-0011-2013. doi:10.1128/microbiolspec.EHEC-0011-2013.

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References

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Abstract:

A series of outbreaks of infection with Shiga toxin (verocytotoxin)-producing or enterohemorrhagic (EHEC) O157:H7 occurred in Japan in 1996, the largest outbreak occurring in primary schools in Sakai City, Osaka Prefecture, where more than 7,500 cases were reported. Although the reason for the sudden increase in the number of reports of EHEC isolates in 1996 is not known, the number of reports has grown to more than 3,000 cases per year since 1996, from an average of 105 reports each year during the previous 5-year period (1991–1995). Despite control measures instituted since 1996, including designating Shiga toxin-producing infection as a notifiable disease, and nationwide surveillance effectively monitoring the disease, the number of reports remains high, around 3,800 cases per year. Serogroup O157 predominates over other EHEC serogroups, but isolation frequency of non-O157 EHEC has gone up slightly over the past few years. Non-O157 EHEC has recently caused outbreaks where consumption of a raw beef dish was the source of the infection, and some fatal cases occurred. Laboratory surveillance comprised prefectural and municipal public health institutes, and the National Institute of Infectious Diseases has contributed to finding not only multiprefectural outbreaks but recognizing sporadic cases that could have been missed as an outbreak without the aid of molecular subtyping of EHEC isolates. This short overview presents recent information on the surveillance of EHEC infections in Japan.

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Shiga Toxin (Verotoxin)-Producing in Japan
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Citation: Terajima J, Iyoda S, Ohnishi M, Watanabe H. 2014. Shiga toxin (verotoxin)-producing in japan. microbiolspec 2(5): doi:10.1128/microbiolspec.EHEC-0011-2013
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FIGURE 1

Reported cases of EHEC infection, 1996 to 2012. doi:10.1128/microbiolspec.EHEC-0011-20013.f1

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FIGURE 1

Reported cases of EHEC infection, 1996 to 2012. doi:10.1128/microbiolspec.EHEC-0011-20013.f1

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FIGURE 2

Incidence rate of HUS in EHEC infection by age groups in Japan, 2006 to 2012. Incidence rate (%) was calculated as (number of patients with HUS) ÷ (number of symptomatic cases) × 100%. doi:10.1128/microbiolspec.EHEC-0011-20013.f2

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FIGURE 2

Incidence rate of HUS in EHEC infection by age groups in Japan, 2006 to 2012. Incidence rate (%) was calculated as (number of patients with HUS) ÷ (number of symptomatic cases) × 100%. doi:10.1128/microbiolspec.EHEC-0011-20013.f2

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Shiga Toxin (Verotoxin)-Producing in Japan
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Citation: Terajima J, Iyoda S, Ohnishi M, Watanabe H. 2014. Shiga toxin (verotoxin)-producing in japan. microbiolspec 2(5): doi:10.1128/microbiolspec.EHEC-0011-2013
/content/microbiolspec/10.1128/microbiolspec.EHEC-0011-2013.T1
TABLE 1

Characterization of 12 EHEC outbreaks with more than 100 culture-positive cases between 2000 and 2012

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TABLE 1

Characterization of 12 EHEC outbreaks with more than 100 culture-positive cases between 2000 and 2012

Source: microbiolspec September 2014 vol. 2 no. 5 doi:10.1128/microbiolspec.EHEC-0011-2013

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