Epidemiology of Infectious Hepatitis 2nd Report. Epidemic Observation on the Infectious Hepatitis in Akaiwa District (No. 2)

Comparing the epidemic of infectious hepatitis that took place in Toyoda, Onoda, as well as Kumayama in Akaiwa County, during the period ranging from march 1951 to sept. do., with the previous report on the epidemic of malignant hepatitis submitted by february 1951, following results were obtained: 1. Number of patients, 120; total ever since the first. occurence, 213 cases; For the total populace, rate of occurence, Toyoda-39%, Onoda-3.1%, Kama-mura, 2.4%. 2. As for the type of disease. contrary to the previous occasion in which typical form was predominant, this time saw the predominaney of abortive form, of which the mortality rate proved only 0.83%, in comparison to 13.9% estimated in the former time. 3. As for state of starting estimated by month, as previous occasion, maximum occurrence took place in July and August. 4. As for age, showing similar trend as before, 21-30 occupying most cases, evenly has diffused from 10 to 60. There were actually 7 cases that were above 61, which verifies that contamination in old age is not so seldom. 5. As has been in the previous occasion, as to state of contamination, what may be called village infection occupied the majority of cases; where, a special increase of familiary infection has drawn our attention, amounting to the rate of 38.3%, in comparison to former 20.4%, Which, as the infection spread itself, increases in number. 6. Familiary infection may be explained by propagated epidemic form. Its three cases had been delivered. 7. On taking a bird's'-eye-view over the whole area that was infected, the special phase for this season will come under two heads; area in which new patients have emerged around those affected formerly., and the other, which has been contaminated with a fixed current toward areas not yet. infected. The latter is considered to take shift into the former form after a while. 8. Though rare, sporadic infection could be found in this epidemic too, each of which was a case infections being pressed onward into uncontaminated area, and 6 out of 9 cases have become the source for later infection. If theses poradic infections were considered in detail, these would be clear to have a connection with that of epidemic places and also able to come under propagated epidemic form

Epidemiology of Infectious Hepatitis 3rd Report. On the Mass Examination Taken for Shakurenzi Hamlet

The mass examination was carried out in Shakurenji, Kama- Village, Akaiwa Connty, Okayama Pref., where great many deathes have been taken place by infectious hepatitis; results were as follows: 1. 127 persons received the examination; it has covered 94.1% of the entire people. 2. Those who have had jaundice previously were enumerated as 5 cases; as it was just the season when infectious hepatitis was in vogue in other parts of the Prefecture, though slight in degree, it was imagined that probably in the past there might have occurred a few sporadic cases. Among those, 3 were taken record of as new victims of disease, 3. In 6 cases, the patients complained of certain pain, each having some sort of liver disturbance more or less. 4. There were 24 cases in which liver enlargement could be detected; its rate, 18.9%, while splenomegaly been discovered in only one case. 5. Two women in pregnancy were recognized, one sickened case, the other inapparent infection case. 6. As for wide-range judgment taken after the examinaton, must-be-treated case, 5, must-be taken-care-of case 5. inapparent infection 60, 70 in total. percentage of contraction, 55.1%, adding 3 cases starting disease as well as 3 deaths; thus, great total, 76 cases; its rate, 57.1%. 7. Percentage of contraction has proved high in thirties and above 50. By sex, females superseded, but as to age, no definite conclusion could be established. 8. In case those patients exposed would be divided by respective family and investigated, it has been revealed thus: (a) with families which have used a well in common with the family in which death case or at least patient was found, Percentage of contraction has proved high and almost in like degree, since many were adviced to receive treatment, or, be taken care of. (b) Families which employed a well in common, were recognized to have proved about the same ratio in infection, containing not a few ought to be treated or taken care of, which suggests us an infection due to a well. (c) Among the group of families, whose relatives died of this disease, master of the house who had presented himasdlf over the funeral diet has been found to have taken infection alone

Epidemiology of Infectious Hepatitis 1st. Chapter Epidemiologic Observations for Infectious Hepatitis in Akaiwa District (No. 1)

Since August 1951 to Feb. 1953, there was a great epidemic of serious infectious hepatitis over the area including Toyota, Onoda, Kama villages in Akaiwa County, as well as Kumayama village in wake County; observing its state, the following results were obtained. 1. Death toll has amounted to 13, out of 93 patients: its mortality rate, 13.98%; in number of the patients, Kama at the top, next, Toyoda, Onoda and Kumayama village, in literal order. 2. The epidemic took the direction, from the south extending to the north in a slow march, taking a hamlet as unit, showed a lack of specific seasonal occurence. 3. As to age, it has ranged roughly from 10 to 60, amid which 21-30 figured out as top years; below 10, only 4 cases; above 70, 5 cases. As to sex, almost similar in number. 4. As to profession, principally, farming people; as one can suppose from its locality. In making investigations into the cause of disease. certain consideration must be taken on the great responsibility imposed on farmers' wives. 5. The infection for this disease was classified as village infection or familiary infection; among 22 cases (23.4% of total patients) of familary infection, there were 4 families, each yielding even 3 sickened members; 5 families whose two members taken infection; in total, amnunted to 9 families. Among these tribal infection, report has been submitted about 1 family whose infection tract was clearly traced, as well as a family in which, if man did not expose certain inapparent infections, all cases have proved utterly whimsical. 6. The incubation period for this disease may probably be estimated to be about 24-27 days, if it may be supposed from these infectious state, and would be considered perorale infection

Studies on the Prophylaxis for Infectious Hepatitis 3rd. Report. on the Prophylaxls By Means of Inoculations With Human Serum γ-GIobulin

Prophylactic treatments, including inoculations with γ-globulin derived from human serum and placenta, were taken to the epidemic of infectious hapatitis at kagato-cho, Wake-gum, Okayama Prefecture. After these treatments, observing the emergence of new patients of hepatitis for full one year, following results were obtained. 1) New patients emerged not only in the contrast group but inoculated one. Of the three group, inoculated with human serum γ-globulin, inocnlated with human placental γ-globulin and contrast group, percentage of contraction is higher the inoculated group with human sernm γ-globtlin than others. 2) By the results of the mass examination, two groups were divided, the one included inapparent and latent infections, and the other was healthy cases. Observing the emergence of new patients in the group of healthy cases, percentage of emergence of the inoculated group with human serum and placental r-globulin was apparently lower than the contrast group. 3) From the facts above mentioned, it has been supposed that the inoculations with γ-globulin derived from human serum and placenta proved to have sufficient effect for non infected, but on the contrary little effect for infected before. 4) More than nine months after the inoculations, no prophylactic effect was supposed using inoculations with human serum γ-globulin for infectious hepatitis

Studies on the Prophylaxis for Infectious Hepatitis 1st. Report. a Consideration Refer to Prophylaxis in General and Its Effect

Patients, including latent infections, were detected by excuting mass examination for two hamlets of Kumayama-cho, a small town prevailing infectious hepatitis, Akaiwa-gun, Okayama Prefecture. Complete medical treatments of these patients were instructed, and also the cases must be taken care of were adequately leaded. Special efforts were taken to improve sanitary and hygienic practices in the community likewise other intestinal infections. In comparison with other hamlets which did not take adequate treatment, epidemic of infectious hepatitis has been almost protected and remarkable results were obtained after one year. These facts might offer interesting materials to prophylaxis for infectious hepatitis

Studies on the Prophylaxis for Infectious Hapatitis 2nd. Report. on the Prophylaxis By Means of inoculations with Human Placental γ-Globulin

1) 1,324 villagers of Yoshikawa Village were inoculated with human placental γ-globulin "Neomasin" and sufficient effect was observed during the period of prevailing infectious hepatitis in this district of Jyobo-gun, Okayama prefecture. 2) These inoculations were effective even as late as 7 days before onset of hepatitis. 3) Effect of these inoculations did not depent upon age as well as sex of patient

A Consideration on the New Patients Attacked By So Called Secondary Epidemic of Infectious Hepatitis

1. The new patients of so called secondary epidemy of infectaous hepatitis were chiefly those who had been listed as the patients of latent hepatitis or inapparent infection in the previous epidemy. 2. In fairly great number of cases in which the patients were listed as inapparent infection, patients complained trifling subjective symptoms and later they were suspected as of slight abortive form. In the cases of compiaining subjective symptoms as well as in the cases of having no complaint, the percentage of onset was approximately the same. In case of infectious hepatitis, it is considered that the germs may have same slight responsive effect upon the patient after infected, or sometimes may have no effect for considerablly long time, but as the physical strength declines, the germs show their special quality of causing the apparent symptoms

Epidemiology of Infectious Hepatitis Report VIII On The Collective Outbreake of Infectious Hepatitis At Showo Junior High School

107 students of Showe Junior High School (out of 510) suffered from infectious hepatitis in a short period after 24th of May, 1954. Detailed clinical and epidemiological researches were made on them and the following results were obtained. 1. In the epidemic of this school, abortive form (gastro-intestinal form and partly common cold form) was seen in most cases and the epidemic belonged to the slight form of infectious hepatitis. 2. At that time, sporadic epidemie was seen among the people of this district. 3. It was supposed that this epidemie was carried by the contaminated water of the common well and it was the common vehicle epidemie. 4. The fact that many hepatitis patients appeared especially in June, was presumably due to the precipitating factor of interim examination, athletic meetings etc. reducing the physical strength

Studies on the Remote Results of Epidemic Hepatitis Report IV On the results at Kamiukan-Mura, Jyobo-Gun, Okayama

The complete examination was done on the 143 cases, passed for 1 year after the release of treatment under the diagnosis of recovery or after the suspensiou of treatment at Kamiarikan-Mura, Jyobo-Gun, Okayama in where there were the prevalence of shight abortive form of epidemic hepatitis with the prolonged course and the repetition of recurrence. 1. The cases remaining of subjective symptom were 50 (34.9%) and their complaints were mainly same to those on the course of disease. 2. Hepatomegaly iu 30 cases (20.9%) and splenomegaly in 10 cases (7.0%) were observed. 3. The cases showing a postive liver function test were 5.6-30.9%, and the cases showing only a slight increasion of serum bilirubin were and 5 (3.5%). 4. Since the above results, the cases required of treatment were 22 (15.4%), the cases required of care were 42 (29.3%). On the other hand, the cases having only subjective symptom without any evidences of liver damage were 36 (25.2%) on the addition of the above cases. 5. In this epidemic district, the unrecovered cases were mainly observed on female, especially female in the third decade. 6. It was keenly felt, that the recovery of epidemic hepatitis was very difficult, since the results of our observations in the epidemic area

Studies on the Remote Results of Epidemic Hepatitis Report II On the Prevalence of Epidemic Hepatitis at Yoshikawa-Mura, Jyobo-Gun, Okayama

The recovery of cpidemic hepatitis was investigated by the massexamination on the 340 cases, released from the treatment for not less than 6 mouths under the diagnosis of clinical recoverh. at Yoshikawa-Mura, Jyobo-Gun, Okayama in where the slight abortive form of epidemic hepatitis broke out in a large number. And the results were as follows. 1. The cases remaining of subjective symptom were 101 (29.6%) and their chief complaints were almost same to those on the course of disease. 2. Hepatomegaly was observed in 36.8% of the cases. The cases with palpable splenomegaly was observed in 2.8% and the cases with the enlargement of splenic dullness was observed in 19.4% of the cases. 3. Serum colloidal reaction was mainly applied for the liver function test, and the positive cases were 4.7-11.5% and questionably positive cases were 5.0-29.1%. On the other hand, the cases showing a increased serum bilirubin were 4.7% and it was 10.9% on the consideration of the cases showing a slight increasion of serum bilirubin. 4. Since the above results, the cases required of treatment were exdosed in 8.5%, the cases required of care were exposed in 23.3%, and the cases belonging to posthepatic syndrom were exposed in 7.1%. Judging from the above results, it is thought that the complete recovery of this disease, even the slight abortive form, is considerably difficuls