Introduction
 Recently, foreign residents' difficulties using the Japanese medical system are being acknowledged. This study investigates the case of the medical intake forms, monshinhyo, that new patients at Japanese medical facilities must complete.Many patients, especially non-native ones, find them difficult.
Method
 First, 6 foreign and 6 Japanese students (hereafter, FS and JS) at 4-year universities were interviewed regarding their understanding of monshinhyo taken from three different departments -obstetrical, surgical, and internal medicine - at a hospital in Kansai; then, a questionnaire was developed and given to 25 FS and 85 JS.
Results
 Both FS and JS noted language problems. JS could pronounce medical terms better than FS but comprehended them only about as well as FS. Moreover, both FS and JS found the styles, layouts, and purposes of some questions unclear, and they sometimes had to guess the details of what monshinhyo requested. These included questions involving symptoms, divisions of medical departments, and semantic range of terms for blood relations. Also, medical practices/norms not found in the native country sometimes puzzled FS.
Conclusions
 Problems with monshinhyo arise from both the patients' side-Japanese as well as foreign-due to limited medical-related vocabulary/kanji and/or a lack of experience using Japanese medical services, and the monshinhyo themselves, due to their inclusion of unclear questions and ambiguous expressions. Probably, monshinhyo's authors' familiarity with medical terms and the Japanese medical system caused them to take for granted more knowledge than many patients actually have. To improve medical services, therefore, we suggest reexamining and reorganizing questions that already exist, introducing multiple choice and yes/no questions when possible, and providing furigana for kanji. Fundamentally, throughout the medical system, patients should be able to understand all the language they encounter. Clarifying the language, cultural assumptions, and purpose(s) of monshinhyo is a good starting point.

A patient, an adultJapanese traveler who had just returned from Thailand, had developed denguehemorrhagic fever (DHF). A primary infection of dengue virus (DENV) wasconfirmed, in particular, DENV serotype 2 (DENV-2) via the detection of the virusgenome, a significant increase in its specific neutralizing antibody and the isolationof DENV-2. DHF is often observed following a secondary infection from another serotypeof dengue virus, particularly in children, but this case was a primaryinfection of DENV. Japan is a non-endemic country of dengue disease. Instead,only Japanese encephalitis (JE) is known to be an endemic flavivirus family. Inthis study, IgG antibody against Japanese encephalitis virus (JEV) was detected.JEV belongs to the family of dengue virus and prevails in Japan, particularly inKyushu. Among many risk factors for the occurrence of DHF, a plausiblecandidate could be a cross-reactive antibody-dependent enhancement (ADE)mechanism by JEV antibody. This indicates that most Japanese travelers, wholive in non-endemic areas of dengue, particularly in Kyushu, should payattention to the occurrence of DHF.