In 2006 there was a multiple outbreak of infectious gastroenteritis due to norovirus in health care facilities, old age nursing homes and other facilities in Hiroshima Prefecture. Also at JA Yoshida General Hospital during the period from October 3 to 17, 2006, symptoms of vomiting and diarrhea were observed in a total of 47 people including 29 in-patients in three out of six wards and 18 hospital staff members.This was reported to the public health center and an emergency meeting of the Infection Control Committee was convened. Under the guidance of the Public Health Center, the Infection Control Team (ICT) immediately had a good control over the situation, took infection preventive measures, informed patients of what had happened, and restricted hospital admissions and hospital visits. The number of new patients dropped to zero on October 17.After re-examining the gastroenteritis outbreak, the ICT reviewed the existing manual and prepared a new operation manual to cope withe future outbreaks of infectious gastroenteritis, including emergency measures to be taken, staff assignments, and improvement of the hospital environment. The ICT considers that there is a need for disseminating knowledge regarding measures against the infection and for making preparations for the future as a vanguard.
Hospitals ; Gastroenteritis ; seconds ; Infectious gastroenteritis, NOS ; Infection as complication of medical care

A new edition of infection control manual was brought out after months of reviewing the utility of the preceding edition. Using the new manual, a series of study meetings were held with the aim of raising awareness among the personnel of infection prevention.Preventive measures have been changing with rapid advances in medical treatment. The old manual, which had undergone revision repeatedly, was not utilized fully. In view of the situation, questionnaires were distributed to all the members of the hospital staff (n=447) to investigate the reasons why the manual had not been utilized. Although many respondents were of the opinion that the old manual was out of date, too thick, and unreadable, 44.7% said they had used it. 55.3% answered that they had asked their superiors or colleagues out of necessity. Based on these results, we started making a compilation of a new manual, easy to understand and friendly to the users. It took about six months to complete it. Copies of the new manual were given to all the staff members. In the study meetings, various subjects were taken up for discussion, including the definition of nosocominal infection, “universal precaution,” how to effectively wash your hands, how to keep the rest rooms clean, how to wear the gloves and mask, and so forth. We believe that the personnel’s consciousness of infection prevention was further raised by holding the study meetings.
Manuals ; Prevention ; Infection as complication of medical care ; Hospitals ; Infections of musculoskeletal system

For severe acute respiratory syndrome (SARS), methodologies are yet to be established for prompt diagnostic testing, treatment and prevention by means of vaccination. Such being the situation, it is necessary to implement stringent measures in preventing the transmission of this infectious disease based on a correct understanding of its epidemiological characteristics. The pathways of transmission are by droplet and by contact. Risk factors include social contacts with SARS cases within a radius of 2 meters or household contacts, badly ventilated rooms, touching contaminated objects and surfaces, exposure to body fluids. The major clinical symptoms of the acute respiratory disease include, like influenza, fever, chill, tiredness (malaise), muscle aches, trepidation, nausea and headache. Compared with patients who contract influenza, SARS patients often had dyspnea and diarrhea, but rarely complain of pharyngalgia and pituita. A close correlation has been noted between the stage of SARS and its infectivity, capability. During the incubation period, which lasts 2 to 10 days, the disease is asymptomatic and reportedly almost no infectious. But there is general agreement among experts that SARS becomes highly infectious when it enters the lower airway infection period and begins to produce such symptoms as fever and dry cough, dyspnea.As the main points of the measures to prevent SARS from spreading, we would like to refer to triage and prevention of cross infection. A triage system should be adopted as the need arises. Under the system, patients suspected to have SARS are separated from other patients and given priority in medical treatment. Standard precautions should not be forgotten. The use of alcohol-based hand rubs and the wearig of surgical masks are effective means to cut off the route of infection. These efforts would make it possible to effectively prevent the infectious diseases like SARS from being spread form person to person and thus protect the public from the pandemic.
Infection as complication of medical care ; Prevention ; symptoms <1> ; strategy ; seconds

Following the previous two seasons, we analyzed cases of influenza virus infection during the 2002/2003 season in the Department of Pediatrics, Mito Kyodo General Hospital. Thanks to price reductions, we could increase the number of children who got vaccination ahead of the season. A close watch was kept throughout the season by dint of one precision type of rapid test kit was newly put to use. Although it was reported that there were serious shortages of antiviral agents in some regions, we could afford to treat patients in our department without a hitch. Severe complications such as encephalopathy were not experienced this season. As we vaccinated children early, morbidity decreased remarkably. We could care each case with enough time. Our department and hospital fully realized that the prevention by vaccination is definitely the main strategy against influenza virus infection.
Seasons ; Review of ; Infection as complication of medical care ; Virus Diseases ; Vaccination

Objective: In urological operations, many endourological procedures and pre-existing urinary tract infections may cause surgical complications. It is essential to identify the risk factors for surgical site infections (SSI) and determine additional influences. Patients and Methods: In the present retrospective investigation, a total of 324 patients who underwent open urological surgery between January 2003 and December 2007 at Anjo-Kosei Hospital were assessed for SSI along with possible associated factors. Results: Forty-four cases (13.6%) proved positive for SSIs during the surveillance period. Among these, 31 demonstrated incisional SSI and 13 demonstrated deep/organ space SSI. Greater age and body mass index, low preoperative haemoglobin levels, long preoperative hospital stay, prolonged operation time and increased blood loss during surgery were all positively associated with SSI in general. For the deep/organ space SSI cases, advanced age, low preoperative haemoglobin levels, long preoperative hospital stay and prolonged operation time were significant factors. Conclusion: This study identified several independent predictors of SSI in general, as well as deep/organ space infection, for urological open surgery at our hospital. The results provided a basis for urologists to decrease the incidence of urological SSI.
Surgical aspects ; Hospitals ; Organ ; Infection as complication of medical care ; Risk Factors

A 73-year-old man with diabetes mellitus fell and sustained distal tibia and fibula fracture on December 8, 2006. On December 14, both tibia and fibula were internally fixed with plates, but on the ninth post-operative day, pus discharge was observed from the surgical sites. MRSA was detected and antibiotic therapy was commenced. But finally all the plates had to be removed and an external fixator was placed instead. The wounds were refractory and maggot therapy was begun from January 26, 2007. Maggots were changed twice a week for three weeks followed by vacuum-assisted closure. On the other hand, pin-tract infection was found, so the external fixator was removed and the fracture was splinted. But from the calcaneal region, pus discharge did not stop. On March 20, extensive debridement was done. From April 6, maggot therapy and vacuum-assisted closure were also used in this area. Although the fracture was malunited, all the infected wounds were healed completely and leg amputation was avoided. Maggot therapy is said to be especially effective against intractable wound such as diabetic ulcer. At present this therapy is not approved in Japan, but its use is expected to spread in the future.
Therapeutic procedure ; Maggots ; Tibia ; Fibula ; Infection as complication of medical care

We retrospectively investigated the prevalence of influenza virus type A infection and the efficacy of Kampo medicine as a prophylactic for handicapped residents at our social welfare institution, during the 2004/5 flu season. Upon studying a nationwide surveillance report for said season, we supposed that it had been difficult to prevent mass infection at our welfare institution with the usual preventive methods, because type B had prevailed for most of the season, and because of the differing type A (AH 3) antigenicity which prevailed late-season, for which there were no type A vaccines.43 of 90 (47.8%) residents given flu vaccinations twice, and 25 of 110 (22.7%) of staff members given flu vaccinations once contracted type A influenza between March and May of 2005. Interestingly, residents who had been administered Hozai for either short-term health problems or chronic disease, demonstrated a low influenza prevalence, there being a statistically significant difference (p<0.05) between our “Hozai” and “non-Hozai” groups. Furthermore Juzentaihoto, known to enhance immune function, seemed beneficial because of its low associated morbidity rate, and only 2 of 8 residents administered it contracted flu. No difference was observed, however, between generalized “Kampo treatment” and “non-Kampo treatment” groups.We consider that certain Kampo medicines may be useful for the prevention of influenza infection, in institutionalized handicapped residents with short-term health problems. Immunological enhancements, and the influence of Hozai are discussed here.
Medicine, Kampo ; Seasons ; Infection as complication of medical care ; Influenza ; Prophylactic

An invasive aspergillosis model in rabbits was attempted using 3 concentrations of A. fumigatus conidia. Conidia concentrations of 1 x 10(6), 1 x 10(7) and 1 x 10(8) were inoculated intravenously into rabbits. The severity of infection was directly proportional to the inoculum size of the conidia. Aspergillus fumigatus was isolated from livers, kidneys, spleens, hearts and lungs of infected rabbits at a rate of 82%, 75%, 57%, 54% and 32% respectively. Cultures of urine specimens taken by bladder tap were positive for A. fumigatus in 30% of the rabbits tested. Blood cultures using the Bactec Fungal System (Becton Dickinson Corp., USA) failed to isolate A. fumigatus in 20 rabbits with biopsy-proven invasive apergillosis. Active infection with high fungal tissue burden occurred between 2-4 days after infection in rabbits inoculated with 1 x 10(7) conidia.
Lower case ecks ; Infection as complication of medical care ; Models ; Aspergillosis ; Invasive

Filariasis, a parasitic infection endemic in parts of India, Myanmar, islands of the South Pacific, West and East Africa and Saudi Arabia can be diagnosed from various types of cytopathological specimens. This case documents the detection of filarial infection from hydrocele fluid cytology in a 30-year-old Myanmar migrant worker in Malaysia.
Liquid substance ; Cellular aspects of ; Infection as complication of medical care ; Microfilaria ; Myanmar

The effects of Enterovirus 71 (HEV71) infection on African green monkey kidney cells (Vero) were investigated. It was found that the infected cells showed progressive cellular morphological changes characteristic in apoptotic cells within 10 hours post-infection. The number of apoptotic cells correlated significantly with the number of HEV71 antigen positive cells when cells were labeled using terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling (TUNEL) and stained for HEV71 antigen. Approximately 11, 26, 45 and 50% of the infected cells were apoptotic at 12, 24, 48 and 72 hours post-infection, respectively. Internucleosomal DNA fragmentation, characteristic in the late stage of apoptosis was noted beginning on day 2 post-infection. The DNA fragmentation, however, was absent in cells treated with the heat- and ultraviolet light-inactivated virus inocula. These results demonstrate the capacity of HEV71 to induce apoptosis in the infected cells. The induction, however, requires high level of HEV71 infectivity and the presence of live virus particles, suggesting the need for the presence of specific viral proteins for apoptosis to occur.
Infection as complication of medical care ; Apoptosis ; seconds ; Enterovirus ; Hour