@article{oai:niigata-u.repo.nii.ac.jp:00015541, author = {山本, 達男 and 筒井, 奈々子}, issue = {3}, journal = {新潟医学会雑誌, 新潟医学会雑誌}, month = {Mar}, note = {Despite the great successes in chemotherapy in the 70’s, the conditions surrounding infectious diseases have changed drastically as we entered into the 80’s. The entire world had been stormed by what we call today the “emerging and re-emerging infectious diseases” during this period and Japan was no exception. In 1996, large outbreaks of enterohemorrhagic Escherichia coli (so called O157) infections, the most drastic example of emerging diseases, had swept throughout the country with 17,877 people infected, 1,795 patients hospitalized, and 12 died (mostly children). All the medical institutions were totally confused at that time, and Dr. Yoshifumi Takeda cried “every single child was in the grip of death”. We live in a “global village” where new diseases emerge in some area and known diseases re-emerge in some other area. Nationwide as well as world-wide networks of disease control, especially quick responses to them are increasingly becoming important. Topics focused here are as follows. (i) Enterohemorrhagic E. coli, alternatively called Shiga toxin-producing E. coli (STEC)(reported in 1982): STEC colonizes the ileal as well as colonic mucosa, and causes “intra-membranous” infections in which the bacterium is totally enwrapped by the elongated membrane on the cell surface. The STEC infections are associated with hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS) especially in the young and elderly, and are believed to have resulted from the globalization of the food supply. The STEC food-borne diseases are classified in the category 3 diseases of the “law concerning the prevention of infections and medical care for patients of infections”. (ii)Helicobacter pylori(isolated in 1982):this bacterium colonizes the gastric mucosa of nearly 50% of the world population. Its infection usually occurs in childhood and continues over decades or for life. H. pylori attaches the gastric epithelial cell surfaces like a leech and causes gastritis and peptic ulcers, and is even closely associated with gastric cancer. The H. Pylori infections, thus far, are not included in any category of the new law. (iii) Vibrio cholerae O139, a new cholera agent (isolated in 1992): this bacterium has a serotype distinct from that of V. cholerae O1 (the initial causative agent of the 7th cholera pandemic). V. cholerae O1 immunity, established, does not afford cross-protection against O139 infection. V. cholerae O139 colonizes the small intestinal mucosa by simply attaching to the mucus as well as the epithelial cell surface, and causes severe watery diarrhea, just like V. cholerae O1. Cholera due to V. cholerae O1 and O139 is included in the category 2 diseases of the new law. V. cholerae O139 had been treated as an agent of food poisoning in Japan till March, 1999. Invasive group A streptococci (GAS): this mysterious bacterium, called “eating bug”, invades quickly into the blood stream rather than locally colonizing the pharynx, resulting in toxic shock-like syndrome (TSLS). The presence of bacterial specific serotype and superantigens or the lack of the protective antibodies and high inflammatory responses are likely to modulate disease severity. TSLS is classified in the category 4 diseases of the new law. The human beings have to develop new systems to combat these new waves of infections.}, pages = {82--91}, title = {2)細菌性新興・再興感染症(シンポジウム 新興・再興感染症, 第549回新潟医学会)}, volume = {114}, year = {2000} }