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Introduction to emerging infectious diseases

October 17, 2017

Disease Control and Prevention Center

National Center for Global Health and Medicine

Shinichiro Morioka, M.D.

Today`s content

1. Previous events of EIDs in Japan (Dr. Morioka)

2. Current Japanese system against infectious diseases (Dr. Kutsuna)

3. Powered Air-Purifying Respirator (Dr. Ohta)

Population: 127 million

8 Regions, 47 Prefectures

Japan National Tourism Organization

Japan

Japanese National Center

Japan has 6 national centers.

Specialized for

Infectious disease

Pediatric disease

Elderly disease

Heart disease

Psychological disease

Cancer

Our Mission

Management of the Risks of Infectious Diseases from a Global Viewpoint

Organization Chart of DCC

Disease Control and Prevention Center (DCC)

Division of

Infectious DiseasesTravel Clinic

Division of Preparedness

and Emerging Infections

Isolation unit for emerging infectious

disease

Unit for Highly Lethal

Infectious Diseases

4 beds

Highly Infectious and Lethal Diseases Unit, 10 beds

NCGM has 4 beds.

Each Other hospital has 2 beds.

High Level Isolation Unit in NCGM

Building constructed in 2003, and immediately accepted suspected

SARS cases.

Located close to the National Institute of Infectious Diseases

(laboratory services easily available).

Training Session

Emerging/re-emerging Infectious Diseases

WHO

Emerging Infectious Disease Events in the Past 30 Years in Japan

Events Place Year

Lassa fever,

imported from Sierra Leone

Tokyo 1987

Anthrax bioterrorism incident Tokyo 1993

Outbreak of EHEC O157 Western Japan 1996

SARS, imported from Taiwan Western Japan 2003

Avian influenza H5N1,

no human case

Western Japan 2004

Pandemic influenza H1N1 Across Japan 2009

Dengue, autochthonous Tokyo 2014

Suspected Ebola Across Japan 2014-15

Emerging Infectious Disease Events in the Past 30 Years in Japan

Events Place Year

Lassa fever,

imported from Sierra Leone

Tokyo 1987

Anthrax bioterrorism incident Tokyo 1993

Outbreak of EHEC O157 Western Japan 1996

SARS, imported from Taiwan Western Japan 2003

Avian influenza H5N1,

no human case

Western Japan 2004

Pandemic influenza H1N1 Across Japan 2009

Dengue, autochthonous Tokyo 2014

Suspected Ebola Across Japan 2014-15

Scientific Data 1: 140004 (2014)

Dengue

RAPID RISK ASSESSMENT Outbreak of Ebola virus disease in West Africa, 10th update, 14 April 2015

4

Figure 1. Distribution of EVD cases by week of reporting; Guinea, Sierra Leone, Liberia, Nigeria,

Senegal and Mali; week 48/2013 to week 15/2015, as of 5 April 2015

* In week 45/2014, WHO carried out a retrospective correction to the data which resulted in 299 fewer cases and a negative value for new cases in week 45 (not plotted) [12]. ** According to WHO, the marked increase in the cumulative total number of cases in week 43 is due to a more comprehensive assessment of patient databases which resulted in 3 792 additional cases. These cases have actually occurred throughout the entire epidemic period. The green trend line is based on a five-week moving average, plotted on the fifth week of the moving average window. The figure includes cases in Nigeria (20), Senegal (1) and Mali (4) [11].

Figure 2. Distribution of confirmed cases of EVD by week of reporting; Guinea, Sierra Leone and

Liberia; weeks 46/2014 to 15/2015

ECDC. Rapid risk assessment. April 15, 2015

2013.12〜

2014.5

2014.6〜

2014.11

2014.12〜

2015.12

2013-2016 Outbreak of

Ebola virus disease in

West Africa

Nosocomial spread of

MERS in South Korea

Current Classification of Highly Infectious Diseases in Japan

Novel

Lethal, pathogens

not identified

Diseases with unknown pathogens,

ex. SARS before SARS-coronavirus identified

Category 1

Lethal, BSL4

pathogens

Viral hemorrhagic fevers, ex. Ebola

Smallpox

Plague

Category 2

Lethal, epidemic-

prone

SARS and MERS

Avian influenza H5N1 and H7N9

Tuberculosis

Polio and Diphtheria

National Agencies for Infectious Disease Control

MHLW

NIID

Qua-rantineOffice

NCGM

NIID: National Institute

of Infectious Diseases

BSL4 laboratory

Epi & Laboratory

NCGM: National Center for

Global Health and Medicine

Case management & IPC

MHLW: Ministry of Health,

Labour and Welfare

Coordination

Open discussions