Sugawara Tamie, Ohkusa Yasushi, Kawanohara Hirokazu, Taniguchi Kiyosu, Okabe Nobuhiko
Infectious Disease Surveillance Center, National Institute of Infectious Diseases.
Kansenshogaku Zasshi. 2011 Nov;85(6):632-7. doi: 10.11150/kansenshogakuzasshi.85.632.
Early potential health hazards and bioterrorism threats require early detection. Smallpox cases caused by terrorist could, for example, be treated by prescribing acyclovir to those having fever and vesicle exanthema diagnosed as chicken pox. We have constructed real-time pharmacy surveillance scenarios using information technology (IT) to monitor acyclovir prescription.
We collected the number of acyclovir prescriptions from 5138 pharmacies using the Application Server Provider System (ASP) to estimate the number of cases. We then compared the number of those given acyclovir under 15 years old from pharmacy surveillance and sentinel surveillance for chickenpox under the Infection Disease Control Law.
The estimated number of under 15 years old prescribed acyclovir in pharmacy surveillance resembled sentinel surveillance results and showed a similar seasonal chickenpox pattern. The correlation coefficient was 0.8575. The estimated numbers of adults, older than 15 but under 65 years old, and elderly, older than 65, prescribed acyclovir showed no clear seasonal pattern.
Pharmacy surveillance for acyclovir identified the baseline and can be used to detect unusual chickenpox outbreak. Bioterrorism attack could potentially be detected using smallpox virus when acyclovir prescription for adults suddenly increases without outbreaks in children or the elderly. This acyclovir prescription monitoring such as an application is, to our knowledge, the first of its kind anywhre.
早期潜在的健康危害和生物恐怖主义威胁需要早期检测。例如，由恐怖分子引发的天花病例，可通过给那些被诊断为水痘且有发热和水疱性皮疹的患者开阿昔洛韦来进行治疗。我们利用信息技术构建了实时药房监测方案，以监测阿昔洛韦的处方情况。
我们使用应用服务器提供商系统（ASP）从5138家药房收集阿昔洛韦处方数量，以估算病例数。然后，我们比较了药房监测中15岁以下接受阿昔洛韦治疗的人数与依据《传染病防治法》对水痘进行的哨点监测结果。
药房监测中15岁以下开具阿昔洛韦的估计人数与哨点监测结果相似，并呈现出类似的水痘季节性模式。相关系数为0.8575。15岁以上但65岁以下成年人以及65岁以上老年人开具阿昔洛韦的估计人数未显示出明显的季节性模式。
对阿昔洛韦的药房监测确定了基线，可用于检测不寻常的水痘暴发。当成人阿昔洛韦处方突然增加而儿童或老年人未出现暴发时，有可能利用天花病毒检测到生物恐怖主义袭击。据我们所知，这种阿昔洛韦处方监测应用尚属首例。
