Yamashita K, Miyamura K, Yamadera S, Kato N, Akatsuka M, Hashido M, Inouye S, Yamazaki S
Department of Epidemiology, National Institute of Health, Tokyo.
Jpn J Med Sci Biol. 1994 Aug;47(4):221-39. doi: 10.7883/yoken1952.47.221.
Two rages of epidemic of aseptic meningitis (AM) due to echovirus 30 (E30) in Japan were analyzed with respect to two sources of information, AM incidence and E30 isolation, both gathered through the National Epidemiological Surveillance of Infectious Diseases. The first E30 epidemic spread throughout Japan in 1983 and ceased within the year. The second epidemic, starting in 1989, continued for the three successive years, and in the last year, 1991, the total E30 reports numbered 4,061, the largest number of a single virus type ever reported. Although the epidemic showed temporal and geographical shift and lasted for one or two years in some areas, most laboratories reported the largest number of E30 isolation in 1991. Among E30-yielding cases with clinical information during 1982-1992, the associating frequency with AM was as high as 82.5%. Other central nervous system involvements such as encephalitis, myelitis, encephalomyelitis and/or paralysis were reported in 36 E30-yielding cases and their monthly and age distributions were different from those of AM cases. The proportion of such disease among E30-yielding cases (0.60%) was close to that of other enteroviruses (0.56%). During the epidemics, E30 was isolated more frequently from cerebrospinal fluid than was E4 or E9 which prevailed coincidentally. E30 was most frequently isolated from cases of 4-7 years of age, sharing the common characteristic pattern of age distribution with other enteroviral meningitis. E30-yielding cases, however, involved a large number of older age groups than those of other enterovirus infections, and this tendency was the most pronounced in the first epidemic year, 1983. The contribution of these E30 epidemics on the yearly trend of clinically reported AM incidence and on the shift of its age distribution was also analyzed.
利用通过全国传染病流行病学监测收集的无菌性脑膜炎（AM）发病率和埃可病毒30型（E30）分离这两项信息来源，对日本发生的两波由E30引起的无菌性脑膜炎疫情进行了分析。第一波E30疫情于1983年蔓延至日本全境，并在当年内结束。第二波疫情始于1989年，持续了连续三年，在最后一年即1991年，E30的报告总数达到4061例，是单一病毒类型报告数量最多的一年。尽管疫情呈现出时间和地域上的变化，且在某些地区持续了一到两年，但大多数实验室报告1991年E30分离数量最多。在1982年至1992年期间有临床信息的E30阳性病例中，与AM的关联频率高达82.5%。在36例E30阳性病例中报告了其他中枢神经系统受累情况，如脑炎、脊髓炎、脑脊髓炎和/或麻痹，它们的月度和年龄分布与AM病例不同。此类疾病在E30阳性病例中的比例（0.60%）与其他肠道病毒的比例（0.56%）相近。在疫情期间，从脑脊液中分离出E30的频率高于同时流行的E4或E9。E30最常从4至7岁的病例中分离出来，与其他肠道病毒性脑膜炎具有相同的年龄分布特征模式。然而，E30阳性病例涉及的老年年龄组比其他肠道病毒感染的病例多，这种趋势在第一波疫情发生的1983年最为明显。还分析了这些E30疫情对临床报告的AM发病率年度趋势及其年龄分布变化的影响。
