Jpn. J. Infect. Dis., 53, 2000

Laboratory and Epidemiology Communications

Sporadic Cases of Yersinla PSeudotuberculosis Serotype 5

Infection in Shodo Island, Kagawa Prefecture
Chizuko Sunahara*, Yasuyo Yamanaka and Shigeki Yamanishi

Kagawa PTlefectural Institute of Public Health
Asahi 5‑3‑105, Takamalsu, Kagawa 760‑0065, Japan
Communicated by Hiroo lnouye(Accepted May 2, 2000)

Genus Yersinia consists of ll species including humanregion, inguinal region, etc., or erythema nodosum in elbows.

Though patient A experienced only slight abdominal paln,

pathogens, Y･ pestis, Y. enterocolitica, and Y. pseudotubercu‑losis.

patients B and C had palm in the right hypogastrium which
resembled that of appendicitis. Patients B and C experienced

Y･ pseudotuberculosis is nowknOwn as the causative agentof Izumi fever whose etiology remained long unknown, andrenal failure in addition but dialysis Was not required.

some cases of Y. pseudotuberculosis infection satisfy theThe Figure shows the location or the patients'residences

criteria of Kawasaki syndroTle (1 )･ The route of infection isand the places from which water samples were collected forconsidered oral, such as via Ingestion of water contaminatedbacteriological examination.

by the excrement of infected wild animals or Ingestion ofPatients A and C were neighbors and patient B took waterfrom the well in patient A's residence before the onset ofraw vegetables washed by such contaminated water (2).

Since the outbreak in Okayama Prefecture in 1981, cases

illness. Patient C played with water from the well in his ownof Y･ pseudotubeyICulosis have been reported sporadically but

residence before his illness.

remain relatively rare. A recent known outbreak was thatcaused by serotype 5a was reported in Aomori Prefecture inpatients and also from wells of both A's and C's residences

Y. pseudotuberculosis 5b was isolated from all the three1991.

(on March 27 and on April 10, respectively) and from the1n Kagawa Prefecture, 5 cases were reported in 1987 and 4

water collected from the T river upstream of both patients'

cases in 1988. The commonest was serotype 5 (9 cases)

residences (on April 10). These isolates were all virFinv'

followed by serotype 2 (3 cases) and serotypes 1 and 4 (1and hadanidentical pattem in pulsed‑field gel electrophoresis

case each)･ No cases were reported in 1 989‑1997. In the spring(PFGE) ofNoII or XbaI DNA digests. The isolate from C'sof 1998, however, an outbreak took place in Shodo Islandwell was, however, virF7nv'and had a PFGE pattem difrTerent
from the isolate from C. This may indicate the bacterial

after a longperiod of absence. This report describes thecontamination of the reglOn from multiple sources, probably
from wild animals. Actually, Y. pseudotubercu/osis 2a wasepidemiologlCal study of this outbreak.

Three cases of Y. pseudotuberculosis infection werereported late in March 1998. They were two 10‑year101d girls

isolated from a well nearby (T). The season was rainy and(patients A and B) who both became sick on 20 March, andan 8‑year‑old boy (patient C) who became sick on 3 1 March.

the overflow from the Triver appeared to have contaminatedthe wells in this area.

The climical picture consisted of fever followed by rash, such as

We wereunable to isolatethe pathogenskom water collectedfacial erythema, rashes on palms, plantae, axillae, hypogastricfrom the river downstream of the patients'residences or fromthe well located closer to the seashore (K), or that locatednear C's house (S), however.

*ComSpOnding author: Fax:+8ト87‑825‑0408

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Jpn. J. Infect. Dis., 53, 2000

FigurF･ Geographical distribution ofpatients'residences and sites舟om which water was collected for bacteriologicalexami‑

nat10n. Patient B's residence was in the same town, but the outside of this map area.

2. Fukushima, H., Gomyoda, M. and Kaneko, S. (1989):

REFERENC E SRole of wild animals as sources of infection with Yersinia

1. Ouchi, K. and Sato, K. (1985): Yersiniapseudotubercu‑pseudotuberculosis. Rep. Shimane Pref. Inst. Publiclosis infection and Kawasaki syndrome. Media Circle,

Heal血Environ. S°i., 3 1, 36‑42 (in Japanese).

30, 40‑45 (in Japanese).

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