2015/7/2870ᖺ䜆䜚䛻෌⯆70ᖺ䜆䜚䛻෌⯆䛧䛯䝕䞁䜾⇕䛸䛧䛯䝕䞁䜾⇕䛸䛿䛿䠛䝠䝖䝇䝆䝅䝬䜹䛳䛶䠛2015ᖺ7᭶18᪥䜏䛱䛾䛟䜴䜲䝹䝇ሿ㧗ᓮᬛᙪ 䠄ᅜ❧ឤᰁ⑕◊✲ᡤ䜴䜲䝹䝇➨୍㒊䠅ᶓ὾᳨␿ᡤ᳨␿⾨⏕ㄢ䠄ే௵䠅ᶓ὾᳨␿ᡤ㍺ධ㣗ရ䞉᳨␿᳨ᰝ䝉䞁䝍䞊䠄ే௵䠅

1⠇㊊ື≀䠄᪻⹸⠇㊊ື≀䠄᪻⹸etcetc䠅፹௓ᛶ䜴䜲䝹䠅፹௓ᛶ䜴䜲䝹䝇䛿䚸arthropod䝇䛿䚸arthropod--borne virusvirus䜰䝹䜰䝹䝪䜴䜲䝹䝇䛸⥲⛠䛥䜜䜛䜰䝹䝪䜴䜲䝹䝇䛿䚸⠇㊊ື≀䛻䜘䜚䝠䝖䜔⬨᳝ື≀䛻䜴䜲䝹䝇䛜ఏ᧛䛩䜛䛸䛔䛖␿Ꮫⓗ䛺ඹ㏻ᛶ䛻ᇶ䛵䛔䛯ᴫᛕ䛷䛒䜚䜚䚸䜴䜲䝹䝇Ꮫⓗ䛺ศ㢮ୖ䛭䛾୰䛻䛿䚸䜴䜲䝹䝇Ꮫⓗ䛺ศ㢮ୖ䛭䛾୰䛻䛿䝣䝷䝡䜴䜲䝹䝇⛉䚸䝖䜺䜴䜲䝹䝇⛉䚸䝤䞁䝲䜴䜲䝹䝇⛉䚸䝺䜸䜴䜲䝹䝇⛉䛺䛹䛾䜴䜲䝹䝇䛜ྵ䜎䜜䜛䚹

1

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䝣䝷䝡䜴䜲䝹䝇ᒓ䛾⣔⤫ᶞ䝕䞁䜾䜴䜲䝹䝇䠏 䠍䠎䠐᪥ᮏ⬻⅖⾑Ύᆺ⩌
WN Kun㯤⇕䝎䝙፹௓ᛶ⬻⅖䜴䜲䝹䝇⩌

MVE JE SLE䝕䞁䜾⇕䛾⑕≧䞉᳨ᰝᡤぢ䜋䛸䜣䛹䛾 •✺↛䛾Ⓨ⇕䠄ከ䛟䛿䠏䠔Υ௨ୖ䛾㧗⇕䠅⑕౛䛷ㄆ䜑 •ᛴ⃭䛺⾑ᑠᯈῶᑡ䞉ⓑ⾑⌫ῶᑡ䠄Ⓨ⑓ᚋ䜙䜜䜛ᡤぢ ᩘ᪥䛷ᛴ⃭䛻ῶᑡ䛩䜛䠅䡚Ⓨ⑓᪥䛻ῶᑡ䛧䛶䛔䜛䜟䛡䛷䛿䛺䛔䡚1.

䜘䛟ㄆ䜑 2.
2䜙䜜䜛ᡤ 3.
ぢ
4.
5.

Ⓨ⑈䠄ከ䛟䛿ゎ⇕ഴྥ䛸䛸䜒䛻ฟ⌧䛩䜛䠅ᝏᚰ ჎ྤ ୗ⑩ᝏᚰ䚸჎ྤ䚸ୗ⑩③䜏䠄㢌③䚸┠䛾ዟ䛾③䜏䚸➽⫗③䚸㛵⠇③䠅
Ⅼ≧ฟ⾑䛺䛹䛾ฟ⾑ഴྥ
⫢ᶵ⬟పୗ

2

2015/7/28┠䛭䛾䜒䛾䛜③䛔䛸䛔䛖䜘䜚┠䛾ዟ䛾᪉䛜③䛔䛸
䛔䛖ឤ䛨䛷䛩䚹

37Υྎ䛾Ⓨ⇕䛾ே䜒䛔䜎䛩䜘䚹

Ⓨ⑈䛜ฟ䜛ே
䛿䚸Ⓨ⑓䛧䛶ᩘ᪥䛯䛳䛶䛛䜙䚹
䛷䛺䛔ே䜒䛔䜎
䛩䚹䛸䛻䛛䛟඲㌟䛜③䛔䛸䛔䛖ᝈ⪅䜒䛔䜎䛩䚹䜴䜲䝹䝇⾑⑕䛸ᢠయୖ᪼䛾㛵ಀ
P/N ẚ

106~7 pfu/mL

NS1ᢠཎ
IgM
䝕䞁䜾䜴䜲䝹䝇
䜴䜲䝹䝇⾑⑕

IgG,୰࿴ᢠయ

Ͳ3Ͳ2Ͳ1012345678910Ⓨ⑓᪥䛛䜙䛾᪥ᩘ3

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䝕䞁䜾ฟ⾑⇕
䠘䝕䞁䜾⇕䛾⑕≧䛻ຍ䛘䛶䠚
9 ฟ⾑⑕≧
9 ⾑ᑠᯈῶᑡ䠄100,000/mm⾑ᑠᯈῶᑡ䠄100,000/mm3௨ୗ䠅
9 ⾑⟶㏱㐣ᛶஹ㐍䛻䜘䜛⾑₢₃ฟ䠄⬚Ỉ䚸⭡Ỉ䛺䛹䜢క䛖䚹䝕䞁䜾ฟ⾑⇕䛜㔜⠜໬䛧䚸ᚠ⎔୙඲䛜ྜే䛩䜛䛸䚸䝕䞁䜾ฟ⾑⇕䛜㔜⠜໬䛧ᚠ⎔୙඲䛜ྜే䛩䜛䛸䝕䞁䜾䝅䝵䝑䜽⑕ೃ⩌䛸䛺䜛䚹㎿㏿䛺἞⒪䛜䛺䛥䜜䛶䜒䚸⮴Ṛ⋡䛿12䡚20䠂䛸㧗⋡䛷䛒䜛䚹䛣䜜䜙䛾⑕≧䠄㔜⑕໬䠅䛿䚸ゎ⇕ഴྥ䛜ㄆ䜑䜙䜜䜛᫬ᮇ䛻Ⓨ⑕䛩䜛䛣䛸䛜ከ䛔䚹䝕䞁䜾⇕ᝈ⪅䛾║ᗏฟ⾑

LRᛴᛶᮇ

ᅇ᚟ᮇ

RLL
䠎䞄᭶ᚋ

R䠎䞄᭶ᚋ
ᅜ❧ᅜ㝿་⒪◊✲䝉䞁䝍䞊⑕౛

4

2015/7/28ᑠඣ䛾䝕䞁䜾䜴䜲䝹䝇ึឤᰁ䛸෌ឤᰁ䛻䛚䛡䜛䝕䞁䜾ฟ⾑⇕/䝅䝵䝑䜽⑕ೃ⩌䛾Ⓨ⏕㢖ᗘ䝕䞁䜾ฟ⾑⇕(DHF grade 1, 2)䝕䞁䜾䝅䝵䝑䜽⑕ೃ⩌䝕䞁䜾䝅䜽⑕ೃ⩌
䠄DHF grade 3,4)ึឤᰁ䠄䠍䠉䠍䠐y䠅

0.18%

0.007%

෌ឤᰁ䠄䠍䠉䠍䠐y䠅2.01%

1.14%

䝕䞁䜾䜴䜲䝹䝇ᢠయ䛻䜘䜛Enhancement䝕䞁䜾䜴䜲䝹䝇ᢠయ䛻䜘䜛Enhancement ຠᯝ஺ᕪ㜵ᚚⓗ䛻ാ䛟ᢠయ䛯䛰⤖ྜ䛩䜛䛰䛡䛾ᢠయᢠཎᢠయ」ྜ≀䜴䜲䝹䝇䝺䝉䝥䝍䞊䛜ᑡ䛺䛛䛳䛯䜚䚸୰࿴ᢠయ䛷䝤䝻䝑䜽䛥䜜䛶䜒Fc䝺䝉䝥䝍䞊䜢௓䛧䛶Fc䝺䝉䝥䝍䞊䜢௓䛧䛶ឤᰁ䛜ᡂ❧䛩䜛䚹⏕యෆ䛻䛿ከ䛟䛾Fc⏕యෆ䛻䛿ከ䛟䛾Fc䝺䝉䝥䝍䞊䝺䝉䝥䝍䞊Ⓨ⌧⣽⬊䛜Ꮡᅾ䛩䜛䟿

5

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䝕䞁䜾䜴䜲䝹䝇䛾ឤᰁ⎔⺅྾⾑୰䛾䝠䝖䝇䝆䝅䝬䜹䜴䜲䝹䝇䝛 䝍䜲䝅䝬䜹
䝛䝑䝍䜲䝅䝬䜹•䝕䞁䜾䜴䜲䝹䝇䠗䝣䝷䝡䜴䜲䝹䝇⛉⮬↛ᐟ୺•䝏䜽䞁䜾䝙䜰䜴䜲䝹䝇䠗䝖䜺䜴䜲䝹䝇⛉⚾䛯䛱ᚅ䛱అ䛫ᆺ䛾⺅䛷䛩䟿᪥ᮏ⬻⅖䜴䜲䝹䝇䛾⏕ά⎔ዷፎ䝤䝍䛜᪥⬻䜴䜲䝹䝇䛻ឤᰁ
䛩䜛䛸ὶ⏘䞉Ṛ⏘䛩䜛䛣䛸䛜䛒䜛䛜䚸䛭䜜௨እ䛻Ⓨ⑓䛩䜛䛣䛸䛿䛺䛔䚹Ὢᾢ

6

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䝁䜺䝍䜰䜹䜲䜶䜹
Culex tritaeniorhynchus䜟䛯䛧䛿䚸䠍䠌km఩䛿㣕䜉䜛䜣䛰䜘䚹㢼䛻஌䛳䛛䜜䜀䜒䛳䛸㐲䛟䜎䛷⛣ື䛧䛱䜓䛖䜘䟿䝁䜺䝍䜰䜹䜲䜶䜹䛿䚸⏣䜣䜌䜔ụ䛾䜘䛖䛺኱䛝䛺䛸䛣䜝䛻⏘༸䛩䜛䚹᫬㛫ᖏ䛻䜘䜛⺅䛾άືᛶฟ඾䛂⺅䛾䛔䛺䛔ᅜ䛃⣽஭㍤ᙪ䠄ᒾἼ᭩ᗑ䚸᫛࿴27ᖺⓎ⾜䠅72015/7/28

䝛䝑䝍䜲䝅䝬䜹䚸䝠䝖䝇䝆䝅䝬䜹䛾Ⓨ⏕ẕᆅ㧗㞝ᕷ䠄ྎ‴䠅䛾㞵Ỉ䝬䝇Ỉ䛜ὶ䜜䛶䛔䛺䛔䛜䛝䜜䛔䛷䛒䜛䠄ୖẁ䠅Ỉ䛜ὶ䜜䛶䛔䜛㞵Ỉ䝬䝇䠄ୗẁ䠅䛷䛿䝛䝑䝍䜲䝅䝬䜹䛿Ⓨ⏕䛧䛺䛔䚹

8

2015/7/28

ᒇෆ䛾䝛䝑䝍䜲䝅䝬䜹䛾⏘༸ሙᡤ䛸䜣䛷䜒䛺䛔䛸䛣䜝⏘༸䛩䜛䛾䛜䝛䝑䝍䜲䝅䝬䜹䟿Ἀ⦖又叐ᡓ๓双口吞呉吇⇕ὶ⾜厮厤叄叀厓ὶ⾜ᆅ叉叏ே叏⾜厯厯叏㢖ᗘ厮኱厯友せᅉ又厤召厓9

2015/7/28

吞呉吇⇕双㛵去召⇕ᚰ友◊✲厮᪥ᮏே双叩召吞呉吇叽叻呂吐ୡ⏺ึศ㞳双叅友厮叄叀䟿

1943ᖺ䛻ᇼ⏣㐍༤ኈ䚸ᮌᮧᗮ༤ኈ䜙䛜㛗ᓮ䛷䝕䞁䜾⇕ᝈ⪅䛛䜙䝕䞁䜾䜴䜲䝹䝇1ᆺ䜢ศ㞳䛧䛯䚹䛣䛾᫬䛾ศ㞳䜴䜲䝹䝇䛿ᝈ⪅䛥䜣䛾ྡ๓䛻䛱䛺䜣䛷䝕䞁䜾䜴䜲䝹䝇 1 ᆺᮃ᭶ᰴ䠄Dengue
virus type 1, Mochizuki strain䠅䛸ྡ௜䛡䜙䜜䠈ୡ⏺䛷᭱ึ䛾䝕䞁䜾䜴䜲䝹䝇ศ㞳ᰴ䛸䛧䛶ㄆ䜑䜙䜜䛶䛔䜛䚹䝕䞁䜾⇕ື≀䝰䝕䝹䛿䠛• ᪧୡ⏺䝄䝹䛿ឤཷᛶ䛜䛒䜛䛜䚸䜴䜲䝹䜴䜲䝹䝇⾑⑕䛿ప䛟ᮇ㛫䜒▷䛔⑕䛿ప䛟ᮇ㛫䜒▷• ᪂ୡ⏺䝄䝹䛷䛒䜛䝬䞊䝰䝉䝑䝖䛿䚸䜴䜲䝹䝇⾑⑕䜒㧗䛟ᮇ㛫䜒㛗䛔䚹䠄䝠䝖䛸ẚ䜉䜛䛸ప䛔䠅• 㑇ఏᏊᨵኚ䝬䜴䝇䛷䛿䚸䜴䜲䝹䝇⾑⑕䛜ㄆ䜑䜙䜜䜛䚹䠄౛䠅 humanized
NOD/SCID/interleukin 2 receptor gamma (IL-2RȖ)null (hu-NSG) miceэ⮬↛䛺䝬䜴䝇䛷䛿⾑୰䛻䜴䜲䝹䝇䜢᳨ฟ䛷䛝䛺䛔䚹

10

2015/7/28

1942䠉45ᖺ䛾䝕䞁䜾⇕ὶ⾜䛻䛚䛡䜛ὶ⾜㒔ᕷู᥎ィᝈ⪅ᩘᕷ㛗ᓮ బୡಖ ኱㜰࣭⚄ᡞ㛗ᓮ࣭బୡಖ኱㜰 ⚄ᡞ⚟ᒸᗈᓥ ࿋ᗈᓥ࣭࿋

306,000

582,000ேཱྀ

458,000

4,219,000

1942
1943
1944
1945
1946

50,0005,000

20,00010,000200

No epidemic

5,000,100,000,

100200Unknown

3,000

No epidemic

Unknown

No epidemic

No epidemic No epidemic

No epidemic No epidemic No epidemic

Susumu Hotta. Dengue epidemics in Japan, 1942-1945. J. Trop. Med. Hygiene. 56: 83. 1953.

䝕䞁䜾⇕㍺ධ⑕౛㒔㐨ᗓ┴ูᒆฟ⑕౛ᩘ䝖䝑䝥10䠄2006䠉13ᖺ䚸᳨␿ᡤ䛛䜙䛾ሗ࿌䜢㝖䛟1005౛䠅㒔㐨ᗓ┴ᮾி⚄ዉᕝ኱㜰ឡ▱රᗜ⚟ᒸி㒔༓ⴥ㟼ᒸᇸ⋢ୖグ௨እᒆ䛡ฟ⑕౛ᩘ㻟㻝㻡㻥㻜㻣㻢㻢㻟㻠㻟㻠㻝㻟㻤㻟㻣㻟㻞㻞㻣㻞㻠㻟๭ྜ㻟㻝㻚㻟㻑㻥㻚㻜㻑㻣㻚㻢㻑㻢㻚㻟㻑㻠㻚㻟㻑㻠㻚㻝㻑㻟㻚㻤㻑㻟㻚㻣㻑㻟㻚㻞㻑㻞㻚㻣㻑㻞㻠㻚㻞㻑11

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䝕䞁䜾⇕ሗ࿌⑕౛ᩘ

2015 ᖺ䛿6᭶5᪥⌧ᅾ䛆㟷Ⰽ䛿㍺ධ⑕౛ᩘ䚸ⲔⰍ䛿ᅜෆⓎ⏕ᩘ䛇㍺ධ⑕౛䛛䜙䛾᳨ฟ䜴䜲䝹䝇2015㍺ධ⑕౛䛛䜙䛾᳨ฟ䜴䜲䝹䝇
2015
䜴䜲䝹䝇ᆺ᳨ูฟᩘ
25
23
21

᳨ฟ⑕౛ᩘ

20

15

10

6
5
3

0

1

2

䜴䜲䝹䝇⾑Ύᆺ

3

4➨23㐌⌧ᅾ

12

2015/7/28

ᵐᵎᵏᵎ࠰ỉ঻ầ‫׎‬ỆấẬỦἙὅἂ༏᠞λၐ̊
ᵐᵒᵑӸ

ᵏᵖ
18

ᵏᵍᵏ

ᵑᵍᵏ

ᵓᵍᵏᵎ

ᵕᵍᵏᵐ

ᵏᵏᵍᵐᵗ

ᵗᵍᵐᵎ

ἤἚἋἊἉἰỽỉ෇ѣ஖᪥ᮏ䛻䛚䛡䜛䝕䞁䜾⇕䛾ឤᰁᡂ❧䛾䝅䝘䝸䜸䝠䝖䝇䝆䝅䝬䜹่ည䝕䞁䜾䜴䜲䝹䝇⾑⑕ᮇ䛾䝠䝖䠄Ⓨ⑕๓᪥䡚Ⓨ⑕䠑᪥ᚋ䠅ឤᰁ䝠䝖䝇䝆䝅䝬䜹่ညᚋ⣙䠓᪥┠䛻䝠䝖䜈䛾ឤᰁᛶ䜢⋓ᚓ䠄ᡂ⹸䛾⏕Ꮡ䚸᭱㛗40᪥㛫䠅่ညᮍឤᰁ䛾䝠䝖

ឤᰁ

13

2015/7/28

ɭမỆấẬỦἤἚἋἊἉἰỽỉЎࠋἤἚἋἊἉἰỽỉ̛λὉ‫ܭ‬ბầᄩᛐẰủẺ‫׎‬ᵆᵏᵗᵕᵗ῍ᵇᵟᶊᶀᵿᶌᶇᵿᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵕᵗᵲᶐᶇᶌᶇᶂᵿᶂᴾᴾᴾᴾᴾᴾᴾᵏᵗᵖᵑ
ᵳᵱᵟ
ᵳᵱᵟᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵖᵓ
ᵏᵗᵖᵓ
ᵠᶐᵿᶘᶇᶊᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵖᵔ
ᵫᶃᶖᶇᶁᶍᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵖᵖᵧᶒᵿᶊᶗᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵗᵎ
ᵬᶇᶅᶃᶐᶇᵿᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵗᵏ
ᵱᶍᶓᶒᶆᴾᵟᶄᶐᶇᶁᵿᴾᵏᵗᵗᵏ
ᵡᶓᶀᵿᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵗᵓ
ᵥᶓᵿᶒᶃᶋᵿᶊᵿᴾᴾᴾᴾᵏᵗᵗᵓ
ᵦᶍᶌᶂᶓᶐᵿᶑᴾᴾᴾᴾᴾᴾᵏᵗᵗᵓ
ᵠᶍᶊᶇᶔᶇᵿᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵗᵕᵟᶐᶅᶃᶌᶒᶇᶌᵿᴾᴾᴾᴾᴾᵏᵗᵗᵖ
ᵡᶍᶊᶍᶋᶀᶇᵿᴾᴾᴾᴾᴾᴾᵏᵗᵗᵖ
ᵮᵿᶐᵿᶅᶓᵿᶗᴾᴾᴾᴾᴾᵏᵗᵗᵖᵤᶐᵿᶌᶁᶃᴾᴾᴾᴾᴾᴾᴾᴾᴾᵏᵗᵗᵗᵡᵿᶋᶃᶐᶍᶍᶌᴾᴾᴾᴾᴾᵐᵎᵎᵎᵮᵿᶌᵿᶋᵿᴾᴾᴾᴾᴾᴾᴾᴾᵐᵎᵎᵐᵬᶇᶁᵿᶐᵿᶅᶓᵿᴾᴾᴾᴾᴾᵐᵎᵎᵑᵱᶕᶇᶑᶑᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵐᵎᵎᵑᵥᶐᶃᶃᶉᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵐᵎᵎᵑᵠᶃᶊᶅᶇᶓᶋᴾᴾᴾᴾᴾᴾᴾᴾᵐᵎᵎᵒᵱᶎᵿᶇᶌᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᴾᵐᵎᵎᵒᮏ᮶䛾ศᕸᆅᇦ᪂䛯䛻౵ධᐃ╔䛧䛯ᆅᇦ㜵㝖䛻䜘䛳䛶㥑㝖䛥䜜䛯ᆅᇦ˽̌̂˘˦ʉɨɯʩ˧˝ˎˍˌ˳ˀʌ࠼ᐹ2013䜲䝍䝸䜰䛿ᐃ╔䛧䛶䛔䛺䛔䛸䛣䜝䛜䜟䛪䛛2015㉥䠖ᐃ╔㯤䠖᳨ฟ⥳䠖ㄪᰝ῭᳨ฟ䛫䛪䚸⅊䠖ㄪᰝ↓14

2015/7/28

ଐஜƷȒȈǹǸǷȞǫƷ҅ᨂ
•1946䡚’47䠗ᰣᮌ┴໭㒊䠄Mosquito Fauna of Japan & Korea.
By Walter J. LaCasse & Satyu Yamaguchi) ⡿㌷䛻䜘䜛඲ᅜつᶍ䛷䛾ㄪᰝ䛷䚸⚟ᓥ┴௨໭䛻䛿䝠䝖䝇䝆䝅䝬䜹䛿☜ㄆ䛥䜜䛺䛛䛳䛯䚹䠅•1970ᖺ௦䠗௝ྎᕷ䛜ኴᖹὒഃ䛾໭㝈䛸䛺䛳䛯䚹•1990ᖺ௦䠗௝ྎ䛛䜙⣙20km໭䛻఩⨨䛩䜛ྂᕝ䛷☜ㄆ䚹ᒣᙧ䚸⛅⏣䚸᪂ᗉ䚸୍㛵䛷䛿☜ㄆ䛥䜜䛺䛛䛳䛯䠄Kurihara et al. 1997䠅䚹ከ䛟䛾㒔ᕷ䛷䛾䝠䝖䝇䝆䝅䝬䜹䛾ศᕸ☜ㄆ䛸ᖺᖹᆒẼ 11Υ௨ୖ䛾ᆅᇦ䛜୍⮴䛩䜛䠄98%௨ୖ䛾୍⮴⋡䠅䟿2035ᖺ䛻䛿㟷᳃┴䛾ᖹᆅ䛩䜉䛶䛻䝠䝖䝇䝆䝅䝬䜹䛾ศᕸ䛜ྍ⬟䚹2100ᖺ䛻䛿໭ᾏ㐨༡➃䛛䜙ᮐᖠ䛻䛛䛡䛶ྠ⺅䛜౵ධ䞉ᐃ╔䛩䜛!

Dengue endemic area15

2015/7/28

䝕䞁䜾䜴䜲䝹䝇䝠䝖༢᰾⌫ෆ䛷ቑṪ䛧䛯䝕䞁䜾䜴䜲䝹䝇⺅⣽⬊䛷ቑṪ䠄C6/36⣽⬊䠅᪥ᮏ䛷䛾ឤᰁ䛜␲䜟䜜䛯䝗䜲䝒ே䝕䞁䜾⇕⑕౛
2013ᖺ9᭶Ⓨ⏕䚸2014ᖺ1᭶ሗ࿌
51ṓዪᛶ䚸⏕᮶೺ᗣ᪥ᮏᅜෆ᪑
⾜*dayͲ15

8/19

ᡂ⏣╔䠄䝣䝷䞁䜽䝣䝹䝖䛛䜙䛾┤⾜౽䠅dayͲ15~Ͳ13

8/19~21ୖ⏣䠄㛗㔝䠅

dayͲ13~Ͳ10

8/21~24➜྿䠄ᒣ᲍䠅

dayͲ10~Ͳ98/24~25

ᗈᓥdayͲ9~Ͳ6

8/25~28ி㒔 䠄Ḣ⡿ே䛻ேẼ䛾⏫ᒇ᪑㤋䠅dayͲ6~Ͳ3

8/28~31ᮾி 䠄᪂ᐟᚚⱌ䜢ゼ䜜䛯䠅

dayͲ3

8/31

ᡂ⏣Ⓨ䠄䝣䝷䞁䜽䝣䝹䝖䜈䛾┤⾜౽䠅

Ⓨ day0
⑕
day 6
ᚋ
⤒
㐣

9/3

Ⓨ⇕䠄᭱㧗య

9/9

䝧䝹䝸䞁䛾་⒪ᶵ㛵䛻ධ㝔
IgG(IFA):1:20,480䠄㝧ᛶ䠅,IgM(IFA):1:320䠄㝧ᛶ䠅NS1ᢠཎ(ELISA):㝧ᛶ,RTͲPCR:㝜ᛶ୰࿴ヨ㦂䠖䝕䞁䜾䜴䜲䝹䝇2ᆺ䛾ឤᰁ40Υ䠅䞉჎Ẽї⣚ᩬୣ⑈ᛶⓎ⑈䜢క䛖Eurosurveillance, Volume 19, Issue 3, 23 January 2014 (*᪑⛬᝟ሗ䛿ProMed䜘䜚䠅

16

2015/7/28

䝕䞁䜾⇕䛾ᅜෆឤᰁ⑕౛䛾Ⓨ⏕≧ἣ
Ⓨ⑕᪥ูሗ࿌ᩘ
䠄Ⓨ⑕᪥୙᫂䛾㻠౛䜢㝖䛟㻝㻡㻝౛䠅ሗ࿌ᩘ12௦䚻ᮌබᅬ8/28༗ᚋ5᫬
-8/29ᮅ㛢㙐௦䚻ᮌබᅬ䜎䛯䛿䛭䛾࿘㎶䛾䜏
n=122

109/4䡚௦䚻ᮌබᅬAᆅ༊㛢㙐ཌປ┬➨1ሗ
Ⓨ⾲䠄8/27䠅᪂ᐟ୰ኸබᅬ䛾䜏 n=886

䛭䛾௚䞉୙᫂ n=214
20Ⓨ⑕᪥

㻥᭶

㻤᭶

䛆ཌ⏕ປാ┬Ⓨ⾲䠄2014ᖺ10᭶6᪥11᫬⌧ᅾ䠅䛻ᇶ䛵䛟䚹䛇

Yoyogi story௦䚻ᮌබᅬ䛾䝠䝖䝇䝆䝅䝬䜹䛾ᩘ䛿༙➃䛺ᩘ䛷䛿䛺䛔䟿䜴䜲䝹䝇㑇ఏᏊ㓄ิ䛿୍⮴䛩䜛䟿⛣ື⛣ື17

2015/7/28

᥎ᐃ᭚㟢᪥ูሗ࿌ᩘ
䠄2014ᖺ8᭶1᪥䠉9᭶30᪥䠅௦䚻ᮌබᅬ䜎䛯䛿࿘㎶䛾䜏䠄n=70䚾122౛୰䚸᭚㟢᪥䛜1᪥䛰䛡䛾⑕౛䛾䜏䚿䠅
7
69/4௦䚻ᮌබᅬAᆅ༊㛢㙐

5

ሗ 4
࿌
ᩘ 3
210

᪂ᐟ୰ኸබᅬ䛾䜏䠄n=5 䚾ྠ8౛୰䚿 䠅

᥎ᐃ᭚㟢᪥

43

ሗ
࿌ 2
ᩘ
11᪥
2᪥
3᪥
4᪥
5᪥
6᪥
7᪥
8᪥
9᪥
10᪥
11᪥
12᪥
13᪥
14᪥
15᪥
16᪥
17᪥
18᪥
19᪥
20᪥
21᪥
22᪥
23᪥
24᪥
25᪥
26᪥
27᪥
28᪥
29᪥
30᪥
31᪥
1᪥
2᪥
3᪥
4᪥
5᪥
6᪥
7᪥
8᪥
9᪥
10᪥
11᪥
12᪥
13᪥
14᪥
15᪥
16᪥
17᪥
18᪥
19᪥
20᪥
21᪥
22᪥
23᪥
24᪥
25᪥
26᪥
27᪥
28᪥
29᪥
30᪥

0

᥎ᐃ᭚㟢᪥

ィ75౛䛾䛖䛱䚸Ⓨ⑕᪥䛾䜟䛛䜛72⑕౛䛛䜙⟬ฟ䛧䛯₯అᮇ䠖୰ኸ್6᪥(⠊ᅖ2䠉13᪥䠅䛆ཌ⏕ປാ┬Ⓨ⾲䠄2014ᖺ10᭶6᪥11᫬⌧ᅾ䠅䛻ᇶ䛵䛟䚹䛇䝕䞁䜾⇕䛾ᅜෆឤᰁ⑕౛䛾ᒃఫᆅู≧ἣ䠄㼚㻩㻝㻢㻞䠅඲ᅜ䛷
19㒔㐨ᗓ┴

18

2015/7/28

䛭䛾௚䛾␿Ꮫ᝟ሗ䠄㼚㻩㻝㻡㻢䠅ᒃఫᆅᖺ㱋⩌ཬ䜃ᛶู㒔㐨ᗓ┴ྡ⑕౛ᩘᮾி㒔

102
14
12
7
33222111111111156

ᖺ㱋㝵⣭

⏨ᛶዪᛶ

ィ

10ṓᮍ‶

41510௦

141630

20௦

2726

5330௦

117

1840௦

12112350௦

11213

㟷᳃┴

60௦

808

⛅⏣┴

70௦

415

ィ

91

64155

ᇸ⋢┴
ᇸ
┴⚄ዉᕝ┴
༓ⴥ┴
᪂₲┴኱㜰ᗓⲈᇛ┴ᒣ᲍┴㟼ᒸ┴໭ᾏ㐨ᒾᡭ┴⩌㤿┴ᒣཱྀ┴ឡ፾┴㧗▱┴රᗜ┴ィ䛆ཌ⏕ປാ┬Ⓨ⾲䠄2014ᖺ10᭶6᪥11᫬⌧ᅾ䠅䛻ᇶ䛵䛟䚹䛇䝕䞁䜾⇕ᝈ⪅ሗ࿌ᩘ䠄ᮾ༡䜰䝆䜰୰ᚰ䠅2013ᅜྡ䜸䞊䝇䝖䝷䝸䜰䜸䝇䝖䝷䝸䜰ሗ࿌ᝈ⪅ᩘ

1,762

Ṛ⪅ᩘ

2014
๓ᖺẚ

䠄2012ᖺ䠅As ofሗ࿌ᝈ⪅ᩘṚ⪅ᩘ

0

1.1(1,541)
( ,)

1,514

NA
21

䜹䞁䝪䝆䜰

16,72253

0.4(40,164)

3,543

䝷䜸䝇

44,17195

4.4 (9,952)

1,716

0

䝬䝺䞊䝅䜰

43,34683

2.0 (21,900)

108,698

215

䝣䜱䝸䝢䞁

166,1071.0 (170,693)

104,741399
4䝅䞁䜺䝫䞊䝹

22,194

528
5

䝧䝖䝘䝮

60,58838

0.8 (79,485)

୰ᅜ

581

0

ʊʊ

9/3

䝙䝳䞊䜹䝺䝗䝙䜰

10,541

7

26.0

9/14

䝋䝻䝰䞁ㅖᓥ

6,591

8

NA

7/17

18,3184.8 (4,632)

䝫䝸䝛䝅䜰䠄௖㡿䠅

17,76617

45,171NA

14NA15,90420

WHOすኴᖹὒᆅᇦእ

䝍䜲

26,067

33

ྎ‴

869

NA

3.3

4/30

19

2015/7/28

䛹䛾䜘䛖䛺䝕䞁䜾䝽䜽䝏䞁䛜ᮃ䜎䜜䜛䛛䠍䠅䝕䞁䜾䜴䜲䝹䝇1䠉4ᆺ䛩䜉䛶䛻ᑐ䛧䛶䠍䠅䝕䞁䜾䜴䜲䝹䝇14ᆺ䛩䜉䛶䛻ᑐ䛧䛶㧗䝺䝧䝹䛾㜵ᚚච␿䠄୰࿴ᢠయ䠅䜢ㄏᑟ䛩䜛䚹䠎䠅䝽䜽䝏䞁᥋✀⪅䛻䝕䞁䜾ฟ⾑⇕䛜ከⓎ䛧䛺䛔䚹䠏䠅Ᏻ౯㛤Ⓨ୰䛾䝕䞁䜾䝽䜽䝏䞁䝍䜲䝥ྡ⛠㛤Ⓨ⪅⮫ᗋヨ㦂ຠຊ

CYDͲTDV䝃䝜䝣䜱䞊䞉䝟䝇䝒䞊䝹3┦⤊஢

56.5%䠄䜰䝆䜰䠅
60.8%(୰༡⡿)(୰༡⡿)

DENVax⡿ᅜ⑌⑓ண㜵⟶⌮䝉䞁䝍䞊Ṋ⏣⸆ရ䠄䜲䞁䝡䝷䞊䝆䜵䞁䠅2┦

ͲaTetraVaxͲDV⡿ᅜ䜰䝺䝹䜼䞊ឤᰁ⑕◊✲ᡤ䜰䝯䝸䜹ᅜ❧⾨⏕◊✲ᡤ

2┦

Ͳa୙ά໬

TDENV PIVTDENVͲPIV䜴䜷䝹䝍䞊䞉䝸䞊䝗㝣㌷◊✲ᡤ䜾䝷䜽䝋䞉䝇䝭䝇䜽䝷䜲䞁

1┦

ͲaDNA

TVDV⡿ᅜᾏ㌷་Ꮫ◊✲䝉䞁䝍䞊
䝞䜲䜹䝹

1┦

Ͳa䝃䝤䝴䝙䝑䝖

DENͲV180䝯䝹䜽䠄䝝䝽䜲䝞䜲䜸䝔䝑䜽䠅1┦Ͳaᙅẘ䜻䝯䝷ຠຊ䛜⟬ฟ䛷䛝䜛䜘䛖䛺ヨ㦂䛿䜎䛰ᐇ᪋䛥䜜䛶䛔䛺䛔䚹

20

2015/7/28

䝕䞁䜾䜴䜲䝹䝇䜻䝯䝷䝽䜽䝏䞁䛿䜎䛰᏶඲䛷䛿䛺䛔
ConstructionofCYDͲTDY;Sanofi Pasteur
NS2B

5’NTR
1000

0C prM
D1prM&M&D2

prM&2000

3000

E

NS1 NS2A

E
E

4000

3’NTR

NS4A
6000

5000

NS37000

8000

NS4B

9000

10000

NS5RNAtransfectioninVerocells

ExchangewithprM/E
genesofwtDEN1Ͳ 4

D3 prM& E

IndividuallytranscribedtoRNA

D4 prM& E

4chimericcDNAs

2ᆺ䜴䜲䝹䝇ឤᰁ䜢㜵ᚚ䛷䛝䛺䛛䛳䛯䟿䠄䝍䜲䛷䛾⮫ᗋヨ㦂䛷䠅

4individual
chimeric
Dengueviruses
(CYD1Ͳ4)

D1

D2

D3

D4

吘吆呉吇吢吢吢叹叽叻呂吐吐吐ឤᰁ⑕21

2015/7/28

䝏䜽䞁䜾䝙䜰⇕䛾⮫ᗋ• ₯అᮇ㛫䛿㏻ᖖ 3–7᪥㛫䛷䛒䜛䚹ᩍ⛉᭩ⓗ䛻䛿3䡚12᪥㛫• Ⓨ⇕䛸㛵⠇③䛜᭱䜒ከ䛔⑕≧䛷䛒䜛䚹• 䛭䛭䛾௚䛾⑕≧䛸䛧䛶㢌③䚸➽⫗③䚸㛵⠇⭘ᙇ䠄㛵⠇⅖䠅䚸Ⓨ⑈䛜௚ ⑕≧䛸䛧 㢌③ ➽⫗③ 㛵⠇⭘ᙇ䠄㛵⠇⅖䠅 Ⓨ⑈䛜䛒䛢䜙䜜䜛䚹• 䝏䜽䞁䜾䝙䜰䜴䜲䝹䝇ឤᰁ䛻䜘䜛Ṛஸ⋡䛿ప䛔䛜䚸⑕≧䛿㔜⑕໬䛒䜛䛔䛿ᶵ⬟㞀ᐖ䠄㛵⠇䛾ኚᙧ䛺䛹䠅䜢䛝䛯䛩䛣䛸䛜䛒䜛䚹• ከ䛟䛾ᝈ⪅䛿୍㐌㛫⛬ᗘ䛷ᅇ᚟䛩䜛䛜䚸㛵⠇⅖䛜ᅇ᚟ᚋ䜒ᩘ䞄᭶ᣢ⥆䛩䜛 䛒䜛䛔䛿෌⇞䛩䜛ሙྜ䛜䛒䜛᭶ᣢ⥆䛩䜛䚸䛒䜛䛔䛿෌⇞䛩䜛ሙྜ䛜䛒䜛䚹• ᪂⏕ඣ䜔㧗㱋⪅(ш65years)䚸㧗⾑ᅽ䚸⢾ᒀ⑓䚸ᚰ⮚⑌ᝈ䜢᭷䛩䜛ே䛷䛿,㔜⑕໬䛩䜛䛣䛸䛜ከ䛔䚹• ⤊⏕ච␿䛸⪃䛘䜙䜜䛶䛔䜛䚹

BonescintigraphyThewrists&handsshowinganintensefocus,particularlyontheleftside.

22

2015/7/28

䜰䝯䝸䜹኱㝣䛻౵ධ䛧䛯䝏䜽䞁䜾䝙䜰䜴䜲䝹䝇䛻䜘䜛ὶ⾜ᣑ኱䟿䝏䜽䞁䜾䝙䜰⇕䛾㛵⠇⅖䠄ᛴᛶᮇ䠅䛸Ⓨ⑈ീ䠄᪥ᮏே⑕౛䠅䠄䜲䞁䝗ே⑕౛䠅

Ⓨ⑈ീ
Hochedez et al.
EID 12(10), 2006.

23

2015/7/28

䝏䜽䞁䜾䝙䜰䜴䜲䝹䝇䛻䜘䜛㛵⠇⅖䠄ᚋ㑇⑕䠅䠄䜲䞁䝗ே䛾⑕౛䠅মପ‫ع‬ృପभৃ়ኵৌੁ५ॣ४গ‫ش‬ঝਛདৌੁ‫؟‬৒ਡ৹ਪ‫ ق‬CDCॺছॵউ‫ك‬पेॊਛདഡ২ঔॽॱজথॢ॑ಲਢ໽དৌੁ‫؟‬໽ད৅ে౺भ௾ுध஬྽

11 াਛདৌੁ‫؟‬౴਽भᗭ৒໽དৌੁ‫؟‬‫؞‬਷भোढञං਷ঐ५भ৹ਪ‫؞‬ଣ઼औोञযੵઍஓभ௾ுध஬྽‫؞‬०঑઼ऌৃಉभ஬྽વਧ౾ਣ‫ق‬ফ਴಑ਞആ12Υਰ঱भ৉ୠ‫ك‬ਛདৌੁ‫؟‬৒ਡ৹ਪ‫ ق‬CDC
ॺছॵউ‫ك‬पेॊਛདഡ২
भঔॽॱজথॢमఢফৰ઱घॊ
* ॿॵॱॖ३ঐढ़भ෶োपुିਔघॊ໽དৌੁ‫؟‬໽ད৅ে౺भ௾ுध஬྽ਛད఑ૐ১

4 া ໽དৌੁ‫؟‬‫؞‬໽དभ৅েखञං਷ঐ५षमIGR॑਺ଖ‫ؚ‬਷௷ऌಉ॑ৰ઱
‫؞‬໽ད৅ে౺भ௾ுध஬྽

CDCॺছॵউ

8ী৑఑ૐ১

5 া ਛདৌੁ‫؟‬৒ਡ৹ਪ‫ ق‬CDCॺছॵউपेॊਛདഡ২भঔॽॱজথॢ॑৫઩

7~8 া ਛདৌੁ‫ൃৣ؟‬࿘ॉ໽དৌੁ‫؟‬ঽ੘৬਌଑‫ؚ‬કড়૞ਸपेॊ
໽ད৅ে౺भ௾ுध஬྽

໽
ད৅
ে
౺

48

‫ ؞‬8ী৑఑ૐ১पेॊਛདഡ২৹ਪ॑ৰ઱‫؞‬জ५ॡ௬੼ĺిજऩᄘஂኵৌੁ॑ৰ઱घॊ

24

2015/7/28

঄ॺ५४३ঐढ़ਛདभཎाৃਚॶॶ४ृ॔ड़य़‫ؚ॔‬४१ॖभेअऩ଩਽भ୴ഫृൄाभর৉એ॑ངअेअप෬ॊॶॱऩनु‫୴ؚ‬ഫपਛདऋཎ॒दःॊ䝕䞁䜾䜴䜲䝹䝇䛻ឤᰁ䛧䛺䛔䛯䜑䛻䟿䠄᪥ᮏᅜෆ䛷ὶ⾜Ⓨ⏕䛧䛯ሙྜ䠅䞉䝠䝖䝇䝆䝅䝬䜹䛾䛔䜛䛸䛣䜝䛻⾜䛛䛺䛔䞉䝠䝖䝇䝆䝅䝬䜹䛻่䛥䜜䛺䛔䜘䛖䛻䛩䜛䞉䝠䝖䝇䝆䝅䝬䜹䛾Ⓨ⏕ሙᡤ䜢䛺䛟䛩

25

2015/7/28

⹸䜘䛡๣䛻䛴䛔䛶
• DEET䜢ྵ䜐⹸䜘䛡๣䛜᭱䜒ຠᯝ䛜䛒
䜛䟿㏻ᖖ䚸㟢ฟ䛧䛯⫙䛻ሬᕸ䛩䜛䚹
䜛䟿㏻ᖖ 㟢ฟ䛧䛯⫙䛻ሬᕸ䛩䜛• ᪥↝䛡Ṇ䜑䜢౑䛖䛸䛝䛿䚸᪥↝䛡Ṇ䜑䜢ሬ䛳䛶༑ศ஝䛔䛶䛛䜙⹸䜘䛡๣䜢ሬ䜛䚹• DEET䜢ྵ䜎䛺䛔䚸䝴䞊䜹䝸䜸䜲䝹䜔䝺䝰䞁䜸䜲䝹䞁䜸䜲䝹䝧䞊䝇䛾⹸䜘䛡๣䛿䚸ᣢ⥆᫬㛫䝇䛾⹸䜘䛡๣䛿䚸ᣢ⥆᫬㛫䛺䛹䛻㛵䛩䜛䝕䞊䝍䛾⵳✚䛜ᑡ䛺䛔䚹䛌DEETƎ䛸䛌TCDDƎ䛿㐪䛔䜎䛩!!

ୡ⏺䛾⯟✵ᶵ䝹䞊䝖26