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1 Vol. 35 No ISSN Vol.35 No. 3 No Infectious Agents Surveillance Report (IASR) http:// 3, 4, : 5, A ; 6, : 8, 9,, 2, SFTS 3, A(HN)pdm09 4, A(HN)pdm09 : 6, : 7, Agbeni 3 Tel : 8, A 9, HIV AIDS 20,,, 2 :,,, RNA AG, AC, 5 3, 4,,,,,,,,, 45 Lancet Infect Dis 2: 364, 202 :,, 3, kenkou/kekkakukansenshou/0058.html,,, , , go.jp/bunya/kenkou/kekkakukansenshou/ html, *, 2 5 *20422 C A, , jp/byogentai/pdf/dataj.pdf : * 2005/ / / / /0 200/ 20/2 202/3 203/4 G G3 G8 G9 G A G2 G4 C , 60 A, 8 C 2005/ / , 200/, 2 A *98 : 20423, C 63 2

2 264 Vol. 35 No , / / / / /0 200/ 20/2 202/ A A G A G2 A G3 A G C / B A : A, 2 VP7 VP4, G P, GP[8], G2P[4], G3P[8], G4P[8], G9P[8] 5 4,, G, A 3,302, 38, 0 6, 2 6, G, G3, G9 G2, ,, C 27, 5 9 8, 04 5 : , 22, 4 A 4 :,,,, IASR G2 G9 G8 G4 G3 G2 G , * () 3 () 9 (2) ** / 2 2 () () 2 26 () 48 () 3 () 08 (3) * **2 C : 34, 202 & 33: 9798, 202 & 33: 27, 202 & 34: 6970, 203 & 34: , , A 05, C 3 2,, A 202 2, 5 A 4, C, , :, 000 g 0 0 0,, GP[8] 5 G, G2, G3, G4, P[8] 2, 30, 53 9, , , :,, 90,, 203 8,, 2,, 2, 3,,

3 Vol. 35 No VP7,,, 80, 7 8,,, , 2 2, 4,,, HUS DIC,,, Reoviridae,,, 2 RNA 6 VP 6 NSP VP6 AG, VP6 VP4. A C, A, A, VP7 G type VP4 P type, 90 GP[8], G2P[4], G3P[8], G4P[8], G9P[8] 5,,,,,, VP7 VP RCWG, VP7VP4VP6VPVP2VP3NSPNSP2NSP3 NSP4NSP5, GxP[x]IxRx CxMxAxNxTxExHx x,,,, G P I R C M A N T E H

4 466 Vol. 35 No % 202/380% 60% 40% 20% 0% 200/ / / / / /07,, GSK, 20, MSD, ,, G P[8], VP7 G4 VP4 P[8] 5 5 5,,, , VP7 40,, 2, G, G2, G3, G9,, 203 0,,,,,, 202, 2007/ / /0 200/ : A 20/2 G2 G9 G8 G4 G3 G2 G Unknown,, G P[8]I2R2C2M2A2N2T2E2H2,,,,, ELISA, multiplexpcr, VP7, VP4,, 2 RNA A RVA, 2 VP7, VP4 G, P, RTPCR, GG4, G9, P[4], P[6], P[8], 2008, Rotavirus Classif ication Working Group RCWG,

5 Vol. 35 No , VP7, VP4,, VP7VP4VP6VPVP2VP3NSPNSP2NSP3 NSP4NSP5 GPIRCMANT EH,, ORF, NCBI BLAST RNA 2, RotaC ORF , RCWG Wa, DS Wa, DS,, G/3/4P[8]IRCMANT EH, G2P[4]I2R2C2M2A2N2T2E2H2, AU G3P[9]I3R3C3M3A3N3T3 E3H3/6 3, 7,,, 2 G/P, G/P,,,, 5, DC, 24,,, G/P VP7/VP4,,, G/P, 5, 5 GP[8], G2P[4], G3P[8], G4P[8], G9P[8], GP[8] 6 G2 G2P[4], G3P[8], G G9, G8 G5, G6,, G0 G4 7,,, Arch Virol 53: 62629, PLoS Pathog 5 e000634, J Virol 86: , 202 4PLoS ONE, 204 in press 5IASR 32: 6466, 20 6Wkly Epidemiol Rec 88: 27223, 203 7Emerg Infect Dis 9: 32323, A RVA, GxP[x]IxRxCxMx AxNxTxExHx x, RVA VP7 G VP4 P, VP6 I, G P GxP[x],

6 668 Vol. 35 No /2 RVA 5, 7 DS GP[8] GP[8]I2E2H2 5 DS GP[8] VP , VP , VP , NSP4 E , NSP5 H , 203 RVA VP7 VP4, GP[8] ,, I, RVA GPI,,, ELISA, TFB RVA RVA 2009, 200 2, 20 2, 202 9, , 200 2, 3 5 ELISA, RVA VP7, VP4 VP6 RTPCR 2,, RotaC 3 GPI, 5 GP[8]I 5, GP[8]I2 2, G2P[4] I2, G9P[8]I 3, RVA 202, 6 GP[8]I2 GP[8]I2, 99,, BLAST, GP[8]I2 202, VP7 VP4 RVA/Humanwt/USA/ /2007/GP[8], RVA G P, DS GP[8], DS GP[8] G2P[4], DS GP[8], DS GP[8], Matthijnssens J, et al., Arch Virol 56: , 20 2Fujii Y, et al., Microbiol Immunol 56: , 202 3RotaC 2.0 automated genotyping tool for Group A rotaviruses 4Yamamoto SP, et al., Emerg Infect Dis, 204 in press 5Kuzuya M, et al., J Med Virol, 203 Sep 6. doi: 0.002/jmv Epub ahead of print 6,, IASR 34: , 203 VP7, 99.6; VP4, 99.4, GP[8]I2 2 6, GP[8]I2R2C2M2A2N2T2 A 200/202/3 E2H2 4 RVA Wa GP[8]IRCMANTEH DS G2P[4]I2R2C2M2A2N2T2E2H2, GP[8]I2 I2 9 DS GP[8], DS GP[8],, A RVA,, RVA VP7 G

7 Vol. 35 No A, 2, RVA /3 6, / 438, 20/2 : 40, 202/3 : 440, RVA ELISA, Gouvea PCR RTPCR 3 G, RVA 200/ 30., 20/2 8.5, 202/3 2.6, 2 RVA RVA, 3, , 200/ 20/2, 202/3,, 20/2, 202/3, 6, 7 RVA, RVA 262 G 3 G G3 65.7, G 30.5, G9 2.3, G2., G G3, 200/, 20/2 2008/09, 2009/0 G3, 20/2 G, 202/3 6 G, 20/2, RVA 4, VP7 VP4 P G Wa GP[8], VP6, NSP4 NSP5/6 G2 DS, genogroup Wa genogroup DS genogroup RVA. G 200/202/ , G 7.4 4, G P, NSP4 NSP5/6 4, 202/3, GP[8] 49 RT PCR NSP4 NSP5/6,, , genogroup, 2, RVA Rotarix GSK 20, RotaTeq MSD 202 7, 3 RVA,, 2,,,,, 2,,,,, IASR 26: 46, ,, IASR 32: 772, 20 3Gouvea V, et al., J Clin Microbiol 28: , 990 4Kuzuya M, et al., J Med Virol, 203 Sep 6. doi: 0.002/jmv Epub ahead of print

8 870 Vol. 35 No , , A RVA, IASR IASR 32: 7374, RVA G, 2009, 200 G3, 20, 202 G3 RVA 202 G3, G9 G2, 203 G , G G GP[8]I2R2 C2M2A2N2T2E2H2 VP7 GVP4 P[8] DS G2P[4], Kuzuya OH3625/ 202 VP6, VP7, NSP4 VP7 VP GP AG 340 GP GP GP8 O22 GP8 O224 GP8 O242 GP8 G JN RVA/Humanwt/USA/ /2007/GP8 DQ RVA/Humanwt/BEL/B3458/2003/G9P8 I DQ RVA/Humanwt/BGD/Dhaka6/2003/GP8 I AB Human rotavirus KU I K02086 Human Wa rotavirus I AF3724 Porcine rotavirus A3 X69487 Rotavirus YM I5 I O26 GP8 O224 GP8 AB RVA/humanwt/JPN/OH3625/202/GP8 JN RVA/Humanwt/USA/ /2007/GP8 DQ RVA/Humanwt/BGD/Dhaka6/2003/GP8 K02033 Human Wa rotavirus G AB Human rotavirus MKU2G G EF67266 RVA/Humantc/GBR/ST3/975/G4P2A G2P G2P4 KC RVA/Humanwt/USA/VU050666/2005/G2P4 HM ES 2842 G2P4 O28 G2P4 HQ65024 RVA/Humantc/USA/DS/976/G2P4 AY Bovine rotavirus WC3 G6 X00896 UK bovine rotavirus G6 AB07404 Human rotavirus T52 G2 D8627 Human rotavirus AU G3 L35055 Porcine rotavirus A3 G3 K02028 Simian i SA G3 EF RVA/Humanwt/BEL/B3458/2003/G9P8 DQ00520 RVA/Humanwt/COD/DRC86/2003/G8P6 M2394 Porcine rotavirus YM G G2 AB RVA/humanwt/JPN/OH3625/202/GP8 O242 GP8 O26 GP GP GP8 340 GP8 O22 2 GP GP8 HM ES G2P G2P4 O28 G2P4 KC RVA/Humanwt/USA/VU050666/2005/G2P G2P G2P4 DQ0052 RVA/Humanwt/COD/DRC86/2003/G8P6 I2 X53667 Bovine rotavirus UK I2 AF4322 Bovine rotavirus WC3 I2 AY87029 Simian rotavirus A/SA I2 DQ RVA/Humantc/USA/DS/976/G2PB4 I2 DQ RVA/Humantc/JPN/AU/982/G3P39 I3 DQ46702 RVA/Humantc/THA/T52/998/G2P9 VP6 I2 VP7 VP GP[8]G2P[4]VP7VP6

9 Vol. 35 No DS GP[8] 202,, , 2, 203, 7, 20 7, 203, DS GP[8], , , , , 5 8, G2P[4]I2, ,,,,, Kuzuya M, et al., J Med Virol, 203 Sep 6. doi: 0.002/jmv Epub ahead of print,,, 53,, 2007,,,,, 4 5, 24 3, 24, i 3,, ,, ,,,

10 072 Vol. 35 No ,, PCR G P 2 ii 5, 20,,,,,,,,,,,, iii,,, RNA, G, P st PCR, 2nd PCR,, i, / G9P[8] 6% G2P[4] 0%, 55,,,, 5, , 4.9, ii % G3P[8] 85% GP[8] 0% G2P[4] 5% G9P[8] 0% 6% G3P[8] 54% GP[8] 35% G9P[8] 0% G3P[8] 29% 4% GP[8] 67% G2P[4] 0% a 2,549 7, ,775 33,000 b,,000, b 4.4 (95%CI: 3.6, 5.3) 4.7 (95%CI: 3.6, 5.9) (95%CI: 4.0, 5.7) 5.4 (95%CI: 4.3, 6.7) (95%CI: 2.0, 4.0) (95%CI: 2., 4.3) 5 c in 40 in 37 in 6 a 2005 b Fisher s exact test c 2007 (2,434), (,57), (,097)

11 Vol. 35 No , /,000 /, 4 iii PCR,, 2007 G3, G 20 2,, 2.7, 5.2/,000/,,,,,,,,,,, cost effective analysis, : Kamiya H, et al., J Infect Dis 200 Suppl : S4046, Kamiya H, et al., Jpn J Infect Dis 64 6: , 20 Francis Dennis, GSK 5 MSD , 520,946, 5 237,034,,, , ,,,,,,,, 204 6, , ,,,,,

12 274 Vol. 35 No ,, , 0 57, 7,,,,,,, 5,,,,,, 2 3,,,, 5,,, 3.9 /,000 /,.4 /,000 /, 5. /,000 /, 3.7 /,000 /,,, 3,,,,,,, 5,,,,,,,,,, :,, 0,

13 Vol. 35 No , 0,,,,,,,,, 5,,,,, 8, / , 2, , 4.6, , 3.3, EHEC EPEC 3., 0.6, 5 8,,, 4, 7 6 Rotarix 24, Rotateq 32,,,, 8,,,,,,, n=, /00,000, 68.3/ 00,000 35/00,000, 38/00,000, 65/00,000, 66/00,000, 7/00,000, 7800/00,000,,,.84 ; , 4, ,, 0 58 Noguchi A, et al., Jpn J Infect Dis, 202 Jul,,,,,,,,,,,,,,,,,,,,,,,,,, SFTS SFTS, 203, 3,,,,,,,,,,, SFTS SFTSV, SFTSV SFTSV SFTSV,, 47 SFTSV,, SFTS, SFTS

14 476 Vol. 35 No , SFTSV SFTSV,,,, : 26,, 8 4,000,,,,,, SFTSV, 5 5, SFTSV,,,,,,,,,,,,,,,,,,,,,,,, 3,,, SFTSV, SFTSV 2 SFTSV : SFTS, IASR 34: , 203, , 2 SFTSV,, 27, 7,,,,,,,,,,,,,,,, SFTSV, 0,,,,,,,,, ;,,,, 3,, 5, 4,, , SFTS, 9,,,,,,,,,,, 9,,,,,,,,, SFTSV,,,,, SFTSV, SFTSV,, SFTSV, 2 SFTSV, SFTS,,,, SFTSV,,,,, SFTSV,, AHNpdm09 203/4,, AHNpdm09 3,,

15 Vol. 35 No /4 AHNpdm09,, 2 NA H275Y,,,, H275Y 2, 2, NA 203/4 N248D, V24I, N369K N386K, 2, 2 2,, 2, AHNpdm09,, 2, 203/4, 203 2, AHNpdm ,, /4, 204 5, 22 7 AHNpdm09, N44S V24I N369K N200S V06I A/PERTH/265/2009 A/PERTH/26/2009 A/NARITA//2009 A/California/07/2009 A/MIE/27/203 Dec A/SAPPORO/9/203 Dec A/SAPPORO/20/203 Dec A/SAPPORO/07/203 Nov A/YAMAGATA/57/203 Nov A/YAMAGATA/58/203 Nov A/KANAGAWA/46/203 Nov A/SAPPORO/TH/203 Nov A/SAPPORO/6/203 Nov A/SAPPORO/4/203 Nov A/SichuanWuhou/SWL2259/203 Sep A/SichuanQingyang/SWL599/203 Nov A/BeijingXichengNanPian/SWL69/203 Sep A/ChongqingBanan/SWL690/203 Nov N386K A/HubeiWuchang/SWL322/203 Nov A/ShanghaiChangning/SWL62/203 Dec A/SichuanDong/SWL87/203 Oct A/Utah/09/203 Oct A/SichuanQingyang/SWL544/203 Sep A/SichuanYucheng/SWL693/203 Nov A/ChongqingYuzhong/SWL676/203 Nov A/HubeiWujiagang/SWL838/203 Dec A/Louisiana/2/203 Oct A/Louisiana//203 Oct A/Louisiana/23/203 Nov A/Louisiana/20/203 Nov S82P A/Mississippi/29/203 Nov I34V A/Louisiana/08/203 Oct N397K I32V A/Louisiana/0/203 Oct A/Louisiana/07/203 Oct K432E A/Louisiana/3/203 Nov A/Utah/0/203 Oct A/Mississippi/28/203 Dec A/Mississippi//203 Nov A/Mississippi/27/203 Dec A/Mississippi/09/203 Oct A/Utah/3/203 Dec A/OSAKAC/2006/203 Sep A/TOKYO/33409/203 Nov A/TOKYO/3247/203 Nov A/Utah/20/203 Nov A/Mississippi/08/203 Oct A/Louisiana/06/203 Sep A/SHIMANE/23/203 Sep A/SHIMANE/24/203 Sep A/SHIMANE/2/203 Sep A/SHIMANE/22/203 Sep A/SHIMANE/25/203 Sep A38T A/SHIMANE/20/203 Sep A/ShanghaiChangning/SWL568/203 Sep A/MIE/23/203 Sep A/MIE/22/203 Sep A/YAMAGUCHI/42/203 Dec L40I S95N, G20R A/YAMAGUCHI/43/203 Dec A/TOKYO/32432/203 Nov A/WAKAYAMA/53/203 Nov A/MIE/24/203 Sep A/KANAGAWA/49/203 Nov A/YOKOHAMA/56/203 Sep A/WAKAYAMAC/3/203 Sep A/WAKAYAMAC/32/203 Sep A/NEWCASTLE/32/20 A/NEWCASTLE/5/20 A/NEWCASTLE/29/20 A/NEWCASTLE/25/20 A/NEWCASTLE/7/20 A/NEWCASTLE/82/20 A/NEWCASTLE/79/20 A/NEWCASTLE/85/20 A/NEWCASTLE/89/20 A/NEWCASTLE/22/20 A/NEWCASTLE/2/20 A/NEWCASTLE/53/20 V62I A/NEWCASTLE/86/20 V06I A/NEWCASTLE/68/20 N386S A/NEWCASTLE/37/20 A/NEWCASTLE/62/20 A/NEWCASTLE/02/20. NA, AHNpdm09,,,,,, 2, /4,, 203/4 A/California/7/2009,, AHNpdm09,, 4,, 2009 HN

16 678 Vol. 35 No , HA D222G, Q223R 57, /204 8,,,, NA H275Y, 9 0,,, IASR 35: 4243, 204 2Takashita E, et al., Euro Surveill 9: pii: 20666, 204 3IASR 35: 4345, 204 4IASR 35: 442, 204 5Chutinimitkul S, et al., J Virol 84: 80283, 200 6Liu Y, et al., J Virol 84: , 200 7Zhang Y, et al., J Virol 86: , 202 8, 203/204 php?content_id=86 9Saito R, et al., Pediatr Infect Dis J 29: , f ludr/ AHNpdm09 204, 9, 2 AHNpdm09 AHNpdm09, AHNpdm , , A,,,,,,, 3 50, A, A, Glasgow coma scalegcs; EVM4,,,,,, DIC,,,,,, Autopsy imagingai MRI,,,,, Sick contact:, 2 5, 2 A : :,,, : 204 7, RTPCR, AHNpdm09, MDCK AHNpdm09, TaqMan RT

17 PCR NA, H275Y AHNpdm09, AHNpdm09,, 2 AHNpdm09, 2009/0 33, Gu 3 AHNpdm09,,, 4,, DIC, Hemorrhagic shock with encephalopathy syndrome HSE HSE,,, 2, DIC IASR 34: , 203 2IASR 35: 442, 204 3Gu Y, et al., PLoS One 203; 8: e , 20 : 4350, 2008,,, Men who have sex with men: MSM 3, ,, 202 Vol. 35 No , , ,226, , ,, , , , , , I , II , , II, , / , , / 2. 0

18 880 Vol. 35 No / , , 4 88., MSM HIV 5,,, MSM,,,,,,,,, 00 6, 202 Sexually Transmitted Disease Surveillance, Centers for Disease Control and Prevention Savage EJ, et al., Euro Surveill. 202; 7 29: pii Bremer V, et al., Euro Surveill. 202; 7 29:pii IASR 29: 23924, IASR 34: 25252, 203 6Kamali A, et al., Lancet 36: , 2003 Agbeni 3, 5 Enteritidis Infantis, 2, tables/525iasrb.html, Agbeni 3, , 2, 4, 4, 3 O3, H g,m, H2, Statens Serum Institute O3 O22, O23, PCR I 2, 3 3 O23, PCR inva, I STM4057, O3, H; g,m, H2; complex H2; e,ncomplex, Agbeni, 3, 23: g, m, [t]:, KirbyBauer, 3,,,,, 6, PFGE

19 Vol. 35 No PCR No. No. PCR O H H2 inva STM4057 O3 H;g, m H2; H2; e, n Sa2675 8/27 O3, 23 g, m Sa2680 9/5 O3, 23 g, m Sa268 9/ O3, 23 g, m (a) (kb) NotI M 2 3 XbaI DNA, NotI, XbaI,,,,,, (b) M M 2 3 M (kb) M: DNA size standard Lambda ladder (BIORAD), : Sa2795, 2: Sa2780, 3: Sa278. PFGEDNA ,,,, PCR, PCR,,,, Lee, et al., Appli Microbio 07: 8058, Franklin, et al., J Clin Microbiol 49: , 20 3 Maurer, et al., J Vis Exp 2: 6, 20 4,, IASR 30: 2223, 2009 A B UVS 4 UVS: Untypable Vi strain group NA NA: CPFX: NA, CPFX NA, CPFX

20 2082 Vol. 35 No HIV AIDS HIV , , 3, , 0 3. AIDS 08 08, 4 0, 7, 02 07, 6, 7 4. HIV AIDS 403. HIV : 205 HIV 69 5 HIV 7 42, 9 2,, AIDS : 59 AIDS AIDS 23 2, 4 3, HIV 34,6 24,533, 26,597, 8,96 7,30, 7, ,077 3,843, 33, , 5,205,89 5,27,03 2. HIV , , HIV, AIDS 2., HIV,, 2, HIV 3.,, HIV HIV, AIDS HIV AIDS,546 2, 20 HIV,,26, AIDS 43,,557. HIV : 760 HIV 7 89 HIV 8 7, 6, AIDS : 268 AIDS 57 0 AIDS 23 7, 4 0, 30, HIV 36, ,56

21 Vol. 35 No , ,09. 25,, HIV AIDS,500, 2. HIV, 20 30, 3. HIV AIDS, 7,, 22,97 4., AIDS AIDS 30 40, 40 63, HIV AIDS AIDS 30

22 2284 Vol. 35 No , 5. 22, HIV,, HIV 6., 0 7., HIV,,

23 Vol. 35 No Verotoxinproducing E.coli ( ) 0 62 ( 2) ( 2) 2 9 ( ) 4 Enterotoxigenic enic E.coli ( 2) 5 3 Enteroinvasive E.coli Enteropathogenic E.coli ( ) Enteroaggregative E.coli ( ) 3 Other diarrheagenic E.coli Salmonella Typhi 3 ( ) 2 ( 2) ( ) 2 ( 2) 2 Salmonella Paratyphi A ( ) 2 ( 2) ( ) 3 ( 2) ( ) ( ) Salmonella O ( ) 8 8 Salmonella O ( ) ( 2) 0 Salmonella O Salmonella O ( 2) 2 Salmonella O3,0 2 3 Salmonella O,3,99 Salmonella O Salmonella O3 Salmonella O8 Salmonella O30 Salmonella O39 Salmonella group unknown 4 2 Vibrio cholerae O:El Tor Ogawa awa,ct+ ( ) Vibrio cholerae nono&o39 Vibrio parahaemolyticus 7 Vibrio furnissii Aeromonas hydrophila Plesiomonas shigelloides Campylobacter jejuni Campylobacter coli Campylobacter jejuni/coli 2 Staphylococcus aureus Clostridium perfringens Bacillus cereus Listeria monocytogenes Yersinia enterocolitica Shigella dysenteriae 4 ( ) Shigella flexneri a Shigella flexneri b ( ) ( ) Shigella flexneri Shigella flexneri 2a 3 Shigella flexneri 2 b ( ) Shigella flexneri 3a Shigella flexneri 4 Shigella flexneri 6 Shigella flexneri other serovars ( ) Shigella flexneri untypable ( ) Shigella boydii 8 Shigella sonnei ( ) 3 ( 8) 2 ( 2) 3 ( 2) 2 ( 2) ( ) 4 ( 2) 2 ( ) ( ) Entamoeba histolytica Streptococcus tococcus group A Streptococcus group B 3 7 Streptococcus group C 2 Streptococcus tococcus group G Streptococcus tococcus other groups 2 S.dysgalactiae subsp.equisimilis Streptococcus pneumoniae Bordetella pertussis Legionella pneumophila Mycobacterium tuberculosis Mycobacterium bovis Mycoplasma pneumoniae Haemophilus influenzae b Haemophilus influenzae nonb Klebsiella pneumoniae 0 Neisseria meningitidis 2 Enterococcus faecalis Enterococcus faecium 20 Enterococcus gallinarum Enterococcus casseliflavus Pseudomonas aeruginosa Leptospira interogans Leptospira sp. 807 ( 2) 622 ( 2) 50 ( 4) 344 ( 4) 339 ( 5) 82 ( 5) 72 ( 6) 206 ( 2) 296 ( 4) 286 ( 3)

24 2486 Vol. 35 No ( 2) ( ) 20 ( ) ( 0) Verotoxinproducing E.coli ( ) 8 ( ) 09 ( 4) Enterotoxigenic enic E.coli Enteroinvasive E.coli ( ) Enteropathogenic E.coli ( ) Enteroaggregative E.coli Other diarrheagenic E.coli 2 ( 2) 4 ( 2) 4 ( ) 2 ( ) 2 ( 2) 25 ( 4) Salmonella Typhi ( ) 2 ( 2) ( ) ( ) 4 ( 3) Salmonella Paratyphi A ( ) ( 4) 24 ( 6) Salmonella O ( 3) Salmonella O ( 2) 5 ( 2) Salmonella O ( 2) 206 ( 4) Salmonella O9 0 Salmonella O3,0 5 Salmonella O,3,99 Salmonella O 2 4 Salmonella O3 Salmonella O8 Salmonella O30 Salmonella O Salmonella group unknown ( ) ( ) 3 ( 3) Vibrio cholerae O:El Tor Ogawa awa,ct+ 2 3 Vibrio cholerae nono&o Vibrio parahaemolyticus Vibrio furnissii 3 Aeromonas hydrophila Plesiomonas shigelloides Campylobacter jejuni Campylobacter coli 3 Campylobacter jejuni/coli Staphylococcus aureus Clostridium perfringens Bacillus cereus 2 Listeria monocytogenes Yersinia enterocolitica ( ) Shigella dysenteriae 4 Shigella flexneri a 2 ( 2) Shigella flexneri b ( ) ( ) Shigella flexneri 4 Shigella flexneri 2a 2 4 ( ) Shigella flexneri 2b ( ) 2 ( ) Shigella flexneri 3a Shigella flexneri 4 ( ) ( ) Shigella flexneri 6 4 ( ) Shigella flexneri other serovars ( ) Shigella flexneri untypable Shigella boydii 8 5 ( 4) 6 ( ) 6 ( 3) 2 ( ) 2 53 ( 29) Shigella sonnei Entamoeba histolytica Streptococcus tococcus group A Streptococcus group B 2 Streptococcus group C Streptococcus tococcus group G 5 Streptococcus tococcus other groups 5 S.dysgalactiae subsp.equisimilis Streptococcus pneumoniae Bordetella pertussis Legionella pneumophila Mycobacterium tuberculosis Mycobacterium bovis Mycoplasma pneumoniae 2 Haemophilus influenzae b Haemophilus influenzae nonb Klebsiella pneumoniae 4 Neisseria meningitidis 4 Enterococcus faecalis 24 Enterococcus faecium Enterococcus gallinarum Enterococcus casseliflavus 0 Pseudomonas aeruginosa 3 Leptospira interogans Leptospira sp. 38 ( 7) 625 ( 3) 64 ( 9) 493 ( 3) 339 ( 5) 249 ( 5) 286 ( ) 5 ( 9) 6857 ( 99)

25 Vol. 35 No Verotoxinproducing E.coli Enteropathogenic E.coli Enteroaggregative E.coli 2 2 Salmonella O4 2 ( 4) 3 ( 4) Salmonella O7 2 2 Salmonella O8 6 ( 2) 7 ( 2) Salmonella O9 4 ( 2) 5 ( 2) Salmonella O3,0 Salmonella O,3,9 Campylobacter jejuni Campylobacter coli 2 4 Staphylococcus aureus Clostridium perfringens 4 4 Yersinia enterocolitica Shigella flexneri ( ) ( ) Streptococcus tococcus group A Streptococcus tococcus group G Streptococcus pneumoniae Bordetella pertussis Legionella pneumophila Mycobacterium tuberculosis 2 2 Mycoplasma pneumoniae 3 3 Haemophilus influenzae nonb ( 9) ( 9) Salmonella O4 Typhimurium 3 ( 2) 3 ( 2) O4 Stanley 4 4 O4 Saintpaul 2 2 O4 Schwarzengrund O4 Coeln O4 Haifa 2 ( 2) 2 ( 2) O7 Thompson O7 Bareilly O8 Litchfield O8 Bovismorbificans ( ) ( ) O8 Manhattan O8 Albany ( ) ( ) O8 Nagoya 2 2 O8 Yovokome O 9 Enteritidis 3 ( ) 4 ( ) O9 Panama ( ) ( ) O3,0 Weltevreden O,3,9 Senftenberg Shigella Shigella flexneri ( ) ( ) T T3 T T TB Untypable

26 2688 Vol. 35 No Verotoxinproducing E.coli 8 8 Enteropathogenic E.coli 2 Enteroaggregative E.coli 2 2 Salmonella O3,0 Staphylococcus aureus Streptococcus pyogenes Mycoplasma pneumoniae 3 4 Moraxella catarrhalis Influenza virus A Hpdm Influenza virus A H3 8 9 Influenza virus B/Victoria 3 Influenza virus B/Yamagat ata 2 Measles virus genotype NT Measles virus genotype B Measles virus genotype D8 2 Measles virus genotype D9 Dengue virus 3 4 Dengue virus 2 Norovirus genogroup II NT Hepatitis A virus NT Hepatitis A virus IA 2 Plasmodium falciparum Dengue virus 4 / NT:

27 Vol. 35 No Picornavirus NT Enterovirus NT Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A4 2 6 Coxsackievirus A Coxsackievirus A2 2 2 Coxsackievirus B Coxsackievirus B Coxsackievirus B Coxsackievirus B Coxsackievirus B Coxsackievirus B6 NT Poliovirus Poliovirus 2 Poliovirus Enterovirus Enterovirus Parechovirus NT Parechovirus Parechovirus Rhinovirus Aichivirus 2 2 Saffold cardiovirus Influenza virus A not subtyped Influenza virus A Hpdm Influenza virus A H Influenza virus B NT Influenza virus B/Victoria Influenza virus B/Yamagata Influenza virus C 2 2 Parainfluenza virus Respiratory syncytial virus Human metapneumovirus Other coronavirus Mumps virus Measles virus genotype NT Measles virus genotype A Measles virus genotype B Measles virus genotype D Measles virus genotype D9 2 9 Measles virus genotype H Rubella virus genotype NT Rubella virus genotype a 3 Rubella virus genotype E Rubella virus genotype 2B Japanese encephalitis virus Dengue virus Chikungunya virus 4 SFTS virus 4 5 Reovirus 2 Rotavirus group unknown 2 Rotavirus group A Rotavirus group C Astrovirus Norovirus genogroup unknown Norovirus genogroup I Norovirus genogroup II Sapovirus genogroup unknown Sapovirus genogroup I Sapovirus genogroup II Sapovirus genogroup III Sapovirus genogroup IV Adenovirus NT Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus 7 Adenovirus Adenovirus 3 Adenovirus 2 Adenovirus 9 3 Adenovirus Adenovirus Adenovirus 40/ Adenovirus Adenovirus 53/ Adenovirus Adenovirus Herpes simplex virus NT Herpes simplex virus Herpes simplex virus Varicellazoster virus Cytomegalovirus Human herpes virus Human herpes virus EpsteinBarr virus Hepatitis A virus NT 2 8 Hepatitis A virus IA Hepatitis A virus IB 2 Hepatitis A virus IIIA 3 4 Hepatitis E virus 2 5 Human papilloma virus B9 virus Human bocavirus Chlamydia trachomatis Chlamydophila pneumoniae Orientia tsutsugamushi Rickettsia japonica NT:

28 Entero N Entero NT Coxsackie A Coxsackie A Coxsackie A Coxsackie A4 Coxsackie A Coxsackie A Coxsackie A Coxsackie A Coxsackie A Coxsackie A8 Coxsackie A Coxsackie A9 2 Coxsackie A Coxsackie A0 2 Coxsackie A Coxsackie A2 2 2 Coxsackie A Coxsackie A Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B Coxsackie B NT cho E cho E cho E 9 cho E cho E 5 8 cho E cho E 3 25 cho E cho E ntero E ntero E Parecho N Parecho NT arecho P 3 arecho P Rhino AFV S Influenza A not subtype Influenza A not subtyped Influenza A Hpdm0 Influenza A Hpdm Influenza A H Influenza A H Influenza B N Influenza B NT Influenza B/Victori Influenza B/Victoria Influenza B/Yamagat Influenza B/Yamagata Parainfluenza Parainfluenza Respiratory syncytial Respiratory syncytial Human metapneum Human metapneumo Other coron Other corona umps M Measles genotype N Measles genotype NT Measles genotype Measles genotype A Measles genotype B Measles genotype B Measles genotype D Measles genotype D Measles genotype D Measles genotype D9 Rubella genotype N Rubella genotype NT Rubella genotype Rubella genotype E Rubella genotype 2 Rubella genotype 2B Japanese encephalitis Japanese encephalitis engue D 2 2 Chikungunya Chikungunya Rota group Rota group A stro A 3 Noro genogroup unknow Noro genogroup unknown Noro genogroup Noro genogroup I 2 Noro genogroup I Noro genogroup II Sapo genogroup unknow Sapo genogroup unknown Sapo genogroup Sapo genogroup I Sapo genogroup I Sapo genogroup II NT deno A deno A deno A Adeno 2 4 deno A deno A deno A 8 deno A 4 2 deno A 3 deno A 37 deno A 3 Adeno 40/4 Adeno 40/ deno A 54 deno A 4 56 deno A 2 Herpes simplex N Herpes simplex NT 8 Herpes simplex Herpes simplex Herpes simplex Herpes simplex 2 4 Varicellazoster Varicellazoster 6 Cytomegal Cytomegalo Human herpes Human herpes Human herpes Human herpes EpsteinBarr EpsteinBarr Hepatitis A N Hepatitis A NT Hepatitis A I Hepatitis A IA 2 Hepatitis A III Hepatitis A IIIA 3 Hepatitis E Hepatitis E Human papilloma Human papilloma B 2 Human boc Human boca Orientia tsutsugamushi Orientia tsutsugamushi 7 Rickettsia japonica Rickettsia japonica NT: Vol. 35 No

29 Entero NT Entero NT Coxsackie A2 Coxsackie A2 5 Coxsackie A4 Coxsackie A Coxsackie A5 Coxsackie A Coxsackie A6 Coxsackie A Coxsackie A8 Coxsackie A Coxsackie A9 Coxsackie A9 5 Coxsackie A0 Coxsackie A0 6 Coxsackie A2 Coxsackie A Coxsackie A6 Coxsackie A Coxsackie B Coxsackie B Coxsackie B2 Coxsackie B Coxsackie B3 Coxsackie B Coxsackie B4 Coxsackie B Coxsackie B5 Coxsackie B5 3 Echo NT Echo NT Echo 6 Echo 6 2 Echo 7 Echo 7 9 Echo 9 Echo Echo Echo Echo 8 Echo Echo 9 Echo Echo 25 Echo Echo 30 Echo Entero 68 Entero Entero 7 Entero Parecho NT Parecho NT Parecho Parecho 2 Parecho 3 Parecho Rhino Rhino SAFV SAFV Influenza A not subtyped Influenza A not subtyped Influenza A Hpdm09 Influenza A Hpdm Influenza A H3 Influenza A H Influenza B NT Influenza B NT Influenza B/Victoria Influenza B/Victoria Influenza B/Yamagata Influenza B/Yamagata Parainfluenza Parainfluenza Respiratory syncytial Respiratory syncytial Human metapneumo Human metapneumo Other corona Other corona Mumps Mumps 3 Measles genotype NT Measles genotype NT 2 Measles genotype A Measles genotype A Measles genotype B3 Measles genotype B3 2 6 Measles genotype D8 Measles genotype D8 3 Measles genotype D9 Measles genotype D Rubella genotype NT Rubella genotype NT Rubella genotype E Rubella genotype E Rubella genotype 2B Rubella genotype 2B Japanese encephalitis Japanese encephalitis Dengue Dengue Chikungunya Chikungunya Rota group A Rota group A Astro Astro Noro genogroup unknown Noro genogroup unknown Noro genogroup I Noro genogroup I Noro genogroup II Noro genogroup II Sapo genogroup unknown Sapo genogroup unknown Sapo genogroup I Sapo genogroup I Sapo genogroup II Sapo genogroup II Adeno NT Adeno NT Adeno Adeno Adeno 2 Adeno Adeno 3 Adeno Adeno 4 Adeno Adeno 5 Adeno Adeno 6 Adeno 6 5 Adeno 8 Adeno 8 Adeno 2 Adeno 2 3 Adeno 3 Adeno 3 5 Adeno 37 Adeno Adeno 40/4 Adeno 40/ Adeno 4 Adeno 4 7 Adeno 54 Adeno 54 5 Adeno 56 Adeno 56 8 Herpes simplex NT Herpes simplex NT Herpes simplex Herpes simplex 6 6 Herpes simplex 2 Herpes simplex Varicellazoster Varicellazoster Cytomegalo Cytomegalo Human herpes 6 Human herpes Human herpes 7 Human herpes EpsteinBarr EpsteinBarr 2 3 Hepatitis A NT Hepatitis A NT Hepatitis A IA Hepatitis A IA 4 Hepatitis A IIIA Hepatitis A IIIA Hepatitis E Hepatitis E 5 5 Human papilloma Human papilloma 8 8 B9 B9 3 3 Human boca Human boca Orientia tsutsugamushi Orientia tsutsugamushi Rickettsia japonica Rickettsia japonica NT: Vol. 35 No

30 Enterovirus NT Coxsackievirus A Coxsackievirus A4 3 5 Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A Coxsackievirus A2 4 6 Coxsackievirus A Coxsackievirus B Coxsackievirus B Coxsackievirus B Coxsackievirus B Coxsackievirus B NT Enterovirus Enterovirus Parechovirus NT Parechovirus Parechovirus 3 2 Rhinovirus Saffold cardiovirus Influenza virus A not subtyped Influenza virus A Hpdm Influenza virus A H Influenza virus B NT Influenza virus B/Victoria Influenza virus B/Yamagata Parainfluenza virus Respiratory syncytial virus Human metapneumovirus 9 20 Other coronavirus Mumps virus Measles virus genotype NT 2 3 Measles virus genotype A 2 Measles virus genotype B Measles virus genotype D8 6 6 Measles virus genotype D9 2 3 Rubella virus genotype NT Rubella virus genotype E Rubella virus genotype 2B Japanese encephalitis virus Dengue virus Chikungunya virus Rotavirus group A Astrovirus Norovirus genogroup unknown Norovirus genogroup I Norovirus genogroup II Sapovirus genogroup unknown Sapovirus genogroup I Sapovirus genogroup II 8 9 Adenovirus NT Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus Adenovirus 2 Adenovirus Adenovirus Adenovirus 40/4 2 2 Adenovirus Adenovirus Adenovirus Herpes es simplex virus NT 7 8 Herpes es simplex virus Herpes simplex virus Varicellazoster virus Cytomegalovirus Human herpes es virus Human herpes es virus EpsteinBarr virus Hepatitis A virus NT 3 3 Hepatitis A virus IA 9 9 Hepatitis A virus IIIA 4 4 Hepatitis E virus Human papilloma virus B9 virus Human bocavirus Orientia tsutsugamush amushi 3 3 Rickettsia japonica NT: Vol. 35 No

31 Vol. 35 No IASR Vol. 35 No. 3 March 204 Infectious Agents Surveillance Report Overview of rotavirus Genotyping of human rotavirus using genomewide nucleotide sequencingglobal trends Rotavirus infection outbreaks and characteristics of the causative strains, Osaka City Detection of group A rotavirus, 200/202/3 seasonsokayama Prefecture Detection of rotavirus from Niigata Prefecture s infectious disease surveillance system, Rotavirus gastroenteritis surveillance in Mie Prefecture, evidencebased policy and assessment for vaccine introduction... 7 Introduction of rotavirus vaccine and its evaluation Incidence of intussusception in Japan prior to rotavirus vaccination implementation, ISSN National Institute of Infectious Diseases and Tuberculosis and Infectious Diseases Control Division, Ministry of Health, Labour and Welfare Geographical distribution of severe fever with thrombocytopenia syndrome (SFTS) virus in Japan (2 nd report) Antiviral drugresistant A(HN)pdm09 detected in Yamagata Prefecture, 203/4 influenza season Fatal case of acute encephalopathy attributed to influenza A(HN)pdm09 infection in a previously healthy child, 203 Nagano Prefecture Increase in the number of syphilis cases reported to the National Epidemiological Surveillance of Infectious Diseases (NESID) system in Japan, Identification of a rare serovar Agbeni from three patients infected with Salmonella, 203Akita Prefecture HIV/AIDS in Japan, OctoberDecember <THE TOPIC OF THIS MONTH> Rotavirus, , Japan Rotavirus belongs to the family Reoviridae, whose genome consists of segments of doublestranded RNA. Rotavirus is classified into groups AG according to the inner core protein s antigenicity, among which groups AC are detected from humans. Group A rotavirus is often referred to simply as rotavirus since this group makes up most of the circulating rotavirus in the world. Rotavirus is a major cause of acute viral gastroenteritis among infants, and majority of the people are believed to have experienced infection at least once by 5 years of age (see p. 65 of this issue). The virus is transmitted by the fecaloral route, and after an incubation of 4 days, clinical manifestations consisting of diarrhea, vomiting and fever appear. Treatment is oral or intravenous rehydration, as no specific treatment is available. While patients usually recover within a week, dehydration is often more severe compared with other viral gastroenteritis. Complications include seizures, which, if sustained, are associated with poor prognosis and increased risk of sequelae. Less frequent complications include renal or hepatic failures and encephalitis/encephalopathy. Although rare in developed countries, much of pediatric diarrheal deaths in developing countries is attributed to rotavirus infection (estimated 450,000 deaths/year) (Lancet Infect Dis 2: 364, 202). Infectious gastroenteritis under the National Epidemiological Surveillance of Infectious Diseases (NESID) system: Under the Infectious Diseases Control Law, rotavirus infection is included under infectious gastroenteritis (notification criteria in a Category V infectious disease to be reported from approximately 3,000 nationwide pediatric sentinel clinics. An amendment on 4 October 203 introduced an additional reporting system; approximately Figure. Weekly number of infectious gastroenteritis cases reported from sentinel clinics and monthly number of rotavirus detections from clinical specimens, September 2004 December 203 Number of rotavirus detections Rotavirus Group C Group A Infectious gastroenteritis (cases/week) (National Epidemiological Surveillance of Infectious Diseases: as of February 2, 204) Month Year (Infectious Agents Surveillance Report: as of February 3, 204) Table. Detection of rotaviruses during 2005/06203/4 seasons Group/genotype Detections from specimens collected during September through August in the following year* 2005/ / / / /0 200/ 20/2 202/3 203/4 Group unknown Group A Not typed G G G G4 2 G8 G G2 Group C Total *Data based on reports received from local public health institutes. (Infectious Agents Surveillance Report: as of February 3, 204) Cases/sentinel clinic 500 select key medical institutions (sentinel hospitals) in Japan are requested to notify patients of gastroenteritis specifically caused by rotavirus infection (notification criteria in go.jp/niid/images/iasr/35/409/de4092.pdf). If a pediatric sentinel clinic is selected as a key medical institution, the clinic is requested to notify a rotavirus gastroenteritis patient as infectious gastroenteritis and also as infectious gastroenteritis specifically caused by rotavirus infection. With these measures, it is believed that epidemiologic features of rotavirus infection (particularly those of severe cases) will become clearer. Every year, infectious gastroenteritis increases sharply during November/December with a wide peak in February/March to May followed by a decline (Fig. ). The FebruaryMay peak of infectious gastroenteritis overlaps with the rotavirus detection peak and the November/December peak overlaps with the norovirus detection peak ( mhlw.go.jp/byogentai/pdf/datae.pdf). Reports of rotavirus detection from public health institutes: Prefectural and municipal public health institutes (PHIs) conduct laboratory diagnosis of infectious gastroenteritis cases based on fecal specimens sent from approximately 0% of the pediatric sentinel clinics and also from specimens collected from out 63 Continued on page 64

32 Figure 2. Genotyping of group A rotaviruses 2005/06202/3 seasons No. cases 64, Vol. 35 No THE TOPIC OF THIS MONTHContinued / / / / /0 200/ 20/2 202/3 Sampled seasons (Infectious Agents Surveillance Report: as of February 3, 204) Genotyping Untyped breaks. During the past 4 years from 200 to 203, 60 PHIs reported group A and 8 PHIs reported group C rotavirus detections. During 2005/062009/0 seasons, rotavirus detections/year were reported, but increased during 200/ (Table, Fig 2). Group A rotavirus has been the majority with few group C detections (0. 2.2% since 200/ season). Group B rotavirus has not been reported in Japan. Genotyping of group A rotavirus: Group A rotavirus is classified according to combination of serotyperelated G and P genotypes, which are respectively determined by the genetic sequences of the outerlayer capsid proteins VP7 and VP4 (neutralizing antibody epitopes). Most human isolates are currently GP[8], G2 G9 G8 G4 G3 G2 G Figure 3. Age distribution of patients from whom rotavirus was detected, M 5 Y 02 M 68 M 9 M *M refers to months and Y refers to years 04 Y No. cases Rotavirus group A Y 2 Y 3 Y 4 Y 59 Y 3,302 Group A genotype G Group A genotype G2 Group A genotype G3 Group A genotype G9 IASR Vol. 35 No. 3 Mar % 2 Y 3 Y 5 Y No. cases Rotavirus group C 59 Y 04 Y % (Infectious Agents Surveillance Report: as of February 3, 204) Table 2. Number of rotavirus infection outbreaks, * Suspected place of Year of onset infection Total Nursery Primary school 6 9 () 3 () 9 (2) Welfare facility 4 5 Kindergarten 4 5 Nursing home 4 Restaurant 2** 2 Junior high school 2 2 High school Dormitory Other/Unknown 2 2 () () Total 2 26 () 48 () 3 () 08 (3) *Data based on reports received fromlocal public health institutes. **2 foodborne outbreaks Numbers in parentheses refer to number of rotavirus group C outbreaks. (Infectious Agents Surveillance Report: as of February 3, 204) G2P[4], G3P[8], G4P[8], and G9P[8] (see p. 66 of this issue). Currently, some PHIs are conducting G genotyping (see pp. 677 of this issue). Among 3,302 patients from whom group A rotavirus were detected during , 38% were year of age, 6% < year of age, and 6% 2 years of age; children under 2 years of age comprised 70% of the patients whose age was known (Fig. 3). Among those < year, those aged 6 months or older composed the majority. The same age distribution was observed across genotypes G, G3 and G9. Genotype G2 had a slightly different age distribution; following those aged year (28%), those aged 5 years were frequent (2%). Of the 27 group C rotavirusdetected cases, 8 were children aged 59 years and 5 were children aged 04 years. Complications: During , rotavirus was detected in 22 cases of encephalitis/encephalopathy and 4 cases of meningitis had rotavirus detection. Additionally, group A rotavirus was detected from 4 cases of intussusception. Outbreak incidents: Rotavirus outbreaks occur frequently in nurseries and in kindergartens, but also occasionally in primary schools, junior high schools, nursing homes for the elderly, and welfare facilities (IASR 33: 34, 202; ibid. 33: 9798, 202; ibid. 33: 27, 202; ibid. 34: 6979, 203; ibid. 34: , 203) (Table 2). Among rotavirus gastroenteritis outbreaks in , 05 were group A and 3 group C (Table 2). Majority of these incidents were attributable to persontoperson transmission except for two food poisoning outbreaks caused by group A rotavirus. Five outbreaks involved more than 50 patients (4 outbreaks due to group A and outbreak due to group C); two were in AprilMay 20 and three MarchApril 202. Prevention: Rotavirus s infectivity is very high and 000 virions are sufficient in establishing infection. An infected patient s stool contains as many as virions per gram, making rotavirus prevention difficult even in developed countries where sanitation and hygiene are well developed. Currently two oral attenuated live vaccines, GP[8] monovalent vaccine and a pentavalent vaccine containing GG4 and P[8] antigens, have been approved and used in more than 30 countries for preventing severe outcomes and introduced as a routine immunization in 53 countries (see p. 7 of this issue). The vaccines are available on a voluntary basis since November 20 and July 202, respectively, in Japan. The estimated vaccine coverage among the target age population was 35% in July 202, and 45% in April 203 (see p. 73 of this issue). Challenges: Japan is currently evaluating incorporation of rotavirus vaccine as a routine immunization. Studies from abroad have indicated that rotavirus vaccine can prevent an estimated 90% of severe outcomes due to rotavirus infection in developed countries (The Immunization and Vaccine Committee of the Health Science Council, Basic Direction of Immunization Policy Subcommittee, Rotavirus Vaccine Task Force Interim Report, 8 November 203). If rotavirus vaccination is to be introduced in Japan, its effectiveness and safety must be evaluated by: ) monitoring trends in rotavirus cases, particularly of severe ones; 2) with regards to safety, given the slight increase in the incidence of intussusception reported from countries that have implemented rotavirus immunization, there is a need for careful monitoring of the occurrence of intussusception (see p.74 of this issue); and 3) to monitor the virus populations in circulation, considering vaccination s potential selection pressure on circulating rotaviruses. Rotavirus surveillance should thus be further strengthened and coordinated between the National Institute of Infectious Diseases and partners such as PHIs and universities. The statistics in this report are based on ) the data concerning patients and laboratory findings obtained by the National Epidemiological Surveillance of Infectious Diseases undertaken in compliance with the Law Concerning the Prevention of Infectious Diseases and Medical Care for Patients of Infections, and 2) other data covering various aspects of infectious diseases. The prefectural and municipal health centers and public health institutes (PHIs), the Department of Food Safety, the Ministry of Health, Labour and Welfare, and quarantine stations, have provided the above data. Infectious Disease Surveillance Center, National Institute of Infectious Diseases Toyama 23, Shinjukuku, Tokyo , JAPAN Tel (+83)