Authors: Nishise, S.¹; Fujishima, T.²; Kobayashi, S.³; Otani, K.⁴; Nishise, Y.⁵; Takeda, H.⁵; Kawata, S.⁵

Source: Annals of Tropical Medicine and Parasitology, Volume 104, Number 5, July 2010 , pp. 383-390(8)

Publisher: Maney Publishing

Abstract:

After two cases of amoebic colitis were detected at an institution for the mentally retarded in the Yamagata prefecture of Japan, the prevalence and epidemiology of Entamoeba histolytica infection at the institution were investigated. When the 76 residents with mental retardation were checked by serology and stool examinations, 40 (53%) showed evidence of infection with E. histolytica (i.e. E. histolytica-specific antibodies in their serum, Entamoeba cysts in their stools, and/or E. histolytica-specific antigens in their stools). The cysts were all assumed to be those of E. histolytica since all nine of the 18 cyst-positive stool samples investigated using a PCR (that distinguishes E. histolytica from E. dispar) were found positive for this species.

The E. histolytica found in the institution in Yamagata appears to have been brought into the institution, from a similar institution in Kanagawa prefecture, by a mentally retarded individual who relocated from Kanagawa to Yamagata. Isolates of E. histolytica recovered during an outbreak in the institution in Kanagawa appear genotypically identical to the genotyped isolates collected in the outbreak investigated in the present study.

The 40 infected individuals in Yamagata were each treated for 10 days with metronidazole or diloxanide furoate. The residents and staff of the institution were encouraged to wash their hands more frequently and more thoroughly, and the staff were asked to clip residents' fingernails and to improve the cleanliness/sterilization of the surfaces in the institution that were most likely to be contaminated with E. histolytica (lavatories, handrails, doors, doorknobs, washrooms, clothing etc). In the last 5 years of follow-up since the instigation of these and other infection-control measures, and the last treatments, no cases of E. histolytica infection have been found in the institution. This encouraging result offers hope and guidance to those attempting to control outbreaks of E. histolytica infection in other institutions.

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/136485910X12743554760388

Affiliations: 1: Department of Gastroenterology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. nishise-sic@umin.ac.jp 2: Division of Surgery, Shirataka Town Hospital, 501 Arato-Ko, Shirataka, Yamagata 992-0831, Japan 3: Department of Tropical Medicine and Parasitology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan 4: Department of Public Health, Yamagata University Graduate School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan 5: Department of Gastroenterology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan

Publication date: 2010-07-01

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• In 2012 Annals of Tropical Medicine and Parasitology changed its name to Pathogens of Global Health to reflect changes and developments in the subject area. View the issues of Pathogens of Global Health available online..
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