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Infectious Diseases Weekly Report TOKYOIDWR Tokyo Metropolitan Infectious Disease Surveillance Center 4 April / Number 13 Surveillance System in Tokyo, Japan The infectious diseases which all physicians must report All physicians must report to health centers the incidence of the diseases which are shown at page one. Health centers electronically report the individual cases to Tokyo Metropolitan Infectious Disease Surveillance Center. The infectious diseases required to be reported by the sentinels The numbers of patients who visit the sentinel clinics or hospitals during a week are reported to health centers in Tokyo. And they electronically report the numbers to Tokyo Metropolitan Infectious Disease Surveillance Center. We have about 500 sentinel clinics and hospitals in Tokyo. Tokyo Metropolitan Institute of Public Health TEL:81-3-3363-3213 FAX:81-3-5332-7365 e-mail:www@tokyo-eiken.go.jp URL:idsc.tokyo-eiken.go.jp/

Number of patients with the diseases which all physicians must report Category I II III IV Diseases 10th 11th 12th 13th Japan 13th Ebola hemorrhagic fever Crimean-Congo hemorrhagic fever Smallpox South American hemorrhagic fever Plague Marburg disease Lassa fever Acute poliomyelitis Tuberculosis 60 57 55 56 695 365 4,797 Diphtheria Severe Acute Respiratory Syndrome(SARS) Middle East Respiratory Syndrome (MERS) Avian influenza H5N1 Avian influenza H7N9 Cholera Shigellosis 2 1 6 27 Enterohemorrhagic Escherichia coli infection 1 1 2 30 28 256 Typhoid fever 1 7 Paratyphoid fever 1 4 Hepatitis E 3 3 2 3 29 12 112 West Nile fever Hepatitis A 2 1 2 1 18 6 114 Echinococcosis 2 Yellow fever Psittacosis 1 1 2 1 8 Omsk hemorrhagic fever Relapsing fever Kyasanur forest disease Q fever Rabies Coccidioidomycosis 1 Monkeypox Zika virus infection Severe Fever with Thrombocytopenia Syndrome 2 6 Hemorrhagic fever with renal syndrome Western equine encephalitis Tick-borne encephalitis Anthrax Chikungunya fever 2 Scrub typhus(tsutsugamushi disease) 1 41 Dengue fever 2 2 1 2 26 5 71 Eastern equine encephalitis Avian influenza (excluding H5N1 and H7N9) Nipah virus infection Japanese spotted fever 2 7 Japanese encephalitis Hantavirus pulmonary syndrome Herpes B virus infection Glanders Brucellosis 1 1 Venezuelan equine encephalitis Hendra virus infection Epidemic typhus Botulism 1 Malaria 2 1 9 Tularemia Lyme disease Lyssavirus infection(excluding rabies) Rift valley fever Melioidosis Legionellosis 1 1 2 2 32 11 327 Leptospirosis 1 1 1 Rocky mountain spotted fever Tokyo 1

Category V Diseases Tokyo 10th 11th 12th 13th Japan 13th Amebiasis 6 6 2 3 45 12 208 Viral hepatitis(excluding hepatitis A and E) 2 6 3 3 26 3 82 CRE infection 5 2 5 5 52 23 458 Acute Flaccid Paralysis (excluding Acute poliomyelitis) 13 Acute encephalitis(excluding JE and WNE) 1 1 35 5 319 Cryptosporidiosis 1 1 4 Creutzfeldt-Jakob disease 7 1 36 Severe invasive streptococcal infections(tsls) 4 2 1 26 8 236 Acquired immunodeficiency syndrome (AIDS) 11 12 12 6 106 21 280 Giardiasis 1 1 3 9 Invasive Haemophilus influenzae disease 2 2 1 1 27 6 163 Invasive meningococcal disease 1 15 Invasive pneumococcal disease 5 7 7 5 118 47 933 Varicella (limited to hospitalized case) 2 3 1 2 15 10 98 Congenital rubella syndrome 1 Syphilis 25 36 30 30 422 80 1,498 Disseminated cryptococcosis 1 2 5 37 Tetanus 1 1 1 12 Vancomycin-resistant S. aureus infection Vancomycin-resistant Enterococcus infection 1 1 1 22 Pertussis 28 39 23 41 501 242 3,987 Rubella 34 28 33 25 341 65 1,112 Measles 2 6 2 6 42 22 378 MDRA infection 2 2 10 Number of patients with the diseases to be reported by the designated clinics and hospitals Diseases Tokyo 10th 11th 12th 13th /sentinel Respiratory syncytial virus infection 54 81 101 57 0.22 Pharyngoconjunctival fever 37 59 49 43 0.17 Group A streptococcal pharyngitis 667 689 570 432 1.66 Infectious gastroenteritis 1,836 1,775 1,591 1,526 5.87 Chickenpox 83 113 128 118 0.45 Hand, foot, and mouth disease 12 30 22 16 6 Erythema infectiosum 148 162 145 115 0.44 Exanthem subitum 102 105 112 99 0.38 Herpangina 3 2 4 2 Mumps 26 11 17 16 6 Kawasaki disease 3 6 1 1 Cold with exanthems 10 14 10 16 6 Influenza 920 525 406 342 0.83 Acute hemorrhagic conjunctivitis Epidemic keratoconjunctivitis 6 11 6 6 0.16 Bacterial meningitis 2 1 4 Aseptic meningitis 1 2 Mycoplasma pneumonia 2 2 1 4 Chlamydial pneumonia (excluding psittacosis) 1 2 2 8 Infectious gastroenteritis (only by Rotavirus) 4 8 7 6 0.25 Influenza-Associated Hospitalizations 12 10 8 10 0.43 ( Blank means 0. ) 2

Disease Trend Graph (weekly reported cases per sentinel in comparison) Respiratory syncytial virus infection Pharyngoconjunctival fever 5.00 Group A streptococcal pharyngitis 35.0 Infectious gastroenteritis 3 25.0 2 15.0 5.0 5.00 Chickenpox 2 Hand, foot, and mouth disease 15.0 5.0 3

2.50 Erythema infectiosum Exanthem subitum 12.0 Herpangina Mumps 8.0 6.0 4.0 2.0 0 Kawasaki disease Cold with exanthems 75 50 25 0 4

8 7 6 Influenza 5 4 3 2 Acute haemorrhagic conjunctivitis Epidemic keratoconjuncitivitis Bacterial meningitis Aseptic meningitis 5

2.50 Mycoplasma pneumonia Chlamydia Pneumonia Infectious gastroenteritis (only by Rotavirus) 1 Influenza-Associated Hospitalizations 1.20 8.00 0.90 6.00 0.60 Number of sentinel facilities for weekly reporting Types of sentinels Number of sentinels Sentinels having reported Pediatric 264 260 Influenza 419 412 Ophthalmic 39 37 Speciallydesignated 25 24 6