JAPANESE OFFICIALS WARN OF MEASLES OUTBREAK

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E.O. 12958: N/A
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SUBJECT: JAPANESE OFFICIALS WARN OF MEASLES OUTBREAK


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1. Summary. On May 12, the Infectious Diseases
Surveillance Center (IDSC) issued a warning that measles
might spread across Japan. According to the IDSC, group
outbreaks have occurred in Ibaraki and Saitama prefectures
since early April 2006. In order to strengthen the
countermeasures against measles and rubella, the Ministry
of Health, Labor and Welfare (MHLW) introduced a new
vaccination system on April 1. MHLW now recommends two
vaccinations with a combined measles and rubella vaccine.
The call for additional vaccinations and changes in MHLW's
guidance are welcome, as vaccination is considered by many
experts to be a very effective way to reduce the incidence
of disease. End summary.


2. On May 12, the Infectious Diseases Surveillance Center
(IDSC) of the National Institute of Infectious Diseases
(NIID) issued a warning to the public that the measles
virus may spread throughout the Kanto region surrounding
Tokyo and across the nation. In Ibaraki Prefecture,
several outbreaks of measles have occurred at elementary,
junior high and high schools since early April. As of May
17, 88 people have been infected with the virus in the
prefecture. In neighboring Chiba, an additional 26
individuals have contracted measles. The IDSC recommended
in its warning that unvaccinated individuals who have
never been infected by the virus urgently receive
vaccinations. The Ibaraki and Chiba governments uploaded
information on measles to their homepages and called for
their citizens to receive the inoculations.


3. According to the ISDC, the number of individuals
infected with measles has been decreasing in Japan, but
the center estimates that the nation still has 100,000-
200,000 cases per year. Researchers at the Kitasato
Institute for Life and Sciences report that the actual
number of measles infections in Japan can be anywhere up
to 300,000 annual cases. (Note: For comparison, according
to the Centers for Disease Control and Prevention's
Morbidity and Mortality Weekly Report, a total of 261
cases of measles were reported in the United States
between 2001-2003, with a historical low of 37 reported
cases in 2004. End note.) The national vaccination rate
in Japan was 81.1 percent in JFY 2000, but the rate for
one-year-old children between 12 months and 24 months of
age was still only at 50 percent in JFY 2001.


4. In order to strengthen the countermeasures against
measles and rubella, the Ministry of Health, Labor and
Welfare (MHLW) introduced a new vaccination system on
April 1. MHLW now recommends two vaccinations of the
measles and rubella vaccine. The first vaccination should
be given to children between 12 and 24 months of age, and
the second one should be given to children between five
and seven years old. Prior to the change, the Japanese
health ministry recommended that children between 12 and
less than 90 months of age should have one vaccination
each for measles and rubella. The new guidelines on MR
vaccination were enacted based on an amendment of the
national law on vaccination that took effect in 2005.
Japan previously used a measles-mumps-rubella (MMR)
vaccine for vaccinations conducted through 1993, however
health authorities stopped using the combined vaccine due
to an increase in aseptic meningitis cases attributed to a
strain of the mumps virus used in the immunization.


5. Comment: The CDC reports that all of the recent cases
of the measles in the U.S. -- particularly since 2000 --
are the result of importations, as the disease is no
longer considered to be endemic in the United States.
These are cases where the measles are imported by
Americans and foreign nationals infected by the virus
overseas. The largest number of imported cases reported
between 2001 and 2003 were traced back to China and Japan.
China continued to be a leading source of imported cases
in 2004 (13 cases),though that same year none were
reported as having originated in Japan. The call for
additional vaccinations and changes in MHLW's guidance are
welcome, as vaccination is considered by many experts to
be a very effective way to reduce the incidence of
disease.

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