{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:54:33Z","timestamp":1791312873870,"version":"4.3.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":5213,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1990,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To study the epidemiology of human T\u2010cell lymphotropic virus type I (HTLV\u2010I)\u2013associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) in Japan, we conducted two nationwide surveys between October 1986 and March 1989. A total of 710 patients with HAM (definite HAM, 589; probable HAM, 121) were reported. Of the 589 patients with definite HAM, 69%0 were residents of the areas with the highest prevalence HTLV\u2010I in Japan. To determine the importance of blood transfusion in the pathogenesis of HAM\/TSP, we performed a case\u2010control study in the Kagoshima district in southern Japan. Significantly more patients with HAM reported a history of blood transfusion (26\/129, or 20%) than did subjects in a health survey of the general population (41\/1,290, or 3%; odds ratio = 7.7, <jats:italic>p<\/jats:italic> &lt; 0.001) or than did hospitalized neurological patients (6\/119, or 5%; odds ratio = 4.8, <jats:italic>p<\/jats:italic> &lt; 0.001). Furthermore, the cumulative percentages of the intervals between blood transfusion and the onset of the symptoms of HAM fit a lognormal curve, suggesting that transfusion was an important common exposure. Blood transfusion probably transmitted HTLV\u2010I to the patients with transfusion\u2010associated HAM because there was a significant decrease in the number of patients with the transfusion\u2010associated HAM who received blood after implementation of nationwide screening of blood donors in 1986 (<jats:italic>p<\/jats:italic> = 0.004). In the first 2 years, screening the blood supply in Japan appears to have decreased the number of reported patients with HAM by 16%.<\/jats:p>","DOI":"10.1002\/ana.410280110","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T14:25:11Z","timestamp":1104589511000},"page":"50-56","source":"Crossref","is-referenced-by-count":205,"title":["Nationwide survey of HTLV\u2010I\u2013associated myelopathy in Japan: Association with blood transfusion"],"prefix":"10.1002","volume":"28","author":[{"given":"Mitsuhiro","family":"Osame","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Janssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kubota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nishitani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Igata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigenobu","family":"Nagataki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuo","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Shimabukuro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima","family":"Khabbaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)92734-5"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90778-0"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)91298-5"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410210203"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)91452-3"},{"key":"e_1_2_1_7_2","first-page":"382","article-title":"World Health Organization. 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