{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:29:00Z","timestamp":1790810940162,"version":"4.1.0"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"unspecified","delay-in-days":80,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Since 1993, reports on tuberculosis (TB) outbreaks have been collected in Japan; however, there has never been an overall analysis of these TB outbreaks. We aim to provide one here. The TB outbreak data were obtained from the Ministry of Health, Labour and Welfare and are described in terms of time, place and transmission site. The average number of TB cases and latent tuberculosis infection (LTBI) were compared by the transmission site. Some 605 TB outbreaks with 3491 TB cases were reported in 1993\u20132015 with an increasing trend (<jats:italic>r<\/jats:italic> = 0.45), during which time 728 777 TB cases were reported nationwide. On an average, TB outbreaks occurred more often in April to May (5.5 outbreaks per 2 months) than in December to January (3.4). The most common transmission sites were workplaces (<jats:italic>n<\/jats:italic> = 255), followed by health facilities (<jats:italic>n<\/jats:italic> = 144), schools (<jats:italic>n<\/jats:italic> = 60) and welfare facilities (<jats:italic>n<\/jats:italic> = 48). Psychiatric hospitals and nursing homes had the highest average number of TB cases per outbreak (8.5 each), whereas schools and prisons had the highest numbers of LTBI cases (29.1 and 38.9, respectively). Countries, particularly those that have resources to investigate TB outbreaks, should collect and analyse findings of TB outbreaks, as it informs surveillance systems and eventually strengthens general health systems.<\/jats:p>","DOI":"10.1017\/s0950268821000625","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T07:19:01Z","timestamp":1616397541000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Analysis of 605 tuberculosis outbreaks in Japan, 1993\u20132015: time, place and transmission site"],"prefix":"10.1017","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3539-4535","authenticated-orcid":false,"given":"M.","family":"Ota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Hoshino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hirao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"S0950268821000625_ref1","unstructured":"1. Tuberculosis Surveillance Center, Research Institute of Tuberculosis. Tuberculosis in Japan. (2018) Annual Report. Available at https:\/\/www.jata.or.jp\/rit\/ekigaku\/en\/statistics-of-tb\/ accessed on 19 August 2020."},{"key":"S0950268821000625_ref22","first-page":"647","article-title":"Chemophylaxis","volume":"80","author":"Yamagishi","year":"2005","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref32","first-page":"783","article-title":"Advances in molecular epidemiology of tuberculosis open the door to the next stage","volume":"84","author":"Matsumoto","year":"2009","journal-title":"Kekkaku: [Tuberculosis]"},{"key":"S0950268821000625_ref30","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.47564-0"},{"key":"S0950268821000625_ref37","unstructured":"37. Field Epidemiology Training Programme, National Institute of Infectious Diseases. Field Epidemiology Training Programme. Available at https:\/\/www.niid.go.jp\/niid\/ja\/fetp.html accessed on 20 August 2020."},{"key":"S0950268821000625_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115647"},{"key":"S0950268821000625_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268819002206"},{"key":"S0950268821000625_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/0033354916688270"},{"key":"S0950268821000625_ref5","first-page":"7","article-title":"Usefulness of QuantiFERON TB-2G in a suspected case of drug resistant tuberculosis outbreak in a university","volume":"83","author":"Masuda","year":"2008","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref20","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2350"},{"key":"S0950268821000625_ref19","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.11.0829"},{"key":"S0950268821000625_ref23","first-page":"497","article-title":"Guidelines for treating latent tuberculosis infection","volume":"88","year":"2013","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268819001092"},{"key":"S0950268821000625_ref14","unstructured":"14. Ministry of Health, Labour, and Welfare (2019) List of tuberculosis outbreaks (in Japanese). Available at https:\/\/www.mhlw.go.jp\/file\/06-Seisakujouhou-10900000-Kenkoukyoku\/0000148155.pdf (accessed 17 July 2020)."},{"key":"S0950268821000625_ref3","first-page":"395","article-title":"A suspected case of mass outbreak of tuberculosis infection in a small company separated into two floors","volume":"78","author":"Seki","year":"2003","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref16","author":"Raffalli","year":"1996","journal-title":"Archives of Internal Medicine"},{"key":"S0950268821000625_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S1579-2129(06)60140-7"},{"key":"S0950268821000625_ref6","doi-asserted-by":"publisher","DOI":"10.5365\/wpsar.2018.9.1.001"},{"key":"S0950268821000625_ref13","first-page":"64","article-title":"Tuberculosis epidemic in the Netherlands","volume":"41","author":"Drion","year":"1968","journal-title":"Bulletin of International Union Against Tuberculosis"},{"key":"S0950268821000625_ref7","first-page":"487","article-title":"An outbreak of tuberculosis in which environmental factors influenced tuberculosis infection","volume":"86","author":"Matsumoto","year":"2011","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref18","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.230.87"},{"key":"S0950268821000625_ref25","doi-asserted-by":"publisher","DOI":"10.3201\/eid1703.101550"},{"key":"S0950268821000625_ref15","unstructured":"15. Japan Meteorological Agency. Tables of climatological normals (1981\u20132010). Available at https:\/\/www.data.jma.go.jp\/obd\/stats\/data\/en\/normal\/normal.html accessed on 20 August 2020."},{"key":"S0950268821000625_ref21","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00114810"},{"key":"S0950268821000625_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4573-3"},{"key":"S0950268821000625_ref28","first-page":"741","article-title":"Molecular epidemiology of Mycobacterium tuberculosis: its accomplishment and future perspective","volume":"77","author":"Takahashi","year":"2002","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60281-0"},{"key":"S0950268821000625_ref8","first-page":"82","article-title":"Summary and issues of concern relating to a tuberculosis outbreak in a prison","volume":"89","author":"Homma","year":"2014","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref31","first-page":"49","article-title":"Progress of molecular epidemiology of Mycobacterium tuberculosis and its application for the prevention of tuberculosis","volume":"84","author":"Hase","year":"2009","journal-title":"Kekkaku: [Tuberculosis]"},{"key":"S0950268821000625_ref34","doi-asserted-by":"publisher","DOI":"10.3201\/eid2313.170594"},{"key":"S0950268821000625_ref29","first-page":"641","article-title":"Molecular epidemiology of Mycobacterium tuberculosis using by RFLP analysis between genomic DNA","volume":"78","author":"Takahashi","year":"2003","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref36","unstructured":"36. United States Centers for Disease Control and Prevention. Epidemiologic Assistance (Epi-Aids) Available at https:\/\/www.cdc.gov\/eis\/request-services\/epiaids.html accessed on 20 August 2020."},{"key":"S0950268821000625_ref11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001199"},{"key":"S0950268821000625_ref9","first-page":"749","article-title":"Outbreaks of tuberculosis in facilities used by an unspecified number of people near a train station \u2013 problems regarding tuberculosis in urban areas","volume":"82","author":"Kinoshita","year":"2007","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085612"},{"key":"S0950268821000625_ref2","first-page":"579","article-title":"An outbreak of tuberculosis in a long-term care unit of a mental hospital","volume":"79","author":"Ota","year":"2004","journal-title":"(in Japanese) Kekkaku"},{"key":"S0950268821000625_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.phr.2004.07.003"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268821000625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T09:19:00Z","timestamp":1618305540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268821000625\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":37,"alternative-id":["S0950268821000625"],"URL":"https:\/\/doi.org\/10.1017\/s0950268821000625","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e85"}}