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BioMed Research International
Volume 2013, Article ID 746053, 7 pages
Research Article

Prescription Surveillance and Polymerase Chain Reaction Testing to Identify Pathogens during Outbreaks of Infection

1Sugiura Clinic, 2-8-3 Imaichi-Kita, Honmachi, Shimane, Izumo 693-0002, Japan
2Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Shinjuku, Tokyo 162-8640, Japan
3Shimane Prefectural Central Hospital, Shimane, Izumo 693-8555, Japan
4Shimane University Hospital, Shimane, Izumo 693-8501, Japan
5Kawasaki City Health Institute of Public Health, Kanagawa, Kawasaki 210-0834, Japan

Received 10 November 2012; Accepted 6 January 2013

Academic Editor: Girdhari Lal

Copyright © 2013 Hiroaki Sugiura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Syndromic surveillance, including prescription surveillance, offers a rapid method for the early detection of agents of bioterrorism and emerging infectious diseases. However, it has the disadvantage of not considering definitive diagnoses. Here, we attempted to definitively diagnose pathogens using polymerase chain reaction (PCR) immediately after the prescription surveillance system detected an outbreak. Specimens were collected from 50 patients with respiratory infections. PCR was used to identify the pathogens, which included 14 types of common respiratory viruses and Mycoplasma pneumoniae. Infectious agents including M. pneumoniae, respiratory syncytial virus (RSV), rhinovirus, enterovirus, and parainfluenza virus were detected in 54% of patients. For the rapid RSV diagnosis kit, sensitivity was 80% and specificity was 85%. For the rapid adenovirus diagnosis kit, no positive results were obtained; therefore, sensitivity could not be calculated and specificity was 100%. Many patients were found to be treated for upper respiratory tract infections without the diagnosis of a specific pathogen. In Japan, an outbreak of M. pneumoniae infection began in 2011, and our results suggested that this outbreak may have included false-positive cases. By combining syndromic surveillance and PCR, we were able to rapidly and accurately identify causative pathogens during a recent respiratory infection outbreak.