Since September 2018, nearly 900 notifications of classical swine fever (CSF) have been reported in Gifu Prefecture (Japan) affecting domestic pig and wild boar by the end of August 2019. To determine the epidemiological characteristics of its spread, a spatio-temporal analysis was performed using actual field data on the current epidemic. The spatial study, based on standard deviational ellipses of official CSF notifications, showed that the disease likely spread to the northeast part of the prefecture. A maximum significant spatial association estimated between CSF notifications was 23 km by the multi-distance spatial cluster analysis. A space-time permutation analysis identified two significant clusters with an approximate radius of 12 and 20 km and 124 and 98 days of duration, respectively. When the area of the identified clusters was overlaid on a map of habitat quality, approximately 82% and 75% of CSF notifications, respectively, were found in areas with potential contact between pigs and wild boar. The obtained results provide information on the current CSF epidemic, which is mainly driven by wild boar cases with sporadic outbreaks on domestic pig farms. These findings will help implement control measures in Gifu Prefecture. 108 domestic pig (DP) (square) and wild boar (WB) (circle). Ellipses with centroids were combined to indicate the 109 directional trend of the CSF outbreaks.110 2.2. Multi-Distance Spatial Cluster Analysis 111The multi-distance spatial cluster analysis was applied to explore the maximum distance 112 between cases of CSF notifications. The results indicated that 23 km was the maximum distance of 113 the significant spatial association between CSF notifications in Gifu Prefecture. The obtained 114 maximum distance was used in the subsequent analyses. 115 2.3. Kernel Density Estimation Analysis 116The kernel density estimation analysis was applied to describe the spatial distribution of the CSF 117 notifications. The analysis showed that the highest density of CSF notifications was located in the 118 southern part of Gifu Prefecture (Figure 2) with further expansion to the east. Among the 16 CSF-domestic farms were located in areas with very low density of notifications (80%), followed by areas 122 with low density (20%). The analysis revealed that CSF-positive farms were located in areas with 123 higher density of notifications, whereas the non-affected farms tended to locate in areas with low 124 density. 125 126 Figure 2. Density of CSF notifications in Gifu Prefecture.127 The heat map illustrates the estimated kernel density of CSF notifications (notifications/km 2 ) from very high 128 (red) to very low (transparent). Each coloured area indicates the density of CSF notifications per square 129 kilometer: very high (> 0.400), high (0.300-0.399), medium (0.200-0.299), low (0.100-0.199), and very low (< 130 0.100). The highest density of CSF notifications was located in the southern part of Gifu Prefecture. A very low 131 density of CSF notifications was located in other areas of the pr...

The prolongation of the classic swine fever (CSF) outbreak in Japan in 2018 was highly associated with the persistence and widespread of the CSF virus (CSFV) in the wild boar population. To investigate the dynamics of the CSF outbreak in wild boar, spatiotemporal analyses were performed. The positive rate of CSFV in wild boar fluctuated dramatically from March to June 2019, but finally stabilized at approximately 10%. The Euclidean distance from the initial CSF notified farm to the farthest infected wild boar of the day constantly increased over time since the initial outbreak except in the cases reported from Gunma and Saitama prefectures. The two-month-period prevalence, estimated using integrated nested Laplace approximation, reached >80% in half of the infected areas in March–April 2019. The area affected continued to expand despite the period prevalence decreasing up to October 2019. A large difference in the shapes of standard deviational ellipses and in the location of their centroids when including or excluding cases in Gunma and Saitama prefectures indicates that infections there were unlikely to have been caused simply by wild boar activities, and anthropogenic factors were likely involved. The emergence of concurrent space–time clusters in these areas after July 2019 indicated that CSF outbreaks were scattered by this point in time. The results of this epidemiological analysis help explain the dynamics of the spread of CSF and will aid in the implementation of control measures, including bait vaccination.

The spread of African swine fever (ASF) has reached pandemic levels over the last decade, and outbreaks of this disease in China, Mongolia, Vietnam and Cambodia in 2018 and 2019 could accelerate its transmission to neighbouring Asian territories. Thus, the risk that the ASF virus (ASFV) will be introduced to disease‐free territories increases each year. Since Japan is an island nation, the most likely way in which ASFV would be introduced is via pork products brought in air passengers’ luggage (PPAP). Therefore, in the present study, we assessed the risk of ASFV introduction to Japan via PPAP. For the purposes of this analysis, we considered 214 international commercial flights travelling from 47 origin territories to 31 destination airports as potential routes of ASFV introduction via PPAP. The risk was estimated quantitatively through a stochastic model that considered the volume of air passengers’ luggage, the amount of confiscated pork products that were carried in air passengers’ luggage and the disease status of the origin territory. The overall mean annual probability of ASFV introduction to Japan via PPAP was found to be 0.941 [95% confidence interval (CI), 0.661–1.000], which approximately corresponds to one introduction every 1.06 years. At the origin territory level, Mongolia was led as the highest risk territory, with a risk of 0.864 (95% CI, 0.434–1.000), followed by China (0.697; 0.223–0.999), Vietnam (0.662; 0.196–0.998) and the Russian Federation (0.136; 0.018–0.401). At the destination airport level, Narita International Airport had the highest risk (0.905; 0.537–1.000), followed by Kansai International Airport (0.496; 0.109–0.961), Tokyo International Airport (0.389; 0.072–0.879) and Chubu Centrair International Airport (0.338; 0.058–0.816). This information will help improve risk management activities and monitoring systems to prevent the introduction of ASFV to Japan.

African swine fever (ASF) is one of the most critical diseases in the pig industry. In Asia, 15 countries have already reported an outbreak as of November 22, 2021. In 2021, China reported the genotype II lower virulent ASF virus (ASFV) and the emergence of genotype I ASFV. ASF is generally known as a contagious and lethal disease, but if chronic infection spreads, then disease control would be more difficult. In the current study, we highlighted the possibility of lower virulent virus distribution throughout China and the subsequent general risk of the virus being released from the country. The kernel density estimation showed that the two highest kernel density areas of ASF notification were located in Northeast and Midwest China. Four of the five provinces where lower virulent ASFV was isolated overlapped with areas of relatively high ASF notification density. In terms of the risk of ASFV spreading from China, eight of the 10 largest airports and three of the 10 largest seaports are located in areas of relatively high ASF notification density. There were flight flow from China to 67 countries and ship flow to 81 countries. Asia had the highest flight flow, followed by Europe, North America, Africa, and Oceania. The highest number of ship flows was also concentrated in Asia, but about 10% of ships head to Africa and South America. Chinese overseas residents were distributed in each continent in proportion to these results. Here, we highlight the potential risk of ASFV spread from China to the world.

African swine fever (ASF) is a highly lethal infectious disease in naive populations of domestic pigs and wild boar. In Asia, from the first outbreak in August 2018 until the end of November 2021, ASF has been reported in 16 Asian countries. The ASF virus (ASFV) circulation in domestic pigs is considered the main problem in Asia. On the other hand, there are very few reports of ASF in wild boar in this region. However, considering the high wild boar density within the same area of smallholder domestic pig farms in Asia, the occurrence of ASFV infection in wild boar may be underestimated. The role of the wild boar in other ASF epidemiological scenarios, such as Europe, is a key for the maintenance and transmission of the disease. Hence, we performed a preliminary study estimating the extent of ASFV infection in the Asian wild boar population. The potential risk area of ASF-infected wild boar was calculated based on the habitat suitability for wild boar, the kernel density of ASF notification in smallholder farms and wild boar, and the ASFV transmission rate of wild boar. As a result of the analysis, high-, medium-, and low-risk areas were identified throughout Southeast and East Asia. The highest risk area was detected in China, followed by Myanmar, Far East Russia, Thailand, Vietnam, Laos, Cambodia, and the Philippines. Additionally, another risk area was detected from northeastern China to the Korean Peninsula, including Far East Russia. This study shows hot spots where a high risk of infection in wild boar is most likely to occur, helping to control ASF.

In recent years, African swine fever (ASF) has become prevalent in many areas, including Asia. The repeated detection of the ASF virus (ASFV) genome in pork products brought in air passenger’s luggage (PPAP) was also reported from Japanese airports. In the present study, the risk of ASFV exposure to susceptible hosts in Japan via three different pathways was assessed. Two quantitative stochastic risk assessment models were built to estimate the annual probability of ASFV exposure to domestic pigs, which could be attributed to foreign job trainees or foreign tourists. A semi-quantitative stochastic model was built to assess the risk of ASFV exposure to wild boar caused by foreign tourists. The overall mean annual probability of ASFV exposure to domestic pigs via PPAP carried by foreign job trainees was 0.169 [95% confidence interval (CI): 0.000–0.600], whereas that by foreign tourists was 0.050 [95% CI: 0.000–0.214], corresponding to approximately one introduction every 5.9 and 20 years, respectively. The risk of ASFV exposure to domestic pigs was dispersed over the country, whereas that of wild boar was generally higher in the western part of Japan, indicating that the characteristics of the potential ASF risk in each prefecture were varied.

An 80-year-old woman was admitted to our hospital complaining of severe abdominal and back pain. Computed tomography (CT) showed an 8.5 x 7.0-cm infrarenal abdominal aortic aneurysm (AAA) with a large contained retroperitoneal hematoma. Known situs inversus totalis was reconfirmed by CT. Just after the CT examination, the patient collapsed and was immediately taken to the operating room. Her hemodynamics stabilized after clamping of the descending aorta via a right anterolateral thoracotomy. A resection of the abdominal aneurysm and prosthetic graft replacement were successfully performed. To our knowledge, there has been no other report of a ruptured AAA in a patient with situs inversus totalis.

Percutaneous cardiopulmonary support (PCPS) is a powerful resuscitation tool for patients in cardiogenic shock. The femoral artery is generally used for arterial access; however, vascular complications, particularly in atherosclerotic arteries, can occur. Although such complications occur infrequently, they can be fatal. We describe the case of a 75-year-old woman who required extended PCPS for cardiogenic shock secondary to coronary spasm after on-pump beating coronary artery bypass grafting. Limb ischemia occurred because of an occlusive cannula, and distal perfusion with a 20G elastic intravenous catheter inserted into the dorsalis pedis artery resolved the ischemia. The catheter was connected to the side port of an oxygenator and provided distal limb perfusion during PCPS. This technique appears to be useful in treating limb ischemia and may have application in patients with arterial occlusive disease who are dependent on mechanical support.