日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Online ISSN: 2434-2505 Print ISSN: 0917-0324
日本性感染症学会 Japanese Society for Sexually Transmitted Infections
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society for Sexually Transmitted Infections Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Japanese Journal of Sexually Transmitted Infections 30(1): 1-7 (2019)
doi:10.24775/jjsti.O-2019-0012

原著原著

日本における梅毒発生動向2004–2018Syphilis notification rate in Japan, 2004–2018

1国立感染症研究所実地疫学専門家養成コースField Epidemiology Training Program, National Institute of Infectious Diseases, Japan

2国立感染症研究所感染症疫学センターInfectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan

3国立感染症研究所細菌第一部Department of Bacteriology I, National Institute of Infectious Diseases

受付日:2019年5月8日Received: May 8, 2019
受理日:2019年6月7日Accepted: June 7, 2019
発行日:2019年9月27日Published: September 27, 2019
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国内で増加している梅毒の発生状況を把握するため、2004–2018年の梅毒の感染症発生動向調査の結果を用いてその動向を確認した。梅毒報告数は2011年以降継続して増加していた。2018年の報告数は7,003例(男4,589、女2,414)で、男女とも早期顕症梅毒が増加の中心であった。男性は40–44歳の報告が最も多く、2014年以降幅広い年齢層、特に20–39歳で増加していた。女性は20–24歳の報告が最も多く、また最も増加していた。感染経路は、男性では異性間性的接触による感染の増加が続いており、感染経路が報告された症例の7割弱を占め、女性も大多数を占める異性間性的接触による感染の増加が続いていた。ただし2018年には東京の異性間性的接触による感染増加の勢いは止まってきていた。若年者を中心にした性教育や早期診断早期治療の推進、不特定多数を相手にした無防備なセックスを避ける啓発等の対策に加え、母子感染を含む梅毒の発生動向を監視していくことが重要である。

In this study, we analyzed the reports of syphilis cases in the National Epidemiological Surveillance of Infectious Diseases to describe the current nationwide syphilis outbreak in Japan. The number of primary and secondary syphilis cases had increased since 2011, reaching 7,003 cases in 2018 (4,589 male and 2,414 female). In 2018, males aged 40–44 years gained the highest syphilis notification rate among all age groups, and the increase was most noticeable among those aged 20–39 years. Meanwhile, females aged 20–24 years gained the highest syphilis notification rate and the highest increase. Heterosexual contacts accounted for approximately 70% of the male cases and nearly all female cases who reported their transmission routes. The overall increasing trend of notification for heterosexual and homosexual contacts in both males and females remained the same. Furthermore, the heterosexual transmission reports among males in Tokyo, which accounted for nearly 20% of syphilis cases nationwide, gradually decreased in the past several months. While careful monitoring of this changing trend is necessary, it is critical to promote education on avoiding casual sex and the importance of protected sex to adolescents, early diagnosis and proper treatment by healthcare workers, and contact investigation in case of clustering among high-risk population to control the current syphilis outbreak. Communication among stakeholders and citizens is also a key to control such outbreak, and the new reporting format of the national syphilis surveillance, which started in 2019, with additional information on pregnancy may play an important role in this health issue.

Key words: syphilis; heterosexual transmission; Japan

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