Severe Acute Respiratory Syndrome (SARS) has rapidly spread and caused epidemics in many countries. During these epidemics, the Japanese government contributed to SARS control by dispatching medical teams. In the present article, the author reviews and discusses the process of control of the SARS outbreak based on experiences in activities to support SARS control in Vietnam and China.
Vietnam succeeded in the effective control of SARS for the first time in the world. This was accomplished by complete isolation of patients and implementation of nosocomial infection control from an early stage of epidemic, etc. In China, due to inadequate response in the early stage, nosocomial infection occurred frequently and the disease quickly spread. However, later, effective actions were taken under the strong direction of the government, and the disease was finally put under control. The Japan Medical Team for Disaster Relief dispatched by the government of Japan to Hanoi, Vietnam and Beijing, China offered cooperative activities for the prevention of nosocomial infection and respiratory management. In addition, the Medical Aid Team sent to Guangdong Province in China provided guidance to the local Japanese residents to prevent the infection of SARS and to alleviate anxiety about the disease.
In the control of SARS, it is essential to take adequate actions from an early stage in the development of the disease. For this purpose, rather than starting measures for the control of nosocomial infection after the eruption of the disease, it is important to train medical staff on a routine basis, to establish a nosocomial infection control system, and to consolidate basic preventive practices.

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We conducted an overseas mobile clinic in Lao PDR and examined the results of biochemical tests and blood examinations. For the biochemical tests, we used a method involving plasma skimming film and filter paper, called “plasma separation plate.” In this study, we report the usefulness of the plasma separation plate, which is a newly developed method for the screening of biochemical tests in Japan. We were able to apply this method in a mobile clinic in Lao PDR. The quantitative concentration of plasma from blood collected from pricked fingers was measured by this method. Using the plasma skimming film and filter paper, the non-cell components in the blood were separated, and a quantity of the plasma was adsorbed by filter paper. Neither elaborate equipment nor electricity was required. The results of our test data indicated that few inhabitants suffered from adult diseases for which we were screening. We concluded, therefore, that this method is suitable for use in mobile clinics in the rural areas of developing countries.

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In order to determine the epidemiological features of cholera in Lao PDR, the presence of mobile genetic elements such as plasmid, class I integron and SXT element in V. cholerae isolated from surface water were examined. Among the 22 strains isolated from 13 distantly separated sampling sites, no mobile genetic elements associated with drug resistance were found reflecting the antibiogram of the strains. Nevertheless, cholera epidemics due to multiple drug resistant V. cholerae occurred repeatedly in those areas until 2000.

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A hypothetical community of one million people where birth rate and death rate are equal was applied to the modified deferential equations Lipsitch and Nowak published in 1995 in order to examine the impact of partner acquisition change on the HIV epidemic over a relatively short term. The results showed that if the partner exchange rate increases from two to three per year in the population, the epidemic caused by a more virulent strain would overweigh that caused by a less virulent strain within a century. This result reveals that an increase in the rate of partner acquisition gives the more virulent strain an advantage in terms of propagating the virus in a given population, at least over a relatively short term of several decades. The partner acquisition rate also exerts an influence on the magnitude of the HIV epidemic and the time it needs to reach a peak in the hypothetical community.
These results indicate that increased sexual contact may be even more important than expected and thus shed a new light on the present HIV epidemic.

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