Tourists could bring nasty surprises

Masayuki Takata and Tatsuya Kimura / Yomiuri Shimbun Staff Writers

Could medical tourists bring something more sinister than their own health problems with them when they come to Japan?

Recent revelations of drug-resistant bacteria infections at Teikyo University Hospital and Dokkyo Medical University Hospital could be precursors of more superbug infections as medical tourism grows around the world, experts have warned.

The superbugs detected at the two university hospitals have already generated fears overseas of mass infections.

This country has been confronted by superbugs before. The multidrug-resistant Salmonella typhi and other bugs highly resistant to antibiotics have snuck into the country from abroad. Experts have urged the government to do more to stop superbugs getting in and wreaking havoc here.

Acinetobacter, the super-resistant bacteria confirmed at Teikyo University Hospital in Itabashi Ward, Tokyo, had previously been found in three prefectures, including Fukuoka.

The earlier Acinetobacter infections were traced to South Korea, the United Arab Emirates and the United States.

The superbug detected in a patient at Dokkyo Medical University Hospital in Tochigi Prefecture--containing an enzyme with the NDM-1 gene that can turn bacteria into superbugs--has been reported in India, as well as European countries and the United States.

Satoshi Hori, an associate professor at Juntendo University, said that globalization and greater flows of people across borders means these outbreaks will inevitably become more common.

"In this age of globalization, a superbug that pops up in one corner of the globe can spread worldwide very quickly," Hori said.

Some observers have suggested that the growing popularity of medical tourism--including the growing number of people coming to Japan for medical checks and treatment--is one cause of the increasing frequency of superbug outbreaks.

Some of the dozens of British people infected with the NDM-1 enzyme had undergone cosmetic surgery in India, where such operations are relatively cheap.

Although medical tourism remains a fledgling industry in Japan, the government is considering promoting medical checkup tours as part of a new economic growth strategy. Some hospitals already accept medical tourists from abroad.

However, Prof. Yasuyoshi Ike of Gunma University warned, "Medical tourism brings with it the risk of a superbug spreading across the nation in an instant."

Since 2000, the Health, Labor and Welfare Ministry has been collating data on in-hospital infections and discoveries of drug-resistant bacteria from 850 medical institutions with 200 or more beds. However, information from other hospitals remains unavailable, which has prompted demands to reinforce the country's surveillance system against superbugs.

"Fighting drug-resistant bacteria should a matter for this nation's crisis management," Tohoku University Prof. Mitsuo Kaku said. "The government should swiftly build an information-gathering system that covers the whole country."