title: Critical appraisal of the 1977 diagnostic criteria for Minamata disease.
abstract: Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata disease). Although the diagnostic criteria for the disease remain current, few studies have been carried out to assess the diagnostic accuracy of the criteria. From a 1971 population-based investigation, data from 2 villages were selected: Minamata (high-exposure area; n = 779) and Ariake (low-exposure area; n = 755). The authors examined the prevalence of neurologic signs characteristic of methylmercury poisoning and the validity of the criteria. A substantial number of residents in the exposed area exhibited neurologic signs even after excluding officially certified patients. Using paresthesia of the extremities as the gold standard of diagnosis, the criteria had a sensitivity of 66%. The current diagnostic criteria as well as the official certification system substantially underestimate the incidence of Minamata disease.
authors.affiliation: Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan. yorichan@md.okayama-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Yorifuji
authors.forename: Toshihide
authors.initials: T
authors.lastname: Tsuda
authors.forename: Sachiko
authors.initials: S
authors.lastname: Inoue
authors.forename: Soshi
authors.initials: S
authors.lastname: Takao
authors.forename: Masazumi
authors.initials: M
authors.lastname: Harada
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005506:Food Contamination; D005517:Foodborne Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D020262:Mercury Poisoning, Nervous System / Q000175:diagnosis* / Q000453:epidemiology; D008767:Methylmercury Compounds / Q000506:poisoning*; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D015203:Reproducibility of Results; D017747:Seafood / Q000506:poisoning*; D012680:Sensitivity and Specificity; D014874:Water Pollutants, Chemical / Q000506:poisoning*; D055815:Young Adult
chemical_list: D008767:Methylmercury Compounds; D014874:Water Pollutants, Chemical