Containing AIDS in Japan (Part 1)

Global spread: The Japanese connection

By William Wetherall

A version of this the article appeard as
"Japanese have role in spread of AIDS around the world" in
The Japan Times, 12 April 1987, page 2

AIDS is not native to Japan, and yet Japanese are responsible for its presence and spread in Japan if not other countries.

Individually, Japanese are sexually active with the citizens of other countries, throughout the world and in Japan. And if they become infected, they could pass it on at home or abroad.

The 25 October 1986 issue of the British medical journal Lancet carried a report suggesting how AIDS could spread from Ghana to Japan and other countries through Japanese and Korean fishermen and seamen.

A February, 1986 survey of 98 Ghanaian prostitutes in the area of Ghana's capital, Accra, including the port of Tema, found only one who was positive for AIDS virus antibodies. 76 had lived in the Accra/Tema area for five or more years. 43 patients reported having had non-Ghanaian sexual partners. Most frequently mentioned were Koreans and Japanese (19), West Africans (16), and Europeans (9).

Until then, no clinical cases of AIDS had been seen in Accra. From March to September, however, 72 Ghanaians were tested positive for AIDS. 63 (88%) were women, 44 (70%) of whom had AIDS or AIDS-related problems. "Most came home from neighboring African countries because they were ill, some dying soon after arrival. 55 have returned from Abidjan (Ivory Coast), 2 from Burkina Faso, 1 from Senegal, and 2 from West Germany."

"In recent years economic hardships have forced many young Ghanaians to go abroad to work as prostitutes," the report continued. "It seems that local prostitutes and residents in Accra are as yet largely uninfected . . . but that there may now be an influx of infected people. The numbers of sexual contacts with Japanese and Koreans may be a pointer to how infection can spread to other areas of the world."

The Lancet report, written by a research team at the University of Ghana Medical School, clearly attributes the rise of AIDS in Ghana to the return of its own citizens from neighboring countries. And it warns that foreign sojourners who patronize infected prostitutes in Ghana could spread the virus elsewhere.

Some Japanese critics angrily charged that the Ghana report "insults Japan" by making it seem as though "Japanese are spreading AIDS all over the world" (Asahi Shimbun, 4 February 1987, evening edition). If so, then it also insults Koreans, and even Ghanaians. But the critics were concerned only with Japan's image, which suggests that their misreading of the report's vital message was caused by a paranoid sense of nationalism, rather than by a language problem.

The Asahi article went on to say that, the views of the critics be what they may, there are, in fact, good grounds for apprehension that Japanese who come into contact with prostitutes in Africa may spread AIDS in Japan. A doctor who returned from East Africa one year ago is said to have diagnosed many transit Japanese for venereal diseases like gonorrhea, syphilis, herpes, and soft chancres.

The Asahi article also said that, in September last year, a Tokyo blood-donation center found AIDS antibodies in the serum of a young Japanese donor who had returned from Africa. The AIDS test he had taken just after returning had been negative, but when donating blood four months later it was positive. When questioned, the man admitted having sexual relations in Africa about a month before his return.

When Europe was hit by syphilis in the 1490s, the French called it the Spanish disease, and the English knew it as the French pox, among other popular names which reflected a theory of outside origins. (Frederick Cartwright, Disease and History, 1972)

Syphilis by whatever name reached India by 1498, China by 1505, Japan by 1512, and Korea by 1515, probably via China, where syphilis was called Canton (Kwangtung, Guangdong) pox, indicating a southern route. Yamato Japanese called syphilis both tomo [China pox] and ryukyumo [Okinawa pox], but Okinawans called it nanbankasa [southern barbarian pox] to express their version of where the new disease had come from. (Tatsukawa Shoji, Nihonjin no byoki, 1976)

Medical historian Tatsukawa attributes much of the early spread of syphilis in East Asia to the pirates and smugglers, mainly Japanese but also Koreans and Chinese, who were raiding coastal towns in Korea and China, and in Southeast Asian countries like the Philippines

How different is the situation today?

In terms of their numbers and mobility, if not their sexual activity, Japanese men are among the most likely AIDS vectors in the world -- be it Africa, Europe, the Americas, or Asia. Only by exercising the ethnocentric abstinence or prophylactic cautions advised in their racy weekly magazines -- as diligently as they travel, work and play -- will Japanese men help keep the global spread of AIDS to a minimum.