Japan, health care systems

Historically, PSP has occurred in North America (the Pacific Northwest and the Northeast) and Europe (Acres and Gray, 1978 Anderson, 1989). More recently, PSP has been reported in Japan, Malaysia, the Philipines, Indonesia, Latin America, and China (Anderson et al., 1996 Kao, 1993). The fatality rate for PSP varies on the basis of local health-care practitioner awareness of the disease and its treatment and on the capacity of the existing medical system to assist one or more poisoning victims needing respiratory support. For example, in recent outbreaks in Europe and North America, no deaths occurred among more than 200 cases. However, in similar outbreaks in southeast Asia and Latin America, where the disease is unfamiliar to local health practitioners and where health-care resources are limited, fatality rates of 2 to 14% have been reported (Kao, 1993). 

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