- Email: [email protected]
Essential guide to travel medicine
280
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TRENDS in Parasitology Vol.18 No.6 June 2002
ParaSite
Not a simple problem after all World Class Parasites: Volume 1 The African Trypanosomes edited by Samuel J. Black and J. Richard Seed, Kluwer Academic Press, 2001. £80.74 (hbk) (192 pages) ISBN 0 79237 512 2
The demise of the colonial system has not brought the birth of a new bright future for Africa. During the past several decades, Africa has suffered from anarchy, famine and tribal warfare. The public health system is in disarray and the region is plagued with epidemics, old and new. The diseases once thought to be under control are resurging. Sleeping sickness, caused by the subspecies of Trypanosoma brucei in sub-Saharan regions, is often overshadowed by AIDS and malaria. Nagana, a trypanosomiasis of cattle, is caused by related organisms and remains a serious impediment to economic development in Africa. The African Trypanosomes, written by renowned authors and edited by Samuel J. Black and J. Richard Seed, contains twelve chapters, which address the economic problems and describe approaches to control and prevent trypanosomiasis. This book represents the first volume of the new series World Class Parasites – intended to cover recent trends and advances in the research of parasites with a high impact on socioeconomics. The editors estimate that 300 000–500 000 people in Africa are affected by trypanosomiasis, which can be fatal if not treated. The situation is worse now than just a few decades ago and corresponds to the situation in the 1930s. The paradox is that, at the same time, in the developed world, more efforts and resources than ever are being devoted to finding rational ways to combat African trypanosomiasis. The book opens with a chapter written by David H. Molyneux, who gives his personal view on the failure of science http://parasites.trends.com
and the public health system to prevent or stop the epidemics. This chapter is truly remarkable and the book deserves a reader’s attention just for this alone. Molyneux noticed that trypanosome research had: ‘yielded an excess of scientific papers but no new drug’. However, science can still be ‘given a final opportunity to solve what ought to be a simple problem given the major differences between trypanosomes and mammalian cells’. Even though the simplicity thesis could be debatable, it is impossible to disagree with Molyneux on his main point: ‘an efficient use of the resources available today and a focus on the disease control would make a difference even in the absence of a magic bullet yet to be delivered by the drug design and vaccine development programs’. Accurate information is crucial for success because part of the solution proposed by Molyneux lies in the realm of rational decision-making. Chapters two and three describe the development of information systems to support the Program Against African Trypanosomiasis (PAAT), the predicted impact of climate and social factors on vector distribution, and the disease risk to year 2050. Both chapters would benefit from color maps instead of black and white ones. The following chapter is devoted to vector control and describes an innovative strategy to reduce disease transmission through replacement of trypanosome-susceptible tsetse with engineered trypanosome-refractory vectors. A reader with a practical mind would also be interested in an evaluation of more traditional strategies based on attractants and traps, but they have not been covered here. The diagnosis and chemotherapy chapters highlight the fact that the absence of effective diagnostic tests and drugs in the field mostly reflects the lack of incentives for the pharmaceutical industry to proceed with validation and production rather than the difficulties to develop these tools in the laboratory. Several chapters are devoted to trypanosome immunology and cell biology, including the new paradigm of host resistance, trypanotolerance mechanisms in some breeds of West African cattle, the discovery of a bloodstream trypanosome-released factor affecting
cell division, and the endocytosis system. The trypanosome genome organization and the ongoing sequencing efforts are also covered, ending with a general discussion on the rational approaches to vaccine development. In the ideal world, the book would also include additional chapters on conventional vector control, mechanisms of human resistance to trypanosomes, and trypanosome metabolism and intracellular transport as mentioned by the editors as glaring omissions. But would there be African trypanosomes in the ideal world? Dmitri Maslov Dept of Biology, University of California, 3401 Watkins Drive, Riverside, CA 92521, USA. e-mail: [email protected]
Essential guide to travel medicine Health Information for the International Traveler, 2001–2002 by The Centers for Disease Control and Prevention, 2001. US$25.00 (pbk) (257 pages)
Health Information for the International Traveler, 2001–2002 is the biannual update of the goldstandard reference book for travel medicine, which is written by physicians and scientists from the Travelers’ Health Section of The Centers for Disease Control and Prevention (CDC). The book is designed for health care providers who provide pre-travel advice on the prevention of infectious diseases. An online version of the text from this book is also updated periodically at http://www.cdc.gov/travel and the hard copy is available for purchase from http://bookstore.phf.org The book does not attempt an exhaustive coverage of the different topics in travel-related infections, but covers essential information in a reader-friendly approach. A useful list of websites including addresses of travel medicine clinics, in addition to
Forum
international disease surveillance reports, is provided in the introduction. The book is not only informative and organized but, as a result of its origination at the CDC, it represents a de facto official policy for travel medicine in the USA. The text is divided into six sections: ‘Vaccine recommendations’; ‘Yellow fever vaccine requirements and malaria risk by country’; ‘Disease-specific recommendations’; ‘Health hints for the international traveler’; ‘Geographic distribution of potential health hazards to travelers’ and ‘Advising the traveler with special needs’. Foldout tabs divide each section, which helps to pull the book off the shelf and find the required information quickly. In ‘Disease-specific recommendations’, I learnt that the risk of a new variant of Creutzfeldt–Jakob disease is estimated to be one case per 10 billion servings of beef in the UK, that the tsetse (vector of African trypanosomiasis) are attracted to dark and contrasting colors and moving automobiles, and that immunoglobulin fails to prevent hepatitis E during outbreaks. If you were not convinced of the value of personal protective measures against insects then this section can also make a cynic convert: the risk of acquiring leishmaniasis from a sandfly bite is at its greatest between dusk and dawn in rural or peri-urban areas, whereas Aedes aegypti (vector of Dengue
Corrigendum In the Research Update article ‘Updating the DALYs for diarrhoeal disease’ by R.L. Guerrant et al. (Trends Parasitol. 18, 191–193, 2002), the address for the 49th Annual Meeting of American Society of Tropical Medicine and Hygiene was given incorrectly in the footnote * on p. 191. The address read Atlanta, GA, USA, and it should have read Houston, TX, USA. The authors and Trends in Parasitology would like to apologize for any confusion that may have resulted from this error. PII: S1471-4922(02)02326-7
http://parasites.trends.com
TRENDS in Parasitology Vol.18 No.6 June 2002
fever) lives in and around houses in urban areas and bites during the day. Malaria contracted from the bite of an infected Anopheles mosquito can be acquired from dusk to dawn in rural areas as well as urban locations in sub-Saharan Africa. The malaria prophylaxis section has a checklist of issues to address with travelers before departure, which includes the risk of malaria in the destination, personal protective measures, chemoprophylaxis, how to recognize the symptoms of malaria and what to do if malaria has been acquired, and special recommendations for pregnancy and young children. Several tables are present, summarizing the drugs approved in the USA for malaria prophylaxis and self-treatment, and include adult and pediatric dosages and comments on toxicity and contraindications. The CDC continually updates the text and provides more detailed information on malaria prevention at http://www.cdc.gov/travel A well-balanced discussion of the pros and cons of mefloquine, doxycycline and Malarone for chemoprophylaxis is also given. Finally, prevention of accidental and potentially fatal ingestion of malaria medications by young children is covered emphatically. ‘Vaccine recommendations’ provides information on vaccine certificate requirements for travelers from the USA
281
going abroad, standard childhood vaccine recommendations of the US Public Health Service, timing of vaccines after administration of immunoglobulin, ‘catch-up’ immunization schedules for children who are inadequately immunized, and travel-specific vaccines such as yellow fever, hepatitis A and typhoid. ‘Health hints’ covers subjects such as the prevention of diarrheal diseases, use of insect repellents, websites for the results from the biannual CDC inspections of cruise ships for food and water safety, and a summary of the WHO Blood Transfusion Guidelines. Pregnancy, breast-feeding and travel, special precautions for the HIV-infected traveler and a pleasing discussion of the medical issues of international adoption are presented in the final section of the book in the special needs section. This is a fun book to sit down and read. A travel clinic in the USA would not function without this reference book, but would also likely supplement the book with computerized databases providing printouts of county-specific information for the traveler. William A. Petri, Jr Division of Infectious Diseases, PO Box 801340, University of Virginia Health System, Charlottesville, VA 22908-1340, USA. e-mail: [email protected]
Cestode Zoonoses: Echinococcosis and Cystericosis An Emergent and Global Problem edited by Philip Craig and Zbigniew Pawlowski, IOS Press, 2002. (€100, £60) (xii + 395 pages) ISBN 158603 220 8
Cestode Zoonoses: Echinococcosis and Cystericosis – An Emergent and Global Problem is a collection of results presented at the NATO Advanced Research Workshop on Cestode Zoonoses: Echinococcosis and Cystericosis – An Emergent and Global Problem, held 10–13 September 2000, in Poznan, Poland. Cestode zoonoses, tapeworm infections of animals that are transmittable to humans, are being increasingly recognised as a public health problem in Europe, Central Asia, the Middle East, sub-Saharan Africa, Latin America and USA. This book provides an update and a comprehensive review of the recent advances in the study and control of these parasitic tapeworms. There are four main sections: ‘Disease status, re-emergence and spread’; ‘Tools and methods for diagnostic, transmission and epidemiological studies’; ‘Wild-life ecology and transmission of Echinococcus’ and ‘Approaches for control’, which cover different sessions from the workshop.
1471-4922/02/$ – see front matter © 2002 Elsevier Science Ltd. All rights reserved. PII: S1471-4922(02)02327-9
Forum
TRENDS in Parasitology Vol.18 No.6 June 2002
ParaSite
Not a simple problem after all World Class Parasites: Volume 1 The African Trypanosomes edited by Samuel J. Black and J. Richard Seed, Kluwer Academic Press, 2001. £80.74 (hbk) (192 pages) ISBN 0 79237 512 2
The demise of the colonial system has not brought the birth of a new bright future for Africa. During the past several decades, Africa has suffered from anarchy, famine and tribal warfare. The public health system is in disarray and the region is plagued with epidemics, old and new. The diseases once thought to be under control are resurging. Sleeping sickness, caused by the subspecies of Trypanosoma brucei in sub-Saharan regions, is often overshadowed by AIDS and malaria. Nagana, a trypanosomiasis of cattle, is caused by related organisms and remains a serious impediment to economic development in Africa. The African Trypanosomes, written by renowned authors and edited by Samuel J. Black and J. Richard Seed, contains twelve chapters, which address the economic problems and describe approaches to control and prevent trypanosomiasis. This book represents the first volume of the new series World Class Parasites – intended to cover recent trends and advances in the research of parasites with a high impact on socioeconomics. The editors estimate that 300 000–500 000 people in Africa are affected by trypanosomiasis, which can be fatal if not treated. The situation is worse now than just a few decades ago and corresponds to the situation in the 1930s. The paradox is that, at the same time, in the developed world, more efforts and resources than ever are being devoted to finding rational ways to combat African trypanosomiasis. The book opens with a chapter written by David H. Molyneux, who gives his personal view on the failure of science http://parasites.trends.com
and the public health system to prevent or stop the epidemics. This chapter is truly remarkable and the book deserves a reader’s attention just for this alone. Molyneux noticed that trypanosome research had: ‘yielded an excess of scientific papers but no new drug’. However, science can still be ‘given a final opportunity to solve what ought to be a simple problem given the major differences between trypanosomes and mammalian cells’. Even though the simplicity thesis could be debatable, it is impossible to disagree with Molyneux on his main point: ‘an efficient use of the resources available today and a focus on the disease control would make a difference even in the absence of a magic bullet yet to be delivered by the drug design and vaccine development programs’. Accurate information is crucial for success because part of the solution proposed by Molyneux lies in the realm of rational decision-making. Chapters two and three describe the development of information systems to support the Program Against African Trypanosomiasis (PAAT), the predicted impact of climate and social factors on vector distribution, and the disease risk to year 2050. Both chapters would benefit from color maps instead of black and white ones. The following chapter is devoted to vector control and describes an innovative strategy to reduce disease transmission through replacement of trypanosome-susceptible tsetse with engineered trypanosome-refractory vectors. A reader with a practical mind would also be interested in an evaluation of more traditional strategies based on attractants and traps, but they have not been covered here. The diagnosis and chemotherapy chapters highlight the fact that the absence of effective diagnostic tests and drugs in the field mostly reflects the lack of incentives for the pharmaceutical industry to proceed with validation and production rather than the difficulties to develop these tools in the laboratory. Several chapters are devoted to trypanosome immunology and cell biology, including the new paradigm of host resistance, trypanotolerance mechanisms in some breeds of West African cattle, the discovery of a bloodstream trypanosome-released factor affecting
cell division, and the endocytosis system. The trypanosome genome organization and the ongoing sequencing efforts are also covered, ending with a general discussion on the rational approaches to vaccine development. In the ideal world, the book would also include additional chapters on conventional vector control, mechanisms of human resistance to trypanosomes, and trypanosome metabolism and intracellular transport as mentioned by the editors as glaring omissions. But would there be African trypanosomes in the ideal world? Dmitri Maslov Dept of Biology, University of California, 3401 Watkins Drive, Riverside, CA 92521, USA. e-mail: [email protected]
Essential guide to travel medicine Health Information for the International Traveler, 2001–2002 by The Centers for Disease Control and Prevention, 2001. US$25.00 (pbk) (257 pages)
Health Information for the International Traveler, 2001–2002 is the biannual update of the goldstandard reference book for travel medicine, which is written by physicians and scientists from the Travelers’ Health Section of The Centers for Disease Control and Prevention (CDC). The book is designed for health care providers who provide pre-travel advice on the prevention of infectious diseases. An online version of the text from this book is also updated periodically at http://www.cdc.gov/travel and the hard copy is available for purchase from http://bookstore.phf.org The book does not attempt an exhaustive coverage of the different topics in travel-related infections, but covers essential information in a reader-friendly approach. A useful list of websites including addresses of travel medicine clinics, in addition to
Forum
international disease surveillance reports, is provided in the introduction. The book is not only informative and organized but, as a result of its origination at the CDC, it represents a de facto official policy for travel medicine in the USA. The text is divided into six sections: ‘Vaccine recommendations’; ‘Yellow fever vaccine requirements and malaria risk by country’; ‘Disease-specific recommendations’; ‘Health hints for the international traveler’; ‘Geographic distribution of potential health hazards to travelers’ and ‘Advising the traveler with special needs’. Foldout tabs divide each section, which helps to pull the book off the shelf and find the required information quickly. In ‘Disease-specific recommendations’, I learnt that the risk of a new variant of Creutzfeldt–Jakob disease is estimated to be one case per 10 billion servings of beef in the UK, that the tsetse (vector of African trypanosomiasis) are attracted to dark and contrasting colors and moving automobiles, and that immunoglobulin fails to prevent hepatitis E during outbreaks. If you were not convinced of the value of personal protective measures against insects then this section can also make a cynic convert: the risk of acquiring leishmaniasis from a sandfly bite is at its greatest between dusk and dawn in rural or peri-urban areas, whereas Aedes aegypti (vector of Dengue
Corrigendum In the Research Update article ‘Updating the DALYs for diarrhoeal disease’ by R.L. Guerrant et al. (Trends Parasitol. 18, 191–193, 2002), the address for the 49th Annual Meeting of American Society of Tropical Medicine and Hygiene was given incorrectly in the footnote * on p. 191. The address read Atlanta, GA, USA, and it should have read Houston, TX, USA. The authors and Trends in Parasitology would like to apologize for any confusion that may have resulted from this error. PII: S1471-4922(02)02326-7
http://parasites.trends.com
TRENDS in Parasitology Vol.18 No.6 June 2002
fever) lives in and around houses in urban areas and bites during the day. Malaria contracted from the bite of an infected Anopheles mosquito can be acquired from dusk to dawn in rural areas as well as urban locations in sub-Saharan Africa. The malaria prophylaxis section has a checklist of issues to address with travelers before departure, which includes the risk of malaria in the destination, personal protective measures, chemoprophylaxis, how to recognize the symptoms of malaria and what to do if malaria has been acquired, and special recommendations for pregnancy and young children. Several tables are present, summarizing the drugs approved in the USA for malaria prophylaxis and self-treatment, and include adult and pediatric dosages and comments on toxicity and contraindications. The CDC continually updates the text and provides more detailed information on malaria prevention at http://www.cdc.gov/travel A well-balanced discussion of the pros and cons of mefloquine, doxycycline and Malarone for chemoprophylaxis is also given. Finally, prevention of accidental and potentially fatal ingestion of malaria medications by young children is covered emphatically. ‘Vaccine recommendations’ provides information on vaccine certificate requirements for travelers from the USA
281
going abroad, standard childhood vaccine recommendations of the US Public Health Service, timing of vaccines after administration of immunoglobulin, ‘catch-up’ immunization schedules for children who are inadequately immunized, and travel-specific vaccines such as yellow fever, hepatitis A and typhoid. ‘Health hints’ covers subjects such as the prevention of diarrheal diseases, use of insect repellents, websites for the results from the biannual CDC inspections of cruise ships for food and water safety, and a summary of the WHO Blood Transfusion Guidelines. Pregnancy, breast-feeding and travel, special precautions for the HIV-infected traveler and a pleasing discussion of the medical issues of international adoption are presented in the final section of the book in the special needs section. This is a fun book to sit down and read. A travel clinic in the USA would not function without this reference book, but would also likely supplement the book with computerized databases providing printouts of county-specific information for the traveler. William A. Petri, Jr Division of Infectious Diseases, PO Box 801340, University of Virginia Health System, Charlottesville, VA 22908-1340, USA. e-mail: [email protected]
Cestode Zoonoses: Echinococcosis and Cystericosis An Emergent and Global Problem edited by Philip Craig and Zbigniew Pawlowski, IOS Press, 2002. (€100, £60) (xii + 395 pages) ISBN 158603 220 8
Cestode Zoonoses: Echinococcosis and Cystericosis – An Emergent and Global Problem is a collection of results presented at the NATO Advanced Research Workshop on Cestode Zoonoses: Echinococcosis and Cystericosis – An Emergent and Global Problem, held 10–13 September 2000, in Poznan, Poland. Cestode zoonoses, tapeworm infections of animals that are transmittable to humans, are being increasingly recognised as a public health problem in Europe, Central Asia, the Middle East, sub-Saharan Africa, Latin America and USA. This book provides an update and a comprehensive review of the recent advances in the study and control of these parasitic tapeworms. There are four main sections: ‘Disease status, re-emergence and spread’; ‘Tools and methods for diagnostic, transmission and epidemiological studies’; ‘Wild-life ecology and transmission of Echinococcus’ and ‘Approaches for control’, which cover different sessions from the workshop.
1471-4922/02/$ – see front matter © 2002 Elsevier Science Ltd. All rights reserved. PII: S1471-4922(02)02327-9