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Peripatetic parasitologists on tour
News
Peripatetic Parasitologists on Tour J.H. Cross The Far East July 1995 Mongolia is a country that was once considered to be off the beaten track. Nevertheless, when an announcement was made that the third Parasitology Delegation organized by the Citizen Ambassador People to People Program to visit the Far East was planning a visit to Ulaan Baatar, the capital of Mongolia, the response for participation was exceptional. The delegation comprised 44 individuals from 15 countries. There are only two ways to enter Mongolia by air: Moscow and Beijing Opting to go via Beijing allowed us a few days ~o visit several institutions and cultural sites there en route.
Beijing Peking Union Medical College is probably the most prestigious medical school in the People's Republic of China. It is the only institution in the country/ offering a doctoral degree in medicine after eight years of study. The school was established in 1917 by the Rockefeller Foundation and had an affiliation with the University of Pennsylvania up to the beginning of World War II, Many famous Americ,~n, European and Chinese parasitologists worl
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and dengue and hepatitis ABC and E. In the Tropical Medicine Ward we saw several cysticercosis and cerebral cysticercosis patients who were being treated with praziquantel. We visited Beijing Medical University, one of the major medical centers in China, which offers bachelor, master and doctoral degrees. The parasitology depatlment showed us an impressive video of a patient undergoing abdominal surgery with an Ascar/s perforating the intestine. We also visited the Institute of Zoology that has a huge collection of insects, fish, snails and mammals.
Mongolia Genghis Khan and his horsemen galloped out of Mongolia and conquered lands all the way fi-om China to Eastern Europe. Landlocked between China and Russia, Mongolia has an area of over 600000 souare miles and is divided into three major zones: the Gobi (a vast dry grassland in the east and south), the low Hangai mountains of the north and the high Altai mountains of the west and no,thNest, The human population is about tv,'o million, about 600000 of whom live in Ulaan Baatar, The majority of the people still live in rural areas moving Iheir poFtable felbcoverecl houses (olllecl gets) as [hey follow their herds of sheep, goats, cattle, ho.ses, camels and yaks in search of pastures, With the development of a fi'ee economy, rural populations are now moving into the cities and industrial areas in searcl; of betterpaying jobs. For decades, the country was almost totally dependent on the Soviet Union for trade and economic aid, but a reform movement began in 1990 that ended Russian influence; a new constitution was signed in 1992 and free elections held. It is only a two-hour flight fi'om Beijing to Ulaan Baatar. The only other transportation is the railroad which runs fi-om Beijing to Moscow through Mongolia. Soon after amval, we visited the National Center for Hygiene, Epidemiology and Microbiology, where S, Tsoodol, the Director, presented a review of activities. The Center provides public health services; hygiene inspections, communicable diseases control, vaccine programs (EPI), health information and statistics and education on sexually transmitted diseases and AIDS. © 1996. ElsevierScienceLtd 0169 4758•96•515.00
With the advent of a fi'ee econom,, and changes in the social system, prostitution is increasing as is the incidence of venereal diseases, especially gonorrhea. Parasitic diseases are not considered to be important public health problems. Previously, parasitology research was carried out by Soviet worl
News is the center for infectious diseases in the country and was constructed with the help of the Soviet Union. Six to seven thousand patients are admitted each year, 50% of whom have viral hepatitis. Unsterile needles are a major source of infection; there are few drug addicts in Mongolia, however, Several hundred cases of brucellosis are seen each year among sheep herders, and the diagnosis is by serological methods. Many had osteoarticular complications. Rabies is occasionally seen, and the source is usually wild camels and wolves. Over 1800 cases of meningococcal meningitis were seen in 1994, and 500 cases in the first six months of 1995. A surgeon presented his experiences in removing hydatid cysts from human livers. The diagnosis is made by ultrasound, serology and surgic J aspirations. Complications are often experienced; jaundice and calcification of the bile duct and blood vessels. There appears to be a wolf and deer life cycle of echinococcosis in Nature with involvement of d, mestic dogs and sheep. Clinicians in our group visit~.:d the wards to see cases of brucellosis and diphtheria, while others visited the lab oratories. They had a good HIV/AIDs lab provided by WHO. So far, only one HIV-positive individual has been found. After a fascinating weekend in the countryside, our next professional visit was to the National Medical University of Mongolia where a briefing was given by D. Dun~erdol i, Vice President of the Unive,sity. The school began in 19':12but it was not organized into the present institution until 1990. Russian was the language of instruction until 1993, and 80% of the libral~' books are presently in Russian. l h e University is the predominant ~nstitution for medical education in Mongolia with faculties in medicine, pediatncs, traditional medicine, public heath, pharmacy and dentistry. There are 268 staff members, 40% with advanced degrees obtained in the Soviet Union. There are about 2700 students (80% females) in var;ous five- ~nd six-year courses of study, mostly in medicine, Postgraduate training and specialization is encouraged. Throughout the country there are 26.6 doctors and 754 paramedical personnel per 10 000 population. As elsewhere in the world, the distnbution is not equitable; ie. 55.6 doctors and 98.7 paramedics per 10000 in Ulaan Baatar, and only 15.2 doctors and 63.9 paramedics per 10 000 in rural areas. The university has several research projects (but none on parasitology) and they also have collaborative projects with other Asian and European institutions. Parasitology Today, vol. 12, no. 2, 1996
The University provides training in parasitology, .and charts posted on the walls covered the field. There are about 40 parasitologists throughout the countt% several being medical doctors. We were not able to vi::.it vetennary facilities, but there must De significant number of veterinary parasitologists, considering the number of domestic animals in the country. There are two research programs in parasitology at the Infectious Disease Hospital, one on Trichomonos voginalis and the other on Enterobius vermicularis. Discussions were held on the training of parasitologists by delegates and Rasul Khan of the Memorial University of Newfoundland and Pedro Morerra fi-orn the University of Costa Rica. Sarah Williams-Blangero of the Southwestern Biomedical Research Foundation in Texas presented work on genetic epidemioiogy of helminthic infections. The practice of traditional medicine is being rejuvenated in Mongolia. Traditional medical products are cheaper than modern drugs, and are considered to be as effective. The Professor of Traditional Medicine,., Tumur Baatar, gave a brief p:esentation and told us about various plants used to treat a plethora of diseases. Many of the drugs were repotted to have anthelminthic activity. There are over 500 herbal plants in Mongolia used in traditional medicine. P. Byanibaa, Director of the Center for Control of Infectious Diseases \~ith Study of Natural Foci, presentc:ct a review of the Institution's activities. There is a staff of t50 people to stuc]y zoonotic diseases, The Cente, has ,'.n extensive collection of fleas, along with other ectoparasites, The main interest of the institution is plague, particJ!arly in hunters exposed to marmots usually durin~ the summer months; they document 20-30 cases per year. The disease has been repolled from 50% of the countr'y with six major foci. They have serological test for diagnosis and ~ vaccine from Russia.
Shanghai, China Our next stop was Shanghai, the leading center of research on parasitic diseases in the People's Republic of China. Our first visit was to the Exhibition Hall for the Prevention of Schistosomiasis. We were given a detailed briefing on how schistosomiasis was eradicated from the area. Over 90% of the area had infected snail colonies in t951, and 46% of the population were passing eggs. Sna!~ colonies were destrayed, infected animals treated or killed
and infectec persons treated. By 1987, eradication had been accomplished. We were invited to participate in the Third Sino-American Conference on Infectious Diseases. Several members of the delegation presented papers, but otherwise little parasitology was discussed. Arrangements were made to visit the Shanghai Institute of Parasitic Diseases, a center of parasitology in China. It is active in research and training, and has been recognized internationally for achievements in science, technology and public health. The library has the largest collection of parasitology publications in the country and is responsible %r the publication of the Chine~.e Journal of Parasitology and Parasitic Diseases. Professor Feng Zhing, Director of the Institute, told us of their contributions to the control and eradication of Schis'~oma japonicum in China. Scientists at the institution have also contributed to the control of lymphatic filariasis, malaria and leishmaniasis. Current efforts are directed towards the development of antimalarial drugs, and the control of soiltransmitted helminths. Over 62% of rural populations are infected with parasites, and most farmers continue to use night soil. Clonorchiasis remains a problem because of the habit of eating raw fish raised in ponds fertilized with night soil. The Institute remains at the cutting edge of p~rasitological research.
Looking Backan~d Looking Forward The visit to Mongolia was vef'y rewarding, The people we met were warm and hospitable, The scientists and academicians are eager to advance their I,nowed~e and to collaboT-ate with others. Although parasitic diseases do not appear to be of public health importance at the moment, it is suspected that future ,.tudies will show the importance of parasites. As we left the country, we felt that the visit was too short. Members of the delegation were in agreement that the visit to Mongolia was the highlight of the tour, The countryside was beautiful, the people fiiendly and the scientists we met were courteous and open and very receptive to collaboration. They welcome scientists fi-om abroad and members of our delegation recommend travels to the Land of Genghis Khan.
~ohn H. Cross is at die Uniformed Services University of the Health Soences. 4301 Jones Bndge Road, Bethesda, MD 20814-4799. USA Tel: ÷1 301 295 3139, Fax: +1 301 295 97 i, e.mail: [email protected]
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Peripatetic Parasitologists on Tour J.H. Cross The Far East July 1995 Mongolia is a country that was once considered to be off the beaten track. Nevertheless, when an announcement was made that the third Parasitology Delegation organized by the Citizen Ambassador People to People Program to visit the Far East was planning a visit to Ulaan Baatar, the capital of Mongolia, the response for participation was exceptional. The delegation comprised 44 individuals from 15 countries. There are only two ways to enter Mongolia by air: Moscow and Beijing Opting to go via Beijing allowed us a few days ~o visit several institutions and cultural sites there en route.
Beijing Peking Union Medical College is probably the most prestigious medical school in the People's Republic of China. It is the only institution in the country/ offering a doctoral degree in medicine after eight years of study. The school was established in 1917 by the Rockefeller Foundation and had an affiliation with the University of Pennsylvania up to the beginning of World War II, Many famous Americ,~n, European and Chinese parasitologists worl
44
and dengue and hepatitis ABC and E. In the Tropical Medicine Ward we saw several cysticercosis and cerebral cysticercosis patients who were being treated with praziquantel. We visited Beijing Medical University, one of the major medical centers in China, which offers bachelor, master and doctoral degrees. The parasitology depatlment showed us an impressive video of a patient undergoing abdominal surgery with an Ascar/s perforating the intestine. We also visited the Institute of Zoology that has a huge collection of insects, fish, snails and mammals.
Mongolia Genghis Khan and his horsemen galloped out of Mongolia and conquered lands all the way fi-om China to Eastern Europe. Landlocked between China and Russia, Mongolia has an area of over 600000 souare miles and is divided into three major zones: the Gobi (a vast dry grassland in the east and south), the low Hangai mountains of the north and the high Altai mountains of the west and no,thNest, The human population is about tv,'o million, about 600000 of whom live in Ulaan Baatar, The majority of the people still live in rural areas moving Iheir poFtable felbcoverecl houses (olllecl gets) as [hey follow their herds of sheep, goats, cattle, ho.ses, camels and yaks in search of pastures, With the development of a fi'ee economy, rural populations are now moving into the cities and industrial areas in searcl; of betterpaying jobs. For decades, the country was almost totally dependent on the Soviet Union for trade and economic aid, but a reform movement began in 1990 that ended Russian influence; a new constitution was signed in 1992 and free elections held. It is only a two-hour flight fi'om Beijing to Ulaan Baatar. The only other transportation is the railroad which runs fi-om Beijing to Moscow through Mongolia. Soon after amval, we visited the National Center for Hygiene, Epidemiology and Microbiology, where S, Tsoodol, the Director, presented a review of activities. The Center provides public health services; hygiene inspections, communicable diseases control, vaccine programs (EPI), health information and statistics and education on sexually transmitted diseases and AIDS. © 1996. ElsevierScienceLtd 0169 4758•96•515.00
With the advent of a fi'ee econom,, and changes in the social system, prostitution is increasing as is the incidence of venereal diseases, especially gonorrhea. Parasitic diseases are not considered to be important public health problems. Previously, parasitology research was carried out by Soviet worl
News is the center for infectious diseases in the country and was constructed with the help of the Soviet Union. Six to seven thousand patients are admitted each year, 50% of whom have viral hepatitis. Unsterile needles are a major source of infection; there are few drug addicts in Mongolia, however, Several hundred cases of brucellosis are seen each year among sheep herders, and the diagnosis is by serological methods. Many had osteoarticular complications. Rabies is occasionally seen, and the source is usually wild camels and wolves. Over 1800 cases of meningococcal meningitis were seen in 1994, and 500 cases in the first six months of 1995. A surgeon presented his experiences in removing hydatid cysts from human livers. The diagnosis is made by ultrasound, serology and surgic J aspirations. Complications are often experienced; jaundice and calcification of the bile duct and blood vessels. There appears to be a wolf and deer life cycle of echinococcosis in Nature with involvement of d, mestic dogs and sheep. Clinicians in our group visit~.:d the wards to see cases of brucellosis and diphtheria, while others visited the lab oratories. They had a good HIV/AIDs lab provided by WHO. So far, only one HIV-positive individual has been found. After a fascinating weekend in the countryside, our next professional visit was to the National Medical University of Mongolia where a briefing was given by D. Dun~erdol i, Vice President of the Unive,sity. The school began in 19':12but it was not organized into the present institution until 1990. Russian was the language of instruction until 1993, and 80% of the libral~' books are presently in Russian. l h e University is the predominant ~nstitution for medical education in Mongolia with faculties in medicine, pediatncs, traditional medicine, public heath, pharmacy and dentistry. There are 268 staff members, 40% with advanced degrees obtained in the Soviet Union. There are about 2700 students (80% females) in var;ous five- ~nd six-year courses of study, mostly in medicine, Postgraduate training and specialization is encouraged. Throughout the country there are 26.6 doctors and 754 paramedical personnel per 10 000 population. As elsewhere in the world, the distnbution is not equitable; ie. 55.6 doctors and 98.7 paramedics per 10000 in Ulaan Baatar, and only 15.2 doctors and 63.9 paramedics per 10 000 in rural areas. The university has several research projects (but none on parasitology) and they also have collaborative projects with other Asian and European institutions. Parasitology Today, vol. 12, no. 2, 1996
The University provides training in parasitology, .and charts posted on the walls covered the field. There are about 40 parasitologists throughout the countt% several being medical doctors. We were not able to vi::.it vetennary facilities, but there must De significant number of veterinary parasitologists, considering the number of domestic animals in the country. There are two research programs in parasitology at the Infectious Disease Hospital, one on Trichomonos voginalis and the other on Enterobius vermicularis. Discussions were held on the training of parasitologists by delegates and Rasul Khan of the Memorial University of Newfoundland and Pedro Morerra fi-orn the University of Costa Rica. Sarah Williams-Blangero of the Southwestern Biomedical Research Foundation in Texas presented work on genetic epidemioiogy of helminthic infections. The practice of traditional medicine is being rejuvenated in Mongolia. Traditional medical products are cheaper than modern drugs, and are considered to be as effective. The Professor of Traditional Medicine,., Tumur Baatar, gave a brief p:esentation and told us about various plants used to treat a plethora of diseases. Many of the drugs were repotted to have anthelminthic activity. There are over 500 herbal plants in Mongolia used in traditional medicine. P. Byanibaa, Director of the Center for Control of Infectious Diseases \~ith Study of Natural Foci, presentc:ct a review of the Institution's activities. There is a staff of t50 people to stuc]y zoonotic diseases, The Cente, has ,'.n extensive collection of fleas, along with other ectoparasites, The main interest of the institution is plague, particJ!arly in hunters exposed to marmots usually durin~ the summer months; they document 20-30 cases per year. The disease has been repolled from 50% of the countr'y with six major foci. They have serological test for diagnosis and ~ vaccine from Russia.
Shanghai, China Our next stop was Shanghai, the leading center of research on parasitic diseases in the People's Republic of China. Our first visit was to the Exhibition Hall for the Prevention of Schistosomiasis. We were given a detailed briefing on how schistosomiasis was eradicated from the area. Over 90% of the area had infected snail colonies in t951, and 46% of the population were passing eggs. Sna!~ colonies were destrayed, infected animals treated or killed
and infectec persons treated. By 1987, eradication had been accomplished. We were invited to participate in the Third Sino-American Conference on Infectious Diseases. Several members of the delegation presented papers, but otherwise little parasitology was discussed. Arrangements were made to visit the Shanghai Institute of Parasitic Diseases, a center of parasitology in China. It is active in research and training, and has been recognized internationally for achievements in science, technology and public health. The library has the largest collection of parasitology publications in the country and is responsible %r the publication of the Chine~.e Journal of Parasitology and Parasitic Diseases. Professor Feng Zhing, Director of the Institute, told us of their contributions to the control and eradication of Schis'~oma japonicum in China. Scientists at the institution have also contributed to the control of lymphatic filariasis, malaria and leishmaniasis. Current efforts are directed towards the development of antimalarial drugs, and the control of soiltransmitted helminths. Over 62% of rural populations are infected with parasites, and most farmers continue to use night soil. Clonorchiasis remains a problem because of the habit of eating raw fish raised in ponds fertilized with night soil. The Institute remains at the cutting edge of p~rasitological research.
Looking Backan~d Looking Forward The visit to Mongolia was vef'y rewarding, The people we met were warm and hospitable, The scientists and academicians are eager to advance their I,nowed~e and to collaboT-ate with others. Although parasitic diseases do not appear to be of public health importance at the moment, it is suspected that future ,.tudies will show the importance of parasites. As we left the country, we felt that the visit was too short. Members of the delegation were in agreement that the visit to Mongolia was the highlight of the tour, The countryside was beautiful, the people fiiendly and the scientists we met were courteous and open and very receptive to collaboration. They welcome scientists fi-om abroad and members of our delegation recommend travels to the Land of Genghis Khan.
~ohn H. Cross is at die Uniformed Services University of the Health Soences. 4301 Jones Bndge Road, Bethesda, MD 20814-4799. USA Tel: ÷1 301 295 3139, Fax: +1 301 295 97 i, e.mail: [email protected]
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