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Tropical Diseases

Tropical Diseases

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Tro p i c a l D i s e a s e s

Definition, Geographic Distribution, Transmission, and Classification
Alimuddin Zumla, MD, MSc, PhD(Lond), FRCP(Lond), FRCP(Edin), FRCPatha,*, Andrew Ustianowski, PhD(Lond), FRCP(Lond), DTM&Hb
KEYWORDS  Classification  Tropical disease  Infectious diseases KEY POINTS 
The term tropical diseases encompasses all communicable and non-communicable diseases that occur principally in the tropics.  Approximately 15 million people die each year because of tropical infectious and parasitic diseases.  Tropical diseases are not restricted to the tropics. Increasing migration, international air travel, tourism, and work visits to tropical regions have contributed to an increased incidence of such diseases being seen in the United States, United Kingdom, and Europe.  Classification of tropical diseases is useful for microbiologists, pathologists, laboratory staff and practicing infectious diseases physicians.  This article gives an overview of the definition, geographical distribution, transmission and practical classification of tropical infectious diseases.

The term tropical diseases encompasses all diseases that occur principally in the tropics. This term covers all communicable and noncommunicable diseases, genetic disorders, and disease caused by nutritional deficiencies or environmental conditions (such as heat, humidity, and altitude) that are encountered in areas that lie between, and alongside, the Tropic of Cancer and Tropic of Capricorn belts. In tropical countries, apart from noncommunicable diseases, a severe burden of disease is caused by an array of different microorganisms, parasites, land and sea animals, and arthropods.1–3 Approximately 15 million people die each year because of tropical infectious and parasitic diseases, most living in developing countries.4 This wide array of diseases is compounded and made worse by the common issues of poverty, poor living conditions, malnutrition, human immunodeficiency virus (HIV)/acquired immune deficiency
Department of Infection, Division of Infection and Immunity, University College London Medical School, University College London Hospitals NHS Foundation Trust, London WC1E 6AJ, UK; b Regional Infectious Diseases Unit, North Manchester General Hospital, Manchester, UK * Corresponding author. E-mail address: a.zumla@ucl.ac.uk Infect Dis Clin N Am 26 (2012) 195–205 doi:10.1016/j.idc.2012.02.007 0891-5520/12/$ – see front matter Ó 2012 Elsevier Inc. All rights reserved. id.theclinics.com

5 Tuberculosis. rickettsioses. Chagas disease. and to higher latitudes that were previously spared. chronic obstructive airways disease. such as the southern United States and the Mediterranean area. and their valuable Web site gives regularly updated information on geographic and temporal trends in disease-associated morbidity among travelers. tourism. leishmaniasis. Increasing migration. international air travel. scorpions.1–4 Schistosomiasis is the second most important parasitic disease after malaria. including Chagas disease. and work visits to tropical regions have contributed to an increased incidence of such diseases being seen in the United States.9 Other previously rare. filariasis. cause much morbidity and mortality from envenomation and secondary infections. parasitic infection caused by the protozoan Trypanosoma cruzi. with advances in immunosuppression. causing millions of deaths each year.196 Zumla & Ustianowski syndrome (AIDS). HIV/AIDS. including snakes. and poor health systems (consequential on poverty. and corruption) that afflict a large proportion of developing countries across the tropics. but presently emerging. The last decade of the twentieth century was marked by a resurgence in tropical diseases being encountered in countries outside the tropics.9. such as the United States. and wide geographic distribution. and vector-borne viral encephalitides. and viral hemorrhagic fever. and fungal respiratory infections remain an important challenge in medical inpatient and outpatient practice in Europe. onchocerciasis. mismanagement. Bites from several animal species. myocardial infarction. enteric fever. immigrants. and refugees. viral. trypanosomiasis. These diseases share population targets. and fungal pathogens. a chronic. and malaria alone are currently responsible for an estimated 6 million deaths annually. African trypanosomiasis.9 TROPICAL DISEASES IN THE UNITED KINGDOM. viral hemorrhagic fevers.6. RTIs remain major causes of morbidity and mortality in adults and children worldwide.1–4 Respiratory tract infections (RTIs) are caused by a variety of bacterial. United Kingdom. and jellyfish.7 The identification and diagnosis of acute and chronic bacterial (including tuberculosis). as well as those in developing countries. and cerebrovascular accidents in resource-poor tropical countries. in the past decade.10 Climate change and global warming (with a resulting increase in average and nadir temperatures) may be causing tropical diseases and vectors to spread to higher altitudes in mountainous regions. make transplants an early therapeutic option for many diseases affecting a considerable number of people worldwide. and developing countries. The Global Surveillance Network of the International Society of Travel Medicine (ISTM) and the Centers for Disease Control (CDC) established a worldwide communications and data collection network of travel/tropical medicine clinics in 1995. diabetes. Although.3 The increasing success rates of solid organ and hematopoietic stem cell transplantations. Respiratory infectious diseases such as severe acute respiratory syndrome (caused by coronavirus) and the avian influenza8 are frequently causes of major concern. and diarrheal diseases have extremely high public health impacts. Thus. In addition to these. EUROPE. viral. helminthiases. and cause significant morbidity and mortality in adults and children. with 200 million people infected and 779 million at risk in more than 70 countries. tropical infectious diseases remain one of the major causes of preventable morbidity and mortality. diseases from particular geographic areas include leptospirosis. have started to .3. ecological niches. lifestyle issues and changes in diet have led to an increase in the number of noncommunicable disease such as hypertension. and Europe. giardiasis. Skin diseases are common in travelers returning from the tropics. AND THE UNITED STATES Tropical diseases are not restricted to the tropics. the United States. transplant programs in Western countries. systemic.

and laboratory staff. reducing morbidity and mortality. Table 1 gives a basic classification of common infectious pathogens for clinical use. For example. and clinicians. order. . For the practicing infectious diseases physician.15 They relate information according to microscopic appearance after staining or culture characteristics.12 A high degree of clinical awareness of the possibility of a tropical disease enables an early diagnosis to be made and enables effective treatment measures to be initiated. and prevention. An extensive enquiry into the travel history is prudent because certain tropical infectious diseases can first present years or even decades after the last tropical travel.Tropical Diseases 197 face the impact of neglected tropical diseases transmitted via the donor tissue.13. and exposure. their means of transmission. and species and have large standard textbooks that give detailed classification and nomenclature. It is prudent to enquire about travel history and geographic origins early in consultations. pathologists. with a view to developing control and prevention strategies to limit the spread of the diseases in the community. to advise the clinician on the most appropriate antibiotic therapy and management. control. with advances in molecular technology. It is imperative that physicians globally are aware of the wide spectrum of tropical. or the important clinical manifestations of the specific disease (Table 2).14 Microbiologists tend to prefer classifying infectious diseases according to the classic microbiological nomenclature codes of kingdom. They often classify infectious diseases according to their distribution. including malaria (Plasmodium ovale and Plasmodium vivax). the causal agent for scrub typhus. class. have historically involved the joint efforts of epidemiologists. place. and their treatment. Such classifications use the routes of transmission or acquisition of the infectious disease (Table 3). specific listings and classifications are useful for streamlining the microbiological and clinical assessment of the patient’s illness. CLASSIFICATION OF TROPICAL DISEASES The number and range of tropical and infectious diseases prevalent globally is extremely large and broad ranging.1–3 Thus. malaria can occur in patients who have not traveled overseas. has been reclassified into the genus Orientia. being acquired near city airports where mosquitoes imported on aircraft arriving from the tropics can survive and transmit the infection during the summer months.11 More posttransplantation respiratory viral. Physicians also tend to classify infectious diseases according to the most important organ or organ system to be affected. The classification of infectious and tropical diseases. and parasitic diseases to which their patients may have been exposed. family. Classification of tropical diseases can also serve as aide´ memoires or checklists for guiding clinicians. microbiologists. protozoal. filariases. DF-2 is now known as Capnocytophaga canimorsus. for practical purposes.16 Epidemiologists usually describe tropical disease in terms of person. time. and according to their reservoirs in nature. bacterial. For example Rickettsia tsutsugamushi. It is imperative to consider the possibility of a tropical disease in cases that are difficult to diagnose. even potentially in those without a suggestive travel history. microorganisms are frequently being reclassified and renamed. to aid early diagnosis and treatment and thereby prevent poor outcomes in many patients. there are several ways in which tropical/infectious diseases are presented in century-old classic tropical diseases textbooks like Manson’s Tropical Diseases or other major treatises that present the classification of tropical diseases with a combination of clinical and microbiological approaches. and fungal infections are being recognized. infectious. trypanosomiases (T cruzi and Trypanosoma brucei gambiense). and schistosomiasis (any Schistosoma spp). However. strongyloidiasis (Strongyloides stercoralis). genus. phylum. microbiologists.

Leishmania spp iv. Intestinal tapeworm larval infections in organs: a. whipworms. vibrios Gram staining Gram-positive (high or low GC) Gram-negative Oxygen requirements Aerobes and anaerobes Chlamydia Chlamydia pneumoniae Chlamydia trachomatis Mycoplasma Mycoplasma pneumoniae Mycoplasma arthritidis Mycoplasma genitalium Spirochetes Treponema spp (Treponema pallidum. Cryptosporium spp Helminths Nematodes (roundworms. Blood flukes (Schistosoma haematobium. Borrelia burgdorferi) Spirillum minus Rickettsia Rickettsia spp Spotted fever group Typhus group Scrub typhus group (now Orientalis) Viruses DNA viruses Group 1: double-stranded DNA (pox. Leptospira canicola) Borrelia spp (Borrelia recurrentis. Diphyllobothrium latum. Trypanosoma spp (T cruzi. rhabdo. hookworms) i. Fusarium spp) Dimorphic (Penicillium marneffei) Parasitologic Grouping and Examples Protozoa Flagellates i. Rhizopus spp. Gnathostoma spinigerum. Ancylostoma spp. Clonorchis sinensis. Trichuris trichiuria. pin/threadworms. Naegleria fowleri Ciliates i. Plasmodium vivax. T brucei gambiense. Marburg) Fungi Ascomycetes (sac fungi) Basidiomycetes (club fungi) Zygomycetes (mucor fungi) Phycomycetes (algal fungi) Morphology Unicellular (Candida spp. guanine and cytosine. hepadna) Group II: single-stranded DNA (parvo) RNA viruses Group III: double-stranded (reo) Group IV: single-stranded (positive sense: orthomyxo. Armillifer armillatus) iii. Balantidium coli Sporozoans i. T rangeli) ii. Schistosoma mansoni. Acanthamoeba spp iii. Linguatella serrata. . Histoplasma spp) Multicellular (Aspergillus spp. Trichinella spiralis. Intestinal tapeworms (Taenia solium. Taenia saginata. Echinococcosis (larvae of dog tapeworms Echinococcus granulosus. Liver flukes (Fasciola hepatica. Entamoeba histolytica ii. toga) Group V: single-stranded (negative sense: Ebola. Giardia lamblia iii. herpes. Opisthorchis spp) ii.198 Table 1 Basic microbiological classification of common infectious pathogens for clinicians Microbiological or Clinical Grouping Bacteria Morphologic descriptions Cocci. and Echinococcus multilocularis) Abbreviation: GC. Cysticercosis (Taenia solium larvae) b. T brucei rhodesiense. Babesia microti iii. Lung flukes (Paragonimus westermani) Cestodes (tapeworms) i. Treponema carateum) Leptospira spp (Leptospira icterohaemorrhagica. Toxoplasma gondii iv. papova. Hymenolepis nana) ii. picorna. Necator americanus) ii. Plasmodium ovale) ii. Tissue/muscle nematode (Dracunculus medinensis. Schistosoma japonicum. Plasmodium malariae. bacilli. Schistosoma mekongi) iii. Enterobius vermicularis. Trichomonas spp Ameboids i. Plasmodium spp (Plasmodium falciparum. Central nervous system nematodes (Angiostrongylus cantonensis) Trematodes (flatworms/flukes) i. Gut nematodes (Ascaris lumbricoides. Fasciolopsis buski. Schistosoma intercalatum. Microsporidium spp v. Treponema pertenue.

compact collection of inflammatory cells in which mononuclear cells predominate. myiasis. cutaneous larva migrans. Angiostrongylus cantonensis. onchocerciasis. coccidia Helminthic: multiple Bacterial: leptospirosis. gnathostomiasis Viral: HIV. hydatidosis Viral: hepatitis A–E. mycobacteria (eg. trypanosomiasis. A granuloma17–19 is defined as a chronic. Acanthamoebae. molecular methods. anaerobes Protozoal: amoebic hepatitis/abscess. botulism. Gnathostoma. histoplasmosis. yellow fever. Pathologic reports often describe the presence of a granuloma in biopsy tissue and the tissue may be processed with special stains. Tuberculosis in HIV-infected individuals or in those on antiTNF-a therapy. polymicrobial. and these can reactivate to cause active disease when the patient becomes immunosuppressed from HIV or immunosuppressive therapy. trypanosomiasis Helminthic: schistosomiasis. tropical pulmonary eosinophilia Protozoal: Plasmodium falciparum Bacterial: endocarditis. larva currens Arthropods: bites and stings. Mycobacterium ulcerans). tungiasis Pyomyositis. and Chagas disease in transplant recipients. in the case of tropical infectious diseases. legionnaires. Some of the organisms contained within the granuloma remain viable. transfusion of blood . anthrax Fungal: sporotrichosis. rabies Bacterial: tropical ulcers. syphilis. tuberculosis. malaria. pneumococcal pneumonia. herpes viruses Bacterial: tuberculosis. coccidioidomycosis. strongyloides hyperinfection. mycetoma. rheumatic fever. enteroviruses. leprosy. diphtheria Protozoal: Naegleria fowleri. scabies. Infectious diseases transmitted through medical procedures (eg. tuberculosis Protozoal: Chagas disease. hydatid Hepatic Respiratory Cardiovascular Renal tract Neurologic Dermatologic Musculoskeletal Many tropical infectious diseases are characterized by chronic inflammation as the battle between the host and pathogen becomes protracted. HTLV-1. liver trematodes. syphilis Protozoal: Chagas disease Helminthic: schistosomiasis Bacterial: poststreptococcal. Loa loa. Japanese encephalitis. tuberculosis. are classic examples. tuberculosis. mycoplasma pneumonia Fungal: aspergillosis.Tropical Diseases 199 Table 2 Some examples of tropical infectious diseases by main organ system involved Main Organ System Involved Common Pathogens Gastrointestinal Bacterial: all gastroenteritides. hydatid. or culture to try to identify further. blastomycosis Helminthic: paragonimiasis. amebiasis. Plasmodium falciparum Helminthic: cysticercosis. leprosy. trichinosis. Giardia. cysticercosis. usually formed as a result of an undegradable product. Penicillium Protozoal: leishmaniasis Helminthic: acute schistosomiasis. tuberculosis Helminthic: schistosomiasis Protozoal: Plasmodium falciparum Bacterial: Neisseria meningitidis and other bacterial meningitis. examples are given in Table 4. hydatid.

mycosis. tuberculosis) Sexually transmitted diseases. plasma. stool. filariasis (bancroftian) Leishmaniasis (all forms). mushroom (Amanita phalloides) Infections caused by nematodes. kissing. trematodes. respiratory infections. Entamoeba histolytica. MRSA Boils. MRSA.200 Zumla & Ustianowski Table 3 Main routes of transmission of tropical and parasitic diseases Route/Mode of Transmission Mother to child Congenital/vertical Transplacental transmission via blood TORCHES group of infections (toxoplasmosis. HIV. Toscana. sex) Indirect (indirect contact with infected fomite. hepatitis A. mycobacteria (eg. St Louis encephalitis. secretions. Japanese B encephalitis. aerosol. typhoid. Chlamydia spp and Mycoplasma spp (eg. fungi. protozoa (eg. trypanosomiases. influenza. C difficile and so forth Disease (Examples) Perinatal Vaginal/cervical contact during delivery Contact via breast milk Airborne/inhalational Inhalation of air. sandfly fever (or Pappataci 3 day fever. hepatitis viruses. sexually transmitted diseases. Lutzomyia spp) Tsetse flies and disease transmission (Glossina spp) Black flies (Simulium spp) Malaria (all Plasmodium spp). bartenellosis (Bartonella bacciliformis) Sleeping sickness (Trypanosoma brucei rhodesiense. body fluid. viruses (eg. cestodes. cholera. West Nile virus) Yellow fever. Sicilian. botulism. dysentery). Bacillus cereus. scabies. scrombrotoxin. protozoa (Entamoeba histolytica. fomite contaminated by microbes Contact of skin/mucosa Direct (touching. syphilis). Herpes simplex. lobal pneumonia. bacterial infections Bacterial. bancroftian filariasis (Wuchereria bancrofti) Arbovirus encephalitis (eg. viruses. Mycobacterium xenopi). Cryptosporidium spp) Staphylococcal. blood. pneumonic plague. cytomegalovirus. viral. rubella. or pus) Ingestion Ingestion of any food or water contaminated with: Microorganisms Infections caused by bacteria (eg. malaria. T brucei gambiense) Onchocerciases (river blindness) (Onchocerca volvulus) (continued on next page) . Cryptosporidium spp) Toxins Parasite ova/cysts Insect/arthropod-borne injection through skin penetration Mosquitoes and disease transmission Anopheles spp Culicine spp Aedes spp Sandfly and disease transmission (Phlebotomus spp. fungal infections Sexually transmitted diseases RTIs caused by bacteria. and Naples virus infections). B. and C).

blood transfusion. tick typhus (Rocky Mountain spotted fever). tularemia (Francisella tularensis) Pediculosis Trench fever. Omsk hemorrhagic fever. airborne (pneumonic plague) eg. hepatitis C. Pasteurella multocida. tularemia (Francisella tularensis). dwarf tapeworm (Hymenolepis nana) Chiggers. Triatoma spp. airborne. relapsing fever (Borrelia recurrentis). louse-borne relapsing fever (Borrelia recurrentis) Plague (Yersinia pestis). babesiosis (Babesia microti) Chagas disease: feces of reduvid bugs with T cruzi spp are rubbed into skin by scratching) Fleas Arachnids Mites Ticks Insect feces rubbed into skin Reduvid bugs (Rhodnius spp. Plague: Y pestis flea bite (bubonic plague). Herpes spp). Malaria: Plasmodium spp eg. traditional scarification via blades Animal and human bites Viruses (rabies. and congenital Skin/mucosa contact. or fungal infections Fly larvae Innoculation or injection Breach of skin or mucous membrane caused by needles. ehrlichiosis (Anaplasma phagocytophilum).Tropical Diseases 201 Table 3 (continued) Route/Mode of Transmission Horse/deer flies (Chrysops spp) Lice Disease (Examples) Filariasis (Loa loa). bacteria. hepatitis B. Anthrax: Bacillus anthracis skin contact with animal hides (cutaneous anthrax). ingestion of contaminated meat (gastrointestinal anthrax) eg. acupuncture. bacillary angiomatosis and endocarditis (Bartonella quintana). needles. actinomycosis. epidemic typhus (Rickettsia prowazekii). Capnocytophaga canimorsus eg. scrub typhus (Orientia tsutsugamushi) Scabies Lyme disease (Borrelia burgdorferi). arboviruses (eg. bacterial infections (anaerobic and aerobic) including tetanus. ear piercing. hookworm and roundworm larvae Fly (bots and warbles) larvae (cutaneous myiases) Viruses. blood transfusion . rat bite fever (Spirillum minus). cupping. endemic/murine typhus (Rickettsia typhi). airborne (pulmonary anthrax). and ingestion of contaminated meat Insect bites. needles. Crimean-Congo hemorrhagic fever. bartonellosis. HIV. tattoos. and cat scratch disease (Bartonella henselae). Panstrongylus spp) Direct penetration through skin Helminth larvae Helminth larvae penetration into subcutaneous tissue: swimmers itch (Schistosoma spp). HIV. hepatitis B Multiple modes of transmission Insect bites and airborne Direct contact.

publications. The GHO also issues analytical reports . and trends. brain. lung) Listerioses (brain) Primary syphilis (skin) Yaws (skin/mucous membranes) Histoplasmosis (any organ) Cocciodomycoses (any organ) Pulmonary aspergillosis (lung) Cryptococcosis (any organ) Toxoplasmosis (eye or brain) Leishmaniases (skin. liver) Granulomas (any organ) Granulomas (liver. Necator americanus Helminth larvae or blood-related products20 and via transplantation) can also be classified microbiologically according to the type of microorganism (Box 1). subcutaneous tissue) Granulomas (cutaneous and visceral) around dead larvae Examples Clinical Disease and Site of Granulomas Brucella spp Yersinia spp Listeria spp Spirochetes Brucella abortus. using core indicators.202 Zumla & Ustianowski Table 4 Infectious causes of granulomas Class of Organism Bacteria Mycobacteria spp Mycobacterium Mycobacterium Mycobacterium Mycobacterium Mycobacterium tuberculosis leprae kansasii marinum bovis Tuberculosis (any organ) Leprosy (skin and nerves) Pneumonia (lung) Fish tank granuloma (skin) BCGiosis (skin) Brucellosis (any organ) Plague (skin. database views. Ancylostoma spp. and therefore published World Health Organization data and map resources can rapidly become outdated because of the lag between data collection and publication. Brucella suis Y pestis Listeria monocytogenes Treponema pallidum Treponema carateum Histoplasma capsulatum Coccidioides immitis Aspergillus fumigatus Cryptococcus neoformans Toxoplasma gondii Leishmania spp Fungi Protozoa Helminth ova/larvae Trematodes Cestodes Schistosoma spp Fasciola spp. Each theme page provides information on the global situation. which are updated on a regular basis. Opisthorchis spp Clonorchis sinensis Taenia solium Ascaris lumbricoides. GEOGRAPHIC DISTRIBUTION OF TROPICAL DISEASES There are geographic differences in the distribution and intensity of tropical infectious diseases and knowledge of these in relation to travel history or country of origin may increase the likelihood of making an accurate and rapid diagnosis. Brucella mellitensis. The Global Health Observatory (GHO)21 is a unique and useful service providing a gallery of global maps illustrating the prevalence of an extensive list of major health topics including tropical diseases. prevalence. and links to relevant Web pages. bile duct) Granuloma around cysticerci (muscle. spleen. including all major infectious and parasitic diseases. The incidence and prevalence of each disease varies with time. These maps are classified by disease themes. mucous membranes.

A key output of the GHO is the annual publication World Health Statistics. which compiles statistics for key health indicators and also includes a brief report on progress toward health-related Millennium Development Goals. E Epstein B virus. In addition. Leptospira spp. Advances in tropical medicine. SOURCES OF LITERATURE ON TROPICAL DISEASES Ongoing research and surveillance continues to yield new information. Treponema pallidum. Brucella spp) Spirochetes Spirochetes (eg. as with all clinical specialties. Borrelia burgdorferi) Ehrlichia Fungi Candida spp Other New variant Creutzfeldt-Jakob disease prion on the current situation and trends for priority health issues. HIV-2 Human T-lymphotropic virus (HTLV) type I. There are several major textbooks focusing on clinical and laboratory aspects of tropical and parasitic . Yersinia spp. Streptococcus spp. tend to be distributed throughout the general medical and scientific literature. C. B. Salmonella spp) Gram-positive bacteria (eg. clotting factors. Pseudomonas spp. platelet. HTLV type II Hepatitis A. and sole reliance on such sources for specialist tropical medicine information does not usually suffice. D. cytomegalovirus Kaposi sarcoma herpesvirus (HHV-8) Parvovirus West Nile virus Severe acute respiratory syndrome Bacteria Gram-negative bacteria (eg. or plasma) Parasites Plasmodium spp Babesia microti ssp Trypanosma cruzi Trypanosoma brucei ssp Leishmania donovani Toxoplasma gondii Viruses HIV-1.Tropical Diseases 203 Box 1 Classification of infections related to transfusion (of blood. Staphylococcus spp. immunoglobulin. the GHO provides analytical reports on cross-cutting topics such as the report on women and health and burden of disease.

et al.24(2):461–95. Whitty C. 13. Respirology 2008. Odolini S. increasingly. Guerrant R. Zumla A. 3. ˜ 11. 2011. Curr Opin Pulm Med 2010. editors. Gill GV. stings. 843. Why aircraft disinsection? Bull World Health Organ 2000. 2012. 6. 5.13(Suppl 1):S33–5. Diseases caused by venomous bites. A worldwide communications and data collection network of travel/tropical medicine clinics. Tropical infectious diseases. Manson’s tropical diseases.78(8):995–1004. databases. but some details may become outdated rapidly because of new developments. and. pathogens and practice. p. 2009. Eddleston M. DOI: 10.16:165–7. Bergey’s manual of systematic bacteriology. 15.22 It is important that any comprehensive search encompasses general and specialist sources. 7. 22nd edition. Steffen R. WHO Report 2008. 2000.23:1–13. . 2011. 4th edition. The Global Burden of Disease 2004 update: 1. New York: Elsevier Saunders. 4. The Global Surveillance Network of the ISTM and CDC. 3rd edition.html. 2. Zumla A.x. Gratz NG. BMJ 1988. Wag DH.istm. World Health Organization. Many traditional print resources. Emerging respiratory infections of the 20th century. 16. et al.204 Zumla & Ustianowski diseases. 14. 2010. London: Elsevier Saunders. editors. Weller PF. Munoz P.14690691. ISBN: 9780199204090.aetiology and classification. ISBN: 9781405180481. et al.trends. p.1–3 The information they contain is comprehensive. London: Saunders. DF-2 infection (may follow dog bites and hazardous to the immunosuppressed). 17. This issue of Infectious Diseases Clinics of North America on tropical diseases covers the epidemiologic. including journals. James DG. p. REFERENCES 1. Parasitic infections in solid organ transplant recipients. Available at: http://www. clinical. 3rd edition. Valerio M. 2001. Issue 3. and poisoning are also described to emphasize that not all tropical diseases are caused by microorganisms. 12. Principles of medicine in Africa. Lecture notes in tropical medicine. editors. books. indexes. Cambridge (UK): Cambridge University Press. editors. 2008 (NLM classification: W 74). Mortality . Boone DR. 1830. Mabey D. Principles. Accessed September 26. Zeng GQ. and Web sites. Infectious Diseases Clinics of North America. laboratory. Puga D. 8. Yew WW. 2.statistics. 2009.org/geosentinel/main. Cook GC. Beeching NJ. editors. Gill G. Pandemic planning in China: applying lessons from severe acute respiratory syndrome. and readers are advised to look up more current sources of literature on each subject area. Davidson R. Granulomatous infections .1111/j. Brent A. Zumla A. 3. Emerging respiratory infections of the 21st century. et al. 10.2011. Oxford handbook of tropical medicine. Zhong NS. Geneva: World Health Organization. books. Hui D. World health . Infect Dis Clin North Am 2010. Clin Infect Dis 1996. Travel-related imported infections in Europe. 24.03596. 9. Parola P. and management aspects of most of the common tropical infectious and parasitic diseases that may present to the physician in the west. Zumla A. Garrity GM. Oxford University Press. 2nd edition.297:1355–6. I. Zumla A. are now available online. Castenholz RW. vol. 2008. Hunters tropical medicine and emerging infectious diseases. EuroTravNet 2009. Cost of illness. London (UK): Springer. such as journals. Blackwell Publishing. McCarthy M. 402. Cocksedge W. Gkrania-Klotsas E. Clin Microbiol Infect 2011.

Granulomatous disorders. Schoonbaert D. Granulomatous infections . 22nd edition. In: Manson’s tropical diseases. Zumla A. 1999. who. 103–21. Eyers AE. Owusu-Ofori S. 2009. p. 21st edition. 21. London (UK): Elsevier.an overview. Accessed December 5. 229–35. Manson’s Tropical Diseases. 2009. Cambridge (UK): Cambridge University Press. editors. Available at: http://www. International Edition. James DG. Cambridge (United Kingdom): Cambridge University Press. .Tropical Diseases 205 18. 1999. p. Zumla A. James DG. Bates I. Eyers J.int/gho/map_gallery/en/. Blood transfusion. WHO website. p. Zumla A. editors. In: Cook G. Granulomatous disorders 616. Chapter 14. Sources of literature on tropical medicine. 19. 22. 2011. Zumla A. Global Health Observatory World Map. editors. 20. 1829. In: James DG.

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