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Emerging Infections
  1. J Kerr

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W M Scheld, B E Murray, J M Hughes, eds. 2004 (paperback): ASM Press, pp 210. ISBN 1 55581 242 2

This book is the sixth of a series of books based on ICAAC symposia on emerging infections, and contains chapters on hepatitis C virus and liver disease, re-emergence of poliovirus disease from a polio vaccine virus, yellow fever associated disease, Ebola haemorrhagic fever, the global epidemiology of AIDS, enteroaggregative Escherichia coli, clostridial necrotising fasciitis in injecting drug users in California, unexplained illness in drug users in the UK, travel associated fungal infections, African trypanosomiasis, Raccoon roundworm infection (baylisascariasis), consideration of the surveillance of unexplained deaths as a public health measure for early recognition of new pathogens, and the international emerging infections program in Thailand. It is edited by three distinguished infectious disease physicians.

The term “emerging” as it relates to infectious disease is difficult to define, but it tends to mean an infectious agent for which the epidemiology has changed greatly within the past two decades, and is usually accepted to be those in which the seriousness of the infection has increased in some way. Confusion arises when the term is overused. However, this book rises above that, dealing with real threats to global health, and is interesting, but it does suffer as a result of the book being a record of a symposium, and the various chapters seem a little uneasy together.

The chapter on yellow fever vaccine associated disease discusses prevention using vaccination and mosquito eradication. Although eradication is clearly most desirable, it is not feasible, and vaccination with the 17D live, attenuated vaccine is a necessity for protection when travelling to an affected area. Reactions are typically mild with headache, myalgia, low grade fever for several days, and occur in approximately 25% of those vaccinated. Immediate hypersensitivity reactions, characterised by rash, urticaria, or asthma occur in those with a history of allergy to egg or other substances (possibly gelatine), and have an incidence of 1/131 000. However, the most serious complications are vaccine associated neurotropic disease and viscerotropic disease, for which the frequency increases dramatically with age, thus creating a problem for the protection of persons 60 years and older. The authors discuss options for the elderly traveller.

I cannot say that I enjoyed reading or reviewing this book, because it feels incomplete; however, it is most certainly factual and I would certainly feel differently if I was researching one of the included topics. The book will be valuable for those interested in global public health or the most up to date information in these various fields.

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