CONTENTS
Section A: General Aspects
1. Prevention of Communicable Diseases: Vaccines
Today and Tomorrow ..................................................................... 1
JK Dutta
Vaccines Meant for Adults 3
Typhoid Vaccine 3
Primary Vaccination Schedule 4
Cholera Vaccine 4
Varicella Vaccine 5
Measles-Mumps-Rubella (MMR) Vaccine 5
Pneumococcal Vaccine 5
Component 5
Japanese Encephalitis Vaccine 6
Prevention Among Travelers 6
Tomorrow's Vaccines (Vaccines Under Development) 7
Combination Vaccines 8
2. Disaster-related Communicable Diseases:
Management and Prevention ........................................................ 9
JK Dutta
Definition 9
Types of Disasters 9
Communicable Disease Outbreak in Disaster Setting 10
Postdisaster Communicable Diseases 10
Control of Communicable Diseases in Disaster Setting 10
Laboratory Support 11
3. Terrorism and Bioterrorism ........................................................ 12
JK Dutta
What is Terrorism? 12
Bioterrorism 12
Historical Background 12
Requirements of a Suitable Biological Weapon 13
Potential Biological Agents 13
Preparedness 13
4. Travel and Recreation-related Infectious Diseases .................. 15
JK Dutta
Travel 15
Runway Malaria 16
Recreation 16
xiv Emerging and Re-emerging Infectious Diseases
5. Transfusion and Transplantation Transmitted
Infectious Diseases ..................................................................... 18
JK Dutta
Transfusion-related Emerging Diseases 18
Transplantation Transmitted Emerging Diseases 18
6. Hospital Infection: Prevention and Control ............................... 21
JK Dutta, Madhumala Giri
Infection Control Program in USA 21
Problems and Control of Hospital Infections in India 22
Section B: Infectious Diseases
7. Ehrlichiosis .................................................................................. 25
JK Dutta
Human Monocytic Ehrlichiosis (HME) 26
Human Granulocytic Ehrlichiosis (HGE) 26
8. Bartonella Infections ................................................................... 28
JK Dutta
Bartenellosis (Carrion's Disease) 28
Clinical Features 28
Cat-scratch Disease 29
Trench Fever 29
9. Escherichia Coli 0157:H7 ............................................................ 32
JK Dutta
Characteristics of the Organism 32
Clinical Features 32
Prevention 32
10. Antibiotic Resistant Enterococci and Drug
Resistant Streptococcus Pneumoniae....................................... 34
JK Dutta
Enterococci 34
Clinical Illness 34
Treatment 34
Drug Resistant Streptococcus Pneumoniae 34
Clinical Illness 34
Drug Resistance 35
11. Salmonellosis ............................................................................... 36
TK Dutta, V Mukta
Introduction 36
History 36
Epidemiology and Public Health 36
The Pathogen 37
Pathogenesis and Pathology 38
Contents xv
Enteric Fever 39
Nontyphoidal Salmonellosis 40
Clinical Syndromes 40
Intra-abdominal Infections 42
Enteric Fever Diagnosis 42
Diagnosis of Nontyphoidal Salmonellosis 43
Treatment 43
Chronic Carriers 44
Vaccines 45
12. Cholera ......................................................................................... 47
JK Dutta
Etiology 47
Pathophysiology 48
Epidemiology 49
Clinical Features 49
Complications 50
Diagnosis 50
Management 50
Antimicrobial Agents 52
Antimicrobial Resistance 53
Preventive Measure 53
13. Plague: The Current Scenario .................................................... 55
JK Dutta
Current Global Scenario 55
Scenario in India 55
Etiology 56
Epidemiology 56
Clinical Manifestations 56
Bubonic Plague 57
Pneumonic Plague 57
Septicemic Plague 57
Meningeal Plague 57
Other Forms of Plague 57
Laboratory Diagnosis 57
Differential Diagnosis 58
Treatment 58
Streptomycin 58
Tetracycline 58
Chloramphenicol 58
Cotrimoxazole 58
Prophylactic Measures 58
Plague Surveillance 59
14. Leptospirosis ............................................................................... 61
TK Dutta, RK Sahoo
Introduction 61
History 61
xvi Emerging and Re-emerging Infectious Diseases
The Pathogen 61
Species 62
Epidemiology 62
Clinical Manifestations 66
Pulmonary Syndrome 67
Uncommon Manifestations 68
Investigation 68
Diagnosis 68
Isolation of Organism 69
Serology 69
Detection of Specific DNA 70
Specific Serovar 70
Who Guidelines 70
Differential Diagnosis 72
Treatment 72
Prognosis 73
Prevention 73
Summary 73
15. Yaws: A Global Menace ............................................................... 75
JK Dutta
Global Scenario 75
Indian Scenario 75
Etiology 76
Epidemiology 76
Clinical Manifestations 76
Histopathological Changes 77
Diagnosis and Differential Diagnosis 77
Serological Tests 77
Treatment 78
Yaws Eradication Program 78
16. Chikungunya Fever...................................................................... 80
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Etiology 80
Epidemiological Features Asia 80
India 80
Re-emergence of Chikungunya Infection-Global Scenario 81
Incidence of Re-emerging Infection in India 81
Clinical Features 81
Laboratory Diagnosis 82
Treatment 82
Control and Prevention 82
Chikungunya Infection in Pregnancy 83
17. Avian Influenza (Bird Flu) ............................................................ 84
JK Dutta
Virus 85
Character 85
Contents xvii
Current Outbreak 85
Clinical Manifestations 86
Drugs 86
Zanamivir (Relenza) 86
Oseltamivir (Tamiflu) 86
Preventive Measures 87
18. Hantavirus Pulmonary Syndrome............................................... 88
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History 88
Clinical Features 88
Treatment 89
Diagnosis 89
Prevention 89
19. Japanese Encephalitis and Other Viral Encephalitis ................ 90
JK Dutta
Global Incidence of Viral Encephalitis 91
Etiology and Epidemiology 91
Scenario in India 91
Clinical Features 92
Laboratory Diagnosis 92
Prevention and Control 93
Other Neuro-viruses of Clinical Importance 93
Arenaviridae 93
Bunyaviridae 93
Phleboviruses 93
Coronaviridae 94
Flaviviridae 94
Herpetoviridae 94
Paramyxoviridae 94
Enteroviruses 94
Rhabdoviridae 94
Alphavirus 94
Rubivirus 94
Kyasanur Forest Disease Virus 95
20. Hepatitis C .................................................................................... 96
JK Dutta, Madhumala Giri
Prevalence 96
Transmission 96
Clinical Features 96
Diagnosis 97
Treatment and Prevention 97
21. Ebola Hemorrhagic Fever, Rift Valley Fever and Nipah
Virus Infection .............................................................................. 98
JK Dutta
Ebola Hemorrhagic Fever 98
Virus 98
xviii Emerging and Re-emerging Infectious Diseases
Clinical Manifestation 98
Rift Valley Fever 99
Treatment 99
Prevention 99
Nipah Virus Infection 99
22. Rabies in Canada and USA ....................................................... 100
JK Dutta
Rabies in Canada 100
History 100
Laboratory Investigation 100
Rabies in USA: Past and Current Status 100
Current Status (2000s) 101
Rabies in 2004 102
A Case of Recovery in Wisconsin 102
23. Dengue Fever ............................................................................. 103
JK Dutta
Etiology 103
Epidemiology 103
First Cases of Dengue in Americas 104
Clinical Features 104
Diagnosis 104
Treatment 104
Prevention 105
24. Malaria: A Re-emerging Infection in USA ................................ 106
JK Dutta
Re-emergence of Malaria in USA 106
Diagnosis of Malaria 107
Treatment and Chemoprophylaxis 107
25. Emerging Therapy for a Re-emerging Disease:
Combination Therapy for Malaria A Brief Outline ................ 109
TK Dutta
Antimalaria Drugs 109
Uncomplicated P. Falciparum Malaria 110
Complicated or Severe Falciparum Malaria 110
26. Hydatidosis/Cystic Echinococcosis......................................... 112
Amitabh Giri, Madumala Giri, BK Giri
Introduction 112
Distribution 112
History, Mode of Infection and Pathogenesis 112
Clinical Features 113
Diagnosis 115
Management 117
Surgery 117
Contents xix
Control And Prevention 118
Conclusion 118
27. Taenia solium Cysticercosis in Man and Animals .................. 119
SC Parija, D Kumar, PS Sahu
Introduction 119
History 120
Epidemiology 120
Worldwide Prevalence 120
Prevalence in India 121
Economic Impact 121
Life Cycle 121
Symptoms 123
Diagnosis 125
Treatment 127
Vaccination 129
Control 129
Conclusion 130
28. Lymphatic Filariasis Revisited ................................................. 135
SP Pani, LK Das
Introduction 135
History of the Disease 135
The Pathogen 136
The Vectors 136
Pathology and Pathogenesis 136
Diagnosis of Lymphatic Filariasis 137
Clinical Diagnosis 137
Acute Filarial Chyluria (AFC) 139
Involvement of Limbs 140
Parasitological Diagnosis 142
Finger Prick Method 142
Membrane Filtration Technique 143
Concentration Technique (Knott's) 143
Ultrasound Method of Detecting of Adult Worms 144
Immunodiagnosis 144
Detection of Antibodies 144
Molecular Diagnosis 145
Diagnosis in Vectors 146
Manual Dissection for L3 Larval Stage of Parasite 146
PCR Based Detection of Infection in Vectors 146
Epidemiology and Public Health 146
Filariasis Problem in India 146
Prevalence, Incidence and Distribution 147
Trend of Filariasis Over Course of Time 147
Management 148
Surgical Management of Lymphedema 152
Towards Elimination of Lymphatic Filariasis (ELF) in India 153
xx Emerging and Re-emerging Infectious Diseases
Recent Research Findings 154
Objectives of ELF 155
The Salient Aspects of ELF Strategy 155
Transmission Control 155
Morbidity Control 155
29. Cryptosporidiosis and Cyclosporiasis .................................... 159
JK Dutta
Cryptosporidiosis 159
Mode of Infection 159
Clinical Features 159
Diagnosis 160
Treatment 160
Prevention 160
Cyclosporiasis 160
Clinical Features 160
Diagnosis 160
Treatment 161
Prevention 161
30. West Nile Virus, Marburg Virus, Legionellosis ........................ 162
JK Dutta
West Nile Virus 162
Virus 162
Clinical features 162
Marburg Virus 162
Treatment 163
Legionellosis 163
Etiology 163
Clinical Features 163
Diagnosis 164
Treatment 164
31. Lyme Disease and Babesiosis .................................................. 165
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Lyme Disease 165
Etiology 165
Clinical Features 165
Treatment 166
Babesiosis 166
Clinical Features 166
Complications 166
Treatment 166
32. Creutzfeldt-Jakob Disease ........................................................ 168
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Etiology 168
Classification 169
Sporadic CJD (sCJD) 169
Contents xxi
Iatrogenic CJD 169
Familial CJD 169
Variant Creutzfeldt-Jakob Disease (vCJD) 169
CJD cases in India 170
Diagnosis 170
Treatment 171
Prevention 171
33. HIV/TB Coinfection .................................................................... 173
T Talukdar
Introduction 173
How HIV and TB Affects Each Other 174
Challenges in Diagnosing TB in the Coinfected 175
Clinical Presentation 175
Other Conditions Mimicking Pulmonary TB in the HIV Infected 176
Extrapulmonary Tuberculosis 177
Drawback of Sputum Microscopy 178
Dillemas in Chest Radiology 178
Mantoux Test 179
Treating HIV/TB Coinfection 179
Antitubercular Treatment 180
Antiretroviral Treatment 180
Drug-Drug Interaction 181
Overlapping Drug Toxicity 182
Immune Reconstitution Inflammatory Syndrome 183
Role of Corticosteroids in HIV-TB Coinfection 183
Multidrug Resistant TB and HIV Coinfection 184
Chemoprophylactic Treatment 184
BCG Vaccination 184
Joint HIV/TB Action Plan 185
Conclusion 185
34. Sexually Transmitted Diseases in India: Historical
Aspects and Emerging Trends (Except HIV Infection) ........... 186
DM Thappa
Introduction 186
Origin of STDs 187
Syphilis 187
Gonorrhea 188
Chancroid 188
Donovanosis 189
Lymphogranuloma Venereum 189
Other STDs 189
Changing Trends of STDs/STIs 190
Global Trends of STDs 190
Current Status of STDs in India 191
Emerging STI Scenario 195
Future Directions 195
xxii Emerging and Re-emerging Infectious Diseases
Section C: Appendices
Appendix 1 : Important Events in the History of
Communicable Diseases ................................................. 199
Appendix 2 : Emerging and Re-emerging Pathogens .......................... 200
Appendix 3 : Prevention of Cholera ...................................................... 201
Appendix 4 : Prevention of Water-borne Infections .............................. 202
Appendix 5 : Prevention of Food-borne Infections ............................... 203
Appendix 6 : Prevention of Rodent-borne Infections ............................ 204
Appendix 7 : Prevention of Bite by Mosquitoes .................................... 205
Index ......................................................................................................... 207