1
Tropical Medicine
This scene is from
Germany!
Theme Park inBrandenburg,
Germany!
Welcome to Brisbane
almost-tropics Peter O’Donoghue
University of
Queensland
Tropical Medicine
perspective:
• personalized
Self-introduction
Brisbane
personalized
• narcissitic
MY FAMILY’S TROPICAL ODYSSEY
Background
ScottishIrish
Ozh b id
moved to
Brisbane
(almost-tropics)
hybrid
UncleSean
Scotland India died!(tea plantations)
Familial experiences with ‘TROPICS’
ague[malaria]
(protozoa)
2
Germany Africa died!(cattle)
Familial experiences with ‘TROPICS’
UncleDavid
anthrax(bacteria)
France Egypt died!(work on dam)
UncleJean-Paul
Familial experiences with ‘TROPICS’
bilharzia(helminth)
Holland East Indies died!(spice plantations)
UncleRutger
Familial experiences with ‘TROPICS’
crypto-coccosis
(fungus)
USA Panama died!
(work on canal)
UncleClint
Familial experiences with ‘TROPICS’
yellow fever(virus)
China New Guinea died!
(gold mines)
UncleJet
Familial experiences with ‘TROPICS’
screwworm
(arthropod)
Tropics can be dangerous!
Presence of nasty infectious diseases
(six exemplars linked to colonial development)
3
Tropical Medicine
Field developed to protect health of colonists
early Schools/Institutes not in tropics
Tropicsbound by latitudes where sun is directly overhead for at least one day per year
23 4N T i f C
36% of land mass
23.4N Tropic of Cancer
23.4S Tropic of Capricorn
Population
40% of people
~3 billion
Temperature
warm (year-long)
no winter
Rainfall
wet (60% global rainfall)
≥ 1 m per year
subsistence level (where possible)
Agriculture
bulk cropping in temperate zones
4
Economic wealth
poor (25% global GDP)
many developing countries
Healthcare
10% global expenditure (per capita)
poor infrastructure
Tropical Medicine
radical changes in knowledge and beliefs
diseases not caused by spirits, spells, miasmas, etc...
Micro-parasites
viruses bacteria protozoa fungi
Germ theoryMacro-parasites
helminths arthropods
multiplicative in hostsevere acute diseases
cumulative in hostchronic diseases
milli-metres centi-metres nano-metres micro-metres
# infectious diseasesAcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasisAnaplasmosisAngiostrongyliasisAnisakiasisAnthraxArcanobacterium haemolyticumArgentine haemorrhagic feverAscariasisAspergillosisAstrovirusBabesiosisBacillus cereusBacterial pneumoniaBacterial vaginosisBacteroidesBalantidiasis
ChromoblastomycosisClonorchiasisClostridium difficile colitisCoccidioidomycosisColorado tick feverCommon cold (acute viral rhinopharyngitis, acute coryza)Creutzfeldt-Jacob disease (CJD)Crimean-Congo haemorrhagic feverCryptococcosisCryptosporidiosisCutaneous larval migransCyclosporiasisCysticercosisCytomegalovirusDengue feverDesmodesmusDientamoebiasisDiphtheriaDiphyllobothriasisDracunculiasis
Haemophilus influenzaeHand, foot & mouth diseaseHantavirus pulmonary syndromeHeartland virus diseaseHelicobacter pyloriHaemolytic uremic syndromeHaemorrhagic fever withrenal syndromeHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHerpes simplexHistoplasmosisHookwormHuman bocavirusHuman ewingii ehrlichiosisHuman granulocytic anaplasmosisHuman metapneumovirusHuman monocytic ehrlichiosis
Meningococcal diseaseMetagonimiasisMicrosporidiosisMolluscum contagiosumMonkeypoxMumpsMurine typhus (endemic)Mycoplasma pneumoniaMycetomaMyiasisNeonatal conjunctivitisNew –variant CJDNocardiosisOnchocerciasisOpisthorchiasisParacoccidioidomycosisParagonimiasisPasteurellosisPediculosis capitisPediculosis corporisPediculosis pubis
SchistosomiasisSepsisShigellosisShinglesSmallpoxSporotrichosisStaphylococcoal food poisoningStaphylococcusStrongyloidiasisSubacute sclerosing panencephalitisSyphilisTaeniasisTetanusTinea barbae Tinea capitisTinea corporisTinea crurisTinea manumTinea nigraTinea pedis
[Wiki N = 240]
BalantidiasisBartonellosisBaylisascarisBK virusBlack piedraBlastocystosisBlastomycosisBolivian haemorrhagic feverBotulismBrazilian haemorrhagic feverBrucellosisBubonic plagueBurkholderiaBuruli ulcerCalcivirus (Norovirus, Sapovirus)CampylobacteriosisCandidiasis (moniliasis, thrush)CapillariasisCarrion’s diseaseCat-scratch diseaseCellulitisChagas diseaseChancroidChickenpoxChikungunyaChlamydiaChlamydophila pneumoniae Cholera
DracunculiasisEbola haemorrhagic feverEchinococcosisEhrlichiosisEnterobiasisEnterococcusEnterovirusEpidemic typhusErythema infectiosum (fifth disease)Exathem subitum (sixth disease)FasciolasisFasciolopsiasisFatal familial insomniaFilariasisFood poisoning (Cl. perfringens)Free-living amoebaeFusobacteriumGas gangrene (Cl. myonecrosis)GeotrichosisGerstmann-Straussler-Scheinker syndromeGiardiasisGlandersGnathostomiasisGonorrhoeaGranuloma inguinale (donovanosis)Group A StreptococcusGroup B Streptococcus
Human monocytic ehrlichiosisHuman papillomavirusHuman parainfluenza virusHymenolepiasisEpstein-Barr virus infectiousmononucleosisInfluenzaIsosporiasisKawasaki diseaseKeratitisKingella kingaeKuruLassa feverLegionellosis (Legionnaire’s disease)Legionellosis (Pontiac fever)LeishmaniasisLeprosyLeptospirosisListerosisLyme diseaseLymphatic filariasisLymphocytic choriomeningitisMalariaMarburg haemorrhagic feverMeaslesMiddle-East respiratory syndromeMelioidosisMeningitis
Pediculosis pubisPelvic inflammatory diseasePertussisPlaguePneumococcusPneumocystis pneumoniaPneumoniaPoliomyelitisPrevotellaPrimary amoebic meningoencephalitisProgressive multifocal leukoencephalopathyPsittacosisQ feverRabiesRelapsing feverRespiratory syncytial virusRhinosporidiosisRhinovirusRickettsiaRickettsialpoxRift valley feverRocky Mountain spotted feverRotavirusRubellaSalmonellosisSevere acute respiratory syndromeScabies
Tinea pedisTinea unguiumTinea versicolorToxocariasis (ocular)Toxocariasis (visceral)TrachomaToxoplasmosisTrichinosisTrichomoniasisTrichuriasisTuberculosisTularemiaTyphoid feverTyphus feverUreaplasma urealyticumValley feverVenezuelan equine encephalitisVenezuelan haemorrhagic feverVibrio vulnificusVibrio parahaemolyticusViral encephalitisViral pneumoniaWest Nile feverWhite piedraYersinia pseudotuberculosisYersiniosisYellow feverZygomycosis
# infectious diseasesAcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasisAnaplasmosisAngiostrongyliasisAnisakiasisAnthraxArcanobacterium haemolyticumArgentine haemorrhagic feverAscariasisAspergillosisAstrovirusBabesiosisBacillus cereusBacterial pneumoniaBacterial vaginosisBacteroidesBalantidiasis
ChromoblastomycosisClonorchiasisClostridium difficile colitisCoccidioidomycosisColorado tick feverCommon cold (acute viral rhinopharyngitis, acute coryza)Creutzfeldt-Jacob disease (CJD)Crimean-Congo haemorrhagic feverCryptococcosisCryptosporidiosisCutaneous larval migransCyclosporiasisCysticercosisCytomegalovirusDengue feverDesmodesmusDientamoebiasisDiphtheriaDiphyllobothriasisDracunculiasis
Haemophilus influenzaeHand, foot & mouth diseaseHantavirus pulmonary syndromeHeartland virus diseaseHelicobacter pyloriHaemolytic uremic syndromeHaemorrhagic fever withrenal syndromeHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHerpes simplexHistoplasmosisHookwormHuman bocavirusHuman ewingii ehrlichiosisHuman granulocytic anaplasmosisHuman metapneumovirusHuman monocytic ehrlichiosis
Meningococcal diseaseMetagonimiasisMicrosporidiosisMolluscum contagiosumMonkeypoxMumpsMurine typhus (endemic)Mycoplasma pneumoniaMycetomaMyiasisNeonatal conjunctivitisNew –variant CJDNocardiosisOnchocerciasisOpisthorchiasisParacoccidioidomycosisParagonimiasisPasteurellosisPediculosis capitisPediculosis corporisPediculosis pubis
SchistosomiasisSepsisShigellosisShinglesSmallpoxSporotrichosisStaphylococcoal food poisoningStaphylococcusStrongyloidiasisSubacute sclerosingpanencephalitisSyphilisTaeniasisTetanusTinea barbaeTinea capitisTinea corporisTinea crurisTinea manumTinea nigraTinea pedis
37% bacterial (86) 29% viral (65)13% helminth (30) 12% fungal (28)7% protozoan (17) 2% arthropod (5)
[Wiki N = 240]
BalantidiasisBartonellosisBaylisascarisBK virusBlack piedraBlastocystosisBlastomycosisBolivian haemorrhagic feverBotulismBrazilian haemorrhagic feverBrucellosisBubonic plagueBurkholderiaBuruli ulcerCalcivirus (Norovirus, Sapovirus)CampylobacteriosisCandidiasis (moniliasis, thrush)CapillariasisCarrion’s diseaseCat-scratch diseaseCellulitisChagas diseaseChancroidChickenpoxChikungunyaChlamydiaChlamydophila pneumoniaeCholera
DracunculiasisEbola haemorrhagic feverEchinococcosisEhrlichiosisEnterobiasisEnterococcusEnterovirusEpidemic typhusErythema infectiosum (fifth disease)Exathem subitum (sixth disease)FasciolasisFasciolopsiasisFatal familial insomniaFilariasisFood poisoning (Cl. perfringens)Free-living amoebaeFusobacteriumGas gangrene (Cl. myonecrosis)GeotrichosisGerstmann-Straussler-ScheinkersyndromeGiardiasisGlandersGnathostomiasisGonorrhoeaGranuloma inguinale (donovanosis)Group A StreptococcusGroup B Streptococcus
Human monocytic ehrlichiosisHuman papillomavirusHuman parainfluenza virusHymenolepiasisEpstein-Barr virus infectiousmononucleosisInfluenzaIsosporiasisKawasaki diseaseKeratitisKingella kingaeKuruLassa feverLegionellosis (Legionnaire’s disease)Legionellosis (Pontiac fever)LeishmaniasisLeprosyLeptospirosisListerosisLyme diseaseLymphatic filariasisLymphocytic choriomeningitisMalariaMarburg haemorrhagic feverMeaslesMiddle-East respiratory syndromeMelioidosisMeningitis
Pediculosis pubisPelvic inflammatory diseasePertussisPlaguePneumococcusPneumocystis pneumoniaPneumoniaPoliomyelitisPrevotellaPrimary amoebic meningoencephalitisProgressive multifocal leukoencephalopathyPsittacosisQ feverRabiesRelapsing feverRespiratory syncytial virusRhinosporidiosisRhinovirusRickettsiaRickettsialpoxRift valley feverRocky Mountain spotted feverRotavirusRubellaSalmonellosisSevere acute respiratory syndromeScabies
Tinea pedisTinea unguiumTinea versicolorToxocariasis (ocular)Toxocariasis (visceral)TrachomaToxoplasmosisTrichinosisTrichomoniasisTrichuriasisTuberculosisTularemiaTyphoid feverTyphus feverUreaplasma urealyticumValley feverVenezuelan equine encephalitisVenezuelan haemorrhagic feverVibrio vulnificusVibrio parahaemolyticusViral encephalitisViral pneumoniaWest Nile feverWhite piedraYersinia pseudotuberculosisYersiniosisYellow feverZygomycosis
5
VIRUSES: genetic vagrants!
influenza virus
herpes coldsore
BACTERIA: biochemical bags!
anthrax
in cytoplasm
FUNGI: zombie-eaters!
filamentous hyphaefilamentous hyphae
ovoid yeasts athlete’s foot
PROTOZOA: ‘first animals’!flagellates
ciliates
leishmaniasis
ciliates
amoebae
sporozoa
hookworm - larval migrans
HELMINTHS: squirmy worms!
nematodes
cestodes
trematodes
ARTHROPODS: mini-vampires!
insects
tick bite
arachnids
6
Exemplars of dermal lesions
Usually sensationalize topic with gory images
Lucky it is a publicpre-dinner talk
(sanitized images)
Vascular
Visceral Enteric
VenerealMost common causes of mortality due to infectious diseases(where cause of death is known, ~ 16 million per annum):• acute respiratory infections 4,000,000• acquired immunodeficiency syndrome 3,000,000• diarrhoeal diseases 1,800,000• tuberculosis (TB) 1,600,000• malaria 1,300,000• measles 600,000• pertussis (whooping cough) 300 000
Cost of tropical diseases
• pertussis (whooping cough) 300,000• tetanus 200,000• meningitis, bacterial 200,000• hepatitis, all types 160,000• syphilis 150,000• trypanosomiasis, all types 100,000• chlamydiasis 20,000• schistosomiasis 15,000• Japanese encephalitis 14,000• dengue 13,000• other communicable diseases 1,700,000
7
Followed 3 main periods in human history:
Epidemiology
1. Foundation (thousands of years ago)
2. Empire (hundreds of years ago)
3. Second Foundation (tens of years ago)
apologies to Asimov
1. FOUNDATION
Humanoid African origins > 10,000 YA hunter/gatherersOld World diseases (fevers, dysentery, lesions)Out-of-Africa migrations >7,000 YA farmers villagersNew World ‘crowd’ diseases (rashes, poxes, plagues, pneumonias)Separation of New and Old Worlds (Sahara desert)
2. EMPIRE
>300 YA Explorers ‘discover’ tropical landsencounter Old World diseases, spread New World diseases
200 YA Slave trade, labour force tougher, more resistant mixing of New and Old World peoples and diseases
3. SECOND FOUNDATION
Emerging/re-emerging diseases, esp. zoonoses (rats/bats/birds)
50 YA Globalization, population translocations (wars, migration,international travel, trade, commerce, tourism, work, etc)
Disease management through:
• Drugs
What can be done?
• Vaccines
• Biological interventions
Drug discovery
Kinch et al. 2014Drug Discovery Today
New
Molecular
Entities
8
Infectious diseases (n=240)AcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasisAnaplasmosisAngiostrongyliasisAnisakiasisAnthraxArcanobacterium haemolyticumArgentine haemorrhagic feverAscariasisAspergillosisAstrovirusBabesiosisBacillus cereusBacterial pneumoniaBacterial vaginosisBacteroidesBalantidiasis
ChromoblastomycosisClonorchiasisClostridium difficile colitisCoccidioidomycosisColorado tick feverCommon cold (acute viral rhinopharyngitis, acute coryza)Creutzfeldt-Jacob disease (CJD)Crimean-Congo haemorrhagic feverCryptococcosisCryptosporidiosisCutaneous larval migransCyclosporiasisCysticercosisCytomegalovirusDengue feverDesmodesmusDientamoebiasisDiphtheriaDiphyllobothriasisDracunculiasis
Haemophilus influenzaeHand, foot & mouth diseaseHantavirus pulmonary syndromeHeartland virus diseaseHelicobacter pyloriHaemolytic uremic syndromeHaemorrhagic fever withrenal syndromeHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHerpes simplexHistoplasmosisHookwormHuman bocavirusHuman ewingii ehrlichiosisHuman granulocytic anaplasmosisHuman metapneumovirusHuman monocytic ehrlichiosis
Meningococcal diseaseMetagonimiasisMicrosporidiosisMolluscum contagiosumMonkeypoxMumpsMurine typhus (endemic)Mycoplasma pneumoniaMycetomaMyiasisNeonatal conjunctivitisNew –variant CJDNocardiosisOnchocerciasisOpisthorchiasisParacoccidioidomycosisParagonimiasisPasteurellosisPediculosis capitisPediculosis corporisPediculosis pubis
SchistosomiasisSepsisShigellosisShinglesSmallpoxSporotrichosisStaphylococcoal food poisoningStaphylococcusStrongyloidiasisSubacute sclerosing panencephalitisSyphilisTaeniasisTetanusTinea barbae Tinea capitisTinea corporisTinea crurisTinea manumTinea nigraTinea pedisBalantidiasis
BartonellosisBaylisascarisBK virusBlack piedraBlastocystosisBlastomycosisBolivian haemorrhagic feverBotulismBrazilian haemorrhagic feverBrucellosisBubonic plagueBurkholderiaBuruli ulcerCalcivirus (Norovirus, Sapovirus)CampylobacteriosisCandidiasis (moniliasis, thrush)CapillariasisCarrion’s diseaseCat-scratch diseaseCellulitisChagas diseaseChancroidChickenpoxChikungunyaChlamydiaChlamydophila pneumoniae Cholera
DracunculiasisEbola haemorrhagic feverEchinococcosisEhrlichiosisEnterobiasisEnterococcusEnterovirusEpidemic typhusErythema infectiosum (fifth disease)Exathem subitum (sixth disease)FasciolasisFasciolopsiasisFatal familial insomniaFilariasisFood poisoning (Cl. perfringens)Free-living amoebaeFusobacteriumGas gangrene (Cl. myonecrosis)GeotrichosisGerstmann-Straussler-Scheinker syndromeGiardiasisGlandersGnathostomiasisGonorrhoeaGranuloma inguinale (donovanosis)Group A StreptococcusGroup B Streptococcus
Human monocytic ehrlichiosisHuman papillomavirusHuman parainfluenza virusHymenolepiasisEpstein-Barr virus infectiousmononucleosisInfluenzaIsosporiasisKawasaki diseaseKeratitisKingella kingaeKuruLassa feverLegionellosis (Legionnaire’s disease)Legionellosis (Pontiac fever)LeishmaniasisLeprosyLeptospirosisListerosisLyme diseaseLymphatic filariasisLymphocytic choriomeningitisMalariaMarburg haemorrhagic feverMeaslesMiddle-East respiratory syndromeMelioidosisMeningitis
Pediculosis pubisPelvic inflammatory diseasePertussisPlaguePneumococcusPneumocystis pneumoniaPneumoniaPoliomyelitisPrevotellaPrimary amoebic meningoencephalitisProgressive multifocal leukoencephalopathyPsittacosisQ feverRabiesRelapsing feverRespiratory syncytial virusRhinosporidiosisRhinovirusRickettsiaRickettsialpoxRift valley feverRocky Mountain spotted feverRotavirusRubellaSalmonellosisSevere acute respiratory syndromeScabies
Tinea pedisTinea unguiumTinea versicolorToxocariasis (ocular)Toxocariasis (visceral)TrachomaToxoplasmosisTrichinosisTrichomoniasisTrichuriasisTuberculosisTularemiaTyphoid feverTyphus feverUreaplasma urealyticumValley feverVenezuelan equine encephalitisVenezuelan haemorrhagic feverVibrio vulnificusVibrio parahaemolyticusViral encephalitisViral pneumoniaWest Nile feverWhite piedraYersinia pseudotuberculosisYersiniosisYellow feverZygomycosis
Diseases for which drugs are available (n=160)AcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasisAnaplasmosisAngiostrongyliasis
AnthraxArcanobacterium haemolyticum
AscariasisAspergillosis
BabesiosisBacillus cereusBacterial pneumoniaBacterial vaginosisBacteroidesBalantidiasis
ChromoblastomycosisClonorchiasisClostridium difficile colitisCoccidioidomycosis
Cryptococcosis
Cutaneous larval migransCyclosporiasis
Dientamoebiasis
Diphyllobothriasis
Haemophilus influenzae
Helicobacter pyloriHaemolytic uremic syndrome
Hepatitis C
HistoplasmosisHookworm
Human ewingii ehrlichiosisHuman granulocytic anaplasmosis
Human monocytic ehrlichiosis
Meningococcal diseaseMetagonimiasis
Murine typhus (endemic)
MyiasisNeonatal conjunctivitis
NocardiosisOnchocerciasisOpisthorchiasis
ParagonimiasisPasteurellosisPediculosis capitisPediculosis corporisPediculosis pubis
SchistosomiasisSepsisShigellosis
SporotrichosisStaphylococcoal food poisoningStaphylococcusStrongyloidiasis
SyphilisTaeniasisTetanusTinea barbae Tinea capitisTinea corporisTinea crurisTinea manumTinea nigraTinea pedis
67%BalantidiasisBartonellosisBaylisascaris
Black piedra
Blastomycosis
Botulism
Brucellosis
Buruli ulcer
CampylobacteriosisCandidiasis (moniliasis, thrush)CapillariasisCarrion’s disease
CellulitisChagas diseaseChancroid
Chlamydia
Cholera
EchinococcosisEhrlichiosisEnterobiasisEnterococcus
Epidemic typhus
FasciolasisFasciolopsiasis
FilariasisFood poisoning (Cl. perfringens)
FusobacteriumGas gangrene (Cl. myonecrosis)Geotrichosis
Giardiasis
GnathostomiasisGonorrhoeaGranuloma inguinale (donovanosis)Group A StreptococcusGroup B Streptococcus
Human monocytic ehrlichiosis
Hymenolepiasis
Isosporiasis
KeratitisKingella kingae
Legionellosis (Legionnaire’s disease)Legionellosis (Pontiac fever)LeishmaniasisLeprosyLeptospirosisListerosisLyme diseaseLymphatic filariasis
Malaria
MelioidosisMeningitis
Pediculosis pubisPelvic inflammatory disease
PlaguePneumococcusPneumocystis pneumoniaPneumonia
Prevotella
PsittacosisQ fever
Relapsing fever
RickettsiaRickettsialpox
Rocky Mountain spotted feverRotavirus
Salmonellosis
Scabies
Tinea pedisTinea unguiumTinea versicolorToxocariasis (ocular)Toxocariasis (visceral)TrachomaToxoplasmosisTrichinosisTrichomoniasisTrichuriasisTuberculosisTularemiaTyphoid feverTyphus feverUreaplasma urealyticumValley fever
Vibrio vulnificusVibrio parahaemolyticus
White piedraYersinia pseudotuberculosisYersiniosis
Zygomycosis
means33% are
untreatable
Diseases with drug-resistance problems (n=55)AcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasis
Babesiosis
Bacterial pneumoniaBacterial vaginosisBacteroides
Chromoblastomycosis
Coccidioidomycosis
Haemophilus influenzae
Helicobacter pyloriHaemolytic uremic syndrome
Meningococcal disease
MyiasisNeonatal conjunctivitis
Nocardiosis
Pediculosis capitisPediculosis corporisPediculosis pubis
SepsisShigellosis
Staphylococcoal food poisoningStaphylococcus
Syphilis
34%Brucellosis
Buruli ulcer
CellulitisChagas diseaseChancroid
Enterococcus
FasciolasisFasciolopsiasis
Food poisoning (Cl. perfringens)
Giardiasis
Gonorrhoea
Group A Streptococcus
KeratitisKingella kingae
LeishmaniasisLeprosy
Lymphatic filariasis
Malaria
Meningitis
Pediculosis pubisPelvic inflammatory disease
Pneumococcus
Pneumonia
Salmonellosis
Scabies
Trichomoniasis
Tuberculosis
Typhoid fever
Valley fever
Vibrio vulnificus
Vaccines
Infectious diseases (n=240)AcinetobacterActinomycosisAfrican trypanosomiasisAcquired immunodeficiency syndromeAmoebiasisAnaplasmosisAngiostrongyliasisAnisakiasisAnthraxArcanobacterium haemolyticumArgentine haemorrhagic feverAscariasisAspergillosisAstrovirusBabesiosisBacillus cerreusBacterial pneumoniaBacterial vaginosisBacteroidesBalantidiasis
ChromoblastomycosisClonorchiasisClostridium difficile colitisCoccidiomycosisColorado tick feverCommon cold (acute viral rhinopharyngitis, acute coryza)Creutzfeldt-Jacob disease (CJD)Crimean-Congo haemorrhagic feverCryptococcosisCryptosporidiosisCutaneous larval migransCyclosporiasisCysticercosisCytomegalovirusDengue feverDesmodesmusDientamoebiasisDiphtheriaDiphyllobothriasisDracunculiasis
Haemophilus influenzaeHand, foot & mouth diseaseHantavirus pulmonary syndromeHeartland virus diseaseHelicobacter pyloriHaemolytic uremic syndromeHaemorrhagic fever withrenal syndromeHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EHerpes simplexHistoplasmosisHookwormHuman bocavirusHuman ewingii ehrlichiosisHuman granulocytic anaplasmosisHuman metapneumovirusHuman monocytic ehrlichiosis
Meningococcal diseaseMetagonimiasisMicrosporidiosisMolluscum contagiosumMonkeypoxMumpsMurine typhus (endemic)Mycoplasma pneumoniaMycetomaMyiasisNeonatal conjunctivitisNew –variant CJDNocardiosisOnchocerciasisOpisthorchiasisParacoccidiomycosisParagonimiasisPasteurellosisPediculosis capitisPediculosis coprporisPediculosis pubis
SchistosomiasisSepsisShigellosisShinglesSmallpoxSporotrichosisStaphylococcoal food poisoningStaphylococcusStrongyloidiasisSubacute sclerosing panencephalitisSyphilisTaeniasisTetanusTinea barbae Tinea capitisTinea corporisTinea crurisTinea manumTinea nigraTinea pedisBalantidiasis
BartonellosisBaylisascarisBK virusBlack piedraBlastocystosisBlastomycosisBolivian haemorrhagic feverBotulismBrazilian haemorrhagic feverBrucellosisBubonic plagueBurkholderiaBuruli ulcerCalcivirus (Norovirus, Sapovirus)CampylobacteriosisCandidiasis (moniliasis, thrush)CapillariasisCarrion’s diseaseCat-scratch diseaseCellulitisChagas diseaseChancroidChickenpoxChikungunyaChlamydiaChlamydophila pneumoniae Cholera
DracunculiasisEbola haemorrhagic feverEchinococcosisEhrlichiosisEnterobiasisEnterococcusEnterovirusEpidemic typhusErythema infectiosum (fifth disease)Exathem subitum (sixth disease)FasciolasisFasciolopsiasisFatal familial insomniaFilariasisFood poisoning (Cl. perfringens)Free-living amoebaeFusobacteriumGas gangrene (Cl. myonecrosis)GeotrichosisGerstmann-Straussler-Scheinker syndromeGiardiasisGlandersGnathostomiasisGonorrheaGranuloma inguinale (donovanosis)Group A StreptococcusGroup B Streptococcus
Human monocytic ehrlichiosisHuman papillomavirusHuman parainfluenza virusHymenolepiasisEpstein-Barr virus infectiousmononucleosisInfluenzaIsosporiasisKawasaki diseaseKeratitisKingella kingaeKuruLassa feverLegionellosis (legionnaire’s disease)Legionellosis (Pontiac fever)LeishmaniasisLeprosyLeptospirosisListerosisLyme diseaseLymphatic filariasisLymphocytic choriomeningitisMalariaMarburg haemorrhagic feverMeaslesMiddle-East respiratory syndromeMelioidosisMeningitis
Pediculosis pubisPelvic inflammatory diseasePertussisPlaguePneumococcusPneumocystis pneumoniaPneumoniaPoliomyelitisPrevotellaPrimary amoebic meningoencephalitisProgressive multifocal leukoencephalopathyPsittacosisQ feverRabiesRelapsing feverRespiratory syncytial virusRhinosporidiosisRhinovirusRickettsiaRickettsialpoxRift valley feverRocky Mountain spotted feverRotavirusRubellaSalmonellosisSevere acute respiratory syndromeScabies
Tinea pedisTinea unguiumTinea versicolorToxocariasis (ocular)Toxocariasis (visceral)TrachomaToxoplasmosisTrichinosisTrichomoniasisTrichuriasisTuberculosisTularemiaTyphoid feverTyphus feverUreaplasma urealyticumValley feverVenezuelan equine encephalitisVenezuelan haemorrhagic feverVibrio vulnificusVibrio parahaemolyticusViral encephalitisViral pneumoniaWest Nile feverWhite piedraYersinia pseudotuberculosisYersiniosisYellow feverZygomycosis
Vaccination-preventable diseases (n=24)
Diphtheria
Haemophilus influenzae
Hepatitis AHepatitis B
Hepatitis D
Meningococcal disease
Mumps
Tetanus
Chickenpox
Cholera
Ebola haemorrhagic fever Human papillomavirus
Influenza
Measles
Pertussis
Pneumococcus
Poliomyelitis
Rabies
RotavirusRubella
Tuberculosis
Typhoid fever
Viral encephalitis
Yellow fever
10%
9
Biological interventions
Sources
• people
• animals
t
(break cycle)
• water• food
• air
Biological interventionsTarget:
• hygiene
• sanitation
• vectors• vectors• reservoir hosts
• environments
• behaviours
It is all about education!‘night-soil’ pots
Life in the tropics is tough!
ENJOY THE CONGRESS!