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Home , Angiostrongyliasis, Dientamoebiasis, Gas gangrene, Kingella kingae, Metagonimiasis, Pasteurellosis

Tropical Medicine Theme Park in Brandenburg, Germany!

This scene is from Germany!

Welcome to Brisbane Self-introduction

almost-tropics Peter O’Donoghue Tropical Medicine University of perspective:

Queensland • personalized

Brisbane • narcissitic

MY FAMILY’S TROPICAL ODYSSEY

Background Familial experiences with ‘TROPICS’

Uncle Scotland  India died! Irish Scottish Sean (tea plantations)

Oz hbidhybrid ague moved to [malaria] () Brisbane

(almost-tropics)

1 Familial experiences with ‘TROPICS’ Familial experiences with ‘TROPICS’

Uncle Germany  Africa died! Uncle France  Egypt died! David (cattle) Jean-Paul (work on dam)

bilharzia () (helminth)

Familial experiences with ‘TROPICS’ Familial experiences with ‘TROPICS’

Uncle Holland  East Indies died! Uncle USA  Panama died! Rutger (spice plantations) Clint (work on canal)

crypto- yellow coccosis (fungus) ()

Familial experiences with ‘TROPICS’ Tropics can be dangerous!

Uncle China  New Guinea died! Presence of nasty infectious diseases Jet (gold mines)

screw worm (arthropod)

(six exemplars linked to colonial development)

2 Tropical Medicine Tropics Field developed to protect health of colonists bound by latitudes where sun is directly overhead for at least one day per year

23. 4N TiTropic of Cancer

23.4S Tropic of Capricorn

early Schools/Institutes not in tropics 36% of land mass

Population Temperature

40% of people warm (year-long)

~3 billion no winter

Rainfall Agriculture

wet (60% global rainfall) subsistence level (where possible)

≥ 1 m per year bulk cropping in temperate zones

3 Economic wealth Healthcare poor (25% global GDP) 10% global expenditure (per capita)

many developing countries poor infrastructure

Tropical Medicine Germ theory Micro-parasites Macro-parasites radical changes in knowledge and beliefs bacteria protozoa fungi helminths arthropods

nano-metres micro-metres milli-metres centi-metres multiplicative in host cumulative in host severe acute diseases chronic diseases

diseases not caused by spirits, spells, miasmas, etc...

37% bacterial (86) 29% viral (65) # infectious diseases [Wiki N = 240] # infectious diseases [Wiki N = 240] 13% helminth (30) 12% fungal (28) 7% protozoan (17) 2% arthropod (5) Acinetobacter Chromoblastomycosis influenzae Acinetobacter Chromoblastomycosis Meningococcal disease Schistosomiasis Actinomycosis Hand, foot & mouth disease Actinomycosis Clonorchiasis Hand, foot & mouth disease Metagonimiasis Sepsis African difficile Hantavirus pulmonary syndrome Microsporidiosis Clostridium difficile colitis Hantavirus pulmonary syndrome Microsporidiosis Shigellosis Acquired immunodeficiency Coccidioidomycosis Heartland virus disease Molluscum contagiosum Shingles Acquired immunodeficiency Coccidioidomycosis Heartland virus disease Molluscum contagiosum Shingles syndrome Colorado tick fever Monkeypox Smallpox syndrome Colorado tick fever Helicobacter pylori Monkeypox Smallpox Common cold (acute viral Haemolytic uremic syndrome Mumps Sporotrichosis Amoebiasis Common cold (acute viral Haemolytic uremic syndrome Mumps Sporotrichosis rhinopharyngitis, acute coryza) Haemorrhagic fever with Murine (endemic) Staphylococcoal food poisoning Anaplasmosis rhinopharyngitis, acute coryza) Haemorrhagic fever with (endemic) Staphylococcoal food poisoning Creutzfeldt-Jacob disease (CJD) renal syndrome Staphylococcus Angiostrongyliasis Creutzfeldt-Jacob disease (CJD) renal syndrome Staphylococcus Anisakiasis Crimean-Congo haemorrhagic fever A Mycetoma Anisakiasis Crimean-Congo haemorrhagic fever Hepatitis A Mycetoma Strongyloidiasis Anthrax Cryptococcosis Hepatitis B Myiasis Subacute sclerosing Anthrax Cryptococcosis Hepatitis B Myiasis Subacute sclerosing Arcanobacterium haemolyticum Cryptosporidiosis Hepatitis C Neonatal conjunctivitis panencephalitis Arcanobacterium haemolyticum Cryptosporidiosis Hepatitis C Neonatal conjunctivitis panencephalitis Argentine haemorrhagic fever Cutaneous larval migrans Hepatitis D New –variant CJD Argentine haemorrhagic fever Cutaneous larval migrans Hepatitis D New –variant CJD Syphilis Cyclosporiasis Hepatitis E Ascariasis Cyclosporiasis Hepatitis E Nocardiosis Taeniasis Aspergillosis Herpes simplex Aspergillosis Cysticercosis Herpes simplex Onchocerciasis Tetanus Astrovirus Cytomegalovirus Histoplasmosis Tinea barbae Astrovirus Cytomegalovirus Histoplasmosis Opisthorchiasis Tinea barbae Babesiosis Dengue fever Paracoccidioidomycosis Tinea capitis Babesiosis Dengue fever Hookworm Paracoccidioidomycosis Tinea capitis cereus Desmodesmus bocavirus Tinea corporis Desmodesmus Human bocavirus Paragonimiasis Tinea corporis Bacterial pneumonia Dientamoebiasis Human ewingii Tinea cruris Bacterial pneumonia Dientamoebiasis Human ewingii ehrlichiosis Pasteurellosis Tinea cruris Bacterial vaginosis Diphtheria Human granulocytic anaplasmosis Pediculosis capitis Tinea manum Bacterial vaginosis Diphtheria Human granulocytic anaplasmosis Pediculosis capitis Tinea manum Human metapneumovirus Pediculosis corporis Tinea nigra Bacteroides Diphyllobothriasis Human metapneumovirus Pediculosis corporis Tinea nigra Balantidiasis Human monocytic ehrlichiosis Pediculosis pubis Tinea pedis Balantidiasis Dracunculiasis Human monocytic ehrlichiosis Pediculosis pubis Tinea pedis Ebola haemorrhagic fever Human papillomavirus Pelvic inflammatory disease Tinea unguium Bartonellosis Ebola haemorrhagic fever Human papillomavirus Pelvic inflammatory disease Tinea unguium Human parainfluenza virus Pertussis Tinea versicolor Baylisascaris Echinococcosis Human parainfluenza virus Pertussis Tinea versicolor BK virus Ehrlichiosis (ocular) BK virus Ehrlichiosis Hymenolepiasis Plague Toxocariasis (ocular) Black piedra Enterobiasis Epstein-Barr virus infectious Pneumococcus Toxocariasis (visceral) Black piedra Enterobiasis Epstein-Barr virus infectious Pneumococcus Toxocariasis (visceral) Blastocystosis mononucleosis Pneumocystis pneumonia Trachoma Blastocystosis Enterococcus mononucleosis Pneumocystis pneumonia Trachoma Blastomycosis Enterovirus Influenza Pneumonia Toxoplasmosis Blastomycosis Enterovirus Influenza Pneumonia Toxoplasmosis Bolivian haemorrhagic fever Isosporiasis Poliomyelitis Bolivian haemorrhagic fever Epidemic typhus Isosporiasis Poliomyelitis Trichinosis Erythema infectiosum (fifth disease) Kawasaki disease Prevotella Botulism Erythema infectiosum (fifth disease) Kawasaki disease Prevotella Trichomoniasis Brazilian haemorrhagic fever Exathem subitum (sixth disease) Primary amoebic Brazilian haemorrhagic fever Exathem subitum (sixth disease) Keratitis Primary amoebic meningoencephalitis Trichuriasis Fasciolasis kingae Progressive multifocal Tuberculosis Brucellosis Fasciolasis Progressive multifocal Tuberculosis Kuru leukoencephalopathy Bubonic plague Fasciolopsiasis Kuru leukoencephalopathy Tularemia Burkholderia Fatal familial insomnia Lassa fever Psittacosis Burkholderia Fatal familial insomnia Lassa fever Psittacosis Typhoid fever Legionellosis (Legionnaire’s disease) Typhus fever Buruli ulcer Filariasis Legionellosis (Legionnaire’s disease) Q fever Typhus fever Calcivirus (Norovirus, Sapovirus) Food poisoning (Cl. perfringens) Legionellosis () Rabies Calcivirus (Norovirus, Sapovirus) Food poisoning (Cl. perfringens) Legionellosis (Pontiac fever) Rabies Ureaplasma urealyticum Free-living amoebae Relapsing fever Valley fever Campylobacteriosis Free-living amoebae Leishmaniasis Relapsing fever Valley fever Candidiasis (moniliasis, thrush) Fusobacterium Respiratory syncytial virus Venezuelan equine encephalitis Candidiasis (moniliasis, thrush) Fusobacterium Leprosy Respiratory syncytial virus Venezuelan equine encephalitis Gas (Cl. myonecrosis) Rhinosporidiosis Venezuelan haemorrhagic fever Capillariasis (Cl. myonecrosis) Leptospirosis Rhinosporidiosis Venezuelan haemorrhagic fever Carrion’s disease Geotrichosis Listerosis Rhinovirus vulnificus Carrion’s disease Geotrichosis Listerosis Rhinovirus -scratch disease Gerstmann-Straussler-Scheinker Rickettsia Cat-scratch disease Gerstmann-Straussler-Scheinker Lyme disease Rickettsia Vibrio parahaemolyticus syndrome Viral encephalitis Cellulitis syndrome Lymphatic filariasis Rickettsialpox Viral encephalitis Lymphocytic choriomeningitis Rift valley fever Viral pneumonia Chagas disease Giardiasis Lymphocytic choriomeningitis Rift valley fever Viral pneumonia Malaria Rocky Mountain West Nile fever Chancroid Glanders Malaria Rocky Mountain spotted fever West Nile fever Chickenpox Marburg haemorrhagic fever Rotavirus White piedra Chickenpox Gnathostomiasis Marburg haemorrhagic fever Rotavirus White piedra Chikungunya Gonorrhoea Measles Rubella Yersinia pseudotuberculosis Chikungunya Gonorrhoea Measles Rubella Yersinia pseudotuberculosis (donovanosis) Middle-East respiratory syndrome Chlamydia Granuloma inguinale (donovanosis) Middle-East respiratory syndrome Salmonellosis Yersiniosis Chlamydophila pneumoniae Group A Severe acute respiratory syndrome Yellow fever Chlamydophila pneumoniae Group A Streptococcus Melioidosis Severe acute respiratory syndrome Yellow fever Group B Streptococcus Scabies Zygomycosis Cholera Group B Streptococcus Meningitis Scabies Zygomycosis

4 VIRUSES: genetic vagrants! BACTERIA: biochemical bags!

influenza virus

in cytoplasm

anthrax herpes coldsore

FUNGI: zombie-eaters! PROTOZOA: ‘first ’!

flagellates

leishmaniasis filamentous hyphae ciliates

amoebae

ovoid yeasts athlete’s foot sporozoa

HELMINTHS: squirmy worms! ARTHROPODS: mini-vampires!

insects hookworm - larval migrans

tick bite cestodes

arachnids trematodes

5 Exemplars of dermal lesions Vascular

Usually sensationalize topic with gory images

Lucky it is a public pre-dinner talk

(sanitized images)

Visceral Enteric

Venereal Cost of tropical diseases Most common causes of mortality due to infectious diseases (where cause of death is known, ~ 16 million per annum): • acute respiratory 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 () 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

6 Epidemiology 1. FOUNDATION Followed 3 main periods in human history:

1. Foundation (thousands of years ago)

2. Empire (hundreds of years ago) Humanoid African origins > 10,000 YA hunter/gatherers Old World diseases (, , lesions) 3. Second Foundation (tens of years ago) Out-of-Africa migrations >7,000 YA farmers  villagers New World ‘crowd’ diseases (, poxes, plagues, ) apologies to Asimov Separation of New and Old Worlds (Sahara desert)

2. EMPIRE 3. SECOND FOUNDATION

>300 YA Explorers ‘discover’ tropical lands 50 YA Globalization, population translocations (wars, migration, encounter Old World diseases, spread New World diseases international travel, trade, commerce, tourism, work, etc) 200 YA Slave trade, labour force tougher, more resistant Emerging/re-emerging diseases, esp. zoonoses (rats/bats/birds) mixing of New and Old World peoples and diseases

What can be done? Drug discovery Disease management through: Kinch et al. 2014 Drug Discovery Today

New •Drugs Molecular Entities

• Vaccines

• Biological interventions

7 Infectious diseases (n=240) Diseases for which drugs are available (n=160)

Acinetobacter Chromoblastomycosis Haemophilus influenzae Meningococcal disease Schistosomiasis Acinetobacter Chromoblastomycosis Haemophilus influenzae Meningococcal disease Schistosomiasis Actinomycosis Clonorchiasis Hand, foot & mouth disease Metagonimiasis Sepsis Actinomycosis Clonorchiasis Metagonimiasis Sepsis African trypanosomiasis Clostridium difficile colitis Hantavirus pulmonary syndrome Microsporidiosis Shigellosis African trypanosomiasis Clostridium difficile colitis Shigellosis Acquired immunodeficiency Coccidioidomycosis Heartland virus disease Molluscum contagiosum Shingles Acquired immunodeficiency Coccidioidomycosis syndrome Colorado tick fever Helicobacter pylori Monkeypox Smallpox syndrome Helicobacter pylori Amoebiasis Common cold (acute viral Haemolytic uremic syndrome Mumps Sporotrichosis Amoebiasis Haemolytic uremic syndrome Sporotrichosis Anaplasmosis rhinopharyngitis, acute coryza) Haemorrhagic fever with Murine typhus (endemic) Staphylococcoal food poisoning Anaplasmosis Murine typhus (endemic) Staphylococcoal food poisoning Angiostrongyliasis Creutzfeldt-Jacob disease (CJD) renal syndrome Mycoplasma pneumonia Staphylococcus Angiostrongyliasis Staphylococcus Anisakiasis Crimean-Congo haemorrhagic fever Hepatitis A Mycetoma Strongyloidiasis Strongyloidiasis Anthrax Cryptococcosis Hepatitis B Myiasis Subacute sclerosing Anthrax Cryptococcosis Myiasis Arcanobacterium haemolyticum Cryptosporidiosis Hepatitis C Neonatal conjunctivitis panencephalitis Arcanobacterium haemolyticum Hepatitis C Neonatal conjunctivitis Argentine haemorrhagic fever Cutaneous larval migrans Hepatitis D New –variant CJD Syphilis Cutaneous larval migrans Syphilis Ascariasis Cyclosporiasis Hepatitis E Nocardiosis Taeniasis Ascariasis Cyclosporiasis Nocardiosis Taeniasis Aspergillosis Cysticercosis Herpes simplex Onchocerciasis Tetanus Aspergillosis Onchocerciasis Tetanus Astrovirus Cytomegalovirus Histoplasmosis Opisthorchiasis Tinea barbae Histoplasmosis Opisthorchiasis Tinea barbae Babesiosis Dengue fever Hookworm Paracoccidioidomycosis Tinea capitis Babesiosis Hookworm Tinea capitis Bacillus cereus Desmodesmus Human bocavirus Paragonimiasis Tinea corporis Bacillus cereus Paragonimiasis Tinea corporis Bacterial pneumonia Dientamoebiasis Human ewingii ehrlichiosis Pasteurellosis Tinea cruris Bacterial pneumonia Dientamoebiasis Human ewingii ehrlichiosis Pasteurellosis Tinea cruris Bacterial vaginosis Diphtheria Human granulocytic anaplasmosis Pediculosis capitis Tinea manum Bacterial vaginosis Human granulocytic anaplasmosis Pediculosis capitis Tinea manum Bacteroides Diphyllobothriasis Human metapneumovirus Pediculosis corporis Tinea nigra Bacteroides Diphyllobothriasis 67%Pediculosis corporis Tinea nigra Balantidiasis Dracunculiasis Human monocytic ehrlichiosis Pediculosis pubis Tinea pedis Balantidiasis Human monocytic ehrlichiosis Pediculosis pubis Tinea pedis Bartonellosis Ebola haemorrhagic fever Human papillomavirus Pelvic inflammatory disease Tinea unguium Bartonellosis Pelvic inflammatory disease Tinea unguium Baylisascaris Echinococcosis Human parainfluenza virus Pertussis Tinea versicolor Baylisascaris Echinococcosis Tinea versicolor BK virus Ehrlichiosis Hymenolepiasis Plague Toxocariasis (ocular) Ehrlichiosis Hymenolepiasis Plague Toxocariasis (ocular) Black piedra Enterobiasis Epstein-Barr virus infectious Pneumococcus Toxocariasis (visceral) Black piedra Enterobiasis means Pneumococcus Toxocariasis (visceral) Blastocystosis Enterococcus mononucleosis Pneumocystis pneumonia Trachoma Enterococcus Pneumocystis pneumonia Trachoma Blastomycosis Enterovirus Influenza Pneumonia Toxoplasmosis Blastomycosis Pneumonia Toxoplasmosis Bolivian haemorrhagic fever Epidemic typhus Isosporiasis Poliomyelitis Trichinosis Epidemic typhus Isosporiasis Trichinosis Botulism Erythema infectiosum (fifth disease) Kawasaki disease Prevotella Trichomoniasis Botulism Prevotella Trichomoniasis Brazilian haemorrhagic fever Exathem subitum (sixth disease) Keratitis Primary amoebic meningoencephalitis Trichuriasis Keratitis33% are Trichuriasis Brucellosis Fasciolasis Kingella kingae Progressive multifocal Tuberculosis Brucellosis Fasciolasis Kingella kingae Tuberculosis Bubonic plague Fasciolopsiasis Kuru leukoencephalopathy Tularemia Fasciolopsiasis Tularemia Burkholderia Fatal familial insomnia Lassa fever Psittacosis Typhoid fever Psittacosis Typhoid fever Buruli ulcer Filariasis Legionellosis (Legionnaire’s disease) Q fever Typhus fever Buruli ulcer Filariasis Legionellosis (Legionnaire’s disease) Q fever Typhus fever Calcivirus (Norovirus, Sapovirus) Food poisoning (Cl. perfringens) Legionellosis (Pontiac fever) Rabies Ureaplasma urealyticum Food poisoning (Cl. perfringens) untreatableLegionellosis (Pontiac fever) Ureaplasma urealyticum Campylobacteriosis Free-living amoebae Leishmaniasis Relapsing fever Valley fever Campylobacteriosis Leishmaniasis Relapsing fever Valley fever Candidiasis (moniliasis, thrush) Fusobacterium Leprosy Respiratory syncytial virus Venezuelan equine encephalitis Candidiasis (moniliasis, thrush) Fusobacterium Leprosy Capillariasis Gas gangrene (Cl. myonecrosis) Leptospirosis Rhinosporidiosis Venezuelan haemorrhagic fever Capillariasis Gas gangrene (Cl. myonecrosis) Leptospirosis Carrion’s disease Geotrichosis Listerosis Rhinovirus Vibrio vulnificus Carrion’s disease Geotrichosis Listerosis Vibrio vulnificus Cat-scratch disease Gerstmann-Straussler-Scheinker Lyme disease Rickettsia Vibrio parahaemolyticus Lyme disease Rickettsia Vibrio parahaemolyticus Cellulitis syndrome Lymphatic filariasis Rickettsialpox Viral encephalitis Cellulitis Lymphatic filariasis Rickettsialpox Chagas disease Giardiasis Lymphocytic choriomeningitis Rift valley fever Viral pneumonia Chagas disease Giardiasis Chancroid Glanders Malaria Rocky Mountain spotted fever West Nile fever Chancroid Malaria Rocky Mountain spotted fever Chickenpox Gnathostomiasis Marburg haemorrhagic fever Rotavirus White piedra Gnathostomiasis Rotavirus White piedra Chikungunya Gonorrhoea Measles Rubella Yersinia pseudotuberculosis Gonorrhoea Yersinia pseudotuberculosis Chlamydia Granuloma inguinale (donovanosis) Middle-East respiratory syndrome Salmonellosis Yersiniosis Chlamydia Granuloma inguinale (donovanosis) Salmonellosis Yersiniosis Chlamydophila pneumoniae Group A Streptococcus Melioidosis Severe acute respiratory syndrome Yellow fever Group A Streptococcus Melioidosis Cholera Group B Streptococcus Meningitis Scabies Zygomycosis Cholera Group B Streptococcus Meningitis Scabies Zygomycosis

Diseases with drug-resistance problems (n=55) Vaccines

Acinetobacter Chromoblastomycosis Haemophilus influenzae Meningococcal disease Actinomycosis Sepsis African trypanosomiasis Shigellosis Acquired immunodeficiency Coccidioidomycosis syndrome Helicobacter pylori Amoebiasis Haemolytic uremic syndrome Staphylococcoal food poisoning Staphylococcus

Myiasis Neonatal conjunctivitis Syphilis Nocardiosis

Babesiosis

Bacterial pneumonia Bacterial vaginosis Pediculosis capitis Bacteroides Pediculosis corporis Pediculosis pubis 34% Pelvic inflammatory disease

Pneumococcus Enterococcus Pneumonia

Trichomoniasis Keratitis Brucellosis Fasciolasis Kingella kingae Tuberculosis Fasciolopsiasis Typhoid fever Buruli ulcer Food poisoning (Cl. perfringens) Leishmaniasis Valley fever Leprosy

Vibrio vulnificus

Cellulitis Lymphatic filariasis Chagas disease Giardiasis Chancroid Malaria

Gonorrhoea Salmonellosis Group A Streptococcus Meningitis Scabies

Infectious diseases (n=240) Vaccination-preventable diseases (n=24)

Acinetobacter Chromoblastomycosis Haemophilus influenzae Meningococcal disease Schistosomiasis Haemophilus influenzae Meningococcal disease Actinomycosis Clonorchiasis Hand, foot & mouth disease Metagonimiasis Sepsis African trypanosomiasis Clostridium difficile colitis Hantavirus pulmonary syndrome Microsporidiosis Shigellosis Acquired immunodeficiency Coccidiomycosis Heartland virus disease Molluscum contagiosum Shingles syndrome Colorado tick fever Helicobacter pylori Monkeypox Smallpox Amoebiasis Common cold (acute viral Haemolytic uremic syndrome Mumps Sporotrichosis Mumps Anaplasmosis rhinopharyngitis, acute coryza) Haemorrhagic fever with Murine typhus (endemic) Staphylococcoal food poisoning Angiostrongyliasis Creutzfeldt-Jacob disease (CJD) renal syndrome Mycoplasma pneumonia Staphylococcus Anisakiasis Crimean-Congo haemorrhagic fever Hepatitis A Mycetoma Strongyloidiasis Hepatitis A Anthrax Cryptococcosis Hepatitis B Myiasis Subacute sclerosing Hepatitis B Arcanobacterium haemolyticum Cryptosporidiosis Hepatitis C Neonatal conjunctivitis panencephalitis Argentine haemorrhagic fever Cutaneous larval migrans Hepatitis D New –variant CJD Syphilis Hepatitis D Ascariasis Cyclosporiasis Hepatitis E Nocardiosis Taeniasis Aspergillosis Cysticercosis Herpes simplex Onchocerciasis Tetanus Tetanus Astrovirus Cytomegalovirus Histoplasmosis Opisthorchiasis Tinea barbae Babesiosis Dengue fever Hookworm Paracoccidiomycosis Tinea capitis Bacillus cerreus Desmodesmus Human bocavirus Paragonimiasis Tinea corporis Bacterial pneumonia Dientamoebiasis Human ewingii ehrlichiosis Pasteurellosis Tinea cruris Bacterial vaginosis Diphtheria Human granulocytic anaplasmosis Pediculosis capitis Tinea manum Diphtheria Bacteroides Diphyllobothriasis Human metapneumovirus Pediculosis coprporis Tinea nigra Balantidiasis Dracunculiasis Human monocytic ehrlichiosis Pediculosis pubis Tinea pedis Bartonellosis Ebola haemorrhagic fever Human papillomavirus Pelvic inflammatory disease Tinea unguium Ebola haemorrhagic fever Human papillomavirus Baylisascaris Echinococcosis Human parainfluenza virus Pertussis Tinea versicolor Pertussis BK virus Ehrlichiosis Hymenolepiasis Plague Toxocariasis (ocular) Black piedra Enterobiasis Epstein-Barr virus infectious Pneumococcus Toxocariasis (visceral) Pneumococcus Blastocystosis Enterococcus mononucleosis Pneumocystis pneumonia Trachoma Blastomycosis Enterovirus Influenza Pneumonia Toxoplasmosis Influenza Bolivian haemorrhagic fever Epidemic typhus Isosporiasis Poliomyelitis Trichinosis Poliomyelitis Botulism Erythema infectiosum (fifth disease) Kawasaki disease Prevotella Trichomoniasis Brazilian haemorrhagic fever Exathem subitum (sixth disease) Keratitis Primary amoebic meningoencephalitis Trichuriasis Brucellosis Fasciolasis Kingella kingae Progressive multifocal Tuberculosis Tuberculosis Bubonic plague Fasciolopsiasis Kuru leukoencephalopathy Tularemia Burkholderia Fatal familial insomnia Lassa fever Psittacosis Typhoid fever Typhoid fever Buruli ulcer Filariasis Legionellosis (legionnaire’s disease) Q fever Typhus fever Calcivirus (Norovirus, Sapovirus) Food poisoning (Cl. perfringens) Legionellosis (Pontiac fever) Rabies Ureaplasma urealyticum Rabies Campylobacteriosis Free-living amoebae Leishmaniasis Relapsing fever Valley fever Candidiasis (moniliasis, thrush) Fusobacterium Leprosy Respiratory syncytial virus Venezuelan equine encephalitis Capillariasis Gas gangrene (Cl. myonecrosis) Leptospirosis Rhinosporidiosis Venezuelan haemorrhagic fever Carrion’s disease Geotrichosis Listerosis Rhinovirus Vibrio vulnificus Cat-scratch disease Gerstmann-Straussler-Scheinker Lyme disease Rickettsia Vibrio parahaemolyticus Cellulitis syndrome Lymphatic filariasis Rickettsialpox Viral encephalitis 10% Viral encephalitis Chagas disease Giardiasis Lymphocytic choriomeningitis Rift valley fever Viral pneumonia Chancroid Glanders Malaria Rocky Mountain spotted fever West Nile fever Chickenpox Gnathostomiasis Marburg haemorrhagic fever Rotavirus White piedra Chickenpox Rotavirus Chikungunya Measles Rubella Yersinia pseudotuberculosis Measles Rubella Chlamydia Granuloma inguinale (donovanosis) Middle-East respiratory syndrome Salmonellosis Yersiniosis Chlamydophila pneumoniae Group A Streptococcus Melioidosis Severe acute respiratory syndrome Yellow fever Yellow fever Cholera Group B Streptococcus Meningitis Scabies Zygomycosis Cholera

8 Biological interventions (break cycle) Biological interventions

Sources Target: • people • hygiene • animals • sanitation • water • vectors • food • reservoir hosts • air • environments • behaviours ‘night-soil’ pots It is all about education!

Life in the tropics is tough!

ENJOY THE CONGRESS!

9