October 2007, Volume 20, Issue 5, pp.449-559 Editorial introductions vii Editorial introductions. Tropical and travel-associated diseases 449 Etiology of travel-related fever. Mary E Wilson; David O Freedman 454 Meningococcal vaccine in travelers. Annelies Wilder-Smith 461 Preerythrocytic malaria vaccine development. Sebastian A Mikolajczak; Ahmed SI Aly; Stefan HI Kappe 467 Asexual blood-stage malaria vaccine development: facing the challenges. Blaise Genton; Zarifah H Reed 476 Mosquito stage, transmission blocking vaccines for malaria. Allan Saul 482 Immune reconstitution disease associated with parasitic infections following initiation of antiretroviral therapy. Stephen D Lawn 489 Zoonotic helminth infections of humans: echinococcosis, cysticercosis and fascioliasis. Hector H Garcia; Pedro L Moro; Peter M Schantz 495 Crimean-Congo hemorrhagic fever. Regina Vorou; Ioannis N Pierroutsakos; Helen C Maltezou Gastrointestinal infections 501 Rotavirus vaccines: entering a new stage of deployment. Osamu Nakagomi; Nigel A Cunliffe 508 The normal intestinal microbiota. Julian Marchesi; Fergus Shanahan 514 The second century of Campylobacter research: recent advances, new opportunities and old problems. Nick Dorrell; Brendan W Wren 519 Below the belt: new insights into potential complications of HIV- 1/schistosome coinfections. W Evan Secor; J Bruce Sundstrom 524 Intestinal cestodes. Philip Craig; Akira Ito Current World Literature Bibliography 533 Current World Literature. Editorial introductions Current Opinion in Infectious Diseases was launched in 1988. entitled ‘‘Endemic Infectious Diseases of the Peruvian It is part of a successful series of review journals whose Amazon’’. His research is supported by grants from the unique format is designed to provide a systematic and United States Public Health Service, National Institutes critical assessment of the literature as presented in the of Health. many primary journals. The field of infectious diseases is divided into 12 sections that are reviewed once a year. Nicholas J. Beeching Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important After undergraduate studies topics at that time. Here we are pleased to introduce the and clinical medical school Section Editors for this issue. in Oxford, Nick Beeching qualified in 1977 and sub- sequently worked in training Section Editors posts in Liverpool, Adelaide, Birmingham and Auckland. Joseph M. Vinetz He was a consultant physi- cian (with gastroenterology) Dr Vinetz graduated from in Khamis Mushayt, Yale University and received southern Saudi Arabia, for his medical degree from the 2 years before taking up University of California, San his current posts in Liver- Diego (UCSD). He has com- pool in l987. He combines pleted a residency in internal teaching and research activities as Senior Lecturer in medicine and a fellowship in Infectious Diseases at the Liverpool School of Tropical infectious diseases at Johns Medicine with clinical and administrative duties as Lead Hopkins School of Medicine. Consultant, Tropical and Infectious Disease Unit, Royal He was also a Howard Liverpool University Hospital. Among his clinical and Hughes Medical Institute research interests are parasitic infections of the bowel, Physician Postdoctoral Fel- salmonella infections, HIV, hepatitis and ‘‘emerging’’ low at the National Institutes and imported diseases and zoonoses, He also has a strong of Health. Prior to joining the interest in postgraduate medical education and has UCSD faculty in 2003, he was an infectious diseases served as Chair of the Specialist Advisory Committee specialist at the University of Texas Medical Branch, in Infectious Diseases and Tropical Medicine and of the Galveston and of the World Health Organization’s DTM&H examinations board of the Royal College of Collaborating Center for Tropical Diseases at Galveston. Physicians of London. He has published over 140 peer- His research focuses on tropical infectious diseases. reviewed papers, numerous book chapters and 5 books, His laboratory takes a comprehensive approach from and has just stepped down after a 3 year term as President laboratory bench to bedside, encompassing mechanistic of the British Infection Society. molecular biology, biochemistry, immunology and cell biology approaches to the study of malaria transmission C. Anthony Hart and leptospirosis, a disease transmitted from infected mammals (wild and domestic) to humans via infected Professor Hart graduated from The Royal Free Hospital urine. A key component of his research program is School of Medicine, University of London in 1972 and field work in the Peruvian Amazon city of Iquitos, where after house jobs in London completed a PhD in Cell he maintains a state-of-the-art laboratory in collaboration Biology. He is currently Professor of Medical Micro- with investigators from Peru and the United States. He is biology in The University of Liverpool, (since 1986) program director of a training program supported by the and is Honorary Consultant Medical Microbiologist to U.S. National Institutes of Health, in partnership with the The Royal Liverpool and Alder Hey Children’s Hospi- Universidad Peruana Cayetano Heredia, Lima, Peru tals. His research interests are in infections in children in Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Editorial introductions both developed and devel- piratory viruses (RSV and human metapneumovirus), oping countries; in particular infections in cystic fibrosis, zoonoses (he is co-director diarrhoeal disease (entero- of the National Centre for Zoonosis Research) and the pathic viruses, enteropathic genetics and molecular epidemiology of antimicrobial E. coli and Cryptosporidium), resistance. He has published over 800 primary articles, meningococcal disease, res- reviews, books and book chapters on these topics. Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Etiology of travel-related fever Mary E. Wilsona and David O. Freedmanb Purpose of review Introduction Many potentially life-threatening infections cause fever. Fever in returned travelers demands immediate attention Several recent large studies help to define causes of fever in because some causes, such as falciparum malaria, can returned travelers. progress rapidly and can be fatal. Complicating Recent findings the evaluation is the wide range of infections that can The destination of travel determines the relative likelihood of be acquired in other geographic regions and the wide the different major causes of fever. Systemic febrile illness range in incubation periods, ranging from days to years occurs disproportionately among ill travelers returning from [1]. Many of these infections are treatable with specific sub-Saharan Africa. Malaria remains the most important interventions. Some are easily transmissible from person overall cause of systemic febrile illness in travelers to to person and have public health implications, so rapid tropical regions; dengue fever is now the most prominent identification and institution of appropriate infection cause of fever in travelers to certain regions, most notably control measures is essential. Diagnostics for exotic dis- Asia. Chikungunya fever has emerged as a major cause of ease are expensive and often time consuming to obtain; fever in travelers to Indian Ocean islands off Africa and to resources need to be focused on the most likely causes for India itself. Causes of fever vary by the time of presentation the individual patient. Febrile returned travelers also after travel. Vivax malaria is an important cause of fever with have common, cosmopolitan infections, such as acute onset more than a month after return; recently studies have pyelonephritis, and occasionally have a noninfectious shown that parasites causing relapse are genetically disease, such as a drug reaction or pulmonary throm- distinct from those causing primary infection. At expert boembolism, that mimics infection. Several recently referral centers up to 25% of febrile patients have no published large studies of ill returned travelers provide specific cause of fever determined. new information for the clinician and a better under- Summary standing of the nature of relapse in vivax malaria. This Knowledge of predominant causes of febrile infections by review will focus on these studies that help to define geographic region, traveler characteristics, and time of causes of fever by traveler characteristics and area of presentation can assist the clinician in guiding posttravel travel; studies that provide new insights about malaria, diagnosis and empiric therapy of ill returned travelers and is the most important cause of fever in returned travelers; also valuable in pretravel preparation. and a brief overview of chikungunya fever. Keywords Causes of fever in ill returned travelers chikungunya, fever, ill returned travelers, malaria Older studies have assessed causes of fever in returned travelers but most have drawn patients from a single Curr Opin Infect Dis 20:449–453. ß 2007 Lippincott Williams & Wilkins. institution or region or have focused on a specific disease, age group, or type of traveler. Some have included only aHarvard Medical School, Harvard School of Public Health, Boston and Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts and bWC Gorgas hospitalized patients. Many of the available studies may Center for Geographic Medicine, Division of Infectious