Schistosomiasis in Travelers and Expatriates
|
|
- Tobias Todd
- 6 years ago
- Views:
Transcription
1 Schistosomiasis in Travelers and Expatriates Tomasjelinek, Hans-Dieter Nothduft, and Thomas Loscher Background: Several outbreaks of schistosomiasis among travelers, expatriates, and military serviceman have been reported in recent years. Methods: The travel histories and anamnestic and clinical features of 62 patients with schistosomiasis, who presented to a German outpatient clinic specializing in infectious and tropical diseases, were investigated to identify risk factors that could lead to infection in travelers and expatriates. Results: All patients remembered incidents that led to a likely exposure to cercariae of Schistosoma sp. Fifty nine patients (95%) acquired infection in Africa, two (3%) in South America, and one each (2% each) in Iraq and the Mekong River, respectively. The highest proportion of infection (45%) was imported from West Africa. Patients returning from West Africa reported either contact with tributaries of the Niger (including freshwater pools in the Dogon country, Mali) or with waters of the Volta River, notably Lake Volta and/or its delta. Six patients (10%) acquired infection in little-visited areas such as Central Africa and the Congo Basin. East Africa (especially Lake Victoria) and Lake Malawi contributed 14 patients (22%) to our study group; a further nine patients (14%) became infected after contact with waters of the Zambezi River. Conclusions: The most sensitive method for detection of possible infection with schistosomiasis appeared to be a combination of thorough travel history and serologic testing by indirect hemagglutination (IHA), immunofluorescence antibody test (IFAT), and enzyme-linked immunosorbent assay (ELSA). Most infections were acquired by travelers on lengthy and adventurous journeys or by expatriates venturing outside their normal areas of activity. Most patients knew that they had traveled in an area endemic for schistosomiasis, but were uninformed about behavioral risks they had taken in specific settings. Schistosomiasis is a curable parasitic infection caused by trematodes (flukes). The disease is endemic in 74 countries in Africa, South America, the Caribbean, and Asia.' Man acquires the infection during exposure to fresh water containing cercariae, the infective form of Srhistosoma sp. Infected snails, the specific intermediate hosts, release cercariae into fresh water where they penetrate actively the intact shn of definite hosts, e.g., humans. Penetration can cause intense itching and a papular rash, cercarial dermatitis. Katayama fever, the syndrome associated with acute schistosomiasis, coincides with larval maturation, migration, and early oviposition.2,3 Katayania fever may develop 2-10 weeks following the initial infection of nonimmune individuals and is, therefore, rarely seen in indigenous populations in endemic area^.^,^ Katayania syndrome is characterized by fever, chills, weakness, weight loss, headache, anorexia, nausea, voniiting, diarrhea, abdominal cramps, tenderness and enlargement of the liver, myalgia and arthralgia, dry cough, dyspnea, and scattered soft mottling of the lung fields on Tornas Jelinek, MD, Hans-Dieter Nothdurft, MD, and Thomas Loscher, MD: Department of Infectious Diseases and Tropical Medicine, University of Munich, Germany. Reprint requests: Dr. Tomas Jelinek, Department of Infectious Diseases and Tropical Medicine, Leopoldstrasse 5, Munchen, Germany J Travel Med 1996; 3: chest films.' Onset may be sudden, followed by a mild to severe, sometimes life threatening, disease. Hypereosinophilia is a common feature. Chronic schistosoniiasis is characterized by inflammation and subsequent fibrosis of tissues infected by schistosoine eggs. The chronic form of schistosomiasis typically develops years to decades after initial infection.' Several outbreaks of schistosomiasis among travelers, expatriates, and military serviceman have been reported in recent years.""."-"therefore, a good knowledge of endemic areas, risk groups, and risk behavior is warranted for those who give pretravel advice to tourists. To identify risk factors leading to infection in travelers and expatriates, we investigated travel histories and anamnestic and clinical features of patients with schistosoniiasis who presented at our outpatient clinic. Patients and Methods Patients Between 1990 and 1994,17,949 patients presented at the outpatient department of our infectious disease clinic for various medical reasons. Most of them had returned recently from a journey to tropical or subtropical areas. Of these 17,949 patients 31.9% had been to Africa, 34.9% to Asia, 19.3% to Central and South America, and 13.9% to other areas. Schistosoniiasis was diagnosed in 62 German patients returning from endemic countries.trave1 and case histories were analyzed for risk factors and behavior leading to infection. Individual data
2 Jelinek et al, Schistosomiasis in Travelers and Expatriates 161 points, stored in a coniputerized data base (Microsoft, Excel) were analyzed for statistical significance by Epi Info (World Health Organization [WHO], Geneva and the Centers for Ilisease Control [CUC], Atlanta). Methods Travelers were considered to be possibly infected if they reported an exposure to fresh water in endemic regions and/or presented with signs indicating acute or chronic schistosomiasis.' The diagnosis of schistosomiasis was considered confirnied if elevated antibody titers against Schistosomn mansoni antigens were detectable and/or living eggs of Schisfosoma sp. were present on microscopic examination of rectal snips, urine, or fecal material. '3-'h Blood saniples were collected from all 62 travelers with schistosoiniasis for hematologic and serologic testing. IgG antibodies to somatic (gut-associated polysaccharide) antigens of S. mansorii were assessed by inimunofluorescence antibody test (IFAT) and indirect heniagglutination (IHA), and antibodies to egg antigens were assessed by an immune-linked imniunosorbent assay (ELISA).I3,'' Elevated antibody titers were defined as factors (multiples of normal activity) 2 1 :64 in IFAT and IHA and factors > 10 in the ELISA. Stool samples of patients with suspected schistosomiasis were investigated for eggs by direct microscopy and formol-ether concentrati~n'~ as were the entire sediments of routine urine samples and urine samples collected over 24 hours. We suggested rectum biopsy and subsequent microscopic investigation of rectal snips for egg to all patients with positive serologic findings and negative results of stool and urine samples. However, 40 out of 55 patients declined these investigations for various reasons, chiefly because serologic testing suggested that a diagnosis of schistosomiasis was already highly likely. Treatment All 62 patients received a single dose of praziquantel (40 nig/kg) after diagnosis was established. Regular follow up examinations were performed for at least 12 months. Results Ofthe 62 investigated patients 14 (23%) were female and 48 (77%) were male.the mean age was 30 years.al1 patients were able to remember incidents that led to a likely exposure to cercariae of Schictosoma sp. Of the 62 patients 58 (95%) acquired infection in Africa, two (3%) 21% Iraq Amazon basin Figure 1 Areas of schistosome infection in travelers and expatriates (n = 62).
3 162 Journal of Travel Medicine, Volume 3, Number 3 in South America, and one each (2% each) in Iraq and the Mekong River, respectively (Fig. 1). The highest proportion of infection (45%) was imported from West Africa. Patients returning from this area reported either contact with tributaries of the Niger (including freshwater pools in the Dogon country, Mali) or with waters of thevolta River, notably LakeVolta and/or its delta. Six out of the 62 patients (1 0%) acquired infection in littlevisited areas such as Central Africa and the Congo Basin. East Africa (especially Lake Victoria) and Lake Malawi contributed 14 patients (22%) to our study group; a further nine (14%) became infected after contact with waters of the Zambezi River. Two groups clearly distinguishable emerged within our study population: travelers returning from a journey to an endemic area (40 patients, 65%) and expatriates returning after a lengthy professional stay (22 patients, 35%).The mean age of travelers was somewhat lower than that of the expatriates (30 years compared to 36 years). Eleven of the 40 travelers (27.5%) were female, whereas this was true for 3 out of22 expatriates (14%).Travelers stayed an average of 112 days (range days) within endemic areas.the mean time of residence was 1057 days in expatriates (range days). Some differences were noticed when the areas of infection in both groups were analyzed (Table 1). One major difference was the important role of thevolta River as a cause of schistosomiasis in expatriates. Eight of 22 patients, 36%, acquired infection in this location compared to its less important role in travelers (seven out of40 patients, 17%;p=.0018).Also notable was that 17% of the travelers acquired infection in Lake Malawi and 8% in the Congo River, whereas none of the expatriates became infected in these areas (p<.001 in both cases). A large proportion of expatriates (59%) and travelers (25%) presented without symptoms that suggested a schistosomiasis (Table 2). However, 23 of the 40 travelers (57%), and seven of the 22 expatriates (32%) developed Table 2 Clinical Signs and Symptoms in 62 Patients with Sc histosomiasis Travelers Expatriates Siyns and Symptoms (n = 40) (n = 22) Cercarial dermatitis" 2 (5%) 1 (4%) Symptoms of Katayama fevert 23 (57%) 7 (32%) Unspecific gastrointestinal 5 (13%) 1 (4%) complaints No symptoms 10 (25%) I 3 (59%) *Itching and papular rash; +Fever, chills, weakness, weight loss, headache, anorexia, nausea, vomiting, diarrhea, abdominal cramps, tenderness and enlargement of the liver, myalg~a and arthralgia, dry cough and dyspnea. symptoms that were suggestive of Katayama fever, notably fever and/or diarrhea.three of the expatriates and five of the travelers suspected malaria as the cause of their symptoms, and they had treated themselves with antimalarials (halofantrine or mefloquine) prior to referral to our outpatient clinic.another three travelers, assumed to have acute amoebiasis, took metronidazole; one traveler took a combined treatment against malaria and amoebiasis (metronidazole and mefloquine); and one traveler was treated for Lyme disease with doxycycline by his family doctor after return from his journey. None of these suspected infections could be confirmed retrospectively by serologic or parasitologic testing.the mean duration of symptoms before establishment of diagnosis was 54 days in travelers (range days) and 154 days in expatriates (range days). Hematologic findings were helpful in 21 out of 40 travelers (53%), who presented with eosinophilia (defined as values 27% of the leukocyte count), and in 14 out of 22 expatriates (64%). Travelers had a mean eosinophil count of 11% (range 0-50%$, and expatriates had a mean value of 12% (range 0-38%). Diagnosis was established in 16 patients (11 travelers and five expatriates) by microscopic detection of schistosome eggs either in urine (three patients), stool saniples (four patients), or in rectal snips (nine patients). Table 1 Areas of Infection with Schistosoma sp - Eleven of these 16 patients were infected with S. mun- Comparison between Travelers and Expatriates soni and five by S. huemutobium.the remaining 46 patients were found to be negative on repeated parasitologic Travelers Expatriates Area oflnfection (n = 40) = 22) examination of stool and urine samples. Six of these patients were also examined by rectoscopy, without any Amazon Basin 2 (5%) 0 positive finding. Forty patients refused rectoscopic exam- Iraq 0 1 (5%) Mekong River 0 (40/o) ination, chiefly because serologic testing suggested that Volta River 7 (17%)) 8 (36%) a diagnosis of schistosomiasis was already highly likely. Niger 11 imj 2 (9%) ' Elevated antibody titers in at least one out of the three Central Africa 1 (3%) 2 (9%) serologic tests performed (IFAT, IHA and ELISA'3,'4) were Nile 0 1 (4%) detected in all patients. East Africa 4 (10%) 3 (14%) Lake Malawi 7 (17%) 0 Treatment consisted of a single dose of praziquan- Congo River 3 (8%) 0 tel (40 mg/kg).all patients were closely followed for at Zambezi 5 (13%) 4 (18%) least 12 months. Relapses were detected in six patients
4 Jelinek et al. Schistosomiasis in Travelers and Expatriates 163 through the finding of viable eggs in urine or stool specimens (4 patients) or through the reoccurrence of eosinophiha and a marked increase of antibody titers compared to the last control (two patients), respectively. These patients were treated by a second course of praziquantel in the same dosage. No further relapses were detected. Discussion Typically, schistosomiasis is described as an infection of either the uninformed, the inexperienced, or the adventurous traveler.. Retrospectively, all 62 patients in our study were able to remember particular incidents that brought them into possible contact with infective cercariae. Judging from our study population, travel to Africa appears to bear an increased risk of infection compared to travel to other endemic areas. Ninety-five percent of all infections were acquired in Africa (see Fig. 1). Contact with tributaries of thevolta River or the Niger in West Africa (notably freshwater pools in Dogon country, Mali) was the probable cause in 45% of our patients.these findings correspond with several recently published reports about outbreaks of schistosomiasis among travelers to Dogon country and the Niger... Although important areas of infection among travelers in our study group, they were less important for infection in expatriates. Only two of the 22 investigated expatriates (9%) became infected in these areas, compared to 11 of 40 travelers (27%) (Table 1). Similar differences were noted for thevolta River, which was an important source of infection in expatriates (36%) and a less important source in travelers (17%); Lake Malawi, where 17% of the travelers and none of the expatriates became infected; and the Congo River (8% infection in travelers, none in expatriates). Questioning of the patients fiequently revealed a specific behavior that led to infection in specific areas.the delta of thevolta River and thevolta Lake in Ghana are popular destinations of expatriates working in the surrounding countries. These areas are visited on public holidays and on short recreation trips.the water of the delta is especially assumed to be free of cercariae since it blends with salt water from the sea. One expatriate reported that a sign, close to his hotel on the beach, stated there was no danger from schistosome infection in this area. He and his family developed typical signs of Katayama fever shortly after their stay at this beach. Patients who became infected after contact with the waters of the Niger reported either bathing in freshwater pools in the Dogon country, Mali, or participating in extended boat trips on the Niger, or both.these patients were aware of the danger of acquiring schistosomiasis fiom the Niger, but they were uninformed about the same danger in freshwater pools. Lake Malawi is now a popular destination with backpackers, who use it for snorkeling and scuba diving. All patients infected at Lake Malawi report extended freshwater contacts during their diving. Due to its excellent water quality, these travelers did not suspect that Lake Malawi harbored cercariae. The analysis of the symptoms, which led to presentation in our outpatient clinic, reveals no sensitive and specific clinical sign to guide towards a diagnosis of schistosomiasis. Katayama fever, a condition believed to be caused by an allergic reaction to migrating and maturing larvae, occurs only in nonimmune patients3 Its symptoms might easily be mistaken for signs of other infections, such as malaria, amoebiasis, or even Lyme disease, as the pretreatment of 13 of our patients demonstrates. Among our patients, single or multiple symptoms of Katayama syndrome were present in 57% of travelers and 32% of expatriates (Table 2). However, 25% of the travelers and 59% of the expatriates exhibited no symptoms at all; they merely presented for a routine examination after their return to Germany.An increased blood eosinophil count suggested a parasitic infection in these patients and led to further diagnostic procedures. Only in a minority of our patients (1 6 out of 62 patients) did the parasitologic examination of urine, stool specimens, and rectal snips confirm diagnosis. The most sensitive method for detection ofschistosomiasis appeared to be a combination of thorough travel history and serologic testing of all patients with possible infection. The availability of sensitive and specific serologic tests has facilitated the diagnosis of schistosomiasis, especially in cases with limited egg secretion and during the prepatent period, before egg production begins. ** Serologic testing has obviated the need for rectal biopsies to confirm diagnosis in patients with negative results in urine and stool examination. However, serology might be negative during the early stages of disease, and testing should therefore be repeated in cases with a travel history and clinical signs suggestive of schistosomiasis. Praziquantel is the current drug of choice for the treatment of schistosomiasis. Maturing larvae of Schktosoma sp. appear to be less vulnerable to the antihelminthic activity of the drug than adult parasites; therefore, treatment during the acute stages of infection is thought to be less effective than during the chronic stages. Early treatment has also been associated with severe allergic However, treatment with praziquantel is generally considered safe and effective, with few side effects. Patients reporting fieshwater contacts in endemic regions, and with significantly elevated antibody titers against schistosonie antigens, should therefore be treated, even if a definite parasitologic diagnosis cannot be established. Treatment failures such as those in six of our patients are reported frequently and are thought to be
5 164 Journal of Travel Medicine, Volume 3, Number 3 due to a substantial first-pass effect ofpraziquantel in the liver, which leads to plasma concentrations of only of the ingested dose.*" Therefore, all patients should be closely followed for several months following treatment. An important proportion of infected patients probably remains undiagnosed, possibly because these patients and their physicians are unaware of the possibility of schistosomiasis.3 Although acute infections gradually improve spontaneously, they can lead to chronic infection accompanied with granuloma formation and subsequent fibrosis. Schistosomiasis can also cause transverse myelitis and other manifestations of neuroschistosomiasis which are caused by an ectopic location of adult worm pairs or eggs in the central nervous systen~.'~'~ This form of infection can cause severe symptoms and is preventable with early diagnosis and rapid treatment.24 In our study group, most infections were acquired by travelers on a lengthy and adventurous journey or by expatriates venturing outside their normal areas of activity. Most patients knew that they had traveled in an area endemic for schistosomiasis, but were uninformed about the behavioral risks they had taken in specific settings, such as snorkeling in Lake Malawi or bathing in Dogon country. Others simply could not avoid skin exposure to freshwater, such as backpackers traveling in boats on the Niger or Congo River. Travelers to the tropics should therefore be informed thoroughly about the dangers of water-related diseases such as schistosomiasis. References 1. Anonymous. Schistosomiasis in US Peace Corps volunteers - Malawi, MMWR Morb Mortal Wkly Rep 1993; 42: Stuiver PC. Acute schistosomiasis (Katayama fever). BMJ 1984; 288: Visser LG, Polderman AM, Stuiver PC. Outbreak of schistosomiasis among travelers returning from Mali,West Africa. Clin Infect Dis 1995; 20: Clarke V dev, Warburton B, Blair DM.The Katayaina Fyndrome: report on an outbreak in Khodesia. Cent Afr J Med 1979; 16: Nash TE, Cheever AW, Ottesen EA, Cook JA. Schistosonie infections in humans: perspectives and recent findings. NIH conference discussion. Ann Intern Med 1982; 97: Corachan M, Ruiz L,Valls ME, Gascon J. Schistosomiasis and the Dogon Country (Mali). Am J Trop Med Hyg 1992; 47:b Junghanss T, Weiss N. Akute Schistosomiasis bei Tropenreisenden. Dtsch Med Wochenschr 1992; 117: Anonymous. Acute schistosomiasis in travelers returning from Africa. Wkly Epideniiol Rec 1990; 65: Anonyniouc.Acute tchistosomiasis in US travelers returning from Africa. MMWR Morb Mortal Wkly Rec 1990; 39: Chapman PJ, Wilkinson PR, Davidson RN. Acute schistosoniiasis (Katayama fever) among British air crew. BMJ 1988; 297:llOl. Harries AD, Fryatt K,WalkerJ, et al. Schistosomiasis in expatriates returning to Britain from the tropics: a controlled study Lancet 1986; 317: Ime GR, Fontaine KE,Tarr J, Hopkins RS. Acute schistosoniiasis among Americans rafting the Onio River, Ethiopia. JAMA 1984; 251: Nash TE. Antibody response to a polysaccharide antigen present in the schistosome gut. 1. Sensitivity and specificity Am J Trop Med Hyg 1978; 27: Deelder AM, Kornelis D. Immunodiagnosis of recently acquired Schirfosoma rnanroni infecti0n.a comparison of various immunological techniques.trop Geograph Med 1981 ; 33: Ridley DS, Hawgood BC.The value of formol-ether concentration of faecal cysts and ova. J Clin Pathol 1956; 9: Katz N, Chaves A, Pellegrino J. A simple device for quantitative stool thick-smear technique in schistoson~iasis niansoni. KKV lnst MedTrop Sao Paulo 1972; 14: Lawley TJ, Ottesen EA, Hiatt RA, Gaze LA. Circulating immune complexes in acute schictosotniasit. Clin Exp Immunol 1979; 37: Evengard B, Manimarstrom L, Smith Cl, Linder E. Early antibody responses in human sch~stosomiasis. Clin Exp Immunol 1990; 80: Hayunga EG, Mollegard I, Duncan JE et al. Development of circulating antibody antigen assay for rapid detection of acute schistosomiasis. Lancet 1986; 318: King CH, Mahmoud AAE Drugs five years later: praziquantel.ann Intern Med 1989; 110: Sabah AA, Fletcher C,Webbe G, Doenhoff MJ. Schistosoma mansoni: chemotherapy of infections of different ages. Exp Parasitol 1986; 61 : Harries AD, Cook GC. Acute schistosomiasis (Katayama fever): clinical deterioration after chemotherapy. J lnfect 1987; 14~ Anonymous. Case records of the Massachusetts General Hospital: case N Engl J Med 1985; 312: Blanchard TJ, Milne LM, Pollok R, Cook GC. Early chemotherapy of imported neuroschistosomiasis [letter]. Lancet 1993:
WRAIR- GEIS 'Operational Clinical Infectious Disease' Course
Schistosomiasis WRAIR- GEIS 'Operational Clinical Infectious Disease' Course The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or
More informationPresentation and Diagnosis of Imported Schistosomiasis: Relevance of Eosinophilia, Microscopy for Ova, and Serology
Presentation and Diagnosis of Imported Schistosomiasis: Relevance of Eosinophilia, Microscopy for Ova, and Serology Wouter F.W. Bierman, José C.F.M.Wetsteyn, and Tom van Gool Background: In nonendemic
More informationSchistosomiasis. Epidemiology. Global epidemiology
Schistosomiasis Introduction Epidemiology Risk for Travellers Transmission Signs and Symptoms Treatment Prevention References Reading List Introduction Schistosomiasis, or bilharzia, is caused by worms
More informationSchistosomiasis / Bilharzia
Schistosomiasis / Bilharzia An update for registered healthcare practitioners April 2017 Aims of resource:- To raise awareness of Schistosomiasis/Bilharzia infection with registered healthcare practitioners
More informationSchistosomiasis. World Health Day 2014 SMALL BITE: Fact sheet. Key facts
Fact sheet Key facts is an acute and chronic disease caused by parasitic worms. At least 249 million people required preventive treatment for schistosomiasis in 2012. The number of people reported to have
More informationPARASITOLOGY CASE HISTORY 11 (HISTOLOGY) (Lynne S. Garcia)
PARASITOLOGY CASE HISTORY 11 (HISTOLOGY) (Lynne S. Garcia) A 37-year-old man from the United Arab Emirates was admitted to the hospital for complaints of upper and lower abdominal pain. The greater omentum
More informationHelminths: Schistosoma mansoni. Schistosoma japonicum 10/14/2009. Trematoda - non-segmented flat worms
Helminths: Trematoda - non-segmented flat worms The schistosomes: Schistosoma mansoni Schistosoma haematobium Schistosoma japonicum Schistosoma mekongi Aquatic freshwater snails are the intermediate hosts
More information10/14/2009. Helminths: Trematoda - non-segmented flat worms. The schistosomes: Schistosoma mansoni Schistosoma haematobium. Schistosoma mekongi
Helminths: Trematoda - non-segmented flat worms The schistosomes: Schistosoma mansoni Schistosoma haematobium Schistosoma japonicum Schistosoma mekongi 1 Japan is schistosome-free as of 1976 2 Aquatic
More informationESCMID Online Lecture Library. by author
Schistosoma epidemiology & diagnosis José Manuel Correia da Costa INSA National Institute of Health Dr. Ricardo Jorge Brindley PJ & Hotez PJ (2013) Break Out: Urogenital Schistosomiasis and Schistosoma
More informationHeterophyiasis Heterophyes heterophyes. Samar N. El-Beshbishi Prof. of Medical Parasitology Mansoura Faculty of Medicine
Heterophyiasis Heterophyes heterophyes Samar N. El-Beshbishi Prof. of Medical Parasitology Mansoura Faculty of Medicine 2 Objectives 1. Overview on heterophyiasis. 2. Geographical distribution. 3. Morphology
More information[black box of sprorocyst/rediae]
Digeneans: All life cycles involve a mollusc and a vertebrate All life cycles are similar but different All life cycles are a variation of one theme. Adult-egg-miracidium-[black box of sprorocyst/rediae]
More informationAcknowledgements. Schistosomiasis Epidemiology
Pulmonary Arterial Hypertension and Schistosomiasis Rubin M. Tuder, M. D. Brian Graham, M.D. Program in Translational Lung Program Division of Pulmonary Sciences and Critical Care Medicine, Department
More informationSchistosomiasis: Challenges and Opportunities
Schistosomiasis: Challenges and Opportunities Charles H. King MD Center for Global Health and Diseases Case Western Reserve University Cleveland, Ohio and Schistosomiasis Consortium for Research and Elimination,
More informationDepartment of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria
DEVELOPING NEW BEHAVIOURAL CHANGE INTERVENTIONS FOR SCHISTOSOMIASIS CONTROL Department of Pure and Applied Zoology, Federal University of Agriculture, Abeokuta, Nigeria SCHISTOSOMIASIS Disease of poverty
More informationFilariasis. Nematoda Systemic round worms
Filariasis Nematoda Systemic round worms Filaria -a roundworm -Adult filaria live in body cavities, lymphatics, and subcutaneous tissues -embryos (microfilaria) live in blood or dermis -all require an
More informationGeneral Description. Cause. Transmission Mode. Epidemiology of Schistosomiasis
General Description Schistosomiasis, also known as bilharziasis, is a human disease caused by a zoonotic parasite that infects a wide range of animals, including cattle, dogs, pigs, and rodents. It most
More informationAcute schistosomiasis, a diagnostic and therapeutic challenge
REVIEW 10.1111/j.1469-0691.2009.03131.x Acute schistosomiasis, a diagnostic and therapeutic challenge S. Jauréguiberry, L. Paris and E. Caumes Department of Infectious, Tropical Diseases and Parasitology-Mycology,
More informationCryptosporidium Incident Response
WWA Response Plan Cryptosporidium Incident Response Summary Cryptosporidium ( crypto ) is a diarrheal illness caused by a microscopic parasite that lives in the intestines of humans & animals. For a number
More informationThe prevalence of schistosomiasis among school children in Zagazig district, Sharkyia Governorate, Egypt
Middle East Journal of Applied Sciences Volume : 05 Issue : 04 Oct.-Dec. 2015 Pages: 1267-1272 The prevalence of schistosomiasis among school children in Zagazig district, Sharkyia Governorate, Egypt 1
More informationINTERNATIONAL JOURNAL OF WOMEN'S HEALTH AND REPRODUCTION SCIENCES
Letter to the Editor INTERNATIONAL JOURNAL OF WOMEN'S HEALTH AND REPRODUCTION SCIENCES http://www.ijwhr.net doi: 10.15296/ijwhr.2014.17 Pathogenic Effects of Genital Schistosomiasis on Men and Women Health
More informationV. Subclass Digenea (Chapters 15-18, BLY ) A. Background 1. Flukes 2. Digenea refers to having an alternation of hosts in the life cycle B.
V. Subclass Digenea (Chapters 15-18, BLY 459 2009) A. Background 1. Flukes 2. Digenea refers to having an alternation of hosts in the life cycle B. Characteristics 1. Cuplike suckers without hooks a..
More informationHussein et al., World J. Biol. Med. Science Volume 2 (3), 74-80, 2015
Indexed, Abstracted and Cited: ISRA Journal Impact Factor, International Impact Factor Services (IIFS), Directory of Research Journals Indexing (DRJI), International Institute of Organized Research and
More informationNew Equimax Elevation.
New Equimax Elevation. Gets worming right, New Equimax Elevation offers 3-way action for lifelong protection. Controlling worms in foals and young horses is important. The immature immune systems of foals
More informationRESEARCH NOTE. 208 Vol 49 No. 2 March 2018
RESEARCH NOTE EFFECT OF PRAZIQUANTEL TREATMENT ON HEPATIC EGG GRANULOMAS IN MICE INFECTED WITH PRAZIQUANTEL-SUSCEPTIBLE AND -RESISTANT SCHISTOSOMA JAPONICUM ISOLATES Ke Qian 1,2,3,4,5, Yousheng Liang 1,2,3,4,
More informationSchistosomiasis in travellers and migrants
Travel Medicine and Infectious Disease (2011) 9, 6e24 available at www.sciencedirect.com journal homepage: www.elsevierhealth.com/journals/tmid REVIEW Schistosomiasis in travellers and migrants Jan Clerinx
More informationBIO Parasitology Spring 2009
BIO 475 - Parasitology Spring 2009 Stephen M. Shuster Northern Arizona University http://www4.nau.edu/isopod Lecture 13 Important Orders a. Echinostomatiformes b. Strigeiformes c. Opisthorchiformes d.
More informationORIGINAL ARTICLE AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY SEPTEMBER 2011 ISBN X VOL 12(3) AJCEM/201092/21133 COPYRIGHT 2011
ORIGINAL ARTICLE AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY SEPTEMBER 2011 ISBN 1595-689X VOL 12(3) AJCEM/201092/21133 -http://wwwajolinfo/journals/ajcem COPYRIGHT 2011 doi: 104314/ajcemv12i35
More informationGSK Medicine: Study Number: Title: Rationale: Phase: Study Period: Study Design: Centres: Indication: Treatment: Objectives:
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationInvestigation of Intestinal Schistosomiasis among School Children in Nteje Town, Oyi Local Government Area of Anambra State
Jan 2016 Vol 3, No.1 Investigation of Intestinal Schistosomiasis among School Children in Nteje Town, Oyi Local Government Area of Anambra State Anyaegbunam, Lucy C Department of Biological Sciences,Chukwuemeka
More informationNEWSLETTER. ACTION AGAINST WORMS FROM ANIMATION TO REALITY IN THIS ISSUE: NOVEMBER 2008 ISSUE 12
ACTION AGAINST WORMS NOVEMBER 2008 ISSUE 12 IN THIS ISSUE: A child taking praziquantel tablets during a deworming campaign in Madagascar, 2008. From animation to reality Prevalence of schistosomiasis Action
More informationThe use of risk management as best practice to reduce outbreaks of recreational water illnesses in disinfected swimming facilities and spas
The use of risk management as best practice to reduce outbreaks of recreational water illnesses in disinfected swimming facilities and spas Roy Vore, Ph.D., NSPF I, CPO Vore & Associates, LLC Email: Roy.D.Vore@gmail.com
More informationTest for Transgenerational Immune Priming in the Snail, Biomphalaria glabrata. by Sonal Anand A THESIS. submitted to. Oregon State University
Test for Transgenerational Immune Priming in the Snail, Biomphalaria glabrata by Sonal Anand A THESIS submitted to Oregon State University University Honors College in partial fulfillment of the requirements
More informationFELLOWSHIP EXAMINATION PRACTICE PAPER
Northern Sydney Hospitals/NSW HETI Network 2 FELLOWSHIP EXAMINATION PRACTICE PAPER 2016.2 Short Answer Questions Candidate directions: 1. This is a 3 hour examination 2. There are 3 separate books of 9
More informationM0BCore Safety Profile. Pharmaceutical form(s)/strength: 5 mg SE/H/PSUR/0002/006 Date of FAR:
M0BCore Safety Profile Active substance: Finasteride Pharmaceutical form(s)/strength: 5 mg P-RMS: SE/H/PSUR/0002/006 Date of FAR: 16.05.2014 4.3 Contraindications Finasteride is not indicated for use in
More informationImmersion pulmonary oedema: is it confused with drowning?
Immersion pulmonary oedema: is it confused with drowning? Dr Peter Wilmshurst Consultant Cardiologist Royal Stoke University Hospital & UK Diving Medical Committee Drowning and pulmonary oedema Drowning
More informationACUTE TEMPERATURE TOLERANCE OF JUVENILE CHINOOK SALMON FROM THE MOKELUMNE RIVER
ACUTE TEMPERATURE TOLERANCE OF JUVENILE CHINOOK SALMON FROM THE MOKELUMNE RIVER Charles H. Hanson, Ph.D. Hanson Environmental, Inc. SUMMARY A series of static acute tests were performed to determine the
More informationThe study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not
The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.
More informationCreative brief for Radio Skits for Uganda Schistosomiasis Prevention Campaign
Creative brief for Radio Skits for Uganda Schistosomiasis Prevention Campaign Priority Audiences: 1) Adults who are at high risk of Schistosomiasis. These include parents of children who are also at risk.
More informationChapter 25. Schistosomiasis
Chapter 25. Schistosomiasis The eradication of schistosomiasis (often referred to as bilharziasis or snail fever) or its elimination by multiple, integrated intervention techniques is beyond the human
More informationTREATMENT GUIDE. Your treatment. Your questions answered.
TREATMENT GUIDE Your treatment. Your questions answered. INDICATIONS: Kineret is a prescription medicine called an interleukin-1 receptor antagonist (IL-1ra) used to: Reduce the signs and symptoms, and
More informationSchistosomiasis Mansoni in Areas of Low Transmission. Epidemiological Characterization of Venezuelan Foci
Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 97(Suppl. I): 5-10, 2002 5 Schistosomiasis Mansoni in Areas of Low Transmission. Epidemiological Characterization of Venezuelan Foci B Alarcón de Noya/ +, R
More informationSpatially explicit modeling of schistosomiasis transmission dynamics: applications to Senegal
Spatially explicit modeling of schistosomiasis transmission dynamics: applications to Senegal Lorenzo Mari Dipartimento di Elettronica, Informazione e Bioingegneria Politecnico di Milano mailto: lorenzo.mari@polimi.it
More informationInternal Parasites: Strategies for Effective Parasite Control
1 of 6 3/25/2010 9:35 AM 4075 Iron Works Parkway Lexington, KY 40511 Phone: 859-233-0147 Fax: 859-233-1968 e-mail: aaepoffice@aaep.org «Go Back Print This Page Internal Parasites: Strategies for Effective
More informationThe current status of Schistosoma mansoni among biomphalaria snails in Kabaka s lake, Kampala Uganda
Research Journal of Agriculture and Environmental Management Vol. 6(2), pp. 031-035, March, 2017 Available online at http://www.apexjournal.org ISSN 2315-8719 2017 Apex Journal International Full Length
More informationNatural Hair Transplant Medical Center, Inc Dove Street, Suite #250, Newport Beach, CA Phone
Natural Hair Transplant Medical Center, Inc. 1000 Dove Street, Suite #250, Newport Beach, CA 92660 Phone-949-622-6969 Finasteride (PROPECIA ) Acknowledgement Finasteride is an oral medication, manufactured
More informationHealth Education as Intervention in Promotion of Knowledge, Attitudes and Practices among School Pupils as Regards Schistosomiasis
EUROPEAN ACADEMIC RESEARCH Vol. II, Issue 9/ December 2014 ISSN 2286-4822 www.euacademic.org Impact Factor: 3.1 (UIF) DRJI Value: 5.9 (B+) Health Education as Intervention in Promotion of Knowledge, Attitudes
More informationSchistosoma mansoni Cercaria and Schistosomulum Antigens in Serodiagnosis of Schistosomiasisl
Schistosoma mansoni Cercaria and Schistosomulum Antigens in Serodiagnosis of Schistosomiasisl HERM~NIA YOHKO KANAMURA,~ SUMIE HOSHINO-SHIMIZU,~ & LUIZ CAETANO DA SILVA~ I Schistosoma mansoni cercaria and
More informationThe Increased Risk of Schistosomiasis Caused by High Frequency of Rainfall and Open-Defecation Habit in Indonesia
International Proceedings of Chemical, Biological and Environmental Engineering, V0l. 93 (2016) DOI: 10.7763/IPCBEE. 2016. V93. 2 The Increased Risk of Schistosomiasis Caused by High Frequency of Rainfall
More informationOne of largest flukes: 30 x 13 mm
One of largest flukes: 30 x 13 mm The adult parasites reside in the intra-hepatic bile ducts, produce eggs, and the eggs are passed in the host's feces. After passing through the first intermediate host
More informationREEFTRIP.com. Medical Questionnaire Dive Medical Recreational AS Section Abbott Street, Cairns T: E:
REEFTRIP.com 100 Abbott Street, Cairns T: 07 4037 2700 E: info@reeftrip.com Medical Questionnaire Dive Medical Recreational AS4005.1 Please complete the following Section 1 1 Surname: Given Names 2 Date
More informationSCHISTOSOMIASIS MALAYENSIS-LIKE INFECTION AMONG THE PENAN AND OTHER INTERIOR TRIBES (ORANG ULU) IN UPPER REJANG RIVER BASIN SARAWAK MALAYSIA
SCHISTOSOMIASIS IN ORANG ULU MALAYSIA SCHISTOSOMIASIS MALAYENSIS-LIKE INFECTION AMONG THE PENAN AND OTHER INTERIOR TRIBES (ORANG ULU) IN UPPER REJANG RIVER BASIN SARAWAK MALAYSIA Sagin DD 1, Ismail G 2,
More informationIATA Guidance for airline health and safety staff on the medical response to Cabin Air Quality Events
IATA Guidance for airline health and safety staff on the medical response to Cabin Air Quality Events (Smoke, Fumes/odours) 1. Introduction Much controversy exists in relation to the potential health ramifications
More informationAtypical Appendicitis: Schistosomal Infection Causing Perforated Appendicitis.
ISPUB.COM The Internet Journal of Surgery Volume 28 Number 2 Atypical Appendicitis: Schistosomal Infection Causing Perforated Appendicitis. V Gundlapalli, M Shah, A Baskara, J Fobia Citation V Gundlapalli,
More informationAcute Mountain Sickness
Innere Medizin VII / Sportmedizin Acute Mountain Sickness Peter Bärtsch www.klinikum.uni-heidelberg.de/sportmedizin AMS: Clinical Picture Symptoms: - Headache - Loss of appetite, nausea, vomiting - Dizziness
More informationBrian Talpos Brandon Elliott
Investigation of a Topical Ointment to Prevent against the Penetration of Trichobilharzia ocellata Cercariae Causing Schistosome Cercarial Dermatitis Brian Talpos Brandon Elliott Introduction Schistosome
More informationCinryze. Cinryze (C1 esterase inhibitor [human]) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.85.05 Subject: Cinryze Page: 1 of 5 Last Review Date: September 20, 2018 Cinryze Description Cinryze
More informationAsk the Vet April Stephen D. Fisch, DVM
Ask the Vet April 2013 Stephen D. Fisch, DVM www.avsequinehospital.com 850-386-3619 Ask the Vet with Dr. Steve Fisch, DVM What is the recommended vaccination schedule for broodmares and foals and why?
More informationMODULE. Schistosomiasis. Degree Program For the Ethiopian Health Center Team. Haramaya University
MODULE \ Schistosomiasis Degree Program For the Ethiopian Health Center Team Laikemariam Kassa, Anteneh Omer, Wutet Tafesse, Tadele Taye, Fekadu Kebebew, Abdi Beker Haramaya University In collaboration
More informationCounty of Santa Clara Emergency Medical Services System
County of Santa Clara Emergency Medical Services System Policy # 700-S01 Ebola Virus Prevention and Control EBOLA VIRUS PREVENTION AND CONTROL Effective: October 30, 2014 Replaces: October 8, 2014 (Version
More information1.2.7 Furunculosis. Emmett B. Shotts, Jr. College of Veterinary Medicine University of Georgia Athens, GA /
1.2.7 Furunculosis - 1 1.2.7 Furunculosis Emmett B. Shotts, Jr. College of Veterinary Medicine University of Georgia Athens, GA 30602 404/542-5811 emshotts@alltel.net A. Name of Disease and Etiological
More informationPr oject Summar y. Principal Investigators: Walter Cook, Elizabeth Williams, Fred Lindzey, and Ron Grogan. University of Wyoming
Pr oject Summar y Chronic wasting disease in white-tailed deer in Wyoming: Interaction with livestock, movement patterns, and evaluation of ante-mortem diagnostic tests Principal Investigators: Walter
More informationWHY IS PREVENTION IMPORTANT?
A GUIDE TO TRUST THE POWER OF PREVENTION < 2 > WHY IS PREVENTION IMPORTANT? Hereditary angioedema (HAE) symptoms can range in severity. Some attacks may be mild or temporarily disabling, but others can
More informationELEDT S APR24 19 DECOMPRESSION SICKNESS AFFECTING THE TEMPOROMANDIBULAR JOINT. Author:
r V COPY to DECOMPRESSION SICKNESS AFFECTING THE TEMPOROMANDIBULAR JOINT 0 N Author: Frederick W. Rudge, M.D. Major, USAF, MC, FS United States Air Force School of Aerospace Medicine Brooks Air Force Base,
More informationHealthy Swimming: Prevention of Recreational Water Illnesses (RWIs)
Healthy Swimming: Prevention of Recreational Water Illnesses (RWIs) Q u e s t i o n s a n d A n s w e r s f o r A q u a t i c s F a c i l i t y S t a f f The following information about recreational water
More informationPRODUCT INFORMATION TESTOVIRON DEPOT. (testosterone enanthate)
PRODUCT INFORMATION TESTOVIRON DEPOT (testosterone enanthate) NAME OF THE MEDICINE Testosterone enanthate is designated chemically as 17 beta-heptanoyloxy-4-androstene-3- one. The empirical formula of
More informationSTAYING ON TRACK WITH CINRYZE THERAPY
YOUR GUIDE TO STAYING ON TRACK WITH CINRYZE THERAPY Indication CINRYZE (C1 esterase inhibitor [human]) is an injectable prescription medicine that is used to help prevent swelling and/or painful attacks
More informationArtificial Insemination
Artificial Insemination Artificial Insemination (A.I) is a technique used to transfer semen from a stallion into the uterus of a mare during the correct stage of her oestrus cycle. A.I has become very
More informationGeneral Characters of Trematodes
Parasitology Department General Characters of Trematodes By Hala Elwakil, MD Intended Learning Outcomes By the end of this lecture, the student will be able to know: 1. General morphology of trematodes
More informationFIRST AID. Study Topics. At a minimum, the following topics are to be studied for the first aid exam.
FIRST AID Study Topics At a minimum, the following topics are to be studied for the first aid exam. TOPIC Avoid getting air in stomach during rescue breathing Burns Kinds of Burns & Care Calling for Help
More informationTREMATODE INFECTION RATES OF FISH FROM A WASTEWATER TREATMENT FACTORY POLISHING POND AND A CANAL IN PHUKET, THAILAND
TREMATODE INFECTION RATES OF FISH FROM A WASTEWATER TREATMENT FACTORY POLISHING POND AND A CANAL IN PHUKET, THAILAND D Krailas, T Janecharat, S Ukong,W Junhom, S Klamkhlai, N Notesiri and P Ratanathai
More informationMedical Aspects of Diving in the Offshore Oil Industry
Medical Aspects of Diving in the Offshore Oil Industry Dr Stephen Watt Retired Consultant in Respiratory and Hyperbaric Medicine Chairman, Diving Medical Advisory Committee What is diving? Diving = Commuting
More informationOCCURRENCE AND DISTRIBUTION OF FRESHWATER SNAILS IN THREE COMMUNITIES IN EKITI STATE ABSTRACT
OCCURRENCE AND DISTRIBUTION OF FRESHWATER SNAILS IN THREE COMMUNITIES IN EKITI STATE Olorunniyi O.F and L.K Olofintoye Department of Zoology and Evn. Biol., Ekiti State University Ado-Ekiti, Nigeria (Received
More informationTreatment of Schistosomiasis in Africa
Treatment of Schistosomiasis in Africa Junyi Mei Junyi is finishing her B.Sc. in Anatomy and Cell Biology and looks forward to working at a medical research lab this summer. She is interested in global
More informationGENETIC ANALYSIS OF PRAZIQUANTEL RESISTANCE IN SCHISTOSOMA MANSONI
GENETIC ANALYSIS OF PRAZIQUANTEL RESISTANCE IN SCHISTOSOMA MANSONI You-Sheng Liang 1,2, Jian-Rong Dai 1, Yin-Chang Zhu 1, Gerald C Coles 2, Michael J Doenhoff 3 1 Jiangsu Institute of Parasitic Diseases,
More informationEXTREME HEAT. Extreme Heat Related Terms. Heat Wave - Prolonged period of excessive heat, often combined with excessive humidity.
Residents of southeast Louisiana are typically accustomed to dealing with warm, humid weather. But extreme and prolonged heat and humidity conditions can result in serious medical emergencies, even for
More informationPACKAGE LEAFLET: INFORMATION FOR THE USER. Exembol Multidose 100 mg/ml concentrate for solution for infusion. Argatroban Monohydrate
PACKAGE LEAFLET: INFORMATION FOR THE USER Exembol Multidose 100 mg/ml concentrate for solution for infusion Argatroban Monohydrate Read all of this leaflet carefully before you start using this medicine.
More informationHYBRIDIZATION OF SCHISTOSOMA MANSONI AND SCHISTOSOMA JAPONICUM IN MICE
HYBRIDIZATION OF S. MANSONI AND S. JAPONICUM IN MICE HYBRIDIZATION OF SCHISTOSOMA MANSONI AND SCHISTOSOMA JAPONICUM IN MICE PC Fan and LH Lin Institute and Department of Parasitology, National Yangming
More informationChapter 37 (pages ): Hereditary Angioedema and Bradykinin-Mediated Angioedema Prepared by: Sarah Spriet, DO
FIT Board Review Corner May 2017 Welcome to the FIT Board Review Corner, prepared by Tammy Peng, MD, and Amar Dixit, MD, senior and junior representatives of ACAAI's Fellows-In-Training (FITs) to the Board
More informationSelf-declaration by New Zealand of its status of freedom from Equine Viral Arteritis
Self-declaration by New Zealand of its status of freedom from Equine Viral Arteritis Self-declaration submitted to the OIE on xxxx2014, by Dr Matthew Stone, Chief Veterinary Officer, Ministry for Primary
More informationBuilding a Healthy Boston. BOSTON PUBLIC HEALTH COMMISSION Infectious Disease Bureau Communicable Disease Control Division
BOSTON PUBLIC HEALTH COMMISSION Infectious Disease Bureau Communicable Disease Control Division Number of cases 200 180 160 140 120 100 80 60 40 93 87 79 89 77 82 75 67 64 70 57 61 49 61 57 58 44 41 40
More informationH.A. Adie, A. Oyo-Ita, O.E. Okon, G.A. Arong, I.A. Atting, E.I. Braide, O. Nebe,
Research Journal of Parasitology 10 (2): 58-65, 2015 ISSN 1816-4943 / DOI: 10.3923/jp.2015.58.65 2015 Academic Journals Inc. Evaluation of Intensity of Urinary Schistosomiasis in Biase and Yakurr Local
More informationEPIDEMIOLOGICAL SURVEY OF URINARY SCHISTOSOMIASIS AMONG PRIMARY SCHOOL CHILDREN IN MICHIKA, ADAMAWA STATE, NORTH-EASTERN NIGERIA
IJCRR Vol 05 issue 05 Section: Healthcare Category: Research Received on: 22/12/12 Revised on:14/01/13 Accepted on: 22/02/13 EPIDEMIOLOGICAL SURVEY OF URINARY SCHISTOSOMIASIS AMONG PRIMARY SCHOOL CHILDREN
More informationSTUDY PERFORMANCE REPORT
STUDY PERFORMANCE REPORT State: Michigan Project No.: F-80-R-7 Study No.: 230654 Title: Evaluation of brown trout and steelhead competitive interactions in Hunt Creek, Michigan. Period Covered: October
More informationSummer Newsletter DO YOU SHOW IN USHJA HUNTER, JUMPER, OR EQUITATION SHOWS?
DO YOU SHOW IN USHJA HUNTER, JUMPER, OR EQUITATION SHOWS? Beginning December 1, 2017, all horses competing at USEF recognized horse shows must have a microchip to accumulate points. With the start of the
More informationfñxv tä TÜà väx Challenges in prevention and control of schistosomiasis in the Sudan Mutamad A.Amin* and Durria Mansour Elhussin* Background
fñxv tä TÜà väx Challenges in prevention and control of schistosomiasis in the Sudan Mutamad A.Amin* and Durria Mansour Elhussin* Background The World Health Organization (WHO) estimated that 200 million
More informationThe legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION. 20 June 2012
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 20 June 2012 CINRYZE 500 units, 2100 IU, powder and solvent for solution for injection B/2 bottles (CIP code: 218
More informationJerri Bartholomew and Sarah Bjork*
The Effects of Flow on the Salmon Parasite Ceratomyxa shasta : Establishing Baseline Information For Assessment of Flow Management Alternatives For Mitigating Effects of Myxozoan Pathogens in the Klamath
More informationAssociation between raised body temperature and acute mountain sickness: cross sectional study
Clinical Biostatistics Exercise: Regression and correlation Read the following paper, "Association between raised body temperature and acute mountain sickness: cross sectional study" (British Medical Journal,
More informationLaboratory experimental infection of the freshwater snail Gyraulus convexiusculus (Hutton, 1849) and the bighead carp Aristichthys nobilis
Diseases in Asian Aquaculture VII Laboratory experimental infection of the freshwater snail Gyraulus convexiusculus (Hutton, 1849) and the bighead carp Aristichthys nobilis (Richardson, 1845) with the
More informationHeat Stress Prevention
Heat Stress Prevention University Facilities Internal Procedure: July 1, 2013 Effective date: July 1, 2013 Last Modified: April 2013 Approved by: Bob Wells 1.0 Program Objective UF has implemented this
More informationThe Truth About Snails!
I want to know! The Truth About Snails! Based on the research of Dr. Bajope Baluku, CRSN-Lwiro, DRC Learn about: The importance of snails in the environment Which snails carry disease, and how you can
More informationClinical Study Synopsis
Clinical Study Synopsis This Clinical Study Synopsis is provided for patients and healthcare professionals to increase the transparency of Bayer's clinical research. This document is not intended to replace
More informationModelling the dynamics and control of Schistosoma japonicum transmission on Bohol island, the Philippines
Biology Microbiology & Immunology fields Okayama University Year 2008 Modelling the dynamics and control of Schistosoma japonicum transmission on Bohol island, the Philippines Hirofumi Ishikawa Hiroshi
More informationThe Round Goby Botulism Connection. Renea A. Ruffing Graduate Research Assistant Penn State University
The Round Goby Botulism Connection Renea A. Ruffing Graduate Research Assistant Penn State University Round gobies in Pennsylvania waters of Lake Erie First goby caught in Lake Erie was in 1993, in Grand
More informationStudent Information Document
Applied Science and Technology 557-306 Secondary Cycle Two, Year One June 2009 Doctors Unlimited A Summer in Colombia Theory Examination Student Information Document Secondary Cycle Two 557-306 Student
More informationBRAIN AND BANNISTER'S CLINICAL NEUROLOGY (OXFORD MEDICAL PUBLICATIONS) BY ROGER BANNISTER
Read Online and Download Ebook BRAIN AND BANNISTER'S CLINICAL NEUROLOGY (OXFORD MEDICAL PUBLICATIONS) BY ROGER BANNISTER DOWNLOAD EBOOK : BRAIN AND BANNISTER'S CLINICAL NEUROLOGY Click link bellow and
More informationSTANDARD OPERATING PROCEDURES TACTICAL OPERATIONS NERVE AGENT RESPONSE EFFECTIVE: OCTOBER 2007
STANDARD OPERATING PROCEDURES TACTICAL OPERATIONS 202.12 NERVE AGENT RESPONSE EFFECTIVE: OCTOBER 2007 BACKGROUND The following establishes procedures for treatment in the event that Department members
More informationIntroduction. Case study 4 - Koi herpes virus. Major impact on commercial food carp production. History. KHV and other species
Introduction Case study 4 - Koi herpes virus Dr. David Huchzermeyer Sterkspruit Veterinary Clinic Lydenburg Koi Herpesvirus is a recently emerged viral disease of carp (Cyprinus carpio) in all of its varieties
More informationEspilat Mountaineering Club
In the name of God Espilat Mountaineering Club May 2013 MEDICAL PROBLEMS IN HIGH MOUNTAIN ENVIRONMENTS Arya Hamedanchi MD, MPH Level one International Anthropometrist International Certificate of Ski Medicine
More informationElements for a public summary
VI.2 VI.2.1 Elements for a public summary Overview of disease epidemiology Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH) and prostatic
More information