Putting parasites in the picture

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Parasitic Diseases (4th edn)D.D. Despommier, R.W. Gwadz, P.J. Hotez and C.A. Knirsch,Apple Trees Productions LLC, 2000. $59.95 (hbk) (xii+346 pages) ISBN 0 9700027 0 XThe new edition of this well-established text shows significant changes from the previous edition published in 1995. There is a change of publisher, an additional author, inclusion of full colour for all figures, expansion of sections on cellular and molecular pathogenesis, new chapters on travel medicine and medical ecology, and an upgraded diagnostic atlas. The life-cycle diagrams, which are such a distinctive feature, benefit from the inclusion of colour to highlight parasite stages – a simple but highly effective device.The book is aimed at medical students and clinicians, rather than those whose interests are more biologically orientated, and it is directed primarily at individuals training or working in the USA. In addition to basic descriptions of life cycles, disease and control, there is an emphasis on diagnosis and treatment, which are covered in some detail in the chapters on travel medicine and anti-parasitic drugs, as well as in the reprinted article on treatments from The Medical Letter. An interesting innovation is the inclusion of summaries of current research (Gray Matters), for example the pharmacology of arthropod saliva and hookworm larval biology.The text covers protozoan and helminth parasites, and includes arthropods both as vectors and as direct causes of disease. It also includes, in the travel medicine chapter, detail on directly acquired bacterial and viral infections, which makes the omission of reference elsewhere to parasites such as the microsporidia rather puzzling. Many of the chapters include up-to-date and helpful information on molecular, biochemical and immunological aspects of parasitic diseases, although the chapter sections headed ‘cellular and molecular pathogenesis’ do not always provide much detail that is directly relevant to this particular topic. The text is supported by useful and current references.Although the majority of the illustrations are excellent, unfortunately some are so badly out of focus as to be of little value. In particular, this affects not only pictures of protozoans, but also illustrations of certain helminths (e.g. those differentiating hookworm and Strongyloides larvae) and clinical conditions (e.g. congenital toxoplasmosis). Some illustrations are included without a sufficiently informative context (e.g. ‘An electron micrograph of trichomonad hydrogenosomes’; ‘GIS views of African vegetation and of Lake Nasser’). The text is generally clearly and concisely written, with few typographical and factual errors, although ‘compliment’ for ‘complement’ should not have got through, and the development of oesophageal varices in schistosomiasis is not the same as the development of collaterals. British readers might struggle a little with some unfamiliar clinical terms but, in general, pathological aspects are clearly described.The book will give medically based readers an informed insight into the nature, causes and control of parasitic diseases. Science-based students will find it a useful additional reference to extend their more biological interests. It is commendable that the authors have broadened the scope of the book to cover practical aspects of parasitic disease (e.g. the chapter on travel medicine) and have tried to place these diseases into an ecological context. Their concern for environmental matters comes through strongly and the relevance of these to continuing, or increasing, parasite transmission is emphasized. For medical readers, putting parasitology into this more biological context will be particularly helpful.