BOOK REVIEW*

Hunter's Tropical Medicine grew out of a World War II Army Medical School tropical and military medicine course taught at the Walter Reed Army Medical Center in Washington, D.C. The first edition, entitled a Manual of Tropical Medicine, was published in 1945 by three of the course instructors, Colonel Thomas T. Mackie, Major George W. Hunter III, and Captain C. Brooke Worth. A second edition was published by the same authors in 1954. Colonel Hunter was joined by co-authors from the Louisiana State University School of Medicine for the third, fourth, and fifth editions, published in 1960, 1966, and 1976, respectively. George Hunter's contribution was acknowledged by adding his name to the book title in the sixth edition, which I edited in 1984. I also edited the seventh edition, published in 1991.

The sixth edition of Hunter's Tropical Medicine was an entirely new book, and Hunter's purpose since that time has been to be the most detailed and comprehensive clinical tropical medicine textbook. It covers all the "tropical" infectious diseases and gives extensive information on other medical conditions, e.g., nutritional problems and deficiencies and snakebite, which occur commonly in the tropics and other developing countries.

There are four criteria for covering an infectious disease in Hunter's Tropical Medicine: (1) The disease occurs exclusively, or almost exclusively, in the tropics and nontropical developing countries, e.g., malaria, schistosomiasis, dengue fever; (2) it occurs much more commonly, or often has a different clinical presentation, in a developing country, e.g., tuberculosis, amebiasis, measles; (3) it is caused by parasites that may occur in temperate climates as well as the tropics, e.g., trichomoniasis, babesiosis, anisakidosis; and (4) it is transmitted by vectors or is a zoonotic disease, e.g., hantavirus infection, Lyme disease, leptospirosis, plague, dirofilariasis.

These criteria, particularly the fourth one, include all of the emerging and re-emerging infectious diseases with the exception of the increasing problem of the development of resistance to antibiotics by antimicrobial agents. In recognition of this extensive coverage of emerging and re-emerging infectious diseases, the title has been modified to Hunter's Tropical Medicine and Emerging Infectious Diseases. The chapters on human immunodeficiency virus and AIDS, viral hepatitis, the viral hemorrhagic fevers, cholera, tuberculosis, malaria, and leishmaniasis have been extensively rewritten and updated. Among the new chapters are those on human T-cell lymphotrophic virus infections, herpes virus infections, spongiform encephalopathies, diseases caused by hantaviruses, Campylobacter enteritis, Helicobacter pylori infections, ehrlichiosis, penicilliosis marneffei, and cyclosporidiosis.

The first part of the book, Clinical Practice in the Tropics, sets the stage for understanding medical practice in developing countries. It approaches illness by body systems and by clinical syndromes or problems, and the authors have attempted to describe medical practice in the tropics as it differs from practice in the more developed temperate climates. In this edition, we have added important chapters on maternal and child health, the integrated management of the sick child, traditional medicine, environmental health hazards in the tropics, and imaging in the tropics and the imaging of tropical diseases as well as updated chapters on pulmonary diseases, sexually transmitted diseases, surgery in the tropics, and heat-associated illness. We have found this part particularly useful to those from North America or Europe who become health care providers in developing countries.

The purpose of the tenth part of the book, Tropical Disease in a Temperate Climate, is the reverse of this. It is to assist the practitioner in a temperate climate who sees patients with illnesses that may have been contracted in the tropics. This is classic "traveler's medicine," and although there are textbooks and other materials available on this subject, we believe that a textbook of tropical medicine must have a section with this approach to patients with tropical diseases. Dr. Jay Keystone has again assisted in preparing this part; chapters on establishing a travel clinic and screening long-term travelers augment the chapters in the seventh edition on advice to travelers, fever in travelers, and diseases in immigrants. The chapter on global epidemiology of infectious diseases, prepared by Dr. Guénaél Rodier and his colleagues in the WHO's emerging and infectious diseases program, is particularly extensive and very useful, with up-to-date information on the global distribution of infectious diseases.

The parts on poisonous plants and animals, vector transmission and zoonoses, and laboratory diagnosis of parasitic diseases have been updated and presented in a format and detail suitable for the medical practitioner who is taking care of patients with tropical medical problems and emerging and re-emerging infectious diseases. Hunter's Tropical Medicine and Emerging Infectious Diseases focuses on clinical practice; it does not include extensive details covering the basic research of tropical infectious diseases. However information on basic research is included if it adds to essential knowledge of the practicing physician, and additional readings on these topics are listed in the chapter's bibliography. Hunter's Tropical Medicine and Emerging Infectious Diseases is not referenced. The editors believe that a bibliography of publications that provide additional information for the clinician is more useful. Most chapter bibliographies are more extensive in the new edition. Extensive illustrations also make this book more useful to the practitioner. An additional two pages of color illustrations have been added. Despite increased text and illustrations, the eighth edition remains a single, and very useable, volume.

I wish to thank Raymond R. Kersey, David H. Kilmer, and Cass Stamato of W. B. Saunders Company for their editorial assistance. Constance Burton has smoothly and efficiently copy edited the book. The two associate editors, the five part editors, and the almost 200 contributors to Hunter's Tropical Medicine and Emerging Infectious Diseases, and I all hope that the readers will find the eighth edition as useful as they have found the earlier versions.

(Preface by G. THOMAS STRICKLAND)

*This book is available at the Library of the Instituto de Medicina Tropical de São Paulo