Book Review

Tropical Infectious Diseases: Principles, Pathogens, and Practice

N Engl J Med 2006; 355:2379-2380November 30, 2006

Article

Tropical Infectious Diseases: Principles, Pathogens, and Practice
Second edition. Edited by Richard L. Guerrant, David H. Walker, and Peter F. Weller. 1721 pp., plus index, in two volumes, illustrated, with CD-ROM. Philadelphia, Churchill Livingstone, 2006. $329. ISBN: 0-443-06668-X

It is generally agreed that the second edition of a textbook is rarely as good as the original; it is also generally agreed that the traditional textbook is dead. This superb new edition of Tropical Infectious Diseases trashes these notions. Tropical Infectious Diseases, now thankfully published in two volumes totaling nearly 1800 pages, is a superb collection of well-written, well-organized, and authoritative chapters that are as up to date as possible. Almost every chapter is outstanding, and some are classics in their own right. There are new and refreshing contributions on social and cultural factors in tropical medicine; on migrant, immigrant, and refugee health; and on tropical infectious diseases in pregnancy. Many of the revised chapters are excellent, particularly those on malaria, respiratory infections, cholera, hepatitis, and neurologic disease and those collected in the last of the volumes' three sections, “Practice: Approach to the Patient in the Tropics.” This section and the other two — “Principles and General Considerations” and “Pathogens” — are clear and easy to navigate, and the accompanying CD-ROM is invaluable when one is traveling. For a textbook of this size, with more than 200 contributors, there is remarkably little overlap between chapters.

The authors represent a who's who of experts on modern tropical infectious diseases, and the editors must have used extraordinary powers of persuasion to get this eclectic group to keep to a uniform format and meet deadlines. A publication from the editors on the methods they used to achieve their goal would be most welcome.

It is almost churlish to offer criticisms of such a superb collection, but that is the unfortunate task of a reviewer. With the planning for the third edition presumably under way, the editors would be well advised to look critically at the list of authors and consider instances in which younger contributors could be brought in to reinvigorate the very few weak chapters. Tropical Infectious Diseases is now firmly established as a “must have” classic; to retain this deserved reputation, the editors should make sure there is a healthy turnover of authors between editions. They might also consider adding a chapter on the design and conduct of clinical trials in the tropics, including information about institutional review boards; a summary of good, sensible clinical practice; a discussion of ethical issues; information about the design of case report forms; and even advice on how to write manuscripts and grants. Such a chapter could also inform clinicians in the tropics about how to access the latest information on the Internet and how to find financial support for their research. This new chapter would complement the superb and detailed factual information available throughout the book.

This future edition will, I hope, be used by the very people who are best positioned to conduct the best clinical research in tropical medicine — namely, clinical scientists working in the tropics. It is also my hope that the publisher of the next edition will sell this great book at a price that will be more affordable for these scientists or will release the CD-ROM alone at a reduced price. The publisher might also consider producing a condensed pocket edition for convenient day-to-day use on the wards.

For the current edition, the choice of David Warrell to write the foreword in the very year that he is due to retire was an inspired one. Particularly in wealthy countries, there is occasionally a sense that medicine has reached a point at which most clinical advances have been made and that we now need to rely on the promised fruits of genomics and molecular biology to provide solutions to the world's most pressing medical problems. The reality is that more than ever, we need to bolster physicians' skills in what some would consider old-fashioned integrated clinical research. We are in danger of losing these essential skills, and sadly, it is doubtful that we will see in the future many physicians who have Warrell's breadth of knowledge, enthusiasm, charisma, and vision for clinical tropical medicine. This book is brilliantly written and edited and sets the standard for textbooks on tropical and infectious diseases.

Jeremy Farrar, M.D., Ph.D.
Hospital for Tropical Diseases, Ho Chi Minh City 5, Vietnam
jfarrar@oucru.org