Plague, most ancient, dreadful and formidable pestilential rodent borne disease was a major public health problem in India till the mid twentieth century A.D. Plague is one of the three epidemic prone diseases still subject to the International Health Regulations and notifiable to the World Health Organization (WHO). In India mortality due to plague reached zero level during 1967. However, sporadic cases of suspected human plague were reported from Himachal Pradesh during 1966 and 1983-1984 and Karnataka during 1984 and at times localized sylvatic plague incidence encountered in the last decade from the trijunction of Karnataka, Andhra Pradesh and Tamil Nadu in peninsular India. During 1994 a bubonic plague outbreak at Beed district, Maharashtra and pneumonic plague outbreak in Surat, Gujarat were recorded. After 8 long years of quiescence a localized outbreak of pneumonic plague occurred in Himachal Pradesh in 2002. In 2004, a bubonic plague outbreak occurred in Uttarkashi district, Uttarakhand. Scientists were in general opinion about the role of rodents and fleas in global transmission of plague, and the main means of dissemination carried by infected rats through the international trade routes. Rodents are the carriers of viral, rickettsial, nematode and bacterial diseases and are responsible for the transmission of more than 35 communicable diseases including Hanta viruses. In indirect transmission of diseases, rodents may serve as intermediate hosts for parasites that ultimately infect man and may serve as reservoirs of disease agents which may be picked up by arthropod vectors like fleas, ticks or mites and transmitted to humans through bites. In direct transmission, rodents may transmit the viruses by inhalation of aerosolized excreta, ingestion of excreta or by direct contact with the rodent itself and may directly transmit a pathogen to man through bite. Plague continues to exist as a major public health problem in many countries of the world. In several countries plague has remained quiescent for years together before reappearing all of a sudden. The enzootic foci of plague in India is believed to be present in four groups of foci in northern, central, western and southern India. From 1989 to 1994 active zoonotic foci of plague were detected from the trijunction of Tamil Nadu (Krishnagiri district), Andhra Pradesh (Chittoor district) and Karnataka (Kolar and Bangalore rural district). As the sylvatic rodents live in wild and peri-domestic situations and maintain the natural transmission in enzootic foci for centuries together, eradication of the disease is highly impossible. Natural decline in plague incidence would not justify the conclusion that plague has disappeared from the area. Plague is a re-emerging zoonotic disease. The number of human plague cases reported to W.H.O. by different countries was always lower than the actual number of cases. Under reporting may be attributed to lack of diagnostic facilities for the confirmation of the cases and cessation of plague surveillance work by number of erstwhile plague endemic countries. The worldwide decline in plague incidence since the 1950s resulted in decreased financial support, lesser interest, and ultimately the deterioration of laboratory-based surveillance systems in many endemic countries in the world. The lack of continuous baseline data on plague surveillance may result in an undetected sudden increase of bubonic/pneumonic cases in an enzootic/endemic foci of the world, or re-emerging of the disease. Since the beginning of the 1990s, the number of plague cases shows rising trend worldwide, and outbreaks are reappearing in various countries of the world after decades of quiescence. Plague can re-emerge, vaccination is useless and mass killing of rodents is not the solution for the eradication of the disease. According to the World Health Organization (WHO), global incidence of human plague was the lowest reported in 30 years, and the actual incidence was probably little different. However, we should be extremely vigilant as it is not uncommon to observe the long years of quiescence in natural plague foci, and the sudden appearance of human cases is always destabilizing for national or even international authorities. A plague outbreak may also cause widespread panic, as occurred in India in 1994 when a relatively small outbreak, with 54 deaths, was reported in the city of Surat. This led to a nationwide collapse in tourism and trade, with an estimated cost of US$600 million. Despite major advances in diagnosis, treatment, and prevention, it has not been possible to eradicate plague. Due to the high public health significance and the risk of its re-emergence after long years of quiescence, plague should not be relegated to the sidelines. It remains a poorly understood threat that we cannot afford to ignore. Potential new foci should be confirmed and investigated, with special attention to harbours with international trade.

This manual aims to: - provide up-to-date guidance about the diagnosis, epidemiological surveillance, case management, prevention, and control of the different forms of plague, both for sporadic cases and during outbreaks; and - to serve as the basis for developing national guidelines, considering the available resources and other determinants in each country. It was developed for clinicians and public health professionals who may be tasked with ensuring preparedness or response. It is also intended to inform the policy- and decision-makers responsible for developing national policies and guideline documents, and making purchasing arrangements, and implementing training programmes.

Tropical Infectious Diseases: Principles, Pathogens and Practice, by Drs. Richard L. Guerrant, David H. Walker, and Peter F. Weller, delivers the expert, encyclopedic guidance you need to overcome the toughest clinical challenges in diagnosing and treating diseases caused by infectious agents from tropical regions. Sweeping updates to this 3rd edition include vaccines, SARS, hepatitis A-E, Crimean-Congo hemorrhagic fever virus, tick-borne encephalitis and Omsk hemorrhagic fever, human papilloma virus, and mucormycosis. New full-color images throughout allow you to more accurately view the clinical manifestations of each disease and better visualize the life cycles of infectious agents. Definitive, state-of-the-art coverage of pathophysiology as well as clinical management makes this the reference you'll want to consult whenever you are confronted with tropical infections, whether familiar or unfamiliar! - Obtain complete and trustworthy advice from hundreds of the leading experts on tropical diseases worldwide, including cutting-edge summaries of pathophysiology and epidemiology as well as clinical management. - Get the latest answers on vaccines, SARS, hepatitis A-E, Crimean-Congo hemorrhagic fever virus, tick-borne encephalitis and Omsk hemorrhagic fever, human papilloma virus, mucormycosis, and much more. - Implement best practices from all over the world with guidance from almost twice as many international authors - over 100 representing more than 35 countries. - Accurately view the clinical manifestations of each disease and visualize the life cycles of infectious agents with new full-color images throughout. - Access the complete contents online at www.expertconsult.com, rapidly searchable; rapidly locate and download all of the images in either PowerPoint or JPEG format; and follow links to PubMed abstracts for most references. - Reference the book more easily thanks to a new streamlined, single-volume format, with all of the references online.

also occurs. New outbreaks of yellow fever have occurred in Colombia and Trinidad and new outbreaks of rift valley fever have occurred in Egypt. Chapter 6, Arenaviruses: The biochemical and physical properties have now been clar ified, and they show a remarkable uniformity in the various viruses constituting the group. The possibility that prenatal infection with LCM may result in hydrocephalus and chorioretinitis has been raised. Serologic surveys have suggested the existence of Lassa virus infection in Guinea, Central African Empire, Mali, Senegal, Cameroon, and Benin, in addition to earlier identification in Nigeria, Liberia, and Sierra Leone. Chapter 7, Coronaviruses: New studies have confirmed the important role of these viruses in common respiratory illnesses of children and adults. The viruses are now known to contain a single positive strand of RNA. About 50% of corona virus infections result in clinical illness. About 5% of common colds are caused by strain DC 43 in winter. Chapter 8, Cytomegalovirus: Sections on pathogenesis of CMV in relation to organ transplantation and mononucleosis, as well as sections on the risk and features of con genital infection and disease, have been expanded. There are encouraging preliminary results with a live CMV vaccine, but the questions of viral persistence and oncogenicity require further evaluation.

This multivolume handbook presents the most authoritative and comprehensive reference work on major zoonoses of the world. The Handbook of Zoonoses covers most diseases communicable to humans, as well as those diseases common to both animals and humans. It identifies animal diseases that are host specific and reviews the effects of various human diseases on animals. Discussions address diseases that remain important public and animal health problems and the techniques that can control and prevent them. The chapters are written by internationally recognized scientists in their respective areas of disease, who work or have worked extensively in the most affected areas of the world. The emphasis for each zoonosis is on the epidemiology of the disease, the clinical syndromes and carrier states in infected animals and humans, and the most current methods for diagnosis and approaches to control. For infectious agents or biologic toxins, which may be transmitted by foods of animal origin, a strong focus is placed on food safety measures. The etiologic and therapeutic aspects of each disease important to epidemiology and control are identified.

This multivolume handbook presents the most authoritative and comprehensive reference work on major zoonoses of the world. The Handbook of Zoonoses covers most diseases communicable to humans, as well as those diseases common to both animals and humans. It identifies animal diseases that are host specific and reviews the effects of various human diseases on animals. Discussions address diseases that remain important public and animal health problems and the techniques that can control and prevent them. The chapters are written by internationally recognized scientists in their respective areas of disease, who work or have worked extensively in the most affected areas of the world. The emphasis for each zoonosis is on the epidemiology of the disease, the clinical syndromes and carrier states in infected animals and humans, and the most current methods for diagnosis and approaches to control. For infectious agents or biologic toxins, which may be transmitted by foods of animal origin, a strong focus is placed on food safety measures. The etiologic and therapeutic aspects of each disease important to epidemiology and control are identified.