ASTMH

This past week, I was hanging out in Philadelphia for the American Society of Tropical Medicine and Hygiene conference. It was pouring rain, but since the conference was indoors, that wasn't really that big of a deal (until my deputy program director insisted I go play tourist, but I'm getting ahead of myself).

The conference started on Sunday night with a student and trainee reception, which wasn't terribly exciting, but it did include free appetizers and wine. I got to talk to a couple of medical students, grad students, and people applying for medical school about the things that they've done and want to do, so that was pretty neat. After that was the first plenary session, which was mostly focused on how global aid is dropping and the impacts that will have on global health and disease prevention and treatment.

Monday started the endless series of sessions, each an hour and forty-five minutes long and consisting of a series of speakers, each talking for fifteen to twenty-five minutes. I went to sessions on a variety of topics, from dengue (since I'm doing my residency project on it) to global health, clinical sessions, and neglected tropical diseases. I actually really enjoyed the sessions on neglected tropical diseases (which are diseases that only affect the poorest of the poor and don't have a lot of research dollars associated with them). Of these diseases, there are a few that the WHO is slated for elimination or eradication.

Let me back up to explain the difference between those terms: elimination is the cessation of transmission in a given geographical area. For example, polio has been eradicated in the Americas. Eradication means that there is no more transmission anywhere in the world. The only disease that has been eradicated is smallpox. The next step, after eradication, is extinction, meaning that there is no more anywhere, and no diseases fall under that definition, including smallpox (there are still lab samples and who-knows-what from the former Soviet Union).

So, back to what I was saying. There are four diseases that the WHO wants to eliminate/eradicate by 2015 (yes, it's coming up quick). One is trachoma, which is the number one cause of blindness from an infectious disease worldwide. I would include a picture, but pictures of eyes gross even me out. It's actually a Chlamydia bacteria that infects the eyelids, causing scarring that scratches the eye and leads to blindness. The treatment (before one is completely blind) is surgery and antibiotics (azithromycin). The prevention is facial hygiene and clean water. Another is onchoceriasis, also known as River Blindness. This is slated for elimination from the Americas by 2015. They'll focus on eradication at some other point.

As you can see, they're close to elimination in the Americas, and there's still a lot of work to be done in Africa. It's a parasitic infection that causes (wait for it...) blindness, and is transmitted by the bite of a black fly.

Number three is lymphatic filariasis, also known as Elephantitis. Here's an illustration (less gross that way):

It's also caused by a parasite, which blocks lymphatic flow, causing backup and the swelling, like in the picture.

The final one is Chagas Disease, which only occurs in the Americas:

Once again, caused by a parasite, transmitted either by the bite of a kissing bug or from mother to child. There's much less transmission from bug bites now, but there's still quite a lot from mother to child or from blood transfusions.

That was a lot more about that than I anticipated writing. Anyway, that was my Monday and Tuesday, and then on Wednesday, it was sessions in the morning and playing tourist in the afternoon. The hotel was only about half a mile from Independence Park, with the Liberty Bell and Independence Hall. Unfortunately, it was pouring rain, so I was quite soaked, but fortunately, it being a Wednesday afternoon and with that weather, I didn't have to deal with large crowds. Here are some pictures:

Inside Independence Hall, where the Continental Congress met and discussed both the Declaration of Independence and the Constitution. The chair in the middle was where George Washington sat when they approved the Constitution.

Liberty Bell. I wasn't all that impressed.

And the outside of Independence Hall. And yes, there's construction going on. And yes, it was really raining.

Next week, back to clinic.