home page | Catalogue table of contents |
How to order | WHO sales agents | Contact information |
|Click here to view a large number of on-line documents|
|These on-line documents provide information on the following topics:|
Guidelines for the Surveillance and Control of Anthrax in Humans and Animals
1998, xiv + 119 pages + 18 colour plates (English)
Sw.fr. 48./US $43.20; in developing countries: Sw.fr. 33.60
Order no. 1930161
This manual provides a comprehensive guide to the surveillance and control of anthrax in humans and animals. Now in its third edition, the manual has been updated to reflect both new knowledge about the disease and recent practical experiences in national control programmes. Information is intended for use by any veterinary or public health service confronted with an epidemic, an isolated case, or questions ranging from the duration of quarantine to the safety of milk.
While noting the effectiveness of vaccines and other preventive measures, the manual gives particular attention to the complexities of controlling a disease spread by remarkably hardy spores that survive environmental extremes and many chemical disinfectants, and can travel great distances in the meat, hides, hair, wool or bones of infected animals. Information ranges from a list of measures that encourage farmers to report cases, through advice on when to vaccinate all animals in a herd, to the reasons why, in many countries, anthrax carcasses are almost always butchered and the meat consumed. Throughout, an effort is made to balance recommended best practices with the realities of resource-poor settings where anthrax poses the greatest threat to human and animal health.
The manual has two parts. Part one provides a state-of-the-art review of all knowledge about the disease relevant to its control. A brief overview of the historical importance of anthrax is followed by a summary of its etiology, cycle of infection, and the environmental behaviour of spores. Section three, on anthrax in animals, gives concise information on host range and susceptibility, geographical occurrence, sources of infection, mechanisms of transmission, pathogenesis, clinical features, and laboratory tests for diagnosis.
Anthrax in humans is covered in the next section, which includes information on incidence, geographical distribution, risks associated with industrial and non-industrial forms, characteristics of the three clinical syndromes, factors influencing the severity of infection, complications, and recommended diagnostic tests. The possible use of anthrax as a biological weapon is also briefly discussed. Other sections summarize what is known about the pathogenesis, pathology, and bacteriology of anthrax, and offer detailed advice on the most appropriate antimicrobial treatment for animals and humans.
The most extensive section, on control, deals with the many difficult problems surrounding the disposal of anthrax carcasses, infection control in the management of human cases, and procedures for the disinfection, decontamination, and safe disposal of infected or contaminated material, including laboratory equipment and facilities, the environment, animal wastes, and animal products used commercially. The place of vaccines in control programmes is also briefly discussed. Part one concludes with a series of recommendations, including standardized case definitions, intended to facilitate surveillance and reporting by national veterinary and public health systems.
Part two sets out a number of technical and practical tools for use in control programmes. These include a guide to standard laboratory procedures for isolation and identification of B. anthracis and confirmation of diagnosis, recommended media and reagents, guidelines for carcass disposal and site decontamination, and lists of manufacturers of veterinary and human vaccines. Additional information includes a contingency plan for prevention and control in response to outbreaks or isolated cases, an example of a model country programme, and advice on the safe transportation of infectious substances and diagnostic specimens.
The Medical Impact of the Use of Antimicrobials in Food Animals
Report and Proceedings of a WHO Meeting (Berlin, Germany, October 1997)
1997, iv + 281 pages (English)
Sw.fr. 30./US $27.00; in developing countries: Sw.fr. 21.
Order no. 1930158
This book records the proceedings of a large consultation convened by WHO to consider current practices surrounding the use of antimicrobials in food animals and assess the implications for human medicine. Practices considered include the use of antimicrobials as growth promoters, for disease prevention, and for the treatment of infection. While acknowledging the many deficiencies in current knowledge, the meeting responded to mounting microbiological and clinical evidence that resistant bacteria might be passed from animals to humans and thus contribute to the growing problem of drug resistance in human medicine.
In view of this concern, the meeting adopted a public health approach, aiming to identify the specific risks to human health, assess their current and future significance, and reach conclusions concerning the components of a timely and appropriate preventive strategy. Throughout, a special effort is made to base recommendations on a rigorous review of the scientific evidence. Issues addressed range from factors influencing the spread of drug resistance in livestock production, through the medical relevance of specific animal pathogens, to the pressing need for better surveillance at the national and international levels. The place of antimicrobials in sustainable food production is also considered in detail.
The volume features 39 presentations organized in three main groups. Papers in the first group describe patterns of antimicrobial use in animal husbandry in different countries, and explain how current practices are controlled by various regulatory frameworks. Factors influencing the development and spread of resistance in different production systems are also identified and discussed. Papers in the second group assess trends in antimicrobial resistance in livestock production, as documented by recent epidemiological and microbiological findings, and consider the impact of these trends on the treatment of human infections. The remaining papers, concerned with preventive measures, describe practical experiences in the use of risk management at the primary production level as a strategy for reducing the need for antimicrobials and thus diminishing the potential risks to public health.
The report also includes a number of key recommendations and conclusions concerning such issues as the use of growth promoters, the need to standardize and harmonize the monitoring of antimicrobial resistance, the elements of national and international monitoring programmes, the use of risk management at the primary production level, and priorities for research and development.
1999, 171 pages [E]
Sw.fr. 15./US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1930170
A complete practical guide to the diagnosis and treatment of human plague and to preventive measures aimed at controlling rodent reservoirs and flea vectors. Written by leading experts on this disease, the manual draws on extensive WHO experience in vector control and in the surveillance of plague as a notifiable disease under the International Health Regulations. Details range from advice on the exact procedures to follow during outbreaks of human disease, through a list of reasons why flea indices must be reduced before control of rodent reservoirs is undertaken, to instructions for the rapid and cheap construction of bait boxes. Over 300 references to the literature are included.
The manual has seven chapters. The epidemiology and distribution of plague are covered in the first, which summarizes current knowledge about Yersinia pestis and its modes of transmission, assesses country-specific trends in morbidity and mortality over the past four decades, and analyzes the characteristics of active plague foci in different geographical areas. Chapter two covers the clinical manifestations of different forms of plague and offers guidelines for diagnosis on the basis of signs and symptoms, differential diagnosis, and laboratory diagnosis. Chapter three, on treatment, gives precise instructions for immediate antimicrobial therapy with first-choice drugs. Guidelines are also provided for supportive management of complications, prophylactic therapy, and hospital precautions.
Chapter four describes the species of rodents and flea vectors found in each geographical region or country known to have endemic foci. The fifth and most extensive chapter provides guidelines for the control of plague transmission, emphasizing the different measures needed for flea control on commensal and wild rodents. The chapter gives especially detailed advice on the characteristics of a large number of first- and second-generation anticoagulants and acute rodenticides classified as extremely hazardous, moderately hazardous, or minimally hazardous to humans and non-target animals. Compounds not recommended by WHO are clearly indicated.
Noting that plague continues to pose a threat to human health in the many areas where natural foci persist, chapter six explains how to set up a surveillance system that collects, analyzes, and interprets clinical, epidemiological, and epizootiological data. Recommended techniques for the surveillance of rodent and vector populations are covered in detail. The final chapter summarizes a four-phased system of plague prevention and control, recommended by WHO, that can be adapted to the requirements and resources of different countries.
World Health Organization Report on Infectious Diseases
Removing Obstacles to Healthy Development
1999, 68 pages (English)
Sw.fr. 12./US $10.80; in developing countries: Sw.fr. 8.40
Order no. 1930156
Click here to view the online edition of this report.
This report provides an alarming assessment of the growing problem posed by infectious diseases. Drawing on the latest WHO statistics, the report cites evidence that the world has dangerously underestimated the threat bacteria and viruses are posing to national security and economic growth, and may soon miss its opportunity to protect people from this risk.
As the report shows, infectious diseases are now the world's leading killer of children and young adults, accounting for some 13 million deaths each year. In 1998, only six diseases AIDS, malaria, tuberculosis, measles, diarrhoeal diseases, and acute respiratory infections accounted for nearly 90% of these deaths.
Apart from documenting the magnitude of the problem, the report also looks for explanations. Factors identified as contributing to the spread of infectious diseases include the growing problem of drug resistance, the emergence of new diseases, the expansion of international travel, and huge increases in mass population movements. These trends raise questions about the world's ability to stop epidemics at affordable costs.
On the positive side, the report describes a number of existing low-cost interventions that can either prevent or cure those infectious diseases which take the greatest toll of human life. Success stories from different parts of the world show how these interventions have also worked to alleviate poverty and further socioeconomic development.
Having underscored both the feasibility of action and its many benefits, the report argues that the world has a window of opportunity to make dramatic progress in controlling these six leading killers and protecting the world against new diseases. As the report stresses, the cost of failure will be high: increased drug resistance and the emergence of new bacteria and viruses could make the control of infectious diseases both scientifically and economically unlikely in the future. The progress that the world can make today might not be possible a decade from now.
In its concluding chapter, the report outlines priority steps for combatting infectious diseases and issues an urgent call for action to reduce their impact as obstacles to healthy development as well as leading causes of death and suffering.
WHO Manual for Strengthening Diagnosis and Surveillance of Creutzfeldt-Jakob Disease
Additional WHO CJD documents available online
M. Zeidler, C.J. Gibbs Jr. and F.-X.
1999, iv + 75 pages + 30 colour plates (English)
Sw.fr. 25./US $22.50; in developing countries: Sw.fr. 17.50
Order no. 1930160
This manual provides an expert assessment of what is currently known about Creutzfeldt-Jakob disease (CJD), a rare and fatal human neurodegenerative condition. Although all human and animal transmissible spongiform encephalopathies are covered, particular attention is given to the potential public health threat posed by the recent identification of new variant Creutzfeldt-Jakob disease (nvCJD).
Noting that many more cases could occur in the next decades, the book addresses the urgent need for global surveillance, offering abundant practical advice on diagnosis, differential diagnosis, case definitions, procedures for standardized data collection and reporting, and mechanisms for global coordination under WHO leadership. Throughout, recommendations for safeguarding public health are based on a balanced assessment of what is known about these diseases and the many uncertainties surrounding their causative agents and modes of transmission.
The manual has 12 sections. The first provides a brief history of the transmissible spongiform encephalopathies (TSE) and explains why global surveillance is needed. Section two summarizes current knowledge about the epidemiology and clinical features of the human TSE, including sporadic CJD, familial disease, iatrogenic CJD, kuru, and nvCJD. For nvCJD, information includes detailed clinical profiles for each of the initial 14 cases identified in the United Kingdom.
Animal TSE are covered in section three, which reviews current knowledge about scrapie, bovine spongiform encephalopathy, chronic wasting disease of mule deer and elk, transmissible mink encephalopathy, feline spongiform encephalopathy, and spongiform encephalopathies of captive wild ruminants and felines.
Subsequent clinical sections compare the sensitivity and specificity of currently available diagnostic tests for CJD, and discuss the "slow-virus " and "prion" hypotheses for explaining the nature of the infective agent. Section seven offers advice on tissue handling and safety precautions, particularly in view of the resistance of the TSE agent to standard procedures of medical sterilization.
The second half of the manual provides information designed to support standardized diagnosis and surveillance. Sections feature case definitions, pathological diagnostic criteria, advice on surveillance reporting, and a series of case reporting forms for the systematic and standardized global collection and reporting of data.
2000, ii + 35 pages [E]
WHO Infection Control Guidelines for Transmissible Spongiform Encephalopathies
An authoritative guide to procedures and precautions needed to prevent iatrogenic and nosocomial exposure to transmissible spongiform encephalopathies (TSEs) in hospitals, health care facilities, and laboratories. Prepared by an international group of 32 leading experts, the guidelines respond to the unusual resistance of TSE agents to conventional chemical and physical methods of decontamination and the corresponding need for special precautions. Areas of patient care and categories of interventions, tissues, instruments, and wastes that do not require special precautions are also clearly indicated.
In issuing these guidelines, WHO aims to help medical officers, specialists in infection control, care-givers, and laboratory workers reduce the risks of TSE transmission to negligible levels. With this goal in mind, the guidelines provide a logical framework for determining levels of risk and knowing when departures from standard procedures for infection control are required. Specific recommendations are set out in tables and explanatory text covering patient care, occupational injury, laboratory investigations, decontamination procedures, waste disposal, and precautions after death. Adherence to these procedures should ensure a high level of safety. As the document repeatedly emphasizes, no TSE patient should be denied admission to a health facility, kept in isolation, or deprived of any procedure.
Further practical advice is provided in a series of annexes, which give exact instructions for recommended decontamination methods and discuss the management of healthy "at risk" individuals and individuals with confirmed or suspected variant Creutzfeldt-Jakob disease.
WHO Recommendations on Rabies Post-Exposure Treatment and the Correct Technique of Intradermal Immunization against Rabies
1997, 26 pages (English)
Sw.fr. 15./US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1930159
This booklet provides a didactic guide to standard regimens, recommended by WHO, for the post-exposure treatment of rabies. Particular attention is given to the correct technique for intradermal vaccine injection, which is now recognized as an effective and economical alternative to traditional intramuscular injections. The intradermal technique produces comparable protection against rabies, yet requires considerably less vaccine. Like the intramuscular technique, the intradermal technique is suitable for people of all ages, and can be used in pregnant women. The intradermal technique is especially appropriate in centres dealing with a large number of patients, provided an established cold chain and well-trained staff are available, and special precautions are followed.
The booklet has two parts. The first sets out WHO recommendations for post-exposure treatment of rabies. Recommendations include advice on when to start and discontinue treatment, guidelines for the first-aid and subsequent treatment of wounds, and detailed instructions for both intramuscular and intradermal schedules using purified cell culture and embryonating egg vaccines. Additional guidelines cover the administration of rabies immune globulin, post-exposure treatment of previously vaccinated patients, and pre-exposure vaccination in groups at special risk.
The second part of the booklet provides an illustrated guide to the correct procedure and special precautions required for intradermal vaccine injection. Information includes advice on the choice of vaccines, a list of vaccines meeting WHO requirements, detailed instructions for the two-site and eight-site intradermal methods, and a description of the correct technique. To facilitate training, colour plates illustrate injection equipment, insertion and injection techniques, and the appearance of the final blanched papule seven days after vaccine administration.
The booklet, which can be used for training purposes or as a guide to policy decisions, should prove particularly useful in developing countries of Africa, Asia, and South America, where more than 99% of human rabies deaths occur, and where the economies promised by the intradermal technique may facilitate the more widespread use of modern rabies vaccines.