Around the world, politicians debate the fate of human immigrants. Meanwhile, non-human migrants are spreading throughout the planet.Countries and Territories in the Americas with Active Zika Virus Transmission. (Centers for Disease Control and Prevention, In the February issue of Pediatrics in Review, we see that parasitic infections affect many aspects of pediatric practice, even in North America. As already experienced by primary care providers and as discussed by Dr. Custodio in “Protozoan Parasites,” Giardia and Cryptosporidium are endemic in the United States; other protozoal infections also are widely seen.
Also in this issue, Drs. Hansen and Dolgin review the diagnosis and management of appendicitis. Appendicitis became more common in North America a century ago as processed food and indoor sanitation were more generally available, and appendicitis is now increasingly seen in “developing” countries as “Western” diets and lifestyles are adopted. Even in the US, though, obstruction of the appendix by parasites such as pinworms accounts for approximately 1% of cases of appendicitis. (1)
And, even pediatric subspecialists must consider parasitic diagnoses. As reported by Drs. Shaw Weaver and Federico in this month’s Visual Diagnosis piece, pulmonary parasites should be in the differential diagnosis of patients with cancer who develop intra-thoracic nodules.
Some readers of Pediatrics in Review are planning tropical trips during these winter months. Whether we travel or not, however, “tropical” viruses are headed our way. As reported in The New York Times in January, (2) changes in climate, travel, and accessible treatment have helped illnesses like West Nile encephalitis, Chagas disease, dengue fever, chikungunya fever, and now, perhaps, Zika expand their range into North America. Wherever in the world we practice pediatrics, we must refresh our medical school microbiology memories and stay current about diseases that were previously isolated to “foreign” places.
Meanwhile, American pediatric trainees have access to increased global child health education. (3) Through residency tracks and pathways, via online and in-person educational sessions, and during international educational service trips, we can all participate in learning about global child health.
So, enjoy this month’s issue of Pediatrics in Review – whether you are traveling to the tropics or seeing children with conditions previously thought to be limited to the tropics. Staying up to date about parasitic infections and other “tropical” diseases will benefit children in our practices, children arriving in our areas, and children we see as we travel.
1. Alemayehu H, Snyder CL, St Peter SD, et al. Incidence and outcomes of unexpected pathology findings after appendectomy. J Pediatr Surg 2014;49:1390-1393.
2. McNeil DG. US becomes more vulnerable to tropical diseases like Zika. New York Times 1-5-2016, http://www.nytimes.com/2016/01/05/health/us-becomes-more-vulnerable-to-tropical-diseases-like-zika.html?ref=health&_r=0, accessed 1-6-2016.
3. Pitt MB, Gladding SP, Suchdev PS, et al. Pediatric global health education. JAMA Pediatrics 2016;170:78-84.