Journal of Infection (I982) 5, 3~ 1-314

B o o k r e v i e w s

Notes on Infectious Diseases. A.P. Ball, Ed. (Pp. 263; £4.50.) Churchill Livingstone, Edinburgh, I982.

This is a welcome addition to the compact, reasonably priced books primarily written for medical students but also useful for recently qualified doctors and those who wish to be updated on the evolving problems of infection in this modern and high-technology world. It has the fresh approach of a predominantly young team of ~ 6 British authors, half of them from Scotland, and emphasises the basic biological mechanisms of infection with its interrelated clinical, microbiological and epidemiological aspects. A short book cannot be compre- hensive as well as readable, but the coverage is commendably wide and the advice sound.

Dr A. P. Ball's introductory chapter gives a useful summary of the general principles and concepts which is followed by chapters on various subjects chosen mainly as clinical syndromes. Croup deserved mention as a complication of measles. Late-developing deafness is omitted as an important complication of congenital rubella. Cerebrospinal fluid in early mumps meningitis may indeed show a polymorph pleocytosis but is usually lymphocytic when seen. Types I and 2 herpesviruses are not strictly confined to above and below the belt respectively, herpetic whitlow is also seen in babies with stomatitis, and virus culture is more sensitive than immunofluorescence or electron microscopy for diagnosing herpes encephalitis from brain biopsy samples. Tuberculous meningitis is uncommon but not rare, and its importance merits more comment on treatment and complications and on the value of early diagnosis by microscopical examination of cerebrospinal fluid. Hepatitis A rarely gives opportunity for diagnosis by detecting rising antibody titres as suggested, but specific IgM testing provides a useful routine method of laboratory diagnosis. The e-antigen status allows the low-risk majority of hepatitis B carriers to be distinguished from those more liable to transmit infection. There is a useful chapter on atypical pneumonias and Legionnaires' disease in which ' typical ' pneumonias are relegated to consideration under differential diagnosis- an interesting sign of the times! Fulminating influenzal pneumonia is briefly mentioned in relation to the compromised host, although classically it devastated healthy young adults. The concise chapter on rabies would benefit from more details to help the doctor faced with evaluating a case of possible exposure and deciding on what active, with or without passive, prophylaxis should be invoked- a much simpler decision now that a safe and effective vaccine is available. There are informative and useful chapters on imported infections and viral haemorrhagic fevers, and a salutary and helpful chapter on infection in hospital patients. There will not be universal agreement with the recommen- dation that nursing staff should be tested for immunity to cytomegalovirus since evidence that they are at greater risk at work than in life outside the hospital is conflicting and no prophylactic vaccine is available; also the significance of the routinely available complement fixation test as a measure

3 I2 Book reviews

of susceptibility to this ubiquitous infection is uncertain. A closing chapter deals with ' the clinician and the bacteriology laboratory' from a traditional point of view. I would prefer to see more emphasis on the importance of providing adequate information with the specimens sent to the laboratory, and also some mention of virology and the incoming range of serological tests for protozoal and parasitological infections.

Other omissions concern ' P U O ', for which at least a checklist reminder of possible causes and appropriate investigations would be useful, as also would be surveillance and control measures with a list, for reference, of currently notifiable diseases and some reminder of other sources of information about those infections which escape the notification system although they may bulk large in public and professional concern - the rising generation could benefit from a reminder that the classical system of'notifications' on which their elders tend to rely is calculated to conceal, rather than reveal, the true quantity and importance of the infectious diseases of today!

But these are small imperfections in a book which is well written, with a useful bibliography of supplementary reading for those who require more detailed information. It is handily sized and neatly produced and represents a 'good buy ' with today's money which I, for one, can certainly recommend to my students.

N. R. Grist

Recent Advances in Infection, 2. D. S. Reeves and A. M. Geddes, Eds. (Pp. 226; £13.oo.) Churchill Livingstone, Edinburgh, I982.

Since the publication in I979 of the first number of what one hopes may become a continuing series, the two editors have succeeded in selecting new topics which again amply justify the inclusion of the words 'recent advances' in the title of their second number. They have chosen experts, not only from the United Kingdom alone as in the first number, but now from the United States, Sweden, Austria and Mexico as well to write on these new topics. The interests of Dr Reeves and Dr Geddes reflect a fair balance between the laboratory and clinical aspects of bacteria and bacterial disease. Viral infections, however, are almost ignored except in the chapters on the prevention of laboratory-acquired infection and on chemoprophylaxis. The only other chapter not primarily concerned with the aetiology, pathophysiology, clinical features, treatment or prevention of bacterial disease is one on antihelminthic drug therapy. A greater emphasis on non-bacterial illness would be welcome in the next number.

The book in semi-stiff covers is well set out and clearly printed. The contents and contributors are listed on the back cover making for easy reference. The book comprises a series of chapters or monographs and starts well on immunisation where four authors individually deal with (I) streptococcal polysaccharide vaccines (pneumococcal and streptococcus Group B), (2) pseudomonas vaccines and specific immunoglobulins (3) the prevention of dental plaque and caries by immunisation and (4) the immunological effect and preventive efficacy of BCG in different populations. Next Dr Casewell tackles the increasingly worrying problem of multiply resistant coliforms acquired in