Infectious diseases remain an important cause of morbidity and mortality in Indonesia. The reduction, elimination, and eradication of infectious diseases have been the subject of numerous meetings and public health initiatives for decades. The malaria, yaws and other communicable disease eradication programs of earlier years, although unsuccessful, contributed greatly to an understanding of the difficulties faced in trying to achieve goal of disease control. The reemergence of old infectious diseases, along with the emergence of new diseases such as SARS, Avian Influenza and the development of antimicrobial resistance, pose significant challenges to public health.

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The emergence of new and the re-emergence of old infectious diseases reverses our previous belief that communicable diseases have been brought under human control. The development of antibiotic-resistant bacterial and fungal infections and the apparent lack of vaccines for many infectious diseases remind us of how vulnerable we are. Infections with SARS coronavirus, Nipah virus, and, more recently, H5N1 influenza virus in humans are just a few reality checks and more are expected. The problems of these emerging and re-emerging infections (ERI) give us several warnings. First, there are a number of pathogens, most of which are viral, that pose potential risks to human health and we know quite little about them. Second, many of these ERI are zoonotic. Effective control of zoonoses needs involvement and collaboration from the non-health sector. Third, since these ERI can easily spread across geopolitical boundaries, countries with a good public health infrastructure are not risk-free and should not be complacent. Surveillance and response efforts cannot be limited within one national boundary. Fourth, aside from the fundamental tools in disease control that we have, e.g. basic sanitation, personal hygiene, isolation and quarantine, and the newly-revised International Health Regulations, we have little other choices, e.g. drugs and vaccines. This limitation suggests that we could eventually be defenseless. Fifth, recent occurrences of certain ERI in some countries have demonstrated that damages caused in non-health terms, e.g. economic losses, can be significant. As a consequence, ERI may be dealt with as an economic problem while the human and health dimensions are ignored. There are a number of guiding principles that we may have to adopt. First, no country can or is allowed to fight ERI alone, no matter how well-developed its economic condition and public health infrastructure. However, it should be noted that ERI is a national health security problem and that national sovereignty must be recognized when addressing the ERI issues. Second, ERI problems need a lot of non-health partners, e.g. business and agriculture. Third, we need to improve our capacity to do surveillance and to respond. Surveillance without response is pointless. Fourth, we need specific tools to help tackle ERI. Networking is a mechanism through which countries can work together to fight ERI. A number of forums exist to address the problems of ERI, e.g. meetings of WHO and other UN agencies including FAO⁄OIE, ASEAN+3, and ACMECS. In addition, several bilateral frameworks are in place to address ERI. However, it is important to note the particular nature of ERI and follow the above-mentioned guiding principles to avoid failure.

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Simulium (Nevermannia) satakei sp. nov. is described on the basis of the pupa and mature larvae collected from the Ogasawara (Bonin) Islands in Japan. This new species, tentatively (due to lack of the adult stage) assigned to the vernum species-group of the subgenus Nevermannia, is characterized in the pupa by four gill filaments lacking transverse ridges, and in the larva by a small, M-shaped postgenal cleft, antenna without hyaline bands, and simple rectal papilla. The morphological differences among this new species and the two known species, S. (N.) uemotoi from Japan and S. (N.) karzhantacum from Uzbekistan and Turkmenistan, are noted. This is the second species of the family Simuliidae from the Islands.

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Little is studied about traditional healers‘ perceptions toward and practice of uvulectomy, which is known as a traditional surgical practice mainly in Africa and which sometimes results in severe complications. This study aimed to clarify the perceptions toward and practice of uvulectomy and the other traditional healing practices of traditional healers in a Congolese refugee camp in Tanzania. Interviews were conducted with 149 traditional healers, comprised of 59 registered, 68 non-registered and 22 faith healers. A total of 1.7% of the registered healers and 8.8% of the non-registered healers had ever conducted uvulectomy on children (a median of 2 months to a median of 3 years of age) and had received cash or domestic fowls equivalent to US$1-3 per operation. Although over 80% of the respondents believed traditional treatments to be more effective than modern medicine, less than 20% considered uvulectomy beneficial and in fact about 40% considered it to be harmful. The respondents raised cough, vomiting, appetite loss and other symptoms as an indication for uvulectomy, and death, bleeding, throat pain and other symptoms as harmful effects associated with uvulectomy. In this camp, the healers also performed other surgical procedures, such as male and female circumcision, tattoos and scarification. In conclusion, only a limited number of the traditional healers believed that uvulectomy is beneficial and performed it on infants and young children, and these were mainly non-registered healers who had relatively little collaboration with modern health professionals. In refugee settings where modern health professionals might not be familiar with traditional healing, it is considered crucial to assess the risks of ongoing traditional practices and to strive to achieve more strategic communication between modern and traditional health providers.

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Nineteen stocks of Trypanosoma cruzi originating from several endemic countries for Chagas‘ disease in Central and South America were subjected to two-dimensional protein electrophoresis analysis. The presence or absence of a total of492polypeptide spots among19gel profiles was determined. The stocks were classified into three major distinctive groups derived from (I) Central America and the northern part of South America; (IIa) Central America and the northern part of South America; and (IIb) central and southern parts of South America, which showed perfect concordance with the previously reported classification based on isozyme and DNA sequence analyses. Late log phase of each epimastigote was inoculated to human cell lines WI-38and Hs224.T originating from the lung and muscle, respectively, and the number of trypomastigotes released was counted. The number of trypomastigotes from T. cruzi in group I released from the two cell lines was significantly higher than that in group III (p&It;0.05). The findings suggested that the phenetic distance appearing within the T. cruzi may, to some extent, be associated with the intracellular growth of T. cruzi, one of the characteristic features of growth found in the species.

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