MCQs in travel medicine
252 s. Oxford: Oxford University Press, 2012. Pris GBP 30
Did you know that more than 90 % of cases of visceral leishmaniasis occur in India, Pakistan, Bangladesh and Nepal? That rafting is the most common way for tourists to contract leptospirosis? That nectar and fruit juice are important energy sources for female as well as male mosquitoes? That Culex tritaeniorhynchus (vector for Japanese encephalitis) can fly 4.82 km under its own power? That MRSA infections can be transmitted by flies? That you should wait at least six weeks before flying following even a minor pneumothorax? If not, this book could be for you.
The book is intended especially for those preparing for an examination in travel medicine. It contains 600 multiple choice questions arranged in chapters on different topics with detailed answers. The author covers the whole of the broad spectrum that is travel medicine: distribution of diseases, entomology, parasitology, vaccines, diseases, pre-travel advice, travel for pregnant women, children, the elderly and the sick, how people travel and the types of activities they engage in, sun cream, jetlag, sexually transmitted diseases, psychiatry, the destination health services, evacuation in case of disease and travellers after returning home. The author calls this «a textbook in MCQ format».
When reading a «multiple choice» book of this type, one is also bombarded with wrong information (usually three out of four statements are false), and one has to remember what is right and what is wrong. In some instances the false statements are not completely false, and this is explained in the answer. It is possible that one may remember later: «Didn’t I read somewhere that… etc.», also when it comes to the wrong answers. The most effective way to learn from this book would be to read only the introductory paragraphs and the model answers, which are well founded.
Some shameful factual errors crop up, such as that ticks are seldom encountered in forests, and that they feed for a maximum of 15 minutes. On occasions I disagree with the author when he addresses discretionary topics. For example, what is most important when running a vaccination office, to have a refrigerator dedicated solely to vaccine storage, or to have more than 20 patients per week? According to the model answer, it is the dedicated refrigerator, but I myself am on the side of patient access! That small children should not be exposed to direct sunlight seems much too stringent for us who think it is fine for children to get a tan in the summer. Those who perform travel vaccinations in Norway should follow the recommendations of the Norwegian Institute of Public Health. For example, Dom Colbert recommends vaccination against hepatitis B for everyone travelling to areas with a prevalence of infection of more than 2 %, whereas the Norwegian Institute of Public Health only recommends this vaccine for those at increased risk of hepatitis B.
The author provides no references for each individual answer, and this book cannot be used as a scientific reference. Its credibility and usefulness would have been enhanced if it had provided references. The book includes so many interesting and useful points that it is surprisingly exciting to read, even though it has no illustrations and the content is only a litany.