The origin of feces: what excrement tells us about evolution, ecology, and a sustainable society / David Waltner-Toews, ECW Press, £12.99

One is drawn immediately to this book by its wonderfully whimsical title – a play on Darwin's famous paper – and the merriment does not end at the front cover. With chapters entitled Turds of Endearment and Know Sh*t: A Way Forward, there are plenty of puns, jokes and anecdotes, but the underlying message of how management of natural waste can provide a solution to environmental challenges is a serious one. Waltner-Toews, a Canadian conservationist and epidemiologist, outlines how in nature excrement is a source of food and energy and is important in the recycling of nutrients. This holistic view of poo is at odds with its perception in today's ultra-sanitised developed societies, where it is seen as something unpleasant and which disposal of is, er, the end point.It is argued that while substandard sanitation leads to fouling of waterways and public health concerns, faeces should be embraced on an industrial scale as a ready made source of energy. Using biodigester technology, both human and animal sewage can be digested anaerobically to make nitrogen-rich fertiliser and to produce methane to generate electricity and heat. Importantly, this would provide a simple, cost-effective solution to the reduction of greenhouse gas emissions from farming waste. The electricity and fertiliser can be sold for profit and the heat generated reused on the farm to save money. A case of "where's there's muck, there's brass". This book is recommended reading for all those with an environmental conscience – not just the organic composters among us

Vaccine myopia: adult vaccination also needs attention

I read with interest the call by Menzies and colleagues for revitalised efforts to vaccinate against common infectious diseases a higher proportion of the adult Australian population.1 Currently, the aim of the adult component of the National Immunisation Program is to protect against the Gram-positive bacterium Streptococcus pneumoniae and the two viruses that cause influenza and herpes zoster (shingles), all pathogens which are prevalent in our environment. In addition to infections derived in Australia, adults are more likely than children to be the focus of imported cases of infection. Exposure of adults to, for instance, tropical infectious diseases, including those transmitted by biting insects (malaria, dengue, yellow fever, chikungunya, Zika, etc.), will be far greater than that of juveniles. This is because adults have more reason to travel overseas and typically undertake more trips than do children.2 Vaccine uptake amongst travellers is mixed and there are groups that are not sufficiently vaccinated including those people who travel overseas to visit friends and relatives. These so-called ‘VFR travellers’ are more likely to consider themselves at low personal risk or threat when travelling to their country of origin, stemming from a sense of familiarity with the destination country and its infectious disease risks.3 Cultural beliefs and language barriers are also important factors associated with suboptimal uptake of pre-travel advice among VFR travellers. While infants accompany their parents for holidays and to visit family abroad intercontinental travel for business and educational opportunities is largely restricted to adults.4 For typical short-stay business trips, rather than for holidays lasting an extended period, it is it is tempting to neglect being up to date with vaccinations.2 In this instance, for the busy business flyer, often a last-minute traveller, the risk aversion to illness may be suppressed by avoidance of the perceived hassle of immunisation. Travel acts as a vector for spread of infection and many outbreaks are imported into Australia through trips overseas. Travellers frequently neglect to seek pre-travel health advice.5 Improving rates of travel vaccination, especially in adults for the reasons outlined, is one area of focus that may help infectious disease control efforts nationally

Contamination of emergency medical vehicles and risk of infection to paramedic first responders and patients by antibiotic-resistant bacteria: Risk evaluation and recommendations from ambulance case studies

Contamination of emergency medical vehicles with pathogenic microbes poses a potential threat to public health considering the many millions of ambulance responses that are made globally each year. This risk of infection is to the patients, to their companions who may travel with them, and to the paramedic first responders whose work involves pre- or inter-hospital transfer. This applies particularly to contamination by those infectious disease-causing microbes for which the threat is heightened because of their recognised resistance to leading antimicrobial agents. Determining the risks should facilitate the advancement of best practices to enhance infection control of routine outbreaks and during a major emergency such as a disease pandemic or a bioterrorism event. This may merit the introduction of amended guidelines for ambulance cleaning and disinfection to achieve more effective pre-hospital infection control among the worldwide community of emergency service providers

Dengue diagnosis, treatment and vaccine design: are efforts hampered by multiple serotypes and cross-reactivity with Zika?

Dengue is acknowledged to be the world’s foremost arboviral infection of humans. This Aedes mosquito-borne pathogen is recognized as the aetiological agent of a preeminent re-emerging tropical disease and serious public health threat. Four discrete but genetically similar serotypes of dengue virus, DENV 1-4, trigger a range of clinical symptoms from mild fever to severe haemorrhagic complications. The existence of a phylogenetically more distant fifth serotype was recently suggested. Verification of identity is now needed before it can be officially ratified as DENV-5. Still, the prospect of another serotype calls into question the intrinsic efficacy of anti-dengue vaccines and therapies founded on DENV 1-4 that are now being developed. Accordingly, the presence of DENV-5 and other closely related sylvatic arboviruses, such as Zika, may hamper attempts to identify and treat dengue fever and related pyrexias of unknown origin. The ramifications of this should be considered when updating protocols for diagnosis, therapy, control and prevention

A vaccine effective against Zika virus is theoretically possible but may not be delivered anytime soon

Following the first report in May 2015 of the unexpected emergence of Zika in north east Brazil there has been an explosive epidemic of this infection across Latin America. The outbreak has caused alarm among social and news media as to the virulence and transmission potential of the Aedes mosquito-borne virus. This debate is heightened by the proximity, both in time and distance, to the forthcoming Olympic Games to be held in Rio de Janeiro this August, provoking fears for the safety of athletes and spectators alike. The threat, real or perceived, is exacerbated by the movement between nations in the same or separate continents of persons who act unwittingly as asymptomatic carriers. Pregnant women are considered at greatest risk because microcephaly in newborn infants is linked to, if not yet proven as caused by, Zika infection. In February this year the World Health Organization declared that further to the then unconfirmed association between the virus and the clinical manifestations of microcephaly and also Guillain-Barré syndrome the Zika epidemic was a “public health emergency of international concern”. No anti-Zika therapy, vaccine or drug, is currently available and while the production of the former has now been prioritized by multiple funding agencies, the history of infectious disease vaccine development indicates that this may take several years to reach the market place. The fact that Zika is a close relative of yellow fever and Japanese encephalitis viruses, for both of which there are already effective vaccines, provides a rational basis for the fast-tracked laboratory-based preparation of a candidate vaccine. However, undertaking clinical trials on pregnant women provides ethical and practical hurdles to overcome before licensure is granted for public administration. Meanwhile, public health management strategies, including mosquito control programs to reduce breeding, are needed to limit the global spread of this re-emerging disease

Secret lives of your uninvited guests [book review]

Review of ‘House Guests, House Pests: A Natural History of Animals in the Home’, Richard Jones, Bloomsbury Publishing, £16.99

Exploring immunology : concepts and evidence. Gordon MacPherson & Jon Austyn

Book revie

Exploring immunology: concepts and evidence. Gordon MacPherson & Jon Austyn

Book revie

Regulation of immunity to Plasmodium : implications from mouse models for blood stage malaria vaccine design

Malaria, a disease caused by the protozoan parasite Plasmodium, remains a serious healthcare problem in developing countries worldwide. While the host–parasite relationship in humans has been difficult to determine, the pliability of murine malaria models has enabled valuable contributions to the understanding of the pathogenesis of disease. Although no single model reflects precisely malaria infection of the human, different models collectively provide important information on the mechanisms of protective immunity and immunopathogenesis. This review summarizes progress towards understanding the broad spectrum of immune responsiveness to the blood stages of the malaria parasite during experimental infections in mice and highlights how examination of murine malarias sheds light on the factors involved in the modulation of vaccine-potentiated immunity

Possible immunopathological sequelae of severe COVID-19 immunotherapy: The lesser of two evils?

Eighteen months into the COVID-19 pandemic the number of people infected with SARS-CoV-2 is still increasing worldwide [1], rapidly in many countries, due to a spike in incidence related to community transmission of a hitherto locally unseen variant of this beta-coronavirus. The global confirmed case mortality statistic continues to escalate in the face of a steady roll out of immunization programs with one or other regulatory authority-approved efficacious vaccine [1]. As infected individuals may experience a potentially life-threatening course of infection, especially those in high-risk groups such as the elderly, people with health conditions and pregnant women, there remains an urgent need for effective drug therapy for severe COVID-19. Due to the sheer scale of the public health crisis caused by the pandemic, the consensus of the global biomedical research community is that time is too short to develop novel specific agents. Thus, existing antivirals or immune modulators with known safety profiles are gaining traction as the fastest route to treat hospitalized cases of COVID-19 [2]. Compounds that have already been tested in other indications now have priority, in particular those shown to be effective in treating infection with the closely related coronaviruses that are the causative agents of SARS and MER