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Annual Conference 2005 - Phoenix, AZ

The CIWEC Clinic Travel Medicine Center

Kathmandu, Nepal

David Shlim, MD

The CIWEC Clinic Travel Medicine Center was started in 1982 in Kathmandu to help serve the medical needs of the foreign residents and tourists in Nepal. It has been in continuous operation since then, and has become an internationally recognized center for travel medicine research and treatment. David R. Shlim, M.D. served as Medical Director from 1983-1998, and was succeeded in this position by Prativa Pandey, M.D. who is the current Medical Director. The following is a list of medical journal articles and letters, along with other articles, chapters, and books that derived from the experience of living and working in Nepal.

The CIWEC Clinic Travel Medicine Center contributes the most cases to the international travel medicine database called GeoSentinel. Prativa Pandey was installed in May 2005 as the president of the International Society of Travel Medicine. Nepal has contributed a great deal to the understanding of the medical problems of travelers around the world, and the following list of articles makes the total of their published work available online.

Journal Articles

  1. Taylor DN, Houston R, Shlim DR, Bhaibulaya M, Ungar BLP, Echeverria P. Etiology of diarrhea among travelers and foreign residents in Nepal. J Am Med Assoc 1988;260:1245-1248.
  2. Shlim DR, Houston R. Helicopter rescues and deaths among trekkers in Nepal. J Am Med Assoc 1989;261:1017-1019.
  3. Schwartz E, Shlim DR, Eaton M, Jenks N, Houston R. The effect of oral and parenteral typhoid vaccination on the rate of infection with Salmonella typhi and Salmonella paratyphi A among foreigners in Nepal. Arch Intern Med 1990;150:349-351.
  4. Schwartz E, Shlim DR. Enteric fever among Israeli travelers in Nepal: The need for typhoid vaccination. Israel Journal of Medical Sciences 1990;26:325-327.
  5. Shlim DR, Meijer HJ. Suddenly symptomatic brain tumors at altitude. Ann Emerg Med 1991;20:315-316.
  6. Shlim DR, Schwartz E. Houston R. Rabies immunoprophylaxis strategy in travelers. Journal of Wilderness Medicine 1991;2:15-21.
  7. Schwartz E, Innis BL, Shlim DR, Snitbhan R. Viral hepatitis in foreign residents and travelers in Nepal. Journal of Wilderness Medicine 1991;2:88-93.
  8. Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BLP. An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. Am J Trop Med Hyg 1991;45:383-389.
  9. Robertson JA, Shlim DR. Treatment of moderate acute mountain sickness with pressurization in a portable hyperbaric (Gamow) bag. Journal of Wilderness Medicine 1991;2:268-273.
  10. Shlim DR, Gallie J. The causes of death among trekkers in Nepal. Int J Sports Med 1992;13:S74-S76.
  11. Connor BA, Shlim DR, Scholes JV, Rayburn JL, Reidy J, Rajah R. Pathologic changes in the small bowel in nine patients with diarrhea associated with a coccidia-like body. Ann Intern Med 1993;119:377-382.
  12. Hoge CW, Shlim DR, Rajah R, Triplett J, Shear M, Rabold JG, Echeverria P. The epidemiology of diarrheal illness associated with a coccidian-like organism among travelers and foreign residents in Nepal. Lancet 1993;341:1175-1179.
  13. Schwartz E, Jenks NP, Shlim DR. “Typhoid hepatitis” or typhoid fever and acute viral hepatitis. Transactions of the Royal Society of Tropical Medicine and Hygiene 1994;88:437-438.
  14. Shlim DR, Papenfus K. Pulmonary embolism presenting as high altitude pulmonary edema. Journal of Wilderness Medicine 1995;6:220-224.
  15. Shlim DR, Hoge C, Rajah R, Rabold JG, Echeverria P. Is Blastocystis hominis a cause of diarrhea in travelers? A prospective controlled study in Nepal. Clin Infect Dis 1995;21:97-101.
  16. Hoge CW, Shlim DR, Ghimire M, Rabold JG, Pandey P, Walsh A, Rajah R, Gaudio P, Echeverria P. Placebo-controlled trial of co-trimoxazole for the treatment of Cyclospora infections among travelers and foreign residents in Nepal. Lancet 1995;345:691-693.
  17. Shlim DR, Schwartz E, Eaton M. Enteric fever in Nepal: The clinical importance of Salmonella Paratyphi A infection. Journal of Travel Medicine 1995;2:165-168.
  18. Hoge CW, Echeverria P, Rajah R, Jacobs J, Malthouse S, Chapman E, Jimenez LM, Shlim DR. Prevalence of Cyclospora species and other enteric pathogens among children less than 5 years of age in Nepal. J Clin Microbiology 1995;33:3058-3060.
  19. Serichantalaergs O, Nirdnoy W, Cravioto A, LeBron C, Wolf M, Svennerholm AM, Shlim DR, Hoge CW, Echeverria P. Coli suface antigens associated with enterotoxigenic Escherichia coli strains isolated from persons with traveler’s diarrhea in Asia. J Clin Microbiol 1997;35:1639-1641.
  20. Hoge CW, Shlim DR, Echeverria P, Rajah R, Hermann JE, Cross JH. Epidemiology of diarrhea among expatriate residents living in a highly endemic environment. JAMA 1996; 275:533-538.
  21. Shlim DR, Pandey P, Rabold JG, Walch A, Rajah R. An open trial of trimethoprim versus Cyclospora infections. J Travel Med 1997;4:44-45.
  22. Taylor DN, Connor BA, Shlim DR. Chronic diarrhea in the returned traveler. Medical Clinics of North America 1999;83:1033-1051.
  23. Shlim DR, Hoge CW, Rajah R, Scott R McN, Pandey P, Echeverria P. Persistent high risk of diarrhea among foreigners in Nepal during the first two years of residence. Clinical Infectious Diseases 1999;29:613-616.
  24. Shlim DR. Traveler's diarrhea. Wilderness and Environmental Medicine 1999;10:165-170.
  25. Shlim DR, Innis B. Hepatitis E vaccine for travelers? (Editorial). J Travel Med 2000;7:167-169.
  26. Pandey P, Cave W, Shlim DR. Hepatitis A post hepatitis A vaccination? J Travel Med 2000;7:213-214. [Awarded “Best Short Article” in the Journal of Travel Medicine for the years 1999-2001]
  27. Pollard AJ, Shlim DR. Epidemic meningococcal disease and travel. J Travel Med 2002;9:29-33.
  28. Pandey P, Shlim DR, Cave W, Springer M. Risk of possible exposure to rabies among tourists and foreign residents in Nepal. J Travel Med 2002;9:127-131.
  29. Shlim DR, Solomon T. Japanese encephalitis: Exploring the limits of risk. Clinical Infectious Diseases 2002;35:183-188.
  30. Shlim DR. Medicine on the move. Book review: Principles and Practice of Travel Medicine, Jane N. Zuckerman, ed. Lancet 2002;359:1442-1443.
  31. Shlim DR. Cyclospora cayetanensis. Clinics in Laboratory Medicine 2002;22:927-936.
  32. Hackett P, Shlim DR. Medical advisors for commercial adventures: coming of age? (Editorial). High Altitude Medicine and Biology 2003;3:343-346.
  33. Cave W, Pandey P, Osrin D, Shlim DR. Chemoprophylaxis use and the risk of malaria in travelers to Nepal. J Travel Med 2003;10:100-105.
  34. Shlim DR. Update in Traveler’s Diarrhea. Infectious Disease Clinics of North America 2005;19:137-149.

Letters

  1. Shlim DR, Dexamethasone in the treatment of acute mountain sickness. N Engl J Med 1985; 312:1390.
  2. Babcock D, Houston R, Kumaki D, Shlim DR. Blastocystis Hominis in Kathmandu, Nepal. N Engl J Med 1985; 313:1419.
  3. Schwartz E, Shlim DR. Tickbite appendicitis. J Am Med Assoc 1988; 259:3561.
  4. Shlim DR, Cohen MT. Guillain-Barre syndrome presenting as high altitude cerebral edema. N Engl J Med 1989;321:545.
  5. Eaton M, Cohen MT, Shlim DR, Innes B. Ciprofloxacin therapy for typhus. J Am Med Assoc 1989;262:772-773.
  6. Shlim DR. Severe facial rash associated with mefloquine. J Am Med Assoc 1991;266:2560.
  7. Hoge CW, Shlim DR, Echeverria P. Cyanobacterium-like cyclospora species. N Engl J Med 1993;329:1504-1505.
  8. Rabold JG, Hoge CW, Shlim DR, Kefford C, Rajah R, Echeverria P. Cyclospora outbreak associated with chlorinated drinking water. Lancet 1994;344:1360-1361.
  9. Shlim DR. Diplopia at high altitude [note]. Journal of Wilderness Medicine 1995;6:341-342.
  10. Connor BA, Shlim DR. Foodborne transmission of cyclospora. Lancet 1995;346:1634.
  11. Shlim DR, Panosian C. Case 21-1998: Rabies. NEJM 1999;340:64-65.
  12. Shlim DR. Into Thin Air: Deaths on Everest. JAMA 1999;282:2212.
  13. Shlim DR. Tropical sprue as a cause of traveler's diarrhea. Wilderness and Environmental Medicine 2000;11:140-141.
  14. Shlim DR. Response: If you don't feel well at altitude…Wilderness and Environmental Medicine 2001;12:156-157.

Book Chapters

  1. DN, Shlim DR. Approach to recurrent and prolonged diarrhea in the traveler. In: Jong, EC and Keystone, JS, eds. Travel Medicine Advisor. Atlanta: American Health Consultants; 1990.
  2. Shlim DR, Houston R, Motamedi M. Helicopter rescues and deaths among trekkers in Nepal. In: Steffen R, Lobel HO, Haworth J, Bradley DJ, eds. Travel Medicine: Proceedings of the first conference on international travel medicine, Zurich, Switzerland, 5-8 April 1988. Berlin: Springer-Verlag; 1989.
  3. Lange RW, Stich AHR, Fleischer K, Shlim DR. Expatriates and long-term travelers. In: Dupont HL and Steffen R, eds. Textbook of Travel Medicine and Health, B.C. Decker, Inc. Hamilton, Ontario 1997.
  4. Connor BA, Shlim DR. Cyclosporiasis. In: Strickland GT, ed. Hunter's Tropical Medicine and Emerging Infectious Diseases. W.B. Saunders Company, Philadelphia 1999:600-603.
  5. Shlim DR, Valk TH. Expatriates and long-term travelers. In: Dupont HL and Steffen R, eds. Textbook of Travel Medicine and Health (2nd edition). B.C. Decker, Inc. Hamilton Ontario 2001.
  6. Shlim DR, Hoge CW. Blastocystis hominis. In: Yu VL, Weber R, Raoult D, eds. Antimicrobial Therapy and Vaccines Volume I: Microbes (2nd edition). Apple Trees Productions, LLC. New York 2002.
  7. Hoge CW, Shlim DR. Cyclospora cayetanensis. In: Yu VL, Weber R, Raoult D, eds. Antimicrobial Therapy and Vaccines Volume I: Microbes (2nd edition). Apple Trees Productions, LLC. New York 2002.
  8. Shlim DR, Pandey P. Diarrhea in Expatriates. In: Ericsson CD, DuPont HL, Steffen R, eds. Travelers’ Diarrhea. BC Decker Inc. Hamilton 2003.
  9. Shlim DR. Self-Treatment of Traveler’s Diarrhea. In: Keystone, Kozarsky, Nothdurft, Freedman, Connor, eds. Travel Medicine. Elsevier Science, 2003.

Medical Newsletters and Monographs

  1. Shlim DR, Schwartz E. Fever and headache among travelers in Asia. Wilderness Medicine Newsletter. July 1989.
  2. Shlim DR, Schwartz E. Enteric fever among travelers in Asia. Wilderness Medicine Newsletter. January 1990.
  3. Shlim DR. Treatment of traveler's diarrhea in children. Wilderness Medicine Newsletter 2000;17(4):11-12.
  4. Shlim DR. Prevention of Rabies in Travelers: Appropriate Care in the Overseas Setting. In: Rethinking Rabies Risks: Sharpening Clinical Skills for a Reemerging Threat. Basgoz N, ed. Sciens Worldwide Medical Education 2000.

Abstracts

  1. Connor BA, Shlim DR, Rajah R. Abnormal d-xylose absorption in patients with cyanobacteria-like body diarrhea. Gastroenterology 1992;102:A610.
  2. Connor BA, Shlim DR, Rajah R. Duodenal aspirates in nine patients with diarrhea associated with a cyanobacteria-like body (CLB). Gastroenterology 1992;102:A610.
  3. Shear M, Connor BA, Shlim DR, Taylor DN, Rabold JG. Azithromycin treatment of Cyclospora infections. Gastroenterology 1994;105:A772.

Lay Periodicals and Book Contributions

  1. Shlim DR. A case of HACE. Off Belay. June 1980;51:9-12
  2. Shlim DR. Acute mountain sickness. Emergency. October 1980;12:77-79.
  3. Shlim DR. Backpacking the upper limits. Backpacker. December/January 1981-82;10:84-85.
  4. Shlim DR. First class first aid. Backpacker. November 1982:10;80-82.
  5. Shlim DR. A perspective on mountain sickness and mountain rescue in Nepal. Nepal Himal 1985 (First Edition):29-33.
  6. Shlim DR. Health and safety. In: Armington S. Trekking in the Nepal Himalaya. Berkeley, Calif: Lonely Planet Publications; 1994:104-136. First published in 1985.
  7. Shlim DR. Vanishing into thin air. In: Insight Guide Nepal. Apa Publications (HK) Ltd. 1991:243-245.
  8. Shlim DR. Good Faith: Reflections on the ethics of rescue in adventure travel. Summit: The Mountain Journal. Summer 1991;92-95.
  9. Shlim DR. Staying healthy in the Himalaya. Nepal Travel Trade Reporter. February 1994.
  10. Shlim DR. Adventure-travel medicine. Summit: The Mountain Journal. Special Guide Issue Spring-Summer 1995.
  11. Shlim DR. Nothing More. Summit: The Mountain Journal. Winter 1995-96.
  12. Shlim DR. Dispelling the Myths of Traveler’s Diarrhea. Summit: The Mountain Journal. Summer 1996: 64-67.
  13. Shlim DR, Connor BA. Medical Sleuths in Kathmandu. In: 1996 Medical and Health Annual, Encyclopedia Brittanica, Inc. Chicago, 1996. [Telling the story of how we discovered a new intestinal pathogen called Cyclospora]
  14. Hackett PH, Shlim DR. The High Life: Health and Sickness at High Altitude. In: 1997 Medical and Health Annual, Encyclopedia Brittanica, Inc. Chicago, 1997.

Books

  1. Rinpoche, Chokyi Nyima, with Shlim DR. Medicine and Compassion: A Tibetan Lama’s Guidance for Caregivers. Wisdom Publishing, Boston, 2004.