Tropical Medicine: Alive and Well in Quebec

Spring 2011

“Tropical medicine is often associated with parasitic diseases in countries with humid climates and sweltering temperatures,” says Michael Libman, MDCM’85, director of McGill’s Division of Infectious Diseases. “But that’s too simplistic to say. What we explore is a combination of diseases often originating from tropical latitudes, from widespread poverty, from areas rampant with parasites – which can mean in all kinds of places – and from certain cultural and traditional practices.”

Libman, who is also interim director of the J.D. MacLean Centre for Tropical Diseases at the Montreal General Hospital of the MUHC, knows first-hand the range of infectious diseases that migrate to Quebec from around the world. For example, in 2000, the province had a mild imported malaria outbreak with the arrival of several infected African refugees. Many of the Centre’s patients are travellers, professionals and volunteers involved in humanitarian work, as well as immigrants.

But infections can also originate from within the province. “A lot of our own First Nations and Inuit populations have what might be considered to be ‘tropical’ infections in the sense that they are parasitic in nature,” says Libman. He cites one case, in particular, of the culinary practices of the Inuit people of Nunavik in Quebec’s North, who often eat raw walrus meat. In recent years, it was discovered that this custom had been causing many Inuit to develop a disease called trichinellosis, which can cause abdominal discomfort, nausea, diarrhea, vomiting, fatigue and fever.

Inuit hunters. Photo: Ansgar Walk. (www.creativecommons.org/licenses/by-sa/2.5, via Wikimedia Commons)

McGill and various collaborators developed an innovative trichinellosis prevention program in consultation with local health authorities and hunters. “We did a lot of work trying to describe what the disease looks like in the North and how we could prevent it by intervening in the way hunting was done and how meat was inspected before people consumed it,” says Libman. The intervention proved successful and helped curb what had become a low-level epidemic.

McGill’s research strengths in tropical medicine lie in diagnostics, more specifically, the exploration of new technologies to diagnose parasitic diseases that are notoriously difficult to identify. Another key focus of McGill’s Division of Infectious Diseases is the development of satellite training programs in tropical medicine, infectious diseases and parasitology. For instance, McGill researchers, together with colleagues from Norway and India, have successfully implemented locally based educational training in southern India.

Each year for the last five years, doctors – half from India and half from Western countries – have attended a course on tropical medicine in southern India. In addition to teaching Indian doctors new approaches and techniques, Western doctors acquire first-hand knowledge of these diseases.

In operation for 30 years, the J.D. MacLean Centre for Tropical Diseases is a one-stop shop for prevention, diagnosis, testing and clinical care of tropical diseases. The Centre houses a day clinic for patients; a pre-travel clinic to educate and assess those leaving for tropical locales; a parasitology laboratory for analysis of pathogens that may arise in patients; and, most notably, the National Centre for Parasitology reference lab, where clinicians and researchers can access the latest knowledge and most advanced technology in laboratory diagnostics. “We operate as one team in one spot so that when research and clinical questions arise, no one has to go running and pull together collaborators from here or there,” says Libman.

J.D. MacLean – Paying Tribute

“As doctors go, there was nobody more dedicated to his patients,” says Michael Libman, director of McGill’s Division of Infectious Diseases. McGill’s renown as a leading clinical, laboratory and research hub in tropical medicine is thanks in a large part to the foresight and vision of one doctor, John D. MacLean. As a physician, he was a role model for generations of students who benefited from his tutelage. Through dedication and a genuine desire to serve patients, in 1980 he created the internationally recognized Centre for Tropical Diseases that bridges the divide between laboratory bench and bedside care.

Despite having no formal training as a researcher, MacLean’s contributions to tropical medicine were vast and had a direct impact on populations in other countries as well as Canadian immigrants and Native groups in the far North. He received countless requests from governments for advice, was invited to speak at the continent’s most prestigious medical schools and had manuscripts published in leading journals.

MacLean passed away in January 2009 at the age of 68. His influence lives on through the many colleagues he inspired to offer the best in medical care and to continually push the boundaries of medical science.

[Annette Mahon]

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