Research & Publication

The CIWEC Clinic Travel Medicine Center has carried on an active research program regarding the health risks of tourists and long-term foreign residents of Nepal. For the benefit of travelers, students, and medical practitioners who would like to pursue a deeper understanding of the medical problems in Nepal, we have supplied the following list of our publications in peer-reviewed medical journals and books. These articles can be obtained in any comprehensive medical library. Dr. Shlim is on the editorial boards of both the Journal of Wilderness and Environmental Medicine and the Journal of Travel Medicine. These two journals are not always available in hospital libraries. They are both quite relevant to the field of travel and wilderness medicine, and you should urge your hospital librarian to subscribe if they don’t already.

  1. Taylor DN, Houston R, Shlim DR, Bhaibulaya M, Ungar BLP, Echeverria P. Etiology of diarrhea among travelers and foreign residents in Nepal. Journal of the American Medical Association 1988;260:1245-1248.
  2. Shlim DR, Houston R. Helicopter rescues and deaths among trekkers in Nepal. Journal of the American Medical Association 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. Archives of Internal Medicine 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. Annals of Emergency Medicine 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. American Journal of Tropical Medicine and Hygiene 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. International Journal of Sports Medicine 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. Annals of Internal Medicine 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. The 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. Clinical Infectious Diseases 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. The 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. Journal of Clinical 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 traeler’s diarrhea in Asia. Journal of Clinical Microbiology 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. Journal of the American Medical Association 1996; 275:533-538.
  21. Shlim DR, Pandey P, Rabold JG, Walch A, Rajah R. An open trial of trimethoprim versus Cyclospora infections. Journal of Travel Medicine 1997;4:44-45.
  22. Pandey P, Cave W, Shlim DR. Hepatitis A post hepatitis A vaccination? J Travel Med 2000;7:213-214.
  23. Canas LC, Lohman K, Pavlin J, Endy T, Singh DL, Pandey P, Shrestha M, Scott RM, Russell KL, Watts D, Hajdamowicz M, Soriano I, Douce RW, Neville J, Gaydos JC. The department of defense laboratory based global influenza surveillance system. Military Medicine 2000;165,Suppl.2:52-56.
  24. Leder K, Sundararajan V, Weld L, Pandey P, Brown G, Torresi J. Respiratory tract infection in travelers: A review of the GeoSentinel surveillance network. Clinical Infectious Diseases 2003;36:399-406.
  25. Pandey P, Shlim DR, Cave W, Springer MFB. Risk of possible exposure to rabies among tourists and foreign residents in Nepal. J Travel Med 2002;9:127-131.
  26. Cave W, Pandey P, Osrin D, Shlim DR. Chemoprophylaxis use and the risk of malaria in travelers to Nepal. J Travel Med 2003;10:100-106.
  27. Cave W, Pandey P, Chatterjee S. Irrational prescribing in South Asia: A case of fluoroquinolone-associated phototoxicity. J Travel Med 2003;10: 290-292.
  28. Lewis MD, Serichantalergs O, Pitarangsi C, Chuanak N, Mason CJ, Regmi LR, Pandey P, Laskar R, Shrestha CD, Malla S. Typhoid fever: a massive, single-point source, multidrug-resistant outbreak in Nepal. Clin Infect Dis. 2005 Feb 15;40(4):554-61.
  29. Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, Sonnenburg FV, Keystone JS, Pandey P, Cetron M. Spectrum of disease and relation to place of exposure among ill returned travelers. New England Journal of Medicine 2006;354: 119-30.
  30. Yates JA, Stetz LC. Reiter`s syndrome (reactive arthritis) and travelers` diarrhea. J Travel Med. 2006 Jan-Feb;13(1):54-6
  31. Ranney M, Partridge R, Jay GD, Rozzoli DE, Pandey P. Rabies antibody seroprotection rates among travelers in Nepal: “Rabies seroprotection in travelers”. J Travel Med 2006; 13: 329-333.
  32. Yates JA, Pandey P. Medical problems of internationally adopted children presenting to a travel medicine clinic in Nepal. J Travel Med 2006;13: 381-383.
  33. Boggild AK, Costiniuk C, Kain KC, Pandey P. Environmental hazards in Nepal: Altitude illness, environmental exposures, injuries, and bites in travelers and expatriates in Nepal. J Travel Med 2007;14; 361-368
  34. Leshem E, Pandey P, Shlim DR, Hiramatsu K, Sidi Y, Schwartz E. Clinical features of patients with severe altitude illness in Nepal. J Travel Med. 2008 Sep-Oct;15(5):315-22.
  35. Pandey P, Bodhidatta L, Lewis M, Murphy H, Shlim DR, Cave W, et al. Travelers` diarrhea in Nepal: an update on the pathogens and antibiotic resistance. J Travel Med. 2011 Mar-Apr;18(2):102-8.

  1. Shlim DR, Dexamethasone in the treatment of acute mountain sickness. New England Journal of Medicine 1985; 312:1390.
  2. Babcock D, Houston R, Kumaki D, Shlim DR. Blastocystis Hominis in Kathmandu, Nepal. New England Journal of Medicine 1985; 313:1419.
  3. Schwartz E, Shlim DR. Tickbite appendicitis. Journal of the American Medical Association 1988; 259:3561.
  4. Shlim DR, Cohen MT. Guillain-Barre syndrome presenting as high altitude cerebral edema. New England Journal of Medicine 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. Journal of the American Medical Association 1991;266:2560.
  7. Hoge CW, Shlim DR, Echeverria P. Cyanobacterium-like cyclospora species. New England Journal of Medicine 1993;329:1504-1505.
  8. Rabold JG, Hoge CW, Shlim DR, Kefford C, Rajah R, Echeverria P. Cyclospora outbreak associated with chlorinated drinking water. The 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. The Lancet 1995;346:1634.

  1. Taylor 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. 1997.
  4. Shlim DR, Pandey P. Diarrhea in expatriates. In: Ericsson CD, Dupont HL, Steffen R, eds.Travelers` Diarrhea, BC Decker Inc. 2008.
  5. Pandey P, Chatterjee S. Pitfalls in Travelers` Diarrhea management. In: Ericsson CD, Dupont HL, Steffen R, eds. Travelers` Diarrhea, BC Decker Inc. 2008.
  6. Pandey P, Shlim DR. The history of the CIWEC Clinic in Kathmandu, Nepal. In: Wilder-Smith A, Schwartz E, Shaw M, eds. Travel Medicine: Tales behind the Science, Elsevier 2007.

  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.