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 and a lot of these are now available online.


  1. Taylor DN, Houston R, Shilm 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. Shilm DR, Houston R. Helicopter rescues and deaths among trekkers in Nepal. Journal of the American Medical Association 1989;261:1017-1019.
  3. Schwartz E, Shilm 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, Shilm DR. Enteric fever among Israeli travelers in Nepal: The need for typhoid vaccination. Israel Journal of Medical Sciences 1990;26:325-327.
  5. Shilm DR, Meijer HJ. Suddenly symptomatic brain tumors at altitude. Annals of Emergency Medicine 1991;20:315-316.
  6. Shilm DR, Schwartz E. Houston R. Rabies immunoprophylaxis strategy in travelers. Journal of Wilderness Medicine 1991;2:15-21.
  7. Schwartz E, Innis BL, Shilm DR, Snitbhan R. Viral hepatitis in foreign residents and travelers in Nepal. Journal of Wilderness Medicine 1991;2:88-93.
  8. Shilm 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, Shilm DR. Treatment of moderate acute mountain sickness with pressurization in a portable hyperbaric (Gamow) bag. Journal of Wilderness Medicine 1991;2:268-273.
  10. Shilm DR, Gallie J. The causes of death among trekkers in Nepal. International Journal of Sports Medicine 1992;13:S74-S76.
  11. Connor BA, Shilm 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, Shilm 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, Shilm 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. Shilm DR, Papenfus K. Pulmonary embolism presenting as high altitude pulmonary edema. Journal of Wilderness Medicine 1995;6:220-224.
  15. Shilm 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, Shilm 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. Shilm 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, Shilm 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, Shilm 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, Shilm 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. Shilm 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. Shilm DR, Hoge CW, Rajah R, Scott R McN, Pandey P, Echeverria P. Persistent high risk of diarrhea among foreigners in Nepal during the first 2 years of residence. Clinical Infectious Diseases 1999;29:613-6
  23. Cave W, Pandey P. Boerhaave’s Syndrome Secondary to Traveller’s Diarrhoea. Journal of British Travel Health Association2000; 1:39-41
  24. Cave W, Pandey P. The limitations of Learning from a case of Probable High Altitude Pulmonary Edema. Letter to the Editor. Journal of Wilderness and Environmental Medicine 2000; 4
  25. Pandey P, Cave W, Shilm DR. Hepatitis A post hepatitis A vaccination? J Travel Med 2000;7:213-214.
  26. 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.
  27. 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., 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.
  28. Cave W, Pandey P, Osrin D, Shilm DR. Chemoprophylaxis use and the risk of malaria in travelers to Nepal. J Travel Med 2003;10:100-106.
  29. Cave W, Pandey P, Chatterjee S. Irrational prescribing in South Asia: A case of fluoroquinolone-associated phototoxicity. J Travel Med 2003;10: 290-292.
  30. 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.
  31. 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.
  32. Yates JA, Stetz LC. Reiter`s syndrome (reactive arthritis) and travelers` diarrhea. J Travel Med. 2006 Jan-Feb;13(1):54-6
  33. 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.
  34. 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.
  35. 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
  36. Greenwood Z, Black J, Weld L, O’Brien D, Leder K, von Sonnenburg F, Pandey P, Schwartz E, Connor BA, Brown G, Freedman DO,Torresi J, for the GeoSentinel Surveillance Network. Gastrointestinal infection among international travelers globally. J Travel Med. 2008; 15 (4): 221-8
  37. Leshem E, Pandey P, Shilm 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.
  38. Perry TL, Pandey P, Grant JM, Kain KC. Severe atovaquone-resistantPlasmodiumfalciparummalaria in a Canadiantraveller returned from the Indian subcontinent. Open Med 2009 Jan 20;3(1):e10-6.
  39. Kapoor A, Li L, Victoria J, Oderinde B, Mason C, Pandey P, et al.Multiple novel astrovirus species in human stool. J Gen Virol. 2009 Dec;90(Pt 12):2965-72.
  40. Schlagenhauf P, Chen LH, Wilson ME, Freedman DO, Tcheng D, Schwartz E, Pandey P, et al. Sex and gender differences in travel-associated disease. Clin Infect Dis. 2010 Mar 15;50(6):826-32.
  41. Pandey P, Bodhidatta L, Lewis M, Murphy H, Shilm 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.
  42. Murphy H,Renvoise A, Pandey P, Parola P, Raoult D. Rickettsia honei infection in human, Nepal, 2009. Emerg Infect Dis. 2011 Oct;17(10):1865-7.
  43. Murphy H, Pandey P. Pathogens for Traveler’s Diarrhea in Nepal and Resistance Patterns.Curr Infect Dis Rep. epub 3 April 2012.
  44. Gautret P, Harvey K, Pandey P, Lim PL, et al for GeoSentinel Surveillance Network.Animal-associated exposure to rabies virus among travelers, 1997-2012.Emerg Infect Dis. 2015 Apr;21(4):569-77
  45. Pandey P. Letter from Nepal June 12, 2015. Travel Med Infect Dis. 2015. Jul-Aug;13(4):344.
  46. Pandey P. Letter from Nepal, July 2015 – Post-earthquake, infectious disease risks and prevention. Travel Med Infect Dis. 2015. Jul-Aug;13(4):345
  47. Pandey P. Letter from Nepal, August 12, 2015–Cholera in post-earthquakeKathmandu. Travel Med Infect Dis. 2015 Sep-Oct;13(5):425
  48. Barker KR, Conroy AL, Hawkes M, Murphy H, Pandey P, Kain KC. Biomarkers of hypoxia, endothelial and circulatory dysfunction among climbers in Nepal with AMSand HAPE: a prospective case-control study. J Travel Med. 2016 Mar 16;23(3).
  49. Pandey P, Lohani B, Murphy H. Pulmonary Embolism Masquerading as High AltitudePulmonary Edema at High Altitude. High Alt Med Biol. 2016 Dec;17(4):353-358.
  50. Bhattarai S, Elson W, Pradhan R, Pandey P. Cervical artery dissection at high altitude: an overview of two patients. J Travel Med. 2016 Oct 30;24(1).
  51. Leder K, Borwein S, Chanthavanich P, Chatterjee S, Htun K, Marma ASP, Nakatani I, Ok JJ, Pakasi L, Pandey P, Piyaphanee W, Rupali P, Schwartz E, Shinozuka T, Phu PTH, Watanabe H, Visser J, Wilder-Smith A, Zhang M, McGuinness SL.Travel medicine perspectives of select travel medicine experts practicing in the Asia-Pacific region. J Travel Med. 2017 Jul 1;24(4)
  52. Serichantalergs O, Ruekit S, Pandey P, Anuras S, Mason C, Bodhidatta L,Swierczewski B. Incidence of Campylobacter concisus and C. ureolyticus in traveler’s diarrhea cases and asymptomatic controls in Nepal and Thailand. Gut Pathog. 2017 Aug 17;9:47
  53. Amatya B, Lakhey PJ, Pandey P. Perforation Peritonitis at High Altitude. JNMA J Nepal Med Assoc. 2018;56(210):625-8.
  54. Pandey P, Vadlamudi R, Pradhan R, Pandey KR, Kumar A, Hackett P. Case Report: Severe Frostbite in Extreme Altitude Climbers-The Kathmandu Iloprost Experience. Wilderness Environ Med. 2018 Jun 7 pii: S1080-6032(18)30057-7.
  55. Margulieux KR, Srijan A, Ruekit S, Nobthai P, Poramathikul K, Pandey P, Serichantalergs O, Shrestha SK, Bodhidatta L, Swierczewski BE. Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016. Antimicrobial Resistance & Infection Control. 2018;7(1):87.
  56. Lurchachaiwong W, Ruksasiri S, Wassanarungroj P, Serichantalergs O, Bodhidatta L, Crawford J, Shrestha SK, Pandey P. Determination of azithromycin heteroresistant Campylobacter jejuni in traveler’s diarrhea.2019 May 6;11:19. doi: 10.1186/s13099-019-0301-1. eCollection 2019.
  57. Amatya B, Pandey P, Shrestha SK. An outbreak of influenza among trekkers in the Everest region of Nepal. J Travel Med. 2020 Sep 26;27(6):taaa003.
  58. Hagmann SHF, Angelo KM, Huits R, Plewes K, Eperon G, Grobusch MP, McCarthy A, Libman M, Caumes E, Leung DT, Asgeirsson H, Jensenius M,  Schwartz E, Sánchez-Montalvá A, Kelly P, Pandey P, Leder K, Bourque DL, Yoshimura Y, Mockenhaupt FP, et al. Epidemiological and Clinical Characteristics of International Travelers with Enteric Fever and Antibiotic Resistance Profiles of Their Isolates: a GeoSentinel Analysis. Antimicrob Agents Chemother. 2020 Nov; 64(11): e01084-20
  59. Nicolini LAP, Stoney RJ, Della Vecchia A, Grobusch M, Gautret P, Angelo KM, van Genderen PJJ, Bottieau E, Leder K, Asgeirsson H, Leung DT, Connor B, Pandey P, Toscanini F, Gobbi F, Castelli F, Bassetti M, Hamer DH. Travel-related hepatitis E: a two-decade GeoSentinel analysis. J Travel Med. 2020 Nov 9;27(7)
  60. Amatya B, Pandey P, Dawadi S, Manandhar S. COVID-19 in fully vaccinated Everest trekkers in Nepal. J Travel Med 2021 Oct 11;28(7)
  61.  Pandey P, Lee K, Amatya B, Angelo KM, Shlim DR, Murphy H.  Health problems in travellers to Nepal visiting CIWEC clinic in Kathmandu – A GeoSentinel analysis. Travel Med Infect Dis. 2021 Mar-Apr;40:101999.
  62.  Pender MA, Smith T, Brintz BJ, Pandey P, Shrestha SK, Anuras S, Demons S, Sornsakrin S, Bodhidatta L, Leung DT. Pender MA, et al. Weather variables as important clinical predictors of bacterial diarrhea among international travelers. J Travel Med. 2022 Feb 3


  1. Shilm DR, Dexamethasone in the treatment of acute mountain sickness. New England Journal of Medicine 1985; 312:1390.
  2. Babcock D, Houston R, Kumaki D, Shilm DR. Blastocystis Hominis in Kathmandu, Nepal. New England Journal of Medicine 1985; 313:1419.
  3. Schwartz E, Shilm DR. Tickbite appendicitis. Journal of the American Medical Association 1988; 259:3561.
  4. Shilm 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, Shilm DR, Innes B. Ciprofloxacin therapy for typhus. J Am Med Assoc 1989;262:772-773.
  6. Shilm DR. Severe facial rash associated with mefloquine. Journal of the American Medical Association 1991;266:2560.
  7. Hoge CW, Shilm DR, Echeverria P. Cyanobacterium-like cyclospora species. New England Journal of Medicine 1993;329:1504-1505.
  8. Rabold JG, Hoge CW, Shilm DR, Kefford C, Rajah R, Echeverria P. Cyclospora outbreak associated with chlorinated drinking water. The Lancet 1994;344:1360-1361.
  9. Shilm DR. Diplopia at high altitude [note]. Journal of Wilderness Medicine 1995;6:341-342.
  10. Connor BA, Shilm DR. Foodborne transmission of cyclospora. The Lancet 1995;346:1634.

 Book Chapters

  1. Taylor DN, Shilm 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. Shilm 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, Shilm 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. Shilm 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, Shilm 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.
  7. Pandey P, Murphy H, Bhalla A. South Central Asia. In: Petersen E, Chen LH, Schlagenhauf P eds. Infectious Diseases: A Geographic Guide, John Wiley & Sons 2011.


  1. Connor BA, Shilm DR, Rajah R. Abnormal d-xylose absorption in patients with cyanobacteria-like body diarrhea. Gastroenterology 1992;102:A610.
  2. Connor BA, Shilm 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,Shilm DR, Taylor DN, Rabold JG. Azithromycin treatment of Cyclospora infections. Gastroenterology 1994;105:A772.