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Infection > 14. Travel Infection > Flashcards

14. Travel Infection Flashcards

1
Q

Why is the travel history important?

A

Recognise imported diseases
Different strains of pathogen - antigenically different, impacts on protection/detection, antibiotic resistance
Infection prevention

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2
Q

What should you ask someone who presents with an infection?

A

Where have they been?
When did symptoms begin?
What are the symptoms/signs?
How did they acquire it?

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3
Q

How can knowing when symptoms began since being back help?

A

<10 days usually virus
10-21 days usually bacteria or fungi
>21 days usually more complex bacteria, possibly fungi

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4
Q

What are the common ways of acquiring foreign infections?

A 
Food/water
Insect/tick bite
Swimming
Sexual contact
Animal contact
Recreational activities
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5
Q

What infection commonly comes from animal bite?

A

Rabies

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6
Q

What infection often comes from rodents?

A

Leptospirosis

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7
Q

What infections often come from mosquito/insect bite?

A

Malaria

Dengue

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8
Q

What infection often comes from tick bite?

A

Rickettsia

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9
Q

What infections often comes from dead or slaughtered animals?

A

Anthrax

Ebola

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10
Q

What infection often comes from game parks?

A

Rickettsia

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11
Q

What infections often come from fresh water?

A

Schistosomiasis

Leptospirosis

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12
Q

What infection often comes from under/uncooked fish/meat?

A

Salmonella

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13
Q

What are the 5 main species of plasmodium and which are the most common?

A 
Falciparum - most common (Africa)
Vivax - second most common (India)
Ovale
Malariae 
Knowlesii
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14
Q

What is the vector for malaria?

A

Female anopheles mosquito

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15
Q

What is the incubation period of malaria?

A

Minimum 6 days
P. falciparum by 4 weeks
P. vivax/ovale up to one year

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16
Q

What are the symptoms of malaria?

A 
Fever chills and sweats every 3rd or 4th day
Headache
Fatigue
Muscle pain
Back pain
Dry cough
Splenomegaly
Nausea
Vomiting
17
Q

How is malaria diagnosed?

A

3 positive blood films
FBC, urea and electrolytes, liver function tests, glucose, coagulation
Head CT if neurological symptoms
CXR

18
Q

What is the treatment for malaria?

A

P. falciparum - artesunate or rarely quinine and doxycycline

P. vivax, ovale, malariae - chloroquine

19
Q

What is the prevention for malaria?

A

Assess risk
Bite prevention
Chemoprophylaxis specific to region

20
Q

What is the mechanism of infection of typhoid and paratyphoid?

A

Faecal-oral from contaminated food or water

Source is cases or carriers

21
Q

What are the types of salmonella?

A

Salmonella typhi

Salmonella paratyphi A, B or C - enterobacyeriaceae aerobic gram negative bacillus

22
Q

What is the virulence of salmonella?

A

Low infectious dose
Survives gastric acid
Fimbriae adhere to epithelium over ileal lymphoid tissue and enters RE system/ blood
Reside within macrophages

23
Q

What are the symptoms and signs of typhoid (enteric fever)?

A 
Systemic disease
Incubation period: 7-14 days
Fever, headache, abdominal discomfort, dry cough
Relative bradycardia
Intestinal haemorrhage and perforation
24
Q

What are the investigations for enteric fever?

A

Moderate anaemia
Lymphopaenia
Mild raised LFTs
Culture - blood, faeces, bone marrow

25
Q

What is the treatment for enteric fever?

A

Multi drug resistant

Usually treated with IV ceftriaxone or azithromycin for 7-14 days

26
Q

What is the prevention for enteric fever?

A

Food and water hygiene precautions

Typhoid vaccine

27
Q

What could a fever and rash suggest?

A

Measles, rubella, parvovirus
Infectious mononucleosis
Acute HIV infection
Rickettsia (spotted fever)

28
Q

Describe dengue

A

First infection ranges from asymptomatic to non-specific febrile illness
Lasts 1-5 days
Improves 3-4 days after rash
Supportive treatment only

Infection (18 decks)

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