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Masters - CDC > Characteristics of Diseases > Flashcards

Characteristics of Diseases Flashcards

1
Q

Difference between meningococcal disease and meningitis

A

Meningococcal disease= infections caused by the bacteria Neisseria Meningitidis
Meningitis = inflammation of the meninges (could be caused by virus/bacteria/other chemicals)

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2
Q

What are the symptoms of meningitis?

A 
Headaches
Fever
Vomiting
Neck stiffness
Seizures
Rash - if septicaemia
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3
Q

When does meningitis occur?

A

Sporadically

Can occur in clusters - eg: start of university/school

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4
Q

Where does meningitis occur?

A

Anywhere

Endemic of group A in SSA

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5
Q

How is meningitis transmitted?

A

Respiratory droplets (airborne)

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6
Q

How long is the incubation period?

A

3-4 days

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7
Q

Name 4 reasons why an epidemic of meningitis may occur

A 
Concurrent respiratory tract infections
Reduced immunity of the pharynx 
Overcrowded pharynx 
Large population displacement
Waning herd immunity
Respiratory tract irritation
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8
Q

How would you manage an individual case of meningitis?

A

Confirm diagnosis by - bood tests, serological, lumbar puncture
Characterise the pathogen if possible
Identify potential source of infection
Identify who else is at risk - close contacts
Give close contacts chemoprophylaxis
Treat

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9
Q

How would you manage a cluster of meningitis cases?

A

Confirm that the cases are linked by organism, plae and time
Work with where the cluster is eg: school, university, nursery etc.
Define who the ‘at-risk’ population are

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10
Q

How would you manage epidemics of meningitis?

A

Same steps as for an individual case

Mass vaccination

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11
Q

Which vaccines are available for meningitis and where are they implemented?

A 
Men A&C - if travelling to Africa
Men C - UK schedule
Men ACWY - UK
Men B - UK
MenAfriVac
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12
Q

What type of surveillance would be used for meningitis?

A

Passive - as it is a notifiable disease

Enhanced if suspected outbreak

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13
Q

What is a HCAI?

A

HealthCare Associated Infection

Either acquired in a hospital setting or acquired as a result of a healthcare intervention

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14
Q

Name 5 common HCAIs

A 
Catheter associated UTI
Ventilator associated pneumonia
SSI (staph aureus)
Central line bloodstream infections 
GI infections
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15
Q

Name 5 common organisms that cause HCAIs

A 
MRSA
MSSA
C.diff
E.coli
Staph.aureus
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16
Q

Name 6 risk factors associated with HCAIs

A 
Extremes of age
Immunocompromised
Long length of stay
Antibiotic treatment
Poor infection control standards
Presence of invasive devices/broken skin/pressure sores
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17
Q

Who is at risk of MRSA?

A

Newborns
IVDUs
Elderly
Surgical patients - usually transmitted through broken skin

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18
Q

How would you manage an outbreak of MRSA?

A 
Investigate the outbreak
Screen staff
Review the infection control practices
Restrict admissions to ward
Limit no. of visitors
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19
Q

Why is C.difficile so difficult to treat?

A

Widely distributed in the digestive tract

Very resistant to heat or drying

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20
Q

When do outbreaks occur?

A

Sporadic - preceded by a background rate

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21
Q

How is C.difficile transmitted?

A

Faeco oral route

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22
Q

How is an individual case of C.diff managed?

A

Isolate
Enteric precautions
Stool sample testing
Treat - with metronidazole/vancomycin

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23
Q

What is the main risk factor for developing C.diff?

A

Broad spec antibiotic use

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24
Q

Name 4 broad ways to manage C.diff infections

A

Control antibiotic use
Surveillance
Infection control measures
Case finding

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25
Q

When do norovirus outbreaks most commonly occur?

A

Winter (known as the ‘winter vomiting’ bug

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26
Q

Name 4 risk areas for catching norovirus

A

Hospitals
Care homes
Schools
Cruise ships

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27
Q

How is norovirus spread?

A

Faeco oral

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28
Q

How is norovirus managed?

A

No specific treatment

INFECTION CONTROL

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29
Q

What is CPE and what characteristic does it hold?

A

Carbapenemase producing Enterobacteria

High level of antibiotic resistance

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30
Q

What increases the risk of CPE infection?

A

Long antibiotic course
Use of ventilators
Use of catheters

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31
Q

How should CPE infections be managed?

A 
Surveillance
Sampling and testing
Isolate any high risk cases
Frequent re testing
Contact tracing
High standard of hygiene
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32
Q

What is the difference between a community acquired and a hospital acquired infection?

A

Hospital - symptoms start 48 hours after admission

Community - symptoms start within 48 hours of admission

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33
Q

Why are hospitals prone to infection outbreaks?

A 
Crowded spaces
Patients bring in infections
Invasive procedures
Shared facilities
Open wounds
Bodily fluids
Visitors
Patients who are immunocompromised/susceptible
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34
Q

What is Hepatitis B caused by?

A

HBV DNA virus

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35
Q

How is Hep B transmitted?

A

Blood borne - through bodily fluids through skin or mucous membranes

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36
Q

What is the reservoir for Hep B?

A

Human hepatocytes

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37
Q

What is the incubation period for Hep B?

A

60-90 days (long!!)

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38
Q

Where is Hep B prevalent?

A

Highest in Africa, Asia and parts of SA

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39
Q

How does Hep B present?

A

Jaundice, abdo pain, nausea and vomiting

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40
Q

Give 5 risk factors for being exposed to Hep B

A 
Risky sexual behaviour (includes MSMs, sex workers)
IVDUs
MTCT
Occupational risk
Blood transfusions
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41
Q

Is Hep B acute or chronic?

A

Both!

More commonly chronic in children (after MTCT)

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42
Q

How can Hep B be prevented?

A

Vaccination
Education on risk factors
HBIGs

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43
Q

Who would be considered for a Hep B vaccination in the UK?

A

MSMs
Sex workers
IVDUs
Health/social care workers

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44
Q

How would you manage a case of Hep B?

A 
Vaccination 
Wound care
Antibiotics
Pegylated interferon
Manage close contacts - test and give prophylaxis (vaccine)
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45
Q

What is gastroenteritis?

A

An infection within the gastrointestinal tract

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46
Q

Name 5 bacteria, 3 viruses and 3 parasites that could cause gastroenteritis

A

E.coli, salmonella, shigella, typhoid, cholera
Rotavirus, noravirus and Hep A/E
Giardia lambia, ameobiasis and cryptosporidium homicus

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47
Q

What is the the difference between a short, medium and long incubation period for these organisms?

A

Short: < 8 hours
Medium: 8 –> 48 hours
Long: > 48 hours

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48
Q

Is the incubation period for these organisms short, medium or long?

  1. Staph aureus
  2. Campylobacter
  3. Bacillus cerues
  4. Salmonella
  5. E.coli
A
  1. Short
  2. Long
  3. Short
  4. Medium
  5. Long
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49
Q

Name 4 risk factors associated with GE

A

Food handlers
Children under 5
Health/social care staff
Poor personal hygiene

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50
Q

What information do you need to identify the source of gastroenteritis?

A

Date of onset of illness
Incubation period
Risk exposure

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51
Q

How do you limit the spread of GE?

A

Proper food handling
Hygiene advice - washing hands etc.
Stay off work for 48 hours after symptoms have stopped

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52
Q

Are you more likely to have diarrhoea or vomiting if the incubation period of the organism is short?

A

Vomiting - hasn’t had time to get into the digestive tract yet

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53
Q

What is an STI?

A

Sexually Transmitted Infection - an infection passed from one person to another via sexual contact

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54
Q

Name 6 STIs

A 
HPV
Chlamydia
Gonorrhoea
Syphillis
Trichomonas vaginalis
HSV
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55
Q

Where are STIs more prevalent?

A

SEA, SSA and latin America - higher in underdevelopment countries

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56
Q

What are the 3 universal risk factors for catching STIs?

A

Several partners
Frequent partner change
Unprotected sex

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57
Q

Name as many things as you can that can be seen as epidemic drivers of STIs

A 
Poverty
Stigma 
Unprotected sex
Poor treatment services
Multiple partners
Early sexual debut 
Political instability 
Lack of education/awareness
Substance misuse 
Asymptomatic infections
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58
Q

What are the potential consequences of STI infections (other than immediate symptoms)?

A

HIV transmission risk
Poor reproductive or maternal health
Poor newborn health
Anogenital cancers

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59
Q

Name the methods of primary prevention of STIs

A

Education on behavioural things eg: condom use, frequent testing, partner change etc
Immunisations
Targeted interventions at ‘at risk’ groups

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60
Q

Name the methods of secondary prevention of STIs

A

STI screening
Universal HIV screening
Rapid/POC tests

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61
Q

Name the methods of tertiary prevention

A

Treatment of disease - antibiotics etc.
Abstinence till end of treatment
Treat contacts

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62
Q

Where would data sources for STI surveillance come from?

A

GUM clinics
Voluntary lab reporting
PHE reference labs

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63
Q

What is Legionellosis?

A

Infection with Legionella pneumophilia

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64
Q

How is Legionellosis caused?

A

Inhalation of aerosols containing the bacteria - usually through taps/showers/humidifiers etc.
Stagnant water = a big risk factors

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65
Q

How does Legionellosis present?

A

Flu-like illness,muscle aches, tiredness, fever, cough

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66
Q

What type of surveillance would be carried out in a Legionellosis outbreak?

A

National active - is a serious environmental issue where the transmission needs breaking

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67
Q

What is the incubation period for Legionellosis?

A

2-10 days

68
Q

Who are at risk of Legionellosis?

A 
Travellers
Cruise ships (common place for outbreaks)
69
Q

How can Legionellosis be prevented?

A

Code of practice for the water sypplies
Maintain water temperatures
Regular flushing/disinfectants
Adequate cleaning and chlorination

70
Q

What is SARS?

A

Severe Acute Respiratory Syndrome - caused by SARS coronavirus

71
Q

What are the symptoms of SARS?

A

High fever,cough, SOB, myalgia and diarrhoea

72
Q

How is SARS spread?

A

Droplet (respiratory)

73
Q

What is the incubation period for SARS?

A

2-7 days

74
Q

What is influenza?

A

An acute onset of upper and lower respiratory tract infection symptoms caused by an influenza virus

75
Q

What is the difference between influenza serotypes A, B and C?

A

A -causes major pandemics, found in horses/birds/pigs/humans
B- causes severe symptoms, most commonly affects school children and only found in humans
C -causes mild symptoms, only found in humans and is sporadic

76
Q

How is influenza spread?

A

Droplet spread

77
Q

When does influenza present?

A

usually seasonal outbreaks (in winter months in UK) as a result of antigenic drift

78
Q

What is the difference between antigenic shift and antigenic drift?

A

Shift - major changes leading to pandemics and major morbidity
Drift - minor changes that have less serious consequences but do occur more commonly

79
Q

Who are at risk of developing influenza?

A

Elderly
Immunocompromised
People with chronic disease

80
Q

How is influenza diagnosed?

A

Culture from throat/nose

PCR or nose/throat swabs

81
Q

What is ‘excess mortality’ and why is it used in surveillance of influenza?

A

Death from influenza is hard to confirm so have to include all deaths from things like bronchitis, pnuemonia, CHD etc as these all increase during influenza epidemics

82
Q

Name 3 ways to manage an influenza outbreak

A

Vaccination
Anti-viral drugs
Raise public awareness

83
Q

What is schistosomiasis and what is it caused by?

A

A water-based disease

Caused by a parasitic worm that lives inside the blood vessels of the intestine or bladder

84
Q

Where is schistosomiasis caught from?

A

Contaminated fresh water

85
Q

Who is most at risk of schistosomiasis?

A

Children

86
Q

Where is schistosomiasis most prevalent?

A

Is an endemic in many countries across Africa/Asia but highest rate in Nigeria

87
Q

Briefly explain the life cycle of schistosomiasis

A

Host –> Eggs –> Miracidia –> Snails –> Cercariae

88
Q

Name 4 ways to prevent/control schistosomiasis

A

Improve quality of water
Reduce the need for contact with the infected water
Health education
Drugs to treat infected people
Sanitation - preventing faeces reaching the fresh water
Molliscicides (to get rid of the snails)

89
Q

What is hepatitis C?

A

Inflammation of the liver caused by Hepatitis C RNA virus

90
Q

Is Hep C chronic or acute?

A

Can be either but the majority of infections lead to chronic infection

91
Q

How is Hep C transmitted?

A

Blood-borne (less contagious than hepB)

92
Q

Name 4 key risk factors for getting Hep C

A

IVDU
HIV positive
Chronic haemodialysis (any other reason for regular blood transfusions)
Children born to Hep C positive mothers

93
Q

How is Hep C prevented/controlled?

A

Vaccination
Advice to patients
Post-exposure management - pegylated interferon and ribavirin

94
Q

What is hepatitis A?

A

Acute infection causing inflammation of the liver due to the Hepatitis A RNA virus

95
Q

How long is the incubation period of Hep A?

A

15-40 days - LONG

96
Q

How is Hep A transmitted?

A

Faeco-oral

97
Q

Name 4 risk factors for Hep A

A 
IVDUs
MSMSs
Poor hygiene 
Food handlers
Working with children or the elderly
98
Q

What does Hep A spread easily?

A

Long incubation period
Low infectious dose
Asymptomatic infections are v common (especially in children)

99
Q

Name 3 preventative measures for Hep A

A

Hand hygiene education
Sanitation
Immunoglobulins (provide passive immunity)
HAV vaccine

100
Q

What is Tuberculosis and how is it caused?

A

An infection caused by mycobacterium tuberculosis - predominantly affects the respiratory tract but may affect other areas of the body (lymphatic system etc)

101
Q

How is TB transmitted?

A

air borne - aerosol droplets

102
Q

Why is TB difficult to prevent spreading?

A

Slow growing - in the person and the lab!

Has a v long incubationperiod

103
Q

How does it present?

A

Fever
Cough
Night sweats
Asymptomatic in majority

104
Q

Name as many risk factors are you can for TB

A 
HIV positive
Elderly
Immunocompromised
Poverty
Overcrowding 
Age and Sex
Malnutrition 
Travel 
Migration
Ethnicity
105
Q

Where is TB most prevalent?

A

Africa

106
Q

How can TB be prevented?

A

BCG vaccine - given to at risk neonates but not very effective in adults

107
Q

How is TB treated?

A 
DOTS
Direct sputum smear mircoscopy
Observation of treatment
Treatment monitoring 
Short course - of RIPE (rifampicin, isoniazid, pyrazinmade and ethambutol)
108
Q

What is important to consider in an outbreak of TB?

A

Has a v long incubation period so cases may present late

Chronic carrier status - many people are symptomatic and carry TB for several years

109
Q

What is HIV caused by?

A

Human Immunodeficiency Virus - infects immune cells

110
Q

Name 4 factors of the HIV virus/disease which make it difficult to treat

A

Reproduces inside immune cells
V long incubation period
Transmitted via sex which is difficult to control
Mutates rapidly

111
Q

What is the natural history of HIV?

A

Mild seroconversion illness for a few weeks
Long asymptomatic phase
Symptomatic HIV - fever, weight loss, night sweats, lymphadenopathy
AIDS

112
Q

What other illnesses may HIV affect the presentation of?

A 
Syphillis
STIs
TB
Tropical diseases
Hep B/C
113
Q

Name 4 epidemic drivers of HIV transmission

A

Unprotected sex
IVDU
Lack of knowledge
Lack of services

114
Q

What surveillance is carried out for HIV?

A

Passive - is a pandemic so regular surveillance is required

In countries with high levels likely to have active surveillance

115
Q

Name the preventative methods for HIV

A 
Male circumcision
Condom use
Mircobicides
PMTCT
PrEP/PEP
HIV testing 
Drug/alcohol use
STI screening and control
Anti retroviral therapy
116
Q

What is Cholera caused by?

A

Bacterial infection - vibrio cholerae

117
Q

How is cholera transmitted?

A

Either water-borne or sometimes faeco-oral

118
Q

How does cholera present?

A

Profuse watery diarrhoea, vomiting, dehydration

119
Q

Name the different ways in which cholera may be caught/spread

A 
From crustacean hosts found in water
Poor food hygiene 
Cross-contamination in health centres
Person to person contact
Seasonal variation
120
Q

Who does cholera affect?

A

Children - more affected

Adults - more deaths

121
Q

What are the challenges associated with controlling a cholera outbreak?

A

Large number of asymptomatic infections
Severe cholera can cause mortality within hours
Large epidemics can spread very quickly
Poor health infrastructure in the commonly affected areas

122
Q

How can cholera be prevented/controlled?

A 
Community education/knowledge of transmission and prevention
Effective excreta disposal
Improve water supplies/drinking water
Good hygiene awareness
Care at funerals of cholera deaths 
Isolation and hygiene practices in hospitals
Vaccination 
Fluid replacement for patients
123
Q

How is malaria caused?

A

Infection by a plasmodium parasite that is found in female mosquitos (vector)

124
Q

What is the incubation period for malaria?

A

9-14 days

125
Q

What are the symptoms of malaria?

A

Acute febrile illness
Muscle pain/fatigue
N&V

126
Q

Where is malaria most prevalent?

A

SSA

127
Q

Name 3 risk groups for malaria

A

Infants/children U5
HIV/AIDS
Pregnant women

128
Q

Name preventative or treatment methods for malaria

A

DEET
Bed nets
Chemoprophylaxis
Treatment - Chloroquine

129
Q

Give examples of the data that may be collected for a HIV surveillance

A

Neonatal heel prick testing
GUM clinic testing
Pregnant women testing

130
Q

How can MTCT of HIV be prevented?

A

Start women on HIV therapy

131
Q

Who is malaria chemoprophylaxis given to and why?

A

Restricted to high risk groups including travellers from non malaria areas (tourists/expats), non immune migrant workers from non endemic areas or indigenous to malarious area
Not for everyone due to cost, drug resistance, poor compliance and adverse effects

132
Q

What is shigellosis?

A

Caused by shigella bacteria - causes bacterial dysentery

133
Q

How is shigella transmitted?

A

Faeco-orally through water or food

134
Q

Why is shigella easily spread?

A

Has a low infectious dose

135
Q

Where is shigella most prevalent?

A

Asia and South America

136
Q

What is trachoma?

A

An infection with chlamydia trachomatis

137
Q

How is trachoma spread?

A

Due to poor sanitation

From eye to eye

138
Q

Who is at risk of getting trachoma?

A

Living in Africa, SA and Asia
Children
Women > Men

139
Q

How is trachoma treated/controlled?

A 
SAFE
Surgery
Antibiotics
Facial cleanliness
Environmental improvement
140
Q

How is polio transmitted?

A

Faceo-oral

141
Q

What is the risk associated with polio?

A

Paralysis

142
Q

What increases the risk of polio?

A

Poor sanitation

143
Q

How can polio be prevented?

A

Vaccination

144
Q

What is giardiasis caused by?

A

A parasite - giardia lamblia

145
Q

What increases the risk of giardiasis?

A

Tropical environment
Travellers
Poor hygiene

146
Q

How is giardiasis transmitted?

A

Faeco oral - usually transmitted by food handlers or through faeces

147
Q

What is typhoid caused by?

A

Salmonella typhi bacteria

148
Q

How is typhoid transmitted?

A

Seawater contaminated by sewage

Milk/dairy contamination

149
Q

Where is typhoid endemic?

A

Tropical areas

150
Q

How can typhoid be prevented and controlled?

A

Protection of water
Sanitary disposal of faeces
Treat water
Identify carriers (can have chronic carries of typhoid)

151
Q

How is tetanus transmitted?

A

Soil, animal faeces and unsterile medical equipment

152
Q

Why is tetanus easily spread?

A

Spores are very hard to kill

153
Q

Which areas are at increased risk of tetanus?

A

Africa/Asia
Places with rudimentary birth practices
Where animal faeces are used for plastering
Agricultural areas

154
Q

How can tetanus be controlled?

A

Vaccination
Good hygiene
Clean and proper wound care - also give penicillin

155
Q

What is filariasis?

A

A disease characterised by swelling caused by a worm

156
Q

Briefly explain the life cycle of filariasis

A

Microscopic larvae enter the body via mosquito bites –. they then migrate into the lymphatic system and develop into adult worms which block drainage systems and caused swelling

157
Q

Where are filariasis worms often found?

A

In septic tanks/flooded toilets

158
Q

What is the management of filariasis?

A

Chemotherapy
Integrated vector management - similar to malaria
Regular washing of the infected area

159
Q

Name the 4 most common causes of food poisoning and their incubation period

A

staph.aureus - short
salmonella - medium
clostridium perfringens - medium
campylobacters - long

160
Q

How is food poisoning managed?

A

Offer general hygiene advice for future
Usually self limiting - stay hydrated if profuse diarrhoea
Microbiology of stool samples
Exclude cases from attending school/work/nursery

161
Q

How can you tell the difference between food poisoning and other causes of GE?

A

Date of onset - clustered with food poisoning to suggest a point source outbreak but in GE may occur in waves
FP usually affects those at the food source whereas GE may be transmitted from case to case so affect anyone
Clinical features/lab tests - in FP show that it has been spread by food/water but in GE show case-to-case transmission
Environmental practices - in FP show poor food handling practices or in GE show poor infection control

162
Q

Give an example of a water-borne disease and how they can be prevented

A

Transmitted by ingestion of the water
Cholera, Typhoid, Hepatitis A
Improve the quality of the drinking water, prevent the use of contaminated sources, improve sanitation

163
Q

Give an example of a water-washed disease and how they can be prevented

A

Transmitted by multiple methods - GI infection/eye infection/lice infection
Trachoma, scabies, diarrhoea
Increase the quantity of water, improve access to water supply, improve sanitation

164
Q

Give an example of a water-based disease and how they can be prevented

A

Ingestion or penetration of the skin by a water-based animal with the disease
Guinea worm, schistosomiasis
Reduce the need for contact with infected water, control the vector host, improve sanitation, improve water quality

165
Q

Give an example of an insect-vector disease and how they can be prevented

A

Spread by insects that breed or bite near water
Malaria, river blindness
Improve surface water management, destroy insect breeding sites, mosquito nets, insecticides

166
Q

In a ‘explain the characteristics and epidemiology of disease x’ question - what should be covered?

A 
Time
Place
Person - risk groups/generally who is affected
Prevalence - high or low
Mode of transmission
Reservoirs
Control
Cause
Clinical Presentation

Masters - CDC (6 decks)

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