Flashcards in Global health, tropical and travel medicine. Deck (37):
Place with the highest 1 week risk of travellers diarrhoea?
India - 54%
Key things to assess when your patient is travelling abroad?
When are they going. - how long for vaccinations, is it rainy season?
Where are they going.
What are they doing. - Healthcare? Aid agency? Duration? Access to healthcare?
Past Medical history. Drug interactions, safe to travel?
ABCD of malaria advice?
A - Awareness of Risk: Fever for up to 6 months after returning could be malaria.
B - Bite avoidance: DEET, Nets, Dusk till dawn, long sleeved clothing.
C - Chemoprophylaxis - Duration pre, post and during, S/Es and cost
D - Diagnose early
Malaria prophylaxis choices?
Malarone (Atovaquone + Proguanil)
- 1 tablet a day, good S/E profile
- 1 day before, 1 week afterwards
- 1 Tablet a day
- 20% risk of photosensitivity
- 1 week before 4 weeks after return. (cheap)
- 1 tablet a week
- Neuropsychiatric S/Es
- 3 weeks before 4 weeks when returning (cheap)
Legally required vaccine for Saudi Arabia?
What are the most common types of illness following travel?
GI illness - 34%
Systemic febrile illness - 23.3%
Dermatological - 19.5%
Where are systemic febrile illnesses most likely caused from?
Where is acute diarrhoea most likely caused from?
Pathogenesis of Giardia bacteria?
Causes inflammatory process by attaching to enterocytes in the jejunum - acute diarrhoea
Most common bacterial causes of acute diarrhoea?
Whats more common parasitic/viral/bacterial infection causing diarrhoea?
Parasitic more common presentation.
Most likely cause of fever presentation?
Difference in Vivax and falciparum malaria?
Falciparum a bit worse generally
What is cutanea larva migrans? Where is it most likely caught from?
Infection from hookworms from cats/dogs. Won't get further than skin as man is not desired host. Most likely caught from Caribbean - C. America
Risks for travellers who are visiting friends and family?
Unlikely to seek pre-travel advice and so more likely to acquire a vaccine preventable illness
62% of falciparum occurred amongst travellers visiting friends and relatives
Which group of Travellers get respiratory illness commonlly
Which group of travellers are most likely to become ill abroad?
Investigations you should do for returning unwell travellers?
Malaria blood test.
Standard: FBC, U+Es, CRP, LFTs, CXR
Most common cause of parasitic diarrhoea?
Clinical features of falciparum malaria?
Fevers, rigors, vomiting, headache, arthralgia, malaise (cough, diarrhoea)
Fevers are usually daily or continuous
Commonly presents within 4 weeks of return from endemic area but can be delayed for much longer
What species of mosquito cause malaria
Female anopheles mosquitos
Serious complications of malaria?
Types of malaria testing?
Blood film - look for it
Treatment of falciparum malaria?
PO (oral): Malarone
Where are you most likely to see flaciparum and where are you most likely to see vivax?
Falciparum - sub saharan Africa
Vivax South and South east asia
Vivax malaria diagnosis?
Blood film only (antigen not sensitive) need several
Vivax malaria treatment?
Followed by primaquine to eliminate liver (hypnozoite) stage
Pattern of Fever in vivax malaria?
Every 3 days there is a peak of fever
How many cases of imported malaria were reported in 2015?
What proportion of falciparum and vivax caused imported malaria?
Falciparum - 75%
Vivax - 15%
Ebola infection management?
IV zmapp - monoclonal antibodies
LFTs in ebola infection?
Clinical presenting signs and symptoms of ebola?
What is MERS
Middle eastern respiratory syndrome
Caused by a virus
>85% in saudi arabia
Treatment of MERS?
Extracorporeal membrane oxygenation
Treatment of Avian flu?