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Flashcards in Infections in travellers Deck (31):
1

Describe the trend in short term visitor arrivals to Australia?

Increasing number of arrivals 

2

Describe the trend in the number of international travellers?

Increasing number of international travellers

Large volumes of movement around the world 

3

Which infectious diseases have been eradicated?

Only smallpox

4

Are travel related illnesses always infectious?

No

5

Describe the incubation period for a travel-related illness?

Vary widely 

6

How far must a person travel for their illness to be described as travel-related?

Can be within own country, but to different conditions (eg. tropics)

7

What is the commonest cause of fatal community-acquired pneumonia in the NT?

Melioidosis

8

Which of the following additional immunisations should a medical student going on an elective to a remote indigenous community in Northern/Central Australia receive?

a) Hep A

b) Japanese encephalitis

c) Hep B

d) MMR

Hep A

9

Approximately what proportion of travellers to developing countries develop a health problem abroad? 

50%

10

Approximately how many cases of travel-associated malaria occur each year?

30,000

11

What is the estimated incidence of traveller's diarrhoea during travel in a developing country?

20-60%

12

Which bacteria associated with travel-related illness have the potential for lifetime persistence?

Mycobacterium leprae

Mycobacterium tuberculosis

Treponema pallidum

Rickettsia prowazeki

Salmonella typhi

13

Which helmiths associated with travel-related illness have the potential for lifetime persistence?

Enchinococcus granulosus

Strongyloides stercoralis

Taenia solium

Schistosoma species 

14

Which protozoa associated with travel-related illness have the potenital for lifetime persistence?

Plasmodium malariae

Toxoplasma gondii

Trypanosoma cruzi

15

Which viruses associated with travel-related illness have the potential for lifetime persistence?

Hep B, C, D

Herpes

HIV-1 and HIV-2

HTLV-1

16

Which fungi associated with travel-related illness have the potential for lifetime persistence?

Coccidioides immitis

Histoplasma capsulatum

17

What are the most common diagnoses in returned travellers with fever?

Malaria

Gastroenteritis/diarrhoea/parasites

Respiratory tract infections

18

Describe the relationship between diseases in a febrile returned traveller and their travel destination?

Pneumonia: Asia

Dengue fever: Asia

Malaria: Asia, Pacific, Africa

Hep A: Asia, Pacific

Typhoid fever: Asia

19

Describe the modes of disease transmission and their relative proportions for travel-related illnesses?

What are the consequences of this for travellers?

Most are vector, respiratory and food and water borne

So, much of the advice for travellers relates to safe behaviour (eg. bed netting, safe eating, etc.)

20

Describe the rate of respiratory infections in travellers?

7-29%

Second most frequent cause of illness in travellers

Second most frequent cause of fever in returned travellers

21

What is the commonest vaccine-preventable disease of travel?

Influenza

22

In which regions of the world are GIT infections most common?

South East Asia

Africa and South America

23

Describe the distribution across sexes for malaria and Dengue fever?

Males get more malaria than females

Not the same sex difference for Dengue fever

24

In which group of travellers is malaria most common?

Why?

Those travelling to visit friends and relatives (35%)

Closer contact with locals for longer periods of time 
Low standard accommodation

Very disproportionate, as this only represents 5% of travellers

25

Describe the relationship between the mortality for malaria and the number of cases seen in that region?

Inverse correlation

Relates to familiarity in treating malaria

26

Describe the time intervals in fatal cases of imported malaria?

Arrival - symptom onset: 5 days

Symptom onset - diagnosis/treatment: 5 days

Diangosis/treatment - death: 2 days

(mean time to death after symptom onset is 5 days)

27

In which region are travellers most at risk of contracting P.vivax?

PNG and Oceania

28

Describe the most common causes of mortality in travellers?

CVD

Injury

Medical

Cancer

Infectious disease only 1%

29

How early should pre-travel healthcare begin?

Preferably >6 weeks

30

Which travellers should be identified as high risk travellers?

Those with chronic illness (esp. immunocompromised)

Pregnant

Long term, remote, high risk location

Extremes of age

Visiting friends and relatives 

 

31

Describe the key issues for traveller education?

Injury (esp road and water)

Diarrhoea prevention and management

Insect bites

Blood-borne, sexually-transmitted infections

Drugs (unsafe/counterfeit)

Rabies - mammal bites

Schistosomiasis (fresh water contact)