Travel Infections Flashcards
In regards to travel what particular bacteria would be of concern?
Rickettsia/spirochaete
In regards to travel what particular parasites would be of concern?
Protozoa, helminth
Why is travel history important important?
Recognise imported diseases
Diff strains: antigenically diff, impacts on protection/detection, Abx res
Infect prevent: on ward, in lab
What questions are included in a travel history?
Where, when, how
Any unwell companions/contacts?
Pre-travel vac, preventative measures?
Healthcare exposure?
What are the 3 main species of plasmodium?
Falciparum (most common), vivax, ovale
What is the minimum incubation period of falciparum vs vivax/ovale?
F = min 6 day – 4 weeks
V/O = 6 days – 1 year
What is the history/examination of malaria?
Fever, chills, sweats, cycle every 3rd to 4th day, +/- splenomegaly
Outline the possible side effects of malaria
CVS: tachycardia, hypotension, arrhythmias
Res: ARDS
GIT: diarrhoea, deranged LFTs,
CNS: confusion
Blood: low/norm WCC, DIC, thrombocytopenia
Renal: AKI
MET: acidosis, hypoglycaemia
Outline malaria
Vector: mosquito
Invest: blood film x3 (parasits), FBC, LFTs, Glu, coag, CT if neuro symptoms, CXR
Treat: falciparum (artesunate), vivax/ovale (chloroquine)
Prevent: ABC = Assess risk, Bite prevention, Chemoprophylaxis
Outline enteric fever
Mainly asia - poor sanitation
Faecal-oral contaminated food/water
Cause = salmonella typhi/paratyphi A, B, C
Sym/sign = fever, headache, abdo pain, dry cough, bradycardia
Comp = intestinal haemorrhage, perforation
Invest: anaemia, lymphopaenia, raised LFTs, culture
Treat: IV ceftriaxone 7-14 days
Prevent: food/water hygiene, typhoid vac
What are the virulence factors of salmonella?
Low infectious dose
Survives gastric acids
Fimbriae adhere peyers patches
Reside in macrophages
Outline dengue fever
Arbovirus
Sym: aymp to non-specific febrile illness, rash
Invest: b/c -ve x2, CRX norm, PCR +ve, serology +ve
Sub and tropical regions
Treat: supportive
What are the common travel related respiratory infections?
Influenza
SARS – severe acute resp syndrome
MERS – middle east resp syndrome
What are the common travel related emerging infections?
Ebola
Zika virus
Briefly outline the life cycle of malaria
1) mosquito feeds - sporozoite enters blood stream
2) make way to liver, infect hepatocytes
3) in hepatocytes: sporozoite devel to schizont = creating thousands of merozoites
4) merozoites burst out of cell, travel in blood steam
5) infect RBCs: reproducing, rupturing cell (massive destruction)
6) few cells devel to gametocytes = remain in blood several days
7) ingested by another mosquito - devel back to sporozoite
