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Travel Related Infection Flashcards

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1
Q

what are the unfamiliar features of imported disease?

A 
presenting features
isolation requirements
diagnostic methods
treatment/management
unexpected complications
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2
Q

how are travellers at risk of infection?

A

temptation to take risks away from home
different epidemiology of some diseases
incomplete understanding of health hazards
stress of travel
refugees - deprivation, malnutrition, disease, injury

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3
Q

name some infections that are common worldwide

A

influenza
community acquired pneumonia
meningococcal disease
STI

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4
Q

name some climate or environment related health problems

A 
sunburn
heat exhaustion and heatstroke
fungal infections
bacterial skin infections
cold injury
altitude sickness
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5
Q

infections controllable by public health measures: sanitation

A
  • Traveller’s diarrhoea
  • Typhoid
  • Hepatitis A or E
  • Giardiasis
  • Amoebiasis
  • Helminth infections
  • Viral gastroenteritis
  • Food poisoning
  • Shigella dysentery
  • Cholera
  • Cryptosporidiosis
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6
Q

infections controllable by public health measures: immunisation

A

poliomyelitis

diphtheria

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7
Q

infections controllable by public health measures: education

A

HIV

STIs

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8
Q

name some water related infections

A
  • Schistosomiasis
  • Leptospirosis
  • Liver flukes
  • Strongyloidiasis
  • Hookworms
  • Guinea worms
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9
Q

name some arthropod-borne infections and their vector

A
  • Malaria (mosquitos)
  • Dengue fever (mosquitos)
  • Rickettsial infections (ticks: typhus)
  • Leishmaniasis (sand flies: Kala-azar)
  • Trypanosomiasis (tsetse fly: sleeping sickness)
  • Filariasis (mosquitos: elephantiasis)
  • Onchocerciasis (black flies: river blindness)
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10
Q

name some emerging infectious diseases and where

A
  • Zika: Latin America, Caribbean
  • Ebola virus disease: West Africa
  • MERS-CoV: Middle East
  • Swine ‘flu (H1N1): worldwide
  • Avian ‘flu (H5N1 and H7N9): China
  • SARS: Far East, worldwide
  • West Nile Virus: USA
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11
Q

what is the malaria vector?

A

female Anopheles mosquito

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12
Q

name the 5 species of malaria

A 
plasmodium falciparum
plasmodium vivax
plasmodium ovale
plasmodium malariae
plasodium knowlesi
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13
Q

clinical features of malaria: symptoms

A 
fever
rigors
aching bones
abdo pan
headache
dysuria
frequency
sore throat
cough
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14
Q

clinical features of malaria: signs

A

none
splenomegaly
hepatomegaly
mild jaundice

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15
Q

list complications of malria

A 
cerebral malaria (encephalopathy)
blackwater fever
pulmonary oedema
jaundice
severe anaemia
algid maria
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16
Q

who is vulnerable to cerebral malaria (encephalopathy)?

A

non-immune visitors

children in endemic areas

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17
Q

what does cerebral malaria (encephalopathy) cause?

A

hypoglycaemia
convulsions
hypoxia

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18
Q

what is blackwater fever

A 
severe intravascular haemolysis
high parasitaemia
profiund anaemia
haemoglobinuria
acute renal failure
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19
Q

what kind of septicaemia (gram +ve/-ve) does algid malaria produce?

A

gram -ve

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20
Q

diagnosi of malaria

A

thick and thin blood films - Giemsa, Field’s stain
Quantitative buff coat
Rapid antigen tests - OptiMal, ParaSight-F

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21
Q

for complicated malaria you need one or more of:

A 
impaired consciousness or seizures
hypoglycaemia
parasite count >= 2%
haemoglobin <= 8mg/dl
spontaneous bleeding/DIC
haemoglobinuria
pH < 7.3
pulmonary oedema or ARDS
shock
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22
Q

SE of quinine

A 
nausea
tinitus
deafness
rash
hypoglycaemia
IV - cardiac depression , cerebral irritation
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23
Q

treatment of uncomplicated p falciparum

A

riamet 3 days
euratesim 3 days
malarone 3 days
quinine 7 days plus oral doxycycline or clindamycin

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24
Q

treatment of complicated or severe p falciparum

A 
IV artesunate (unlicensed in UK)
IV quinine + oral doxy/clindamycin
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25
treatment of p vivax, p ovale, p malariae, p knowlesi
chloroquine 3 days riamet 3 days add primaquine 14 days in vivax and ovale to eradicate liver hypnozoites
26
when giving primaquine which exzyme do you need to check for deficiency in?
G6PD
27
what organisms cause enteric fever?
salmonella typhi | salmonella paratyphi
28
clinical features of enteric fever: incubation period
7 days - 4 weeks
29
clinical features of enteric fever: 1st week
``` fever headache abdo pain constipation dry cough relative bradycardia neutrophilia confusion ```
30
clinical features of enteric fever: 2nd week
``` fever peaks at 7-10 days rose spots diarrhoea begins tachycardia neutropneia ```
31
clinical features of enteric fever: 3rd week (complications)
intestinal bleeding perforation peritonism metastatic infection
32
diagnosis of enteric fever: clinical
not easy | based on evolution of features
33
diagnosis of enteric fever: lab
culture blood, urine, stool | culture bone marrow
34
treatment of enteric fever
oral azithromycin | IV ceftriaxone
35
clinical features of dengue fever
``` sudden fever severe headaches, retro-orbital pain severe myalgia and arthralgia macular/maculopapular rash haemorrhagic signs - petechiae, purpura, positive tourniquet test ```
36
diagnosis of dengue fever: clinical
thrombocytopenia leukopenia elevated transaminases positive tourniquet test
37
diagnosis of dengue fever: lab
PCR | Serology
38
management of dengue fever
no specific IV fluids fresh frozen plasma platelets
39
complication sof dengue fever
dengue haemorrhagic fever | dengue shock syndrome
40
prevention of dengue fever
avoid bites | new vaccine - dengvaxis
41
where is schistosomiasis found?
freshwater | freshwater snails
42
what organisms can cause schistosomiasis ?
schistosoma haematobium s. mansoni s. japonicum
43
clinical features of schistosomiasis: 1st few hours
swimmers itch clears after 24-48 hrs
44
clinical features of schistosomiasis: invasive stage > 24 hrs
cough abdo discomfort splenomegly eosinophilia
45
clinical features of schistosomiasis: karaymama fever (15-20 days)
``` prostrate fever urticaria lymphadenopathy splenomegaly diarrhoea eosinophilia ```
46
clinical features of schistosomiasis: acute disease (6-8 weeks)
eggs deposited in bowel (dysentery) or bladder (haematuria)
47
diagnosis of schistosomiasis
clinical diagnosis antibody tests ova in stools and urine rectal snip
48
treatment of schistosomiasis
praziquantel 20mg/kg, two doses 6 hrs apart | prednisolone if severe
49
organisms and diseases of rickettsiosis
``` tick typhus - r. conorrii, r. africae rocky mountain spotted fever - r. rickettsi endemic typhus - r. prowazeki murine or endemic typhus - r. mooseri scrub typhus - r, tsutsugamushi ```
50
what type of rickettsiosis is most common imported to the UK?
tick typhus
51
where does tick typhus come from?
Southern Africa Mediterranean Arabian Gult
52
signs and symptoms of tick typhus
``` abrupt onset swinging fever headache confusion endovasculitis rash (macular, petechial) bleeding ```
53
diagnosis of tick typhus
clinical features | serology
54
treatment of tick typhus
tetracycline
55
give examples of viral haemorrhagic fevers
ebola congo-crimea haemorrhagic fever lassa fever marburg disease
56
what is the maximum incubation period for viral haemorrhagic fevers?
3 weeks
57
what is the treatment for viral haemorrhagic fevers?
supportive
58
what type of virus is zika?
flavivurus
59
how is zika transmitted?
daytime biting Aedes mosquito sexual contact blood transfusion
60
what is Zika related to?
dengue yellow fever Jap B encephalitis West Nile virus
61
clinical features of zika
``` mild or no symptoms headache rash fever malaise conjunctivitis joint pains Guillain-Barre syndrome ```
62
in pregnancy what can zika cause?
microcephaly and other neurological problems
63
returned traveller. what diseases cause rash?
typhoid thypus dengue
64
returned traveller. what diseases cause jaundice?
hepatitis malaria yellow fever
65
returned traveller. what diseases cause lymph nodes?
leishmania | trypanosomiasis
66
returned traveller. what diseases cause hepatomegaly?
malaria typhoid amoebic abscess
67
returned traveller. what diseases cause spleenomegaly?
visceral leishmaniasis typhoid malaria

Year 3 (164 decks)

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