Travel Related Infection Flashcards
(47 cards)
What factors can make the individual more vulnerable to infections?
Temptation to take risks away from home
Different epidemiology (HIV and TB)
Incomplete understanding of health hazards
Stress of travel
Refugees or workers that move (bring infections)
What are the three main areas that can be controlled by public health measures?
Sanitation, immunisation and education
What are some examples of water-related infections?
Schistosomiasis Leptospirosis Liver flukes Strongyloidiasis Hookworms Guinea worms
What are some examples of arthropod-borne infections?
Malaria (mosquitos)
Dengue fever (mosquitos)
Rickettsial infections (ticks: typhus)
Leishmaniasis (sand flies: Kala-azar)
Trypanosomiasis (tsetse fly: sleeping sickness)
Filariasis (mosquitoes: elephantiasis)
Onchocerciasis (black flies: River Blindness)
What is the vector for malaria?
Female Anopheles mosquito
What are the 5 species of malaria?
Plasmodium falciparum Plasmodium vivax Plasmodium ovale Plasmodium malariae Plasmodium knowlesi
What is the most serve species for malaria?
Plasmodium falciparum
What are the signs and symptoms of malaria?
SYMPTOMS fever rigors aching bones abdo pain headache dysuria frequency sore throat cough
SIGNS none splenomegaly (chronic) hepatomegaly (chronic) mild jaundice
What are the complications of malaria?
Cerebral malaria (encephalopathy) non- immune visitors, children in endemic areas hypoglycaemia, convulsions, hypoxia
Blackwater fever
severe intravascular haemolysis, high parasitaemia, profound anaemia, haemoglobinuria, acute renal failure
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria
How is malaria diagnosed?
Thick & thin blood films (Thick = presence, Thin= species) - Giemsa, Field’s stain Quantitative buffy coat (QBC) - centrifugation, UV microscopy Rapid antigen tests - OptiMal - ParaSight-F
What are the ancient malaria drugs?
Quinine (from chinchona) and Artemisinins (from Quinghaosu)
What are the treatment options for uncomplicated P.falciparum?
Riamet ® (artemether-lumefantrine) 3 days
Eurartesim ® (dihydroartemisinin-piperaquine) 3 days
Malarone ® (atovaquone-proguanil) 3 days
Quinine 7 days
What are the side effects of quinine?
S/E nausea, tinnitus, deafness (cinchonism), rash, hypoglycaemia plus oral doxycycline (or clindamycin)
What are the treatment options for complicated or severe P.falciparum?
IV artesunate (unlicensed in UK) IV quinine plus oral doxycycline (or clindamycin)
When patient is stable & able to swallow, switch to oral treatments
What is the treatment of P. viva, P.ovale, P.malariae and P.knowlesi?
chloroquine 3 days
Riamet ® (artemether-lumefantrine) 3 days
add primaquine* (14 days) in vivax and ovale, to eradicate liver hypnozoites
What are the species involved in Typhoid Fever?
Salmonella typhi
Salmonella paratyphi
What are the species involved in Typhoid Fever?
Salmonella typhi
Salmonella paratyphi
How is it transmitted?
Contaminated food and water
What are the clinical features of Typhoid fever?
Incubation period: 7 days - 4 week
1st week:
fever, headache, abdo. discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
2nd week:
fever peaks at 7-10 days, Rose spots, diarrhoea begins, tachycardia, neutropenia
3rd week (Complications):
intestinal bleeding, perforation, peritonism, metastatic infections
week 4 (Recovery):
10 - 15% relapse
What is the treatment for uncomplicated typhoid fever?
Oral Azithromycin
What is the treatment for complicated typhoid fever?
IV Ceftriaxone
How is Dengue transmitted?
Aedes aegypti mosquito
What is the classical clinical presentation of dengue fever?
Sudden fever Severe headache, retro-orbital pain Severe myalgia and arthralgia Macular/ maculopapular rash Haemorrhagic signs: petechiae, purpura, positive tourniquet test
What laboratory results would you expect in a pt with Dengue?
Thrombocytopenia
Leucopenia
Elevated transaminases
