Travel Related Infections

Question 1

Why are travellers vulnerable to infection?

Answer 1

Temptations to take risks when away from home
Different epidemiology of some diseases
Incomplete understanding of health hazards
Stress of travel
Refugees: deprivation, malnutrition, disease, injury

Question 2

What are some climate of environment related health conditions?

Answer 2

Sunburn 
Heat exhaustion and heatstroke 
Fungal infections 
Bacterial skin infections 
Cold injury 
Altitude sickness

Question 3

What are some sanitation related health conditions?

Answer 3

Travellers diarrhoea 
Typhoid 
Hepatitis A or E 
Giardiasis 
Amoebiasis 
Helminth infections 
Viral gastroenteritis 
Food poisoning 
Shigella dysentery 
Cholera 
Cryptosporidiosis

Question 4

What are some immunisation related health conditions?

Answer 4

Poliomyelitis

Diphtheria

Question 5

What are some health education related health conditions?

Answer 5

HIV

STDs

Question 6

What are some water related infections?

Answer 6

Schistosomiasis 
Leptospirosis 
Liver flukes 
Hookworms 
Strongyloidiasis 
Guinea worms

Question 7

What are some anthropod-borne infections?

Answer 7

Malaria
Dengue fever
Rickettsial infections
Leishmaniasis

Question 8

What are some of the emerging infectious disease associated with travel?

Answer 8

Zika virus 
Ebola virus disease 
MERS-CoV 
Swine flu 
Avian flu 
SARS 
West Nile virus

Question 9

What is the vector for malaria?

Answer 9

Female Anopheles mosquito

Question 10

What are the 5 species of malaria?

Answer 10

Plasmodium falciparum 
Plasmodium vivax 
Plasmodium ovale 
Plasmodium malariae 
Plasmodium knowlesi

Question 11

What are the symptoms of malaria?

Answer 11

Fever 
Rigors 
Aching bones 
Abdominal pain 
Headache 
Dysuria 
Frequency 
Sore throat 
Cough

Question 12

What are the signs of malaria?

Answer 12

None
Splenomegaly
Hepatomegaly
Mild jaundice

Question 13

What are the complications of malaria?

Answer 13

Cerebral malaria 
Blackwater fever 
Pulmonary oedema 
Jaundice 
Severe anaemia 
Algid malaria

Question 14

How is a diagnosis of malaria made?

Answer 14

Thick and thin blood films
Quantitative buffy coat (QBC)
Rapid antigen tests

Question 15

How is the severity of malaria assessed?

Answer 15

Impaired consciousness or seizures 
Hypoglycaemia 
Parasite count >2% 
Haemoglobin <8mg/dL 
Spontaneous bleeding /DIC 
Haemoglobinuria 
Renal impairment or pH <7.3 
Pulmonary oedema or ARDS 
Shock

Question 16

What are the 2 main malaria drugs?

Answer 16

Quinine

Artemisinins

Question 17

What are the treatment options for uncomplicated malaria?

Answer 17

Riamet for 3 days
Eurartesim for 3 days
Malarone for 3 days
Quinine for 7 days plus oral doxycycline

Question 18

What are the treatment options of complicated or severe malaria?

Answer 18

IV Artesunate

IV Quinine plus oral doxycycline

Question 19

What are the treatment options for the benign species of malaria?

Answer 19

Chloroquine for 3 days
Riamet for 3 days
Add primaquine to eradicated liver hypnozoites

Question 20

What is involved in malaria control programmes?

Answer 20

Mosquito breeding sites (drainage of standing water) 
Larvacides 
Mosquito killing sprays 
Bed nets 
Mesh windows

Question 21

What is the cause of typhoid (enteric) fever?

Answer 21

Poor sanitation

Unclean drinking water

Question 22

What are the organisms that cause typhoid fever?

Answer 22

Salmonella typhi

Salmonella paratyphi

Question 23

What are the clinical features of typhoid fever?

Answer 23

Fever 
Headache 
Abdominal pain 
Constipation 
Tachycardia 
Neutrophilia 
Confusion 
Diarrhoea 
Intestinal bleeding 
Perforation and peritonism

Question 24

How is typhoid fever diagnosed?

Answer 24

Culture blood, urine and stool

Culture bone marrow

Question 25

What is the treatment for typhoid fever?

Answer 25

Oral azithromycin | IV ceftriaxone

Question 26

How is dengue fever transmitted?

Answer 26

Aedes aegypti mosquito

Question 27

What is a classic presentation of dengue fever?

Answer 27

``` Sudden fever Severe headache, retro-orbital pain Severe myalgia and arthralgia Macular/ maculopapular rash Haemorrhagic signs (petechiae, purpura, positive tourniquet test) ```

Question 28

How is dengue diagnosed?

Answer 28

``` Thrombocytopenia Leucopenia Elevated transaminases Positive tourniquet test Lab PCR and serology ```

Question 29

What are the complications of dengue fever?

Answer 29

Dengue haemorrhagic fever | Dengue shock syndrome

Question 30

How are the complications of dengue fever treated?

Answer 30

IV fluids Fresh frozen plasma Platelets

Question 31

How can dengue be prevented?

Answer 31

Avoid bites | New vaccine in use

Question 32

What are the clinical features of schistosomiasis?

Answer 32

``` Swimmers itch Cough Abdominal discomfort Spelnomegaly Eosinophilia Katayama fever Eggs deposited in bowel or bladder ```

Question 33

How is a diagnosis of schistosomiasis made?

Answer 33

Antibody tests Ova in still or urine Rectal snip

Question 34

What is the treatment for schistosomiasis?

Answer 34

Praziquantel | Prednisolone if severe

Question 35

What are the clinical features of rickettsiosis?

Answer 35

``` Abrupt onset swinging fever Headache Confusion Endovasculitis Rash Bleeding ```

Question 36

How is rickettsiosis managed?

Answer 36

Tetracycline

Question 37

What are some serious viral haemorrhagic fevers?

Answer 37

Ebola Congo-Crimea haemorrhagic fever Lassa fever Marburg disease

Question 38

How is Zika virus transmitted?

Answer 38

Daytime biting aedes mosquito Sexual contact Blood transfusion

Question 39

What are the clinical features of zika virus?

Answer 39

``` None Headache Rash Fever Malaise Conjunctivitis Joint pains ```

Question 40

What is the effect of Zika virus within pregnancy?

Answer 40

Can cause microcephaly and other neurological problems | Gillian Barre syndrome