Travel Related Infections Flashcards
(43 cards)
Why are travellers vulnerable to infection?
- tempted to take risks away from home
- different disease epidemiology
- incomplete understanding health hazards
- stress of travel
- refugees; deprivation, malnutrition, disease, injury
What are common worldwide infections?
Influenza, community acquired pneumonia, meningococcal disease, STDs
What are climate/environmental health problems?
Sunburn Heat exhaustion and heatstroke Fungal infections Bacterial skin infections Cold injury Altitude sickness
What traveler infections are controlled through sanitation?
- travelers’ diarrhoea
- typhoid
- hep A or E
- giardiasis
- amoebiasis
- helminth infections
- viral gastroenteritis
- food poisoning
- shigella dysentery
- cholera
- cryptosporidiosis
What traveler infections are controlled through immunisation?
Poliomyelitis
Diphtheria
What are some water related infections?
- schistosomiasis
- leptospirosis
- liver flukes
- strongyloidiasis
- hookworms
- guinea worms
What are some arthropod borne infections?
- malaria, dengue fever
- rickettsial infections
- leishmaniasis
- trypanosomiasis
- filariasis
- onchocerciasis
What arthropod causes malaria and dengue fever?
Mosquitoes
What arthropod causes rickettsial infections?
Ticks; typhus
What arthropod causes leishmaniasis?
sand flies; Kala-azar
What arthropod causes trypanosomiasis?
tsetse fly; sleeping sickness
What arthropod causes onchocerciasis?
black flies; river blindness
Describe the species of malaria
Plasmodium falciparum (potentially severe)
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi
What are the clinical features of malaria?
Non-specific
Fever, rigors, aching bones, abdo pain, headache, dysuria, frequency, sore throat, cough
What are the major complications of malaria?
6 major
- cerebral malaria; hypoglycaemia, convulsions, hypoxia
- blackwater fever; dark urine due to intravascular haemolysis - acute renal failure
- pulmonary oedema
- jaundice
- severe anaemia
- algid malaria
Describe management of malaria
Diagnosis through thick and thin blood films, quantitative buffy coat, rapid antigen tests
Severity assessment; complicated or not
How is malaria assessed for severity?
Complicated malaria is one or more of
- impaired consciousness or seizures
- hypoglycaemia
- parasite count >2%
- haemoglobin <8mg/dL
- spontaneous bleeding / DIC
- haemoglobinuria
- renal impairment or pH <7.3
- pulm oedema or ARDS
- shock (algid malaria)
What are drugs for malaria?
Quinine (from chinchona) and artemisinins (from Quinghaosu)
How is uncomplicated falciparum malaria treatment?
- Riamet 3 days
- Eurartesim 3 days
- Malarone 3 days
- Quinine 7 days + oral doxycycline
How is complicated or severe falciparum malaria treated?
- IV artesunate
- IV quinine + oral doxycycline
- once stable and can swallow switch to oral
How are vivax, ovale, malariae and knowlesi malaria treated?
- Chloroquine 3 days
- Riamet 3 days
- add primaquine in vivax and ovale to eradicate liver hypnozoites
Describe some malaria control programmes
Mosquito breeding site drainage of standing water
Larvacides
Mosquito killing sprays
Human behaviour i.e. ned nets and mesh windows
What are the two typhoid viruses?
Salmonella typhoid and salmonella paratyphi
Describe the clinical features of typhoid
1st week; fever, headache, abdo discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
2nd week; fever peaks at 7-10days, rose spots, diarrhoea begins, tachycardia, neutropenia
3rd week; intestinal bleeding, perforation, peritonism, metastatic infections
Week 4; 10-15% relapse but recover generally
