Travel Related Infections Flashcards
(36 cards)
What are the most significant parts of the infection model when looking at travel infections?
Person;
- Age
- Gender
- Physiological state
- Pathological state
- Social factors
Time;
- Calendar time
- Relative time
Place;
- Current
- Recent
Outline how pathogens can cause travel related infections
Bacteria (Rickettsia) and parasites (Protozoa, Helminths) are transmitted via vectors
What are 3 reasons that travel history is important?
- To recognise imported diseases (Rare/ unknown in UK)
- Infection prevention (On the ward/ in the lab)
- Different strains of pathogen exist (Variation in antibiotic resistance, impact on protection/ detection)
What are 4 guiding questions involved in taking a travel history?
Where have they been?
When did the symptoms begin?
What are the symptoms/ signs?
How did they acquire it?
What are 6 common regions associated with travel infections
- Sub Saharan Africa
- North Africa
- Southeast Asia
- South/ Central Asia
- South/ Central America
- Middle East
(Also North Australia and North America)
What are the 3 groups of incubation periods for travel related infections?
Acute: <10 days
Sub-Acute: 10–21 days
Chronic: >21 days
What are 5 types of symptoms seen in travel related infections
- Respiratory (Cough)
- GI (Diarrhoea
- Skin (Rash)
- CNS (Headache)
- Haematological (Haemorrhage/ splenomegaly/ lymphadenopathy)
What are 5 activities that can result in travel related infections
- Food/ water
- Insect/ tick bite
- Swimming
- Sexual contact
- Animal contact (Bite/ safari)
What are 3 key aspects of travel history
- Any unwell travel companions/ contacts?
- Preventative measure taken? (Pre-travel vaccination)
- Any healthcare exposure?
What is the commonest imported infection to the UK?
What is the vector for this infection?
Malaria
Female Anopheles mosquito
What are the 5 main species of Plasmodium?
Which is most dangerous?
Which one is mainly in Africa?
Which ones are mainly in India?
- Plasmodium falciparum;
- Most dangerous
- Mainly in Africa - Plasmodium vivax;
- Mainly in India - Plasmodium ovale;
- Mainly in India - Plasmodium malariae
- Plasmodium knowlesii
What is the Incubation period for malaria?
What about Plasmodium falciparum, vivax and ovale in particular?
At least 6 days
P. falciparum: Up to 4 weeks
P. vivax/ ovale: Up to 1 year+
How does Malaria present in the history and upon examination
History;
- Fever, chills and sweats in a cycle every 3rd or 4th day
Examination;
- Often few signs except fever
- May or may not have splenomegaly
What are 7 types of symptoms of Malaria due to Plasmodium falciparum presents?
- Cardiovascular (Tachycardia, Hypotension, Arrhythmia)
- Respiratory (Acute Respiratory Distress Syndrome)
- GI (Diarrhoea, Abnormal LFTs, raised Bilirubin)
- Renal (Acute kidney injury)
- Blood (Low/ normal WCC, DIC, Low platelets)
- CNS (Confusion, fits)
- Metabolic (Hypoglycaemia, metabolic acidosis)
(Possible secondary infection)
Describe the life cycle of the malaria parasite
- Parasite invades body via bite
- Travels to liver, matures
- Enters blood, attacks RBCs
How is Malaria diagnosed? Include 6 methods
- FBC
- U&Es
- Blood glucose
- Coagulation test
- Head CT (If neurological symptoms)
- Chest X Ray
What do you need to do to discount a malaria diagnosis
3 negative blood films
How do you treat Malaria due to;
- P. falciparum
- P. vivax/ ovale/ malariae
Falciparum;
- Artesunate (1st line treatment)
- Quinine + Doxycycline
Vivax/ ovale/ malariae;
- Chloroquine
- If recurrent, Primaquine
What are 3 methods of prevention of malaria
- Asses risk
- Bite prevention
- Chemoprophylaxis
What is Enteric fever?
What 2 diseases are example of enteric fever?
Which organisms cause these? Which disease is milder
A potentially fatal, multisystemic disease caused by Salmonella typhi
Typhoid;
- Salmonella typhi
Paratyphoid;
- Salmonella paratyphi A/B/C
- Milder
What are 3 high risk regions for Enteric fever?
What is the mechanism of infection?
- Asia
- Africa
- America
Faecal-oral
Describe 4 virulence factors of Enteric fever
- Low infectious dose
- Survives gastric acid
- Reside within macrophages
- Fimbriae adhere to epithelium over Peyer’s patches, bacteria enter the blood
State the incubation period of Enteric fever
State 6 symptoms/ signs
7-14 days
- Fever
- Headache
- Dry cough
- Relative bradycardia
- Abdominal discomfort
- Constipation/ diarrhoea
State 3 complications of Enteric fever
- Intestinal haemorrhage
- Intestinal perforation
- Death (10%)
