Traveller Flashcards

Question

What do mosquitos transmit?

Answer 1

malaria dengue zika chikingunya

Answer 2

Viral disease (genus Alphavirus) Transmitted by infected mosquitoes – Aedes aegypti and Aedes albopictus Incubation: 3 to 7 days ``` High fever (40°C) joint pain & swelling (lower back, ankle, knees, wrists or phalanges) rash headache muscle pain nausea fatigue ``` Can have persistent rheumatologic symptoms - arthritis/ arthralgia, oedematous polyarthritis of fingers & toes, morning pain & stiffness & severe tenosynovitis (especially of wrists, hands, ankles). Occasionally, unusual joints (such as sternoclavicular or temperomandibular joints) involved. New onset Raynaud phenomena 2-3 months after infection – 20% Duration of persistent symptoms variable

Answer 3

Transmitted: Aedes mosquito / also sexual transmission Ongoing outbreak: Americas, theCaribbean, Pacific Incubation: 2 to 14 days Clinical manifestations - 20-25% of infected individuals Acute onset of low-grade fever (37.8 to 38.5°C) with maculopapular rash, arthralgia (small joints of hands & feet), conjunctivitis (nonpurulent) Other: myalgia, headache, retro-orbital pain, and asthenia Complications — Congenital microcephaly & fetal losses among women infected during pregnancy and Guillain-Barré syndrome. Zika virus RNA detected in blood, urine, semen, saliva, cerebrospinal fluid, amniotic fluid, and breast milk

Answer 4

Systemic hypersensitivity reaction to schistosome antigens & circulating immune complexes Malawi Presentation - Fever, sweats, cough, headache - Urticarial - Rash Initial treatment: consider steroids - Subsequently: praziquantel after acute symptoms have subsided and repeated 4-6 weeks after

Answer 5

Salmonella typhi; Salmonella paratyphi (A,B,C) Hot spot = SE Asia Incubation: 10-14 days Symptoms Aspecific - Headache → abdominal distension, diarrhoea - Fever, progressively increasing - Malaise, headache, drowsiness - Diarrhoea or constipation, abdominal discomfort - Dry cough - Hepatosplenomegaly Presentation Week 2 - Sustained high fever with relative bradycardia - Abdominal distension and tenderness - Rose spot rash on chest & upper abdomen - Splenomegaly – 75% Week 3 - Delirious and confused - Marked abdominal distension → intestinal haemorrhage or perforation - Osteomyelitis Diagnosis: based on culture – blood, faeces, urine Treatment: IV ceftriaxone Vaccine

Answer 6

Case 1: Presents 4 months post Egypt trip; Fever, RUQ tenderness, High WCC, dysenteric illness while travelling Diagnosis: serology +/- aspiration Treatment: - Metronidazole - Follow therapy for invasive disease with intraluminal agent (paromomycin or diloxanide furoate)

Answer 7

Triad: fever, headache, rash - Maculopapular, vesicular, or petechial rash +/- eschar at site of bite - Adenopathy often present Incubation: 1-2 weeks Diagnosis: clinical; serology retrospective  Treatment: Doxycyline (alternative: Azithromycin in allergy, pregnancy)

Answer 8

Southern/Sub-saharan Africa Tache noir Mild illness

Answer 9

Northern Africa & Med Rash, fever Mild illness

Answer 10

Transmitted by mites in Asia More severe illness including encephalitis Headache, lymphadenopathy, splenomegaly, cough, hearing difficulties, and encephalitis 20-50% untreated mortality

Answer 11

N, central and S America Tick Multi-system involvement (GI, lung, CNS, renal) 20% untreated mortality

Answer 12

Have you been to (West) Africa in the past 3 weeks? Clinical features - Non-specific: fever, rash, sore throat - GI upset - Haemorrhagic features uncommon - Malaria remains most likely diagnosis Relevant history - Lassa: rural conditions, rats - Marburg/Ebola: caves, mines, primates/antelopes/bats - CCHF: tick bite/contact, animal slaughter - Patient with VHF

Answer 13

Human Coronavirus  = Enveloped; positive-sense, ss RNA virus Incubation: 2-14 days Severe acute respiratory tract infection - Fever, shortness of breath, cough, severe acute pneumonia, GI upset (diarrhea) 30% fatality No specific antiviral therapy or vaccine Emerged in 2012 in Saudi Arabia - linked with Arabian peninsula; some related to travel Transmission between humans requires close contact with patient – no sustained circulation in community atm - link to camels - serve as intermediate hosts Risk assessment - Severe respiratory infection requiring hospital admission - and Fever >/= 38C & cough - and Pulmonary parenchymal disease (evidence of pneumonia/ARDS) - and not explained by other infection/aetiology - and at least one of these

Answer 14

Bacteria >80% - E.coli - enterotoxigenic and enteroaggregative - Camplyobacter jejuni - Shigella  - Salmonella  - Vibrio cholerae (rare) - Yersinia underestimated - Aeromonas and Plesiomonas may have localised importance Viruses 5-10% - Rota, noro and sapovirus Protozoa 2-10% - Giardia intestinalis - Entamoeba histolytica - Cryptosporidia - Cyclospora

Answer 15

Commonest identified cause of persistent travellers’ diarrhoea Cysts passed in stool with motile trophozoites in duodenal aspirates Incubation: 1-2 weeks without fever Foul smelling malabsorptive diarrhoea, floating stool & post-prandial bloating Treatment = metronidazole Disrupted brush border leads to disaccharidase deficiency - may become lactose intolerant

Answer 16

Itchy rash on foot of traveller returning from Jamaica Pruritic serpiginous eruption Tropical/subtropical beaches Larvae of hookworm of dogs and cats (Ancylostoma braziliense) Treatment - ivermectin, albendazole

Answer 17

Tunga penetrans – tiny, parasitic flea; W. Indies, S. & C. America, W. & E. Africa Gravid female burrows into broken skin on contact; lives there for 2 weeks until eggs are ready to be shed. Avoid walking barefoot!

Answer 18

Maggots of African tumbu fly or South/Central American botfly Eggs hatch and larvae burrow into human skin Persistent boils - exude serous fluid; report sensations of movement/pain in skin Close inspection reveals moving spiracles of larvae

Answer 19

plasma leakage haemorrhage organ impairment

Traveller Flashcards

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