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Year 3 Infection > 12. Travel related infection > Flashcards

12. Travel related infection Flashcards

1
Q

Why are travellers at risk of infection?

A 
Take risks away from home
Different risks of different diseases
uncomplete knowledge of health hazards
Stress of travel
deprivation, malnutrition, disease, injury
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2
Q

What diseases can travellers get due to the environemnt

A 
Sunburn, heat exhaustion and heatstroke
Fungal infections
Bacterial skin infections
Cold injury
Altitude sickness
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3
Q

What water based infections can travellers contract?

A 
Schistosomiasis
Leptospirosis
Liver flukes
Strongyloidiasis
Hook worm
Guinea worms
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4
Q

What athropod borne infections can travellers contract?

A 
Malaria
Dengue fever
Rickettsial infections
Leishmaniasis
Trypanosomiasis
Filariasis
onchocerciasis
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5
Q

What are some emerging infections worldwide?

A 
Zika- latin america,carribean
Ebola- west africa
Coronavirus- far east, worldwide
MERS-CoV middle east
Swine Flu 
Avian flue
SARS- far east, worldwide
West nile virus- USA
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6
Q

What are some important tropical disease?

A 
Malaria
Typhoid
Dengue fever
Schistosomiasis
Rickettsiosis
Viral heamorrhagic fevers
Zika fever
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7
Q

Describe the life cycle of a malaria parasite

A

Mosquitos inject sprozites into the blood. These parasites travel around the blood into the blood and interfere with the making of RBC. They become entangled in the blood. They are then repassed through mosquitos where the sporozites are re-made

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8
Q

What are the 5 species of malaria?

A 
Plasmodium falciparum- potentially severe 
Plasmodium vivax
Plasmodium ovale
Plasmodium malarie
Plasmodium knowlesi
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9
Q

What are the symptoms of malaria?

A

Fever, rigor,aching bones
Abdo pain, headache
dysuria,frequency, sore throat, cough

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10
Q

What are the clinical signs of malaria?

A

Splenomegaly
Hepatomegaly
Mild jaundice

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11
Q

What are the complications of malaria?

A 
Cerebral malaria (encephalopathy)
Non-immune vissitors, children in endemic areas, hpoglycaemia, convulsions, hypoxia
Blackwater fever- acute renal failrue
Pulmonary oedema
jaundice
Severe anaemia
Algid malaria
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12
Q

How is complicate malaria treated?

How is uncomplicated malaria treated?

A

Artesunate
Parenteral artesunate is used treat severe or complicated malaria.
Intravenous artesunate can cause haemolysis and follow-up blood tests are required.

Artemisinin combination therapy (ACT)
ACT may be used to treat uncomplicated malaria and is the preferred treatment for mixed infection.

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13
Q

How do you diagnosemalaria?

A

Thick and thin blood films (giemsa, field’s stain)
Quantitive buffy coat (centrigugation, UV microscopy)
Rapid antigen tests (optiMal, Parasight-F)

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14
Q

How do you differentiate between severe and uncomplicated malaria?

A

Severe malaria will have one or more of the following:

Impaired conciousness or seizures
Hypoglycaemia
Parasite count>2%
Heamoglobin <8mg/dl
SPontaneous bleeding
Haemoglobinuria
Renal impairement or PH<7.3
Pulmonary oedema or ARDS
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15
Q

How do you treat uncomplicated P.falciparum malaria

A

One of

Riamet (3 days)
Eurartesim (3 days)
Malarone (3 days)
Quinine (7 days)

plus oral doxyclycline

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16
Q

How do you treat severe P.falciparum?

A

IV arteesunate

plus doxycycline

17
Q

How do you treat the other malarias?

A

Chloroquine 3 days

add primaquine for 2 weeks (check is G6DP deficient first

18
Q

What is typhoid fever?

A

Salmonella typhi and salmonella paraatyphi infection

widespread in areas of poor sanitation and unclean drinking water

19
Q

What are the clinical features of the typhoid fever?

A 
incubation period (7 days-4 weeks)
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, tachycarida, neutropenia
3rd week complications- intestinal bleeding, perforation, peritonism, metastatic infections
week 4 (10-15% relapse)
20
Q

How do you diagnsoe tyhpoid fever

A

Very hard to diagnose clincially, monitor symptoms and recognise pattern
Labs, culture blood, urine and stool, culture bone marrow

21
Q

How do you treat typhoid fever?

A

Oral azithromycin- uncomplicated

IV ceftriaxone- complicated or concerns regardign absorbtion (note increasing resistance)

22
Q

What are the symptoms of dengue fever?

A

Sudden fever, headache,retro orbital pain
Severe myalgia and athralgia
Macular/maculopapular rash
Haemorrhagic signs, petiechiae, purpura, positive tourniquet test

23
Q

How do you diagnose dengue fever?

A 
Thrombocytopenia
Lecupenia
Elevated transaminases
Positive tourniquet test
Labs, PCR, serology
24
Q

Discuss the management of dengue fever

A

No specific therapies, take painkillers
Avoid bleeding nand dengue heamrrhagic shock syndrome or dengue shock syndrome
Treatment in that instance is IV fluids,flesh frozen plasma, platelets

25
Q

Describe the life cycle of schistosomiases

A

parasite eggs hatch in etaer, form into parasites in snails. Penetrate skin and migrate to portal blood into the liver and mature into adults. Adult worms lay eggs in bowel, rectum. Eggs released in bowel and urine

26
Q

What are the symptoms of schistossomiasis?

A

Swimmers itch
Invasive stage- cough, abdo discomfort, splenomegaly, eosinophilia
katayma fever- prostrate enlargeent, fever urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia
Acute disease, eggs deposited in bowel (dysentery) or bladder (haematuria)

27
Q

How do you diagnose schistosomiases?

A

Antibody tests
Ova in stool and urine
Rectal snip

28
Q

How do you treat schistosomiasis?

A

Praziquantel (20mg/kg) two doses 6 hrs apart, prednisolone if severe

29
Q

What is rickettsiosis?

A

Tick typhus, presnets with swinging fever, headache, confusion, endovascultits, rash, bleeding

30
Q

How do you diagnose rickettsiosis?

A

Clinical features and serology

Managed with tetracycline

31
Q

What is Zika?

A

Disease transmitted by mosquits, sex and blood transfusion

Relate to dengue, yellow fever, jap B encephalitits and west niel viruses

32
Q

What are the signs and complications of zika?

A

No or mild symptoms- headache, rash,fever, malaise, conjuctivits, joint pains
may cause gullain-barre syndrome

In pregnancy can cause microcephaly and other neurological conditions

33
Q

What examiantion fevers indicate what is what?

A

Rash- typhoid, typhus, dengue
jaundice0- hepatits, malaria, yellow fever
Lymoh nodes- leishmania, trypanosomiasis
liver- malaria, typhoid, amoebic abscess
Spleen- visceral leishmaniasis, typhoid, malaria

34
Q

What general investigations are good for suspecte tropical diseases?

A 
FBC,
malaria films
Liver functions tests
stool microscopy and culture
Blood cultures
CXR

Year 3 Infection (15 decks)

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