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Infection > 9. Travel-related infections > Flashcards

9. Travel-related infections Flashcards

1
Q

What questions should be asked when taking a travel history?

A 
Where did you go?
How long did you go for?
When did you return?
What are the symptoms/signs?
When did they start?
What activities did they take part in?
Any other travel companions suffering?
What pre-travel vaccinations/preventative measures?
Any healthcare exposure abroad?
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2
Q

Why is it important to know how long the patient was travelling for and when symptoms began?

A

In order to work out possible incubation period of a disease

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3
Q

How are travel-related infections categorised into acute, sub-acute and chronic?

A

< 10 days = acute
10-21 days = sub-acute
> 21 days = chronic

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4
Q

What is the vector for malaria?

A

Female anopheles mosquito

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5
Q

What are the 4 species of plasmodium that cause malaria?

A
  1. Falciparum
  2. Vivax
  3. Ovale
    (4. Malariae) less common
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6
Q

Which patients are at higher risk of a severe malarial infection?

A

Young children
Pregnant women
Elderly

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7
Q

What type of virus is malaria?

A

Arbovirus

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8
Q

What is the minimum incubation period of malaria?

A

6 days

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9
Q

How do the incubation periods of P.falciparum and P.vivax/ ovale differ?

A

Falciparum- up to 6 months

P. Vivax/Ovale - up to 1 year

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10
Q

Why do P. vivax and ovale have a longer incubation period?

A

Lie latent in the liver as hypnozoites

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11
Q

What history is typical of malaria presentation?

A

Fever

Chills and sweats cycling every 3rd/4th day

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12
Q

What might be present upon examination of a patient presenting with malaria?

A

Splenomegaly

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13
Q

What symptoms are associated with malaria?

A 
Skin - chills/sweating
Systemic - fever
Resp - coughing
Stomach - nausea + vomiting
Back pain
Muscle pain and fatigue
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14
Q

What investigate is important to do in suspected malaria?

A

3 blood smears

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15
Q

How is P.falciparum malaria treated?

A

Artesunate

Quinine & doxycycline

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16
Q

How are P. vivax, ovale and malariae treated?

A

Chloroquine + primaquine

17
Q

How can malaria be prevented?

A

‘ABC’
Assess risk - which areas
Bite prevention - repellant,nets, clothing
Chemoprophylaxis - start before and continue after return

18
Q

What parasite load can cause severe falciparum malaria?

A

> 2%

19
Q

What symptoms are associated with severe falciparum malaria?

A 
CV - tachycardia, hypotension
CNS - confusion, fits
Resp - ARDS
GI - diarrhoea
Renal - acute kidney injury
Metabolic acidosis , hypoglycaemia
20
Q

What organisms can cause typhoid and paratyphoid?

A

Salmonella typhi

Salmonella paratyphi A,B or C

21
Q

What are typhoid and paratyphoid?

A

Enteric fevers, paratyphoid is less severe

22
Q

What it the incubation period of typhoid/paratyphoid?

A

7-14 days

23
Q

What are the virulence factors of Salmonella?

A
  • Fimbriae adhere to epithelium over peyer’s patches
24
Q

What are the signs and symptoms of enteric fever?

A

Fever, headache, abdominal discomfort, constipation, dry cough, bradycardia

25
Q

What are the complications of enteric fever?

A

Intestinal haemorrhage and perforation

26
Q

How is typhoid transmitted?

A

Faecal-oral from contaminated food and water

27
Q

How is enteric fever treated?

A

Ceftriaxone or azithromycin

28
Q

What type of virus is dengue fever?

A

Arbovirus

29
Q

What are the symptoms of dengue fever?

A

headache, fever, back pain, severe myalgia , widespread rash on trunk and back

30
Q

How is dengue fever treated?

A

Supportive only

31
Q

How can dengue fever be diagnosed?

A

PCR

Serology

32
Q

What happens during the first infection of dengue fever?

A

asymptomatic to severe febrile illness
lasts 1-5 days
supportive treatment only

33
Q

What happens if a person is re-infected with a different serotype of dengue fever?

A

Dengue haemorrhagic fever

Dengue shock syndrome

34
Q

Briefly describe the malarial life cycle.

A
  1. Infected mosquito injects sporozoites
  2. Sporozoites migrate to liver where they form merozoites
  3. Merozoites released and invade RBC’s
  4. Merozoite becomes trophozoite in RBC
  5. In RBC, trophozoite multiplies, producing new merozoites. Merozoites released when cell ruptures.
  6. Some merozoites become gametocytes
  7. Female anopheles picks up gametocytes from infected human and forms sporozoites which are passed on.

Infection (15 decks)

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