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INF > GASTROINTESTINAL INFECTIONS > Flashcards

GASTROINTESTINAL INFECTIONS Flashcards

1
Q

GENERAL ISSUES PRINCIPLES TO BE FOLLOWED FROM A PH PERSPECTIVE REGARDING CONTROL GI INFECTIONS?

A
  • STOOL SAMPLE COLLECTION
  • IDENTIFY SOURCE
  • MODE OF TRANSMISION - HELPS DEFINE CONTROL MEASURES
  • DIARRHOEA; GREATER CONTAMINATION; GREATER RISK OF SPREAD
  • ENTERIC PRECAUTIONS
  • RISK GROUS
  • EXCLUSION (ISOLATING PEOPLE): 48HR; MICROBIOLOGICAL CLEARANCE (NEGATIVE STOOL SAMPLES)
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2
Q

TRANSMISSION OF GI INFECTIONS?

A
  • FAECO-ORAL
  • FOODBORNE
  • ENVIRONMENTAL
  • AIRBORNE

6Fs OF FAECO-ORAL INFECTIONS:

  • FOOD
  • FINGERS
  • FLIES
  • FLUIDS
  • FECES
  • FOMITES (NON-LIVING OBJECTS THAT CAN TRANSMIT AN INFECTION)
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3
Q

6Fs OF FAECO-ORAL INFECTIONS:

A
  • FOOD
  • FINGERS
  • FLIES
  • FLUIDS
  • FECES
  • FOMITES (NON-LIVING OBJECTS THAT CAN TRANSMIT AN INFECTION)
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4
Q

EXAMPLES OF PRIMARY PREVENTION OF GI INFECTIONS?

A
  • FOOD SAFETY; ‘FARM TO FORK’, MILK PASTERISTAION, SEPARATING POTENTIALLY INFECTED ANIMALS FROM THE HEALTHY ONES ETC
  • WATER QUALITY (FILTERING WATER ETC)
  • PUBLIC AWARENESS; OPEN FARMS (RISK OF INFECTION WHEN PETTING ANIMALS), SUMMER BBQ (MAKE SURE MEAT ISN’T UNDERCOOKED)
  • FOREIGN TRAVEL; ADVICE (IN SOME PLACES NOT EATING STREET FOOD, DRINKING BOTTLED WATER ETC), VACCINES
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5
Q

SOME MEASURES INDIVIDUALS CAN TAKE TO ENSURE FOOD SAFETY AND HYGIENE?

A

AT HOME

  • COOK FOOD PROPERLY
  • CHILL FOOD (KEEP IN THE FRIDGE UNTIL READY TO USE)
  • CLEANING (SURFACES ON WHICH THE COOKING IS TAKING PLACE)
  • BEWARE OF CROSS CONTAMINATION

BUYING AND EATING FOOD

  • FOOD HYGIENE RATINGS (CHECK FOR PLACES YOU EAT FROM)
  • BEST BEFORE AND USE-BY DATES

—> MAINTAINING PERSONAL HYGIENE

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6
Q

HAZARD ANALYSIS AND CRTICAL CONTROL POINT (HACCP)

A

A MANAGEMENT SYSTEM IN WHICH FOOD SAFETY IS ADDRESSED THROUGH THE ANALYSIS AND CONTROL OF BIOLOGICAL, CHEMICAL AND PHYSICAL HAZARDS FROM RAW MATERIAL PRODUCTION, PROCUREMENT AND HANDLING TO MANUFACTURING, DISTRIBUTION AND CONSUMPTION OF THE FINISHED PRODUCT.
- BUSINESS ARE REQUIRED TO IDENTIFY WHAT COULD GO WRONG AND WHERE FOOD SAFETY MIGHT BE COMPROMISED SO THAT CAN MITIGATE AGAINST THOSE RISKS AND ENSURE ACTION IS TAKEN IF SOMETHING GOES WRONG AND ALL THE PROCEDURES ARE FOLLOWED + HAVE TO KEEP RECORDS TO SHOW PROCEDURES ARE WORKING

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7
Q

HOW IS FOOD HYGIENE IN RESTAURANTS AND SIMILAR ESTABLISHMENTS CONTROLLED?

A
  • THROUGH INSPECTIONS WHICH CHECK: HOW SAFELY IS FOOD HANDLED IN PRACTICE (STORAGE, HANDLING, PREPARATION), THE PREMISES (OVERALL CLEANLINES, FACILITIES, LAYOUT), MEASURES TO MAINTAIN HYGIENE STANDARDS (E.G. INTERNAL SYSTEMS AND POLICIES)
  • FREQUENCY OF INSPECTIONS DEPENDS ON THE POTENTIAL RISK TO PH: TYPE OF FOOD, NUMBER AND TYOE OF CUSTOMER (E.G. VULNERABLE GROUS), TYPES OF PROCESSES BEFORE FOOD SOLD OR SERVED, HYGIENE STANDARDS AT LAST INSPECTION
  • FOOD STANDARDS AGENCY GIVES A FOOD HYGIENE RATING TO EACH RESTAURANT (0-5; 0 MEANING URGENT ACTION NEEDED, 5 MEANING VERY GOOD), THERE IS A STICKER INDICATING THIS RATIG A DEPENDING ON A COUNTRY IT HAS TO OR IS RECOMMENDED TO BE VISIBLY DISPLAYED
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8
Q

WHAT DOES FREQUENCY OF FOOD HYGIENE INSPECTIONS DEPEND ON?

A

DEPENDS ON THE POTENTIAL RISK TO PH: TYPE OF FOOD, NUMBER AND TYOE OF CUSTOMER (E.G. VULNERABLE GROUS), TYPES OF PROCESSES BEFORE FOOD SOLD OR SERVED, HYGIENE STANDARDS AT LAST INSPECTION

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9
Q

HOW GIVES THE FOOD HYGIENE RATING TO RESTAURANTS + WHAT IS IT?

A

FOOD STANDARDS AGENCY GIVES A FOOD HYGIENE RATING TO EACH RESTAURANT (0-5; 0 MEANING URGENT ACTION NEEDED, 5 MEANING VERY GOOD), THERE IS A STICKER INDICATING THIS RATIG, DOESN’T RELATE TO THE QUALITY OF FOOD OR TASE, JUST HYGIENE PRACTICES!!!!!!!!

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10
Q

WHAT ARE ENTERIC PRECAUTION AND WHAT IS THE ADVICE RGEARDING THEM?

A

ENTERIC PRECAUTIONS;PRECAUTIONS TAKEN TO PREVENT INFECTIONS THTA ARE TRANSMITTED PRIMARILY THROUGH DIRECT OR INDIRECT CONTACT WITH FECAL MATERIAL —> THEY ARE INDICATED FOR PATIENTS WITH KNOWN OR SUSPECTED INFECTIOUS DIARRHOEA OR GASTROENTERITIS

INCLUDE:

  • PERSONAL HYGIENE
  • ENVIRONMENTAL CLEANING
  • DISPOSAL OF SOILED MATERIALS
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11
Q

THE MOST IMPORTANT METHOD OF PREVENTING AND CONTROLLING SPREAD OF GI INFECTION (FECL-ORAL ROUTE SPECIALLY)

A

HAND WASHING (HAND HYGIENE)

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12
Q

ALL INDIVIDUALS WHO HAVE ONFIRMED OR SUSPECTED GASTROENTERITIS SHOULD BE EXCLUDED FROM WORK, SCHOOL OR OTHER INSTITUTIONALISED SETTINGS FOR HOW LONG AFTER BEING FREE FROM DIARRHOEA AND VOMITTING?

A

48HR AFTER SYMPTOMS STOP

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13
Q

WHAT ARE THE HIGH RISK GROUPS FOR SPREADING GI INFECIONS (SOMETIMES REFERRED TO JUST AS ‘GASTROENTERITIS’)

A

GROUP A: DOUBTFUL PERSONAL HYGIENE, UNSATISFACTORY FACILITIES
GROUP B: CHILDREN AGED 5 YEARS OLD OR YOUNGER
GROUP C: FOOD HANDLERS
GROUP D: CLINICAL, SOCIAL CARE OR NURSERY STAFF

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14
Q

WHAT IS THE MOST COMMON BACTERIAL CAUSE OF HUMAN GASTROENTERITIS IN THE WORLD AND IN THE UK?

A

CAMPYLOBACTER

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15
Q

CAMPYLOBACTER

A
  • THE MOST COMMON BACTERIAL CAUSE OF HUMAN GASTROENTERITIS IN THE WORLD AND IN THE UK
  • ONE OF THE MOST COMMON CAUSES OF TRAVELLER’S DIARRHOEA IN UK
  • UNDERCOOKED MEATS, CONTAMINATED WATER, ANIMAL CONTACT
  • LOW RISK OF PERSON TO PERSON SPREAD
  • GENERALLY MILD ILLNESS, BUT CAN BE FATAL IN CERTAIN GROUPS (VERY YOUNG, ELDERLY, IMMUNOSUPPRESED
  • DIARRHOEA, ABDOMINAL PAIN, FEVER (LESS COMMON: BLOODY DIARRHOEA, VOMIT)
  • LASTS 2-3 DAYS
  • NO ACTIVE PH MANAGEMENT OF SPORADIC CASES
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16
Q

CRYPTOSPORIDIOSIS

A
  • caused by tiny, one-celled cryptosporidium parasites
  • SPREAD THROUGH CONTACT WITH ANIMALS, PERSON TO PERSON, CONTAMINATED WATER
  • OUTBREAKS: PUBLIC WATER SUPPLIES, SWIMMING POOLS (CRYPTO HAS HIGH TOLERANCE TO CHLORINE)
  • PROFUSE WATERY DIARRHOEA, ABDOMINAL CRAMPS, VOMITING, FEVER
  • LASTS 10-14 DAYS
  • IF SOMEONE IS IMMUNOCOMPROMISED; CHRONIC DIARRHOEA, LIFE-THREATENING
17
Q

SURVEILLANCE OF CRYPTOSPORIDIUM (CRYPTO CASES) IN ENGLAND?

A

WEEKLY SURVEILLANCE OF NUMBER OF CASES BASED ON LABORATORY DATA
+ EHO (ENVIRONMENTAL HEALTH OFFICERS) GI QUESTIONNAIRE

18
Q

ENTERIC FEVER?

A
  • GI DISEASE CAUSED BY SALMONELLA TYPHI (TYPHOID) OR SALMONELLA PARATYPHI (PARATYPHOID) 9ESSENTIALLY SAME MANAGEMENT FOR BOTH)
  • SERIOUS DISEASE, CAN BE LIFE THREATENING
  • LASTS SEVERAL WEEKS
  • PREDOMINANTELY ACQUIRED ABROAD (CONTAMINATED FOOD/WATER) (INDIA, PAKISTAN, BANGLADESH, PARTS OF AFRICA AND SOUTH AMERICA…)
  • HIGHLY CONTAGIOUS
  • HIGH FEVER, ABDOMINAL PAIN, HEADACHE, CONSTIPATION/DIARRHOEA
  • ANTIBIOTICS
  • TRAVEL VACCINE (RECOMMENDED IF TRAVELLING TO COUNTRIES WHERE TYPHOID IS ENDEMIC)
  • MICROBIOLOGICAL CLEARENCE (3 NEGATIVE STOOL SAMPLES REQUIRED, EACH 48HRS APART, STARTING ONE WEEK AFTER COMPLETION OF ANTIBIOTIC TREATMENT —> UNTIL THIS IS SATISFIED, INDIVIDUALS SHOULD BE EXCLUDED FROM INSTITUTIONALISED SETTINGS)
19
Q

GIARDIASIS

A
  • caused by the microscopic parasite Giardia duodenalis
  • PERSON TO PERSON SPRED COMMON, WATERBORNE, ANIMAL CONTACT
  • OUTBREAKS: INFECTED FOOD HANDLERS, SWIMMING POOLS
  • DIARRHOEA, ABDOMINAL PIN, FLATULENCE, STEATHORREA
  • ANTIBIOTIC TREATMENT
  • PARASITE FORMS CYSTS THAT ARE EXCREETED IN FECES AND WHICH ARE RESISTANT TO CHLOINATION
  • INSTRUCTIONS: PEOPLE WITH GIARDIASIS SHOULDN’T GO SWIMMING FOR 2 WEEKS POST RECOVERY
20
Q

HEPATITIS A

A
  • VIRAL INFCTION, PERSON TO PERSON SPREAD
  • FOREIGN TRAVEL, CONTAMINATED WATER AND FOOD
  • TRANSMISSION WITHIN UK: SEXUAL INTERCOURSE (ESPECIALLY BETWEN MEN)
  • SYMPTOM SEVERITY INCREASES WITH AGE; 90% OF CHILDREN UNDER THE AGE OF 5 ARE ASYMPTOMATIC
  • SYMPTOMS WHEN OLDER: JAUNDICE, FEVER, LOSS OF APPETITE, UPPER ABDOMINAL PAIN, DARK URINE WITH PALE STOOLS —> CAN LAST FOR WEEKS
  • TRAVEL VACCINE
  • PH RESPONSE: VACCINE, IMMUNOGLOBULIN (GIVEN TO EVERYONE AT HIGH RISK WHO HAS BEEN IN CONTACT WITH SOMEONE WHO HAS HEP A)
  • MASS TESTING OR VACCINATION IN SCHOOL INCIDENTS (OUTBREAKS)
21
Q

LISTERIOSIS

A
  • caused by the germ Listeria monocytogenes
    -MAJORITY OF CASES ARE FOODBORNE
  • MOTHER-TO-BABY TRANSMISSION POSSIBL
  • ASYMPTOMATIC, GASTROENTERITIS, FEVER
  • MOST DANGEROUS TO AN UNBORN CHILD: STILLBIRTH, PRETERM DELIVERY, NEONATAL MENINGITIS (>50% FATALITY RATE —> PREGNANT WOMEN ADVISED TO AVOID FOOD THTA COULD CONTAIN LISTERIA, E.G. UNPASTEURISED MILK, SOFT CHEESE, RAW MEAT AND FISH)
    + PREGNANT WOMEN ALSO ADVISED TO AVOID ANIMALS GIVIG BIRTH AND TO AVOID NEWBORN ANIMALS (E.G. LAMBS) BECAUSE LISTERIA MIGHT BE PRESENT
22
Q

% OF ASYMPTOMATIC CASES OF HEP A IN CHILDRNE UNDER 5?

A

90% (THIS GROUP HAS THE LEAST SYMPTOMS SO CAN BE SPREADING HEP A UNKNOWINGLY)

23
Q

WHICH GI INFECTION IS ESPECIALLY DANGEROUS TO DEVELOPING FETUS IF A PREGNANT WOMAN GETS IT?

A

LISTERIOSIS

24
Q

NOROVIRUS?

A
  • COMMON VIRAL CAUSE OF GI INFECTION
  • HIGHLY INFECTIOUS: PERSON TO PERSON, INHALATION, INGESTION, NVIRONMENT TO PERSON
  • SUDDEN ONSET NAUSEA, PROJECTILE VOMITTING, WATERY DIARRHOEA (SHORT INCUBATION PERIOD)
  • OUTBREAK MANAGEMENT
  • ## FAR MORE COMMON IN WINTER MONTHS, CONTRIBUTES TO INCREASED ADMISSION OF ELDERLY INTO HOSPITALS AT THIS TIME OF THE YEAR
25
Q

SALMONELLA

A

> 2500 SEROTYPES OF SALMONELLA

  • UNDERCOOKED MEATS, RAW EGGS, CONTAMINATED MILK, DAIRY PRODUCTS, SALADS..
  • MOST COMMON CAUSE OF FOOD BORNE ILLNESS IN THE US
  • PERSON TO PERSON SPREAD
  • WATERY DIARRHOEA, ABDOMINAL PAIN, HEADACHE, VOMITING, FEVER
  • LASTS 4-7 DAYS
26
Q

SHIGELLA

A
  • DIARRHOEA (WATERY, SLIMY OR BLOODY), FEVER, ABDOMINAL CRAMPS
  • MANY TYPES (SONNEI, BOYDII, DYSENTERIAE, FLEXNERI»)
  • SHIGELLA SONNEI: MILD ILLNESS
  • ILLNES LASTS 1-2 WEEK
    SPREAD: PERSON TO PERSON, ENVIRONMENT TO PERSON, SEXUAL CONTACT (ESP BETWEEN MEN), FOREIGN TRAVEL (CONTAMINATED FOOD/WATER)
  • ANTIBIOTIC TREATMENT
  • ONE NEGATIVE STOOL SAMPLE REQUIRED (MICROBIOLOGICAL CLEARENCE)
27
Q

STEC?

A
  • MILD GASTROENTERITIS, SEVERE BLOODY DIARRHOEA, HAEMOLYTIC URAEMIC SYNDROME (KIDNEY COMPLIATON, CAN LEAD TO KIDNEY FAILURE), THROMBOTIC THROMBOCYTOPAENIC PURPURA (BLOOD CONDITION, RISK OF SEVERE BLEEDING)
  • MAIN RESERVOIR; CATTLE, OTHER RUMINANTS
  • LOW INFECTIOUS DOSE (CONSUMPTION OF CONTAMINATED FOOD OR WATER, DIRECT OR INDIRECT CONTACT WITH ANIMALS OR THEIR FECES, PERSON TO PERSON SPREAD)
  • YOUNG CHILDREN ARE THE MOSTL
    LIKELY TO BECOME INFECTED, SERIOUSLY ILL AND SPREAD INFECTION
28
Q

SEROVAR?

A

OTHER NAME: SEROTYPE
a distinct variation within a species of bacteria or virus
e.g.
Genus: Salmonella
Species: Salmonella enterica
Subspecies: Salmonella enterica subsp. enterica
Serovar: Salmonella enterica subsp. enterica ser. Typhi

29
Q

Example of bacteria classification?

A 
Domain:	Bacteria
Phylum:	Proteobacteria
Class:	Gammaproteobacteria
Order:	Enterobacterales
Family:	Enterobacteriaceae
Genus:	Escherichia
Species:	E. coli
\+ can add subtypes/strains
\+ serovars
30
Q

THE HIERARCHY OF BIOLOGICAL CLASSIFICATION

A 
Life
Domain 
Kingdom
Phylum
Class
Order
Family
Genus
Species
31
Q

PHYLOGENETIC TREE?

A

A phylogenetic tree, also known as a phylogeny, is a diagram that depicts the lines of evolutionary descent of different species, organisms, or genes from a common ancestor.

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