Infections in travellers Flashcards
Describe the trend in short term visitor arrivals to Australia?
Increasing number of arrivals
Describe the trend in the number of international travellers?
Increasing number of international travellers
Large volumes of movement around the world
Which infectious diseases have been eradicated?
Only smallpox
Are travel related illnesses always infectious?
No
Describe the incubation period for a travel-related illness?
Vary widely
How far must a person travel for their illness to be described as travel-related?
Can be within own country, but to different conditions (eg. tropics)
What is the commonest cause of fatal community-acquired pneumonia in the NT?
Melioidosis
Which of the following additional immunisations should a medical student going on an elective to a remote indigenous community in Northern/Central Australia receive?
a) Hep A
b) Japanese encephalitis
c) Hep B
d) MMR
Hep A
Approximately what proportion of travellers to developing countries develop a health problem abroad?
50%
Approximately how many cases of travel-associated malaria occur each year?
30,000
What is the estimated incidence of traveller’s diarrhoea during travel in a developing country?
20-60%
Which bacteria associated with travel-related illness have the potential for lifetime persistence?
Mycobacterium leprae
Mycobacterium tuberculosis
Treponema pallidum
Rickettsia prowazeki
Salmonella typhi
Which helmiths associated with travel-related illness have the potential for lifetime persistence?
Enchinococcus granulosus
Strongyloides stercoralis
Taenia solium
Schistosoma species
Which protozoa associated with travel-related illness have the potenital for lifetime persistence?
Plasmodium malariae
Toxoplasma gondii
Trypanosoma cruzi
Which viruses associated with travel-related illness have the potential for lifetime persistence?
Hep B, C, D
Herpes
HIV-1 and HIV-2
HTLV-1
Which fungi associated with travel-related illness have the potential for lifetime persistence?
Coccidioides immitis
Histoplasma capsulatum
What are the most common diagnoses in returned travellers with fever?
Malaria
Gastroenteritis/diarrhoea/parasites
Respiratory tract infections
Describe the relationship between diseases in a febrile returned traveller and their travel destination?
Pneumonia: Asia
Dengue fever: Asia
Malaria: Asia, Pacific, Africa
Hep A: Asia, Pacific
Typhoid fever: Asia
Describe the modes of disease transmission and their relative proportions for travel-related illnesses?
What are the consequences of this for travellers?
Most are vector, respiratory and food and water borne
So, much of the advice for travellers relates to safe behaviour (eg. bed netting, safe eating, etc.)
Describe the rate of respiratory infections in travellers?
7-29%
Second most frequent cause of illness in travellers
Second most frequent cause of fever in returned travellers
What is the commonest vaccine-preventable disease of travel?
Influenza
In which regions of the world are GIT infections most common?
South East Asia
Africa and South America
Describe the distribution across sexes for malaria and Dengue fever?
Males get more malaria than females
Not the same sex difference for Dengue fever
In which group of travellers is malaria most common?
Why?
Those travelling to visit friends and relatives (35%)
Closer contact with locals for longer periods of time
Low standard accommodation
Very disproportionate, as this only represents 5% of travellers
Describe the relationship between the mortality for malaria and the number of cases seen in that region?
Inverse correlation
Relates to familiarity in treating malaria
Describe the time intervals in fatal cases of imported malaria?
Arrival - symptom onset: 5 days
Symptom onset - diagnosis/treatment: 5 days
Diangosis/treatment - death: 2 days
(mean time to death after symptom onset is 5 days)
In which region are travellers most at risk of contracting P.vivax?
PNG and Oceania
Describe the most common causes of mortality in travellers?
CVD
Injury
Medical
Cancer
Infectious disease only 1%
How early should pre-travel healthcare begin?
Preferably >6 weeks
Which travellers should be identified as high risk travellers?
Those with chronic illness (esp. immunocompromised)
Pregnant
Long term, remote, high risk location
Extremes of age
Visiting friends and relatives
Describe the key issues for traveller education?
Injury (esp road and water)
Diarrhoea prevention and management
Insect bites
Blood-borne, sexually-transmitted infections
Drugs (unsafe/counterfeit)
Rabies - mammal bites
Schistosomiasis (fresh water contact)
