Infectious Disease & Travel Flashcards
Molluscum Contagisum
The umbilicated appearance described is consistent with Molluscum contagiousum.
✓ Molluscum contagiosum is a common viral skin infection caused by molluscum contagiosum virus. It is spread by close contact or through fomites (contaminated surfaces) such as shared towels.
✓ It is a self-limiting condition (usually resolves within 18 months).
✓ Treatment is not usually needed unless causing symptoms or secondary infection develops.
✓ Pruritis should be managed with an emollient and mild topical steroid. Mild secondary infection can be treated with topical antibiotics such as Fusidic acid 2%.
✓ As lesions are contagious it is sensible to avoid sharing towels, clothing, and baths with uninfected people.
Notifiable Diseases
Acute encephalitis
Acute infectious hepatitis
Acute meningitis
Acute poliomyelitis
Anthrax
Botulism
Brucellosis
Cholera
COVID-19
Diphtheria
Enteric fever (typhoid or paratyphoid fever)
Food poisoning
Haemolytic uraemic syndrome (HUS)
Infectious bloody diarrhoea
Invasive group A streptococcal disease
Legionnaires’ disease
Leprosy
Malaria
Measles
Meningococcal septicaemia
Monkeypox
Mumps
Plague
Rabies
Rubella
Severe Acute Respiratory Syndrome (SARS)
Scarlet fever
Smallpox
Tetanus
Tuberculosis
Typhus
Viral haemorrhagic fever (VHF)
Whooping cough
Yellow fever
✓Don’t wait for laboratory confirmation of suspected infection/contamination before notification.
✓ Complete notification form immediately on diagnosis of a suspected notifiable disease.
✓RMP to send the form to proper officer <3 /, or notify verbally < 24 hours if urgent.
Hand Foot and Mouth disease
✓ Hand, foot and mouth disease is a clinical diagnosis and investigations are not usually required.
✓ Management is supportive and parents should be advised on how to avoid spread (hand washing, no sharing of bedding/towels/plates and crockery, laundry to be done on a hot wash, blisters should not be pierced, avoid contact with pregnant women).
✓ Children do not need to be isolated and can attend nursery/school (if well enough).
✓ Doctors should contact Public Health Unit if there are outbreaks.
✓ Complications are rare and include dehydration (severe/painful oral lesions), secondary bacterial infection and neurological sequelae (if caused by enterovirus).
Scabies
1st line: Permethrin 5%
2nd line: Malathion aqueous 0.5% is used for patients in whom permethrin is contraindicated, not tolerated or the permethrin course failed to treat the scabies.
Oral ivermectin is a potential treatment for crusted scabies that does not respond to topical treatment alone.
there would be no indication to repeat the permethrin treatment. There is no permethrin 10% formulation.
The itch of scabies can persist two to four weeks after the last treatment has been applied. As long as no new burrows have appeared in that time, it is reasonable to monitor the symptom
Causes of food poisoning
Scombrotoxin food poisoning occurs between one and three hours of eating scombroid fish, for example mackerel or tuna. Other types of fish may be involved. Histamine released from tryptophan by marine microbes causes hot flush, headache, diarrhoea. Recovery occurs after a few hours.
Botulism is an extremely severe form of food poisoning due to ingestion of a preformed neurotoxin – botulin – from the spore-bearing anaerobe Clostridium botulinum (gram-positive bacilli). The organism may be found in any food except for acid fruits which inhibit germination. Canned foods which have been incompletely sterilised are commonly implicated. Traditionally, home-bottled vegetables are a prime cause in the UK.
Campylobacter jejuni food poisoning is characterised by a prodromal malaise, abdominal pain, diarrhoea, with vomiting being uncommon. The problems are due to multiplication organisms within the gut and the release of endotoxin, with symptoms occurring after two to five days. It was the most common cause of gastroenteritis in England and Wales in 1991. The organism comes from poultry and unpasteurised milk.
Staphylococcal food poisoning clinical features include nausea and vomiting, abdominal pain, and dehydration, with or without diarrhoea after a two to six hour incubation period. Recovery is after six to 24 hours. Sources include food handlers, cooked meat, unpasteurised milk, cream cakes and fruit salads.
Health screening in HIV +
- Women 25–64 years -annual cervical cytology
- Men and women a=>40 years - annual lipids and HbA1c
- Men and women => 50 years - 3-yearly FRAX score
Prophylactic ABx in HIV+
- Co-trimoxazole against Pneumocystis pneumonia (PCP) - when the CD4 count falls to less than 200 cells/μL.
- Azithromycin against Mycobacterium avium when the CD4 count is less than 50 cells/μL.
