Lecture 5 - Travel Infections

Question 1

What questions should you ask as part of a travel history?

Answer 1

Where have you been?
When did the symptoms appear relative to now and to travel?
What are the symptoms?
What did you do there?
Any ill travel companions?
Any preventative measures?
Any healthcare exposure whilst abroad?

Question 2

What causes malaria?

Answer 2

The malaria parasite, one of 4 species of Plasmodium

Question 3

What are the 4 species of Plasmodium?

Answer 3

falciparum
vivax
ovale
malariae

Question 4

What is the vector for malaria transmission?

Answer 4

female Anopheles mosquito

Question 5

What is the incubation period of malaria?

Answer 5

1 - 3 weeks

Question 6

Briefly outline the way in which a malaria infection takes hold

Answer 6

Mosquito bites human, injecting parasite into bloodstream. Travels to liver and infects liver cells, and then enters bloodstream and infects RBCs

Question 7

What symptoms may someone present with if they have malaria?

Answer 7

Fever, chills, sweats, general flu-like symptoms

Question 8

What are the clinical signs of malaria?

Answer 8

Generally none at all, but may have fever or splenomegaly

Question 9

What are the major investigations for malaria?

Answer 9

Blood smear x3

FBC

Question 10

How is malaria treated?

Answer 10

Falciparum - Quinine or Artemisinin

Vivax, ovale and malariae - Chloroquine +/- primaquine

Question 11

What are is the ABC of malaria prevention?

Answer 11

Assess risk
Bite prevention
Chemoprophylaxis

Question 12

What conditions are included under the umbrella term of enteric fever?

Answer 12

Typhoid and paratyphoid

Question 13

How is typhoid spread?

Answer 13

Faecal-oral transmission

Question 14

What organisms cause enteric fever?

Answer 14

Salmonella typhi or paratyphi types A, B and C

Question 15

Classify Salmonella enterica species in terms of gram staining, shape and oxygen preference

Answer 15

Anaerobic Gram negative bacilli

Question 16

What are the symptoms of typhoid?

Answer 16

Fever
Headache
Abdominal pain
Constipation
Relative bradycardia

Question 17

What is the treatment for typhoid?

Answer 17

Ceftriaxone or azithromycin for 7 - 14 days

Question 18

What sort of disease is dengue fever?

Answer 18

Arbovirus - virus spread by arthropods

Question 19

Briefly outline the significance of re-infection with dengue fever

Answer 19

First infection generally mild, but second infection with different serotype results in antibody-dependent enhancement. Can lead to dengue haemorrhagic fever or dengue shock syndrome.

Question 20

Why is it important to take a travel history in anyone in whom you suspect an infection?

Answer 20

May be an infection you are not familiar with, or may be a different strain of a familiar infection, including one that is resistant to conventional treatments