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Infection > Τravel Related Infections > Flashcards

Τravel Related Infections Flashcards

0
Q

What do you need to find out about the place?

A 
Specific location
When they went
How they got there
Stop anywhere en route?
Accommodation type
Were preventative measures taken eg vaccines?
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1
Q

What is it important to find out about if a patient has been travelling

A

Where they went
How long for
Time of year they went (so when)
What they did there

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2
Q

What can you find out about the person?

A

Did they take any preventative measures?

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3
Q

Why is it important to find out about the pathogen?

A

Can get different strains in different places which are antigenically different.
Impacts on protection and detection
Can get different antibiotic resistance depending on which antibiotics are regularly used in that country

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4
Q

Why is it important to identify if the infection is travel related?

A

Patient may need to be isolated

Labs should be alerted to potential hazards

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5
Q

What are the four species of malaria?

A

Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae

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6
Q

What is the vector of malaria?

A

Female Anopheles mosquito

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7
Q

Where is malaria common?

A

Tropics of Africa
Asia
Middle East
South and Central America

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8
Q

What is the incubation period of malaria?

A

1-3 weeks

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9
Q

History of malaria?

A 
Fever chills and sweats every 3rd/4th day
Malaise
Headache
Cough
Fatigue
Arthralgia
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10
Q

What investigations should be done for malaria?

A 
LFTs
U&Es
Head CT if there are CNS symptoms
Glucose
Blood smear to detect parasites
FBC
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11
Q

Treatment of malaria?

A

P. falciparum (malignant) - quinine/artemisinin

P. vivax, ovale, malariae (benign) - chloroquine, primaquine

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12
Q

How does malaria get to humans?

A

Mosquito carries the parasite in its salivary gland and gut

Bites the human

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13
Q

What are the two cycles of malaria?

A

Liver - exo-erythrocytic

Blood - erythrocytic

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14
Q

How can malaria be prevented

A

Assess risk - knowledge of risk areas
Bite prevention - repellant, clothing, nets, chemoprophylaxis
Chemoprophylaxis - specific to region, start before and continue after return

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15
Q

Reasons why patients don’t take malarial prophylaxis properly?

A

Don’t know or think they need to take it

Don’t take it for the required period

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16
Q

What is entered fever?

A

Typhoid paratyphoid

Caused by salmonella

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17
Q

Where is enteric fever common?

A

Asia
Africa
South America

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18
Q

How is enteric fever spread?

A

Fecal-oral route from food and water
Due to poor sanitation
The only source is another infected human only

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19
Q

What causes enteric fever?

A

salmonella
Subspecies is enterica
Part of the Enterobacteriacea genus/family?

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20
Q

Features of salmonella?

A

Anaerobe
Gram negative bacilli
Does not ferment lactose

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21
Q

How does salmonella cause disease?

A

Produces Gram negative endotoxin
Invasin allows intracellular growth
Fimbriae adhere to epithelium over ileal lymphoid tissue (Peyer’s patches) where they multiply
Gain entry into the reticuloendothelial system

22
Q

Symptoms and signs of enteric fever?

A 
Systemic disease with fever and headache
Abdominal discomfort
Constipation
Dry cough
Hepatosplenomegaly
Rash on abdomen (rare)
Bradycardia
23
Q

Incubation period of enteric fever?

A

7-14 days

24
Q

Complications of enteric fever?

A

Intestinal haemorrhage

Perforation around Peyer’s patches

25
Q

Investigations for enteric fever?

A

Moderate anaemia
Lymphopenia (low lymphocytes)
Raised LFTs (transaminase and bilirubin)
Blood and faeces cultures

26
Q

Treatment of enteric fever?

A

Ceftriaxone or azithromycin

27
Q

Prevention of enteric fever?

A

Food and water hygiene

Vaccine for high risk travel and lab personnel

28
Q

What can non-typhoidal salmonella infections be caused by?

A

Salmonella typhimurium and enteritidis

29
Q

Symptoms of non-typhoidal salmonella infections?

A 
Diarrhoea
Fever
Vomiting
Abdominal pain
(Food poisoning)
30
Q

Complications of non-typhoidal salmonella infections?

A

Normally self-limiting
Bacteraemia
Deep-seated infection

31
Q

What type of virus is influenza?

A

Enveloped
Negative
Single-stranded RNA

32
Q

What are the three subtypes of influenza and what is the subtype defined by?

A

A, B, C
Nucleoproteins
-haemagglutin
-neuraminidase

33
Q

What is antigenic drift?

A

Mutations within the genes that code for antibody binding sites
This is what changes the antigens annually

34
Q

What is antigenic shift?

A

Process by which two or more strains of a virus combine to form a new antigen having a mixture of the surface antigens of the two and of the original strains

35
Q

Is it A or N which normally undergoes antigenic shift?

A

A

36
Q

Does antigenic shift or drift lead to pandemics?

A

Shift

37
Q

Incubation period of influenza?

A

1-4 days

38
Q

Signs and symptoms of influenza?

A

Headache
Myalgia
Fever
Cough

39
Q

When is influenza infectious?

A

The day preceding and first 3 days of symptoms

40
Q

Complications of influenza?

A

Primary viral pneumonia

Secondary bacterial pneumonia

41
Q

Characteristics of Legionella pneumophilia?

A

Fastidious
Gram negative
Pleomorphic

42
Q

Where is Legionella pneumophilia found?

A

Water between 20 and 40*C

43
Q

How is Legionella pneumophilia spread?

A

When aerosols are generated eg showers and AC systems

44
Q

What is Legionella pneumophilia associated with?

A

Previous lung disease
Smoking
High alcohol intake
Immunocompromised patients in hospital are vulnerable if AC is not adequately maintained

45
Q

Clinical features of Legionella pneumophilia

A

Mild, flu like illness sometimes
Other times - pneumonia with severe respiratory failure and high mortality
Can have GI symptoms before lung symptoms
Unproductive cough
Progressive dyspnoea
Confusion

46
Q

How is Legionella pneumophilia diagnosed?

A

Sputum/bronchoalveolar lavage fluid cultured

Colonies identified serologically

47
Q

Treatment of Legionella pneumophilia

A

Macrolide

Rifampicin

48
Q

What type of bacteria is the one that causes Brucellosis?

A

Gram negative

Coccobacillus

49
Q

How is the brucellosis pathogen (Brucella melitensis, abortus, suis) transmitted?

A

Direct contact with animals or their products though skin breaks/ingestion
abortus - cattle
suis - pigs
melitensis - goats

50
Q

How does Brucella cause disease?

A

Lives in cells of the reticulo-endothelial system

Uses superoxide dismutase and nucleotide-like substances to inhibit intracellular killing mechanisms of host

51
Q

Symptoms of Brucellosis?

A 
High fever
Myalgia
Arthralgia
Lumbosacral tenderness
Epidydimitis
52
Q

How is brucellosis diagnosed?

A

Blood cultures

53
Q

How is brucellosis treated?

A

Doxycycline

Rifampicin

Infection (14 decks)

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