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Semester 3 - Infection > Session 5 - Travel infections > Flashcards

Session 5 - Travel infections Flashcards

1
Q

Give four reasons why travel history is important?

A

• Imported diseases are rare/unknown in UK
• Different strains of pathogen may be present, adding to difficulty of treatment
- Antibiotic resistance

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2
Q

Why does having different strains of pathogen make treatment difficult?

A

• Antigenically different, which impacts on protection and detection

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3
Q

What are six key aspects of travel history

A
  • Where?
    • When?
    • How (direct or via)?
    • Accommodation
    • How long?
    • Specific risks (including sexual contact
    • Preventative measures
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4
Q

Outline a differential diagnosis with 6 different possibilities after someone has returned from central Africa

A
  • Malaria
    • Typhoid
    • Meningococcal septicaemia
    • Dengue
    • Yellow fever

Non-travel related infection

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5
Q

What are the four main species of malaria?

A
  • Plasmodium falciparum
    • Plasmodium vivax
    • Plasmodium ovale
    • Plasmodium malariae
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6
Q

What is the malaria vector?

A

• Anopheles mosquito

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7
Q

How many cases of malaria each year? How many deaths?

A
  • 250 million

* 1 million

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8
Q

What is the incubation period of malaria?

A

• 1-3 weeks after bite

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9
Q

Give the symptoms of malaria

A
  • Headache
    • Cough
    • Fatigue
    • Malaise
    • Arthralgia
    • Myalgia
    • Fever and chills which eventually cycle every three/four days
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10
Q

Give three additional features you may see upon examination of someone with

A
  • Splenomegaly
    • Cerebral features - Coma
    • Respiratory distress (metabolic acidosis, pulmonary oedema)
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11
Q

Give five tests you would perform on someone you suspected of harboring the malaria parasite

A
  • Blood smear to detect parasiste
    • Full blood count
    • Urea and electrolytes
    • Liver function test
    • Glucose
    • Head CT if coma
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12
Q

What treatment would you give for a malignant “P. Falciparum’ infection?

A
  • Quinine

* Artemisinin

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13
Q

What treatment would you give for benign P. Vivax, ovale or malariae?

A

• Chloroquine

+/- primaquine (for exo-erythrocytic phase)

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14
Q

What are the three main stages of life cycle of plasmodium?

A
  • Exo-erythrocytic
    • Erythrocytic
    • Mosquito stages
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15
Q

What occurs in the mosquito stage?

A

• Mosquite takes a blood meal from infected host, ingesting gametocytes

Plasmodium develops in mosquito

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16
Q

What occurs in the exo-erythrocytic cycle?

A
  • Plasmodium infects hepatocyte and forms schizont

* Shizont ruptures, spreading malaria into blood

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17
Q

What occurs in the erythrocytic stage?

A

Schizonts form and rupture

18
Q

What are the ABC’s of malaria prevention?

A 
• Assess risk - Knowledge of at risk areas
		○ Regular/returning travellers 
	• Bite prevention
		○ Repellant, adequate clothing, nets
		○ Chemoprophylaxis before travel
	• Chemoprophylaxis
		○ Specific to region
		○ Start before and continue after return
19
Q

How many cases of typhoid and paratyphoid fever are there per year in the UK?

A

• 500/year

20
Q

What is the mechanism of infection of typhoid and paratyphoid infection?

A

Faecal-oral from contaminated food/water, source is cases or carriers

21
Q

What organism causes typhoid and paratyphoid?

A

• Salmonella enterica serovar

22
Q

Categorise salmonella enterica serovar

A

• Enterobacteriaceae, aerobic gram-negative rod

Non-lactose fermenter

23
Q

How virulent is salmnella enterica serovar?

A
  • Secretes gram negative
    • Substance called invasin allows intracellular growth
    • Fibrimae adhere to epithelium over ileal lymphoid tissue (peyer’s patches) -> RE system
24
Q

What is enteric (typhoid) fever?

A

• Systemic disease with fever and headache

25
Q

What is the incubation period for enteric (typhoid) fever?

A

7-14 days

26
Q

What are signs and symptoms of enteric (typhoid) fever?

A
  • Abdominal discomfort
    • Constipation
    • Dry cough
    • Heaptosplenomegaly
    • Relative bradycardia
    • Intestinal haemorrhage and perforation
27
Q

Give three investigations for enteric fever

A
  • FBC (anaemia)
    • LFT (transaminase & bilirubin)
    • Culture - Blood, faeces
28
Q

What are the anti-biotics used to treat enteric fever?

A

• Ceftriaxone or azithromycin

7-14 days

29
Q

Give two main protections that can protect one from typhoid fever?

A

• Food and water hygiene precautions

Typhoid vaccine

30
Q

Describe non-typhoidal salmonella infections

A

• Widespread distribution including UK

31
Q

What are the two main cuases of non-typhoidal salmonella infection?

A
  • Salmonella typhimurium

* S.enteritiditis

32
Q

What is brucellosis? What two organisms cause it and how are they classified?

A
  • Primary animal pathogen
    • Brucella abortus (cattle), B. Meltinesis (goats and sheep)
    • Gram negative coccobacillulus
33
Q

How is brucellosis transmitted?

A

• Skin breaks/GI tract (milk)

34
Q

What is a main featuree of brucellosis?

A

• Non specific febrile illness

35
Q

How is brucellosis generally diagnosed?

A

• Blood culture

36
Q

What is brucellosis treated with?

A
  • Doxycycline

* Rifampicin

37
Q

Name three large pandemics of the 20th/21st century

A
  • Spanish flu 1918-19
    • Asian flu 1968
    • H1N1 (swine flu) 2009
38
Q

Name two recent types of corona virus?

A
  • SARS - CoV in 2003 (Severe Acute Respiratory Syndrome)

* MERS - CoV in 2012 (Middle East Respiratory Syndrome)

39
Q

What is antigenic drift in the influenza virus?

A

• Single base pair mutations cause different antigens to be presented

40
Q

What is antigenic shift?

A

• Influenza genome chanes very quickly by exchanging genes with animal virus

41
Q

Give a protozoan cause of travel infection

A

Trypanosoma brucei

Semester 3 - Infection (14 decks)

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