Session 9-Travel Infection Flashcards
Why is travel history important?
- recognise imported diseases
- different strains of pathogen (antibiotic resistance)
- infection prevention (on the ward, in the lab)
How many days after symptoms begin is classified as:
1) acute
2) sub-acute
3) chronic
1) <10 days
2) 10-21 days
3) >21 days
What are the symptoms/signs of infection from:
1) sub-Saharan Africa
2) SE Asia
3) S/C America
4) N Africa/M East
5) S/C Asia
6) N Australia
7) N America
1) resp (cough)
2) GI (diarrhoea)
3) skin (rash)
4) jaundice
5) CNS (headache)
6) haematological (lymphadenopathy/splenomegaly/haemorrhage)
7) eosinophilia
How do people acquire infection from:
1) sub-Saharan Africa
2) SE Asia
3) S/C America
4) N Africa/M East
5) S/C Asia
6) N Australia
1) food/water
2) insect/tick bite
3) swimming
4) sexual contact
5) animal contact (bite)
6) beach
What are the key aspects of taking a travel history?
1) any unwell travel companions/contacts?
2) pre-travel vaccinations/preventative measures?
3) recreational activities?
4) healthcare exposure?
Which three species of malaria (Plasmodium) do we need to know?
Falciparum
Vivax
Ovale
What is the vector of malaria?
Female anopheles mosquito (night biter)
What is the minimum incubation period of malaria?
6 days
What is the incubation period of Plasmodium falciparum?
Up to 6 months
What is the incubation period of Plasmodium vivax/ovale?
Up to 1 year +
What is the history of a patient with malaria?
Fever chills and sweats
What are the symptoms of malaria?
Headache Fever Fatigue Pain Chills Sweating Dry cough Splenomegaly Nausea Vomiting
What are the cardiovascular symptoms of severe falciparum malaria?
Tachycardia
Hypotension
Arrhythmia
What are the respiratory symptoms of severe falciparum malaria?
Acute respiratory distress syndromes (fluid in lungs)
What are the GI symptoms of severe falciparum malaria?
Diarrhoea
Deranged LFTs
Bilirubin
What are the renal symptoms of severe falciparum malaria?
Acute kidney injury
What are the CNS symptoms of severe falciparum malaria?
Confusion
Fits
Cerebral malaria
What are the blood-related symptoms of severe falciparum malaria?
Low/normal WCC
Thrombocytopenia
DIC
What are the metabolic symptoms of severe falciparum malaria?
Metabolic acidosis
Hypoglycaemia
Why are three blood smears needed to test for malaria?
Need 3 negatives to exclude malaria
Which investigations are conducted to test for malaria?
Blood smear x3 FBC U&Es LFTs Glucose Coagulation Head CT Chest x ray
What is used to treat Plasmodium falciparum?
Artesunate
Quinine and doxycycline
What is used to treat Plasmodium vivax and ovale?
Chloroquine + primaquine
How can malaria be prevented?
- assess risk
- bite prevention (repellant, adequate clothing, nets)
- chemoprophylaxis
What does salmonella typhi cause?
Typhoid (enteric fever)
What is the mechanism of infection of enteric fever?
Faecal-oral from contaminated food/water
Describe the gram stain of salmonella typhi?
Gram-negative rod
What are the virulence factors of salmonella typhi?
1) gram-negative endotoxin
2) survives gastric acid
3) invasin-allows intracellular growth
4) fimbriae adhere to epithelium over ileal lymphoid tissue
What is the incubation period of enteric fever?
7-14 days
What are the signs/symptoms of enteric fever?
Fever Headache Abdominal discomfort Constipation Dry cough Relative bradycardia
True or false: the signs and symptoms of paratyphoid are milder than typhoid
TRUE
What are the complications of enteric fever?
Intestinal haemorrhage and perforation
What do the investigations done for a patient with enteric fever show?
Moderate anaemia
Relative lymphopenia
Raised LFTs
Culture (blood)
How can enteric fever be prevented?
Food and water hygiene precautions
Typhoid vaccine
Capsular polysaccharide antigen
Live attenuated vaccine
What are the symptoms of non-typhoidal salmonella infections (eg food poisoning)?
Diarrhoea
Fever
Vomiting
Abdominal pain
What is the commonest arbovirus?
Dengue
How does the first dengue infection present?
Ranges from asymptomatic to severe febrile illness
How does a re-infection of dengue present?
Dengue haemorrhagic fever
Dengue shock syndrome
Give an example of a viral haemorrhagic fever
Ebola
What are the symptoms of Ebola?
Flu-like illness with vomiting, diarrhoea, headaches, confusion and rash
What type of virus is Zika virus?
Arbovirus
What are the symptoms of Zika virus in pregnant women?
Foetal loss
Baby has congenital microcephaly
