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Phase 1 - S2 Infection (M) > Session 9 - Travel Related Infections > Flashcards

Session 9 - Travel Related Infections Flashcards

1
Q

What is the most important piece of knowledge to have when you suspect someone has a travel related infection?

A
  • How long they have had symptoms for
  • What their recent travel history is
  • Where they have recently travelled to
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2
Q

What is a bacterium that is commonly seen in travel related infections?

A

Rickettsia

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3
Q

What is special about Rickettsia as compared to other bacteria?

A
  • Can only live within other cells
  • Doesn’t have the same gram staining capabilities as normal bacteria
  • Needs a vector
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4
Q

What are some other travel related infections?

A
  • Malaria
  • Dengue
  • Enteric fever
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5
Q

Why is a patient’s travel history so important?

A
  • Recognise imported diseases
  • May be a different strain of a pthogen
  • Can prevent infection from spreading
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6
Q

How can people acquire travel related infections?

A
  • Contaminated food and water
  • Insect or tick bite
  • Swimming in contaminated water
  • Sexual contact
  • Animal contact
  • Beach or recreational activities
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7
Q

What is the organism that causes malaria?

A

Plasmodium (a parasite)

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8
Q

What are the four main species of malaria?

A
  • Plasmodium flaciparum (msot common)
  • Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae
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9
Q

What is the vector that trasmits malaria?

A

Female anopheles mosquitos

(night biter mosquitos)

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10
Q

What is malaria’s incubation period?

A
  • A minimum of 6 days
  • P. falciparum: up to 6 months
  • P. vivax/ovale: up to a year
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11
Q

What are the common symptoms of malaria?

A
  • Headache
  • Fever
  • Chills and sweating
  • Dry cough
  • Spleen enlargement
  • Nausea and vomitting
  • Muscle fatigue and pain
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12
Q

How would you classify severe falciparum malaria?

A

This is when the parasites occupy more than 2% of red blood cells.

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13
Q

What are the risks with severe malaria?

A

Cardiovascular:

  • tachycardia
  • hypotension
  • arrhythmias

Respiratory:

  • acute respiratory distress syndrome (ARDS)

Gastrointestinal:

  • bilirubin (haemolysis)

Renal:

  • acute kidney injury

Blood:

  • thrombocytopenia

Metabolic:

  • metabolic acidosis
  • hypoglycaemia

Also susceptible to secondary infections.

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14
Q

How does the malaria parasite infect the body?

A
  • Parasite enters the blood stream
  • Enters the liver
  • Multiplies in the liver
  • Re enters the bloodstream and red blood cells
  • Leads to red blood cells bursting
  • Some parasites become gametocytes that can be picked up by mosquitos
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15
Q

How do you test for malaria?

A

Blood smear

  • Done three times and to be cleared of infection, must receive 3 negatives

FBC, Urea and Electrolytes, Liver Function Tests

Chest X ray

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16
Q

How do you treat P. falciparum malaria?

A
  • Artesunate
  • Quinine and Doxycycline
17
Q

How do you treat the other three forms of malaria?

A
  • Chloroquinine and primaquine
  • Hypnozoites (liver stage)

Can recur months-year later

18
Q

How can malaria be prevented?

A
  • Know the risk areas
  • Prevent bites (insect repellant, clothing etc.)
  • Chemoprophylaxis
    • specific to the region
    • start before and continue after return (normal course is 4 weeks)
19
Q

Where can someone get enteric fever?

A
  • Found in mainly asian countries
  • Due to poor sanitation
20
Q

What is the mechanism of infection for enteric fever?

A

Faecal-oral transmission from contaminated food and water.

Source comes from cases or carriers (human pathogen only).

21
Q

What is the name of the bacteria that causes enteric fever?

A

Salmonella typhi

22
Q

What kind of bacteria is Salmonella typhi?

A
  • Aerobic
  • Gram-negative rod bacteria
23
Q

What are some of the virulence factors for enteric fever?

A
  • Gram negative endotoxin
  • Invasin - allows intracellular growth
  • Fimbriae that can adhere to epithelium over the ileal lymphoid tissue
24
Q

What are the common symptoms of enteric fever?

A
  • Fever
  • Headache
  • Abdominal discomfort
  • Constipation
  • Dry cough
  • Bradycardia
25
Q

What is the incubation period of enteric fever?

A

7-14 days.

26
Q

What are some complications that can arise from enteric fever?

A
  • Intestinal haemorrhage and perforation
  • Has a 10% ortality if left untreated
27
Q

How do you test for enteric fever?

A
  • Blood culture should be taken (main one)
  • Faeces test
  • Serology not reliable in these cases
28
Q

How do you treat enteric fever?

A

Enteric fever has increasing ability to resist drugs (highly drug resistant).

Therefore is normally treated with IV ceftriaxone.

Can also be treated with azithromycin for 7-14 days.

29
Q

How can enteric fever be prevented?

A
  • Food and water hygiene precautions
  • Typhoid vaccine can be given if going to areas of high risk
    • this is either an antigen or a live attenuated (less dangerous) version of the bacteria
30
Q

What is the microorganism that causes dengue fever?

A

Dengue fever is caused by the arbovirus.

It has 4 different serotypes.

31
Q

How is dengue fever transmitted?

A

It is transmitted by day-biting mosquitos.

32
Q

What are the symptoms of dengue fever?

A
  • Abrupt fever
  • Back pain
  • Headache originating from behind the eyes
  • Flat and widespread rash
33
Q

How would you test for dengue fever?

A
  • Blood culture and malaria screenings normally show negative.
  • Need to conduct a Dengue PCR and serology (IgM)

The serology and PCR take time, but treatment must be started immediately.

34
Q

How long does dengue fever last?

A

First infection can range from asymptomatic to severe illness.

  • Lasts 1-5 days
  • Improves few days post-rash
  • Only supportive treatment needed
35
Q

What happens if someone gets re-infected with dengue fever, with a different serotype?

A

Antibody dependent enhancement occurs, leading to:

  • dengue haemorrhagic fever
  • dengue shock syndrome

Phase 1 - S2 Infection (M) (11 decks)

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