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446- ID and transplant > Travel Health > Flashcards

Travel Health Flashcards

1
Q

personal travel risk factors include

A

medical conditions, medications, allergies, vax hx, travel experience, risk perception and tolerance, financial

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2
Q

destination travel risk factors include

A

Where: not just the country but the specific location within the country- urban or rural?
When: date of departure and duration (must plan around timeline)
Why: business, holiday, visiting family, volunteer, medical tourism
How: transportation, accommodation
What: types of activities

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3
Q

T or F: pharmacists can carry out a care plan for travel without need for MD intervention

A

T

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4
Q

traveler’s diarrhea is primarily caused by

A

bacteria, less often virus or protozoa

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5
Q

TD is often ________ to _______ days

A

self limiting
3-4 days

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6
Q

which of the following is considered a “riskier choice” for traveler’s diarrhea
1. boiling water involved in cooking cabbage
2. apples
3. hibachi grills
4. bananas

A

2- not peelable or cooked

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7
Q

Dukoral vaccine is originally a _______ vaccine

A

cholera

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8
Q

dukoral offers some protection against ________ which protects against TD

A

ETEC, enterotoxigenic E coli

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9
Q

which of the following is the best description of the dukoral vaccine
1. benefits are limited, risks are significant
2. benefits are limited, risks are limited
3. benefits are significant, risks are significant
4. benefits are significant, risks are limited

A

2

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10
Q

the use of a dukoral vaccine is primarily based on
1. location of travel
2. hx of GI issues
3. patient’s willingness to get it (ex- $$, other med issues, risk tolerance)
4. none of the above

A

3

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11
Q

what 2 OTCs can be used for TD

A

bismuth subsalicylate
loperamide

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12
Q

what is the first choice abx for TD tx

A

azithromycin

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13
Q

what is the main AE of azithromycin

A

QT interval prolongation

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14
Q

what are options for TD for pts who can not take azithromycin

A

ciprofloxacin and rifaximin

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15
Q

ciprofloxacin is
1. limited in effectiveness in asia due to resistance
2. not used in children
3. only used in adults who can’t tolerate azithro
4. has risk of tendon injury
5. all of the above

A

5

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16
Q

hepatitis A is transmitted through

A

fecal oral, contaminated food and water

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17
Q

T or F: hep A vaccines are not part of routine childhood immunizations in Canada

A

T

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18
Q

what is the Hep A schedule? how many doses are needed for trip protection?

A

2 doses: 0 and min 180 days apart
1 dose needed for trip protection, get FU dose in 180+ days

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19
Q

what is the twinrix schedule and accelerated schedule? how many doses are needed for protection?

A

Schedule: 0, 30d, 180d
2 doses needed to provide sufficient immunity

Accel sch: 0, 7, 21, 365d
3 doses needed to provide sufficient immunity
Difference of 7 days

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20
Q

what is the Twinrix Jr schedule

A

0, 30, 180 days

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21
Q

what is the alternative peds twinrix schedule

A

use adult twinrix at 0 and 180 days

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22
Q

how many doses of hep A offers trip protection?

A

1

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23
Q

hep B is transmitted by

A

contaminated blood or body fluids

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24
Q

those born before ____ are not hep B vaxxed as part of childhood vaccines

A

1982

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25
Q

typhoid fever is a ______ infection spread by ____________

A

bacterial
contaminated food and water

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26
Q

sx of typhoid fever

A

fever, rash, stomach pain

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27
Q

how to tx typhoid fever

A

antibiotics

28
Q

highest risk of typhoid fever is in

A

south asia

29
Q

the oral typhoid vaccine
_________vaccine
PO schedule: day ___________
Protected ~_____days after last dose + lasts _____ yrs
For ________yrs old

A

Live vaccine
PO schedule: day 1, 3, 5, 7
Protected ~7 days after last dose + lasts 5-7yrs
For =>5yrs old

30
Q

Injectable typhoid vaccine
________ vaccine
________ dose
_____ days for protection which lasts ___ yrs
For ____ yrs old

A

Inactivated vaccine
IM single dose
~14 days for protection which lasts 2-3yrs
For =>2yrs old

31
Q

yellow fever is _________ infection spread by ______

A

viral
mosquitos

32
Q

highest risk of yellow fever is in _______ and ________

A

sub Saharan Africa and South America

33
Q

the yellow fever vaccine is a ____ given ________ as a ____ dose

A

live
SC
single dose

34
Q

the yellow fever vaccine takes ____ to take effect

A

10 days

35
Q

what is the age limit for yellow fever vaccine

A

=>9mths

36
Q

japanese encephalitis is a _____ infection spread by ____

A

viral
mosquitos

37
Q

japanese encephalitis is a risk throughout

A

Asia- primarily rural/ agricultural areas

38
Q

the japanese encephalitis vaccine is an __________ vaccine, administered IM on days __________. it provides protection for _______ or ______ if a booster is given at 1-2rys

A

inactivated
0, 7-28
protection for 1-2yrs
10yrs

39
Q

the pt must be > _____ to receive the japanese encephalitis vaccine

A

2 months

40
Q

rabies is a _____ infection spread through __________

A

viral
saliva of ifnected animal

41
Q

If infected with rabies + no post exposure prophylaxis =

A

99.99% fatal and horrible way to die

42
Q

what is the #1 animal for rabies transmission

A

dogs (others include monkeys, bats, other mammals)

43
Q

the rabies vaccine is an _________ vaccine given IM on adys _____________

A

inactivated
IM on days 0, 7, 21-28

44
Q

duration of rabies protection is determined by

A

titres

45
Q

factors to consider when offering rabies vaccine

A

Activities on trip- related to animals?
Spending a lot of time in caves?
Remote travel- access to medical care and post exposure prophylaxis
Future travel
Risk tolerance
Price (~$700 if no coverage)

46
Q

meningococcal vaccine
________ vaccine
Protects against _______
______ dose
Protection for _________yrs
____________ vaccine given as part of G9 vax in AB

A

Inactive vaccine
Protects against 4 serotypes
IM single dose
Protection for 3-5yrs
Quadrivalent ACWY vaccine given as part of G9 vax in AB

47
Q

what is the meningitis bell in africa

A

high risk travel area esp in dry season (Nov-May) when outbreaks can occur

48
Q

meningitis is a __________ infection spread by __________

A

viral
coughing, sneezing

49
Q

polio is a ______ infection spread by ________

A

viral
fecal oral route

50
Q

polio is endemic in

A

afghanistan and pakistan

51
Q

adults can get a booster dose of polio as a single ______ dose

A

SQ

52
Q

polio is a(n) ___________ vaccine

A

inactivated

53
Q

4 antimalarial options

A

chloroquine
mefloquine
doxyxycline
atovaquone/ proguanil

54
Q

pros for chloroquine

A

weekly dosing
cheap

55
Q

cons for chloroquine

A

Resistance in most of the world except Central America and Caribbean
Have to take at least 2 wks before + 4 wks after leaving risk area
Tablets not commercially available in Canada rn

56
Q

pros of mefloquine

A

Weekly dosing
Inexpensive

57
Q

cons of mefloquine

A

AEs include psych SEs (avoid in those w/ FHx mental illnesses even if it is mild or well controlled)
Have to take at least 2 wks prior + 4 wks after leaving risk area

58
Q

doxycycline pros

A

Inexpensive
Typically 1st or 2nd choice

59
Q

cons of doxycycline

A

Daily dosing
SEs: GI irritation, ↑ sun sensitivity, vaginal yeast infxns
Have to take 28 days after leaving area

60
Q

pros of atovaquone/ proguanil

A

Mostly well tolerated- possible GI upset
Need to take only 7 days after leaving risk area

61
Q

cons of atovaquone/ proguanil

A

Daily dosing
Expensive
May be 1st choice if cost not a concern

62
Q

dangue fever is a virus transmitted by the

A

aedes mosquito

63
Q

dengue fever has
1. a risk anywhere tropical
2. severe sx can result in hemorrhagic fever
3. tx only with supportive and sx tx
4. 4 serotypes
5. all of the above

A

5

64
Q

preventative measures for dengue fever include

A

bite protection, clothing, bug sprays

65
Q

T or F: there are currently no vaccines available in Canada for Dengue fever

A

T- dengvaxia and qdenga in progress

66
Q

which country requires yellow fever vaccine

A

kenya
south africa and mozambique require proof of vax if traveling through coutnry with risk of yellow fever transmission

67
Q

If pt has been to malaria country + develop a fever =

A

treat like pt has malaria until proven otherwise

446- ID and transplant (18 decks)

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