Travel Illnesses Flashcards
List the most common travel illness(es) in:
a) Sub-Saharan Africa
b) Caribbean
c) Southeast Asia
d) South-central Asia
SUB-SAHARAN AFRICA:
Malaria
Rickettsia
CARIBBEAN:
Dengue fever
SOUTHEAST ASIA:
Dengue fever
SOUTH-CENTRAL ASIA:
Typhoid fever
What are the 4 aspects of bite avoidance advice that you would give to travellers?
Stay indoors Impregnated netting (permethrin) Clothing (cover your whole body) Insect repellent (DEET - remember to reapply)
Which mosquitoes transmit malaria?
List 4 types of malaria.
Anopheles mosquitoes
TYPES OF MALARIA: Plasmodium falciparum P. vivax P. ovale P. malaria
Describe the incubation periods of different types of malaria, including:
a) P. falciparum
b) P. vivax
c) P. ovale
d) P. malaria
P. FALCIPARUM: 7-14 days
P. VIVAX: 12-17 days
P. OVALE: 15-18 days
P. MALARIA: 18-40 days
Describe the life cycle of plasmodium parasites. (5)
- Anopheles bites and transmits sporozoites, which are taken up into the liver
- In the liver, sporozoites develop into schizonts
a. Schizonts undergo asexual reproduction and produce many mature merozoites - Liver cells rupture, releasing mature merozoites into blood
- Merozoites invade RBCs, where they replicate further
- Merozoites then destroy RBCs, causing symptoms
How do you diagnose malaria? (4)
DETERMINING PRESENCE OF MALARIA:
Thick blood film
Antigen testing
DETERMINING TYPE OF MALARIA:
Thin blood film
PCR
Describe the clinical features of malaria. (7)
Fever (in 90%) General malaise Myalgia Anaemia GI problems Respiratory problems Headaches
Describe the clinical features of severe malaria. (8)
Parasitaemia 2+% Cerebral malaria Severe anaemia Renal failure Shock Disseminated intravascular coagulation (DIC) Acidosis Pulmonary oedema
How do you treat malaria? (3)
FIRST LINE:
- Quinine
- Doxycycline
OTHER TREATMENTS:
-Artemether compounds
Describe chemoprophylaxis for malaria. (3)
Mefloquine (1/week)
Doxycycline (1/day)
Malarone (1/day)
When do you start/stop mefloquine for malaria prophylaxis?
List 1 side effect.
Start: 2-3 weeks before travel
Stop: 4 weeks after return
SIDE EFFECTS:
Neuropsychiatric (ranging from vibrant dreams to severe anxiety)
When do you start/stop doxycycline for malaria prophylaxis?
List 1 side effect.
Start: 1-2 days before travel
Stop: 4 weeks after return
SIDE EFFECTS:
Photosensitivity
When do you start/stop malarone for malaria prophylaxis?
Describe the benefits and disadvantages of malarone.
Start: 1-2 days before travel
Stop: 1 week after return
BENEFITS:
Few side effects
DISADVANTAGES:
Very, very expensive
Which bacteria causes typhoid fever?
What is the incubation period?
Salmonella typhi
Incubation period: 5-21 days
How would you diagnose typhoid fever? (4)
Travel history
Blood cultures
Stool cultures
Widal’s test
Describe the clinical features of typhoid fever.
What are the symptoms? (6)
What are the signs O/E? (4)
SYMPTOMS OF TYPHOID FEVER: Asymptomatic period (7-14 days) Fever Flu-like symptoms Abdominal pain Constipation Diarrhoea
SIGNS OF TYPHOID FEVER: Tender abdomen Hepatosplenomegaly Relative bradycardia Rose spots (disappear quickly)
Describe the clinical features of severe typhoid fever. (5)
Rectal bleeding Intussusception Bowel perforation Enteric encephalopathy (e.g. reduced consciousness, confusion) Bacteraemia
How would you treat typhoid fever? (3)
Quinolones
3rd generation cephalosporins
Azithromycin
Duration: 14 days
Describe the clinical features of dengue fever. (5)
What are the laboratory signs of dengue? (3)
SYMPTOMS OF DENGUE FEVER: Headache Fever Retro-orbital pain Arthralgia/myalgia Rash
LABORATORY FINDINGS:
Leukopenia
Thrombocytopenia
Transaminitis
What is the most severe type of dengue fever?
List 4 symptoms associated with this.
Dengue haemorrhagic fever
Symptoms:
- Increased vascular permeability
- Thrombocytopenia
- Fever
- Bleeding
How would you treat dengue fever? (3)
Painkillers
Fluid replacement
Rest
List 7 examples of viral haemorrhagic fevers (VHFs).
Lassa fever (most common) Ebola Crimean-Congo haemorrhagic fever (CCHF) South American VHFs Rift Valley fever Dengue haemorrhagic fever Yellow fever
What is the maximum incubation period for VHFs?
Maximum 21 days
What are the laboratory features of VHFs? (4)
Decreased WCC
Decreased platelets
Prolonged TT
Prolonged APTT
