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6. Microbiology > Travel Illnesses > Flashcards

Travel Illnesses Flashcards

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1
Q

List the most common travel illness(es) in:

a) Sub-Saharan Africa
b) Caribbean
c) Southeast Asia
d) South-central Asia

A

SUB-SAHARAN AFRICA:
Malaria
Rickettsia

CARIBBEAN:
Dengue fever

SOUTHEAST ASIA:
Dengue fever

SOUTH-CENTRAL ASIA:
Typhoid fever

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2
Q

What are the 4 aspects of bite avoidance advice that you would give to travellers?

A 
Stay indoors
Impregnated netting (permethrin)
Clothing (cover your whole body)
Insect repellent (DEET - remember to reapply)
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3
Q

Which mosquitoes transmit malaria?

List 4 types of malaria.

A

Anopheles mosquitoes

TYPES OF MALARIA:
Plasmodium falciparum
P. vivax
P. ovale
P. malaria
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4
Q

Describe the incubation periods of different types of malaria, including:

a) P. falciparum
b) P. vivax
c) P. ovale
d) P. malaria

A

P. FALCIPARUM: 7-14 days

P. VIVAX: 12-17 days

P. OVALE: 15-18 days

P. MALARIA: 18-40 days

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5
Q

Describe the life cycle of plasmodium parasites. (5)

A
  1. Anopheles bites and transmits sporozoites, which are taken up into the liver
  2. In the liver, sporozoites develop into schizonts
    a. Schizonts undergo asexual reproduction and produce many mature merozoites
  3. Liver cells rupture, releasing mature merozoites into blood
  4. Merozoites invade RBCs, where they replicate further
  5. Merozoites then destroy RBCs, causing symptoms
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6
Q

How do you diagnose malaria? (4)

A

DETERMINING PRESENCE OF MALARIA:
Thick blood film
Antigen testing

DETERMINING TYPE OF MALARIA:
Thin blood film
PCR

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7
Q

Describe the clinical features of malaria. (7)

A 
Fever (in 90%)
General malaise
Myalgia
Anaemia
GI problems
Respiratory problems
Headaches
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8
Q

Describe the clinical features of severe malaria. (8)

A 
Parasitaemia 2+%
Cerebral malaria
Severe anaemia
Renal failure
Shock
Disseminated intravascular coagulation (DIC)
Acidosis
Pulmonary oedema
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9
Q

How do you treat malaria? (3)

A

FIRST LINE:

  • Quinine
  • Doxycycline

OTHER TREATMENTS:
-Artemether compounds

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10
Q

Describe chemoprophylaxis for malaria. (3)

A

Mefloquine (1/week)
Doxycycline (1/day)
Malarone (1/day)

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11
Q

When do you start/stop mefloquine for malaria prophylaxis?

List 1 side effect.

A

Start: 2-3 weeks before travel
Stop: 4 weeks after return

SIDE EFFECTS:
Neuropsychiatric (ranging from vibrant dreams to severe anxiety)

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12
Q

When do you start/stop doxycycline for malaria prophylaxis?

List 1 side effect.

A

Start: 1-2 days before travel
Stop: 4 weeks after return

SIDE EFFECTS:
Photosensitivity

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13
Q

When do you start/stop malarone for malaria prophylaxis?

Describe the benefits and disadvantages of malarone.

A

Start: 1-2 days before travel
Stop: 1 week after return

BENEFITS:
Few side effects

DISADVANTAGES:
Very, very expensive

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14
Q

Which bacteria causes typhoid fever?

What is the incubation period?

A

Salmonella typhi

Incubation period: 5-21 days

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15
Q

How would you diagnose typhoid fever? (4)

A

Travel history
Blood cultures
Stool cultures
Widal’s test

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16
Q

Describe the clinical features of typhoid fever.

What are the symptoms? (6)

What are the signs O/E? (4)

A 
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)
17
Q

Describe the clinical features of severe typhoid fever. (5)

A 
Rectal bleeding
Intussusception
Bowel perforation
Enteric encephalopathy (e.g. reduced consciousness, confusion)
Bacteraemia
18
Q

How would you treat typhoid fever? (3)

A

Quinolones
3rd generation cephalosporins
Azithromycin

Duration: 14 days

19
Q

Describe the clinical features of dengue fever. (5)

What are the laboratory signs of dengue? (3)

A 
SYMPTOMS OF DENGUE FEVER:
Headache
Fever
Retro-orbital pain
Arthralgia/myalgia
Rash

LABORATORY FINDINGS:
Leukopenia
Thrombocytopenia
Transaminitis

20
Q

What is the most severe type of dengue fever?

List 4 symptoms associated with this.

A

Dengue haemorrhagic fever

Symptoms:

  • Increased vascular permeability
  • Thrombocytopenia
  • Fever
  • Bleeding
21
Q

How would you treat dengue fever? (3)

A

Painkillers
Fluid replacement
Rest

22
Q

List 7 examples of viral haemorrhagic fevers (VHFs).

A 
Lassa fever (most common)
Ebola
Crimean-Congo haemorrhagic fever (CCHF)
South American VHFs
Rift Valley fever
Dengue haemorrhagic fever
Yellow fever
23
Q

What is the maximum incubation period for VHFs?

A

Maximum 21 days

24
Q

What are the laboratory features of VHFs? (4)

A

Decreased WCC
Decreased platelets
Prolonged TT
Prolonged APTT

6. Microbiology (15 decks)

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