travel medicine Flashcards
what was most common causeof efevr in Geosentinal study ?
Malaria(SSA) followed by Dengue(SEA) –> Enetric fever
History taking and Prob solving in fever ?
- ?Travel
- ?Co morbidities
- ?Immunocompromised
- ?Need to isolate
- ?Need for screening for resistence organisms
- ?Need to notify
How to guess organism based on IP?
Acute <10 days: Influenza,Dengue ,ZIKA
Intermediate:10-21D: Typhoid, VHF, mALARIA
Chronic> 21d: Malara ,Hep B, TB
what ar eimportant pont in Travel history Taking?
Travel :Dates,purpose , part of region, Accomodation
Pre Exposure Vaccine: Whic one and compliance
Specific eposure : Animal , sexual,health tourism.,bites
Gp exposure
in which travel infection you d see a eschar ?
Rickettsia,TRypanosomniasis, Plague
which infection will have Conjunctivitis?
Measels ,ZIKA, and subcongunctival infection in lepoto
what are Lives vaccines
MMR,Vericella Zoster, BCG,Yellow fever , Oral Typhoid and IMOJEV Oralchol C/I :in pred >20 mg daily HIV and CD4 less tan 200 Biologics
what i s the issue with Conjugated vaccines in Immunosuppressed ?
May not be that immunogenic and req repeated doses
what are Basic test of malaria and Typhoid?
Malaria: RDT or microscopy
Typhoid: Blood culture +ve only 50%
Bone marrow Culture most sensitive
What is emepric treatment for typhoid?
Cef/ or Azithro
But SEA has Cef resistent strains of S typhi and Enterica
Can repeated Episodes of Malaria provide immunity
Yes , partial . And hence can have asymptomatic Parasitaemia
what can we detect in Thin films?
density and specifity
What are draw backs of RDT for Malaria?
Can not determine Density
Can remain positive weeks after succesful RX
Can have mutation of antigen encoding genes SUCH AS Pfhrp and 3
What are predicters of Severity of Malaria ?
End organ dysfunction
High Density>10%
what is th evidence of Atrimether over Quinolones ?
Clears infection faster and reduces mortality
Which areas are developing resistence to Artimether?
SEA particularly border B/W Thai and Cambodia border
This is confered by Kelch 13 mutation due o Artimether monotherapy.
Mostly clonal spread
How Vivax and Ovale are different from Falci?
They can remain dormant in Liver and cause relapses
How do we treat Hypnozoite of Vivax
Primaquine for 7-14 days
What is evidence for Tefnoquine?
as a single dose –>NJEM 2019–>Lower relapse rate
Must have >70 % function of G6PD
If typhoid is acquired in Pakistan, what should we treat it with?
Carbapenam due to emergence of ESBL strain of Styphi
what do we use for carriers of typhoid?
Cipro 4 weeks
what are vaccines for Parathyroid ?
None
Even for S typhi vaccines does not provide complete prevention
- Dengue and Zika Class?
2. Chikungunya ?
- Flavi virus
2. Alpha virus (Ros river virus family
what are carriers of Dengue, Chikungunya and Dengue
Aedes Agypti and albopictus
