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Infection > Travel Related Infection > Flashcards

Travel Related Infection Flashcards

1
Q

What are some infections controllable by sanitation measures?

A

Travellers diarrhoea, typhoid, hepatitis A and E, giardiasis, cholera, food poisoning and viral gastroenteritis

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2
Q

What are some infection controllable by immunisation?

A

Poliomyelitis and diphtheria

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3
Q

What are some water related infections?

A

Schistomiasis, Leptospirosis, liver flukes, hookworms, guinea worms and strongyloidiasis

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4
Q

What are some arthropod-borne infections?

A

Malaria, dengue fever, rickettsial infections, leishmaniasis, trypanosomiasis, filariasis and onchocerciasis

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5
Q

What are some important tropical diseases?

A

Malaria, typhoid, dengue fever, schistosomiasis, rickettsiosis, viral haemorrhage fevers and zika fever

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6
Q

What is the malaria vector?

A

Female anopheles mosquito

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7
Q

Describe the malaria life cycle

A

Mosquito takes blood meal and implants sporozoites which change to merozoites in liver
RBCs then carry the gametocyte which is picked up by mosquito

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8
Q

What are the 5 species of Malaria?

A

Plasmodium falciparum (potentially severe), vivax, ovale, malariae, and knowlesi

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9
Q

What are the symptoms of Malaria?

A

Fever, rigors, aching bones, abdomen pain, headache, dysuria, frequency, sore throat and cough

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10
Q

What are the signs of Malaria?

A

None
Splenomegaly, hepatomegaly and mild jaundice

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11
Q

What are some complications of Malaria?

A

Cerebral malaria - encephalopathy
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria

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12
Q

Describe blackwater fever

A

Severe intravascular haemolysis
High parasitaemia and profound anaemia
Haemoglobinuria
Acute renal failure

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13
Q

Describe cerebral malaria

A

Non invasive visitors and children in endemic areas
Get hypoglycaemia, convulsions and hypoxia due to reduced BF

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14
Q

How is malaria diagnosed?

A

Thick and thin blood films - Giemsa and field stain
Quantitative buffy coat - centrifugation and UV microscopy
Rapid antigen test - OptiMal and ParaSight-F

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15
Q

What does complicated malaria have one or more of?

A

Impaired consciousness or seizures, hypoglycaemia, parasite count more than 2%, haemoglobin less than 8mg/dl, spontaneous bleeding, haemoglobinuria, renal impairment, pulmonary oedema, and shock

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16
Q

What are the Malaria drugs?

A

Quinine from Chinchona
Artemisinins from Quinghaeosu

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17
Q

What are the treatment options for uncomplicated P. falciparum malaria?

A

Riamet 3 days
Eurartesim 3 days
Malarone 3 days
Quinine 7 days plus oral doxycycline

18
Q

What are the treatment options for complicated or severe P. falciparum malaria?

A

IV quinine plus oral doxycycline
When patient is able to swallow and is stable then switch to oral treatment
IV artesunate - not in UK

19
Q

What is the treatment for the other types of malaria?

A

Chloroquine 3 days
Riamet 3 days
Add primaquine in vivax and ovale to eradicate liver hypnozoites

20
Q

What are malaria control programmes?

A

Mosquito breeding sites
Larvacides
Mosquito killing sprays
Human behaviour

21
Q

Describe typhoid fever

A

Salmonella typhi and salmonella paratyphi
Widespread - poor sanitation and unclean drinking water
Incubation period - 7 days to 4 weeks

22
Q

What are the clinical features of typhoid fever?

A

1st week - fever headache, abdomen pain, constipation, dry cough, bradycardia, neutrophilia and confusion
2nd - fever peaks, rose spots, diarrhoea, tachycardia and neutropenia
3rd - complications
4th - recovery

23
Q

What are the complications of typhoid fever?

A

Intestinal bleeding, perforation, peritonism and metastatic infections

24
Q

How is typhoid fever diagnosed?

A

Clinical - not easy
Lab - culture blood, urine and stool
Culture bone marrow

25
Q

What is the treatment for typhoid fever?

A

Oral Azithromycin
IV Ceftriaxone

26
Q

Describe Dengue

A

Swahili
Commonest human arbovirus infection
Infection - 100 million cases a year and 25000 deaths a year

27
Q

How is Dengue transmitted?

A

Aedes aegypti - mosquito daytime biting near pools of water

28
Q

What is the classical Dengue fever?

A

Sudden fever
Severe headache and retro-orbital pain
Severe myalgia and arthralgia
Macular rash
Haemorrhagic signs - petechiae, purpura and positive tourniquet test

29
Q

What is the Dengue rash?

A

Muscular and petechial rash

30
Q

How is Dengue diagnosed?

A

Clinical - thrombocytopenia, leukopenia, elevated transaminases and positive tourniquet test
Lab - PCR and serology

31
Q

What is included in management of Dengue?

A

No specific therapeutic agents
Complications - IV fluids, fresh frozen plasma and platelets
Prevention - avoid bites and new vaccine

32
Q

What are the complications of Dengue?

A

Dengue haemorrhagic fever
Dengue shock syndrome

33
Q

How is Schistosomiasis transmitted?

A

Fresh water and freshwater snails

34
Q

What are the types of schistosomiasis?

A

S. haematobium, mansoni and japonicum

35
Q

Describe the Schistosomiasis life cycle

A

Eggs hatch releasing miracidia - penetrates snail tissue then sporocysts in snail
Penetrates skin - shistosomulae go into circulation and migrate to liver and mature
Paired adult worm migrates to bowel to lay eggs in stool

36
Q

What are the clinical features of Schistosomiasis?

A

Swimmers itch - 1st few hrs
Invasive stage - cough, abdo discomfort, splenomegaly and eosinophilia
Katayama fever
Acute disease - eggs in bowel or bladder
Chronic disease

37
Q

What is katayama fever?

A

Prostate, fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea and eosinophilia

38
Q

How is schistosomiasis diagnsoed?

A

Clinical
Antibody test
Ova in stool and urine
Rectal snip

39
Q

What is the treatment for schistosomiasis?

A

Praziquantel
Prednisolone if severe

40
Q

What are characteristics of tick typhus?

A

Tick bite eschar
Maculopapular rash

41
Q

What is the main type of Rickettsiosis?

A

Tick typhus

42
Q
A

Infection (13 decks)

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