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3rd Year Infection > Travel Related Infection > Flashcards

Travel Related Infection Flashcards

1
Q

Why are travellers at greater risk of infection?

A 
Temptation to take risks away from home
Different epidemiology of some diseases
Incomplete understanding of health hazards
Stress of travel
Refugees
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2
Q

Name 4 common worldwide infections

A

Influenza
Community-acquired pneumonia
Meningococcal disease
Sexually transmitted diseases

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3
Q

What are the common environment-related health problems?

A 
Sunburn
Heat exhaustion and heatstroke
Fungal infections
Bacterial skin infections 
Cold injury
Altitude sickness
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4
Q

What factors an help manage controllable public health measures?

A

Sanitation
Immunisation
Education

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5
Q

Education can help control which infections?

A

HIV

STDs

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6
Q

Immunisation can help control which infections?

A

Polio

Diphtheria

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7
Q

Why are Refugees at greater risk of infection?

A

Deprivation
Injury
Stress
Malnutrition

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8
Q

What are the more common water-related infections?

A 
Schistosomiasis
Leptospirosis
Liver flukes
Strongyloidiasis
Hookworms
Guinea worms
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9
Q

What are the common arthropod-borne infections?

A 
Malaria
Dengue fever
Ricksettial infections (typhus)
Leishmaniasis
Trypanosomiasis
Filariasis
Onchocerciasis
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10
Q

Which arthropod-borne infections are spread by mosquitos?

A

Malaria
Dengue fever
Filariasis

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11
Q

What are the UK important Tropical Diseases?

A 
Malaria
Typhoid
Dengue Fever
Schistosomiasis
Rickettsiosis
Viral haemorrhagic fevers
Zika fever
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12
Q

Malaria is what?

A

Parasitic infection of RBC

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13
Q

What is the most significant imported disease?

A

Malaria

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14
Q

What is the distribution of malaria?

A

Tropics/subtropics
Subsaharan africa
Central america
India/SEA/islands

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15
Q

What is the vector of malaria?

A

female Anopheles mosquito

Sporazoites into the blood which travel to the liver

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16
Q

What are the most important species of malaria?

A

Plasmodium falciparum

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17
Q

What are the benign species of malaria?

A

Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi

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18
Q

Symptoms of malaria

A 
NON-SPECIFIC
fever/rigors
aching bones
abdo pain
headache
dysuria
frequency
sore throat
cough
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19
Q

Signs of malaria

A

In ESTABLISHED malaria
Splenomegaly
Hepatomegaly
Mild jaundice

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20
Q

Complications of malaria

A 
Cerebral malaria
Blackwater fever
Pulmonary oedema
Jaundice
Severe anaemia
Algid malaria
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21
Q

Who are at risk of cerebral malaria?

A

non- immune visitors

children in endemic areas

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22
Q

What is the presentation of cerebral malaria?

A

hypoglycaemia
convulsions
hypoxia
(meningitis symptoms)

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23
Q

What is algid malaria?

A

Complication of severe malaria

Gram -ve septicaemia

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24
Q

What is the presentation of blackwater fever?

A 
Severe intravascular haemolysis
High parasitaemia
Profound anaemia
Haemoglobinuria
Acute renal failure
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25
Q

How is Malaria diagnosed?

A

Thick and Thin blood films (Giemsa, Field’s stain)
Quantitative Buffy Coat (QBC)
Rapid Antigen Tests

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26
Q

How is complicated malaria assessed?

A 
One or more of:
Impaired consciousness or seizures 
Hypoglycaemia
Parasite count >2%
Haemoglobin <8mg/dL
Spontaneous bleeding / DIC
Haemoglobinuria 
Renal impairment or pH <7.3
Pulmonary oedema or ARDS
Shock (algid malaria)
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27
Q

Treatments for uncomplicated P. falciparum?

A

Riamet 3 days
Eurartesim 3 days
Malarone 3 days
Quinine 7 days (plus oral Doxycycline/Clindamycin)

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28
Q

Typhoid fever is caused by what?

A

Salmonella typhi

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29
Q

How common is Typhoid globally?

A

27 million infections

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30
Q

How is Typhoid spread?

A

Poor sanitation

Unclean drinking water

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31
Q

What is the incubation period of Typhoid fever?

A

7d - 4wk

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32
Q

What is the most common arbovirus infection?

A

Dengue

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33
Q

How many dengue deaths occur a year?

A

25,000

34
Q

How many dengue infections occur a year?

A

100 million/year

35
Q

What is the vector for dengue fever?

A

Water Mosquitoes - Aedes aegypti

36
Q

How does Dengue fever present?

A 
Sudden fever
Headache
Myalgia/arthralgia
Macular/maculopapular rash
Petechiae 
Purpura
\+ve Tourniquet test
37
Q

How is Dengue Diagnosed?

A 
Clinical presentation
Tourniquet test
Transaminases 
Elevated platelets/WCC
PCR
Serology
38
Q

How is Schistosomiasis spread?

A

Fresh water - freshwater snails

39
Q

What organisms cause schistosomiassis?

A

S. haematobium
S. mansoni
S. japonicum

40
Q

What are the generalised malaria drugs?

A

Quinine

Artemisinins

41
Q

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

A

IV artesunate

IV quinine + oral doxycycline/clindamycin

42
Q

What are the treatment options for non-P. falciparum malaria?

A

Chloroquine 3 days
Riamet 3 days
Primaquine (P. vivax, ovale)

43
Q

How is Primaquine used in Malaria?

A

P. vivax and P. ovale for liver hypnozoites

Be aware of G6PD deficiency

44
Q

What are the available Malaria control programs?

A

Mosquito breeding site removal - standing water
Larvacides
Mosquito killing sprays
Human behaviour

45
Q

What can humans do to reduce the spread of malaria?

A

Bed nets

Mesh windows

46
Q

What are the clinical features of Typhoid fever?

A 
7d-4wk incubation
1st week:
Fever, headache, abdominal pain, constipation, bradycardia, confusion
2nd week:
Fever peaks 7-10 days
Rose spots
Tachycardia
Diarrhoea
3rd week (complications):
Intestinal bleeding
Perforation
Peritonitis
4th week (recovery):
10-15% relapse
47
Q

How is Typhoid fever diagnosed?

A

Evolution of features
Stool culture, urine and stool
Bone marrow culture

48
Q

How is Typhoid feature treated?

A

Oral Azithromycin - uncomplicated

IV Ceftriaxone - complicated

49
Q

How is Dengue fever managed?

A

No treatment
Manage complications
Prevent

50
Q

How is Dengue fever prevented?

A

Avoid bites

Vaccine

51
Q

What are the complications of Dengue fever?

A

Dengue haemorrhagic fever

Dengue Shock syndrome

52
Q

How are the complications of Dengue fever managed?

A

IV fluids
Fresh frozen plasma
Platelets

53
Q

What is the life cycle of Schistosomiasis?

A

Schistosomiasis release eggs into water
These live in snails as sporocysts
Mature and penetrate the skin
Live in bowel/rectum

54
Q

What is the clinical presentation of schistosomiasis?

A 
Swimmer's itch
Invasive stage
Katamaya Fever
Acute Disease 
Chronic disease
55
Q

How does the invasive stage of schistosomiasis present?

A 
After 24hrs
Cough
Abdo discomfort 
Splenomegaly 
Eosinophilia
56
Q

How does the Katayama fever stage of schistosomiasis present?

A 
After 15-20 days
Prostrate
Fever, urticaria
Lymphadenopathy
Splenomegaly
Diarrhoea
Eosinophilia
57
Q

How long does the acute phase of schistosomiasis last?

A

6-8 weeks

58
Q

How is schistosomiasis diagnosed?

A

Clinical
Antibody Tests
Ova in stools and urine
Rectal snip

59
Q

How is schistosomiasis treated?

A

Praziquantel 20mg/kg, 2 doses, 6hrs apart

Prednisolone if severe

60
Q

How does Tick Typhus present?

A 
Tick-bite Eschar
Maculopapular rash
Abrupt swinging fever
Headache
Confusion
Bleeding
61
Q

What species cause Tick Typhus?

A

Rickettsiosis conorii, R. africae

62
Q

Where is Tick Typhus endemic?

A

Southern africa
Mediterranean
Arabian Gulf

63
Q

How is Tick Typhus diagnosed?

A

Clinical features

Serology

64
Q

How is Tick Typhus treated?

A

Tetracycline

65
Q

What are the most common viral Haemorrhagic fevers?

A

Ebola
Congo-Crimea haemorrhagic fever
Lassa fever
Marburg disease

66
Q

How are viral haemorrhagic fevers managed?

A

3 week incubation
Rule out common infections
High Security Infection Unit
Supportive management

67
Q

What type of virus is Zika?

A

Flavivirus

68
Q

How is Zika transmitted?

A

Daytime-biting Aedes mosquitoes
Sexual contact
Blood transfusion

69
Q

Where is Zika Endemic?

A

Mexico to brazil (central america)

70
Q

How does Zika present?

A

Mild symptoms - headache, rash, fever, malaise, conjunctivitis, joint pain
Teratogenic
Guillain-Barre

71
Q

What is the impact of Zika on Pregnancy?

A

Microcephaly

Neurological issues

72
Q

How is Zika managed?

A

Vaccines

Mosquito control measures

73
Q

What are the most common causes in returned traveller fever?

A 
Malaria 30-40%
Hepatitis
URTI
UTI
Undiagnosed (25%)
74
Q

Which travel-related infectious diseases commonly cause rash?

A

Typhoid
Typhus
Dengue

75
Q

Which travel-related infectious diseases commonly cause jaundice?

A

Hepatitis
Malaria
Yellow fever

76
Q

Which travel-related infectious diseases commonly cause lymphadenopathy?

A

Leishmeniasis

Trypanosomiasis

77
Q

Which travel-related infectious diseases commonly cause liver issues?

A

Malaria
Typhoid
Amoebic abscess

78
Q

Which travel-related infectious diseases commonly cause spleen issues?

A

Visceral Leishmaniasis
Typhoid
Malaria

79
Q

What investigations are used in travel-related infectious diseases?

A 
FBC
Malaria films
LFTs
Stool microscopy &amp; culture
Urine analysis &amp; culture
Blood culture
CXR
Specific tests for pathogens
80
Q

Generally, how are travel-related infectious diseases treated?

A

Isolation
PPE
Supportive measures

3rd Year Infection (16 decks)

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