Travel related infection Flashcards
What makes travellers more vulnerable to infection?
Temptation to take risks away from home
Different epidemiology of some diseases
Incomplete understanding of health hazards
Stress of travel
Refugees - deprivation, malnutrition, disease, injury
What are examples of climate or environmental related health problems?
Sunburn Heat exhaustion Fungal infections Bacteria skin infections Cold injury Altitude sickness
What infections are controllable by improved sanitation?
Travellers diarrhoea Typhoid Hep A or E Giardiasis Amoebiasis Helminth infections Viral gastroenteritis Food poisoning Shigella dysentry Cholera Cryptosporidiosis
What infections are controllable by immunisation?
Poliomyelitis
Diphtheria
What infections are controllable by education?
HIV
STDs
What are examples of water-related infections?
Schistosomiasis Leptospirosis Liver flukes Strongyloidasis Hookworms Guinea worms
What are examples of arthropod-borne infections?
Malaria - mosquitos Dengue fever - mosquitos Rickettsial infections - ticks Leishmaniasis - Sand flies Trypanosomiasis - tsetse fly Filariasis - mosquitos Onchocerciasis - black flies
What are emerging infectious diseases?
Zika virus in latin america and caribbean Ebola virus in west Africa Swine flu worldwide Avian flu in China SARS West Nile Virus
What are the important tropical diseases that need to be known?
Malaria Typhoid Dengue Fever Schistosomiasis Rickettsiosis Viral haemorrhagic fevers Zika fever
What is the vector for malaria?
Female Anopheles mosquito
What species causes severe malaria?
Plasmodium falciparum
What are symptoms of malaria?
Fever Rigors Aching bones Abdo pain Headache Dysuria Frequency Sore throat Cough
What are possible signs of malaria?
Splenomegaly
Hepatomegaly
Mild jaundice
What are potential complications of malaria?
Cerebral malaria Blackwater fever Pulmonary oedema Jaundice Severe anaemia Algid malaria
What is Blackwater fever?
Severe intravascular haemolysis high parastiaemia profound anaemia haemoglobinuria acute renal failure
What are features of cerebral malaria?
Arching posture of back
Small brain infarcts
Convulsions
Hypoxia
What drugs should be used to treat malaria?
Malarone
Riamet
Quinone
How is Malaria diagnosed?
Thick and thin bloodfilms
Quantitative buffy coat
Rapid antigen tests
What are features indicative of complicated malaria?
One or more of: Impaired consciousness or seizures Hypoglycaemia Parasite count >2% Haemoglobin<8mg/dL Spontaneous bleeding Haemoglobinuria Renal impairment pH<7.3 Pulmonary oedema or ARDS Shock
How is complicated malaria treated?
IV quinine plus oral doxycycline
How is malaria controlled?
Mosquito breeding sites - drainage of standing water
Larvacides
Mosquito killing sprays
Human behaviour
What are causative organisms of typhoid fever?
Salmonella typhi
Salmonella paratyphi
What are clinical features in the 1st week of typhoid fever?
Fever Headache Abdominal discomfort Constipation Dry cough Relative bradycardia Neutrophilia Confusion
What are clinical features in the 2nd week of typhoid fever?
Fever peaks at 7-10 days Rose spots Diarrhoea begins Tachycardia Neutropenia
What are complications in the 3rd week of typhoid fever?
Intestinal bleeding
Perforation
Peritonism
Metastatic infections
How is typhoid fever diagnosed?
Blood culture
Urine cultures
Stool culture
Bone marrow culture
How is typhoid fever treated?
Oral azithromycin - uncomplicated
IV ceftriaxone - complicated
What species transmits dengue fever?
Aedes aegypti mosquito
What are classical features of Dengue fever?
Sudden fever Severe headache, retro-orbital pain Severe myalgia and arthralgia Macular/maculopapular rash Haemorrhagic signs - petechiae, purpura, positive tourniquet test
How is dengue diagnosed?
Thrombocytopenia Leucopenia Elevated transaminases Positive tourniquet test PCR Serology
What are potential complications of dengue?
Dengue haemorrhagic fever
Dengue shock syndrome
What are vector organisms for schistosomiasis?
Freshwater snails
What species cause schistosomiasis?
S.haematobium
S.mansoni
S.japonicum
What is the progression of schistosomiasis?
Swimmers itch Invasive stage Katayama fever Acute disease Chronic disease
What are features of the invasive stage of schistosomiasis?
Cough
Abdominal discomfort
Splenomegaly
Eosinophilia
How is schistosomiasis diagnosed?
Antibody tests
Ova in stools and urine
Rectal snip
How is schistosomiasis treated?
Praziquantel 20mg/kg
What are clinical features of rickettsiosis?
Abrupt onset swinging fever Headache Confusion Endovasculitis Rash Bleeding
How is rickettsiosis diagnosed?
Serology
How is rickettsiosis treated?
Tetracycline
What are features of zika?
Mild symptoms Headache Rash Fever Malaise Conjunctivitis Joint pains Can cause microcephaly and other neuro problems in pregnancy
