Travel related infection

Question 1

What type of infection is typhoid?

Answer 1

Salmonella infection

Question 2

What is the incubation period of typhoid? i.e. how long does it take for a person to develop symptoms

Answer 2

1 week - 4 weeks

Question 3

Symptoms of typhoid

Answer 3

Fever
Headache
Abdominal discomfort
Constipation
Dry cough
Confusion

Question 4

What lab tests are carried out in order to diagnose typhoid?

Answer 4

Culture blood, urine & stool

Question 5

Treatment of typhoid fever

Answer 5

Oral Azithromycin

IV ceftriaxone if complicated

Question 6

How is Dengue fever transmitted?

Answer 6

Mosquito

Question 7

Common symptoms of dengue fever

Answer 7

Sudden fever

Severe headache, retro-orbital pain

Severe myalgia and arthralgia

Macular/ maculopapular rash

Haemorrhagic signs: petechiae, purpura, positive tourniquet test

Question 8

How is Dengue fever diagnosed in the lab?

Answer 8

PCR

Serology

Question 9

Complications of Dengue

Answer 9

Dengue haemorrhagic fever (DHF) or Dengue shock syndrome (DSS)

Manage with IV fluids, fresh frozen plasma, platelets

Question 10

What are the intermediate hosts involved in the Schistosomiasis life cycle?

Answer 10

Freshwater snails

Question 11

Species of Schistosomiasis

Answer 11

S. haematobium
S. mansoni
S. japonicum

Question 12

Describe the life cycle of schistosomiasis

Answer 12

Eggs are shed from humans in their urine or stool released into water.

The eggs hatch in the water releasing miracidia which penetrate snail tissue (first host)

Cercariae released by snail into water. They swim and penetrate human skin.

Cercariae lose tails during penetration and become schistosomulae. They get into the circulation and migrate to the portal blood in the liver where they mature into adults.

Paired adult worms migrate to: mesenteric venules in the bowel/rectum or venous plexus of bladder

Question 13

Symptoms of Schistosomiasis and time frame

Answer 13

Swimmers itch 1st few hours

Invasive stage (24 hours) - cough, abdo discomfort, splenomegaly

Katayama fever (2-3 weeks) - fever, hives, lymphadenopathy, diarrhoea

Acute disease - 6-8 weeks - eggs deposited in the bowel (dysentery/intestinal inflammation) or bladder (haematuria)

Chronic disease

Question 14

Diagnosis of Schistosomiasis (3)

Answer 14

Antibody tests

Ova in stools and urine

Rectal biopsy/snip

Question 15

Treatment of schistosomiasis

Answer 15

PRAZIQUANTEL

Prednisolone if severe

Question 16

What is Rickettsiosis also known as?

Answer 16

Tick typhus

Question 17

Clinical signs of tick typhus

Answer 17

Tick-bite eschar (lesion)

Maculopapular rash

Question 18

Clinical features of tick typhus (6)

Answer 18

Abrupt onset swinging fever
Headache
Confusion
Endovasculitis
Rash (macular, petechial) Bleeding

Question 19

Treatment for tick typhus

Answer 19

Tetracycline

Question 20

What are the 4 viruses that cause Viral hemorrhagic fevers (VHFs) - bleeding, fever, shock and sometimes death?

Answer 20

Ebola

Congo-Crimea haemorrhagic fever

Lassa fever

Marburg disease

Question 21

Zika virus

Answer 21

Part of the Flaviviridae family

Transmitted by daytime-biting Aedes mosquitos. Also by sexual contact, blood transfusion and vertical transmission

Can be asymptomatic or show mild symptoms - headache, rash, fever, malaise, conjunctivitis, joint pains

No antiviral therapy

Question 22

What can zika virus cause in pregnancy?

Answer 22

Microcephaly and other neurological problems in the newborn

Question 23

Examination signs and their likely diagnosis

Answer 23

Rash - typhoid, typhus or dengue

Jaundice - hepatitis, malaria, yellow fever

LN involvement - leishmania (sandfly)

Liver - malaria, typhoid, amoebic abscess

Spleen - typhoid, malaria

Question 24

How is yellow fever transmitted?

Answer 24

Aedes Mosquitoes

Question 25

Which infections does the Aedes mosquito transmit?

Answer 25

Zika
Yellow fever
Dengue
Chikungunya