Travel Related Infections Flashcards
Why is travel history important?
- Recognise imported diseases
- Different strains of pathogen
- Infection prevention
Symptoms of malaria
(occur every second or third or fourth)
- Headache
- Dry cough
- Fever
- Splenomegaly
- Nausea and vomiting
- Chills
- Sweats
- Body aches
4 main species of Plasmodium
- Falciparum (most severe infection)
- Vivax
- Ovale
- Malariae
Vector of malaria
Female Anopheles mosquito
Incubation period of P. falciparum
7 to 14 days
Incubation period of P. vivax and P. ovale
12 to 18 days, but can take months or years
Severe falciparum malaria
- Tachycardia, hypotension, arrhythmias
- Acute respiratory distress syndrome
- Diarrhoea, abnormal LFTs, bilirubin
- Acute kidney injury
- Confusion, fits, cerebral malaria
- Low/normal WBC, thrombocytopenia, DIC
- Metabolic acidosis, hypoglycaemia
Malaria investigations
- Blood smear x3
- FBC, urea and electrolytes, LFTs, glucose, coagulation
- Head CT if CNS symptoms
- Chest x-ray
Malaria treatment
P. falciparum:
- Quinine + doxycycline
- Artesunate
P. vivax, ovale, malariae:
- Chloroquine + primaquine
- Hypnozoites (liver stage)
Which organism causes enteric fever?
Salmonella typhi - aerobic, gram negative, rod
Symptoms of enteric fever
- Systemic disease (bacteraemia)
- Fever
- Headache
- Abdominal discomfort
- Constipation
- Dry cough
- Bradycardia
- Complications: intestinal haemorrhage and perforation
- Parathyroid: generally milder
Incubation period in typhoid fever
7 to 14 days
Enteric fever investigations
- Moderate anaemia
- Lymphopenia
- Raised LFTs
- Blood and faeces culture
- Serology is not reliable
Enteric fever treatment
Ciprofloxacin resistance is now common, so it is usually treated with ceftriaxone or azithromycin, 7-14 days
Enteric fever vaccine
Vi capsular polysaccharide antigen or live attenuated vaccine, protection 50-75%
