Travel Related Infections Flashcards
Why are travellers vulnerable to infection?
Temptations to take risks when away from home
Different epidemiology of some diseases
Incomplete understanding of health hazards
Stress of travel
Refugees: deprivation, malnutrition, disease, injury
What are some climate of environment related health conditions?
Sunburn Heat exhaustion and heatstroke Fungal infections Bacterial skin infections Cold injury Altitude sickness
What are some sanitation related health conditions?
Travellers diarrhoea Typhoid Hepatitis A or E Giardiasis Amoebiasis Helminth infections Viral gastroenteritis Food poisoning Shigella dysentery Cholera Cryptosporidiosis
What are some immunisation related health conditions?
Poliomyelitis
Diphtheria
What are some health education related health conditions?
HIV
STDs
What are some water related infections?
Schistosomiasis Leptospirosis Liver flukes Hookworms Strongyloidiasis Guinea worms
What are some anthropod-borne infections?
Malaria
Dengue fever
Rickettsial infections
Leishmaniasis
What are some of the emerging infectious disease associated with travel?
Zika virus Ebola virus disease MERS-CoV Swine flu Avian flu SARS West Nile virus
What is the vector for malaria?
Female Anopheles mosquito
What are the 5 species of malaria?
Plasmodium falciparum Plasmodium vivax Plasmodium ovale Plasmodium malariae Plasmodium knowlesi
What are the symptoms of malaria?
Fever Rigors Aching bones Abdominal pain Headache Dysuria Frequency Sore throat Cough
What are the signs of malaria?
None
Splenomegaly
Hepatomegaly
Mild jaundice
What are the complications of malaria?
Cerebral malaria Blackwater fever Pulmonary oedema Jaundice Severe anaemia Algid malaria
How is a diagnosis of malaria made?
Thick and thin blood films
Quantitative buffy coat (QBC)
Rapid antigen tests
How is the severity of malaria assessed?
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
What are the 2 main malaria drugs?
Quinine
Artemisinins
What are the treatment options for uncomplicated malaria?
Riamet for 3 days
Eurartesim for 3 days
Malarone for 3 days
Quinine for 7 days plus oral doxycycline
What are the treatment options of complicated or severe malaria?
IV Artesunate
IV Quinine plus oral doxycycline
What are the treatment options for the benign species of malaria?
Chloroquine for 3 days
Riamet for 3 days
Add primaquine to eradicated liver hypnozoites
What is involved in malaria control programmes?
Mosquito breeding sites (drainage of standing water) Larvacides Mosquito killing sprays Bed nets Mesh windows
What is the cause of typhoid (enteric) fever?
Poor sanitation
Unclean drinking water
What are the organisms that cause typhoid fever?
Salmonella typhi
Salmonella paratyphi
What are the clinical features of typhoid fever?
Fever Headache Abdominal pain Constipation Tachycardia Neutrophilia Confusion Diarrhoea Intestinal bleeding Perforation and peritonism
How is typhoid fever diagnosed?
Culture blood, urine and stool
Culture bone marrow
What is the treatment for typhoid fever?
Oral azithromycin
IV ceftriaxone
How is dengue fever transmitted?
Aedes aegypti mosquito
What is a classic presentation 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 Lab PCR and serology
What are the complications of dengue fever?
Dengue haemorrhagic fever
Dengue shock syndrome
How are the complications of dengue fever treated?
IV fluids
Fresh frozen plasma
Platelets
How can dengue be prevented?
Avoid bites
New vaccine in use
What are the clinical features of schistosomiasis?
Swimmers itch Cough Abdominal discomfort Spelnomegaly Eosinophilia Katayama fever Eggs deposited in bowel or bladder
How is a diagnosis of schistosomiasis made?
Antibody tests
Ova in still or urine
Rectal snip
What is the treatment for schistosomiasis?
Praziquantel
Prednisolone if severe
What are the clinical features of rickettsiosis?
Abrupt onset swinging fever Headache Confusion Endovasculitis Rash Bleeding
How is rickettsiosis managed?
Tetracycline
What are some serious viral haemorrhagic fevers?
Ebola
Congo-Crimea haemorrhagic fever
Lassa fever
Marburg disease
How is Zika virus transmitted?
Daytime biting aedes mosquito
Sexual contact
Blood transfusion
What are the clinical features of zika virus?
None Headache Rash Fever Malaise Conjunctivitis Joint pains
What is the effect of Zika virus within pregnancy?
Can cause microcephaly and other neurological problems
Gillian Barre syndrome
