Travel Related Infections Flashcards
What pathogens are transported by vectors
Rickettsia/spirochaete (bacteria)
Protozoa and helminth (parasites)
Why is travel history important
Recognise imported diseases
Check for different strains of pathogen - greater chance of MDR bacteria abroad
Infection prevention
What is a sign of a multicellular organism infection
Eosinophilia
What are some possible ways for patients to be infected while abroad
Food/water
Insect/tick bite
Swimming
Sexual contact
Animal contact
Recreational activities
What infection might you get from an animal bite
Rabies
What infection might you get from rodents
Leptospirosis
What infections might you get from a mosquito/insect bite
Malaria
Dengue
What infection might you get from a tick bite
Rickettsia
What infection might you get from dead/slaughtered animals
Anthrax
Ebola
What infection might you get from farms
Q-fever
What infection might you get from game parks
Rickettsia
What infection might you get from fresh water
Schistosomiasis
Leptospirosis
What infection might you get from caves
Histoplasmosis
What infection might you get from unpasteurised dairy
Brucellosis
What infection might you get from eating under/uncooked fish/meat
Salmonella
Name some species which cause malaria
Plasmodium flaciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesii
What is the vector which carries malaria
Female anopheles mosquito
What are the symptoms of malaria
Headache
Fever
Muscle pain and fatigue
Back pain
Chills and sweating
Dry cough
Splenomegaly
Nausea
Vomiting
What investigations are done to test for malaria
3 Blood films
FBC
Urea and electrolyte
LFTs
Glucose
Coagulation
Head CT if neurological symptoms
CXR
How do you treat malaria caused by P. falciparum
Artesunate
How do you treat malaria caused by P. vivax, ovale or malariae
Choloroquine
What do you give to kill any malarial parasites lying dormant in the liver
Primaquine
What is the mechanism of infection of typhoid/parathyphoid fever
Faecal-oral from contaminated food/water
What type of fever are typhoid and paratyphoid fever
Enteric fever
What some of the causative organisms of enteric fever
Salmonella typhi
Salmonella paratyphi A, B and C
What type of bacteria are salmonella typhi and paratyphi
Enterobacteriaceae - aerobic Gram-negative bacillus
What is the incubation period of malaria
Minimum 6 days
P. falciparum - by 4 weeks
F. vivax/ovale - up to 1 year+
What is the incubation period of enteric fever
7 - 14 days
What are the signs and symptoms of enteric fever
Fever
Headache
Abdominal discomfort
Dry cough
Relative bradycardia
Paratyphoid - generally milder
What are the complications of enteric fever
Intestinal haemorrhage
Perforation and seeding
Mortality if left untreated - 10%
What investigations are performed to test for enteric fever
FBC - moderate anaemia and lymphopaenia in enteric fever
LFTs - raised transaminase and bilirubin
Blood (+ve in 40-80%) and faeces culture
What is the treatment for enteric fever
Uncomplicated - azithromycin (PO)
Complicated - IV ceftriaxone
What other infections can salmonella cause and what are the symptoms
Non-typhoidal salmonella infections - ‘food poisoning’
Symptoms - diarrhoea, fever, vomiting, abdominal pain
What are some potential causes of fever and rash
Measles, rubella, parvovirus (childhood viruses)
Infectious mononucleosis (EBC/CMV)
Acute HIV infection
Rickettsia - spotted fever
How is dengue tested for
Dengue PCR
Dengue serology (IgM)
Describe some feature of dengue fever
Commonest arbovirus
4 serotypes
Common in sub and tropical regions
1st infection ranges from asymptomatic to non-specific febrile illness - supportive treatment only
Re-infection with different serotype is harmful/deadly
What are the possible consequences of re-infection with the same or different serotype of dengue
Consequence is antibody dependent enhancement causing:
Dengue haemorrhagic fever
Dengue shock syndrome
What is the term for infection with a fly larvae
Myiasis
Give some examples of fly larvae that can cause myiasis
Tumbu/mango fly
Bot fly
Name a type of viral haemorrhagic fever
Ebola
What type of virus causes ebola and what are the symptoms
Filovirus
Flu-like symptoms with vomiting, diarrhoea, headaches, confusion, rash, and internal/external bleeding at 5-7 days
Name an arbovirus
Zika virus
Dengue virus
What tests and investigations should be performed on a patient with a suspected travel related infection
Malaria film x3
Blood culture x2 (prior to antibiotics)
FBC
U&E/LFT
CXR
Serology/PCR based on Hx/symptoms
Name some features of severe malaria
Tachycardia
Hypotension
Arrhythmias
Acute respiratory distress syndrome
Diarrhoea
Derranged LFTs
Acute kidney injury
High bilirubin
Confusion and fits
Cerebral malaria
Thrombocytopenia
DIC
Metabolic acidosis
Hypoglycaemia
Secondary infection
