Travel Related Infections Flashcards
What are the possible symptoms of traveller’s diarrhoea?
Anorexia Malaise Abdominal cramps Watery (non-bloody) diarrhoea Fever Nausea and vomiting
How can mosquito bites be physically avoided?
Air conditioning
Screens
Permethrin impregnated meeting
Clothing to cover the arms, legs, ankles and feet
What is the most common cause of fever in travellers from sub saharan Africa?
Malaria
What techniques are used to diagnose malaria?
Antigen testing
Blood films
PCR
What are the clinical features of malaria?
Fever Malaise Headache Myalgia Diarrhoea Anaemia Jaundice Renal impairment
In severe malaria there is parasitaemia. What are the other clinical features of severe malaria?
Cerebral malaria Severe anaemia Renal failure Shock DIC Acidosis Pulmonary oedema
What drugs can be used for chemoprophylaxis for malaria?
Mefloquine
Doxycycline
Malarone
Which chemoprophylactic agent for malaria has the side effect of photosensitisation?
Doxycycline
Which organisms cause enteric fever?
S.thyphi
S.parathyphi
S.typhi and s.parathyphi have an animal reservoir. T/F?
False - it only exists in humans
What is the incubation period for enteric fever?
5 to 21 days depending on age, gastric acidity, immune status and infectious load
What are the symptoms of enteric fever?
Fever Myalgia Headache Cough Abdominal pain Constipation Diarrhoea
Diarrhoea or constipation can occur in enteric fever. Which is more likely in children?
Diarrhoea
What is the diagnosis of enteric fever based upon?
Travel history
Blood culture
Stool culture
Serology
What antibiotic class is the most effective agents against enteric fever?
Quinolones
If there is resistance to quinolones in enteric fever what agent is used?
Cephalosporins
What is the incubation period of dengue fever?
5-14 days
What are the clinical. features of dengue fever?
Headache Fever Retro-orbital pain Arthralgia/myalgia rash cough sore throat nausea diarrhoea
What laboratory findings are seen with dengue fever?
Lecuopaenia
Thrombocytopaenia
Transaminitis
How is dengue haemorrhage fever defined?
Increase in vascular permeability
Thrombocytopenia
Fever
Bleeding
What can cause viral haemorrhagic fever?
Lassa Ebola/marburg CCHF SAVHFs RVF DHF Yellow fever
Exposure to viral haemorrhagic fever is more common in rural areas. T/F?
True
Which causes of fever is a returning traveller more at. risk of if they worked in hospitals or refugee camps?
TB
HIV
VHF
typhus
Which causes of fever is a returning traveller more at. risk of if they had sexual exposure?
HIV
Hepatitis B and C
Syphilis
Gonorrhoea
Which causes of fever is a returning traveller more at. risk of if they visited an African game park?
Tick typhus
Which causes of fever is a returning traveller more at. risk of if they had fresh water exposure?
Schistosomiasis
Leptospirosis
Which causes of fever is a returning traveller more at. risk of if they went caving?
Histoplasmosis
Rabies
Which causes of fever is a returning traveller more at. risk of if they were exposure to contained food or water?
Enteric fever Shigella Salmonella Campylobacter Amoebiasis Helminth infections Hepatitis A and E
Which causes of fever is a returning traveller more at. risk of if they ingested. unpasteurised milk?
Brucella
Listeria
Salmonella
Which causes of fever is a returning traveller more at. risk of if they had animal contact?
Brucella
Q fever
Which causes of fever is a returning traveller more at. risk of if they used air-con systems or. showers?
Legionella
How can malaria be diagnosed?
Thick or thin blood. film
Rapid diagnostic antigen test
What initial investigations should be conducted in a patient with suspected malaria?
FBC, LFTs, U&Es 3 malaria. blood films or rapid diagnostic tests over 3 days Blood. cultures HIV test Urine and. stool culture and microscopy Serology. gro dengue fever CXR and ultrasound of liver and spleen
What is the most severe causative agent of malaria?
Falciparum malaria
What. is the standard treatment for falciparum malaria?
Quinine plus doxycycline. for a week
What. are the four plasmodium. species which are. responsible. for human malaria?
P.falciparum
P.vivax
P.ovale
P.malariae
Which causative agents. of malaria typically show no drug resistance?
P.ovale
P.malariae
Patients with confirmed non-falciparum malaria may be treated as outpatients with…?
Chloroquine
What are the clinical features of uncomplicated malaria?
Fever Malaise Headache Myalgia Splenomegaly Anaemia Minor GI symptoms
What are the clinical features of severe malaria disease. in adults?
Impaired consciousness or seizzures Hypoglycaemia Haemoglobin <8g Spontaneous bleeding or. DIC Haemoglobinuria Renal impairment Acidosis Pulmonary oedema / acute respiratory distress syndrome Shock Death
Fresh water exposure when travelling can predispose to which infections?
Schistosomiasis
Leptospirosis
Caving when travelling can predispose to which infections?
Histoplasmosis
Rabies
Why should malaria blood tests be taken several times over 2-3 days?
Malaria parasites may be in the blood at very low concentrations, especially in patients who have taken prophylaxis
Parasites may not be visible in the peripheral blood at different stage of their life cycles.
What are the advantages and disadvantages of thin blood film in diagnosing malaria?
Good for speciation and estimation of parasitaemia
Low sensitivity
What are the advantages and disadvantages of thick blood film in diagnosing malaria?
Most sensitive method of detecting parasites
Requires expertise to interpret
What are the advantages and disadvantages of rapid diagnostic tests in diagnosing malaria?
Less sensitive
Require less expertise to interpret
What four parasites can cause malaria?
P.ovale
P.vivax
P.malariae
P.falciparum
Which causative organisms of malaria exhibit drug resistance?
P.falciparum
Why do p.vivax and p.ovale require additional treatment to prevent relapse of malaria?
These parasites can lie dormant in the liver
What additional treatment do p.vivax and p.ovale infections require to prevent relapse of malaria?
Primaquine
Non-falciparum malaria can be treated as outpatient with what drug?
Chlorowuine
What clinical features are suggestive of severe disease in adults with malaria?
Impaired consciousness or seziures Hypoglycaemia Haemoglobin <8g/dl Spontaneous bleeding or DIC Haemoglobulinuria Renal impairment Acidosis Pulmonary oedema Shock Death
