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Infection > Travel Related Infections > Flashcards

Travel Related Infections Flashcards

1
Q

What are the most significant parts of the infection model when looking at travel infections?

A

Person;

  • Age
  • Gender
  • Physiological state
  • Pathological state
  • Social factors

Time;

  • Calendar time
  • Relative time

Place;

  • Current
  • Recent
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2
Q

Outline how pathogens can cause travel related infections

A

Bacteria (Rickettsia) and parasites (Protozoa, Helminths) are transmitted via vectors

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3
Q

What are 3 reasons that travel history is important?

A
  • To recognise imported diseases (Rare/ unknown in UK)
  • Infection prevention (On the ward/ in the lab)
  • Different strains of pathogen exist (Variation in antibiotic resistance, impact on protection/ detection)
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4
Q

What are 4 guiding questions involved in taking a travel history?

A

Where have they been?

When did the symptoms begin?

What are the symptoms/ signs?

How did they acquire it?

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5
Q

What are 6 common regions associated with travel infections

A
  • Sub Saharan Africa
  • North Africa
  • Southeast Asia
  • South/ Central Asia
  • South/ Central America
  • Middle East

(Also North Australia and North America)

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6
Q

What are the 3 groups of incubation periods for travel related infections?

A

Acute: <10 days

Sub-Acute: 10–21 days

Chronic: >21 days

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7
Q

What are 5 types of symptoms seen in travel related infections

A
  • Respiratory (Cough)
  • GI (Diarrhoea
  • Skin (Rash)
  • CNS (Headache)
  • Haematological (Haemorrhage/ splenomegaly/ lymphadenopathy)
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8
Q

What are 5 activities that can result in travel related infections

A
  • Food/ water
  • Insect/ tick bite
  • Swimming
  • Sexual contact
  • Animal contact (Bite/ safari)
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9
Q

What are 3 key aspects of travel history

A
  • Any unwell travel companions/ contacts?
  • Preventative measure taken? (Pre-travel vaccination)
  • Any healthcare exposure?
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10
Q

What is the commonest imported infection to the UK?

What is the vector for this infection?

A

Malaria

Female Anopheles mosquito

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11
Q

What are the 5 main species of Plasmodium?

Which is most dangerous?
Which one is mainly in Africa?

Which ones are mainly in India?

A
  1. Plasmodium falciparum;
    - Most dangerous
    - Mainly in Africa
  2. Plasmodium vivax;
    - Mainly in India
  3. Plasmodium ovale;
    - Mainly in India
  4. Plasmodium malariae
  5. Plasmodium knowlesii
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12
Q

What is the Incubation period for malaria?

What about Plasmodium falciparum, vivax and ovale in particular?

A

At least 6 days

P. falciparum: Up to 4 weeks
P. vivax/ ovale: Up to 1 year+

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13
Q

How does Malaria present in the history and upon examination

A

History;
- Fever, chills and sweats in a cycle every 3rd or 4th day

Examination;

  • Often few signs except fever
  • May or may not have splenomegaly
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14
Q

What are 7 types of symptoms of Malaria due to Plasmodium falciparum presents?

A
  1. Cardiovascular (Tachycardia, Hypotension, Arrhythmia)
  2. Respiratory (Acute Respiratory Distress Syndrome)
  3. GI (Diarrhoea, Abnormal LFTs, raised Bilirubin)
  4. Renal (Acute kidney injury)
  5. Blood (Low/ normal WCC, DIC, Low platelets)
  6. CNS (Confusion, fits)
  7. Metabolic (Hypoglycaemia, metabolic acidosis)

(Possible secondary infection)

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15
Q

Describe the life cycle of the malaria parasite

A
  • Parasite invades body via bite
  • Travels to liver, matures
  • Enters blood, attacks RBCs
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16
Q

How is Malaria diagnosed? Include 6 methods

A
  • FBC
  • U&Es
  • Blood glucose
  • Coagulation test
  • Head CT (If neurological symptoms)
  • Chest X Ray
17
Q

What do you need to do to discount a malaria diagnosis

A

3 negative blood films

18
Q

How do you treat Malaria due to;

  1. P. falciparum
  2. P. vivax/ ovale/ malariae
A

Falciparum;

  • Artesunate (1st line treatment)
  • Quinine + Doxycycline

Vivax/ ovale/ malariae;

  • Chloroquine
  • If recurrent, Primaquine
19
Q

What are 3 methods of prevention of malaria

A
  • Asses risk
  • Bite prevention
  • Chemoprophylaxis
20
Q

What is Enteric fever?

What 2 diseases are example of enteric fever?
Which organisms cause these? Which disease is milder

A

A potentially fatal, multisystemic disease caused by Salmonella typhi

Typhoid;
- Salmonella typhi

Paratyphoid;

  • Salmonella paratyphi A/B/C
  • Milder
21
Q

What are 3 high risk regions for Enteric fever?

What is the mechanism of infection?

A
  • Asia
  • Africa
  • America

Faecal-oral

22
Q

Describe 4 virulence factors of Enteric fever

A
  • Low infectious dose
  • Survives gastric acid
  • Reside within macrophages
  • Fimbriae adhere to epithelium over Peyer’s patches, bacteria enter the blood
23
Q

State the incubation period of Enteric fever

State 6 symptoms/ signs

A

7-14 days

  • Fever
  • Headache
  • Dry cough
  • Relative bradycardia
  • Abdominal discomfort
  • Constipation/ diarrhoea
24
Q

State 3 complications of Enteric fever

A
  • Intestinal haemorrhage
  • Intestinal perforation
  • Death (10%)
25
Q

State 5 investigations for Enteric Fever

A
  • FBC (Low lymphocytes, moderate anaemia)
  • LFTs (Mildly raised)
  • Serology (Ab detection, not reliable)
  • Blood culture (Primary investigation)
  • Faces/ bone marrow culture
26
Q

Describe the drug resistance of the organism causing enteric fever

Outline the treatment of enteric fever

A

Multi-drug resistant (Including penicillins)

Usually;
- IV ceftriaxone (a cephalosporin)/ azithromycin (a macrolide) for 7-14 days

  • Fluoroquinolones may work (Increasing resistance)
27
Q

What are 2 methods of prevention of enteric fever

A
  • Food and water hygiene

- Typhoid vaccine (capsular polysaccharide antigen or Live attenuated vaccine)

28
Q

Suggest a non-typhoidal infection caused by Salmonella species

What are 4 symptoms

A

Food poisoning

  • Fever
  • Vomiting
  • Abdominal pain
  • Diarrhoea
29
Q

Name 4 travel related infections that present with fever and rash

A
  • Childhood viruses (Measles, rubella, parvovirus)
  • Infectious mononucleosis
  • Acute HIV
  • Rickettsia (Spotted fever)
30
Q

What is Dengue fever

A

A mosquito borne tropical disease caused by dengue virus

Commonest arbovirus) (a virus transmitted by mosquitoes, ticks, or other arthropods

31
Q

How many serotypes are there of Dengue virus

What are 3 high risk regions of Dengue fever

A

4 serotypes

Africa
Asia
Indian subcontinent

32
Q

Describe the range of symptoms of Dengue fever, if its your first time being infected

How long does it last?
When does it improve?

A

Ranges from asymptomatic to non-specific febrile illness (Sudden fever)

  • Lasts 1-5 days
  • Improves 3-4 days after a rash
33
Q

State 2 consequences of re-infection with Dengue fever

A
  • Dengue haemorrhagic fever (damages vessels)

- Dengue shock syndrome (Above + weak rapid pulse)

34
Q

What is Myiasis

A

Infection with a fly larva

35
Q

What disease are caused by the coronaviruses;

MERS-CoV
SARS-CoV-2

A

MERS: Middle East Respiratory Syndrome
SARS: Coronavirus

36
Q

What is Zika virus?

What are the symptoms
Name 2 complications

Is there a treatment or vaccine

A

An arbovius transmitted via Aedes mosquito and sexual transmission

Mild, dengue link (only 20%)
Congenital microcephaly, foetal loss

No treatment, no vaccine

Infection (26 decks)

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