Vector Borne disease II

Question 1

How is rabies spread?

What is the incubation period

Answer 1

saliva of infected animal Ex: bats, raccoons, skunks, and foxes
-bites to the head and face have a ↑ risk of infection

1-3 months

Question 2

Prodromal symptoms of rabies ?

The disease eventually evolves into what 2 major forms?

Answer 2

• flu like symptoms
• photophobia(think like if you got bit by a bat and turning into a vamp)

1. encephalitic (furious) rabies 80%→ ex: crazy behavior/foaming at mouth
2. paralytic (dumb) rabies <20%

Question 3

Clinical manifestations of rabies encephalitic vs. paralytic

Answer 3

encephalitic:
- fever
- ★ hydrophobia /aerophobia
- coma/death
- agitation
- autonomic instability→ sweating/foaming at mouth

paralytic:
-ascending paralysis

Question 4

How to diagnose rabies? Tx?

Answer 4

PE:

• visible bite (usually infected)
• mental status change

★ must involve CDC if you have multiple clinical suspicions

Tx:
-pre exposure vaccines 3 IM injections 0,7,21
-post exposure
→ immunocompetent: 4 IM 0,3,7,14
→ immunocompromised: 5 IM 0,3,7, 14 28

Question 5

Rabies prognosis?

Answer 5

if not treated most people die w/n 2 weeks after coma

Question 6

Malaria transmission and where is it endemic to?

Answer 6

Female Anopheles mosquito→ endemic to Africa

Question 7

Uncomplicated vs. Severe Clinical Presentation of Malaria

Answer 7

Uncomplicated:

• ★ fever
• tachypnea
• flu like symptoms

Severe:

• Cerebral Malaria → confusion, obtunded (dull senses), seizures, coma
• hemolysis→ hemoglobinuria- PALPABLE SPLEEN(hepatosplenomegaly)
• ARDS (inflammation in lungs)
• hypotension→ tachycardia; AKI
• hyperglycemia ★ esp in pregnant women → diaphoresis (sweating)
• parasitemia

Question 8

Diagnostic studies of Malaria?

Tx?

Answer 8

-random fever of pt that has been to area endemic with malaria
Rapid diagnostic test (RDT): if + → blood smear (look for evidence of hemozoin

Tx depends on the spices of plasmodium → ex: cholorquine

Question 9

What is Tularemia ? What is its mode of transmission ?

Answer 9

-zoonotic infection caused by Francisella tularensis
→ common in hunters ★
-human contract disease through direct or indirect anima/ insect bites
→ indirect: containmented water source or airborne transmission

Question 10

Tularemia Clinical manifestations:

Answer 10

3-5 days after exposure:

• soreness in the chest or muscles***
• flu like symptoms
• abdominal pain

 if  patients don't seek treatment disease can process to specific manifestations:
ulceroglandular
oculoglandular
pharyngeal
glandular
pneumonic

Question 11

Diagnostic studies of Tularemia?

Tx?

Answer 11

*clinical suspicion b/c f. tylgarensis serology can take a while to come back and might show neg

mild illness:

• doxy
• ciprofloxacin

severe:

• streptomycin
• gentamicin

Question 12

What causes the plague?

Where is it most endemic too?

Answer 12

Yersiniz Pestis transmitted by rodent fleas, domestic cats , infect animal tissue.. pretty much anything that has it can transmit it through any type of way
→ incubation is 2-8 days unless infected via respiratory causes which it can be as little as a few hours

africa

Question 13

What are the three major clinical syndrome of the plaque and their symptoms

Answer 13

★ bubonic 80-95%:→ w/ no tx can cause sepsis, meningitis,

• skin lesions(necrotic)
• intense pain and swelling of lymph node
• sudden onset of fever
• purpura

★ septicemic plague 10-20%

• hypotension*
• GI (n/v/d)
• DIC
• fever

★ Pneumonic (fatal unless tx started w/n 1st day)

• pleuritic chest pain → pain w/ inhalation
• cough +/- blood sputum
• sudden dyspnea
• high fever

Question 14

Plague diagnosis

Answer 14

any pt that have fever and painful ★ lymphadenopathy ★ should be question about ★ travel(Africa) ★ or exposure to ★ vector (dead rodents)★

Question 15

Plague treatment

Answer 15

DOC: streptomycin
alternatives : doxy + tetra

ISOLATION:
-bubonic plague=not tx: 50%-90%→ tx: 10-20%