Week 5 - Travel Related Infections Flashcards
1
Q
How could you catch an infection whilst travelling?
A
- Food/water
- Insect/tick bite
- Swimming
- Sexual contact
- Animal contact
- Beach/recreational activities
2
Q
Why is a travel history important?
A
Key aspects:
- Any unwell travel companions/contacts?
- Pre-travel vaccinations/preventative measures
- Recreational activities?
- Healthcare exposure?
For:
- Recognition of imported diseases
--- May be rare/unknown in the UK
- Infection prevention
--- On the ward
--- In the lab
- Different strains of pathogen
--- Antigenically different
--- Impacts on protection/detection
--- Antibiotic resistance
-- Different countries have different regulations over antibiotic prescription
3
Q
How does malaria cause disease?
A
- 4 main species of Plasmodium:
- – Falciparum (most worrying)
- – Vivax
- – Ovale
- – Malariae
- Incubation period = 1-3 weeks
- Vector = female mosquito
- Mechanism of action: uses haemoglobin as a nutrient and causes destruction of RBCs
4
Q
How does malaria present?
A
- Fever, chills and sweats which cycle every 3-4 days
- Painful joints and muscles
- Headaches
If very severe: - Tachycardia
- Hypotension
- Acute respiratory distress syndrome
- Diarrhoea
- Deranged LFTs
- Bilirubin
- Acute kidney injury
- Confusion, fits
- Cerebral malaria
- Low/normal white cell count
- Thrombocytopenia
- Metabolic acidosis
- Hypoglycaemia
- Secondary infection
5
Q
How do you treat malaria?
A
Treatment depends on species:
- P.falciparum: quinine or artemisinin
- P.vivaz, ovale, malariae: choroquine, primaquine
6
Q
How can you prevent malaria?
A
- Assess risk
- – Knowledge of at risk areas
- Bite prevention
- – Insect repellent
- – Adequate clothing (especially after dusk)
- – Nets
- – Chemoprophylaxis before travel
- Chemoprophylaxis
- – Specific to region
- – Start before and continue after return
7
Q
How does enteric/typhoid fever occur?
A
- Organism: salmonella typhi
- – Gram negative, bacilli, aerobe
- Incubation period = 7-14 days
- Transmission: faecal-oral from contaminated food/water
8
Q
How does enteric fever present?
A
- Headache
- Hepatosplenomegaly
- Abdominal pain
- Constipation
- Dry cough
- Relative bradycardia
9
Q
How do you investigate and treat enteric fever?
A
- Investigations:
- – Moderate anaemia
- – Relative lymphopenia
- – Raised LFTs
- – Culture (blood and faeces)
- Treatment:
- – Ceftriaxone or azithromycin for 7-14 days
10
Q
How can you prevent enteric fever?
A
- Food and water hygiene precautions
- Typhoid vaccine
11
Q
How does influenza present?
A
- Fevers
- Generalised ‘aches and pains’
- Non-productive cough
- High temperature
- High resp rate
- Bilateral inspiratory crackles
12
Q
How is influenza disease caused?
A
- Virus: influenza A (possibility)
- Transmission = droplet, airborne
- Mechanism of action: can use antigenic drift or antigenic shift, which may lead to changes in genes or neuraminidase/hemagglutinase proteins respectively
13
Q
How do you manage influenza?
A
- Bedrest
- Drink lots of fluid
- Anti-inflammatory drugs for fever
14
Q
How does legionnaire’s disease present?
A
- Fever
- Shortness of breath
- Productive cough
- Confused
- Low oxygen sats
- High temperature
- Low bp
- Bibasal crepitations upon chest auscultation
15
Q
What causes legionnaire’s disease?
A
- Pathogen: legionnella pneomophilia
- – Gram negative bacteria
- Airborne infection of droplets from stagnant water
