Download Symptoms

Tropical Health
Update
FLT LT LAURA HODSON
Acknowledgement
Sqn Ldr Matt Adam
Infectious Diseases Registrar
Scope
Causes of Disease:
Protozoa
Viruses
Bacteria
Worms
Prevention
Protozoa
Single celled ‘complex’ organisms
Malaria
Amoebic Dysentery
African Trypanosomiasis
Leishmaniasis
Giardiasis
Toxoplasmosis
Trichomoniasis
Malaria
Transmitted by bite of female
Anopheles mosquito
Four Species:
P. Falciparum
P. Ovale
P. Vivax
P. Malariae
Incubation is 10-15 days
Symptoms:
Fever
Flu-like symptoms
Treatment:
Antipyretics
Analgesia
Antimalarial Chemotherapy
Amoebic Dysentery
Third leading parasitic cause of death
Occurs via the faeco-oral route
Symptoms:
Only 10% are symptomatic
Bloody diarrhoea
Abdominal pain
Treatment:
Metronidazole 800mg TDS for 5/7
Diloxanide furoate 500mg TDS for 10/7
African trypanosomiasis – Sleeping
sickness
Caused by Trypanosoma brucei:
T.b. gambiense – Central & West Africa
T.b. rhodesiense – East Africa
Transmitted by the bite of tsetse flies
T.b. gambiense is a chronic disease
T.b. rhodesiense is an acute disease
African trypanosomiasis
Symptoms
Non specific symptoms – fever, myalgia, malaise
CNS – headaches, forgetfulness, psychosis, seizures
Painful chancre (T.b. rhodesiense)
Rash (T.b. rhodesiense)
Multiorgan failure
Meningoencephalitis within 1-3 months
African trypanosomiasis
Treatment (T.b. gambiense)
Early - Pentamidine 4mg/kg IM od for 7/7
Late - Eflornithine 100mg/kg IV q6h for 14/7
Treatment (T.b. rhodesiense)
Early - Suramin 5mg/kg IV (1), 20mg/kg (3,10,17,24,31)
Late - Melarsoprol 3.6mg/kg TDS x3 (7-10/7 between cycles)
Leishmaniasis
Transmitted by nocturnal bite of female
sandfly
Two types:
Visceral leishmaniasis
Cutaneous leishmaniasis
Cutaneous Leishmaniasis
Clinical Features:
Nodule develops at bite site
Grows and crusts over
Develops into painless ulcer
Heals over months/years
Tissue paper scar remains
Leishmania are killed at 40-42
degree heat so radiofrequency or
heat pads improve healing
Infiltration of sodium stibogluconate
or meglumine antimoniate into
lesion is most common treatment
Viruses
Ebola
Lassa
Yellow Fever
Dengue
Zika virus
Chikungunya
HIV
Hepatitis A, B, C, D, E
Rabies
Polio
Dengue fever
Transmitted by day biting Aedes
mosquitoes
Begins 5-8 days after bite
Usually lasts 4-7 days
Symptomatic management only
Zika Virus
Related to dengue
Transmitted by day biting Aedes mosquitoes
Symptoms mild and self limiting:
Fever
Conjuntivitis
Joint pain
Headache
Rash
Myalgia
Usually lasts 2-7 days
Symptomatic management only
Linked to birth defects
Ebola
Viral Haemorrhagic Fever
Spread by contact with body fluids
Incubation 2-21 days
Management:
Isolation
PPE
Supportive care
Bacteria
Faecal oral
Spirochetes
Rickettsias
Bacteria – faecal oral

Salmonella

Food poisoning vs Typhoid/paratyphoid

Shigella

Cholera

E coli

Campylobacter

Staphylococcus

Listeria

Brucella
Typhoid
Transmission via contaminated food/water
Incubation period 10-20 days
Early antibiotic treatment decreases mortality
Untreated illness lasts 4 weeks:
Week 1- Malaise, headache, fever
Week 2 – Toxic, apathetic, rose spots, distended abdomen
Week 3 – Delirium, weak pulse, diarrhoea, neuro complications
Week 4 – Start to improve
Bacteria - Spirochetes
Leptospirosis
Borrelia
Lyme disease
Worms/Helminths
Nematode
Cestode
Trematode
Nematodes
Examples are:
Whipworm
Pinworm
Hookworm
Threadworm
Roundworm
Treatment
Albendazole 400mg
Cestodes (tapeworms)
Acquired by eating raw or undercooked meat
Symptoms:
Often asymptomatic
Abdominal pain/distention
Nausea
Visible worms in stool
Treatment
Praziquantel 10mg/kg
Trematodes (Flukes)
Schistosomiasis (bilharzia) is second only to malaria
Transmission occurs when exposed to parasitic worms found in fresh
water infested with snail hosts
Symptoms:
Swimmers itch
Fatigue
Fever
Abdominal pain
Diarrhoea
Treatment
Praziquantel 40mg/kg
Look after yourself
Preparation:
Education & Training
Vaccination
Acclimatisation
Sexual Heath
Mental Health
Security
During:
Bite prevention
Chemoprophylaxis
Hygiene
Sun protection
Hydration
Any Questions?