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Epidemiology and Public Health
PPT8: Infectious Disease 2
81
Other
Graduate
02/16/2012

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Cards

Term
What is the Agent in Malaria?
Definition
Plasmodium sp.
-P. Vivax
-P. falciparum
-P. ovale
-P. malariae
Term
What is the vector for malaria?
Definition
Anopheles Mosquitoes
Term
What are the symptoms of malaria?
Definition
High fevers, shaking chills, sweats, flu-like symptoms, headache, and anemia (dependent on species)
Term
How is Malaria Diagnosed?
Definition
Microscopic examination; serologic tests
Term
Malaria is the _____ biggest cause of death from infectious diseases world wide
Definition
5th
Term
Use one word to describe fevers due to malaria
Definition
cyclic. Each different type of malaria presents with a fever that follows a different cyclical pattern (the fever spikes when the cells are dividing)
Term
In order to protect themselves from malaria, travelers receive chemoprophylaxis which is ________ weekly starting 1 week before arrival and continuing 4 weeks after departure. What are 3 other drug options if the area you are traveling to is resistant to the above mentioned drug?
Definition
-chloroquine
-Atovaquone-proguanil, doxycycline, mefloquine
Term
What are 4 protective measures one can take against contracting malaria?
Definition
-mosquito nets while sleeping
-dwellings with screens
-wear protective clothing
-mosquito repellent (DEET)
Term
What are 5 examples of Arboviral Infections?
Definition
-eastern equine encephalitis (EEE)
-western equine encephalitis (WEE)
-St. louis encephalitis (SLE)
-lacrosse encephalitis (LAC)
- West nile virus encephalitis
Term
At what time of year is arboviral encephalitis most common?
Definition
often occurs from June through September, when arthropods are most active

in milder parts of the country, where arthropods are active late into the year, cases can occur into the winter months
Term
What are the symptoms of arboviral infections?
Definition
-majority of human infections are asymptomatic or may result in a non-specific flu-like syndrome
-onset may be insidious or sudden with fever, HA, myalgias, and malaise
-Infection can lead to encephalitis, with a fatal outcome or permanent neurologic sequelae
Term
How are arboviral infections diagnosed?
Definition
serologic tests; IFA/EIA (enzyme-linked immunosorbent assay) for IgG/IgM
Term
What is the tx for arboviral infections?
Definition
Supportive care, reduce swelling of the brain; antibiotics are not effective and no effective antiviral drugs have yet been discovered
Term
St. Louis Encephalitis is predominantly seen in states bordering the _______ River
Definition
Mississippi
Term
In what demographic is LAC typically seen? What is characteristic of the encephalitis that it can cause?
Definition
-younger children
-can cause a very severe encephalitis that can go on to have long term sequelae, it effects the nervous system and the pt's never really fully recover
Term
What state had the highest prevalence of West Nile Virus in 2010?
Definition
Arizona
Term
What are the three groups of bacterial infections?
Definition
-mycobacterial disease (TB)
-spirchetal disease
-bacteria
Term
What are the two different forms of mycobacterial disease?
Definition
-Tuberculosis
-Atypical mycobacterial disease (TB that is nonhuman but humans can still get it)
Term
What is the leading cause of infectious disease mortality worldwide? What fraction of the world population is infected?
Definition
Tuberculosis
1/3 of the world population is infected
Term
During what decade was there a resurgence in the US of TB?
Definition
the early 1990s
Term
What population is at a much higher risk of becoming infected with TB?
Definition
people with HIV
Term
What is the fatality rate for untreated TB?
Definition
50%
Term
What is the agent in TB?
Definition
mycobacterium tuberculosis
Term
If you thought you were exposed to TB, would you go get a TB test the following day and expect it to be accurate?
Definition
No. Tuberculin reactivity 2-12 weeks after initial infection
Term
What is the transmission of TB?
Definition
Via microscopic droplets released into the air by a person with active TB who coughs, speaks, sneezes, spits, laughs, or sings
Term
What are the symptoms of latent TB and active TB?
Definition
-latent: bacteria remain inactive and cause no symptoms, not contagious

-active: symptomatic and contagious: cough, unexplained weight loss, fatigue, fever, night sweats, chills, loss of appetite
Term
How is TB diagnosed?
Definition
PPD tuberculin skin test; followed with a chest x-ray; culture identification of MTB from induced sputum
Term
What is the treatment for TB? What are 4 things that the exact drugs and length of treatment depend on?
-How long is the antibiotic treatment?
-what are 4 possible antibiotics to use?
Definition
-exact drugs and length of treatment depend on age, health, possible drug resistance, the form of TB (latent or active) and its location in the body

-Antibiotics for at least six-nine months
-Isoniazid (INH); Rifampin; Ethambutol; Pyrazinamide
Term
Most people with active TB who have had appropriate drug treatment for at least two _______ are no longer contagious
Definition
weeks
Term
Who is more likely to have TB in the US, US born persons or foreign born persons?
Definition
Foreign born
Term
What is the "face" of the TB patient in TN?
Definition
The face of the TB patient in TN is the old white man who comes in with a cough. Most likely he was exposed young, never knew, as he aged he's become immunocompromised and the bacteria was able to overcome his immune system
Term
What are three complications with TB and antibiotic use: are the antibiotics effective? how long must they be taken to be effective? What does improper use lead to? What type of therapy works best?
Definition
-antibiotics are effective, but must be taken for several months; additionally side effects lead to compliance issues
-improper use of antibiotics lead to resistance, including multi drug resistance, mortality rate 50%
-Directly observed therapy (DOT) works best to prevent antibiotic resistance
Term
Multidrug resistant TB (MDR TB) is resistant to at least _____ of the 1st line TB drugs
Definition
two
Term
Extensively drug-resistant TB (XDR TB) is resistant to _______ and __________ plus at least ____ of the 2nd line drugs
Definition
-Isoniazid
-Rifampin
-One
Term
What is the agent in atypical mycobacterium disease?
Definition
any non tuberculosis mycobacteria (NTM)
Term
NTM are ubiquitous in nature and found in ______,______,_____,and _______. Approx how many species are there? Is there evidence of person to person transmission?
Definition
-soil, food, water, and animals
-100 species
-no evidence of person to person transmission (many cases transmitted from bird to human)
Term
What are the symptoms of atypical mycobacterium disease?

clinical presentation varies by _________ and _____ of______
Definition
fever, night sweats, weight loss, abdominal pain, fatigue

clinical presentation varies by species and site of entry
Term
How is atypical mycobacterium disease diagnosed?
Definition
culture from a sterile site
Term
WHat does the treatment for atypical mycobacterium disease depend on?
Definition
Exact drugs and length of treatment depend on species, drug susceptibility, and the site of infection
Term
What is the agent in RMSF?
Definition
Rickettsia Rickettsii
Term
What is the vector for RMSF?
Definition
The American Dog tick and the Lone Star Tick
Term
What is the incubation period for RMSF?
Definition
3-14 days
Term
What are some symptoms for RMSF?
Definition
-high fever, severe HA, myalgias, N/V, abd pain
Term
The rash for RMSF usually is not apparent until how many days after onset?
Definition
2-5 days
Term
Describe the rash associated with RMSF: how does it begin? where is it? what occurs later in its course? What percentage have the rash within the first 3 days?
Definition
-begins as 1 to 5 mm pink macules
-in ankles, wrists, forearms, spreads centrally
-petechia occur later
-rash may be asymmetric, localized, or absent
-less than 50%
Term
What is a DDX for RMSF?
Definition
syphilis
Term
What is the treatment for RMSF?
Definition
doxycycline (100 mg BID; 5-7 days)
Term
What is the mortality in RMSF?
Definition
10-40% untreated
5% treated
Term
What is the median time to death in RMSF?
Definition
8 days
Term
How many pts with RMSF have no reported tick bite?
Definition
30-40%
Term
What time of year is RMSF common? What age groups?
Definition
Summer months
-55+ and 5-9 yo's
Term
What is the agent in ehrlichiosis?
Definition
Ehrlichia Chafeensis
Term
What is the vector in Ehrlichiosis?
Definition
lone star tick
Term
What is the incubation period for Ehrlichiosis
Definition
5-10 days
Term
what are the symptoms for Ehrlichiosis
Definition
high fever, sever HA, myalgias, N/V, abd pain
-rash less common, seen in 30%
Term
What is the only way to tell the difference between this and RMSF? Does it really matter if you find out exactly which one it is?
Definition
-serology
-not really, you will treat both with doxycycline
Term
What is the treatment for Ehrlichiosis?
Definition
doxycycline 100 mg BID 5-7 days
Term
What is the mortality in Ehrlichiosis?
Definition
~2%
Term
Where, Who and When for Ehrlichiosis?
Definition
Where: Eastern US (missouri, arkansas, oklahoma)
Who: 55+ yo's
When: summer months
Term
What is the agent in Lyme disease?
Definition
Borrelia Burgdorferi
Term
What is the difference between ehrlichia chafeensis (HME) and anaplasma phagocytophila (HGA)?
Definition
the reactivity of the RBC (?)
Term
What is the vector in lyme disease?
Definition
the black-legged tick
Term
What is the name for the rash associated with lyme disease?
Definition
erythema migrans
rash >5 cm
Term
Lyme disease shows evidence of manifestation in what three body systems?
Definition
musculoskeletal
neurologic
CV
Term
Where is lyme disease most common?
Definition
NE states
Term
What is the acute treatment for lyme disease?
late disease?
Definition
doxycycline 100 mg BID
amoxicillin 500 mg TID
cefurozime acetil 500 mg BID
for 14 days

-late disease depends on symptoms
Term
Who does lyme disease usually affect?
Definition
Male children and older adults
Term
What is the agent for southern tick associated rash illness (STARI)?
Definition
borrelia lonestari
Term
what is the vector for STARI?
Definition
lone-star tick
Term
What are the symptoms for STARI?
Definition
-erythema migraines like rash >8cm
-fatigue
-HA
-stiff neck
-arthralgia
-myalgia
-occasional fever
Term
What is controversial about STARI?
Definition
it has been identified but they have yet to be able to grow it in the lab
Term
What is the tx for STARI?
Definition
doxycycline 100 mg BID; 14 days
Term
What is the agent in syphillis? the incubation period?
Definition
Treponema pallidum
3 weeks (range 10-90 days)
Term
How is syphilis passed from person to person?
Definition
through direct contact with a syphilis sore which occur mainly on the external genitals, vagina, anus, or in the rectum (also on lips/ in mouth)
-Sexually transmitted
Term
Can pregnant women with syphilis pass it along to their babies?
Definition
yes, its called congenital syphilis
Term
What about the incubation period with syphilis makes it hard to track?
Definition
People with multiple multiple partners have trouble figuring out who they have been with during the incubation period, since the period is so long
Term
Describe the symptoms of the primary, secondary, late and latent stages of syphilis.
Definition
-primary: small sore/chancre
-secondary: rash begins on the trunk, eventually overs entire body, even the palms and soles
-late and latent: can last for years, can present as difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia
Term
What is the infectious part of syphilis?
Definition
the open wounds
chancres completely resolve without treatment within 6 weeks
Term
What race/gender/sexual behavior category has the highest rate of primary and secondary syphilis?
Definition
white and black MSM population
Term
How is syphilis diagnosed?
Definition
Rapid plasma reagin (RPR) test
T pallidum particle agglutination (TP-PA) test
Term
What is the treatment for syphilis?
Definition
penicillin
dose and duration cary and depend on the stage of disease
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