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59 Cards in this Set
- Front
- Back
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Routine Vaccinations that must be up to date before traveling
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DPT/Td/Tdap
IPV Hib Rotavirus Pneumovax/Prevnar MMR Varicella Hepatitis A & B |
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Travelers diarrhea, Hep A, Typhoid, Polio have what in common?
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Food-borne diseases
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Malaria, Dengue, Yellow Fever, Japanese encephalitis have what in common?
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Insect-borne diseases
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Vaccines for African Travel
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Hep A, typhoid, polio, Hep B (update other routine vacs), yellow fever, maybe meningococcal depending on where going in africa
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Early tx for traveler's diarrhea in adults and adolescents
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Cipro
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Early tx for traveler's diarrhea in children and pregnancy
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Azithromycin
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Non-pharmaceutical Prevention of malaria
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DEET or Picaridin, permethrin, mosquito nets, clothing/behavior
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What are chloroquine-sensitive malarial endemic areas?
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Latin America north of Panama, Parts of Middle East, Northern China
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Mefloquine should NOT be given in what patients?
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psych history, cardiac arrhythmia, seizures
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T/F Vaccine for yellow fever is live
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T
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What is the meningitis belt?
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Sub-saharan africa. Give menigococcal vaccine
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Difference between the two typhoid vaccines (oral and parenteral)
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1) Oral: Live, attenuated. Effective for 5 years. Use in >6 yo
2) Parenteral polysaccharide vaccine: effective for 2-3 years, use in >2 yo |
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When is polio booster given?
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Booster dose if traveling to area of high endemicity/high risk.
Usually given between 30-35 years of age. South Asia, Some parts of africa |
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Malaria prophylaxis
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Chloroquine
Mefloquine Doxycycline Malarone (atovaquone/proguanil) [Primaquine] |
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Doxycycline can be used as malaria prophylaxis in what instances?
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Consider in mefloquine-resistant areas or short trips
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Malarone can be used as malaria prophylaxis in what instances?
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Mefloquine-resistant areas or short trips
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Primaquine: special considerations
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Causes hemolytic anemia in patients with G6P deficiency, requires testing before prescription.
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Dosing schedules for chloroquine and mefloquine
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Start 1wk prior to travel
Weekly while in country Weekly x 4 wks after return |
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Dosing schedules for doxycycline, malarone, primaquine
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Start 1-2 days prior to travel
Daily while in country Daily for A) 1 week after return - Malarone Primaquine B) 4 weeks after return - Doxycycline |
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Chikungunya: defn
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insect-borne virus, of the genus Alphavirus, that is transmitted to humans by virus-carrying Aedes mosquitoes.
Similar to dengue fever. CHIKV manifests itself with an acute febrile phase of the illness lasting only two to five days, followed by a prolonged arthralgic disease that affects the joints of the extremities. The pain associated with CHIKV infection of the joints persists for weeks or months, or in some cases years |
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Chikungunya virus belongs to alphavirus genus of the ______ family
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Togaviridae
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Areas at risk for Chikungunya
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Subsaharan Africa, Southern Middle East, India, SE Asia
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yellow fever: where is it endemic?
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Northern S America, Subsaharan africa
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Japanese encephalitis: where is it endemic?
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Far East and SE Asia
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Two forms of the meningococcal vaccine
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Conjugate protein (MCV4) and polysaccharide (MPV4)
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When is rabies vaccine given?
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Only for pts at risk
HDCV on day 1, 7, and 21/28 for pre-exposure prophylaxis |
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A field at the intersection of demography, economics, epidemiology, political economy & sociology
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Global health
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approx ____% of the world lives in substandard housing
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80
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T/F Population growth in poor regions is 6-fold faster than in rich regions
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T
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3 types of population pyramids
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1) Expansive
2) Constrictive 3) Stationary |
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Expansive population pyramid : defn
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Larger numbers of population in young age groups. Found in rapidly growing populations with very large fertility rates and lower than average life expectancies (developing countries).
Looks like a pyramid |
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Constrictive population pyramid : defn
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Lower numbers of younger people
(Eg, United States) |
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Stationary population pyramid : defn
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Slowly growing population - births roughly equal deaths, numbers of individuals in different age groups are roughly equal to older ages.
Looks like a column found in Scandinavian countries |
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Where is life-expectancy the lowest?
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Subsaharan Africa (Age 46 - due to HIV/AIDS)
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T/F Urbanization results in decrease in disease transmission
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F; increase
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How are cities in the world growing?
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The largest cities in the world are growing rapidly and shifting from the more developed regions to the less developed regions
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____% of deaths in children under 5 years occur in low- & middle-income countries
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99
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Globally, ___% of deaths occur in people <5 years old
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20
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Leading causes of death in developing world
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Mostly infectious
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Two-factor complexes: defn
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Agent is transmitted <b>directly from person-to-person</b>.
Wide geographic distribution, affected by human behavior but not temp or rainfall. Ex. polio |
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Three-factor complexes: defn
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Involve transmission <b>thru a vector or invertebrate intermediate host </b> (example : snail, mosquito).
Limited geographically by distribution of vector. |
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Four-factor complexes: defn
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Involve transmission between nonhuman vertebrate and arthropod, with humans usually as accidental hosts.
Geographic distribution is even more limited than 2 and 3 factor complexes. |
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Which factor complex has the narrowest distribution? The widest?
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Narrowest: 4 factor
Widest: 2 factor |
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The following are examples of what factor complexes:
A) Polio B) Eastern Equine Encephalitis C) Dengue |
A) Two factor (human-human)
B) Four factor (humans are accidental hosts) C) Three factor |
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How does temperature affect size of mosquitoes and thus spread of disease?
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Mosquitoes are smaller in warm climates and thus require more blood meals.
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T/F Rainfall & other water sources are essential to many 3- & 4-factor complexes (requirement for mosquitoes & snails)
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T
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t/F dramatic growth in urban populations favors emergence of infectious disease
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T
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How does dam building favor emergence of infectious disease?
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displaces rural populations, favors growth of mosquitoes and other vectors
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How does Movement into previously uninhabited forested areas favor emergence of infectious disease?
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In the US, linked to emergence of Lyme disease, ehrlichiosis, babesiosis, Rocky Mountain Spotted Fever due to exposure to ticks
In tropical Africa, linked to emergence of Ebola virus, Lassa Fever, monkeypox, HIV due to close exposure to nonhuman primates |
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High rates of colonization with antibiotic-resistant organisms (AROs) are found in what setting?
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Nursing homes
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Of the 33 million persons living with HIV infection, what proportion are in sub saharan Africa?
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2/3
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US prevalance of HIV
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0.6%
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T/F 95% of the world’s TB cases & 98% of TB deaths occur in the developing world
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T
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Accounts for 20-25% of childhood mortality in the developing world
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Diarrheal diseases
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Primary pathogens causing diarrheal disease
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rotavirus & enterotoxigenic E. coli
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Which diarrheal pathogen is associated with bacteremia?
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Shigella
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Major intervention for diarrheal diseases:
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oral rehydration therapy
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Global distribution of malaria is very similar to distribution of what diseases?
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TB, HIV
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T/F Malaria exacerbates HIV
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T
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