ID Exam 3: O'Donnel Parasites and Travel Infections

pinworm, malaria, ectoparasites

What parasites are of importance for human disease?

1. ___ (enterobius vermicularis)

2. ___ (plasmodium family)

3. ____ (lice, scabies)

enterobiasis

Pinworms

-official name is Enterobius vermicularis

-name for infection with pinworm = ___

fecal-oral

Pinworms

-spread via ___-___ route

intestine

Pinworms

-the female pinworm lives in the ___

eggs

Pinworms

-when host is asleep, the female pinworm will emerge from the anus and lay ____, which leads to itching

1-2

Pinworms

-eggs sit in the colon and take __-__ months and mature into adults

kids

Pinworms

-humans are the only host

-common in ___ under 18 and caretakers of infected kids

itchy, sleep

Symptoms of enterbiasis

-___ anal region

-disturbed ___

-secondary bacterial infections can result from itching

children)

Malaria

-kills 1-3 people annually (mostly ___)

-does better in warmer climates (bc passed by mosquitos)

sexual, asexual

Malaria

-intracellular protozoa with __ and __ reproductive cycles

humans, mosquitos

Both ___ and ___ are required for malaria life cycle

mosquitos, humans

Malaria

-sexual phase occurs in ___

-asexual phase occurs in ___

RBCs

Malaria

-first target is liver

-second target is ___ (this is when patient starts experiencing symptoms)

plasmodium

Malaria

-name of parasite is ____ (5 different species)

falciparum, vivax

Malaria-know these 2 plasmodium species

1. Plasmodium ____ (associated with most severe cases of malaria)

2. Plasmodium ____ (common)

anopheles

Malaria

-species of mosquito that causes malaria = ____

life cycle

If someone has malaria, take a blood sample and look at the red blood cells—each one shows a distinct pattern as the parasite moves through its ___ ___ That’s how we can tell which type of malaria they have.

non-specific

Uncomplicated Malaria

-initial symptoms are ___-____ (headache, muscle aches, nausea, fever, anemia)

malarial paroxysms

Uncomplicated Malaria

-the next phase after initial symptoms = ___ ____ (lasts for weeks, hallmark of malaria infections)

cold, heat/headache, sweating/exhaustion

malarial paroxysms consists of rapid cycles of:

1. intense ___

2. intense ___/___

3. profuse ___/____

rupture, merozoites

What causes the fever in malarial paroxysms?

-the RBCs ____ and release new ___ (ie release next set of parasites that go on to infect next set of RBCs)

Parasitemia

____ = parasite load (how many parasites are in your blood)

highest

Parasitemia

Ovale/Malariae: 6000/9000

Vivax: 20,000

Falciparum: 50,000-500,000 (___ by FAR)

children

If malaria is untreated, symptoms can last for weeks and the infection can persist for years—especially in ___

Anemia

___ is a common symptom of malaria because the parasite destroys red blood cells, reducing the body's ability to carry oxygen.

coma, consciousness, renal

Complicated/Severe Malaria

-involves other organ systems

-can manifest as anemia, ___ (cerebral malaria), impaired ___, pulmonary complications, __ impairment, jaundice

falciparum

Complicated/Severe Malaria

-high parasite load, most often associated with Plasmodium ___

capillaries

Plasmodium falciparum can block ___ in different organs (viral load is so high that it causes "clogs")

delayed

Complicated/Severe Malaria

-typically occurs due to ___ treatment of uncomplicated malaria

ectoparasites

Some parasites exist entirely outside of the human body, like ____ (lice and scabies)

eggs

Lice- Life cycle has 3 stages

1. ___ ("nits"): look like dandruff; take 1 week to hatch

nymphs

Lice- Life cycle has 3 stages

2. ___: size of a pinhead

adults

Lice- Life cycle has 3 stages

3. ___: size of a sesame seed; can live up to 30 days

eggs

Lice

-humans are the only host

-symptoms include itching, tickling sensation in hair, sleeplessness, sores from scratching

-OTC medications will kill live live, but NOT ___

eggs

Lice

-Prescription medications will kill live lice, and some will also kill ___ (ovicidal)

heat

Lice

-can be killed by exposure to ___ (>128°F for 5 min)

sealed

Lice

-items that cannot be exposed to heat/laundered can be ___ in a plastic bag for 2 weeks (bc the lice cannot live that long without a meal)

upper

Scabies

-"human itch mite"

-lay eggs in the ___ layers of skin

itching

Scabies

-causes an intense, itchy rash

-may look like pimples, but distinguished by ___

thousands

crusted scabies: infection with ___ of mites/eggs

elderly, immunocompromised

crusted scabies: seen in the ___ and ___; also called "Norwegian scabies"

skin, 4-6

Scabies

-most common sites of infection are between fingers/toes, elbows/wrists, waistline, genitals, chest, face and palms of hands

-passed by prolonged ___ with skin

-symptoms take __-__ weeks to develop

no

are there any OTC treatments for scabies?

scabicides, household

Scabies Treatment

-prescription medications = ____

-usually recommend treating all members of a ___

-wash bedding and towels in hot water

-can return to work 24 hours after tx starts

pets

DO NOT use scabicides for ___ (different mite!)

Leptospira, Malaria

Travel Medicine: Pathogens to Know

Bacteria → ___

Parasites → ____

Ebola, Flaviviruses

Travel Medicine: Pathogens to Know

Viruses → ____ + ____ (Dengue, Zika, West Nile)

animal urine

Leptospira

-transmitted through drinking water contaminated by ___ ___ (commonly rodents, cattle, dogs; an issue after floods)

spirochete

Leptospira

-shape = ___ (spiral with hook on end)

burrowing, complement

Leptospira

-hooked end of bacteria allows for ___ into tissues

-interference with ___ binding allows for systemic infection

tags

Leptospira

-complement is how our immune system __ foreign material for destruction, and this bacteria is good at avoiding it

Leptospirosis

Leptospira

-cause of ___

2

Leptospirosis

-systemic flu-like illness with various clinical presentation

-has __ phases

myalgia

Leptospirosis

Phase 1→ fever, nausea, vomiting, severe ___

hepatic, renal, CNS

Leptospirosis

Phase 2→ impaired ___ and ___ function; jaundice; __ involvement is common

hemorrhagic rash

Leptospirosis

Phase 2→ if a ___ ___ appears, this is indicative of a fatal outcome

animal, africa

Ebola Virus

-circulating in an ___ reservoir (we think its fruit bats)

-largely seen in central __

non-specific

Ebola Virus

-symptoms are __-___ (fever, headache, weakness, diarrhea, etc)

50

Ebola Virus

-about ___% mortality from the 2014-2016 outbreak

antibodies

Ebola Virus

-in the 2014-2016 outbreak, the patients who died did not develop a specific immune response against ebola (never made ___)

monoclonal antibody

Ebola Virus

-2 ___ ___ therapies available (to help immune system fight back)

-also important to maintain fluids/electrolytes and monitor blood pressure/O2

accelerated

Ebola Virus

-in response to the 2014-2016 outbreak, clinical trials for new anti-Ebola drugs and vaccines were ___

-development of mAb therapies and vaccine!

COVID

Ebola Virus

-vaccine has same backbone as the J&J ____ vaccine

mosquitos

Flaviviruses

-enveloped +RNA viruses

-includes West Nile virus, Dengue virus, Zika virus, etc.

-all are spread via ___

febrile illness

Flaviviruses

-All flaviviruses initally present as ___ ___

arthritis

Flaviviruses

-Dengue and Zika can progress to ___

hemorrhagic fever

Flaviviruses

-Dengue can also progress to ___ ___ (antibody-dependent enhancement)

microcephaly

Flaviviruses

-Zika can also progress to ____ (small brain in developing fetus)

encephalitis

Flaviviruses

-West Nile, JEV, St. Louis, rarely Dengue can cause ____ (inflammation of the brain)

west nile

Even though it is a travel virus, we are particularly concerned about ___ ___ virus because it is now found in Pennsylvania

asymptomatic, febrile

West Nile Virus

-around 80% of people are ___

-20% develop a ___ illness (rash, fever, vomiting, joint pain)

elderly

West Nile Virus

-greatest pathogenesis in the ___

paralysis, encephalitis

West Nile Virus

-neurological complications can be severe and life-long (___ and ___)

treatment, vaccine

West Nile Virus

-no ___ or __ (true for most flaviviruses)

pain, supportive

West Nile Virus

-focus is ___ management and ___ therapy

mosquito, surveillance

West Nile Virus

-Prevention is via ___ control and ___