Travelers - Diseases transmitted by insect bites

38 important questions on Travelers - Diseases transmitted by insect bites

Insects that transmit disease

Vectors (carries an organism to an individual to cause infection)

Any place the disease lives and can multiply

Reservoir (animal, insect, soil, plant)

What are the diseases spread by mosquitoes?

Dengue
Japanese encephalitis
Malaria
Yellow fever
Zika virus
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What can be done to avoid insect bites?

Mosquito repellents with DEET on exposed skin
Permethrin to treat clothing, gear, bed nets (NOT directly to skin)

What live recombinant vaccine is recommended only for those with a past dengue infection?

Dengvaxia

Where is Japanese Encephalitis infection risk the highest?

Rural agricultural areas

What is the Japanese Encephalitis vaccine, and who is it for?

Ixiaro
Travelers with extended exposure to outdoors or if plan to spend at least 1 month in endemic area during JE transmission season 

What mosquito spreads malaria?

Anopheles mosquito

With the Anopheles mosquito as the vector, once in a human host, how does it go through the body?

1st multiplies in liver, then moves into red blood cells to multiply and destroy them

What is the most common malaria species?

Plasmodium vivax

What is the most deadly malaria species?

P. Falciparum

Why are certain prophylactic meds recommended for malaria?

It can be fatal, even with treatment

How can the nausea caused by malaria drugs be decreased?

Take with water, food, or milk

Malaria prophylaxis meds should be started how many days before travel?

1-2 days

How often are the malaria prophylaxis meds taken?

Daily

The malaria prophylaxis meds should be avoided in what?

Pregnancy

What malaria prophylaxis can be stopped 4 weeks after travel?

Doxycycline (Doryx, Vibramycinn)

What malaria prophylaxis can be stopped 1 week after travel?

Atovaquone/Proguanil (Malarone)
Primaquine

Malaria prophylaxis: Atovaquone/Proguanil (Malarone)

Good coverage
NOT used in: pregnancy, breastfeeding, severe renal impairment

Daily Malaria prophylaxis: Primaquine

Most effective for P.vivax
NOT used in: G6PD deficiency (hemolytic anemia risk), pregnancy, breastfeeding

What malaria prophylaxis meds are safe in children and pregnancy and taken weekly?

Choloroquine
Mefloquine

When is Choloroquine started and stopped?

Start 1-2 weeks before
Stop 4 weeks after

Weekly malaria prophylaxis: Chloroquine

Resistance issues with P.falciparum and P.vivax
Can cause retinal toxicity/visual changes

Weekly malaria prophylaxis: Mefloquine NOT used in:

Underlying psychiatric conditions
Seizures
Arrhythmias

Areas of mefloquine resistance

When is Mefloquine started and stopped?

Start >/= 2 weeks before
Stop 4 weeks after

What is the weekly malaria prophylaxis that requires a loading dose started 3 days before travel?

Tafenoquine (Arakoda)

What cannot be used for yellow fever acute infection symptom relief?

Aspirin & other NSAIDs due to increased risk of bleeding

What is the LIVE yellow-fever vaccine to prevent and stop transmission?

YF-VAX

After yellow fever vaccine, what are patients given? And when are they valid?

ICVP "yellow card"
10 days after vaccination

How long of protection is given from a single dose of yellow fever vaccine?

Life-long protection

Who cannot receive the yellow fever vaccine?

Egg hypersensitivity and severely immunocompromised

Due to the risk of serious adverse effects, yellow fever vaccination is only recommended for who?

Travelers at high risk of exposure or who require proof of vaccine to enter a country

What mosquito primarily spreads the zika virus?

Aedes species mosquito

What are the other types of transmission have been reported of zika virus?

Sexual and blood-transfusion

What is the most important concern with the zika virus?

Infants born with microcephaly (birth defect that causes significant disability and can be life threatening in severe cases)

Is there a vaccine for zika virus?

No.

Because there is no vaccine for zika virus, how to reduce transmission risk?

Avoid mosquito bites and use condoms

Does the CDC recommend pregnant women traveling to any area with ongoing transmission of zika virus?

NO. Avoid all contact.

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