Infectious diseases

Supervisor

Nigel Curtis

Department

Paediatrics

Email

nigel.curtis@rch.org.au

Objectives

The goal of the elective is for students to understand the interaction of the pathogen and the host immune response in childhood infections. The student will negotiate with the supervisor to decide which of the following questions to study.

1. What is the significance of a child presenting with fever?
   • Question: "How would your approach to managing a 3 month old child with fever differ from your approach to a 4 year old with the same problem?"
   • Addresses: causes of childhood fever at different ages; possible benefits vs. disadvantages of fever; use of antipyretics; rationale underlying guidelines for management of 'fever without source'; appropriate investigation and management of child with fever
2. What are the infectious diseases that cause a rash?
   • Question: "Should I worry about my 8 month infant with a red blotchy rash?"
   • Addresses: common infections associated with rash, their management and prevention
3. What do the following viruses have in common: HSV1, HSV2, VZV, CMV, EBV, HHV6?
   • Question: "Why does my child get recurrent cold sores and what can I do about it?"
   • Addresses: common infections caused by herpes viruses; primary infection, latency, reactivation; issues in VZV, HSV; mechanism of action and appropriate use of antivirals
4. What illnesses do travellers need to worry about?
   • Question: What advice would you give to a family with a 6 week old son and a 2 year old daughter returning to visit relatives in Vietnam?
   • Addresses: common childhood infections: importance of routine immunisations; use of immunisations against 'tropical' diseases (typhoid, TB etc.); prevention of mosquito-transmitted and food- and water-borne diseases, treatment of travellers diarrhoea
5. What infections can affect the baby in utero?
   • Question: What infectious diseases can harm babies during pregnancy?
   • Addresses: congenital infections; management of infections in pregnant mum (eg. parvovirus, toxoplasma, CMV)
6. What infections can group A streptococcus cause?
   • Question: Why do indigenous Australians have the highest rate of rheumatic fever recorded worldwide?
   • Addresses: GAS diseases including issues around treatment of pharyngitis; Public Health issues including overcrowding, access to healthcare
7. How do antibiotics work?
   • How would you approach (i) the mother of a child with bacterial meningitis who doesn't want her child to have antibiotics because "they are unnatural" and (ii) the mother of a child with a viral URTI who insists the child is given antibiotics because "they worked last time he had the flu"
   • Addresses: understanding the mechanisms of antibiotic action; issues of antibiotic resistance; Public Health, expectations; principles of communicating with parents re: antibiotics
8. How are infections spread?
   • Question: How would you approach a mother who is worried about sending her child to child care as he might catch lots of infections
   • Addresses: transmission of infectious diseases (droplets, food and water, vectors, needle-stick injuries, other); infection control issues
9. Which infectious diseases are a particular risk for adolescent?
   • Question: An adolescent presents with jaundice - what infections to consider?
   • Addresses: sexually transmitted infections; blood-borne viruses - drug use, piercing; immunisation in adolescents; adolescent issues

Resources and learning opportunities

Arrange with your supervisor to participate in the following:

• Clinics
• Reading
• Ward rounds
• External visits
• Meetings