Dr. Jessica Pelletier and Dr. Tracy Walczynski discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of trachoma.

Take-Home Points:

• Trachoma is the most common infectious cause of blindness worldwide
• Chlamydia trachomatis is spread via direct contact, and its spread is propagated in resource-limited settings where there is poor access to good sanitation and personal hygiene
• This is a chronic condition involving cycles of infection and scarring that eventually lead to blindness
• SAFE - Surgery, Antibiotics, Facial cleanliness, and Environmental improvement - are the cornerstones of management

You can view the full show notes and references here: https://docs.google.com/document/d/1vYMyw76A9oRW-hZtCmqgH_SYEghtWY7GxGKqjCzqHvo/edit?usp=sharing

Episode art attribution: image generated using Adobe Firefly

Episode sound attribution:

• HUGE EXPLOSION by SamsterBirdies -- https://freesound.org/s/733120/ -- License: Creative Commons 0
• huge explosion in distance.wav by SuperPhat -- https://freesound.org/s/417691/ -- License: Creative Commons 0
• Realistic Gun-Fire by Mr_KeybOred -- https://freesound.org/s/414023/ -- License: Creative Commons 0
• Atomic Bomb by Hard3eat -- https://freesound.org/s/379352/ -- License: Creative Commons 0
• Huge Explosion by unfa -- https://freesound.org/s/259300/ -- License: Creative Commons 0
• 240615-12_Applause_indoor by kevp888 -- https://freesound.org/s/762606/ -- License: Attribution 4.0

Dr. Jessica Pelletier and Dr. Kamoga Dickson discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of cholera.

Take-Home Points:

• Cholera is a disease with high morbidity that disproportionately affects sub-Saharan Africa
• The O1 and O139 serogroups of V. cholera make cholera toxin and cause the disease
• Colonization happens in the small intestine, so higher volumes of bacteria that make it to the small intestine are more likely to cause disease
• The classic presentation involves rice water stools and dehydration, but vomiting is also possible
• Patients with mild to moderate dehydration should receive oral rehydration, and those with severe dehydration should receive balanced IV fluids (where available)
• Severe cases need antibiotics based on local guidelines
• Prevention involves sanitation measures and vaccination

You can view the full show notes and references here: https://docs.google.com/document/d/1HCMld8vCdiPMRSAdSeWu2VWZFBhEF15Nvrsa_ov9YuA/edit?usp=sharing

Episode art attribution: image generated using Adobe Firefly

Episode sound attribution:

• Eating.m4a by smellyrat -- https://freesound.org/s/702179/ -- License: Creative Commons 0
• Poop fall 3 by frenkfurth -- https://freesound.org/s/776535/ -- License: Creative Commons 0
• Washing Hands.wav by allie_on_toast -- https://freesound.org/s/648346/ -- License: Creative Commons 0

Dr. Jessica Pelletier and Noah Kronk speak with Dr. Steve Liang and Dr. Gaston Omba about the diagnostic workup, management, and prevention of ebola virus disease (EVD).

Take-Home Points:

• Patients may present in either the dry or wet phases of disease and may progress to death or recovery
• Early recognition of possible EVD cases helps protect more people from becoming infected
• IPC measures are critical to break the cycle of infection and stop outbreaks
• Care in the ED is primarily supportive
• Patients with the Zaire strain of EVD OR neonates born to mothers who test positive are eligible to receive mAb114 or REGN-EB3, where available
• Individuals exposed to the Zaire strain of EVD should receive the Ervebo vaccine

You can view the full show notes and references here: https://docs.google.com/document/d/1193rLGFHzSXLY2rnUzUc5m0utFjAGCRVUPNG3oULKFw/edit?usp=sharing

Episode art attribution: image generated using Adobe Firefly

Dr. Jessica Pelletier and Noah Kronk speak with Dr. Gaston Omba, an emergency medicine resident physician with expertise in international cooperation, humanitarian aid, health management, and ebola epidemic response.

Take-Home Points:

• Ebola virus outbreaks typically occur in Sub-Saharan Africa
• The natural reservoir is thought to be bats, but this isn’t definitive
• Early detection of suspected Ebola cases is crucial to prevent viral spread
• Fever is the most common early symptom, and may be accompanied by headaches, myalgias, GI symptoms, or rash
  • Since these symptoms are non-specific, we need to take excellent travel and exposure histories
• Later symptoms include bleeding, shock, multiorgan failure, and death, which occur in the 2nd week of disease
• Transmission is via direct contact with infected patients or their body fluids
• Healthcare workers need to ensure strict use of PPE to prevent infection of themselves or other patients

You can view the full show notes and references here: https://docs.google.com/document/d/1193rLGFHzSXLY2rnUzUc5m0utFjAGCRVUPNG3oULKFw/edit?usp=sharing

Episode art attribution: By BernbaumJG - Own work, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=64106638

Audio clip attribution: water splash 5.wav by lwdickens -- https://freesound.org/s/269008/ -- License: Attribution NonCommercial 4.0

Dr. Jessica Pelletier and Noah Kronk speak with Dr. Stephen Liang, an emergency medicine physician and infectious disease expert, about the diagnosis and management of mpox in the ED setting.

Take-Home Points:

• Two clades:
  • Clade 1 (Central Africa): classic, more severe disease
  • Clade 2 (West Africa): subtle, non-classic presentations including genital/anal lesions and proctitis in the 2022 global outbreak
• Transmitted via exposure to body fluids, skin lesions, or respiratory secretions
• Incubation period: 5-14 days
• Lesions can mimic a wide range of diseases - keep a broad differential, including other sexually transmitted infections in the right context
• For most patients, care is supportive
• Those with or at high risk for severe disease should receive tecovirimat

You can view the full show notes and references here: https://docs.google.com/document/d/1CS5lo3HhvE_FiuDDgPPDkUnXHf49gydahGSWiGBlDFA/edit?usp=sharing

Episode art attribution: NIAID, CC BY 2.0 , via Wikimedia Commons

Dr. Jessica Pelletier speaks with Ambrose Ndabahwerize, a nurse working in Uganda, regarding his first-hand experience working with mpox patients in a resource-limited setting.

Take-Home Points:

• Most cases of mpox are non-severe
• Treatment of mpox is primarily supportive
• Community education, isolation of suspected cases, and proper PPE access are key for preventing the spread of disease

Episode art attribution: image generated using Adobe Firefly

In this special episode of ID4U, we move away from our focus on tropical medicine and instead discuss the non-profit Techies Without Borders (TWB). We learn the following:

• What does the TWB non-profit do?
• Why are the TWB volunteers passionate about their work?
• What is the Continuing Medical Education Solutions (CMES) initiative, and how does it work?
• How are donations used?

You can learn more about TWB here: https://techieswithoutborders.us/

You can learn more about CMES here: https://cmesworld.org/

If you are interested in donating to TWB to help our cause, visit this link: https://techieswithoutborders.us/#donate

Episode sound bite attributions:

• GONG2.aif by loofa -- https://freesound.org/s/23581/ -- License: Attribution NonCommercial 4.0
• JamesportWindChimes.wav by acclivity -- https://freesound.org/s/30606/ -- License: Attribution NonCommercial 4.0

Dr. Jessica Pelletier speaks with Dr. Emmanuel Effa, a nephrology expert, about tropical infections in chronic kidney disease (CKD) patients.

Take-Home Points:

• CKD and particularly end-stage kidney disease (ESKD) impose significant morbidity and mortality.
• Early recognition and management of CKD is critical to prevent progression to ESKD.
• Numerous tropical infections can increase the risk for AKI, CKD, and ESKD.
• Management typically involves treatment of the underlying infectious cause.

You can view the full show notes and references here: https://docs.google.com/document/d/1p1u-TU5-lrlLcunm_MxNd0fJHdpaHPHuin9j_dTRUgQ/edit?usp=sharing

Episode art attribution: image generated using Adobe Firefly