malaria: the ancient deadly disease by: allen bowman & sandra fridlund

Malaria: The Ancient Malaria: The Ancient Deadly DiseaseDeadly Disease

By: Allen BowmanBy: Allen Bowman

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Sandra FridlundSandra Fridlund

What is Malaria?What is Malaria?

Infection spread by the Infection spread by the AnaphelesAnapheles mosquitomosquito

Mosquito bite causes parasite to get into Mosquito bite causes parasite to get into your blood streamyour blood stream

Parasite lays eggs in blood streamParasite lays eggs in blood stream 4 known species: 4 known species:

Plasmodium falciparumPlasmodium falciparum (most deadliest) (most deadliest) P. VivexP. Vivex P. OvaleP. Ovale P. MalariaeP. Malariae

Where is Malaria?Where is Malaria?

At least 90 countries in Africa, At least 90 countries in Africa, Asia, the Caribbean, and Central Asia, the Caribbean, and Central and South America are considered and South America are considered malariousmalarious

Leading cause of death worldwideLeading cause of death worldwide 300-500 million people infected 300-500 million people infected

each yeareach year 2 million die each year2 million die each year

History – 2700 BCE – History – 2700 BCE – 340 CE340 CE ChinaChina

– Nei Ching – medical writingsNei Ching – medical writings– Anti fever properties of Quinhao known as Anti fever properties of Quinhao known as

artemisininartemisinin GreeceGreece

– 44thth century BC – recognized a decrease in century BC – recognized a decrease in population due to a disease.population due to a disease.

– Pericles era(495-429) – sanskrit medical writings of Pericles era(495-429) – sanskrit medical writings of insect bites causing death.insect bites causing death.

RomeRome– Malaria disease in swampsMalaria disease in swamps

History: Early 17History: Early 17thth CenturyCentury Spanish learned of medical bark Spanish learned of medical bark

from Quinquina calisayafrom Quinquina calisaya

DiscoveriesDiscoveries

1800: Discovery of the Malaria 1800: Discovery of the Malaria Parasite by Charles Louis Alphonse Parasite by Charles Louis Alphonse LaveranLaveran– Noticed parasites in bloodNoticed parasites in blood– Species name: Oscillaria malariaeSpecies name: Oscillaria malariae

Differential speciesDifferential species– Camillo GolgiCamillo Golgi

Tertian periodicity (fever every other day)Tertian periodicity (fever every other day) Quartan periodicity (fever every 3Quartan periodicity (fever every 3rdrd day) day)

Malaria NamingMalaria Naming

Quivanni Batista Grassi and Quivanni Batista Grassi and Raimondo Filetti (1890): Raimondo Filetti (1890): Plasmodium vivaxPlasmodium vivax and and P. malariaeP. malariae

William Welch (1897): William Welch (1897): – P. falcipariumP. falciparium (tertian malaria (tertian malaria

parasite)parasite)– Took over Laverans name of Took over Laverans name of

Oscillaria malaria Oscillaria malaria

Malaria NamingMalaria Naming

John William Watson Stephens John William Watson Stephens (1922): 4(1922): 4thth human malaria human malaria parasite (parasite (P. ovaleP. ovale))

Malaria ControlMalaria Control

1942 – 1945: Southern United 1942 – 1945: Southern United States had problematic areasStates had problematic areas

1946 – present: CDC focused on 1946 – present: CDC focused on prevention, surveillance and prevention, surveillance and technical support internationallytechnical support internationally

1950’s: US was eradicated from 1950’s: US was eradicated from malariamalaria

Malaria ControlMalaria Control

1955 – 1978: Eradication in temperate 1955 – 1978: Eradication in temperate climate areas – India and Sir Lankaclimate areas – India and Sir Lanka

Huge increase of eradication in these Huge increase of eradication in these areas, but fell quickly with major areas, but fell quickly with major infections of malariainfections of malaria

Negligible progress in Indonesia, Negligible progress in Indonesia, Afghanistan, Haiti, and NicaraguaAfghanistan, Haiti, and Nicaragua

Excluded efforts from sub Saharan Excluded efforts from sub Saharan AfricaAfrica

PreventionPrevention

Protection from malaria:Protection from malaria:– Keep from getting mosquito bitesKeep from getting mosquito bites– Sleep in a room with screensSleep in a room with screens– Use insect repellent that contains no Use insect repellent that contains no

more than 35% of deetmore than 35% of deet– Wear long sleeves and light colored Wear long sleeves and light colored

clothesclothes– Do not go outside after sunsetDo not go outside after sunset

MedicationsMedications

Known as Prophylactics, must be Known as Prophylactics, must be taken weeks before leaving to a taken weeks before leaving to a malaria infested country and malaria infested country and weeks after returning homeweeks after returning home

– Cloroquine: 4-aminoquinoline that Cloroquine: 4-aminoquinoline that inhibits the heme polymerase and inhibits the heme polymerase and prevents the coversion of hemeprevents the coversion of heme

MedicationsMedications

Known as Prophylactics, must be Known as Prophylactics, must be taken weeks before leaving to a taken weeks before leaving to a malaria infested country and malaria infested country and weeks after returning homeweeks after returning home

– Mefloquine (standard): derived of Mefloquine (standard): derived of methanal methanal

MedicationsMedications

Known as Prophylactics, must be Known as Prophylactics, must be taken weeks before leaving to a taken weeks before leaving to a malaria infested country and weeks malaria infested country and weeks after returning homeafter returning home

– Proguanil (aka chloroguanide Proguanil (aka chloroguanide hydrochloride): manufactured in Great hydrochloride): manufactured in Great Britian and unavailable in the U.S.Britian and unavailable in the U.S.

MedicationsMedications

Known as Prophylactics, must be Known as Prophylactics, must be taken weeks before leaving to a taken weeks before leaving to a malaria infested country and weeks malaria infested country and weeks after returning homeafter returning home

– Doxycycline: attacks the preerythrocytic Doxycycline: attacks the preerythrocytic phase which occurs in the liver and the phase which occurs in the liver and the erythrocytic phase of the Plasmodium erythrocytic phase of the Plasmodium life cycle through ribosomal inhibitionlife cycle through ribosomal inhibition

MedicationsMedications

Known as Prophylactics, must be taken Known as Prophylactics, must be taken weeks before leaving to a malaria weeks before leaving to a malaria infested country and weeks after infested country and weeks after returning homereturning home

– Primaquine: reserved for people who travel Primaquine: reserved for people who travel for extensive periods of timefor extensive periods of time

– Before primaquine therapy is initiated, the Before primaquine therapy is initiated, the possibility of glucose-6-phosphate possibility of glucose-6-phosphate dehydrogenase defidiciency must be dehydrogenase defidiciency must be excludedexcluded

MedicationsMedications

Known as Prophylactics, must be Known as Prophylactics, must be taken weeks before leaving to a taken weeks before leaving to a malaria infested country and malaria infested country and weeks after returning homeweeks after returning home

– If present, this deficiency can result If present, this deficiency can result in severe hemolytic anemia in in severe hemolytic anemia in persons taking Primaquinepersons taking Primaquine

Malaria SymptomsMalaria Symptoms

FeverFever Headache and Muscle painHeadache and Muscle pain FatigueFatigue ChillsChills SweatsSweats Nausea and VomitingNausea and Vomiting Dry coughDry cough

Malaria SymptomsMalaria Symptoms

Severity depends on individual’s Severity depends on individual’s health and immune system AND the health and immune system AND the infecting parasiteinfecting parasite

Incubation Range for symptoms to Incubation Range for symptoms to show:show:– Plasmodium falciparumPlasmodium falciparum: 7 to 14 days: 7 to 14 days– P. vivaxP. vivax: 8 to 18 days: 8 to 18 days– P. ovaleP. ovale: 8 to 18 days: 8 to 18 days– P. malariaeP. malariae: 7 to 40 days: 7 to 40 days

Malaria SymptomsMalaria Symptoms

http://www.cdfound.to.it/hTML/pf2http://www.cdfound.to.it/hTML/pf24.htm4.htm

Malaria Life CycleMalaria Life Cycle

Malaria Life CycleMalaria Life Cycle

http://www-ermm.cbcu.cam.ac.ukhttp://www-ermm.cbcu.cam.ac.uk/dcn/swf001dcn.htm/dcn/swf001dcn.htm

Diagnostic Tests for Diagnostic Tests for MalariaMalaria Blood smearBlood smear

– Number and shape of blood cellsNumber and shape of blood cells– Checks morphology of RBCsChecks morphology of RBCs

DNA probeDNA probe ImmunoassayImmunoassay

Malaria: The Ancient Malaria: The Ancient Deadly DiseaseDeadly Disease