SAN JOSE, California – Though preventable and curable, malaria is a potentially fatal disease that kills upwards of 600,000 people a year. The mosquito-borne disease was eliminated from the U.S. in the 1950s; however, malaria still poses a great threat in over 100 countries and to half the world’s population. According to the World Health Organization, malaria cases totaled over 200 million in 2012 alone. Telling of the poor medical infrastructure, an approximate 91 percent of malaria deaths happen in Africa.
Malaria symptoms manifest in a wide range of ways. One individual infected with malaria may exhibit almost no symptoms, while another may suffer an agonizing course of symptoms before dying. Blood parasites are responsible for all symptoms of malaria, when bitten by an infected mosquito, a patient may experience an incubation period lasting anywhere from a week to a month before symptoms appear.
In a case of uncomplicated malaria, a patient in a typically malaria-free country might mistake symptoms as being a case of the cold or flu. An infected person will experience several malaria attacks, lasting six to ten hours, which include a cold stage, a hot stage and a final sweating stage. The cold stage causes shivering and the sensation of being cold. The hot stage comprises headaches, vomiting, fever and seizures in young children. The last sweating stage consists of fatigue, sweats and a return to normal body temperature.
Physically, symptoms of mild jaundice, enlarged liver, enlarged spleen, elevated temperatures, increased respiratory rate, perspiration and weakness characterize cases of uncomplicated malaria. Mild anemia and mild decrease in blood platelets may also affect patients.
Infections with serious failure of organs or blood and metabolism abnormalities most often advance into cases of severe malaria. These cases are complicated by life-threatening symptoms, including severe anemia due to destruction of red blood cells, hemoglobin in the urine, acute kidney failure, cerebral malaria, acute respiratory distress syndrome (ARDS), low blood pressure from cardiovascular collapse, low blood glucose and excessive acidity in the blood and tissue fluids.
Cerebral malaria induces seizures, coma, impairment of consciousness and other neurologic abnormalities. Hyperparasitemia, where malaria parasites infect more than five percent of red blood cells, may also occur. With ARDS, oxygen-inhibiting lung inflammation may persist even after treatment decreases the parasite counts.
To reduce transmission and ultimately prevent deaths, early diagnosis and treatment are crucial. Currently, artemisinin-based combination therapy (ACT) is the best available treatment.
Unfortunately, resistance to antimalarial medicines is increasing. In the 1970s and 1980s, parasites became widely resistant to previously used medicines such as chloroquine and sulfadoxine-pyrimethamine. This was a huge blow to malaria control efforts and progress in child survival rates. Recently, ACT’s effectiveness has been threatened by increasing parasite resistance, particularly in the regions of Myanmar, Thailand, Vietnam and Cambodia.
When the resistance to artemisinins spreads geographically, the public health consequences will be disastrous – for at least five years, the world will lack an alternative antimalarial medicine. Additionally, there aren’t any licensed anti-malaria vaccines.
– Annie Jung