1. Malaria: Coming soon to an airport near you! Tropical Diseases in the Global Village

2. You too can get tropical diseases without leaving the comfort of your own home.

3. What accounts for the geographic restriction of some diseases? How do diseases move into new areas? Are tropical diseases really diseases of economic underdevelopment?

5. Malaria has been with us for a long time now 10,000 BC mummiesDNA evidence The A- African variant of G-6-PD may date as far back as 11,760 years ago

6. When did malaria come to the New World? with Columbus or the slave trade –no documented blood polymorphisms associated with malaria resistance in the Amerindians, so malaria is recent –Ravenels extinction hypothesis: eradication of the original natives of the Caribbean islands and coastal plain was caused by malaria

7. Did malaria arrive twice? P. simium in New World monkeys looks like Asian P. vivax New World P. vivax is distinct from both –DNA –vector specificity

8. Conclusion: malaria entered the New World twice –once > stable transmission in monkeys –once > stable transmission in man

9. How is transmission established? mosquito man bite first host bite second host

13. Factors that influence transmission mosquito man bite first host bite second host susceptible vector species

14. Factors that influence transmission mosquito man bite first host bite second host vector longevity

15. Factors that influence transmission mosquito man bite first host bite second host biting preferences

17. Factors that influence transmission mosquito man bite first host bite second host infected reservoir

18. Factors that influence transmission mosquito man bite first host bite second host available to vector

22. Colonial America malaria was well established in Connecticut by 1650 Charleston, SC, was almost abandoned in 1680 because of the intensity of malaria transmission

23. Eradication in the north 1900: Staten Island, NY, one in five residents has malaria 1901: Port Authority gives $50,000 to Alvah Doty to drain the marshes 1908: Staten Island is malaria-free

24. Malaria and the New Deal ecological degradation of major river basins in the South –deforestation –erosion –uncontrolled floods 1933: 150,000 cases of malaria, 5,000 deaths annually in Tennessee R. basin

25. TVA: Power and Public Health 21 dams, 600,000 acres of lakes mosquito control teams –periodically raise and lower water levels –speed water flow in canals –clear aquatic vegetation 1942: 50,000 malaria cases annually, 600 deaths

26. DDT 1943: widescale aerial application 1952: malaria eradicated 1962: Silent Spring

27. Will malaria return? reappearance of infected hosts –immigrants from endemic regions –returning military personnel transmission from a single marine to 35 campers in the California Sierras

28. Will malaria return? introduction of new efficient vectors –1930: Anopheles gambiae introduced into Brazil by a French naval vessel; epidemic malaria, 16,000 deaths –malaria vectors brought to Guam by military aircraft during WWII and Viet Nam war; outbreaks in 1966 and 1969

29. Airport Malaria: The case for disinsection between 1969 and 1999 –26 cases in France –17 cases in Belgium –14 cases in the UK –4 cases in Germany –4 cases in the US