1. Malaria: The Ancient Deadly Disease By: Allen Bowman & Sandra Fridlund

2. What is Malaria? Infection spread by the Anapheles mosquito Infection spread by the Anapheles mosquito Mosquito bite causes parasite to get into your blood stream Mosquito bite causes parasite to get into your blood stream Parasite lays eggs in blood stream Parasite lays eggs in blood stream 4 known species: 4 known species: Plasmodium falciparum (most deadliest) Plasmodium falciparum (most deadliest) P. Vivex P. Vivex P. Ovale P. Ovale P. Malariae P. Malariae

3. Where is Malaria? At least 90 countries in Africa, Asia, the Caribbean, and Central and South America are considered malarious At least 90 countries in Africa, Asia, the Caribbean, and Central and South America are considered malarious Leading cause of death worldwide Leading cause of death worldwide 300-500 million people infected each year 300-500 million people infected each year 2 million die each year 2 million die each year

4. History – 2700 BCE – 340 CE China China –Nei Ching – medical writings –Anti fever properties of Quinhao known as artemisinin Greece Greece –4 th century BC – recognized a decrease in population due to a disease. –Pericles era(495-429) – sanskrit medical writings of insect bites causing death. Rome Rome –Malaria disease in swamps

5. History: Early 17 th Century Spanish learned of medical bark from Quinquina calisaya Spanish learned of medical bark from Quinquina calisaya

6. Discoveries 1800: Discovery of the Malaria Parasite by Charles Louis Alphonse Laveran 1800: Discovery of the Malaria Parasite by Charles Louis Alphonse Laveran –Noticed parasites in blood –Species name: Oscillaria malariae Differential species Differential species –Camillo Golgi Tertian periodicity (fever every other day) Tertian periodicity (fever every other day) Quartan periodicity (fever every 3 rd day) Quartan periodicity (fever every 3 rd day)

7. Malaria Naming Quivanni Batista Grassi and Raimondo Filetti (1890): Plasmodium vivax and P. malariae Quivanni Batista Grassi and Raimondo Filetti (1890): Plasmodium vivax and P. malariae William Welch (1897): William Welch (1897): –P. falciparium (tertian malaria parasite) –Took over Laverans name of Oscillaria malaria

8. Malaria Naming John William Watson Stephens (1922): 4 th human malaria parasite (P. ovale) John William Watson Stephens (1922): 4 th human malaria parasite (P. ovale)

9. Malaria Control 1942 – 1945: Southern United States had problematic areas 1942 – 1945: Southern United States had problematic areas 1946 – present: CDC focused on prevention, surveillance and technical support internationally 1946 – present: CDC focused on prevention, surveillance and technical support internationally 1950’s: US was eradicated from malaria 1950’s: US was eradicated from malaria

10. Malaria Control 1955 – 1978: Eradication in temperate climate areas – India and Sir Lanka 1955 – 1978: Eradication in temperate climate areas – India and Sir Lanka Huge increase of eradication in these areas, but fell quickly with major infections of malaria Huge increase of eradication in these areas, but fell quickly with major infections of malaria Negligible progress in Indonesia, Afghanistan, Haiti, and Nicaragua Negligible progress in Indonesia, Afghanistan, Haiti, and Nicaragua Excluded efforts from sub Saharan Africa Excluded efforts from sub Saharan Africa

11. Prevention Protection from malaria: Protection from malaria: –Keep from getting mosquito bites –Sleep in a room with screens –Use insect repellent that contains no more than 35% of deet –Wear long sleeves and light colored clothes –Do not go outside after sunset

12. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –Cloroquine: 4-aminoquinoline that inhibits the heme polymerase and prevents the coversion of heme

13. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –Mefloquine (standard): derived of methanal

14. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –Proguanil (aka chloroguanide hydrochloride): manufactured in Great Britian and unavailable in the U.S.

15. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –Doxycycline: attacks the preerythrocytic phase which occurs in the liver and the erythrocytic phase of the Plasmodium life cycle through ribosomal inhibition

16. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –Primaquine: reserved for people who travel for extensive periods of time –Before primaquine therapy is initiated, the possibility of glucose-6-phosphate dehydrogenase defidiciency must be excluded

17. Medications Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home Known as Prophylactics, must be taken weeks before leaving to a malaria infested country and weeks after returning home –If present, this deficiency can result in severe hemolytic anemia in persons taking Primaquine

18. Malaria Symptoms Fever Fever Headache and Muscle pain Headache and Muscle pain Fatigue Fatigue Chills Chills Sweats Sweats Nausea and Vomiting Nausea and Vomiting Dry cough Dry cough

19. Malaria Symptoms Severity depends on individual’s health and immune system AND the infecting parasite Severity depends on individual’s health and immune system AND the infecting parasite Incubation Range for symptoms to show: Incubation Range for symptoms to show: –Plasmodium falciparum: 7 to 14 days –P. vivax: 8 to 18 days –P. ovale: 8 to 18 days –P. malariae: 7 to 40 days

20. Malaria Symptoms http://www.cdfound.to.it/hTML/pf24.h tm http://www.cdfound.to.it/hTML/pf24.h tm http://www.cdfound.to.it/hTML/pf24.h tm http://www.cdfound.to.it/hTML/pf24.h tm

21. Malaria Life Cycle

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

23. Diagnostic Tests for Malaria Blood smear Blood smear –Number and shape of blood cells –Checks morphology of RBCs DNA probe DNA probe Immunoassay Immunoassay

24. Malaria: The Ancient Deadly Disease