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Brandon Garcia Professor Mrs. Di Laudo Science 28 October 2011 Malaria Malaria is an intense flu-like parasitic disease that can be fatal. Everyone is vulnerable to become infected with malaria; however the parasite that causes malaria is mainly found in areas with tropical and subtropical climate. The WHO (World Health Organization) currently classifies malaria as an endemic (constantly occurring) disease in over 100 countries around the world; countries which are annually visited by more than 125 million tourists. Malaria generates a major disease hazard for tourists, as it malaria is the most common imported disease, and can easily be transmitted to other people who never travelled. The WHO also reports that many tourists become infected with malaria each year while visiting the over 100 countries where the disease is endemic, and well over 10 000 tourists will get infected after returning home. An estimate conducted by the CDC (Centres for Disease Control and Prevention) states that there are 300-500 million cases of malaria annually, more than 1 million people die from it. Malaria is caused by one of five species of parasite of the genus Plasmodium: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowles. The Plasmodium parasites single celled animals that have the ability to shift shapes, changing their chemistry to invade cells, escape the defence system (white blood cells), and build resistance to drugs. Infections with Plasmodium falciparum are superior menace as it is more fatal than the other species. Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae are milder in intensity and are not fatal, however they can remain

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unnoticed in the liver for many months, which delays symptoms or causes relapses of malaria infection. Plasmodium knowles is the latest species that once inside a human; it multiplies at a faster rate than any of the 4 other Plasmodium species. Plasmodium knowles was originally a monkey parasite; however this parasite has jumped species barrier from monkeys to humans. On the positive side, Plasmodium knowles is only found in Southeast Asia mainly Malaysia. Malaria is caused when Plasmodium parasites are injected from salivary glands of an infected mosquito (mainly the female Anopheles) to a human as the infected mosquito is feeding on the blood of the human. Once the Plasmodium parasites have entered into the circulatory system (into the blood), the parasites make their way to the liver where they home in (invade the cell and feeds on the proteins the cell produces). In a span of about six days that one parasite replicates itself over 20 000 times forcing the liver cell to expand, and the cell eventually ruptures and the parasites enter back into the circulatory system where they face a battle with the outnumbered white blood cells (part of the immune system). In order to protect themselves, the parasites hide inside (invade) red blood cells and feed of proteins that the red blood cells produce (mainly haemoglobin), and multiply. The invasion of parasites in the red blood cells kills the red blood cell which eventually burst. When millions of red blood cells rupture, they release parasites and this kicks the immune system (white blood cells) to over drive, causing high fevers. If an infected human is bit by a mosquito, the mosquito will suck infested red blood cells into gut, then the parasites will make their way to the mosquitos salivary glands and the cycle continues. In a mosquitos life span, it will bite as much as ten people, and inject the parasites into their systems. This is why malaria is common around the world.

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Malaria can also be transmitted by transfusion with injected blood, however it is rare. This occurs when needles are shared, organ donation, or from a mother to her unborn baby (congenitally). The complications caused by this parasite vary on the specie. The most common complications (affects) of this parasite to the human body are: destruction of red blood cells (causing haemolytic anemia) and liver cells, kidney failure, meningitis, respiratory failure as a result of fluid in lungs (pulmonary edema), brain infection (cerebritis), enlargement of the spleen (can lead to the rupture of the spleen leading to massive internal bleeding; hemorrhage), and lodging of vessels (as a result of fragile, infected red blood cells) which can cause damage to the surrounding organ. Of the five species Plasmodium falciparum leads to the most severe complications listed, complications that can lead to death. Malaria-caused deaths are preventable, and most cases are curable when detected early. Malaria can be suspected with the common symptoms that the parasite causes after a mosquito bite. Symptoms include fever and flu-like symptoms (such as headaches, nausea, vomiting, muscle pain and malaise), rigors (severe shakes or muscle spasms) and chills, infection (causing the enlargement of spleen and make the liver tender), anaemia, bloody stools, coma, convulsion, jaundice, severe sweating, and in some extreme cases personality changes, confusion, lethargy, and seizures. The first symptoms have a tendency of occurring ten days to four weeks after infection; however they can appear as early as eight days after infection or as late as a year after infection. The symptoms usually occur in intervals of 48-72 hours. During an examination, a doctor may suspect malaria is he finds an enlarged liver or spleen, and if the patient has experienced the symptoms that malaria causes. However, since the symptoms of malaria arent specific an accurate diagnosis is not possible without a blood test .A

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complete blood count is also conducted to identify whether or not anaemia is present. If diagnosed early and treated properly, malaria can be completely cured. However, even short delays in the diagnosis can make elevate the difficulty of the treatment and reduce the probability of cure since as time passes the disease becomes more and more dangerous. Treatment for malaria also varies on the type of specie that the Plasmodium parasite is. The treatment also depends on factors such as severity of infection, the age of the infected person, and the pattern in which the parasite tends to acts in the area where the infection was obtained (as in some areas of the world the parasites have become immune to certain antibiotics). Chloroquine is the most utilized anti-malaria medication; however in some areas the malaria parasite has generated immunity for this medication and obligates alternative methods. The alternative methods include: a combination of quinidine or quinine pus doxycycline, tetracycline, or clindamycin, atovaquone plus proguanil (Malarone), mefloquine or artesunate, or a comibation of pyrimethamine and sulfadoxine (Fansidar). Again the treatment (medications) used are determined by location of where the disease was obtained. Despite the trajectory and reputation of malaria, there is no vaccine available. Malaria can be prevented however with the avoidance of mosquito bites usually incorporate the usage of insecticides. Unfortunately in some areas mosquitoes have become immune to pesticides. To combat this unfortunate fact, effective anti-malarial medications have been found decreasing the risk of people becoming infected. However, these medication do not 100% ensure protection against the disease. These medications include mefloquine, doxycycline, hydroxychloriquine, and Malarone. A positive outcome is expected in the infections caused by the three well-known and milder species of the Plasmodium parasite: Plasmodium vivax, Plasmodium ovale, and

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Plasmodium malariae, as long as the parasites do not become immune to all medications. The prognosis for Plasmodium falciparum does not look bright as it is the most dangerous specie of the parasite. The severe complications that this specie generates in a short period, and the fact that parasite is becoming immune to medications makes it hard to envision a positive future for this specie. The other species that is difficult to envision a positive future is the latest discovered specie (the Plasmodium knowles specie), which is new and is hard to predict the future of this specie as further research must be conducted.

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References WHO | Malaria." Who.int. World Health Organization, Oct. 2011. Web. 28 Oct. 2011. <http://www.who.int/mediacentre/factsheets/fs094/en/>. "Malaria - Care Guide." Drugs.com | Prescription Drug Information, Interactions & Side Effects. Thomson Reuters. Web. 29 Oct. 2011. <http://www.drugs.com/cg/malaria.html>. "WHO | Malaria." WHO.cm. World Health Organization. Web. 28 Oct. 2011. <http://www.who.int/topics/malaria/en/>. "Malaria - PubMed Health." Ncbi.nlm.nih.gov/pubmedhealth/. U.S. National Library of Medicine - The World's Largest Medical Library. Web. 29 Oct. 2011. <http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001646/>. "Malaria." Kidshealth.org/. KidsHealth - the Web's Most Visited Site about Children's Health. Web. 30 Oct. 2011. <http://kidshealth.org/parent/infections/parasitic/malaria.html#>. "Frequently Asked Questions - Malaria - Public Health Agency of Canada." Phac-aspc.gc.ca/. Public Health Agency of Canada (PHAC) | Agence De La Sante Publique Du Canada (ASPC), 25 Nov. 2004. Web. 30 Oct. 2011. <http://www.phac-aspc.gc.ca/media/advisories_avis/mal_faqeng.php>. "CDC - Malaria." Cdc.gov/. Centers for Disease Control and Prevention, 26 Oct. 2011. Web. 29 Oct. 2011. <http://www.cdc.gov/MALARIA/>. "Malaria Foundation International." Malaria.org/. Malaria Foundation International. Web. 30 Oct. 2011. <http://www.malaria.org/index.php?option=com_content>. "Cerebral Malaria." Brown.edu/. Brown University. Web. 30 Oct. 2011. <http://www.brown.edu/Courses/Bio_160/Projects1999/malaria/cermal.html>.