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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

Malaria has infected humans for over 50,000 years, and may have been a human pathogen for the entire history of our species.[1] Indeed, close relatives of the human malaria parasites remain common in chimpanzees, our closest relatives.[2] References to the unique periodic fevers of malaria are found throughout recorded history, beginning in 2700 BC in China.[3] The term malaria originates from medieval Italian: mala aria — "bad air"; and the disease was formerly called ague or marsh fever due to its association with swamps.

Historical Perspective

Scientific studies on malaria made their first significant advance in 1880, when a French army doctor working in Algeria named Charles Louis Alphonse Laveran observed parasites inside the red blood cells of people suffering from malaria. He therefore proposed that malaria was caused by this protozoan, the first time protozoa were identified as causing disease.[4] For this and later discoveries, he was awarded the 1907 Nobel Prize for Physiology or Medicine. The protozoan was called Plasmodium by the Italian scientists Ettore Marchiafava and Angelo Celli.[5] A year later, Carlos Finlay, a Cuban doctor treating patients with yellow fever in Havana, first suggested that mosquitoes were transmitting disease to and from humans. However, it was Britain's Sir Ronald Ross working in India who finally proved in 1898 that malaria is transmitted by mosquitoes. He did this by showing that certain mosquito species transmit malaria to birds and isolating malaria parasites from the salivary glands of mosquitoes that had fed on infected birds.[6] For this work Ross received the 1902 Nobel Prize in Medicine. After resigning from the Indian Medical Service, Ross worked at the newly-established Liverpool School of Tropical Medicine and directed malaria-control efforts in Egypt, Panama, Greece and Mauritius.[7] The findings of Finlay and Ross were later confirmed by a medical board headed by Walter Reed in 1900, and its recommendations implemented by William C. Gorgas in the health measures undertaken during construction of the Panama Canal. This public-health work saved the lives of thousands of workers and helped develop the methods used in future public-health campaigns against this disease.

The first effective treatment for malaria was the bark of cinchona tree, which contains quinine. This tree grows on the slopes of the Andes, mainly in Peru. This natural product was used by the inhabitants of Peru to control malaria, and the Jesuits introduced this practice to Europe during the 1640s where it was rapidly accepted.[8] However, it was not until 1820 that the active ingredient quinine was extracted from the bark, isolated and named by the French chemists Pierre Joseph Pelletier and Jean Bienaime Caventou.[9]

In the early twentieth century, before antibiotics, patients with syphilis were intentionally infected with malaria to create a fever, following the work of Julius Wagner-Jauregg. By accurately controlling the fever with quinine, the effects of both syphilis and malaria could be minimized. Although some patients died from malaria, this was preferable than the almost-certain death from syphilis.[10]

Although the blood stage and mosquito stages of the malaria life cycle were established in the 19th and early 20th centuries, it was not until the 1980s that the latent liver form of the parasite was observed.[11][12] The discovery of this latent form of the parasite finally explained why people could appear to be cured of malaria but still relapse years after the parasite had disappeared from their bloodstreams.

In February 2002, the journal Science and other press outlets[13] announced progress on a new treatment for infected individuals. A team of French and South African researchers had identified a new drug they were calling "G25".[14] It cured malaria in test primates by blocking the ability of the parasite to copy itself within the red blood cells of its victims. In 2005 the same team of researchers published their research on achieving an oral form, which they refer to as "TE3" or "te3".[15] As of early 2006, there is no information in the mainstream press as to when this family of drugs will become commercially available.

In 1996, Professor Geoff McFadden stumbled upon the work of British biologist Ian Wilson, who had discovered that the plasmodia responsible for causing malaria retained parts of chloroplasts[16], an organelle usually found in plants, complete with their own functioning genomes. This led Professor McFadden to the realisation that any number of herbicides may in fact be successful in the fight against malaria, and so he set about trialing large numbers of them, and enjoyed a 75% success rate.

These "apicoplasts" are thought to have originated through the endosymbiosis of algae[17] and play a crucial role in fatty acid bio-synthesis in plasmodia[18]. To date, 466 proteins have been found to be produced by apicoplasts[19] and these are now being looked at as possible targets for novel anti-malarial drugs.

Malaria in the United States

  • Malaria was eliminated from the United States in the early 1950's.[20]
  • Between 1957 and 2011, in the United States, 63 outbreaks of locally transmitted mosquito-borne malaria have occurred; in such outbreaks, local mosquitoes become infected by biting persons carrying malaria parasites (acquired in endemic areas) and then transmit malaria to local residents.[20]
  • During 1963-2011, 97 cases of transfusion-transmitted malaria were reported in the United States; approximately two thirds of these cases could have been prevented if the implicated donors had been deferred according to established guidelines.[20]

References

  1. Joy D, Feng X, Mu J; et al. (2003). "Early origin and recent expansion of Plasmodium falciparum". Science. 300 (5617): 318–21. PMID 12690197.
  2. Escalante A, Freeland D, Collins W, Lal A (1998). "The evolution of primate malaria parasites based on the gene encoding cytochrome b from the linear mitochondrial genome". Proc Natl Acad Sci U S A. 95 (14): 8124–9. PMID 9653151.
  3. Cox F (2002). "History of human parasitology". Clin Microbiol Rev. 15 (4): 595–612. PMID 12364371.
  4. "Biography of Alphonse Laveran". The Nobel Foundation. Retrieved 2007-06-15. ] Nobel foundation. Accessed 25 Oct 2006
  5. "Ettore Marchiafava". Retrieved 2007-06-15.
  6. "Biography of Ronald Ross". The Nobel Foundation. Retrieved 2007-06-15.
  7. "Ross and the Discovery that Mosquitoes Transmit Malaria Parasites". CDC Malaria website. Retrieved 2007-06-15.
  8. Kaufman T, Rúveda E (2005). "The quest for quinine: those who won the battles and those who won the war". Angew Chem Int Ed Engl. 44 (6): 854–85. PMID 15669029.
  9. Kyle R, Shampe M (1974). "Discoverers of quinine". JAMA. 229 (4): 462. PMID 4600403.
  10. Raju T (2006). "Hot brains: manipulating body heat to save the brain". Pediatrics. 117 (2): e320–1. PMID 16452338.
  11. Krotoski W, Collins W, Bray R; et al. (1982). "Demonstration of hypnozoites in sporozoite-transmitted Plasmodium vivax infection". Am J Trop Med Hyg. 31 (6): 1291–3. PMID 6816080.
  12. Meis J, Verhave J, Jap P, Sinden R, Meuwissen J (1983). "Malaria parasites--discovery of the early liver form". Nature. 302 (5907): 424–6. PMID 6339945.
  13. Malaria drug offers new hope. BBC News 2002-02-15.
  14. One step closer to conquering malaria
  15. Salom-Roig, X. et al. (2005) Dual molecules as new antimalarials. Combinatorial Chemistry & High Throughput Screening 8:49-62.
  16. "Herbicides as a treatment for malaria". Retrieved 2007-09-25.
  17. Khöler, Sabine (1997). "A Plastid of Probable Green Algal Origin in Apicomplexan Parasites". Science. 275 (5305): 1485–1489. Unknown parameter |month= ignored (help)
  18. Gardner, Malcom (1998). "Chromosome 2 Sequence of the Human Malaria Parasite Plasmodium falciparum". Science. 282 (5391): 1126–1132. Unknown parameter |month= ignored (help)
  19. Foth, Bernado (2003). "Dissecting Apicoplast Targeting in the Malaria Parasite Plasmodium falciparum". Science. 299 (5607): 705–708. Unknown parameter |month= ignored (help)
  20. 20.0 20.1 20.2 Malaria Facts. CDC.gov accessed on 07/24/2014 [1]


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