MALARIA: TINY, BIG EXPLOSION
Drums Of Destiny

By RAJGOPAL NIDAMBOOR

Think of the most improbable airliner of all, or those hateful “drum beats” in your ear. You gotcha the whole idea right -- a hazard you’d not even touch with a perch pole, as it were.

Now, to the basics. With her brittle body, spiky arsenal of wings, legs and antennae poking out in every possible direction, the hazardous mosquito is making fun of our scientific and technological progress.

This ain’t all. The dangerous mosquito, with her aggro image, is, indeed, the “femme fatale,” in more ways than one. She enacts a biting tale of paramount importance, with more than an element of computerised consistency. Her message is simple -- she needs blood to propagate her race.

As she scans her horizon for a possible target, her wings beat from 250-500 times a second. Rainfall cannot affect her movements; in fact, nothing can, except, of course, the latest repellent, or the more advanced spray… to an extent, up until she overcomes its medicinal potency with her indigenous craftiness.

Not only that. The female mosquito can switch off her incredible wing muscles in her midsection. She can enable them to relax and contract as quickly as you can draw her away from you. Interestingly, her sense of sudden attack or “blitzkrieg” is variable. If some of the 2,800 mosquito species, we now know of, bite only during daytime, others revel in their activity at dusk -- especially when it is quietly dark.

Because she cannot see in the dark, the night-biting mosquito uses sensors on her two antennae and three pairs of legs -- to find for herself a grand meal. She catches the scent of your exhaled carbon dioxide, and gets closer to determine whether you are “sport” to her culinary instincts. Smart creature that she is, a mosquito is often in the family way -- having mated already -- even before she has drawn her first blood snack.

Tiny, Big Time Bomb

The malicious insect sure has a volatile biology. One mosquito bite, for example, can inject up to 600 malaria sporozoites: each one of them yielding up to 30,000 “daughters.” While the males of all species -- and, females of several species -- survive primarily on the nectar of flowers and also play an important role in pollination, some prefer the bloodstream of elephants and even mice -- not just human beings alone. Wait a moment. A species, in Africa, for instance, preys only on ants, drawing from its mouth honey, not blood! Another species bites turtles through their shell -- yes, through the animal’s hard armour!

Though tiny, mosquitoes have destroyed civilisations. Science testifies that they may have contributed to the decline of ancient Greece and Rome.

Even today, the devastation of mosquito-borne diseases continues: mainly in the form of malaria, yellow and dengue fevers, and filariasis, otherwise called elephantiasis.

Today, the mosquito menace has rocked several regions of Asia, Africa and South America. Its treacherous effects, aside from that “small, high, hateful bugle” in your ear as D H Lawrence put it in purple prose, have returned to rattle the US too, with a vengeance.

Persistent Dilemma

Malaria [mal’aria = bad air] has been a relentless menace since olden times. In ancient Egypt, malaria occurred mainly in lowland areas. The testimony: enlarged spleen, the organ, which is the illness’s “refuge,” of some Egyptian mummies.

The disease has also claimed many illustrious victims, down the ages. To name a few: Alexander the Great, in June 323 BC; Pope Innocent III, in 1216; Dante Alighieri, the great poet, in 1321; Raphael Sanzio, the legendary artist, in 1520; and, Oliver Cromwell, in 1658, to name a few.

A complicated and deadly infection, malaria, in factual terms, is actually four diseases, caused by four related parasites, each having distinctive characteristics: Plasmodium falciparum, P vivax, P ovale, and P malariae.

The bite of a female mosquito of the genus anopheles transmits infection to people during the process.

The disease is obviously a big target of intense international efforts that employ some of the most advanced techniques available at the frontiers of modern science and medicine in an attempt to discover new weapons for fighting an old enemy. All the same, malaria still continues to claim over a million lives in the tropics alone -- on an annual basis.

Malarial patterns, in India, are manifold. And, although the government spends almost 25 per cent of its entire healthcare budget on malaria control, there has been no let-up in outbreaks of the disease. For several reasons -- most notably, the ineffectiveness of DDT and other insecticides, chloroquine’s losing battle with its potency, besides bad environmental hygiene.

After making significant progress against the parasite in the 1940s and 1950s, modern medicine seems to have also run out of ideas due to new resistant strains. No wonder why the disease is now felling victims in over 100 countries, most of them children. The African countries where 90 per cent of malarial deaths occur have been ravaged by hostilities, no less, making it all the more difficult to combat the disease. What’s more, developed nations, especially the US, that used to earlier fund most of the malaria research, are limiting and even cutting their budgets.

According to a report published by the Institute of Medicine [IoM], US, scientists still have a long way to go in deciphering malaria’s basic biology. For instance, it’s not known why some people living in malarial areas become violently ill, while others develop immunity to the disease. True, the IoM study had to go through a difficult path: of competing camps, basic researchers, clinicians and mosquito-control experts. In the end, the IoM panel did not single out any particular strategy for attention, but instead proposed one, which embraced them all. Here’s a short checklist of a couple of the specifics:

• Reorient massive screening programmes.
• Collect data, focused on high risk groups and potential epidemics on the basis of scientific merit, rigorous peer review, and co-ordination.

The IoM report is not without its critics. As one of its authors themselves explained: “There is too much emphasis in this study on malaria research, while little attention is given to malaria prevention and control.”

Malaria Protection: Basic Facts

Malaria is commonplace in many tropical and subtropical countries; it is also a serious and sometimes fatal disease. There is no vaccination available against malaria; however, you can protect yourself by avoidance of bites, because mosquitoes cause much inconvenience owing to local reactions to the bites themselves, and from the infections they transmit [Mosquitoes also spread yellow fever, dengue and Japanese-B encephalitis, besides malaria]. They can bite at any time of day; however, most bites occur in the evening.

• Avoid mosquito bites, especially after sunset. Best to wear long-sleeved clothing and long trousers at night.
• Mosquitoes often bite through thin clothing. You may spray/apply a repellent on your clothing, and, of course, on exposed skin.
• Repellents may be sprayed in the room, or you can burn coils [some researchers question its safety in the light of reports suggesting that coils and other newer products may be carcinogenic] and/or use heated insecticide-impregnated tablets to control mosquitoes.
• When you sleep in an unscreened room, or outdoors, the best thing is to use a mosquito net. There are easy-to-carry, lightweight nets available.
• Contrary to popular belief, garlic, vitamin B and ultrasound devices, do not prevent mosquito bites.

Medications

• If you intend to travel, you need to take anti-malarial tablets, which your doctor can prescribe, three weeks before departure
• You ought to take tablets regularly, preferably during, or after, a meal
• Physicians/therapists advise that you continue taking tablets for four weeks after you have returned. This is suggested to cover the incubation period of the disease. Some medications require short post-travel-return treatment -- of just about a week.
• There are also effective alternative medicines and herbs available to help you beat the malarial threat and complications. Speak to a complementary physician/therapist to know your options better.

Caveat

It is not that preventive measures offer one hundred per cent guarantee of protection. But, they are useful. However, if you are subject to malarial, or any other infectious, fever between one week after first exposure, and up to two years following your return, it is ideal to seek a physician’s/therapist's advise -- more so, if you had travelled to a malarious, or malaria-prone, area.

Preventing Malaria

Any preventive step, if it is to work, should interrupt the life-cycle of the parasite, especially at the egg-laying phase when stagnant water becomes essential to the mosquito. This is the most tricky part. One new method has worked well: the bio-environmental strategy, which employs fish, like guppy, to eat the mosquito larvae.

The idea has paid dividends in the mosquito density and malarious areas of UP, Gujarat and Pondicherry. Yet another [high-tech] methodology which has excited scientists is a polymeric vaccine developed by the Columbian biochemist, Manuel Patarroya, among a few new vaccines. Reports “Nature:” “The degree of protection is not dramatic, but it is the first time that such a [large] trial has been undertaken and, indeed, a certain degree of protection was achieved.” Certain degree isn’t full degree yet!

Researchers also expect new vaccines that are in use, or on the anvil, to be the touchstone in the future development of malaria prevention. This includes a multi-stage vaccine that would be capable of attacking the parasite at different stages of its life-cycle. If everything goes well -- and, the potent weapon does achieve its full potential -- we will have good reason to celebrate a huge victory in one of mankind’s longest battles... ever fought in history.