A Malaria epidemic has emerged on the remote island MKC. Evidence of early cases of Malaria can be found carved on stone tablets dating as far back as to the primal civilizations of Mesopotamia, and later being spread across the globe following the cultivation of new civilizations. This lethal infectious disease reaches around the globe, killing around 2000 people per day. This is why the outbreak of Malaria on Island MKC must be eliminated for the good of the public health of the residents.
When an infected female Anopheles mosquito sucks blood from its human host, they inject sporozoites, the infectious agents, that they seek out and invade liver cells (hepatocytes). In roughly 5-8 days the sporozoites grow, and eventually burst, giving birth from 10,000 to up to 30,000 daughter merozoites (White 2014, p. 724). These infectious agents infect red blood cells, consumes the contents of the cell and hijacks the cell to make copies of the parasite; “By the end of the intraerythrocytic lifecycle, the parasite has consumed most of the red-cell contents and several nuclear divisions have taken place.
The erythrocytic schizont then bursts and releases between six and thirty daughter merozoites, each of which can invade erythrocytes and repeat the cycle.” (White, 2014, p. 724)
All species of the Malarial Disease are from the Plasmodium genus. About five species of Plasmodium cause malaria in humans, but most infections are caused by either Plasmodium falciparum or Plasmodium vivax. Plasmodium falciparum is usually associated with most of the deaths from Malaria, but P.
vivax is now being recognized for causing mortality as well. The two species differ in some respects such as their incubation times of merozoites in liver cells, and Plasmodium vivax can remain latent for longer periods (8-10 months) in a primary infection (Roach 2014, p. 142).
High transmission rated of Malaria are seen in regions that are located close to the equator and have warm climates year-round (25°C-30°C). However, the transmission of Malaria will not occur in regions of high altitude, colder climates, deserts, and areas where transmission has been interrupted through elimination. Of the 219 million cases of Malaria in 2017, 92% of cases were from the African region and 70% of the victims being children under the age of 5 (WHO). Although Sub-Saharan-Africa is burdened the most carrying about 80% of the cases of Malaria, South-East Asia, the Eastern Mediterranean and the Americas, and the Western Pacific are also heavily affected by this disease. This equals the death of one child every two minutes from Malaria.
Before the biology of Malaria was discovered, it was the common belief that Malaria was caused by pollution from the unsanitary environment, giving it the name Malaria, which translates literally to ‘bad air’ in Italian. In Mozambique, South Africa 1837, was the first well-documented case of Malaria when it killed 20 out of 53 men exploring South Africa. It wasn’t until years later, in 1880, that Charles Louis Alphonse Laveran discovered that mosquitoes were responsible for transmitting the parasite to humans (Achan 2011, p. 1).
During WWI Malaria was an unforeseen obstacle that many troops had to face resulting in thousands of casualties. Specifically, in 1918 there was an outbreak of Malaria in Palestine and Iraqi regions that plagued British troops. Malaria was first contracted by Indian troops who later made up ¾ of the British Army introducing the parasite to them. Also, the warm June climate and the average temperature of 15.5°C, was peak mosquito breeding time. As British lines advanced deeper into the region while combating Turkish forces, they encountered areas with high transmission rates causing the cases of Malaria to skyrocket. To fight the Malaria epidemic British and Australian command established malaria diagnostic stations, to try and decrease the mortality rates in Palestine. Of 150,000 collected samples, approximately 50,000 samples tested positive for Malaria, equaling about 28.9% of soldiers from British and Australian Army’s. The British forces spent large sums of time money on a preventative measure such as oiling, draining of swamps and streams that attract mosquitoes, mosquito nets, and Quinine prophylaxis. During WWI Malaria was able to spread with ease infecting thousands, sparking outbreaks not only in Palestine, but also in Macedonia, England, Italy, Sub-Saharan Africa, and the Pacific Region, marking Malaria an unexpected enemy on a global scale (Brabin 2014).
The symptoms for Malaria can range from mild to severe first appearing approximately 10-15 days after an individual is bitten by an Anopheles mosquito. The host of the plasmodium parasite will start to experience symptoms after the schizont bursts releasing toxins into the bloodstream causing symptoms (CDC). Most commonly patients present with fever, chills, headache, nausea, vomiting, and body aches. Mild symptoms are similar to the flu, so recognizing if you have Malaria can be difficult. If the infection is not treated it might develop into severe Malaria, and the patient may experience, organ failure or severe anemia due to the destruction of healthy red blood cells (WHO).
Quinine is derived from the bark of a cinchona (quina-quina) tree and was one of the earliest known treatments for Malaria since the 1600s, and “is marked as the first successful use of a chemical compound to treat an infectious disease” (Achan, 2011, p. 1). Side effects from Quinine can range from mild headache, hearing impairment, and nausea, to severe vertigo, vomiting, abdominal pain, diarrhea, hearing loss, and including loss of vision. Even though Quinine was one of the earliest treatments for Malaria, it is still commonly used as the first- or second-line treatment for uncomplicated Malaria and pregnant women (Achan 2011, p.2).
Recently, a new class of drugs has been developed called ACTs, they are easy to use and cheap, but many factors such as money and politics have prevented their use in areas such as Sub-Saharan Africa, where they are desperately needed. However, agencies such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria have been on the push to provide a sufficient supply of ACTs and other combination drugs. ACTs are derived from a wormwood plant and were commonly used in ancient Chinese medicine, but in the 1970s their effectiveness against Malaria was discovered. This new drug has shown few signs of resistance but must always be used in combination with another drug to treat Malaria to maximize its effectiveness. Almost all African country’s policies regard ACTs and the most effective and standard treatment to fight Malaria. In 2016 198 million treatments of ACT was delivered, and 99% of the treatments went to Sub-Saharan Africa. There are also many struggles distributing the drugs across such a large mass of land such as Africa. Many residents live in rural isolated areas, and volunteers and employees of the government must first be trained to educate civilians and health professionals about the drug, which requires time and money. Although there are still many obstacles when treating Malaria, medicines like ACTs and new regimens in development give hope for better treatments in the future (Enserink 2007).
There are various ways and methods to protect yourself and others from contracting Malaria. One way is to install barriers, such as a net when you sleep, and long clothing when you go outside. Barriers prevent exposure to mosquitoes by adding a physical barrier that is able the insects to transfer the parasite to a new host (CDC). Pesticides can be sprayed to eliminate mosquitoes in the environment. For travelers visiting regions in the world with high rates of Malaria such as Africa, South East Asia, or the Eastern Mediterranean, there are Anti Malaria drugs people can take before and during their trip to prevent an infection (WHO). Other additions such as ceiling fans and air conditioning are repellants for insects that might be carrying the parasite.
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