Tuesday, March 31, 2009

History of Global Killer- Malaria.

Malaria is also spreading in new areas in Jharkhand.
Blame it on climate change.
Dr. Nitish Priyadarshi

A female Anopheles mosquito acts as a deadly hypodermic, injecting the malaria parasite when she feeds on human blood. Nearly half billion people get malaria each year. More than a million die. After decades of neglect, the world is renewing its fight against the disease.

In truth, malaria now affects more people than ever before. It’s endemic to 106 nations, threatening half the world’s population. In recent years, the parasite has grown so entrenched and has developed resistance to so many drugs that the most potent strains can scarcely be controlled. In coming years malaria will strike up to a half billion people.

According to National Geographic Magazine( July,2007), at least a million will die, most of them under age five, the vast majority living in Africa. Death may also occur in Asia including India, where malaria is spreading to new areas. Blame on climate change.

Changes in temperature can affect the development and survival of malaria parasites and the mosquitoes that carry them, according to a joint 2004 study by the State University of New York, Buffalo, and the Kenya Medical Research Institute.

Rainfall also influences the availability of mosquito habitats and the size of mosquito populations, the research found.
Jharkhand State of India is on the front line of climate change and is witnessing a rise in tropical diseases such as malaria.
Jharkhand was nearly free of malaria in 1970, but it is making a comeback. We are now finding malaria in places that we did not expect to find it. It is spreading to the new areas. Every year thousands are being affected and hundred’s being killed.
Spreading of malaria is worrying because people have not built up immunity to the malaria parasite. Epidemics are now more deadly, particularly for humans who do not have immunity and are taken by surprise when they're bitten.
Patients can get cerebral complications and lung and kidney failures if they do not get immediate treatment."

Malaria is a changed disease in recent times. Benign, through chronic disease of yesterdays, has undergone a malignant transformation. Often, it results in multiorgan (system) failure, which need immediate multi specially attention for survival. Suddenly, malaria may behave as an epidemic and end in high mortality.

Malaria past to present:

The disease has been with humans since before we were human. Our hominin ancestors almost certainly suffered from malaria. The parasite and the mosquito are both ancient creatures- the dinosaurs might have had malaria-and this longevity has allowed the disease ample time to exploit the vulnerabilities of an immune system.

Malaria is probably one of the oldest diseases known to mankind that has had profound impact on our history. But for malaria, the outcomes of many a wars and destinies of many a kings would have been different. It has been responsible for the decline of nations and crushing military defeats, often having caused more casualties than the weapons themselves. For centuries it prevented any economic development in vast regions of the earth. It continues to be a huge social, economical and health problem, particularly in the tropical countries. History of malaria and its terrible effects is as ancient as the history of civilization, therefore history of mankind itself.

Malaria was linked with poisonous vapours of swamps or stagnant water on the ground since time immemorial. This probable relationship was so firmly established that it gave the two most frequently used names to the disease mal’aria, later shortened to one word malaria, and paludisme. The term malaria (from the Italian mala “bad” and aria “air”) was used by the Italians to describe the cause of intermittent fevers associated with exposure to marsh air or miasma. The word was introduced to English by Horace Walpole, who wrote in 1740 about a “horrid thing called mal’aria, that comes to Rome every summer and kills one.” The term malaria, without the apostrophe, evolved into the name of the disease only in the 20th century. Up to that point the various intermittent fevers had been called jungle fever, marsh fever, paludal fever, or swamp fever.

Mentions of malaria can be found in the ancient Roman, Chinese, Indian and Egyptian manuscripts and later in numerous Shakespearean plays. The belief that mosquitoes transmit disease also is an ancient one.

One of the oldest scripts, written several thousand years ago in cuneiform script on clay tablets, attributes malaria to Nergal, the Babylonian god of destruction and pestilence, pictured as a double-winged, mosquito-like insect. A few centuries later, the natives told Philistines settling in Canaan, on the eastern shore of the Mediterranean, of the god Beelzebub, lord of the insects. The evil reputation of this deity increased through the ages until the early Jews named him "Prince of the Devils."

The connection between malaria and swamps was known even in antiquity and the evil spirits or malaria gods were believed to live within the marshes. This belief is likely the origin of the Greek fable of Hercules and Hydra.

Sumerian and Egyptian texts dating from 3,500 to 4,000 years ago refer to fevers and splenomegaly, suggestive of malaria. The Sumerian records apparently make frequent reference to deadly epidemic fevers, probably due to P. falciparum.

The Vedic (3,500 to 2,800 years ago) and Brahmanic (2,800 to 1,900 years ago) scriptures of Northern India (Indus valley) contain many references to fevers akin to malaria. They are also said to make reference to autumnal fevers as the "King of diseases". The Atharva Veda specifically details the fact that fevers were particularly common after excessive rains (mahavarsha) or when there was a great deal of grass cover (mujavanta). The ancient Hindus were also aware of the mosquito's harmful potential. In 800 B.C. the sage Dhanvantari wrote, "Their bite is as painful as that of the serpents, and causes diseases... [The wound] as if burnt with caustic or fire, is red, yellow, white, and pink color, accompanied by fever, pain of limbs, hair standing on end, pains, vomiting, diarrhea, thirst, heat, giddiness, yawning, shivering, hiccups, burning sensation, intense cold..." Charaka Samhita, one of the ancient Indian texts on Ayurvedic medicine which was written in approximately 300 BC, and the Susruta Samhita, written about 100 BC, refer to diseases where fever is the main symptom. The Charaka Samhita classifies the fevers into five different categories, namely continuous fevers (samatah), remittent fevers (satatah), quotidian fevers (anyedyuskah), tertian fevers (trtiyakah) and quartan fevers (caturthakah) and Susruta Samhita even associated fevers with the bites of the insects.

Malaria appeared in the writings of the Greeks from around 500 BC. Hippocrates, "The Father of Medicine" and probably the first malariologist, described the various malaria fevers of man by 400BC. Hippocratic corpus distinguished the intermittent malarial fever from the continuous fever of other infectious diseases, and also noted the daily, every-other-day, and every-third-day temperature rise. The Hippocratic corpus was the first document to mention about splenic change in malaria and also it attributed malaria to ingestion of stagnant water: "Those who drink [stagnant water] have always large, stiff spleens and hard, thin, hot stomachs, while their shoulders, collarbones, and faces are emaciated; the fact is that their flesh dissolves to feed the spleen..." Hippocrates also related the fever to the time of the year and to where the patients lived.

Malaria likely originated in Africa and has coevolved along with its hosts. The first evidence of malaria (also called paludisme) parasites had been found in mosquitoes preserved in amber from the Paleogene period that are approximately 30 million years old. Malaria may have been a human pathogen for the entire history of the species. Indeed, close relatives of the human malaria parasites remain common in chimpanzees, the closest evolutionary relative of modern humans.About 10,000 years ago malaria started having a major impact on human survival which coincides with start of agriculture (Neolithic revolution).

Interesting historical facts about Malaria:

1. By one estimate, malaria has killed half the people who have ever lived on this planet
2. Fossils of mosquitoes 30 million years old show signs of malaria, suggesting even prehistoric man could have suffered
3. Researchers studying bodies of ancient Egyptians have found evidence of malaria in people who lived over 3,000 years ago
4. Malaria is thought to have directly contributed to the fall of the Roman Empire
5. In 1574 the Vatican was moved from its original location to where it stands today by Pope Gregory XIII because of the high incidence of malaria that had led to its unhealthy reputation
6. William Shakespeare (1564–1616), mentioned ague (malaria) in eight of his plays. For example, in The Tempest (Act II, Scene II), the slave Caliban curses Prosper, his master: "All the infections that the sun sucks up / from bogs, fens, flats, on Prosper fall and make him / By inch-meal a disease!"
7. Lancisi (1717) linked the disease with poisonous vapours of swamps and thus originated the name malaria, meaning bad air
8. In 1809 Napoleon used malaria as a biological warfare agent, flooding the Dutch countryside. Over 4,000 British Army troops are reported to have died of the disease with another 10,000 unable to continue with military service
9. In 1640, Huan del Vego first employed the tincture of the cinchona bark for treating malaria, although aborigines of Peru and Ecuador had been using it even earlier for treating fevers.
10. Morton (1696) presented the first detailed clinical picture of malaria and its treatment with cinchona.
11. Lancisi (1717) linked malaria with poisonous vapours of swamps and thus originated the name malaria, meaning bad air
12. Gize (1816) studied extraction of quinine from the cinchona bark
13. Pelletier and Caventou (1820) extracted pure quinine alkaloids
14. Laveran (1880) a French physician working in Algeria, first identified the causative agent for human malaria while viewing blood slides under a microscope.
15. P.vivax and P.malariae were identified in 1885 by Golgi
16. Sakharov (1889) and Marchiafava and Celli (1890) identified P.falciparum
17. Sir Ronald Ross (1897) while working as a military physician in India, demonstrated the malarial oocysts in the gut tissue of female Anopheles mosquito. This was reported in the British Medical Journal
18. Paul Muller (1939) discovered the insecticidal properties of DDT
19. Curd, Davey and Rose (1944) synthesised proguanil for treating falciparum malaria

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Hayakawa T, Culleton R, Otani H, Horii T, Tanabe K (2008). "Big bang in the evolution of extant malaria parasites.". Mol Biol Evol. 25 (10): 2233–2239.

Martin MJ, Rayner JC, Gagneux P, Barnwell JW, Varki A (2005). "Evolution of human-chimpanzee differences in malaria susceptibility: relationship to human genetic loss of N-glycolylneuraminic acid.". Proc Natl Acad Sci U S A. 102 (36): 12819–12824.

Sinha, A.K., 2005. Malaria. A.P.H. publishing corporation, New Delhi.


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