A
Ton of Kids Die from Malaria
Grisly fact: Each day a ton of kids die from malaria. Actually about
10-15 tons of children, measured by weight. Even though the kids are
usually malnourished, they do weigh something. Figuring at least 10
pounds per child and 3000 deaths a day, half of which are under age
1, that's 30,000 pounds. 15 tons. The good news: nets will save about
a million children.
Malaria
Malaria is a serious, sometimes fatal, disease caused by a parasite.
There are four kinds of malaria that can infect humans: Plasmodium falciparum
(plaz-MO-dee-um fal-SIP-a-rum), P. vivax (VI-vacks), P. ovale (o-VOL-ley),
and P. malariae (ma-LER-ee-aa).
What
are the signs and symptoms of malaria?
Symptoms
of malaria include fever and flu-like illness, including shaking chills,
headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea
may also occur. Malaria may cause anemia and jaundice (yellow coloring
of the skin and eyes) because of the loss of red blood cells. Infection
with one type of malaria, Plasmodium falciparum, if not promptly treated,
may cause kidney failure, seizures, mental confusion, coma, and death.
Malaria
and Mosquitoes
Mosquitoes
transmit malaria. Mosquitoes are known as 'vectors' of the disease.
We know that mosquitoes carry diseases from the recent outbreaks and
spread of West Nile Virus across the United States. A few curious facts
help us understand why the malaria campaigns focus on providing Insecticide
Treated Nets, or ITN's, also known as bednets.
Mosquitoes
cannot pass the malaria parasites on to their offspring. Each mosquito
must obtain the parasite on her own. I use 'her' because only female
mosquitoes can transmit the parasite. Female mosquitoes of certain anopheles
species, to be more precise.
Each
mother mosquito seeks out humans (or juicy plants or animals) to obtain
a 'bloodmeal' for her eggs. If she bites humans that have no parasites,
she cannot become infectious. She can only obtain the parasite from
an infected human. (No mosquitoes share infected needles that I have
ever heard of).
Hence
the human reservoir of the malaria parasite plays a big role in malaria
transmission. No human reservoir, no malaria. That's why Europe and
the US have few cases of malaria, most of which originates in tropical
countries and is carried in. Every year or two some person who has never
traveled out their county comes down from malaria, probably from some
mosquito that survived the trip to the US, or that bit an infected visitor
and then passed the parasite on, but that's rare.
As
an aside, malaria also infects birds, apes and even lizards. The types
of malaria do not jump species. So you're safe if the birds or apes
or lizards have malaria so long as the local humans do not.
The
reason sleeping under insecticide treated nets works so well is that
mosquitoes bite their victims mostly between 9 pm and 3 am. Insecticides
repel the mosquitoes by making them feel sick so that they fly away.
If the mosquito touches the net, she will probably die. Even if she
doesn't die, if she touches a net she usually will fall to the ground
and be eaten by other insects or get crushed underfoot. The life of
mosquitoes is perilously short.
The
other key fact is that mosquitoes that have dined on infected blood
are not immediately infectious. The parasite must stay in the gut and
salivary glands of the mosquito for 10 days before it can pass on to
another human being. The 10 day period includes at least 5 and perhaps
as many as 50 bloodmeals. This is the 10-day rule. If a single one of
those feedings includes a meaningful encounter with a treated net, the
mosquito dies before she becomes infectious.
The
mathematically gifted analysts tell us that this 10 days/ 5+ feedings
means that not everyone must sleep under a mosquito net to interrupt
transmission. I haven't gotten a straight answer from any such analyst,
but coverage of 50% of the people is enough, according to most studies,
to lower the rates of malaria dramatically.
Likewise,
getting malaria from a single infected bite or a couple of bites probably
gives a lighter case of malaria than a heavier one. A single bite is
different from getting it from 100 or 1000 infected bites, as happens
in the areas of highest transmission. Furthermore, education about malaria
and its symptoms can lead those who do get malaria to seek rapid treatment.
Whether
covering exactly 50% or 38.2% of a given population with nets is the
magic number to interrupt transmission we may never know. What we do
know is that at some point of coverage, we interrupt transmission completely.
Is that point 68% or 73% or 92%? We do not know. The point may vary
with local conditions. Infected mosquitoes can always blow in from the
neighboring village or country on a storm. The ITNs could kill enough
mosquitoes early enough to stop reinfection completely.
The
other key to understanding malaria transmission is that the parasite,
if not reintroduced to the human, will usually 'burn itself out' in
120 days, plus or minus a few. We are talking about the deadly plasmodium
falciparum variety of malaria in this case. What does that mean? If
we can keep a group of people from getting or transmitting malaria for
a few months, perhaps a malaria season, if transmission is seasonal,
there may be no more parasites in the human reservoir to go around in
the first place.