November 9, 2015 Dr. Jeffrey Musser Bugs in your Blood: Malaria!

Malaria’s Impact Worldwide Incidence 200 million clinical cases

Malaria’s Impact Worldwide Incidence 200 million clinical cases 500,000 deaths each year 400,000 are children < 5 yrs. old 46 children per hour

Malaria Where does malaria occur? What is malaria? What is the history of malaria? How people get malaria? What are the clinical signs? - what happens to infected people? - life cycle of malaria?

Questions Malaria in Texas - how did it get here and why is it not here now?

Misinformation on the Web

Where does malaria occur? World Health Organization, January 2004 Tropic of Cancer Equator Tropic of Capricorn

Population Map Worldmapper.org Land Area Map Territories are sized in proportion to the absolute number of people (i.e. population)

Population Map Worldmapper.org Territories are sized in proportion to the absolute number of people who died from malaria in one year Malaria Deaths Map

Worldmapper.org Land Area Map

What is Malaria?

Art.com

What is Malaria? Art.com

What is Malaria? Art.com

What is Malaria? Art.com protozoan parasite, a single-celled organisms, that infects red blood cells Plasmodium sp.

Early History Has infected man during known history Originated in Africa and followed human migration Malaria

Where and when did Malaria first occur?

AFRICA

Where and when did Malaria first occur?

Malaria 3 Demons: Chills, Fever, Headaches Nei Ching 2700 BC Great cold, intense shivering, body convulsing Fever up to 106º, great thirst Massive headaches ~6 hours, fever breaks Cycles every 48 or 72 hrs., depending on malaria species

Miasma theory poisonous air exhaled by decaying vegetable matter, especially by swamps

Malaria lifecycle before Demons: Chills, Fever, Headaches Miasma

Charles Laveran Military physician stationed in Algeria in 1876

Malaria in 1876 Algeria

Malaria in 1876 Algeria

What did he see? Plasmodium spp. protozoan parasite – single-celled organisms

Malaria lifecycle

Malaria in 1897 India

Malaria in 1897 India

Sir Ronald Ross India August 1897 Found the malaria protozoan in the stomach of an Anopheles mosquito…

“… clear and almost perfectly circular outline … another, and another exactly similar cell. Here was the clue … the mosquito itself had become infected”

The Anopheles mosquito was the vector An organism (such as an insect or rodent) that transmits a pathogen

Malaria lifecycle

Infected mosquito Mosquito gets infected

Malaria lifecycle Infected mosquito Mosquito gets infected

Malaria lifecycle & illness 3 Demons

Malaria 3 Demons: Chills, Fever, Headaches Nei Ching 2700 BC Great cold, intense shivering, body convulsing Fever up to 106º, great thirst Massive headaches ~6 hours, fever breaks Cycles every 48 or 72 hrs., depending on malaria species

Malaria lifecycle & illness 3 Demons

Malaria is species specific Humans Primates Birds Reptiles All Plasmodium but different species

Malaria comes to the Americas

No malaria prior to 1492

Malaria comes to the Americas 1492 – European exploration

Malaria in the U.S. circa 1850

Malaria in the U.S. circa 1912

Malaria in the U.S. circa 2015

For Malaria to persist, need Vector – Anopheles mosquitoes Reservoir – where the mosquitoes get the parasite Host – the animal that gets infected

Elimination and Prevention of Malaria Reduce contact with vector Reduce reservoir 2015

Elimination and Prevention of Malaria Reduce contact with vector Reduce reservoir Increase resistance of host

Elimination and Prevention of Malaria Reduce contact with vector Is the vector in Texas? Mosquito is the vector YES!!!

Elimination and Prevention of Malaria Reduce contact with vector

Elimination and Prevention of Malaria Reduce contact with vector

Elimination and Prevention of Malaria Reduce contact with vector Reduce reservoir Infected person Infected mosquito Infected Mosquito gets infected by biting infected person - where the mosquitoes get the parasite

Malaria in USA No endemic malaria

Malaria in USA 1,500 to 2,000 cases report every year in United States Almost all in recent travelers

Elimination and Prevention of Malaria 2015

Just a touch of Malaria quinine from the Cinchona tree (South America, 17 th century) artemisinin from the Qinghaosu plant (Artemisia annua, China, 4th century) medical studies vaccines and other preventions treatments

Just a touch of Malaria Role of malaria in war Evolution in response to malaria pressures

Just a touch of Malaria Videos Manson and Ross: Death by mosquito by British Medical Journal A Mutation Story by PBS

Readings National Geographic July 2007

Malaria information

Remember, protect yourselfRemember,

Remember, protect yourselfRemember,