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Precautions Against Malaria


By Nicky McLean

This is not a substitute for medical advice, related to your situation by a trained expert. The idea is to give you some idea of the issues and enough background so that during your consultation, you have a better idea of what is involved in the choices available and can ask useful questions while making sensible replies to your doctor's questions. Few adults would need to modify their travel wishes in order to avoid malarial risk, but pregnant women or those responsible for young children might.


Mozzie
Malaria is a real killer disease, sweeping away well over two million victims a year, most of whom will never have seen a doctor in their often brief lives. However, the statistics are not good for the majority of the regions where deaths occur so no-one really has a good idea. Also, continual low-grade infestation with the parasites wears down every victim, so that other diseases may sweep them away rather than be resisted, and malaria itself is not blamed directly. Many many more suffer chronic ill-health, especially anaemia.


We have advantages, and should use them. Chance plays a large part in the exposure to the risk, so you should be especially careful of anecdotes as a basis for your procedure. This is not an opportunity for casual experimentation or casual behaviour even though many people get away with it.


Malaria is caused by a parasite that lives within red blood cells. It breeds until the cell eventually bursts and the released parasites seek other red blood cells to set up home in and breed further. As the parasite hides within your own cells, it is more difficult for your body's defences to slaughter them, but they do.


Alas, the parasite also changes its skin randomly as its generations pass, so that there are likely to be survivors of an onslaught that manage to rebuild the parasite numbers until a fresh assault is mounted, thus the famous cycles of fever, reduction, and relapse in an exhausting cycle. The fever can be very high, alone enough to kill, and in the past has been used to end infections by other organisms that can't withstand high temperatures.


Thanks to all the killed red blood cells, the liver and spleen, overloaded with their recycling task, are likely to become swollen and tender. But no symptom can be absolutely relied upon to be clearly present in a particular case. You need diagnosis by experienced personnel (which may well not include your doctor at home, no disrespect), and best, a blood test.


It is not infectious. As just about everyone knows, it is spread by bites from certain species of mosquito. I suppose sharing uncleaned needles might work occasionally, but you won't be doing that anyway, will you? Blood transfusions would be another unlucky chance. Just as was the case with AIDS (and Hepatitis before AIDS), no-one sees a need to test for malarial parasites, so you can do all of us a favour by not giving any blood until, say, six months after returning home. There is no need to present the parasite with the chance of profiting via a new trick.

The parasite is well-adapted not just to us, but also to its life in the mosquito. As with many parasites, the fascinating schemes deployed bring smiles to the faces of parasitologists, but for the rest of us, to hell with that.


The infection to you is injected along with the saliva from the mosquito, that contains an anti-coagulant to assist the mosquito's sucking. It is not a matter of injecting you with blood from a previous meal, as the parasite has a special life stage that takes up residence in the mosquito's salivary glands.


Fleas and ticks may re-gurgitate part of a previous meal as they gorge, but mosquitoes do not. Entomologists delight over these details also, perhaps to the degree that they wouldn't scratch the lumps, and hurrah for them.


The advantage to the mosquito is that a protein meal enables a far larger batch of eggs to be laid, so the female has a strong incentive to get past any defence and make off with a load of blood rather than plant sap. Mosquito bites do not transfer AIDS, human folly is quite adequate for that.

Article added on March 01, 2005

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