NEPA Vital Signs - Winter Spring 2019 - 15

WINTER/SPRING 2019

MALARIA:

A DISEASE WITHOUT BORDERS
HAT IS THE DEADLIEST ANIMAL IN THE WORLD?

The grizzly bear? The African lion? The great white shark?
None come close to the mosquito, which is responsible for
over 700,000 deaths a year. Almost half of those deaths are
due to malaria. This disease, caused by a Plasmodia protozoan infection, condemns its victims to flu-like symptoms,
alternating bouts of shivering and fever, and eventually death
if untreated. Every year, about 1,700 returning travelers are
diagnosed with this dangerous disease. But have no fear fellow
traveler: there are proven ways to stay safe when traveling
to high-risk countries.
The first description of malaria can be found in the writings
of the most ancient civilization, the Chinese Nei Ching (Canon
of Medicine). Malaria did not discriminate its destruction: it
toppled Greek city-states, contributed to the fall of Rome, and
continues to plague Sub-Saharan Africa to this day. It wasn't until
the mid-17th century that an effective cure was found. Quinine,
or Peruvian bark, inhibits Plasmodium's ability to metabolize
hemoglobin. In fact, legend has it that it saved the Spanish viceroy's wife from certain death.

The mosquito is responsible
for over 700,000 deaths a year.
Almost half of those deaths
are due to malaria. Every
year, about 1,700 returning
travelers are diagnosed with
this dangerous disease.

Thankfully, there are much better treatments available today,
both therapeutic and prophylactic. There are four drugs that you
can take while you're traveling in endemic countries:
* Malarone
* Lariam
* Aralen
* Doxycycline
You can choose which drug to take based on your destination, convenience, and financial means. Most find Malarone to
be the drug of choice. It works everywhere, and only needs to
be taken for a week after you return-the other drugs require
a month. Although prophylaxis is highly recommended, it is
not 100% effective. If you contract malaria, there are plenty
of cures out there.

Speaking of countries, there are many around the world
that are endemic for malaria. Southeastern Asia, most of
Sub-Saharan Africa, and some of South America carry the
real risk of malaria infection. Although your risk varies
depending on region, it is best to take prophylaxis and remain
vigilant for malaria symptoms. Drugs are an effective way to
prevent malaria but remember to wear DEET spray and long
sleeves to ward off the world's deadliest animal. Stay safe
brave travelers!

The first line antimalarial drugs are quinoline derivatives,
such as chloroquine and quinine. Antifolates such as dapsone and sulfonamides may be added to the regimen to help
eradicate the parasite. Antibiotics like doxycycline could
also be prescribed. Unfortunately, counterfeit medication is
still a major problem worldwide and should be avoided by
purchasing drugs only within the formal health care system
of the country you are in.
N E PA

ANIS ADNANI, Medical Student at Geisinger Commonwealth
School of Medicine

VITAL SIGNS

NEPA Vital Signs - Winter Spring 2019

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