Malaria

When preparing for an excursion that involves visiting anywhere from 8-12 different countries, there are a number of things to consider:
climate
visas
currency
accommodations
culture
disease
Disease? Definitely. Southeast Asia and its tropical rain forest is the perfect home for Anopheles mosquitoes,the causative agent of malaria.
As you can see from the map below, malaria is endemic to Asia, particularly the parts that we plan on visiting.

The Anopheles mosquito (featured left), is the vector for malaria.
Malaria is from the Italian for "bad air," mal (bad) aria (air). Malaria earned it's name due to ignorance of how the disease is actually transmitted. People acquired malaria in swampy, damp, warm, and humid environments.

Of course the air in such places feels heavier and logically people deduced that it was the bad air that was making folks sick. Historical records of the disease can be found dating as far back as 2700 BC, but determination of the mosquito as the vector of disease did not occur until 1897. Ronald Ross of the British Navy in India discovered that the parasite that causes chills, anemia, fever, and ultimately death, is transmitted to humans and animals via the Anopheles mosquito. This parasite called Plasmodium and is injected into a human or animal via the mosquito. The parasite's life cycle involves an all expense paid vacation in an unsuspecting host (see left) and then can be transmitted to another host via another mosquito. In the body of the host the parasite causes liver and red blood cells to burst, toxins are released into the blood stream and a person can sustain any number of symptoms, including aches,sweats, fever, anemia, jaundice, spleen enlargment, and death.


Historically there have been many different treatments for malaria. The Chinese used wormwood, an herb, upon their arrival to the new world the Spanish discovered quinine from the Cinchona tree, and currently malarone and mefloquine are prescribed for prevention and treatment of the disease. My personal favorite treatment for malaria is the "Gin and Tonic." You laugh, but it's true. When the Brits were in the east they drank tonic water (contains quinine) to help fight off the disease. Tonic water by itself is somewhat unbearable, but as the saying goes, "a spoon full of gin helps the medicine go down."


We will not be relying on gin and tonic to keep us safe, the Travel Clinic at Beth Israel Hospital has prescribed us with plenty of malarone. Malarone prevents the formation of folic acid, which is a necessary step in the reproduction of the parasite. No folic acid, no Plasmodium babies, no malaria.