Prevention and treatment of Malaria

Last time I talked about malaria--an old disease that we could encounter while at home or during vacations to tropical and subtropical areas.  (While most malaria cases occur in tropical countries, 1500 new cases are reported every year in the US.)  Today we look at how to prevent catching malaria and any treatments.

Prevention of malaria involves a person becoming educated in prevention strategies such as learning whether a travel destination is at risk, learning when the mosquitos are most likely to bite (for malaria it’s dusk to dark), dressing appropriately to avoid mosquito bites, using mosquito repellants and using mosquito netting, More information about malaria and how to avoid mosquito bites and malaria can be found at http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/protection-against-mosquitoes-ticks-and-other-insects-and-arthropods.htm 

Treatment of malaria involves several drugs; the protozoa are becoming resistant to these drugs.

More information about malaria can be found at http://www.cdc.gov/malaria/

Old diseases that travelers may encounter--Malaria

World travelers need to know about old diseases they may encounter during travels like malaria, cholera and diptheria.

Malaria 

Malaria causes illness and even death to people. While most of the malaria infections occur in sub-sahara Africa and Asia, 1500 cases are reported every year in the US. People traveling to tropical and sub –tropical areas of the world can check to see if their destination poses a malaria-risk at http://www.cdc.gov/malaria/travelers/index.html

Malaria is caused by a protozoa (tiny parasite) which is passed onto people by mosquito bites (a specific mosquito called the Anopheles mosquito). When the infected mosquito bites a person, the tiny parasites are injected into the person’s body, move to the person’s bloodstream and are carried to the person’s liver where they invade and reproduce. The reproduced protozoas then burst out of the person’s liver cells and cause symptoms such as fever, shivering, fatigue, headache, and possibly GI (gastrointestinal symptoms) such as nausea, vomiting, and diarrhea.  

Next time we talk about prevention and treatment of malaria. 

In the news--Ebola kills people in Uganda

Currently 16 people have died (and 38 people are ill) in western Uganda during the month of July 2012.  The World Health Organization (WHO) staff have identified the cause of death as Ebola.  What is Ebola Hemorrhagic Fever? 

The Ebola virus first became known in 1976 when 280 people (out of 318 who became ill) died.  These people lived on the banks of the Ebola River. Since that time, the Ebola virus has caused illness and death, then seems to disappear.  But it reoccurs and again, causes illness and death. 

There is much we do not know about Ebola.  What the experts do know is this:  Ebola is caused by a virus (Filoviridae) It spreads between people through blood and body fluids of people infected and sick from the virus. There are four strains of the virus and the illness kills between 50 to 90% of the people who become infected.  (The different virus strains have different mortality rates.)  Symptoms begin with 2 to 21 days of being infected:  fever, weakness, pain in muscles, joints and abdomen, headache, sore throat, nausea, exhaustion, then profuse bleeding within the body tissues (including the eyes) as well as externally. 

Treatment for Ebola is supportive care of the infected person.  No vaccine has been developed. The numbers of people infected and dying are relatively small (usually in the hundreds during outbreaks).  So far all outbreaks of Ebola has been confined to the African continent.  But Ebola is a scary infectious disease.  According to the news story, the current epidemic has sent Ugandan people fleeing their homes and communities to escape the virus.  Any travelers contemplating travel to Uganda (or anywhere outside the US), should check the CDC website for travel advisories at http://wwwnc.cdc.gov/travel/destinations/list.htm  For more information on the Ebola outbreak and how travelers can protect themselves, see http://wwwnc.cdc.gov/travel/notices/outbreak-notice/ebola-uganda-2012.htm

Treatment for the ancient disease, tuberculosis

In 1921 A vaccine for Tuberculosis was developed and given in some countries.  It’s not used in the US because according to the CDC, “it does not completely prevent people from getting TB”.  Antibiotics have been American treatment for TB since 1946 when streptomycin was developed.  Over the years, the Mycobacterium has evolved and become resistant to antibiotics used in the past.  Currently treatment involves 6-12 month-long treatment with multiple antibiotics but promising research may change that.  In March 2012 a new two-drug combo treatment was reported at the American Chemical Society meeting.  This drug combo involves the antibiotic meropenem plus clavulanate (a Beta-lactam inhibitor drug which is a component of the antibiotic combo-drug Augmentin).  This information can be found at http://www.sciencedaily.com/releases/2012/03/120326160528.htm A second announcement involves a three-in-one combo drug called PaMZ which shows promise for treating TB.  This drug combo is a combination of the TB drug pyrazinamide, the antibiotic moxifloxacin and PA-824. 

Both of these drug combos are currently in scientific trials and show promise for future treatments.  This information can be found at http://www.newscientist.com/article/dn22095-threeinone-drug-wipes-the-floor-with-tb.html?full=true&print=true

Tuberculosis poses a serious threat to people whose immune systems are weakened (those taking immunosuppressant drugs, and those suffering with HIV/AIDS.) TB thrives in poor living conditions where people lack good nutrition, and live in crowded areas.  More information about tuberculosis can be found at CDC, Tuberculosis, http://www.cdc.gov/tb/publications/factsheets/general/tb.htm

Moore, Peter, The Little Book of Pandemics, (New York City:  Fall River Press, 2009), 57-59. 

An ancient disease that won't die off--tuberculosis

Tuberculosis (TB)---A few years ago (maybe 25) the medical community thought they had defeated  tuberculosis.  That didn’t happen; the tuberculosis bacteria has become resistant to antibiotics that formerly killed the germs.

Tuberculosis has a long history.  As far back as 4000 B.C., skeletal remains show evidence of TB.  A German doctor, Robert Koch, is credited for identifying the Mycobacterium tuberculosis bacteria.  Dr Koch received the Nobel Prize of Physiology and Medicine in 1905 for this discovery.  What is TB?  It’s a disease caused by a bacteria (mycobacterium tuberculosis).  In the past TB was called “consumption or wasting disease”.  TB presents itself as a “bad cough that lasts three weeks or longer, pain in the chest, coughing up blood or sputum (phlegm from deep inside the chest), weakness or fatigue, weight loss, no appetite, chills, fever, sweating at night” 

 CDC, http://www.cdc.gov/Features/TBsymptoms/     TB is spread from one person who has TB through his coughing (sneezing, singing, speaking) to another person who doesn’t have TB.  The healthy person breathes in the germs left in the air by the ill person’s coughing, sneezing, etc.) The healthy person may not become ill if his immune system is strong and healthy.  The healthy person may become ill with the tuberculosis bacteria.  Next time I will discuss treatment for tuberculosis. 

Treatment for the ancient disease--Whooping cough

Whooping cough is a bacterial infection caused by any of three bacteria from the family of Bordetella. Children are especially susceptible to whooping cough.  When anyone has whooping cough infection, the bacteria stick to the outer lung cells and release a toxin which keeps the person’s lungs from clearing mucus.  The person deals with severe coughing as the body tries to rid itself of excess mucus.  As the person (child) finally coughs up the mucus and clears the throat, he draws in a big breath of air which creates the “whoop” sound. 

Antibiotics are only partially effective as treatment for whooping cough because the bacteria live on the outer lining of the lungs and cause this illness.  Until the recent questions by the experts, the pertussis vaccine was considered the answer.  The pertussis vaccine is included in the DPT (diphtheria, pertussis and tetanus) More information can be found at http://www.post-gazette.com/stories/news/health/feds-find-whooping-coughs-increase-alarming-645472/?print=1 Moore, Peter, The Little Book of Pandemics, (New York City:  Fall River Press, 2009), 48.    

Old diseases that won't die off--Whooping cough

Old diseases that won’t die off---Whooping cough (pertussis)

A July 20, 2012 news headline reads, “Feds find whooping cough’s increase alarming”  The experts fear that a rising number of whooping cough cases means we face an epidemic. So far this year’s number of cases (18,000 cases) has doubled last year.   

Whooping cough is another very old disease.  It was first recorded over 2 million years ago.  In the past, whooping cough epidemics seem to cycle and occur every four to five years.  Vaccination for whooping cough was developed during the 1940s and the number of cases dropped to less than 5000 U.S cases each year.  During the 1990s the vaccine was changed in an effort to decrease side effects.  The experts at Centers for Disease Control (CDC) question whether the changes in the vaccine decreased its effectiveness or length of its effectiveness.   More information about this news story can be found at http://www.post-gazette.com/stories/news/health/feds-find-whooping-coughs-increase-alarming-645472/?print=1 More information about whooping cough next time.