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Online Discussion: Tracking new emerging diseases and the next pandemic.

Drug resistant malaria

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EdwinSm, View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote EdwinSm, Quote  Post ReplyReply Direct Link To This Post Topic: Drug resistant malaria
    Posted: January 31 2017 at 2:03am
This is only a small beginning, but it joins other cases of drug resistant diseases.  Together they point to a  bleak medical situation some time in the future.  I have no idea how long in the future as I have no good model for how this (or say drug resistant TB) would spread.

Originally posted by BBC BBC wrote:

A key malaria treatment has failed for the first time in patients being treated in the UK, doctors say.

The drug combination was unable to cure four patients, who had all visited Africa, in early signs the parasite is evolving resistance.

A team at the London School of Hygiene and Tropical Medicine said it was too early to panic.

But it warned things could suddenly get worse and demanded an urgent appraisal of drug-resistance levels in Africa.

Malaria parasites are spread by bites from infected mosquitoes.

It is a major killer of the under-fives with one child dying from the disease every two minutes.

Between 1,500 and 2,000 people are treated for malaria in the UK each year - always after foreign travel.

Most are treated with the combination drug: artemether-lumefantrine.

But clinical reports, now detailed in the journal Antimicrobial Agents and Chemotherapy, showed the therapy failed in four patients between October 2015 and February 2016.

All initially responded to therapy and were sent home, but were readmitted around a month later when the infection rebounded.

.....

All of the patients were eventually treated using other therapies.

But the detailed analysis of the parasites suggested they were developing ways of resisting the effects of the front-line drugs.

.....

Two of the cases were associated with travel to Uganda, one with Angola and one with Liberia - suggesting drug-resistant malaria could be emerging over wide regions of the continent.

....

The malaria parasites all seemed to be evolving different mechanisms rather than there being one new type of resistant malaria parasite spreading through the continent.

The type of resistance is also clearly distinct from the form developing in South East Asia that has been causing huge international concern.

...
http://www.bbc.com/news/health-38796337
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Dutch Josh View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: January 31 2017 at 2:25am
http://www.who.int/csr/resources/publications/drugresist/malaria.pdf Drug resistant-malaria is not new and a big worry. 


Symptoms of malaria can recur after varying symptom-free periods. Depending upon the cause, recurrence can be classified as either recrudescencerelapse, or reinfection. Recrudescence is when symptoms return after a symptom-free period. It is caused by parasites surviving in the blood as a result of inadequate or ineffective treatment.[32] Relapse is when symptoms reappear after the parasites have been eliminated from blood but persist as dormant hypnozoites in liver cells. Relapse commonly occurs between 8–24 weeks and is commonly seen with P. vivax and P. ovale infections.[3] P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite.[33] Reinfection means the parasite that caused the past infection was eliminated from the body but a new parasite was introduced. Reinfection cannot readily be distinguished from recrudescence, although recurrence of infection within two weeks of treatment for the initial infection is typically attributed to treatment failure.[34] People may develop some immunity when exposed to frequent infections


There is much evidence of associations between climatic conditions and infectious diseases. Malaria is of great public health concern, and seems likely to be the vector-borne disease most sensitive to long-term climate change. Malaria varies seasonally in highly endemic areas. The link between malaria and extreme climatic events has long been studied in India, for example. Early last century, the river-irrigated Punjab region experienced periodic malaria epidemics. Excessive monsoon rainfall and high humidity was identified early on as a major influence, enhancing mosquito breeding and survival. Recent analyses have shown that the malaria epidemic risk increases around five-fold in the year after an El Niño event 
Que sera, sera, Whatever will be, will be, The future is not ours to see, Que sera, sera !
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