Malaria war sitrep

It is a war for those of us who happen to spend time traveling or living in parts of tcopy-of-steven-j-strommer.JPGhe world where malaria is an issue to be not only aware of, but one to also consider when it’s implications can affect our health and welfare. Modern medicine is on our side, and is also our greatest ally in this struggle.

Apart from our own due diligence in preventing exposure from the main vector of transmission (the venerable mosquito) this is usually done through the use of repellants, caution and prophylactic medication. Sometimes, depending on the area you may be staying in, and the length of time there, the odds unfortunately will go against you and the likelihood of contracting this scourge can become more then just a concern they turn into a reality.

Then the critical issues become many. How long since contraction do the symptoms start to manifest themselves? From that point, how long before the correct diagnosis is made and the proper treatment is started? Is it a common strain, or a multi-drug resistant type? Lastly, and hopefully on a minimal level, what will be the resulting and lasting effects of contraction and exposure and will the resulting effectiveness of the treatment have been optimal?

I don’t know about you, but the fact of the matter is (maybe I’m just hypersensitive) after spending a good part of my life working in a medical environment (a hospital) these are the kinds of issues that freak me out and make me go all obsessive compulsive when I go abroad, especially to malarial zones. I read up, and get my scripts and shots, cross my fingers and hope for the best, and as I’ve written here before, I tend to worry about my travel partners commonly much more then I do about myself. Low and behold my worries are usually well founded, not malaria thus far (inshallah) but most recently altitude sickness. But I digress (I’ll write about that in another entry) back to the war.

This year has been nothing less than a banner year for progress in this epic struggle, mostly for folk’s (developed world) who have been unfortunate enough to have contracted this disease. Some post exposure treatments have been not only found to be effective in killing this bug, but have also been approved by various governmental and legislative bodies for treatment of the malaria parasite. Quinine has long been known to be an effective treatment, yet in the United states it was never approved by the FDA until recently in the form of Qualaquin (quinine sulfate) though admittedly to read about all the contraindications and various drugs interactions it can cause you begin to realize just how bad the disease it’s treating is. Maybe the most important advance though on a global level is the Artimesia based medication Coartem (reg) (artemether-lumefantrine) considered to be the most effective treatment for many of the more common resistant strains of malaria. The only real down side at this point looks to be availability, mostly because the plant varieties of Artimesia used in production are only mass farmed in a few places most notably China. The other notable advance has been made in the realm of diagnosis. As I stated earlier, the sooner you find out you’re infected the better off you are because treatments that start early are not only more effective but you’ll more than likely suffer far less from some of the more debilitating symptoms. Binax NOW has been developed to give a positive blood test result in minutes as opposed to days as in the past. Unlike a skilled technician making a diagnosis from a blood sample utilizing a microscope this product will not only allow a quicker diagnosis (using microscopic analysis after the fact) but will also be able to differentiate whether the strain is a resistant one or not!

Though this is awesome news I’ll have to brush up on just how that is actually possible. Something along the line of a pregnancy test I suppose.

Regardless in these particular circumstances let’s certainly hope that the old adage of “If it sounds too good to be true it must be!” couldn’t in this day and age and in regards to the subject at hand be proven at least for once wrong.

http://www.drugs.com/mtm/qualaquin.html

http://www.medicalnewstoday.com/articles/23629.php

http://www.fda.gov/bbs/topics/NEWS/2007/NEW01659.html

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