Partisans still argue over who first reached certain milestones in the investigation of malaria. But there is no doubt that a French Army doctor named Charles Laveran was the first to see malaria parasites in the blood of an infected person. He made the discovery while working as a doctor for the French Foreign Legion outpost in Constantine, Algeria. It was out of colonial concern, not scientific curiosity that the French government sent Laveran to Algeria in 1876. Military officials were desperate to stop the epidemics that plagued their outposts. The sick and the dead among the Foreign Legion had to be replaced, and the cost in both cash and morale was astronomical.
There were few better places to study malaria. The disease was endemic in Constantine, and the soldiers in the legion were wholly susceptible. Laveran wrote that upon his arrival he immediately “had the opportunity of making autopsies on subjects who had died from pernicious attacks”.
On November 6, 1880 the thirty-five year old Laveran drew blood from a soldier who was wracked by fever. He placed a drop under his microscope and saw that it was alive with little moving animals. Laveran was sure that this protozoan, not a bacillus previously found in the soil by an Italian-based group, was the cause of malaria.
Laveran’s work eventually was confirmed in major laboratories, and he alone was credited with the discovery that earned him a Nobel Peace Prize (1907)."
- From the book ‘Mosquito’ by Andrew Spielman and Michael D’Antonio
In Burkina Faso (formerly Upper Volta) alone, one child dies from malaria on average every 34 minutes. Elsewhere around the world, some 300 million people are affected by malaria each year. Of these, up to 2 million people die from it. Symptoms of the disease were noted in Sanskrit texts two thousand years ago, and ‘malaria’ was later named when it was believed to be caused by bad air.
Today malaria is mostly confined to Africa, Asia and Latin America. Poor living conditions and inadequate health services aggravate the problems yet there is now much concern about malaria’s increasing resistance to conventional medicines, and the unknown factors facing us with climate change. If global temperatures continue to rise, allowing the mosquito to extend into geographic areas not yet affected, malaria will soon have the potential to kill an additional 1 million people each year.
New Infections Emerging With Global Travel
Travel has always played a significant part in the spread of communicable diseases. With global travel, a person can be bitten by a mosquito on holiday in the Bahamas (they’re on holiday, not the mosquito!). Twenty-four hours later the holiday is over and a jet plane has returned the holidaymaker home in another part of the globe. Within a short time, another mosquito could bite, taking with it the children of the plasmodium that person became host to in the Bahamas. Global travel is simply an evolution of the religious pilgrimages, trade caravans and military campaigns that facilitated the spread of such disease from more confined origins. With global travel, new infections and new strains will continue to emerge with varying severity and frequency.
Like the Black Death, where the rat was the carrier and the cause was the Oriental Rat Flea, another blood sucking parasite, malaria is merely carried by the mosquito, the underlying cause being a plasmodium parasite. In her need to feed on blood to reproduce, it is the female Anopheles mosquito that carries the plasmodium parasite. Of the four types of plasmodium, Plasmodium Falciparum is the most widespread and dangerous.
The parasite develops in the gut of the mosquito. Anywhere between 10 – 100 parasite spozorites can be transferred into humans in the saliva of an infected mosquito each time it prods you to source a new blood meal. The parasites are then carried by the blood in the victim's liver where they invade the cells and multiply prodigiously. Within 5 days each spozorite can multiply in number up to 40,000. After 10-15 days they return to the blood and attack the red cells, bursting them open. At this stage the plasmodium increase 10 fold every 2 days and are a physical burden to the blood stream, effortlessly overcoming any immune response.
Symptoms of fever and anaemia are the first signs on infection, followed by an intestinal chill with violent shivering, intense heat and sweating then either recovery, or death. The mature plasmodium become gametocysts and are sucked up by another mosquito to start the cycle all over again in a new mosquito and a new host.
The cause of malarial death is painful: one of the functions of the spleen is to filter out of the circulation system dead or injured red blood cells. In its normal state, the spleen is a 3-5 pound organ. This parasite-induced migration of dying red blood cells swells the spleen until it becomes around 18-20 pounds, causing death when it ruptures.
Blackwater fever is a complicated and lethal form of malaria. 500,000 men were out of action in World War One from this. My great uncle Willie caught Blackwater Fever while fighting alongside the Argyll & Sutherland Highlanders in Gallipoli. Returning to convalesce in his home town of Gourock on the Clyde in 1916, his delirium caused him to stagger as he approached his mother’s home. Believing him to be intoxicated she refused to let him in. One of the non-medical ‘cures’ in those days was champagne, but the ‘highs’ were predictably mixed with prolonged ‘lows’.
The bad news for the pharmaceuticals is that common sense is finally prevailing. Rather than shipping expensive, and useless, anti-malarial drugs to the African sub-continent, it occurred to some bright spark to send mosquito nets instead.
Million of nets are now being delivered to mothers of children aged below 5 years throughout Central Africa before the rainy season sets in each year. The positive impact of this initiative is already seeing a reduction in the death rate in Burkina Faso.