To date there were four main malaria strains - Plasmodium falciparum which causes malignant disease and is predominant in sub-Saharan Africa, Papua New Guinea and Amazonian rain forests; so called benign P. vivax in Indian sub-Continent; P. ovale in sub-Saharan Africa and lastly P. malariae which occurs rarely in all malarious areas, but mostly in Africa.
Recently a fifth new strain Plasmodium knowlesi is emerging (see News from The Star Malaysia) which was thought to only affect monkeys, but research and improved tests have shown it in evidence in 58% of patients.
What makes some forms of Plasmodium infections deadlier than others is the ability and speed with which the parasite replicates. After infection, Plasmodium migrates to the liver and then tunnels into red blood cells where they explode and spread the infection. This repeating cycle depletes the body of oxygen, causing fever, chills and muscle pain.
The alarming thing about P. knowlesi is that replication occurs every 24hours. With every replication the patient grows weaker, with fewer red blood cells to pass oxygen around the body, thus straining the heart and lungs. The high parasite count of P. falciparum is what makes it deadly and this is the worry with P. knowlesi as replication is as rapid.
The Malaysian research has shown that cases of malaria need to be assumed to be knowlesi rather than malariae and hence treated aggressively, rather than risk deadly delays in treatment.
WHO also acknowledged that surveillance is needed to detect whether or not human to human transmission is occurring.
The Travel Clinic Ltd can advise on all anti malarial medication as well as give advice and provide DEET products, mosquito nets and deterrents. Please see the web site for further details.
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