Malaria has been a known disease since antiquity. Its name means bad air, “mala aria” in medieval Italian, because it was so pervasive near the smelly swamps around Rome during medieval times. Malaria is caused by the Plasmodium family of parasites and is transmitted by mosquitoes. While malaria has been largely eliminated in the developed world thanks to mosquito control efforts, the disease still ravages tropical countries, especially in sub-Saharan Africa. Malaria causes severe headache, joint and muscle pain, nausea and vomiting, but it is the high fever that comes and goes in a regular cycle that is the most dangerous and unique sign of the disease. The majority of those who die from malaria are children. The high fever leads to a coma, neurological damage, and death.
In the past several years, malaria has been a huge focus of the global health community. The rates of death from malaria have decreased from efforts to prevent transmission by targeting the mosquitoes that carry the parasite. Pesticide laden mosquito nets in particular have been a huge help in the fight against malaria. Effective medical treatments for malaria exist but are expensive and many of the sickest people live in remote villages with poor roads. A storm during the rainy season could isolate a village for weeks while the mosquito population exploded.
This week, the preliminary results of a massive study taking place in seven sub-Saharan countries investigating the effectiveness of a vaccine against the Plasmodium Falciparum species of the malaria parasite was published. What makes this vaccine unique is that it is the first vaccine against a parasite. Most vaccines are against viruses and a few are against bacteria. The malaria vaccine cuts infection rates in vaccinated children in half and reduces serious, potentially deadly cases by 35% of those who get infected compared to the non-vaccinated children.
While this vaccine will be a powerful new tool in the fight against malaria, it is not perfect. The study has not analyzed the data looking at the effectiveness in babies at this time. Those results will be available in a year from now. It is also unclear how long the vaccine will have its protective effect. Some evidence suggests that the vaccine becomes less effective one year after it is given. That is still being examined and a booster shot is being looked at as a way to combat this potential problem. Vaccinating against parasites is uncharted territory so potential issues could appear from unexpected places.
If no major problems arise, this vaccine could be a powerful new tool in the fight against malaria in the developing world. It is wonderful to see the cool breeze of medical science and technology blowing away the bad air of malaria away.
Dr. Bruce Feinberg