Ah, malaria – I’m all too acquainted with this particular issue, having had it several times in the course of my fieldwork. The first time is pretty miserable . . . but by about the fourth case, it is just a day feeling like you have the flu. Of course, this presumes that you are relatively young and healthy – if not, malaria can be quite dangerous.
I am one of the “lucky” few who could not go near Mefloquine (brand name Larium to those of you who have taken anti-malarials) back when it was the “best choice” for preventing malaria. I didn’t get malaria . . . but it did drive me toward a temporary bipolar situation and left me with residual vertigo that even now, 13 years later, I still feel at times. So, after that experience, I simply stopped taking antimalarials entirely, and tried to deal with bugsprays and long pants as much as possible. The relatively recent arrival of Malarone has made it possible for me to take effective antimalarials again, and when I am on short trips I do. For the long term, though, you really shouldn’t be taking anti-malarials . . . they are really not good for you, and at some point they do become more problematic than malaria itself.
Given this situation, I have taken a rather acute interest in the efforts to battle malaria. I’ve watched vaccines come and go. I’ve seen the rage for bed nets as panacea consume everyone, even though they are quite compromised in their effectiveness by the fact that the anopheles mosquito likes to fly in the evening, when people are not yet in bed, and tends to fly very low to the ground, and thus below the level of many beds. Hell, some crazy people have come up with a laser that can shoot mosquitos out of the air, thus preventing bites – the coolest, and most totally impractical solution for malaria I’ve ever seen (click here for a movie – really). How, precisely, are people meant to power and maintain a LASER WHEN THEY HAVE NO ELECTRICITY? And as I have watched all of these efforts, I have wished and hoped that someone could figure out a way to deal with this damn disease for the purely selfish reason that I am tired of getting it.
So, I was pretty excited to hear about a new development in this fight – an effort to genetically engineer mosquitos so that they cannot carry the parasite in the first place (LA Times, BBC, Tonic). Malaria is obscenely difficult to kill, because it goes through a large number of stages in its life cycle, and each stage is vulnerable to treatment in different ways – thus, a treatment that works early in the infection cycle may not work on later stage infections – and worse, if there are parasites going through different stages at the same time (some have been gestating for longer than others), a treatment might only work on a fraction of the parasites in the bloodstream and liver at any given time. But malaria has one weakness – it must have people to live in. Without us, eventually there would be no malaria – we are the host, and mosquitos must collect it from our blood, before passing it to other people. So, if the mosquito cannot act as the carrier, the parasite cannot move between hosts – and eventually the parasite dies out (the only real way to contract malaria is through mosquito bite*). In other words, this just might work . . .
But there are serious caveats here. First, we have to genetically modify mosquitos to do this. Then we have to get the genetically modified versions to mate with unmodified versions, and for the genes that restrict malaria to be the ones that emerge in the offspring. Since these genes would not convey any adaptive advantage to the mosquitos (the genetic modification actually causes them to die young, which strikes me as a significant genetic disadvantage), there is really no guarantee that this would happen – it could be that the modified mosquitos’ impact on the overall genetic pool is tiny – or huge. I shudder a little at the proposed solution for this (From LA Times):
“connecting the gene to a piece of DNA that helps it spread by, for example, producing something that kills any mosquitoes that don’t contain the desired gene. Other research groups are working to develop such clever genetic tricks, but they are still years away from implementation.”
Once we start playing with a wider set of genes, I get worried. As the article goes on to note, the effects of such modification are hard to predict in a single species, and since that species participates in a wider ecosystem, the impact on other species is equally hard to predict. The last thing anyone wants are supermosquitos (a la superweeds and other superbugs that have resulted from previous genetic modification efforts). So this is not a magic bullet, just a hopeful volley in what has been, and promises to be, a long battle.
*Funny side story: in 1999, I arrived back in Syracuse, NY just as a pretty bad case of malaria flared up. Despite my protestations, several of my grad student colleagues bundled me off to the emergency room. When the admissions person asked me what was wrong, I told her – rather simply – “I have malaria”. The women stared at me for a second, and then said “should I be wearing a mask or something?” I was pretty beaten up at that point, with an accordingly short temper, which explains my response: “Honey, unless you have a jar of anopheles mosquitos back there, I think we’re going to be alright.”
Hahahaha!! Good stuff. I remember getting malaria once a year back in the day. I’m not sure what medicine I took back then. It was once a week, had a pink coating and had to be swallowed whole. If you messed up and sucked on it, the taste was soooo sour, no amount of sugar would help. That is, if the local stores even had sugar. 🙂
The laser – very cool, completely impractical, ultimately geeky. Thinking inside their very own techno-box.
@ Tchaka – the pink pills sound like Nivaquine.
i like your articles a lot and will be excited to read more
Ah yes….I looked it up and that’s also chloroquine. I believe you are correct. Thanks.