Resistant Malaria Spreads Rapidly To Thai-Myanmar Border

[george]

Resistant malaria spreads rapidly to Thai-Myanmar border

WASHINGTON, April 5, 2012 (AFP) - Deadly malaria that is resistant to drug treatment has spread rapidly from Cambodia to the border between Thailand and Myanmar, raising concerns of an uncontrollable epidemic, scientists said Thursday.

A pair of studies published in The Lancet and the journal Science showed how the disease is moving fast into new territory and identified a region of the parasite's genome that may be responsible for mutating in order to survive.

Malaria is a mosquito-borne disease commonly caused by a parasite, Plasmodium falciparum, that kills up to 1.2 million people a year, according to 2010 estimates by the Institute of Health Metrics and Evaluation at the University of Washington, Seattle.

Malaria that was resistant to treatment with the current standard therapy, artemisinin, was confirmed in Cambodia in 2006 and has since surged 800 kilometers (500 miles) westward to the Thailand-Myanmar border, the researchers said.

By studying 3,202 patients along the northwestern border of Thailand near Myanmar from 2001 and 2010 and measuring the time it took them to clear malaria infections from their blood after treatment, scientists were able to show a steady increase in drug resistance.

The number of slow-clearing infections rose from 0.6 percent of cases treated in 2001 to 20 percent in 2010.

In western Cambodia, 42 percent of malaria cases were resistant between 2007 and 2010, indicating that the Thailand-Myanmar region was swiftly catching up to Cambodia's rates.

"Genetically determined artemisinin resistance in P. falciparum emerged along the Thailand-Myanmar border at least eight years ago and has since increased substantially," said The Lancet study.

"At this rate of increase, resistance will reach rates reported in western Cambodia in two to six years."

The research in the journal Science focused on what was making these parasites different, and found that a region on chromosome 13 of the parasite was strongly associated with slow clearance of infection.

They sequenced the genomes of 91 P. falciparum parasites from Cambodia and western Thailand and compared them to parasites from Laos, where resistance to the latest artemisinin-based drugs has not yet emerged.

They found seven genes that may be responsible for making the parasite resistant to drugs, and which may explain up to 35 percent of the growing resistance in southeast Asia.

"We have now seen the emergence of malaria resistant to our best drugs, and these resistant parasites are not confined to western Cambodia," said leader of the study Francois Nosten, director of the Shoklo Malaria Research Unit that studies and treats malaria in the Thai-Myanmar region.

"This is very worrying indeed and suggests that we are in a race against time to control malaria in these regions before drug resistance worsens and develops and spreads further."

The death toll from malaria has been declining in Africa -- the part of the world worst hit by the disease -- in recent years, largely due to the increased use of artemisinin drugs and the widening distribution of insecticide-treated bed nets.

But if resistance spreads to artemisinin therapies -- used alone or taken in combination with other anti-malarials -- some experts are concerned that a resurgence of drug-resistant malaria could return to Africa.

Researchers say a new anti-malaria drug is not expected to appear on the world market before the next decade is up.

The two studies were funded by the Wellcome Trust and the US National Institutes of Health, and included scientists from Mahidol University, Bangkok; the Centre for Tropical Medicine at Britain's Oxford University; and the Texas Biomedical Research Institute in the United States.

-- (c) Copyright AFP 2012-04-06

[alant]

Very worrying, I tend to think of Thailand asked malaria free. The geography is also a concern. How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West? Via what route? Does this mean the central belt of Thailand is now infected? Or did it not transit at all and all malarial strains are simply mutating into a resistant form which being resistant may spread across previously uninfected areas?

[h90]

Very worrying, I tend to think of Thailand asked malaria free. The geography is also a concern. How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West? Via what route? Does this mean the central belt of Thailand is now infected? Or did it not transit at all and all malarial strains are simply mutating into a resistant form which being resistant may spread across previously uninfected areas?

Maybe just infected people transit?

Koh Payam, a beautiful island is also infected......

[bangkokburning]

Very troubling. Dengue is already pandemic here.

This is Fulciparium malaria note.

Funny, when I meet all these (stupid) European hippy types young and old in the islands and they pull out their citronella and all sorts of non-deet concoctions. I always tell them I prefer to put poison on my body, greatly outweighs the risk of severe illness from Dengue or death from Malaria. They laugh...hah hah.

Give me the 95% DEET every time!

Basically same article from AFP:

http://www.rawstory.com/rs/2012/04/05/drug-resistant-malaria-spreading-rapidly-in-cambodia-myanmar-thailand/

[h90]

Very troubling. Dengue is already pandemic here.

This is Fulciparium malaria note.

Funny, when I meet all these (stupid) European hippy types young and old in the islands and they pull out their citronella and all sorts of non-deet concoctions. I always tell them I prefer to put poison on my body, greatly outweighs the risk of severe illness from Dengue or death from Malaria. They laugh...hah hah.

Give me the 95% DEET every time!

Basically same article from AFP:

http://www.rawstory....anmar-thailand/

smoking marihuana, sleeping close to the jungle, etc etc getting bitten by 1000 mosquitoes

[bangkokburning]

Sometimes you have to sleep in the jungle, it's the way the NPs are set up. Some islands do not have much of a mossy problem - others, pretty serious.

Certainly, mainland jungle parks are a huge worry, esp with this report.

[TeddyFlyfisherDavis]

Future tourists will love to hear this...

[drdoom6996]

Plasmodium falciparum is preventable with Larium tablets once a week, There is a daily tablet that you can get outside of Asia. They stopped making it here when the counterfits would not work. Some antibiotics give daily protection as well, but you should check which one.

I know this because I work in Africa and the company compells us to take something and then urine tests us to make sure we comply. Plasmodium falciparum is deadly and starts with flu symptoms. See a doctor, don't wait.

[supaprik]

another HUB...

[Payboy]

How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West?

Poor Thailand, as usual caught in the middle of all that evil spreading to and from its neighbors.

[drdoom6996]

Very troubling. Dengue is already pandemic here.

This is Fulciparium malaria note.

Funny, when I meet all these (stupid) European hippy types young and old in the islands and they pull out their citronella and all sorts of non-deet concoctions. I always tell them I prefer to put poison on my body, greatly outweighs the risk of severe illness from Dengue or death from Malaria. They laugh...hah hah.

Give me the 95% DEET every time!

Basically same article from AFP:

http://www.rawstory....anmar-thailand/

A pandemic (from Greek πᾶν pan "all" + δῆμος demos "people") is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic. Further, flu pandemics generally exclude recurrences of seasonal flu. Throughout history there have been a number of pandemics, such as smallpox and tuberculosis. More recent pandemics include the HIV pandemic and the H1n1 pandemic.

I don't think dengue applies as a pandemic. But I'm sure you scared somebody that is not knowledgeable about such things.

[necronx99]

Plasmodium falciparum is preventable with Larium tablets once a week, There is a daily tablet that you can get outside of Asia. They stopped making it here when the counterfits would not work. Some antibiotics give daily protection as well, but you should check which one.

I know this because I work in Africa and the company compells us to take something and then urine tests us to make sure we comply. Plasmodium falciparum is deadly and starts with flu symptoms. See a doctor, don't wait.

Hmmm......http://www.cbsnews.com/2100-500164_162-538144.html

Roche, the drug company, claims that Lariam causes serious psychiatric side effects in only one in 10,000 people. But Dr. Paul Clarke, an infectious disease specialist and the medical director of a large network of travel clinics in Great Britain, organized his own study, after he and other British doctors saw problems with much greater frequency.

[kurtgruen]

Mosquitos up here don't like alcohol. Just stay drunk and you will be fine ;-)

[drdoom6996]

Very worrying, I tend to think of Thailand asked malaria free. The geography is also a concern. How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West? Via what route? Does this mean the central belt of Thailand is now infected? Or did it not transit at all and all malarial strains are simply mutating into a resistant form which being resistant may spread across previously uninfected areas?

Plasmodium falciparum is a different strain of Malaria. Thailand have not been Malaria free since I got here in 1987, probably years and years before but I know 25 years. But Plasmodium falciparum was less that 1% of people bitten in Thailand until now. Malaria is transmitted by mosquito's, NOT PEOPLE.

Edited April 6, 2012 by craigt3365
removed inappropriate sentence

[docspinoff]

I think that Thailand should re think the boarder crossings! as Falang are being shipped unnecessary across boarders every 30 days or less to just get a stamp . they could do in a local Immigration office

its a bit like England we were a Island that;s why we don't have Rabies,so not long before we get it with the channel tunnel

so every time a Falang unnecessary cross the border we are increasing the chance of

Malaria and other infections

[chiangmaicharlies]

Mosquitos up here don't like alcohol. Just stay drunk and you will be fine ;-)

Sounds good to me - pass me a saucer of laced milk, please

[cowboydog]

Mosquitos up here don't like alcohol. Just stay drunk and you will be fine ;-)

imagine your worst hangover & multiply it 10 fold or more. this will the first symptom..followed by delirium ..loss of consciousness, multi-organ failure ...welcome to p falciparum.

[david555]

Thailand & neighbors resistant malaria , And in India a resistant Tuberculosis , Europe resistant hospital bacteria ........ looks like nature once more go take care about the over population as before it did

[craigt3365]

This is not good!

[TomTao]

Last year I saw a man with malaria waiting to see a doctor in Chumphon hospital, he was in obvious discomfort, delerious and vomiting clear mucus, if that was the common malaria I would not want to be infected with this new variety.

Posted with Thaivisa App http://apps.thaivisa.com

[creck]

Very worrying, I tend to think of Thailand asked malaria free. The geography is also a concern. How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West? Via what route? Does this mean the central belt of Thailand is now infected? Or did it not transit at all and all malarial strains are simply mutating into a resistant form which being resistant may spread across previously uninfected areas?

Plasmodium falciparum is transmitted by mosquito, not people. A mosquito has to bite a person with Malaria and then bite you. Humans can not get Malaria from other humans. You should read up on this as you clearly don't have a clue and Plasmodium falciparum kills in 4 to 6 days and it is painful. I personnaly know several people that have had it. Please pull your head out of the sand.

Are you saying people with malaria are immediately immobile? I see nothing wrong with that post except that we cannot know the answer. Malaria can travel in humans and mosquitoes I would say. True, new cases must have been bitten by a mosquito that has bitten an infected human – or some other mammal that has it in his blood? You are right there cannot be any other way than a bite, but the infected human could have flown in a plane further than a mosquito without a ticket. The spraying of insecticide in planes coming from that direction should also be started immediately.

Four to six days is very fast, I did not realise it was so lethal. It could take that long to know what disease a person has?

This is not entirely a joke, - but is gin not any use now?

[jerrysteve]

These are a quote from a reliable Medical source on the Symtoms. "There are three main types of malaria, depending upon the parasites which cause it. They are tertian fever, quartan fever and malignant tertian malaria. The most common symptom of all types of malaria is high fever, which may occur every day, on alternate days, or every fourth day. The fever is accompanied by chills, headache, shivering, and pain in the limbs. The temperature comes down after some time with profuse sweating."

These misquitos are indeed moving rapidly. All these Thai people that water and plants and misquito would do better to empty all of them coz they are indeed a huge magnet for these deadly critters.

I believe Singapore way back when had their citizens remove all the large vases and or pots in a combined effort do help do away with the Dengue fever which affects the blood. You can probably bet money these these drug resistant misquitos are carrying Dengue as well as Malaria.

I did read way back when that Grapefruit eaten daily is a pretty effective remedy for the onset of symtoms from Malaria. I believe the huge Som O you see in the thai markets, and in the grocery stores like Big C etc is related to the grapefruit we have in the west.

[jerrysteve]

A bottle of Jungle Formula Extra Strength Lotion, for Tropical Use from the U.K. is by far the best defense against these nasty varmits; it <deleted> works against Midgets, Misquitos, and All biting insets. but not against bar girls I have never seen it in Thailand, but I carry it with me all the time. 10hr hours of protection is dam good.

www.jungleformula.co.uk I am reading this right off the bottle I have.

[FangFerang]

I wonder what course the WHO is recommending for this problem?

PS: The laced milk comment from ChiangMaiCharlies was a welcome bit of comic relief.

[rotorbreeze]

Last year I saw a man with malaria waiting to see a doctor in Chumphon hospital, he was in obvious discomfort, delerious and vomiting clear mucus, if that was the common malaria I would not want to be infected with this new variety.

Posted with Thaivisa App http://apps.thaivisa.com

How many readers have had malaria? Well FYI I have had it on my return from West Africa 1996, got bitten while at airport awaiting my return, as luck had been favorable I developed the full disease on my return...I went to hospital and local Dr. puzzled as all the signs did not comply with normal disease found in Canada. A specialist look at my case..he was specialized in "Foreign Disease" yes I had Malaria. I was given treatment and recovered. FYI I can not give blood for 10yrs as I had to complete the donor quiz before giving, having had malaria.

I would like to share this information concerning Malaria... http://www.themiraclemineralsupplement.com/

Miracle Mineral Supplement interview with “Mr. MMS” Jim Humble!

If you prefer to rather listen to the interview:

According to Jim Humble, it all started…

In mid 1996, deep within the mining jungles of South America, a United States scientist, named Jim Humble, made an almost accidental discovery…

An alternative discovery that would supposedly change the course of human health history forever?

Jim said, it started with malaria…

Caused by a protozoan parasite, this disease kills over one million people every year.

According to Jim Humble, after more than 75,000 documented successful treatments of this disease (see his book for more information), many of which took effect in less than 4 hours, it was discovered to have similar effects on diseases caused by viruses, bacteria, parasites, fungi and proteins.

In the summer of 2007, this man stepped out of the shadows to make this information and natural solution freely available to all humanity. He believes the long-term availability of this substance (called “miracle mineral supplement” or shortly “mms”) may soon be heavily controlled by “the powers that be”.

I trust this information will benefit you and your family...Mr. Ron

FYI I have brought this mixture in dry form from Canada and use it on a regular basis, prevention is best way, like taking a multivitamin daily.

A supplier here in Thailand can be posted on request.

[cricketer]

Very worrying, I tend to think of Thailand asked malaria free. The geography is also a concern. How did this form of malaria transit from Cambodia to the east of Thailand and Burma in the West? Via what route? Does this mean the central belt of Thailand is now infected? Or did it not transit at all and all malarial strains are simply mutating into a resistant form which being resistant may spread across previously uninfected areas?

Maybe just infected people transit?

Koh Payam, a beautiful island is also infected......

h90,

Do you have any further info on how it's affecting Ko Payam, Have been there many times and have friends on the island

[Skywalker69]

Future tourists will love to hear this...

It´s already out, it was on the Swedish news this morning.

[david555]

Future tourists will love to hear this...

It´s already out, it was on the Swedish news this morning.

tranlate it to Russian and just put pattaya instead ....... and not forget to send to the Pravda newspaper (a bad thing can serve a" noble" cause too )

Edited April 6, 2012 by david555

[mrireland]

Just a few questions and im not completely clear on a few things which ive heard about Malaria and also about that article.

It was my understanding that Thailand for the most part was Malaria free with the exception of the border areas and jungle areas, now i understand the odd one might travel further so there is no 100% malaria free zone but outside of the jungle and border areas were pretty safe, Has this changed or is the article just saying that the same areas that were affected now have a stronger resistance to drugs but it still affects the same zones that had Malaria originally?

ed

Giving Chiang Mai is nearer the Jungle and border areas is it at higher risk, and when you say higher risk do you mean 0.02% risk or 2% or 20% or is there no reliable information on this, my doctors back home on several occasions have said that Chiang Mai area is Malaria free.

If it is in fact spreading to non Malaria areas and its not just that the new resistant type of Malaria is spreading to previously affected areas then i have some questions off of that.

1 - I always assumed that Malaria tables dont prevent you getting the disease but just put the drug that treats it in your body so if you do get infected your chances of recovery is higher

2 - Do people staying long term in Thailand in affected areas take Malaria tablets and is there side affects, IIRC these drugs are very expensive and some have noticeable side effects

So reading the article and these posts i was getting the impression that this is something that everyone should be worried about, id like to clear up if this is the case or if it only affects previously affected Malaria zones? Also if this is a concern anyone know a good place in Chiang Mai that sells high strength deet, all the ones ive seen previously are low 15-30%, where to get the 90% ones and is there side affects to deet? Is it bad for the skin? I tend to get bitten almost exclusively on the legs and feet particularly the lower ankles and feet, is there any logical reason they prefer those other than i have fabulous legs, should i put deet on my face, dont think ive been bitten there before and i dont fancy doing my body head to toe with deet everyday but wouldnt mind putting on my legs and arms, bit freaked out now so would love if someone knowledgeable could clear that up

[geriatrickid]

Wow. Some wild notions and an offer of a snake oil type of treatment.

This is an illness ENDEMIC to the region.

The Bill &Melinda Gates Foundation, along with the Clinton Foundation and WHO have been directing resources to this health problem for several years. Humans and other vertebrates are indeed reservoirs and the mosquito is the vector (transmission vehicle). The most effective course of prevention is common sense;

- wear long sleeves, pants & socks from late afternoon until sunrise

- use mosquito netting in risk zones

- use repellents with DEET

- avoid areas with concentrations of mosquitos

- prophylaxis with medication if staying in high risk areas.

Malaria is a rural, non urban disease, Those people living in big cities like Chiang Mai are much less at risk than someone living in a jungle village. Dengue is an urban disease. Urban dwellers are more likely to contract dengue than rural dwellers.

IMO -The laissez fair attitude of the regional governments to the widespread presence of counterfeit medications has had a large role in the presence of resistant strains of malaria. The doses provided were either ineffective through poor formulation, lack of Active pharmaceutical ingredient, or just bogus. This failure is considered to be a major contributing factor to the inability to effectively treat patients. NGO's have been in large part compelled to purchase their medications through government designated sources. Those sources are not secure. Those NGOs that have obtained their medication through WHO approved distributors or direct from the manufacturer have had better success in responding.

Not my specialty, but I have talked shop with some of the researchers in Chiang Mai, and they have been in crisis mode for at least 2 years. One concern not mentioned and it has serious ramifications for Thailand is that malaria combined with TB is lethal and requires very specialized care.

A word of caution, whenever taking a drug for malaria or a presumed "natural" cure, be sure to verify that it won't have an impact on other drugs or medication one is taking. For example, I note the reference to grapefruit. well, if you are on a statin like Crestor, that's a big no no. You have to leave time between eating grapefruit and taking the medication, the same way you need to leave 2 hours if you have taken an acid relief drug (e.g. Tums/Rolaids/Gavascon)

The only effective long term control of mosquitos is to maintain predator populations, birds, bats and reptiles and to destroy breeding sites for mosquito larvae, either through the introduction of chemicals or predators that eat the larvae. Malaraia has been killing humans since the dawn of time. it isn't going away, so use common sense and you might just be okay.

Edited April 6, 2012 by geriatrickid