Modified mosquitoes to eradicate malaria?

Researchers claim they have managed to genetically engineer mosquitoes which can resist the malaria infection, doing it in such a way that can nearly ensure the trait will rapidly spread through a population.

Californian researchers have utilised a cutting edge new technique known as gene editing, a technique that involves precise placement of new DNA to enable specific desired effects.
The gene editing technique they used – called CRISPR – allows the new trait to quickly spread and almost guaranteeing the new gene will be transmitted to new generations, limiting the transmission of malaria to humans.

“This opens up the real promise that this technique can be adapted for eliminating malaria,” said Anthony James of the University of California Irvine, who helped lead the study.

“We know the gene works. The mosquitoes we created are not the final brand, but we know this technology allows us to efficiently create large populations.”

The new breed that the researchers looked at were genetically modified Anopheles stephensi mosquitoes – of which normal versions are a common carrier of malaria within India and the Middle East – will not be able to either carry or transmit the deadly disease.

The scientists at the University of California modified the Anopheles stephensi mosquitoes’ DNA with a “resistance” gene, placed into the ‘code’ via a common “cut and paste” gene-altering method known as CRISPR/Cas9.

The technique has previously been utilised to look at the safety of using pig organs safe for human transplants, and produce an HIV-resistant immune system.

Specifically, an analysis was conducted on the mosquitoes’ DNA to try and transmit malaria-fighting antibodies for the particular type of malaria infection that impacts humans that infects humans - Plasmodium falciparum. For the modified mosquitoes, the malarial parasite is either killed off entirely, or stopped from forming into a strain that could be deadly to humans.

The Californian study includes an optimistic future plan to emit the modified mosquitoes into the wild and then the theory is these mosquitoes would give the anti-malarial genes to their offspring, thus generating a resistance to the parasite.

Amazingly, the DNA was successfully passed on to 99.5% of the mosquitoes’ offspring in the lab; genes only have a 50% chance of being passed on usually. In addition, a tracer gene was added to the malaria-resistant one, which would make the modified mosquitoes’ eyes become a fluorescent red in colour.

With further research and development, the team of scientists at the University of California are optimistic they will be able to eventually engineer an anti-malarial mosquito population, helping to eradicate a potentially deadly disease that afflicts millions of people around the globe each year.

Don’t forget, if you are wanting to escape the wet and miserable weather in the UK currently, and are travelling to particularly at-risk countries for malaria, The NHS Malaria Fit For Travel website offers advice about antimalarials such as Malarone and includes a map to show what other serious diseases are rife in certain regions.

Malaria moving to higher altitudes due to climate change

Rising temperatures and climate change could put people living in the tropics at risk of contracting the mosquito-borne malaria, according to scientists who have spent two decades monitoring the deadly disease within two densely populated mountainous regions in South America and Africa.

Those residing in higher altitudes have typically not been at risk from the disease, as mosquitoes carrying the malaria parasite find it difficult to survive in the cooler air.

Professor Mercedes Pascual University of Michigan, who led the research, says: “The risk of the disease decreases with altitude and this is why historically people have settled in these higher regions.”

Health experts have spent years arguing if malaria will move because of climate change, and this is one of the only studies of its kind that demonstrates how malaria can migrate higher with a temperature increase. This puts millions of people at risk, who historically have been benefiting from living in malaria-free areas in the high-altitude tropics.

The study involved an analysis of the densely populated areas in the highlands of Colombia and Ethiopia as there were comprehensive records kept for the two of both temperature and malaria cases from the 1990s to 2005.

It was discovered that during warmer years, malaria managed to transmit into the mountains and for the years when the temperatures were cooler, the disease was restricted to lower altitudes.

“We have identified that malaria does indeed move up and down and that the movement is temperature dependent. It’s been difficult to prove and people have been questioning it now for 20 years,” said Menno Bouma of the London School of Hygiene and Tropical Medicine, who was involved in the research.

“The implications are that if this is true, and that a global warming is occurring leading to an increase in temperatures, then malaria will increase at higher altitudes where many people live. The high altitude areas in the tropics are particularly highly populated,” Dr Bouma added.

Dr Bouma says that those in the higher altitudes do not have any protective immunity as they are not exposed to malaria, meaning they could be susceptible to potentially even more serious and fatal cases of the disease.

Around half of Ethiopia’s population live at an altitude between 1,600m (5,250ft) and 2,400m, and the scientists estimate there could be a surge in malaria cases. They predict even just a 1C increase in average local temperatures will mean there will be three million children more children who will contract malaria annually.

“We have estimated that, based on the distribution of malaria with altitude, a 1C rise in temperature could lead to an additional three million cases in under-15-year-olds per year,” says Professor Pascual.

The most recent figures released by the World Health Organization show an estimated 207 million cases of malaria in 2012, resulting in about 627,000 deaths. The majority of these deaths occur among children in Africa. Clearly more work needs to be done into control efforts of the disease, getting malaria treatment and prevention methods to the millions who need them.

In addition, if you are travelling to particularly at-risk countries, The NHS Malaria Fit For Travel website offers advice about antimalarials such as Malarone and includes a map to show what other diseases are common in certain regions.

Holiday and Travel packing checklist

Christmas is now almost a forgotten memory as we approach the end of January. A long five-week month after Christmas has left many of us skint and the struggle to stick to our New Year’s resolutions will simply be adding to the misery.

However, as payday is upon the majority of the nation this week, Brits can now switch their attentions to jetting off to warmer climates. In fact, the UK’s leading travel association, Abta, has already noted a substantially high number of bookings already for summer holidays, with some tour operators experiences a sales rise of more than 10% annually.

With that in mind, perhaps it is time to think about your health and wellbeing whilst on holiday, especially when considering that a past survey suggested that an alarming 80% of us are not prepared to deal with minor medical problems in the home, never mind when out and about within a foreign country.

If you are visiting a tropical region for example, there are a number of prescription and over-the-counter products to consider. The NHS fit for travel website can provide more information about the risks in particular countries, but in terms of tropical regions, malaria is the obvious risk and is still a massive killer.

According to the World Health Organization, in 2010, there were approximately 219 million malaria cases (with an uncertainty range of 154 million to 289 million) and an estimated 660,000 malaria deaths (with an uncertainty range of 490,000 to 836,000).

Antimalarials

Therefore, an antimalarial is must, with Doxycycline, Malarone and Paludrine all different medications for malaria prevention. Malarone can also be used for the treatment of malaria, should you contract the disease. All three are prescription-online medicines but you can also boost your protection with Jungle Formula Maximum pump spray, which effectively repels mosquitoes, midges and other biting insects for up to 10 hours per application. You must remember to order your prescriptions well in advance of your trip.

Antihistamines

Antihistamines such as Loratadine are commonly taken to ease the symptoms of seasonal allergic rhinitis (hay fever). Loratadine is useful for insect bites, easing the itching associated with them, and avoiding bites in tropical places is absolutely imperative due to the risk of malaria.

Asthma Inhalers

The last thing you want is to suffer an asthma attack on holiday and be without your inhaler. Order repeat prescriptions well in advance and make sure you have a good supply of blue reliever and brown preventer inhalers.

Contraception

For women who have been prescribed a daily contraceptive pill such as Dianette or Yasmin, it is important that you make sure you have a sufficient supply of your medication to last before, during and after your holiday, until you can obtain some more. Contraceptive pills alone will not provide protection against sexually transmitted infection and with a tendency for Brits to have a carefree attitude to sex when on holiday, condoms are essential to pack for your getaway.

Travel sickness

If you or any of your travelling group suffer from travel sickness then make sure you have necessary treatment to hand. Travel sickness is caused by repeated unusual movements, usually when travelling by boat, car, plane or train, and is especially common in young children and women. Kwells and Avomine tablets are widely used for the prevention and relief of travel sickness.

Other items

Sunblock cream with a high sun protection factor (SPF) is a must to minimise the risk of sunburn. Inbuprofen, Paracetamol, or other pain killers, are also handy should you require them during your holiday. You should also considering packing a first aid kit armed with assorted plasters, dressings, latex gloves, tape, scissors and other essentials.

Andy Murray and Lionel Messi join campaigns to combat malaria

Famous sporting figures from around the world have offered their help in the battle against the potentially-deadly disease malaria.

Tennis star Andy Murray, who yesterday defeated Russian Mikhail Youzhny to reach the quarter finals of Wimbledon, has lent his support to charity Malaria No More UK.

Since their inception in 2009, Malaria No More UK have successfully pushed the coalition government to guarantee malaria is one of the key factors of its international development agenda and have secured a major coup in getting Andy Murray on board for their ‘Be The Net’ campaign – an interactive digital campaign to raise awareness about fighting the disease.

Murray, 26, spoke about malaria to the Huffington Post, saying: "In the past year I’ve won some of the biggest matches of my career but I’m still striving for the world to win the fight against malaria. Every minute a child dies unnecessarily from this disease, yet it is easy to prevent and costs less than a pack of tennis balls to treat. Be The Net is an easy way for us to come together and show our support for this winnable fight, something I am proud to support."

Members of the public are able to insert their face onto a virtual mosquito net via social networking sites Twitter and Facebook, or email and share the activity with their friends or family. Users can also develop their understanding about malaria and the huge challenges there are in combating the disease, in addition to being able email their local MP to show support in the UK’s help in battling malaria and decreasing the risks and deaths caused by it.

Arabella Gilchrist, Director of Communications for Malaria No More UK says: “This campaign is all about getting the public involved and empowered in a democratic movement to fight malaria – one of the best humanitarian investments on the planet. Andy’s the perfect fit for this campaign, he’s tenacious and persistent – Be The Net promotes the message that united we can win.”


However the tennis superstar is not the only sporting figure who is united in fighting malaria. On Thursday 27^th June, Barcelona and Argentina footballer and current FIFA World Player of the Year Lionel Messi arrived for a humanitarian trip to the West African country Senegal.

Messi, 26, was there in conjunction with Qatari football academy ASPIRE Football Dreams to help promote mosquito nets for a new anti-malaria program.

The organisations new initiative – Football Combating Malaria – hopes to distribute an initial 400,000 medicated bed nets across 10 countries in Africa, but aims to have over 1,000,000 to people across the continent each year in the very near future. Nearly 1,000,000 people are thought to have cheated death over the past 12 years by sleeping under nets coated with insecticide.

Despite this, according to the World Health Organization, during 2010 malaria was still responsible for an estimated 660,000 deaths around the world.  The 660,000 deaths emanated from a staggering approximate 219 million cases of the disease, which is preventable and treatable through medicines such as Doxycycline, Malarone and Paludrine.

Around 91% of those fatalities occur in Africa, where most of the deaths are children under the age of 5. Tragically, about 180 children die because of malaria every 90 minutes – the same time duration as a football match.

Speaking to BBC Sport, Messi opened up about the plight of malaria, saying: “I am really delighted to come to Senegal. My commitment to be part of this battle against malaria is relentless. Whenever I have the opportunity to help, I will not hesitate. There is no doubt that I’ll co-operate with organisations involved in this initiative to trim out the pernicious effects of malaria.”

Malaria-infected mosquitoes more enticed by human odour

Malaria-carrying mosquitoes are more drawn to human scent compared with mosquitoes that do not carry the parasite, suggests the findings of a new study.

For the study, led by Dr James Logan of the London School of Hygiene and Tropical Medicine, mosquitoes carrying the malaria parasite Plasmodium falciparum were exposed to nylon socks that had been worn by one of the study authors (Renate Smallegange from Wageningen University in the Netherlands) for about 20 hours previously.

Ms Smallegange state the socks were used as ‘bait’ for the 176 mosquitoes that were analysed in the laboratory. She says: “Volatiles emitted by human feet are known to be highly attractive to Anopheles gambiae females.”

It was estimated that the infected mosquitoes were approximately three times more likely to land and try and bite on the worn socks compared to the mosquitoes without any parasite. For study purposes, the species of mosquito analysed was the Anopheles gambiae – the cause of high transmission rates of malaria in Africa. Both infected and healthier mosquitoes were not particularly keen on unworn socks that were also tested.

Experts are already aware that Anopheles gambiae mosquitoes have certain odour receptors which are effective at picking out specific human scents. The scientists involved in the study are convinced that it is the parasites which are creating a heightened craving for human smells, ergo increasing a risk of UK holiday makers being bitten in the dangerous areas for malaria.

Dr Logan was interviewed by BBC News and explained the findings in the study, commenting: “We think the parasite is giving them a heightened sense of smell. We are hypothesizing there is an alteration somewhere in their olfactory system that allows them to find us quicker,” which would make it more likely that the parasite enters the blood stream, ensuring its survival and the spread of the disease.”

The researchers conclude they are unsure how precisely the parasite alters mosquitoes’ sense of smell, in addition to which component(s) of human odour is the most is deemed most appealing to the mosquitoes as human skin emits over 350 different odour molecules. If this information could be attained from future studies, effective traps could be devised to catch the infected mosquitoes and hopefully lessen the risk of a disease that infects around 200,000 million people around the world each year, killing over 600,000.

If you are about to travel abroad and are unsure of what potential health risks there are or which medications are suitable for your area of travel, Medical Specialists Pharmacy recommend visiting the NHS Fit For Travel website.

Here you can click onto the continent and country you are about to travel to, see a highly detailed list of preventative measures to take before and during travel, what diseases are prominent in that particular country as well as a list of the symptoms of each, and also what medications/immunisations are advisable – i.e. Malarone, Paludrine and Doxycycline are all prescription medications to prevent malaria, with Malarone also able to treat the disease if you contract it. All three are available now from the Medical Specialists Holiday and Travel area of the website, where you can also find treatments for the prevention and control of travel sickness; Kwells, Kwells Kids and Avomine.

Dismay at the effectiveness of GSK’s malaria vaccine

The expectations and anticipation regarding the world’s first potential malaria vaccine have been dealt a blow after trial results demonstrated that the protection the vaccine offers, can significantly diminish and disappear altogether over time, disappointing researchers who had high hopes for it.

Developed by British pharmaceutical giant GlaxoSmithKline (GSK), the new vaccine is currently only referred to as ‘RTS,S’. Scientists state that full data from final-stage trials which include 15,000 children, are expected by the end of 2014. However, early results from the vaccine are not encouraging and expose the difficulties in creating a vaccine that offers full protection from a deadly disease such as malaria that claims the lives of more than 650,000 children every year – the most ‘at risk’ group in regards to mosquito bites.

The vaccine has been primarily engineered to help babies aged between six to 12 weeks and in a large-scale phase III trial that was carried out last year, only a third of babies aged within this range were prevented from becoming ill after being administered the new vaccine. Moreover, the protection was lower than what was evident in older children.

Microsoft co-founder Bill Gates, worth an estimated £40bn, was one of the backers behind the research, and after those results emerged last year he commented: “The efficacy came back lower than we had hoped, but developing a vaccine against a parasite is a very hard thing to do.”

Christopher Plowe, a malaria researcher at the University of Maryland School of Medicine in the United States, who was not involved in the RTS,S trial, also spoke on the findings last year, saying: “The results are kind of disappointing because we’d all like to see a malaria vaccine that has closer to 80 percent or 100 percent efficacy.”

Results of the latest data were published this week in the New England Journal of Medicine. Although the RTS,S vaccine was found to have a rate of protecting peaking at 53%, after an average of merely eight months, the level of protection had declined at an alarming rate.

Ally Olotu of the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme in Kenya, who led the follow-up study, said: “It was a bit surprising to see the efficacy waned so significantly over time. In the fourth year, the vaccine did not show any protection.”

A GSK spokesperson commented on the latest results, stating that because they were derived from a small, mid-stage trial, they did not “provide definitive answers about the duration of protection or how the vaccine candidate works in different malaria transmission settings.”

Phillip Bejon, a researcher at the KEMRI-Wellcome Trust programme, was involved with the study and he said in spite of the decreasing effectiveness, “there is still a clear benefit to the vaccine.”

Bejon added: “Many of the children (in Africa) will experience multiple episodes of clinical malaria infection, but overall we found that 65 cases of malaria were averted over the four-year period for every 100 children vaccinated. We now need to look at whether offering a vaccine booster can sustain efficacy for longer.”

Travellers need strong vigilance against malaria and typhoid fever

In recent years more and more Brits have become fed up of the freezing cold temperatures over the winter season and many even decide to jet off to sunnier climates and areas such as the Tropics, where necessities to stave off the cold such as electric blankets, hot water bottles and a piping hot brew are simply not required!

Upon arriving back in the UK though, what would you do if you begin to feel unwell after a week or two of being back? In these instances, symptoms such as muscular aches/pains, diarrhoea, vomiting and a high temperature are commonly (and usually incorrectly) blamed on simple problems such as seasonal flu or food poisoning from out-of-date food or a dodgy takeaway meal. In fact, some of these symptoms are not too dis-similar to those suffered by over a million Brits recently with the norovirus epidemic which is still rife in many areas.

However, if you are feeling slightly under the weather after a visit to tropical regions such as West Africa, Southeast Asia, India, the Caribbean, etc., then it could be a cause for concern and something more serious than just a seasonal flu or food poisoning.

The findings of one particular study, published online yesterday in the American Journal of Tropical Medicine and Hygiene, have suggested that travel illnesses such as malaria and typhoid ought to be discussed with your GP following a visit to a tropical climate. In addition though, Medical Specialists Pharmacy strongly advise that these and many other travel illnesses such as traveller’s diarrhoea and dengue also be discussed, before travelling to your destination where there may be a high risk of such diseases.  To prevent contracting malaria, there are numerous antimalarial medications available from Medical Specialists for anybody visiting a country of risk. These include Doxycycline, Paludrine and Malarone – with the latter also able to treat the disease if you should get it.

University of Oslo researcher Mogens Jensenius, MD, PhD, and his team looked at the GeoSentinel surveillance network database to attain an incredible 15 years worth of information; this comprising of data contained on 82,825 returning travellers from Europe, North America, Israel, Japan, Australia and New Zealand. All had requested treatment for different health problems from June 1996 through to August 2011. It was ascertained that 4.4% (3,655) of these people had contracted either malaria, typhoid fever, or another type of deadly tropical disease. In total, 13 deaths were documented from the 3,655 patients and 10 of these were due to malaria.

Malaria was actually the most prevalent of the tropical diseases, seen in 76.9% of the diagnoses. The disease is caused by the Plasmodium parasite. The parasite is passed on to humans through the bites of infected female mosquitoes. Symptoms include muscular pain, headaches, diarrhoea, vomiting, severe sweats and chills and a fever of 38C (100.4F) or more.  

The second most common tropical disease was typhoid fever. Caused by the Salmonella typhi bacterium, it is an infection that may spread through the body after the person consumes food or water that has been contaminated with a small amount of infected faeces or urine. Symptoms include stomach pain and rashes in the first week of illness. During the second week, the sufferer will likely experience a worsening of symptoms that can include abdominal pain, weight loss and a fever that increases in temperature to about 39–40C (103–104F).

Both conditions are fatal without a prompt diagnosis and treatment; however those who contract malaria are more likely to die than those who contract typhoid fever, which can be treated in merely a few days with antibiotics.

Surprisingly, not one of the 80,000 had caught the often-fatal Ebola virus – one of the top-feared diseases in travellers due to its 90% fatality rate. ‘Ebola haemorrhagic fever’ as it is also known, occurs mainly via outbreaks within remote villages in Central and West Africa that are close to tropical rainforests.

Researcher Mogens Jensenius commented on the findings in the study, stressing just how serious the issue of tropical diseases is. He said: “While diagnosis and treatment of malaria and typhoid fever and many other tropical diseases have improved greatly over the years, people still can die from them if they are not treated quickly after their symptoms begin. Doctors and nurses in Western countries need to be vigilant in considering these potentially life-threatening tropical infections in recently-returned travellers with fevers, and identify and treat them quickly.”