Scientists to Pay Volunteers Thousands to Be Exposed to Deadliest Form of Malaria (Seattle, WA)

Fox News / AP ^ | March 6, 2008

[Stoat]

SEATTLE  —  Within the next 18 months, medical researchers will be asking people in Seattle to volunteer to be exposed to the deadliest form of malaria to help them test the effectiveness of vaccine candidates.

The Seattle Biomedical Research Institute is collaborating with the PATH Malaria Vaccine Initiative to accelerate malaria vaccine research by opening a new vaccine testing center in Seattle's south Lake Union neighborhood.

Scientists at the center will use early testing of vaccines to weed out those that don't work so they can speed up research on the ones that are effective. Malaria vaccine testing has already begun at a second site in the United States, the Walter Reed Army Institute of Research in Maryland, and is also being conducted at labs in England and the Netherlands.

"We're particularly excited by the center's location in Seattle, a community where many people have an interest in global health issues and, as a result, are willing to volunteer for such an important cause -- to help save the lives of young children in some of the world's poorest countries," said Dr. Christian Loucq, Malaria Vaccine Initiative director.

Malaria, which is spread by mosquitoes, kills more than a million people each year, most of them children. Deaths doubled in Africa over the past 20 years due to resistance to existing drugs and insecticides.

Seattle volunteers will be paid an estimated $2,000 or more to hold a paper cup containing infected mosquitoes against their arm, waiting for the insects to bite. Symptoms usually develop within nine to 11 days, and volunteers will be treated for malaria when the first parasites show up in their blood. The treatments last three days.

[Stoat]

CDC - Malaria

Disease CDC Malaria

Disease
 

Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria disease can be categorized as uncomplicated or severe (complicated) . In general, malaria is a curable disease if diagnosed and treated promptly and correctly.

Patient with symptoms of malaria seen at the Moronacocha Health Center in the outskirts of Iquitos, on the Peruvian Amazon. A blood smear confirmed that he had malaria. (Image contributed by Dr. Jaime Chang, USAID/Peru)

Incubation Period

Following the infective bite by the Anopheles mosquito, a period of time (the "incubation period") goes by before the first symptoms appear. The incubation period in most cases varies from 7 to 30 days. The shorter periods are observed most frequently with P. falciparum and the longer ones with P. malariae.

Antimalarial drugs taken for prophylaxis by travelers can delay the appearance of malaria symptoms by weeks or months, long after the traveler has left the malaria-endemic area. (This can happen particularly with P. vivax and P. ovale, both of which can produce dormant liver stage parasites; the liver stages may reactivate and cause disease months after the infective mosquito bite.)

Such long delays between exposure and development of symptoms can result in misdiagnosis or delayed diagnosis because of reduced clinical suspicion by the health-care provider. Returned travelers should always remind their health-care providers of any travel in malaria-risk areas during the past 12 months.

Uncomplicated Malaria

The classical (but rarely observed) malaria attack lasts 6-10 hours. It consists of:

• a cold stage (sensation of cold, shivering)
• a hot stage (fever, headaches, vomiting; seizures in young children)
• and finally a sweating stage (sweats, return to normal temperature, tiredness)

Classically (but infrequently observed) the attacks occur every second day with the "tertian" parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the "quartan" parasite (P. malariae).

More commonly, the patient presents with a combination of the following symptoms:

• Fever
• Chills
• Sweats
• Headaches
• Nausea and vomiting
• Body aches
• General malaise.

In countries where cases of malaria are infrequent, these symptoms may be attributed to influenza, a cold, or other common infections, especially if malaria is not suspected. Conversely, in countries where malaria is frequent, residents often recognize the symptoms as malaria and treat themselves without seeking diagnostic confirmation ("presumptive treatment").

Physical findings may include:

• Elevated temperature
• Perspiration
• Weakness
• Enlarged spleen.

In P. falciparum malaria, additional findings may include:

• Mild jaundice
• Enlargement of the liver
• Increased respiratory rate.

Diagnosis of malaria depends on the demonstration of parasites on a blood smear examined under a microscope. In P. falciparum malaria, additional laboratory findings may include mild anemia, mild decrease in blood platelets (thrombocytopenia), elevation of bilirubin, elevation of aminotransferases, albuminuria, and the presence of abnormal bodies in the urine (urinary "casts").

Severe Malaria

Severe malaria occurs when P. falciparum infections are complicated by serious organ failures or abnormalities in the patient's blood or metabolism. The manifestations of severe malaria include:

• Cerebral malaria, with abnormal behavior, impairment of consciousness, seizures, coma, or other neurologic abnormalities
• Severe anemia due to hemolysis (destruction of the red blood cells)
• Hemoglobinuria (hemoglobin in the urine) due to hemolysis
• Pulmonary edema (fluid buildup in the lungs) or acute respiratory distress syndrome (ARDS), which may occur even after the parasite counts have decreased in response to treatment
• Abnormalities in blood coagulation and thrombocytopenia (decrease in blood platelets)
• Cardiovascular collapse and shock

Other manifestations that should raise concern are:

• Acute kidney failure
• Hyperparasitemia, where more than 5% of the red blood cells are infected by malaria parasites
• Metabolic acidosis (excessive acidity in the blood and tissue fluids), often in association with hypoglycemia
• Hypoglycemia (low blood glucose). Hypoglycaemia may also occur in pregnant women with uncomplicated malaria, or after treatment with quinine.

Severe malaria occurs most often in persons who have no immunity to malaria or whose immunity has decreased. These include all residents of areas with low or no malaria transmission, and young children and pregnant women in areas with high transmission.

In all areas, severe malaria is a medical emergency and should be treated urgently and aggressively.

Malaria Relapses

In P. vivax and P. ovale infections, patients having recovered from the first episode of illness may suffer several additional attacks ("relapses") after months or even years without symptoms. Relapses occur because P. vivax and P. ovale have dormant liver stage parasites ("hypnozoites") that may reactivate. Treatment to reduce the chance of such relapses is available and should follow treatment of the first attack.

Other Manifestations of Malaria

• Neurologic defects may occasionally persist following cerebral malaria, especially in children. Such defects include troubles with movements (ataxia), palsies, speech difficulties, deafness, and blindness.
• Recurrent infections with P. falciparum may result in severe anemia. This occurs especially in young children in tropical Africa with frequent infections that are inadequately treated.
• Malaria during pregnancy (especially P. falciparum) may cause severe disease in the mother, and may lead to premature delivery or delivery of a low-birth-weight baby.
• On rare occasions, P. vivax malaria can cause rupture of the spleen or acute respiratory distress syndrome (ARDS).
• Nephrotic syndrome (a chronic, severe kidney disease) can result from chronic or repeated infections with P. malariae.
• Hyperreactive malarial splenomegaly (also called "tropical splenomegaly syndrome") occurs infrequently and is attributed to an abnormal immune response to repeated malarial infections. The disease is marked by a very enlarged spleen and liver, abnormal immunologic findings, anemia, and a susceptibility to other infections (such as skin or respiratory infections).

[verklaring]

Seattle volunteers will be paid an estimated $2,000 or more to hold a paper cup containing infected mosquitoes against their arm, waiting for the insects to bite. Symptoms usually develop within nine to 11 days, and volunteers will be treated for malaria when the first parasites show up in their blood. The treatments last three days.

A wonderful idea. They artificially now carry the disease. USA mosquitoes pick it up and spread it across the nation like lime disease and ticks. We all get it.

This could be a wonderful plan to cause a new epidemic.

[johnny7]

Seattle’s a Sanctury City... their citizens already do it for free.

[Stoat]

Not specific to dentistry but I thought that you might find this interesting nevertheless :-)

[Westlander]

Wonder what casket company CEO is on the board of directors at Seattle Biomedical Research Institute.

[Stoat]

Related article from The Seattle Times

(I'm not posting the text because, just as is the case with Fox News, Free Republic requires excerpting of articles from this source)

Health You can get paid to catch malaria Seattle Times Newspaper

 

MIKE SIEGEL / THE SEATTLE TIMES

You can get paid to catch malaria

Seattle Biomedical Research Institute has a colony of Anopheles mosquitoes infected with Plasmodium falciparum, the parasite that causes the most dangerous form of malaria.

 

[maine-iac7]

Pandora’s Box

[Stoat]

A related FR thread from 2005 that may be of interest. 

BRING BACK DDT (Michelle Malkin showcases articles from four thoughtful advocates)

[Born Conservative]

Ping

[gleeaikin]

“USA mosquitoes pick it up and spread it across the nation.”

Exactly my thought, and are these people going to be held indoors for the 9 to 11 days so there is no chance of their being bitten by a mosquito? And if the vaccine does not work will they forever be a focus of disease? How can we stop this madness? Isn’t there some tropical area where there are already malaria problems where they would be willing to be part of this experiment and cash money outlay?

[arthurus]

Malaria has always been here. A few soldiers also brought it back from Vietnam. A friend of mine who came back with it has a relapse annually. Some years it is like getting flu for a few days. A couple of years he noticed nothing. Some years he is in bed for a month. It is not fun.

[arthurus]

The volunteers won’t “spread” malaria any more than the people who already have it spread malaria. Malaria exists in the US. It is rare but it is here.

[gleeaikin]

I did not say they would “spread” malaria. I said they would be a focus of the disease if they are bitten by the right kind of mosquito. Dengue fever has been moving northward in the past few years, probably the same for malaria mosquitos.

[R. Scott]

This is one medical experiment I’d never volunteer for.
I’m very familiar with:
a cold stage (sensation of cold, shivering)
a hot stage (fever, headaches)
and finally a sweating stage (sweats, return to normal temperature, tiredness)
It hit me on a weekend a couple months after I returned and lasted almost 2 days. The doc asked if I had been to Viet Nam and when I replied in the affirmative he just shrugged and said I’d have it occasionally for a few years. That was in 1968. I had one or two a year for over 20 years. They scared the daylights out of my wife.

[jimtorr]

I wonder if the people who are violently opposed to animal testing will be among the first to volunteer?

[JDoutrider]

"Anopheles mosquitoes infected with Plasmodium falciparum"

Across the pond, over in the Nam, when the sun starts going down...or even during daylight in the triple canopy jungle, KAWAAAMO!" Them damned skeeters would eat you alive!

The one's that had the white "fur" on them were the Anopheles... much smaller than their cousins that came out with them. The Anopheles bite wasn't as sharp as their cousins either. Their cousins bite was horrendous! You would swell up big time and ITCH like crazy!

It was the Anopheles that made many of my fellow soldiers sick with malaria. I, daily handed out two pills a day to those in my charge, mefloquine and halofantrine, both made you slightly ill, but were supposed to keep you healthy. It didn't work as well as some thought... In fact if you caught malaria in Viet Nam, it was a court Martial offense if I remember correctly.

Yes, some guys out in the jungle didn't take what I gave them, just to get out of the field of Battle. Can't say I blamed them, but malaria is a life long disease...

[rbg81]

When I was a college student and low on $$, I briefly considered volunteering for some medical trials. I went there and they explained what they wanted to do. Long/short of it was that they said they wanted to partially inhibit my immune system. While the effect was supposed to be “temporary”, there was no guarantee that my immune system would be 100% where t was before the experiment. It paid $1200, which was a lot of $$ in 1990. I really needed the $$, but ended up passing ‘cause the potential damage just wasn’t worth it. Never regretted that decision! [Looked around for a Sperm bank gig, but (sadly) I could never land one of those.]

[Robert A Cook PE]

That’s OK. The diseases can’t spread anywhere else.

There are NO mosquitoes, fleas, or other biting insects in Seattle, and ALL of these 2000 victims (er, volunteers) are going to stay in place and not go anywhere else in the US or worldwide where there are mosquitoes.

/sarchasm - the gaping canyon between reality and a liberal

[Jemian]

I really don’t think you have anything to worry about. The volunteers would be treated immediately and it takes more than one bite (usually!) for malaria to be transmitted. Then, the mosquito must bite the patient at the right time in the malaria cycle, again several bites, and then fly a short distance to another person and bite them repeatedly. There just are not that many anapholes mosquitoes in the US anymore to make this happen.

Further, malaria symptoms are easily recognized and treated. The wonderful new drug, artesemate, is very efficacious and with few side effects.

Yes, I know very well that malaria is a killer disease. But in a place where treatment and drugs are plentiful and applied immediately, it is of little consequence.

[vetvetdoug]

The USAF used their chimpanzees to test and evaluate anti malarial drugs in the late 1960’s and early 1970’s. For years I kept a bound notebook of the results that were to be published and somehow have lost it over the years. I do know the results were published. I have a real healthy respect for malaria, all 4 types. I hope the volunteers take a second look at what they are getting into...you couldn't pay me enough to be a guinea pig for malaria.