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May 13 is Ronald Ross’ 160th Birth Anniversary: Finding the course of Dreaded Disease ‘Malaria’ – for 8 Annas

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May 13, 2017: Affecting humans across all continents for centuries, this debilitating disease was long believed to be caused by unhealthy vapours, which gave its name – malaria (from Latin for bad air). While several scientists in the 19th century began zeroing in on its actual cause, the definitive proof was obtained by a British doctor in India who paid a volunteer eight annas for being bitten the same number of times by the suspected vector.

And Ronald Ross, who would be knighted and win the second Noble Prize for Medicine (not without controversy), celebrated his discovery by writing a poem to his wife – ending “I know this little thing/A myriad men will save/O Death, where is thy sting? Thy victory, O Grave?” (the last lines a reworking of the hymn “Abide With Me”).

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Though the discovery in August 1897 was built on work of many scientists around the world since the beginning of the century, Ross (1857-1932), whose 160th birth anniversary is on Saturday (May 13), was also a mathematician, novelist, dramatist, poet, amateur musician, composer and artist though it is as a persistent — and impulsive medical researcher he is most famous.

Born in Almora in the family of a British general, he studied in Britain where he proved to be exceptionally good in mathematics and wanted to be a writer but was admitted to St Bartholomew’s Hospital Medical College by his father in 1874.

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Though he spent most of his time writing poems and plays, he did pass his examinations to become a surgeon in 1880. He entered the Indian Medical Service in 1881 and was posted to various areas including Madras, Bangalore (where in 1883 he noticed mosquitoes could be controlled by limiting their access to water and suffered from malaria himself), Baluchistan and even the Andaman Islands.

His interest in malaria was sparked by a meeting with Sir Patrick Manson, the “father of tropical medicine”, during a spell of leave in London in 1894 and they discussed findings of Charles Laveran, a French army surgeon in Algeria who had discovered parasitical cells in the blood of a patient.

It was in Secundrabad, where he was posted in 1895, that Ross began his research to ascertain whether mosquitoes transmitted malaria parasites, but for years, made no headway.

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“Eventually in July 1897 he reared 20 adult ‘brown’ mosquitoes from collected larvae. Following identification of a volunteer (Husein Khan) infected with crescents of malignant tertian malaria and the expenditure of 8 annas (one anna per blood-fed mosquito!), Ross embarked on a four-day study of the resultant engorged insects. This ‘compact’ study was written up and submitted for publication.

“Imagine today sending an article to a leading medical journal ‘in which you describe observations on novel objects found on the midguts of just two ‘brown’ mosquitoes, obtained from larvae of natural origin, that you had previously fed on a naturally infected patient – with no appropriate controls and no replicates! What hope would it have of getting past the editor and reviewers,” asked Robert Sinden in an article on Ross and his discovery in the January 2014 bulletin of the World Health Organisation.

Sinden, of the Faculty of Natural Sciences in London’s Imperial College, however goes on to say that despite the “perceived inadequacies of the study design, it is difficult to overstate the importance of Ross’s paper: the award of a Nobel Prize hardly does justice to the subsequent impact of his conclusions”, especially in identifying the most vulnerable stage in the parasite’s lifecycle for effective intervention.

But that was not the limit of Ross’ contribution to fighting this — or other dreaded diseases.

Before resigning from the IMS in 1899 after trying unsuccessfully to find the cause of kala azar in eastern India, he subsequently joined the Liverpool School of Tropical Medicine and continued to work on prevention of malaria in different parts of the world. He also developed mathematical models for the study of malaria epidemiology.

Ross, who won the Nobel in 1902 (after a tussle with Italian researchers who had also identified the cause in 1897), went on to set up the Ross Institute and Hospital for Tropical Diseases in 1926 which he headed till his death.

But despite his path-breaking work, malaria, which due to its high mortality and morbidity levels, has had the greatest selective pressure on the human genome in recent history, still exerts its malignant effect across some of the world’s poorest regions — though some hope lies in a vaccine due to be tested in Africa the next year. (IANS)

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An Experimental Vaccine to Treat Malaria

Scientists hope to get a better grasp on the system these vaccines employ, known as cellular immunity. Harnessing this system could help tackle hepatitis and HIV infection.

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Vaccines
A doctor assists people looking for treatment for malaria at a health center in San Felix, Venezuela. VOA

After decades of disappointment in efforts to develop a malaria vaccine, researchers are starting to see promise in a new approach.

While most vaccines trigger the body’s defenses to produce antibodies against a disease-causing germ, the new approach recruits an entirely different branch of the immune system.

If it works, it could open up a new route to attack other diseases, including hepatitis and possibly HIV, the virus that causes AIDS.

Nearly 450,000 people die of malaria each year, according to the World Health Organization. The parasites that cause the disease are increasingly becoming drug-resistant.

One successful vaccine has been developed so far, but it prevented only about a third of cases in a clinical study.

Experts have decided that’s better than nothing. The vaccine is being piloted in Ghana, Kenya and Malawi.

Vaccine
Defensive cells killed liver cells that were infected with malaria parasites. (VOA)

New angle

Other scientists are trying a different angle of attack.

There are basically two ways to prevent germs from causing infections. “You either prevent them from getting into cells with antibodies, or you kill them inside the cells with T-cells,” said Stephen Hoffman, chief executive officer of Sanaria, a company working on one vaccine.

Most vaccines target the infection by building up antibodies. “If you need to kill them inside the cells with T-cells, we haven’t been overwhelmingly successful,” Hoffman said.

But Sanaria is one group seeing success by targeting malaria parasites inside infected liver cells, the first stop in the complex life cycle of the disease.

One key difference is how the vaccine is delivered. Hoffman’s group tried a typical route: injecting radiation-weakened parasites into patients’ skin or muscle. That didn’t work.

But it did work when injected directly into veins.

Vaccine
A public health worker takes a blood sample from a woman to be tested for malaria in Bo Rai district, Trat province, Thailand. VOA

The weakened parasites traveled to the liver, where they set off an immune reaction. Defensive cells killed liver cells that were infected with malaria parasites.

And the liver’s defenses were ready when faced with the real thing months later.

Most of that early work has been done in mice and macaques. When Hoffman and colleagues did something similar with a handful of human patients, most were protected against infection.

No waiting

Recruiting immune cells in the liver is especially effective because “we don’t need to wait until the immune system figures out that the parasite is in the liver and starts mounting an immune response, which can take days and sometimes weeks,” said Adrian Hill, director of the Jenner Institute at Oxford University.

“By then, the malaria’s gone. It only spends a week in the liver, and then it’s out in your blood causing disease.”

Vaccine
FILE – A worker of the Ministry of Public Health and Population fumigates in the street against mosquito breeding to prevent diseases such as malaria, dengue and Zika in Port-au-Prince, Haiti, Feb. 15, 2016. VOA

Hill’s group just published a study in the journal Science Translational Medicinein which immune cells in the liver were triggered by using a protein from the parasite, rather than the entire organism.

Scientists hope to get a better grasp on the system these vaccines employ, known as cellular immunity. Harnessing this system could help tackle hepatitis and HIV infection.

Also Read: Alcohol Kills More People Than AIDS, Violence Combines: WHO

Drugs can control HIV infection but can’t eliminate it from the body.

“If somebody could get cellular immunity to work really well for vaccination, that would be transformative for a whole range of diseases,” Hill said. “Not just for infectious diseases that we want to prevent, but ones that we want to treat and we can’t treat today.” (VOA)