
Malaria 'Completely Stopped' by Microbe - simonswords82
https://www.bbc.com/news/health-52530828
======
cguess
As someone who doctors once put "12 hours from coma" due to malaria (and I was
in rural Tanzania, so coma == death out there), this is straight up the best
news I've heard in a very long time.

Seriously, don't get malaria if you can help it. Your bones hurt from the
inside out while you lay in a pool of your own sweat, crawling to the toilet
every hour or two because of oscillating vomiting and diarrhea. Since you're
most likely in a developing country, air conditioning is usually out of the
question (you're shivering in the 100F+/35C+ temps anyways from the fever).
The drugs, if you're lucky, only give you the most vivid and disconcerting
dreams you've ever had (if you're unlucky, which 50% of people are, they're
the most horrifying night terrors you can imagine).

The good news is it's highly treatable. The bad news is that at ~$3 for a
round of treatment it's prohibitively expensive if you're only making $2/day
and have a family to support.

We only got rid of it here in the US because of DDT. Malaria was endemic in
the South (and parts of the North in the summer) until the mid-20th century.

~~~
derefr
> The drugs, if you're lucky, only give you the most vivid and disconcerting
> dreams you've ever had

Now I'm intrigued. What do anti-malarials do to healthy people? Does anyone
take them recreationally to experience this effect, the way they do other
"weird downers" like mescaline/DMT/salvinorin/etc? Or is the psychotropic
effect of the drug predicated on actually having malaria?

~~~
tonyarkles
I took Chloroquine as a prophylactic anti-malarial before and during a trip to
Central America. You can get the crazy dreams whether or not you’re infected.
Mine were, fortunately, quite vivid (and sometimes lucid) but not disturbing.
The scenarios were pretty wild though. Other friends of mine had less pleasant
experiences. For example, one had a recurring dream that his abdomen got
ripped open, a load of pebbles fell out (instead of viscera), and a flock of
ravens came and eat the pebbles while he watched in agony. Every night, over
and over, for about two months.

During your waking hours, nothing feels amiss at all. Keep in mind too that
the dosing is once a week. It took a week or two for the effects to start for
me, and they persisted for almost a month after I was home. Unlike reports
from the various psychedelics you listed, I felt absolutely no euphoria or
“spiritual awakening” from any of it; I just woke up every morning and thought
“wow, that was fucked up!”

~~~
derefr
I wonder how much of the "crazy dreams" comes down to people usually taking
such a drug when travelling and having new experiences/seeing new
places/expanding their mental schemas (which is known to increase BDNF /
promote neuronal plasticity, and therefore likely to cause intense dreaming
under the "memory reconsolidation" hypothesis of dreaming.)

It'd be interesting to compare to the dreams of people who take the drug
without travelling, e.g. medical staff native to malarial regions, who take it
as a prophylactic when interacting with malaria-infected patients.

~~~
tonyarkles
Yeah that would be curious to investigate for sure!

I can only speak to my own experiences, but while I have observed the
phenomenon you describe in preparation for travel/while travelling,
Chloroquine dreams were waaaaay more dramatic than anything I've experienced
with other travel. I forget what the exact timeline was, but I think I started
taking them about a month before departing, and the dreams started about two
weeks before departing, and stayed pretty much constant until a few weeks
after I'd been home and stopped taking the pills.

------
darkerside
> More than 400,000 people are killed by malaria each year, most of them
> children under the age of five.

This is one of those sentences that is just too easy to read over. But losing
a young child to a disease must be unbearably painful. Multiply that grief by
400,000.

My greatest comfort in these times is that COVID19 appears to have little
effect on young children. I wish these researchers the best, and I hope they
get all the support they need.

~~~
GoToRO
I would really like to know if covid19 is worse than malaria, globally. Up
until now it seems that it is worse only because it affects us. I was shocked
to find out there is no treatment for malaria when I traveled in affected
areas. I felt the same way as I am today, except I was the only one feeling
like that.

~~~
jml7c5
Around 500,000 people died of malaria in 2018. COVID-19 deaths are currently
at 250,000 (according to worldometers.info), but deaths are only just starting
to slow down, and it's unclear how many deaths are going unreported. (There
has been suggestion that in some places, actual deaths may be twice as high;
apparently even after one adds reported COVID-19 deaths to an area's expected
"regular" deaths, there is a shortfall vs actual deaths.)

It's worth noting that in terms of person-years lost, an average malaria death
is significantly worse as it predominantly kills children under the age of 5.

~~~
SamBam
> in terms of person-years lost

"Potential" person years lost, I guess. If you used "person years" the same
way you use "Our firm has a combined 125 years of experience" then it's the
other way round.

(Grim discussion, I guess, but I'm just not certain I agree with the unspoken
assumption that seems to be in that statement, that the younger the death, the
more tragic/more effect on society.)

~~~
jml7c5
Yes, "potential person years" or a similar phrasing would have been clearer.

>(Grim discussion, I guess, but I'm just not certain I agree with the unspoken
assumption that seems to be in that statement, that the younger the death, the
more tragic/more effect on society.)

It is a matter of morality and personal ethics. I chose to mention it only
because the discrepancy in this case is so large, and it felt almost
misleading to not relate the information. That said, I regret framing it in
such a coldly utilitarian way.

~~~
vikramkr
These cold terms are how these discussions are had in industry. It's the core
behind value based pricing - quality adjusted life years or QALYs are what
many health systems use to determine what they will or wont pay for. As long
as money is scarce, these are how conversations are had. A drug that saves a
child's life is worth more, and people are willing to pay more, than a drug
that saves an older person's life. There are cutoffs and thresholds. In the
UK, with a few exceptions, a drug cant cost much more than 30 thousand pounds
for each extra quality adjusted year of life (e.g. an extra year bedridden
might only count as 30% of a year, while an extra year closer to functional
might count as 95%) for NICE to approve paying for it. In the developing
world, the value of a human life is set at about 2x GDP per capita per QALY.
In the US, for a drug to be cost effective, it should be less than 150,000
dollars per QALY (but many drugs aren't).

------
mikeappell
I've heard that mosquitoes are believed to be completely replaceable in the
food chain of the various species which prey upon them. Considering how
mosquitoes are a vector for _numerous_ diseases, malaria being the most deadly
but still one of many, what's stopping research into eradicating mosquitoes
entirely? A lack of research and surety on the overall effect on the
ecosystem?

Honestly, fuck mosquitoes. If the mosquito laser system were ever actually
viable/purchasable, I'd happily drop thousands of dollars to keep those
bastards out of my bedroom at night.

~~~
trianglem
Not to take away too much focus from this issue, but we gotta start talking
about ticks in the same vein.

~~~
mikeappell
No clue how important they are in the ecosystem, but from the perspective of
insects which piss me off, I'm on board 100%.

~~~
cc81
I read somewhere that they are not important and that is good enough source
for me. It could have been written on a post-it for me to support an
eradication campaign.

I hate ticks.

~~~
chr1
There is a joke that ticks and lice were crucial for human evolution, since
removing them from each other helped to make monkeys spend time together:)

------
cestith
I fully expected this to be another article on wolbachia. It's a pleasant
surprise to see another microbe that can help block malaria in mosquitoes.
Between the two a good dent might be put into that and other diseases.
Wolbachia was shown to help with dengue too, and at least somewhat with
Chikungunya and Zika - which are viral. This sort of trend looks hopeful for
the future.

If we're really fortunate and have the people and funds made available to do
this sort of research, perhaps we could see West Nile, yellow fever, Lyme
disease, bubonic plague, Rocky Mountain spotted fever, and other bite-passed
pathogens severely curtailed.

[https://journals.plos.org/plospathogens/article?id=10.1371/j...](https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1007333)

[https://www.nature.com/articles/ncomms11772](https://www.nature.com/articles/ncomms11772)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085076/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085076/)

------
BurningFrog
So 5% of mosquitos in one area has the microbe.

If it has a survival benefit for mosquitos, it will reach 100% by itself.
Since that hasn't happened, I'm a little worried that there are some caveats
here.

~~~
sdiq
Maybe it happened already. Growing in Kenya in the 80s, many regions were
considered malaria endemic. A number of this regions from these 2000s are now
considered malaria-free. Could this be the reason? I don't know.

~~~
lukeschlather
Most tropical/subtropical areas that are malaria-free did it by virtually
eliminating mosquitoes with pesticides long enough that malaria was virtually
eliminated in the human population, which eliminated malaria in the mosquito
population when the mosquitoes rebounded.

------
stevenking86
Given how helpless much of the world is against Malaria and how many people it
continues to kill each year, this strikes me as one of the most significant
scientific discoveries of our lifetime. Am I missing something?

~~~
rriepe
It's a treatment for mosquitoes, not people.

~~~
macintux
If anything, that would seem to make it even more significant. Treatments for
people often have side-effects for the patient, and as we see with increasing
resistance, side-effects for the population as a whole.

This is potentially a way to stop malaria permanently with few side effects.

~~~
rriepe
Are you disagreeing with something I said?

~~~
macintux
I’m disagreeing with the implication of your statement that it’s _less_
significant because it’s a treatment for mosquitos.

If that implication was not intended, then I have no idea what you were
attempting to infer.

~~~
rriepe
He asked what he was missing and I pointed out that the headline was referring
to malaria in mosquitoes, and not malaria in humans (as a human reading it
might assume).

I wasn't making any point about overall impact. One is simply a much, much
bigger news item than the other (It's "We can cure 400k people with malaria
right now!" vs. "We've made a promising step in the overall fight against
malaria" \-- one has never happened and one happens monthly).

The BBC retained this ambiguity for clickbait reasons. I was just dispelling
the ambiguity. If they added "in mosquitoes" to the headline this wouldn't
have happened. But then we also wouldn't be commenting on it.

~~~
bastawhiz
> He asked what he was missing and I pointed out that the headline was
> referring to malaria in mosquitoes, and not malaria in humans

Yes, but mosquitos are a vector for malaria in humans. If mosquitos are
infected (at scale) with the microbe and can be cured or made "immune" to
malaria, it effectively stops the transmission of malaria to people. If the
science checks out and infected male mosquitos are released into the
environment in areas with high (human) malaria infection rates, it becomes
extremely easy (fast, cost effective, simple) to prevent new malaria
infections in people.

This general approach is already being used today, albeit with less success.
See Google's "Debug" project:

[https://debug.com/](https://debug.com/)

Dismissing the importance of the findings here as "only treating malaria in
mosquitos" ignores the much broader implications of the research here. The
headline is not sensational, and the perceived ambiguity in the headline does
not decrease the significance or potential importance of the discovery.

~~~
rriepe
It's extremely trashy to quote someone when they didn't actually say the thing
you put in quotation marks. Bother someone else with your straw-man bullshit.

~~~
robbrown451
I don't see any indication that you were misquoted.

------
brownbat
Original study in Nature:
[https://www.nature.com/articles/s41467-020-16121-y](https://www.nature.com/articles/s41467-020-16121-y)

------
mudiaga
Coming from a malaria-prone region and remembering the times I had to take
Chloroquine injections and trying different malaria tablet treatments just
makes this the best news I’ve heard this year. I hope they can conclude on
these findings fast enough.

------
tyho
So this microbe is already circulating in the mosquito population at a 5%
infection rate. The scientists propose either:

a) release spores en masse to infect mosquitoes

b) infect male mosquitoes in the lab and release them into the wild to infect
the females when they have sex

There is an obvious third way. We could attempt to genetically engineer a more
virulent strain of the pathogen and release it into nature. In the current
climate I think this is less than likely to happen.

~~~
vikramkr
Once you genetically engineer the virulent strain, the way you are going to
release it is through either of the first two ways. So it's not as much a
third way as it is an augmentation of either of the first two.

------
lymeeducator
Many people (~thousands) in the US use a few species of Cryptoleptis
(sanguinolenta) to good effect for Babesia, a less virulent and dangerous
"cousin" of Malaria. It is generally safe for all ages. It is also used pretty
effectively in Africa for Malaria
([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956313/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956313/)
... more studies should be done!). It is often hard to get young children to
describe their symptoms, but night sweats and temperature disregulation (via
nervous system) are common in both parasitic pathogens. At any rate, the more
low cost solutions with minimal to zero side effects we have, the better.

------
phkahler
Is this fungal infection transmitted to humans? If so, is that bad?

~~~
brownbat
Here's a really comprehensive overview of Microsporidia --
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613672/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613672/)

Still working through this and the original paper, but while it can cause
encephalitis in humans, it seems to be ubiquitous already anyway, and we don't
seem to typically get it from insects. Setting aside the fact that you could
swap malaria for almost any other infectious disease and humanity would be
massively better off.

(Caveat: IANA Microbiologist and welcome corrections.)

~~~
bdamm
If it is ubiquitous anyway then why isn't it blocking malaria in the wild?

~~~
brownbat
I should have said "not uncommon" rather than "ubiquitous," but it appears it
already is blocking malaria development in a small portion of mosquitoes.

[https://www.nature.com/articles/s41467-020-16121-y](https://www.nature.com/articles/s41467-020-16121-y)

------
random_savv
Out of pure curiosity, I would love to know what Bill Gates thinks about this!

~~~
syntheticnature
Malaria has been a big deal for the Gates Foundation for a long time. I recall
reading discussions of his hope to breed, or maybe genetically modify, the
relevant mosquitoes to make them incapable of carrying malaria, then
manipulating the wild population to uptake the genetic change.

There's also this page: [https://www.gatesfoundation.org/what-we-do/global-
health/mal...](https://www.gatesfoundation.org/what-we-do/global-
health/malaria)

~~~
garaetjjte
> breed, or maybe genetically modify, the relevant mosquitoes to make them
> incapable of carrying malaria

"Debug Project" is trying to do that (curiously, funded by.. Google):
[https://debug.com/](https://debug.com/)

~~~
forgingahead
This is an incredibly dangerous idea -- I do not think we should be
genetically messing with mosquitoes, whatever the perceived or desired
benefits, when the downside (a bad strain multiplying exponentially) could be
horrible for all of us.

~~~
oceanofsolaris
AFAIK there isn't much genetic engineering involved in that project at the
moment. They just rear male mosquitos that are infected with a Wolbachia
bacterium (making them sterile).

------
projektfu
This is good. We need ecological solutions that don't involve killing
bystander species, and this sounds like a good option.

~~~
Jimmc414
As a bystander species, I support this argument.

------
muktabh
Apart from the huge human misery this technique can avoid, also hope it can
avoid the pandemic of avian malaria killing many birds.

------
arkanciscan
And my doctor told me that having fungus in my genitals was a _bad_ thing

