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Science,
Aug 8, 2013, DOI: 10.1126/science.124800, reports a new highly successful
Malaria vaccine. Stephen Hoffman's intravenous (IV) vaccine consists of live
attenuated plasmodium falciparum sporozoites -- labeled pfspz.
In a group
of volunteers given four or five intravenous injections of the vaccine: 0/6 of
the volunteers receiving five injections contracted malaria when later inoculated
(p=0.018); 3/9 of the volunteers given only four injections (p=0.028); and 5/6
of the untreated volunteers contracted malaria. Despite the small population, the
results were significant.
Prior experiments
had shown that multiple mosquito bites by infected but radiated Mosquitos induced
immunity. Hoffman took the process forward in employing numbers of radiated sporozoites.
Sub-cutaneous injections did not work well, but the intravenous injections did.
Logistics
in Africa may pose a problem in that the vaccine requires delivery in liquid
Nitrogen containers. The IV dosing may not be so difficult because the volume
is quite small, but getting patients back for four more injections likely will
be. The authors suggest including the malaria vaccine along with other
routinely delivered frozen veterinary products as a feasible avenue. Go.nature/mae5tu
has a helpful summary on the background development of the vaccine.
Prior
malaria vaccination attempts proved only slightly effective. Malaria remains,
despite slow improvement, the number one killer worldwide with deaths estimated
by WHO to be between 490,000 and 836,000 in 2010 and cases worldwide between
154 million and 289 million.
Global
warming may once again result in Malaria's spread to northern regions, as p. vivax
did in the first half of the twentieth century as far north as Archangel,
Russia. (Lat: 64.5333)
The
emergence of an effective vaccine comes at a good time. It remains to be seen
if the vaccine works on other than the p. falciparum variety and on young
children.
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