For Canadian campers and cottagers, the war against the pesky mosquito is a struggle to avoid weeks of itchy inconvenience. For one-year-old John Kilel, the stakes were much higher.
Baby John came to our Baraka health clinic in rural Kenya this past March with a 40-degree fever. The normally upbeat infant was lethargic, weak and dehydrated from repeated vomiting. A blood test diagnosed John with malaria. His mother was frantic.
Mosquito-borne diseases kill 725,000 people a year -- including one child in Africa every minute from malaria alone -- making the seemingly innocuous bugs responsible for more human deaths than every other creature combined. These resilient pests have existed for 100 million years, surviving ice ages and the dinosaurs, and spreading their deadly diseases among people since at least the times of ancient Greece and China. So how is such a novice species as ours to defend itself against such a stealthy predator?
Thankfully, we've moved beyond the citronella candle and campfire incantations. Baby John's blood test was the first step to getting the right treatment of anti-malarial drugs and rehydration salts to boost his body's fight. If misdiagnosed, an illness with similar symptoms but a drastically different remedy -- like the meat-borne brucellosis -- could have been deadly. Instead, when John returned to Baraka two days later, he was happy and playful again with no signs of fever. His mother was given an insecticide-treated bed net to protect against future bites and instructed on preventive measures like clearing pools of stagnant water by their home.
In these simple ways, malaria deaths have declined by 42 per cent over the last decade. But it still finds more than 200 million people in 97 countries -- and kills 600,000 -- a year. Worse, the adaptable disease is mutating in southeast Asia to resist the latest drugs, according to a report last month in the New England Journal of Medicine. The centuries-old war between man and mosquito carries on.
Fortunately, a new weapon may be on the horizon. Last month PLoS Medicine reported the most promising results in decades for a new malaria vaccine for children, with prevention rates close to half in some regions. The vaccine is now being reviewed by regulatory authorities in Europe and could be available worldwide in 2015.
Local approaches to reducing the mosquito population are now focusing on taking them out in the dry season before they explode with the rains, with mosquito-sniffing dogs and traps attached to hot air balloons. British biotech entrepreneur Haydn Parry is leading a fascinating project where sterilized male mosquitoes are sent out to mate, making their offspring unviable and reducing populations (more or less) naturally by up to 85 per cent in a few months.
A similar strategy is incubating in Indonesia, where researchers are tackling another mosquito-borne disease, dengue fever, by infecting mosquitoes with a common insect bacterium they currently lack -- Wolbachia -- which blocks the transmission of dengue fever and is harmless to humans.
But perhaps the simplest and smartest tactic is a Cambodian project that returns to the basic science of malaria transmission. Since mosquitoes overwhelmingly transmit malaria to humans from other humans, and those initial human hosts can carry the disease unknowingly for up to 15 years (as opposed to a few weeks for the mosquito), wiping out the malaria in the human population would remove the possibility of transmission in the first place. The catch: testing and treating an entire population for malaria is possibly as difficult -- in terms of cost, logistics and resistance from the subjects in question -- as eradicating every mosquito from Earth.
Still, some argue the most effective strategy is to just exterminate all mosquitoes from the face of the Earth. The journal Nature once suggested that global ecosystems would barely miss a beat if ridded entirely of the irritating insect -- its role as foodstuff for birds, bats and other insects would be quickly filled by another. But messing with the delicate balance of life on our planet seems risky, and as any Canadian cottager can attest, the pesky pests just keep coming back no matter what you do.
The race, then, is on. Mosquitoes are part of life on our planet, no matter where we live. The stakes, though, are higher than a few weeks scratching every inch of skin. In the life-and-death struggle of millions of our fellow humans, it's imperative that we use our collective smarts to outwit the bug and the diseases it passes along.
Brothers Craig and Marc Kielburger founded a platform for social change that includes the international charity, Free The Children, the social enterprise, Me to We, and the youth empowerment movement, We Day.
Primary Care in Kenya: Touring the Baraka Health Clinic
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