It's World Malaria Day! As experts on malaria at the Center for Global Infectious Disease Research at Seattle Children's Research Institute, we are here to answer your questions and help raise awareness about this deadly disease. Ask us anything!

I got malaria last year (on my honeymoon in Thailand) and spent three days in the hospital (I also had another infection, what a fun time) then someone asked me "did you get the kind that keeps coming back? Malaria can keep coming back."

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EXCUSE ME WHAT

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My doctors said no such thing. What were they talking about? Is this true? How do I know?

There are multiple species of the malaria parasite, some of which lie dormant in the liver for weeks, months or even years after you are initially infected by mosquito bite. In Thailand, both Plasmodium falciparum (which does not have a dormant form) and Plasmodium vivax (which does, and thus can recur) are present.

How truly influential has the Bill & Melinda Gates foundation been in Malaria eradication in Africa?

The Bill and Melinda Gates foundation calling attention to the problem and boldly stating that the infection COULD be eradicated has been a game changer for the field.

I see you are based in Seattle. Why is Seattle such a hotbed for malaria research?

We think Seattle is a major hotbed for malaria research because of the amazing, globally-minded community in and around the city, and because of the top-notch, innovative and collaborative research happening on many topics here. This combination has led to many groups based here to adopt malaria as a major focus, and also attracted groups to the area. This includes us at Seattle Children's, the Bill and Melinda Gates Foundation, the University of Washington, the Fred Hutchinson Cancer Research Center, PATH, Infectious Disease Research Institute and others. We are truly lucky to be doing such important work in such a vibrant, collaborative environment!

I heard the news this week about the new RTSS vaccine. How does that fit in with your work?

Late to the party but can I ask as a follow up how exactly a vaccine that targets a parasite like malaria works (versus say a flu virus vaccine)?

Thanks for your question. The vaccine that is currently being rolled out in three countries (called RTS,S) is thought to stimulate the immune system to produce antibodies (proteins made by a type of cell called a B cell) that bind the surface of the malaria parasite, and stop it from moving. Other malaria vaccines could work in other ways, for instance by stimulating the immune system to produce other immune cells called T cells, that attack the parasite once it has already infected the liver. Here at Seattle Children's we are actively working on both whole parasite vaccines and next-generation subunit vaccines. We are also investigating the question of how the existing RTS,S vaccine can be made better when used in the field.

What are the factors that led to half of the population be at risk of contracting malaria?

The population at risk for malaria is a result of the species of mosquitoes that are present around the world. A population is at risk if it co-habitates with Anopheles mosquitoes. While currently approximately 40% of the world's population lives in an area that has Anopheles mosquitoes, climate change is leading to a redistribution of multiple species of mosquitoes, and this could lead to additional parts of the population being at risk for malaria.

Can you donate blood if you've had malaria?

Blood donation requirements vary. For donation through the red cross, see this website: https://www.redcrossblood.org/faq.html#eligibility-travel

Why can’t we just kill all the mosquitoes?

Vector control efforts have been successful in some areas of low to modest transmission, for example, the United States in the 1940s and 1950s. However, in areas where mosquito populations are dense, and in some cases resistant to insecticides, it is likely that a multifaceted approach including the use of drugs, vaccines and mosquito control is needed. Controlling the mosquito population comes with its own challenges: for example, bednets intended for mosquito control and impregnated with insecticides are often used for fishing, and this can contaminate the water that is essential for maintaining the livelihood of the community.

I'm on the board of directors for a small historical museum in PA. I am putting together an exhibit on the effects three different diseases had on people at the time, which wouldn't be any different from people today were they sans medicine probably.

Do you have any materials on malaria you could recommend for the project? The exhibit will feature malaria, yellow fever and small pox. The museum is focused on the mid-18th century but the exhibit will talk about the disease in general, how it affected people then and what is happening with it now.

Thank you for the important work you are doing to raise awareness about these diseases. There are a lot of interesting resources available to talk to the public about malaria. One of my favorites is this short film produced by Disney on the malaria control efforts in the US from 1943: https://www.youtube.com/watch?v=y68F8YwLWdg.

In terms of additional information, there are many sources. Here are Seattle Childrens, we have put together a series of articles on malaria and other infectious disease topics intended for public consumption. Although they are not currently posted online, if you would like a copy, please send an email to: [email protected]. Thanks for your work and your interest on this topic.

What do you think about vaccines and its effects?

Vaccines are a critically important tool for infectious disease eradication. While vaccine use is depicted by some as 'controversial' or politically charged, the reality is that an effective vaccine is one of the very safest, most effective ways to reduce infection. Vaccines do the most good through what is called "herd immunity", meaning that most (or nearly all) people in a community are vaccinated. This means vaccinated people protect not only themselves, but also other members of the community that may have sub-par vaccine efficacy and/or cannot be vaccinated for medical reasons (for example, if people are on immune-suppressant drugs, they cannot receive certain live vaccines).

Neat! I like to travel and am about to take my 2nd trip where I need to take malarone. I was going to ask if there's a Vaccine in the works that I can look forward to, but I see someone else already did. Exciting progress! Keep up the good work! I don't suppose you have an ETA on the availability of such a wonder of modern science?

At the moment, RTS,S (the only licensed malaria vaccine) is currently only available in three countries. If the vaccine is effective in these high-transmission settings, it is likely to be used in other settings. However, there are a number of drugs and vaccines currently in different stages of development (including here at Seattle Children's) that, if successful, could be part of the recommendation for travelers in the future. Sorry for the lack of a specific ETA. I can say we are not the most patient bunch and would love to see our work make a difference in people's lives sooner rather than later. This is a huge part of what drives us to do the science we do!

Thank you for your work, CGID! I know there are interesting and non-traditional, multidisciplinary partnerships to tackle the prevention of malaria, like the Tableau and PATH Vizualize No Malaria work in forecasting. What other under-the-radar multidisciplinary partnerships are addressing malaria that you think we should know about? Please feel free to share about CGID partnerships too.

Thank you for your thoughtful question. Here at Seattle Children's we love to think about and engage in non-conventional partnerships that will push forward efforts to fight malaria. This is critical -- conventional tools haven't yet wiped out the disease! In my mind, one of the partnerships that holds the most promise is that between systems biologists and scientists with a deep fundamental knowledge of malaria biology. This approach gives us a different and exciting method to interrogate the malaria parasite, and new ways to combat it. By using the tools of systems biology, we can predict how different interventions will impact the malaria parasite. Our hope is that this approach will not only lead to better drugs and vaccines that target the parasite, but also allow us to predict what will be most effective in the field, and reduce the time from basic discovery to saving lives. Some of our partnerships in this area are within Seattle Children's (between classical "malaria" labs and "systems biology" labs), other collaborations are with other groups in the area such as the Institute for Systems Biology and the University of Washington bioengineering department.