77 cases overseas!We must not take it lightly about this ancient infectious disease!

According to reports, from July 1st to August 8th, a total of 77 cases of malaria input cases were found in Hong Kong in my country, most of which were intended to return to the Mainland from Africa through Africa, of which 47 were still treated in the hospital in public hospitals. Two people died [1].

Since 1999, there have been reports from local malaria dissemination in Hong Kong, and only occasionally input cases have occurred. What kind of disease is malaria? Can malaria vaccines in the world be vaccinated? Let's take a look at these issues today.

Malaria is commonly known as "swinging" and "hot and cold disease". It is a kind of infectious disease that is caused by Plasmodium, mainly by bite by bite (a type of mosquito), and infects humans and other animals. Essence

Malaria generally cannot spread directly through the daily contact between people (such as hugging, handshake, common dining, etc.), but females carrying Plasmodium may cause transmission after bite or animals. In addition, the blood or blood products, transplant organs or joint syringes of Plasmodium in the infusion belt can also lead to malaria dissemination [2-3].

After entering the human body, the incubation period is mostly 7-12 days after entering the human body. The shortest can appear clinical symptoms in 7 days-fever, headache, cold war, muscle pain, and a lot of sweating [4]. If not treated in time, malignant malaria cases may develop into severe illnesses within 24 hours and even cause death.

In 2019, there were about 229 million malaria patients and about 409,000 people worldwide died. [5] In recent years, the number of new patients in my country has decreased year by year, less than 1,000 cases, and the mortality rate is lower than 0.0002/100,000 [6].

April 25th every year is "World Malaaria Day"

Malaria was one of the most popular history in my country, the most influential scope, and the worst infectious diseases. In the 1940s, my country reported about 30 million malaria cases each year, of which 300,000 were killed. In the early 1980s, there were 3 million malaria cases across the country [7].

After the founding of the People's Republic of China, through long -term hard work, my country has improved the malaria prevention and control strategy and emergency response system, and has developed antimalarial special effects and treatment plans such as artemisinin (Professor Tu Yu also obtained 2015 Nobel Physiology or Medicine in 2015 Award) improves the ability to prevent malaria input and re -propagation.

In April 2016, my country reported the last case of local primary malaria; in November 2020, my country submitted an application for malaria certification to the World Health Organization (WHO); on June 30, 2021, WHO announced that my country has passed the elimination of malaria certification Essence This is another major infectious disease that is eliminated by ceiling, spinal ash (pediatric paralysis), silkworm disease, and neonatal tetanus. [8]

(Poster that regularly eliminated malaria in my country)

Similar to many infectious diseases, although local communication has been eliminated, the input risks of malaria have continued to exist.

In 2010, my country formulated the "China Elimination of malaria (2010-2020)" to launch the general plan to eliminate the threat of malaria. At the same time, some areas are still facing very difficult input case pressure.

For example, Yunnan Province is hot all year round, moist in the rainy season, suitable for mosquito breeding, and borders the three malaria popular countries, Laos, Myanmar, and Vietnam. According to statistics, from 2011 to 2019, nearly 5,000 cases of input malaria in Myanmar's entry in Myanmar alone [9].

According to WHO data, the death cases of malaria in Nigeria and Congo countries accounted for more than half of the total number of malaria deaths in the world [2]. The input malaria cases in Hong Kong this time also entered the country from African countries (such as Guinea, Ghana, Congo, Nigeria, etc.).

In 2008, the World Health Organization tied malaria and pneumococcal diseases as "only high priority" to use vaccines for prevention of "Very High Priority" [10].

(WHO published infectious diseases use vaccine priority level)

Unlike the 7 -valent, 13 -valent and 23 -valent pneumococcal vaccine we have already been listed in the world, it was not until October 6, 2021 that WHO suggested that southern Sahara Africa and other "moderate to high malaria dissemination areas" Children's first malaria vaccine (named "RTS, S") is widely vaccinated in the world. In these areas, children at the age of May can inoculate 4 doses of malaria vaccine.

As of now, children of the three African countries (Ghana, Kenya and Malawi) have vaccinated more than 2.3 million dose of malaria vaccine, and the vaccine has also shown good safety. Clinical trial data show that the vaccine can reduce about 30%of severe malaria [12].

The Director -General of WHO believes, "If it is widely vaccinated, the vaccine can save tens of thousands of people's lives every year." However, the vaccine has not yet been listed in mainland China (including Hong Kong) [13].

Most of the existing vaccines can prevent diseases (such as new crowns, influenza, measles, chickenpox, HPV virus, etc.) and bacteria (such as pneumococcus, cholera, stiped brain, ) Infection.

Relatively speaking, these fixed "pathogen" itself is relatively simple, the entire process of infection with the human body is relatively clear, and the research and development process and production process of vaccines are relatively mature. However, Plasmodium, which causes malaria, is a parasite. It will experience multiple stages during the entire process of growth and development and entering the human body. A variety of changes occur, which is very complicated. Once changing, the vaccine antigen and structure based on Plasmodium may also change, resulting in insufficient immune effects, which brings certain difficulty to the research and development and approval of the vaccine [14].

In addition, problems such as fewer vaccine demand areas, low cost -effectiveness, insufficient R & D personnel, health funding and vaccine distribution are also possible for malaria vaccine to be unable to go public.

Under the premise that there is no extensive vaccination, the primary method of preventing malaria is to prevent bite by mosquitoes.

In daily life, it is recommended to wear loose, light -colored long -sleeved tops and trousers, and mosquito repellent containing the ingredients of mihamines on exposed skin and clothes. Clean up water in various containers in time, properly store food and handle garbage, and prevent mosquito breeding. In addition, when traveling to malaria popular areas, a mosquito net should be prepared.

Drug prevention is also a more common measure. Intermittent prevention medications help reduce the risk of infection of high -risk people. Healthy people who go or from high -risk areas from malaria can choose as appropriate. If malaria -related signs occur during travel, you should take a timely consultation.

Review expert:

Chen Tao

Deputy Chief Physician of the Infectious Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology

He Yan

The Department of Pharmacist at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology

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