Day and Night Pharmacy – African Fever

abel-pharmacy

 

The treatment for African fever, “..8 grains .. of jalap, ..8 of rhubarb, ..4 of calomel, and 4 of quinine, made into pills with spirit of cardamoms. On taking effect, quinine (not the unbleached kind), in 4 grains or larger doses is given every 2 hours or so, till the ears ring, or deafness ensues; this last is an essential part of the cure.”

They saw him and thought he was in prayer. He was kneeling beside his bed, his body leaning forward, his head in clasped hands on a pillow but a touch on his cheek was cold. The English-man was gone.
Dr. David Livingstone could not be saved by his own medicine. Malaria and possibly dysentery took him to his Maker. I am in the middle of reading the 2191 pages of David Livingstone Collection: Missionary Travels and Researches etc. I have deliberately referred to this humble but great Scot missionary, explorer, biologist, and anthropologist as English because that is how he referred to himself-his blindness to tribe (and race) would have annoyed the likes of Sturgeon and Salmond.

After my last article in which I risked sounding frivolous to some, I have neither liberal allowance of time for palaver nor the appetite to descend to mere trifles. I have instead admonition for those who may wish to wander off these temperate islands to the warmer parts of the globe where notorious mites are vectors of some pernicious diseases like malaria.

As a fly transforms in its life cycle; eggs, worm, pupa then fly, malaria does the same but inside two hosts- mosquitoes and humans. Without the need for me to induce delirious fever in the reader: An infected female Anopheles inoculates into the human blood stream malarial sporozoites.
day and night-mozzieSporozoites infect liver cells and mature into schizonts which rupture and release merozoites. This cyclical rupture causes the cyclical malaria fever of chills and sweats. (I’ve been there; the fever, muscle aches, headache, loss of appetite are horrendous- poor Dr Livingstone.)

Without good food for love or money and without anti-malarials death was slow and painful. I have yet to scrutinise what medication he had on him but I know his last was calomel in boiled water. He must have run out of quinine which he correctly mentions in his portion above. What could not be cured had to be endured, but unfortunately this was one bout too many for him. A person with merozoites in his blood stream can be bitten by an uninfected mosquito and thus the disease is perpetuated and the life cycle completes.

To complicate matters the parasite does not always trigger symptoms in the standard 8 days, it could be 3 months or in some cases a year after infection. This is why one still has to continue to take malaria prophylaxis for the stated period after leaving the malaria endemic region. By the way, we instruct to start taking the prophylaxis medication before travelling so that the drug is already in the system when one gets there but most importantly to ascertain that one is not going to suffer excessive undesirable effects.

There are about 500 species of Anopheles, more than 50 transmit malaria through the infected females. (That the female is the nasty one is common in many organisms, like wives or mother-in-laws.) The male mosquito has a sweet tooth, it does not bite humans or animals, it feeds primarily on flower nectar. The female also likes sweet but needs a bloody meal for ample energy to produce eggs.
Mosquito females are attracted to substances in skin emanations; the greater one perspires the greater the draw; their attack of ankles can be attributed to that. They also display a greater affection for adults and men rather than children or women. They have also been demonstrated to gravitate towards carbon dioxide hence bites on the face. These propensities apparently explain the proven predilection for bigger persons. I am running out of space- Aedes and Zika virus shall have their day.

The most effective repellent DEET, at 20% or stronger, was first patented by the US Army in 1946. It remains the best. I advise formulations which are not sprays because you want the repellent smell to linger on your skin for as long as possible. Apply as needed, different mosquito species and sub-species bite at different times of the day.. Space! Space! For more advise, call in.

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