[HN Gopher] Egypt declared malaria-free after 100-year effort
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Egypt declared malaria-free after 100-year effort
Author : thunderbong
Score : 454 points
Date : 2024-10-21 12:51 UTC (10 hours ago)
(HTM) web link (www.bbc.com)
(TXT) w3m dump (www.bbc.com)
| dotancohen wrote:
| Do other states in the area have malaria? How and when were they
| resolved?
| ignoramous wrote:
| Israel Jacob Klinger quite famously rid Palestine (mandate) of
| malaria. In the Galilee and around Lake
| Kinnereth (Sea of Galilee), malaria had decimated the Jewish
| settlements, with the incidence rate at 95%+ of the workers in
| 1919.
|
| https://en.wikipedia.org/wiki/Malaria_in_Mandatory_Palestine
| Jackim wrote:
| Egypt has been low-risk for malaria for some time. This
| declaration is from the WHO:
|
| WHO declares a nation as a 'malaria-free' upon receiving valid
| proof that the Anopheles mosquito-borne native malaria
| transmission chain has been broken for at least the previous
| three years on a national level. A country must also
| demonstrate the capacity to prevent the re-establishment of
| transmission.
|
| In June 2024, the WHO confirmed that there was no local
| transmission of malaria in Egypt, with all identified cases
| being imported from endemic countries. Egypt's robust
| surveillance system was instrumental in early case detection,
| facilitated by collaboration with relevant stakeholders.
|
| Neighbouring countries to the south have a high risk for
| malaria, but Egypt has had significant efforts to eliminate the
| disease since the '40s.
| dotancohen wrote:
| > Egypt's robust surveillance system was instrumental in
| early case detection
|
| This sounds like HN material on its own.
| j_maffe wrote:
| Ecological surveillance...
| pmontra wrote:
| On the north shore of the Mediterranean sea Italy got malaria
| free by removing many swamps and flooded lowlands, quinine and
| eventually by using DDT. It was a very long effort, more that
| one century long. Details at
| https://pmc.ncbi.nlm.nih.gov/articles/PMC3340992/
| dsign wrote:
| How dare they? Mosquitoes are a vital part of the ecosystems.
| And they should restore the swamps too. Now, that DDT
| perversion, for that alone they deserve a second flood.
|
| Sarcasm aside, I love swamps and I hate mosquitoes, other
| bugs and crocodiles because they don't let me enjoy the
| swamp. I also don't like cities nor agriculture for the same
| reason. But I like people and people being happy.
|
| Humanism and environmentalism are at odds more often than
| they are not.
| TeMPOraL wrote:
| > _Humanism and environmentalism are at odds more often
| than they are not._
|
| It gets less surprising when people realize that nature is
| red in tooth and claw, an uncaring shithole we're
| evolutionary conditioned to find pretty - at least the
| parts we see. Beautiful meadows and happy animals and
| careless people are just propaganda - in reality, the
| people are sick and busy with back-breaking work, and
| animals are all on the verge of starvation, and that
| doesn't even touch the microbiological scale. Ecological
| balance is achieved by means that, when applied to balance
| between humans, we'd call unending war of attrition.
|
| Humanism and environmentalism are at odds because nature
| doesn't care about humans anymore than it cares about
| anything else. Brutal death and constant suffering are
| hallmarks of nature.
| mmooss wrote:
| Did anyone besides you say these things?
| dsign wrote:
| I understand the _sentiment_ behind your question
| (lashing back in hurt), but not your reasoning. What is
| it? Do you believe that people can live prosperous lives
| in harmony with nature, and thus what you perceive as
| cynicism offends you? Or, do you agree with me but you
| think that it 's something better silenced in polite
| company? Or something else entirely? Do you like the
| mosquitoes and the crocodiles, or do you believe that
| it's unfair people have to live near them? The mosquito
| is the Great Killer, the animal that kills most people,
| even above and beyond other people. I like swamps though,
| they are beautiful. And I like the happy careless
| shoppers and their giggles in huge malls in huge
| metropolis, but I know the terrible cost it has to our
| nature. And I resent the contradiction dearly.
|
| In any case, I can't elaborate on the things I say
| without understanding what exactly you take issue with.
| soperj wrote:
| The US and Canada used to have a big malaria problem. Over a
| thousand people died constructing the Rideau Canal, and
| majority were from malaria.[0]
|
| [0]https://en.wikipedia.org/wiki/Rideau_Canal#Construction_deat
| ...
| bufferoverflow wrote:
| Doesn't it take just one tourist with malaria to bring it back?
| umanwizard wrote:
| Malaria isn't contagious
| folli wrote:
| That's technically correct, but an infectious person can
| infect another person over a vector (i.e. mosquitos).
|
| So you get rid of mosquitos OR rid of malaria.
| umanwizard wrote:
| That's true; I didn't realize it could go human -> mosquito
| -> human but according to Google you're right.
| tshaddox wrote:
| Isn't that the _only_ way? I'm pretty sure the human
| hosts are a vital step in the Plasmodium lifecycle.
| arp242 wrote:
| Also not all species of mosquito transmit malaria, or have
| a much smaller chance of transmitting it. I remember
| watching a BBC programme where someone was researching
| whether malaria mosquito had returned to Britain (they
| hadn't).
|
| So even if you would somehow introduce a few busloads of
| Malaria-stricken people, that's not likely to re-introduce
| Malaria.
| tshaddox wrote:
| FTA:
|
| > Certification is granted when a country proves that the
| transmission chain is interrupted for at least the previous
| three consecutive years.
|
| And
|
| > To get the WHO certification, a country must demonstrate the
| capacity to prevent the re-establishment of transmission.
| eacnamn wrote:
| Do you know whether that capacity is regularly
| reinvestigated? Because if not you could get the
| certification, wait a couple of years, and then dismantle all
| infrastructure while still reaping the, if ephemeral,
| benefits.
| lenzm wrote:
| As if the main benefit of being certified malaria free is
| the certification instead of actually being malaria free?
| yaseer wrote:
| It's not quite like other infectious diseases (e.g. COVID), in
| that transmission is dependent on mosquitos as a vector.
|
| If they've sufficiently damaged the vector one tourist alone
| cannot bring it back - the disease vector would also need to
| come back.
| dotcoma wrote:
| I don't think so. I don't think malaria is contagious.
| Tepix wrote:
| Fantastic news! Now lets continue this trend!
| hcurtiss wrote:
| I presume they used insecticides. Anyone know what they used?
| QuercusMax wrote:
| I can't actually find any articles that actually describe it
| other than "vector control" and eliminating breeding sites,
| along with working with neighboring countries. I know some
| groups are using sterile male mosquitos to prevent breeding, as
| females can only mate once.
| amluto wrote:
| I don't, but there are quite a few techniques aside from nasty
| insecticides:
|
| Fish. Many species of fish think that mosquito larvae are
| delicious and will eat them. Some of these species will also
| thrive even in small bodies of water with little assistance.
|
| Sterile insects. Male mosquitos don't bite, and females only
| mate once, so releasing large numbers of sterile males will
| reduce the population.
|
| Wolbachia. There are bacteria that live in mosquitoes, are
| quite effective at infecting the next generation, will not
| infect humans, and prevent malaria from living in the mosquito.
|
| Bti. There's a species of bacteria that produces a bunch of
| toxins that are very specific to mosquito larvae. I have no
| idea why it evolved to do this, but you can buy "mosquito
| dunks" and commercial preparations that will effectively kill
| mosquito larvae in water. They're apparently entirely nontoxic
| to basically anything else. I expect that they're too expensive
| for country-scale control, but they're great for a backyard
| puddle.
|
| You can kill mosquito pupae in water by spraying with an oil
| that makes a surface film for a few days. The pupae suffocate.
| setopt wrote:
| Great overview. Add to the list the nuclear option of a "gene
| drive", a genetic modification that spreads exponentially
| through a mosquito population.
| j_maffe wrote:
| From what I know about malaria prevention, insecticides are
| mostly used in insecticide-treated bed nets.
| Fomite wrote:
| There's a variety of insecticide classes:
|
| pyrethroids (e.g., permethrin),organochlorines (e.g., DDT);
| carbamates (e.g., bendiocarb); and organophosphates (e.g.,
| malathion)
|
| Pyrethroids are most often in bed nets, insecticide impregnated
| clothing, etc. How and what to apply these chemicals to is the
| subject of a lot of ongoing research.
|
| Beyond this, there's just things like finding and eliminating
| mosquito breeding sites.
| jjmarr wrote:
| I imagine it's more complicated than "spray insecticides
| everywhere" otherwise it'd be easy. Here's the WHO white paper
| on it:
|
| https://www.who.int/publications/i/item/9789240031357
|
| It's 40 pages long. To summarize, the three pillars are
| universal healthcare, identifying the areas where malaria is
| more/less prevalent/even eradicated, and surveilling
| eradicated/low transmission areas for new infection.
|
| Insecticides are a part of the "universal healthcare" aspect
| because vector control is a part of actually preventing
| malaria. But you can kill mosquitoes with things other than
| insecticides and mosquitoes in different regions are sometimes
| immune, which is why it's important to identify specific
| regions to target for eradication as there's no "one-size fits
| all" strategy. The paper goes into more detail on page 18 on
| the various methods of using different insecticides or parasite
| killing methods. All the methods have to be utilized in
| concert.
|
| Once a region has eradicated malaria, surveillance is what
| prevents it from coming back. But it's also necessary as the
| number of infections go down to spend more resources on trying
| to find the few that are left.
|
| Interestingly, discrimination plays a role because the last
| people getting malaria are generally those of very low status
| that don't get healthcare. If you don't expand healthcare to
| every single person in a society, malaria will come back.
|
| I'm probably oversimplifying the paper a lot as a non-expert,
| but it seems the best way to eradicate malaria isn't a magic
| technological bullet but effective administration and project
| management using the treatment methods we already have.
| db48x wrote:
| Dramatic reenactment: https://www.youtube.com/watch?v=ljmifo4Klss
|
| (smallpox instead of malaria; close enough)
| zahlman wrote:
| Jai's blogpost has been one of my favourites for a while now. I
| didn't know there was an animation like this, thank you.
| db48x wrote:
| You're welcome.
| whimsicalism wrote:
| it's unfortunate that the last person to have smallpox (and
| survived) died at 58 of malaria
| D-Coder wrote:
| Good news items like this in the medical, social, environmental
| areas is available via a weekly free email from
| https://fixthenews.com/. (A premium version is also available.)
|
| _Some_ of the items from last week (each has a paragraph of
| details):
|
| * India is finally becoming a clean energy superpower
|
| * United States designates a massive new marine sanctuary
|
| * India officially eliminates trachoma as a public health problem
|
| * Global electric vehicle sales soared in September
|
| * Global teen pregnancy rates have dropped by one-third since
| 2000
| dr_dshiv wrote:
| Formerly futurecrunch. It's my only paid newsletter. I love it.
| SoftTalker wrote:
| Another one that was pointed out on HN last week:
| https://www.newsminimalist.com/
|
| Not strictly "good news" but tries to be significant news
| without clickbait.
| yakhinvadim wrote:
| Thanks for the callout! (I'm the founder)
|
| I already have the "positivity" scores for each article, so
| I'll add a separate "positive and significant news" page in
| the coming weeks.
| ricardo81 wrote:
| Cool indeed. Traditional media is so desperate with click bait
| and riddled with ads. And social media of course.
| marssaxman wrote:
| Reasons To Be Cheerful offers a similar periodical:
| https://reasonstobecheerful.world/
|
| (I have no idea why the web site calls it a "self help
| magazine"; it's just a collection of interesting positive
| news.)
| deepfriedbits wrote:
| This is great. Thanks for sharing!
| lysozyme wrote:
| It's interesting how Egypt's efforts to monitor and test for
| malaria contributed to this accomplishment. It underscores how
| eradicating many infectious diseases will require a deep
| understanding not only of the disease itself, but also the cycles
| of transmission and the complex ecology of different hosts.
|
| Malaria's complex lifecycle [1] seems like it would be easy to
| "break" with different interventions, but we've seen historically
| malaria has been difficult to eradicate. Why is this?
|
| 1.
| https://en.m.wikipedia.org/wiki/Plasmodium#/media/File%3ALif...
| foxyv wrote:
| I think the greatest challenge with eradicating Malaria is that
| it is most prevalent in impoverished regions of the world. The
| USA occasionally has incursions of Malaria which is quickly
| quashed by the CDC National Malaria Surveillance System. If you
| have enough funding, Malaria is preventable. However, if most
| people do not have access to medical care, they cannot be
| diagnosed or tracked.
|
| Essentially, a lack of access to health care results in Malaria
| continuing to devastate regions of the world. If you ever want
| to save a life, donating to the MSF is a great way to do it.
|
| https://www.cdc.gov/malaria/cdc-malaria/index.html
|
| https://www.doctorswithoutborders.org/what-we-do/medical-iss...
| Fomite wrote:
| This. That malaria is not prevalent in the Southern U.S.
| (there's a reason the CDC is in Atlanta) is as much an
| economic choice as an epidemiological success story.
| te_chris wrote:
| I heard an urban legend that the original eradication was
| basically carpet bombing the south with DDT back before we
| knew better.
| dragonwriter wrote:
| "Carpet bombing" is perhaps a hyperbolic term, but
| widespread application of DDT in the southeastern US was,
| in fact, a central component of the effort.
|
| https://stacks.cdc.gov/view/cdc/100616/cdc_100616_DS1.pdf
| JumpCrisscross wrote:
| > _If you have enough funding, Malaria is preventable_
|
| Malaria is also dependent on a non-human vector. That means
| you can target it without requiring peoples' co-operation.
| Contrast that with _e.g._ polio where you have to convince
| people to get vaccinated.
| ffsggdvh wrote:
| Malaria has multiple dependencies but they're all resilient
| like well set up k8s. You can reduce its function by attacking
| multiple paths but, mathematically, to destroy it one of the
| decencies has to go to 0 or several have to be severely
| degraded. Polio was comparatively easy because it had a cheap
| vaccine you could take by mouth and you could isolate
| zjp wrote:
| Fuck yeah! On to the rest of the continent. Let's eradicate our
| oldest, deadliest adversary.
| killjoywashere wrote:
| I find it hard to believe this will be durable, but best of luck
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