Malaria cases are on the rise and the United States is not ready to deal with it because the supply of drugs left to treat the disease has expired, an expert has warned.
Currently severe cases of life-threatening mosquito-borne disease are being treated with an IV form of quinidine gluconate.
However, the remaining supply of IV Centers for Drug Control and Prevention expires earlier this year, according to Dr. Mark Travasos, Assistant Professor of Pediatrics at the University of Maryland School of Medicine (UMSOM).
He says that oral doses of quinidine are available, but they cannot reduce or delay the reproduction of parasites in the blood as fast as the IV form.
While there is an FDA-approved drug that can be used, it can take up to a day to get to hospitals, says Dr. Travasos.
University of Maryland School of Medicine expert warned that residual delivery of IV form CDC of quinidine gluconate for treatment we malaria expired in April 2019 (file image)
Malaria is a disease caused by a parasite that is transmitted by mosquito bites to humans.
Flu-like symptoms include fever, chills, headaches, muscle aches, fatigue, nausea and vomiting.
Plasmodium falciparum is a parasite that causes severe malaria affecting the liver, brain and cardiovascular system.
In 1951, malaria was considered to be eliminated in the United States, but there are still about 1,500 cases diagnosed annually, according to the CDC.
With increasing temperatures, mosquito populations are increasing worldwide, as is the spread of insect-borne disease.
Alongside these increases, people travel more than a country to a country, increasing the risk of someone returning to the United States from abroad.
Of the 1,500 cases confirmed in 2015 in the US, 259 – about six percent – are serious and require IV treatment.
"Severe patients with malaria may have brain damage or recurrent vomiting and may not tolerate oral medications, putting them at high risk of complications," explained Dr. Travasos.
There were 219 million cases of malaria worldwide in 2017, compared to 216 million in 2016.
In 2017, 435,000 people died from malaria worldwide, a drop of 445,000. estimated deaths in 2016
According to the CDC, malaria cases have increased steadily over the last 40 years.
The United States Food and Drug Administration (FDA) approved IV quinidine for the treatment of severe malaria in 1991 and it is still the only FDA approved treatment.
But as of April 2019, residual delivery of quinidine to the United States has expired, which means that there is currently no
Dr. Travassos, a malaria expert at UMSOM's Malaria Research Program, says that oral treatments are available in the US, but they are not as effective in treating serious cases.
"Severe malaria is a medical emergency" requires immediate treatment with IV drugs to reduce the risk of death, he said.
Doctors currently treat severe patients on a case-by-case basis with IV form of artesunate, a non-FDA-approved drug to the treatment facility where the patient is treated for malaria.
Delivery takes an average of eight hours but can take up to 24 hours.
In his comment, Dr. Travasos recommends that the CDC find pharmaceutical companies that can produce IV form of artesunate – and send an accelerated approval application to the FDA.
This will reduce the approval time from two-and-a-half years to just six months.
He further recommended that hospitals immediately test patients who have recently traveled to areas known to have a high rate of malaria for the disease.
"As we become more global in the United States, it is important to understand the risks and concerns of diseases such as malaria," says UMSOM Dean Dr. E. Albert Reese.
“At the University of Maryland Medical School, our scientists and physicians study the best methods and approaches for managing and treating the most complex and challenging diseases. "