Opinion
Volume 5 Issue 1 - 2016
Plasmodium Vivax: Outbreaks and Overview
Attapon Cheepsattayakorn1, 2* and Ruangrong Cheepsattayakorn3
110th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
25th Office of Disease Prevention and Control, Ratchaburi, Department of Disease Control, Ministry of Public Health, Thailand

3Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*Corresponding Author: Attapon Cheepsattayakorn, 10th Zonal Tuberculosis and Chest Disease Center, 143 Sridornchai Road Changklan Muang Chiang Mai 50100 Thailand.
Received: December 26, 2016; Published: December 26, 2016
Citation: Attapon Cheepsattayakorn and Ruangrong Cheepsattayakorn. “Plasmodium Vivax: Outbreaks and Overview”. EC Microbiology 5.1 (2016): 04.
Plasmodium vivax, a human malarial parasite occurs in both tropical and temperate zones, between 45o N and 40o S. In 2014, Egypt (Aswan Governorate) had an outbreak of Plasmodium vivax after several years of maintaining zero indigenous cases. Twenty-one confirmed cases during May-June 2014 were detected. In 2011, as of 27 December, 20 Plasmodium vivax malaria cases were identified from Lakonia, Evrotas, and other geographical areas in Greece. During the mid-20th century, malaria transmission in the United States was largely eliminated. Between 1951 and 1990, in the United States, 21 introduced malaria outbreaks that all were caused by Plasmodium vivax. Nevertheless, 14 of these outbreaks occurred in California (seven outbreaks during 1986, 1988, and 1989 (2 outbreaks in 1989 in San Diego County)). During 1997 to 2002, four separate probable mosquito-transmitted malaria outbreaks had been reported to the United States Centers for Disease Control and Prevention (US CDC), including one outbreak from Virginia. This report described the investigation of two patients with Plasmodium vivax malaria that occurred in northern Virginia in August 2002. In 2002, in Kyrgyzstan, 2,744 malaria cases were registered mainly in the Fergana valley with 98 % of Plasmodium vivax and 2 % of Plasmodium falciparum. The investigation revealed that malaria outbreak in Kyrgyzstan was imported from Uzbekistan, Azerbaijan, Tajikistan, and Afghanistan. Because of only intraerythrocytic schizogony occurring, neither transfusion nor congenital malaria is expected to relapse. Spreading of Plasmodium vivax infection is exclusively by female anopheline mosquitoes. Individuals with Plasmodium vivax (or Plasmodium ovale) infection may have relapses after several weeks, months or years. Plasmodium vivax and Plasmodium ovale primarily infect young erythrocytes, whereas Plasmodium malariae infects older erythrocytes. Plasmodium falciparum infects erythrocytes of all ages. The diagnosis of Plasmodium vivax malaria is made by history of traveling, physical examination, amoeboid shape of growing trophozoites, appearance and size of erythrocyte, Maurer ‘s dots, irregular parasite cytoplasm, appearance of parasite pigment, number of merozoites (12-24, average is 16), parasite’ s stages identified in circulating blood. Mixed infections is found approximately 5 %, mostly are Plasmodium vivax and Plasmodium falciparum. Chloroquine remains the treatment of choice for Plasmodium vivax malaria, except in the geographically contiguous Papua Guinea and Indonesia’ s Irian Jaya (Western New Guinea) region. Korea and India are areas that developed chloroquine resistance. Artesunate is the drug of choice for Plasmodium vivax malaria when chloroquine resistance and chloroquine contraindication developed. Detecting gametocytes of Plasmodium falciparum in an individual obviously infected with Plasmodium vivax is diagnostic. Individuals who lack certain Duffy blood group determinants are protected against Plasmodium vivax infection. Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency has been associated with protection from malaria, but scientific evidences are less striking than with these other genetic abnormalities. In conclusions, mostly, Plasmodium vivax outbreaks are due to local transmissions. To prevent transmission and control the disease on long term, the development of an integrated preparedness and response plan for malaria that covers all aspects from surveillance, clinical management, laboratory diagnosis, entomological surveillance, vector control, and communication is necessary.
Copyright: © 2016 Attapon Cheepsattayakorn and Ruangrong Cheepsattayakorn. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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