Treatment for Human Malaria and Chicken Malaria

Two months ago, I saved two of my two month old chickens from certain death due to malaria. 

Early detection is key. High temperature. No appetite. And one of them has blood droppings.

Tri-Sulfa water-soluble gamecock medicine (see “Treatment” below) during feed times – morning, noon, and before dark.

Hand feeding morning and before dark.

For 2 weeks minimum.

Mosquito prevention is a must during treatment and always.

– Gameness til the End

CDC’s Malaria Program

Malaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills, and flu-like illness. Left untreated, they may develop severe complications and die. In 2010 an estimated 219 million cases of malaria occurred worldwide and 660,000 people died, most (91%) in the African Region.

Download CDC Malaria Program PDF here.

WHO and Malaria

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells.

Symptoms of malaria include fever, headache, and vomiting, and usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Key interventions to control malaria include: prompt and effective treatment with artemisinin-based combination therapies; use of insecticidal nets by people at risk; and indoor residual spraying with insecticide to control the vector mosquitoes.

Malaria Treatment

The treatment of malaria depends on the severity of the disease. Uncomplicated malaria may be treated with oral medications. The most effective strategy for P. falciparuminfection is the use of artemisinins in combination with other antimalarials (known as artemisinin-combination therapy, or ACT), which reduces the ability of the parasite to develop resistance to any single drug component. These additional antimalarials include amodiaquinelumefantrine, mefloquine or sulfadoxine / pyrimethamine. Another recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia.

Severe malaria requires the parenteral administration of antimalarial drugs. Until the mid-2000s the most used treatment for severe malaria was quinine, but artesunate has been shown to be superior to quinine in both children and adults. Treatment of severe malaria also involves supportive measures that are optimally performed in a critical care unit, including management of high fevers (hyperpyrexia) and the subsequent seizures that may result from it, and monitoring for respiratory depression, hypoglycemia, and hypokalemia. Infection with P. vivax, P. ovale or P. malariae is usually treated on an outpatient basis (while a person is at home). Treatment of P. vivax requires both treatment of blood stages (with chloroquine or ACT) as well as clearance of liver forms with primaquine.

Mosquitoes of Poultry

Mosquitoes that feed on poultry blood usually belong to the genera Culex, Aedes, or Psorophora. Large numbers can decrease egg production or cause death. Mosquitoes transmit Plasmodium gallinaceum (chicken malaria), P hermansi (in turkeys), and other Plasmodium species causing avian malaria. They also transmit many viruses, including Eastern and Western equine encephalomyelitis, St. Louis encephalitis, fowlpox, and West Nile viruses. West Nile virus is transmitted from infected birds to other birds primarily by mosquitoes and has been found in >110 species of birds in America, including chickens, turkeys, pigeons, budgerigars, cockatiels, ducks, finches, and birds of prey. (see West Nile Virus Infection in Poultry.)

Removal of mosquito-breeding habitats by emptying water-filled containers, clearing pool and pond edges of emergent vegetation, draining swampy areas, and filling low areas that collect water are the best physical control measures. Insecticidal control involves chemicals such as malathion, propoxur, permethrin, chlorpyrifos, or temephos. Insect growth regulators such as methoprene and diflubenzuron are also effective. Microbial control uses Bacillus thuringiensis israelensis. Screening to prevent mosquito entry, residual wall sprays, and fogging within poultry houses also aid in control.

Plasmodium Infection in Poultry

Plasmodium spp, which often are not host-specific, infect a wide variety of domestic and wild birds in most areas of the world. Penguins, falcons, canaries, owls, domestic poultry, ducks, and pigeons are most often affected. Passerine birds commonly carry the organism asymptomatically. Cold-climate species are particularly susceptible (eg, penguins, snowy owls, gyrfalcons). P gallinaceum infects chickens in Asia and Africa and causes low mortality in indigenous chickens; however, rates may be as high as 80–90% in commercial birds. P juxtanucleare infects chickens in Asia, Africa, and South America; most infections are mild or asymptomatic. P durae infects turkeys and gallinaceous birds other than chickens in Africa; mortality in turkeys can approach 100%. Clinical malaria has not been reported from poultry in North America, but indigenous wild turkeys can become infected with at least 4 different Plasmodium species. The most common species affecting wild birds is P relictum, which has been found in at least 360 species of birds. It is the species that most often causes disease in raptors and penguins. Asymptomatic infections in endemic or introduced birds can be spread via mosquitoes and cause fatal disease in introduced (eg, zoo penguins, gyrfalcons) or resident (eg, Hawaiian avifauna) birds, respectively. Invertebrate hosts are ornithophilic mosquitoes, usually Culex,Culiseta, or Aedes spp.

Clinical Findings, Lesions, and Diagnosis

Infection with Plasmodium spp may be nonclinical or cause illness characterized by weakness, lassitude, dyspnea, anemia, abdominal distention, increased right heart weight, ocular hemorrhage, biliverdinuria, and death. Death results from severe anemia or blockage of capillaries in the brain or other vital organs by exoerythrocytic meronts in endothelial cells. Liver and spleen are markedly enlarged and often discolored (dark brown to black). Pigmented parasites including meronts are found in both immature and mature RBC. Infrequently, parasites are found in thrombocytes and WBC. In birds that die acutely, organisms may be sparse or absent in blood, but numerous meronts can be found in capillaries by examining squash or impression smears of brain, lung, liver, and spleen. Serologic and molecular diagnostic methods exist but are not available commercially. Serology and PCR can detect infection when parasites are too few to be identified in blood smears.

Treatment and Control

Therapy is variably effective in treating infected birds or flocks. Persistent parasitemia or relapse may occur during and after treatment. Birds that survive initial infections may be refractory to subsequent infections. Prevention of exposure to mosquitoes is an important adjunct.

No antimalarial drug is commercially available or approved to treat poultry flocks. However, a mixture of trimethoprim and sulfaquinoxaline in the feed for a 5-day period has been shown to be efficacious against experimentally induced P gallinaceum malaria in chickens. An experimental study on the pathogenicity and chemotherapy of P durae suggested that a combination of sulfamonomethoxine and sulfachloropyrazine could be an effective therapy; halofuginone was suggested for chemoprophylaxis in endemic areas.

In caged birds and penguins, chloroquine (10 mg/kg) and primaquine (0.3–1 mg/kg) is given orally and followed by administration of chloroquine (5 mg/kg) 6, 24, and 48 hr later. Chloroquine in drinking water (250 mg/120 mL) has also been used in songbirds. Grape or orange juice can disguise chloroquine’s bitterness. Treatment including both primaquine and chloroquine is recommended over chloroquine alone because only primaquine is active against the tissue schizonts. Chloroquine has activity against erythrocytic schizonts and gametocytes. Primaquine also has activity against erythrocytic gametocytes. When aliquoting the medications, it is important to remember that a 500-mg tablet of chloroquine contains 300 mg of active base, and a 26-mg primaquine tablet contains 15 mg of active base.

In raptors, control of the disease can be achieved by oral administration of mefloquine (30 mg/kg) repeated 12, 24, and 48 hr after the initial dose. Alternatively, a combination of chloroquine (25 mg/kg) and primaquine (1.3 mg/kg) can be given orally and is followed by the administration of chloroquine (15 mg/kg) 12, 24, and 48 hr later. In endemic areas, mefloquine once a week (30 mg/kg) has been used successfully for chemoprophylaxis in large falcons.

A DNA vaccine trial in captive African black-footed penguins was successful in reducing parasitemia and clinical disease.

poultry gamefowl chicken gamecock

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