Three-Day Treatment Cures Decades-Old Case Of Malaria

February 06, 1998

A Johns Hopkins physician has discovered that a 74-year-old woman originally diagnosed with a blood cell cancer actually had a very mild case of malaria that lasted for as many as 70 years. Once he nailed down the cause of her symptoms, he cured her within three days.

"This appears to be the longest documented case of malaria on record," says Joseph Vinetz, M.D. The Hopkins physician, is now at the Laboratory of Parasitic Diseases at the National Institute of Allergy and Infectious Diseases. A report on the case appears in the Feb. 5 issue of the New England Journal of Medicine. The work was supported by a Physician Postdoctoral Fellow Award from the Howard Hughes Medical Institute.

Using a technique developed by his collaborators at the National Institutes of Health, the group used a novel test to greatly amplify the genetic material of malarial ribosomes -- the tiny protein-making factories in all living things. Using the ribosomal RNA as a guide, he made large quantities of the genes that code for ribosomal RNA, then applied genetic "probes" that sought out and highlighted only genes that occur in one type of malarial parasite known as Plasmodium malariae. He suspected that P. malariae was the culprit, because it is known to cause very mild cases that last for years.

The tale of misdiagnosed malaria began in 1994, when the woman, from the Greek island of Karpathos, was found by a newly minted young medical graduate to have an enlarged spleen during a routine physical in a rural clinic.

Following a diagnosis of lymphoma, the woman began treatment with the anti-cancer drug methotrexate. But she developed severe headaches and a cyclical fever called a quartan fever that occurred every 72 hours. After doctors took her off methotrexate, she recovered from her symptoms but still had an enlarged spleen.

In 1996, the woman came to Baltimore, where her daughter lives, to be examined at Johns Hopkins, infectious disease clinic. There, Vinetz, who was also then working at the Laboratory of Parasitic Diseases, suspected the fever and large spleen might be caused by malaria. In only three days, using five doses of anti-malaria medicine, she was cured.

Vinetz, who has a reputation for tackling difficult research problems, noted that the ancient Greek physician Hippocrates characterized quartan fevers as the mildest fevers. "He was right then and he was right now," Vinetz says of his patient.

Greece has been free of malaria since about 1950, so the patient, who had never left the country until she came to Hopkins, could not have been infected after that year, Vinetz says. "We learned from her sister that she had been infected with malaria when she was about 3 years old, but was thought to have recovered without being treated. She clearly was never really cured until now."

Vinetz is known for his research into rat-borne diseases in Baltimore and his success in scouring alleyways to trap and test rodents for testing.

Other authors of the paper include Jun Li, Thomas F. McCutchan and David C. Kaslow (National Institute of Allergy and Infectious Diseases).

Media Contact: Marc Kusinitz (410)955-8665
Johns Hopkins Medical Institutions' news releases are available on a PRE-EMBARGOED basis on EurekAlert at, Newswise at and from the Office of Communications and Public Affairs' direct e-mail news release service. To enroll, call 410-955-4288 or send e-mail to or

On a POST-EMBARGOED basis find them at, Quadnet at, ScienceDaily at or on CompuServe in the SciNews-MedNews library of the Journalism Forum under file extension ".JHM".

Johns Hopkins Medicine

Related Malaria Articles from Brightsurf:

Clocking in with malaria parasites
Discovery of a malaria parasite's internal clock could lead to new treatment strategies.

Breakthrough in malaria research
An international scientific consortium led by the cell biologists Volker Heussler from the University of Bern and Oliver Billker from the UmeƄ University in Sweden has for the first time systematically investigated the genome of the malaria parasite Plasmodium throughout its life cycle in a large-scale experiment.

Scientists close in on malaria vaccine
Scientists have taken another big step forward towards developing a vaccine that's effective against the most severe forms of malaria.

New tool in fight against malaria
Modifying a class of molecules originally developed to treat the skin disease psoriasis could lead to a new malaria drug that is effective against malaria parasites resistant to currently available drugs.

Malaria expert warns of need for malaria drug to treat severe cases in US
The US each year sees more than 1,500 cases of malaria, and currently there is limited access to an intravenously administered (IV) drug needed for the more serious cases.

Monkey malaria breakthrough offers cure for relapsing malaria
A breakthrough in monkey malaria research by two University of Otago scientists could help scientists diagnose and treat a relapsing form of human malaria.

Getting to zero malaria cases in zanzibar
New research led by the Johns Hopkins Center for Communication Programs, Ifakara Health Institute and the Zanzibar Malaria Elimination Program suggests that a better understanding of human behavior at night -- when malaria mosquitoes are biting -- could be key to preventing lingering cases.

Widely used malaria treatment to prevent malaria in pregnant women
A global team of researchers, led by a research team at the Liverpool School of Tropical Medicine (LSTM), are calling for a review of drug-based strategies used to prevent malaria infections in pregnant women, in areas where there is widespread resistance to existing antimalarial medicines.

Protection against Malaria: A matter of balance
A balanced production of pro and anti-inflammatory cytokines at two years of age protects against clinical malaria in early childhood, according to a study led by ISGlobal, an institution supported by ''la Caixa'' Foundation.

The math of malaria
A new mathematical model for malaria shows how competition between parasite strains within a human host reduces the odds of drug resistance developing in a high-transmission setting.

Read More: Malaria News and Malaria Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to