Kiss of the Mosquito

I'm sorry for vanishing from this space so suddenly last week. The truth was that, by the time of Mr Thaksin's resignation last Tuesday night, I was feeling very peculiar, to an extent that could not fully be explained by my elation at witnessing history in the making.

I had a drumming headache, tiredness, aches in the limbs and joints, a fiery thirst, and the shakes - in other words, I felt exactly as most male British tourists in Bangkok do for most of the time. Taking a shower on my last morning was easy enough, although towelling myself dry afterwards required a lot more effort, and packing my three shirts and two pairs of trousers aged me by several decades. At the airport, I looked enviously at the complacent elderly trundling by in their wheelchairs. I spent the flight back to Tokyo shivering under two blankets.

At home on Thursday night I told myself that I'd go to the doctor if I wasn't feeling better by Monday. On Friday afternoon I made an appointment for that evening. On Saturday morning, the tests confirmed what would have seemed obvious days ago to one better in tune with his own health - I had malaria.

Not the nastiest kind of a malaria - merely Plasmodium vivax, rather than the much more complicated, and frequently drug-resistant, Plasmodium falciparum. The origin of the infection is obvious enough - the trip I made in mid-March to the Thai-Burma border. At some point, a pregnant female mosquito pushed her drinking straw through my skin and exchanged a drop of my blood for the smallest traces of her saliva, in which the vivax parasites were stowing away. Since then they had been biding their time in my liver, and now they were whooping it up in parasitic orgy, new generations breeding one after another in my red blood cells, causing the waves of fever.

Within a few hours I was in hospital with a drip attached to my arm and a dose of mefloquine in my gut. Twenty four hours later, I was sufficiently recovered to start feeling bored, and this afternoon I am back at home, at that exasperating stage of recovery where my fever has receded but I don't have the energy or concentration to do anything much more than stare at a television.

So I'm racking my brains for some addled observations on this experience. I wan't all that ill, but it's certainly the illest I have been as an adult, and the worst part of all was the brainpan banging headache. I still cmarvel that I didn't even realise I had a high temperature, despite all the obvious symptoms - somehow the influenza fevers I've had before have always seemed more flushed and fiery than this one, which was just dry and painful. Finally, I suppose, how lucky I am to be able to regard a bout of malaria as a curiosity, an interesting experience, almost as good material.

The image above is a micrograph of a red blood cell containing four Plasmodium vivax rings, next to something described as "a growing trophozoite".

Excuse me if postings to this blog are intermittent for a few more days.

Comments

[myrick]

Ouch. My sympathies and best wishes on the recovery. But do recount any strange dreams caused by the mefloquine. I had rather strange dreams with a three-week prophylactic dose - a theraputic dosage doesn't strike me as something entertaining, especially when suffering from malaria's other symptoms.

[timothy evans]

Richard, I wondered where you had gone; into Thaksins BMW thought me. My condolences on a worse condition. I have not heard of anyone with Malaria for years. I contracted Hepatitis on Labuan Island some time ago and like you with malaria found the effects the worst of my adult life. Where was Mum? Now I always carry a good thermometer with me. And a reminder of one's normal body temperature. Get well.

[Richard Lloyd Parry]

Right after Christmas 2004, I flew to Aceh to cover the Boxing Day tsunami. In Singapore, along with camping equipment and a visa, I picked up medical supplies from the Guardian pharmacy, including several weeks supply of the malaria drug Lariam. The chunky pills were to be taken once a week, but the course was supposed to begin three weeks in advance of travel. Since I was going into Indonesia the next day the pharmacist advised that I take a double dose to begin with.

The next night was New Year's Eve which I spent in a hotel in Medan, the transit point for travel into Aceh. I was wound as tight as a wire with jet lag, tiredness, disappointment at the upset of my Christmas holiday and trepidation about what lay ahead in the disaster zone. I slept exhaustedly through the stroke of midnight and then woke about 40 minutes later as if shaken by a big cold scaly hand.

For the next two hours I felt as close as I ever have to going mad. My heart was racing, I was sweating, and I was seized by an uncontrollable and irrational panic. Horror is the only word I can use to describe it, although there was nothing to be horrified by, and this I also knew. I couldn't sleep; reading or watching TV did nothing to fend off the bogeys of dread. Eventually, I did manage to nod off, by repeating the alphabet backwards, over and over again (a trick I picked up from an old episode of Doctor Who, by the way).

The next morning, the fit had passed and a quick glance at the Internet confirmed what I had suspected - poisoning by Lariam, a drug blamed for causing suicides, murders and lesser psychotic attacks all over the world. The descriptions of the experiences of other victims closely matched my own. I threw away the pills, trusted myself to the mosquitoes of Aceh, and never experienced another "episode".

When I went into hospital last Saturday, the only thing I had decided in advance was that I would not, under any circumstances, accept treatment with Lariam. When they presented me with mefloquine, I was very relieved.

The next day I realised that mefloquine is Lariam. I had just had five doses of it - two and half times the amount which (I believed) had almost sent me over the edge the year before.

I don't know how to explain it. Perhaps the effect of the drug depends on your state of mind and health at the time (I had taken it once before with no ill effects). Perhaps my earlier panic had been one of tiredness and nerves, rather than chemical psychosis (never happened like that before though). At any rate, the mefloquine/Lariam has done the trick without a hint of any side-effects. And my medical ignorance, which got me into this trouble in the first place, saved me from me from making a bad and hasty decision.

[CulturalSnow]

Glad you're on the road to recovery, Richard. But next time, try dengue fever. Malaria's so 1990s.