title: Clinical manifestations of Plasmodium falciparum malaria experimentally induced by mosquito challenge.
abstract: To determine the characteristics of clinical illness accompanying Plasmodium falciparum infection induced by controlled exposure to infected mosquitoes, records of 118 volunteers participating in studies conducted between 1985 and 1992 were reviewed. One hundred fourteen volunteers (97%) reported at least one symptom attributable to malaria, with fatigue, myalgias or arthralgias, headache, and chills most commonly reported. The median duration of symptoms was 3 days. Fever was recorded in 61% of volunteers; 4 volunteers had temperatures >40 degrees C. Neutropenia and thrombocytopenia were present in 9% and 12% of volunteers, respectively. Despite counts as low as 658/microL (neutrophils) or 73,000/microL (platelets), no secondary infectious or hemorrhagic complications occurred. In all cases, volunteers recovered completely and laboratory values returned to baseline after specific antimalarial therapy. Recrudescence did not occur in any volunteer. In this model, mosquito inoculation of P. falciparum is a reliable, safe, and well-tolerated method of experimental challenge.
authors.affiliation: Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: L W
authors.initials: LW
authors.lastname: Church
authors.forename: T P
authors.initials: TP
authors.lastname: Le
authors.forename: J P
authors.initials: JP
authors.lastname: Bryan
authors.forename: D M
authors.initials: DM
authors.lastname: Gordon
authors.forename: R
authors.initials: R
authors.lastname: Edelman
authors.forename: L
authors.initials: L
authors.lastname: Fries
authors.forename: J R
authors.initials: JR
authors.lastname: Davis
authors.forename: D A
authors.initials: DA
authors.lastname: Herrington
authors.forename: D F
authors.initials: DF
authors.lastname: Clyde
authors.forename: M J
authors.initials: MJ
authors.lastname: Shmuklarsky
authors.forename: I
authors.initials: I
authors.lastname: Schneider
authors.forename: T W
authors.initials: TW
authors.lastname: McGovern
authors.forename: J D
authors.initials: JD
authors.lastname: Chulay
authors.forename: W R
authors.initials: WR
authors.lastname: Ballou
authors.forename: S L
authors.initials: SL
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000852:Anopheles / Q000469:parasitology*; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings; D007303:Insect Vectors / Q000469:parasitology*; D007958:Leukocyte Count; D016778:Malaria, Falciparum / Q000097:blood / Q000150:complications* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D018512:Parasitemia / Q000209:etiology; D010976:Platelet Count; D012189:Retrospective Studies