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Saturday, September 23, 2017

Spread Of A Single Multidrug Resistant Malaria Parasite Lineage (PfPailin) To Vietnam

Where weaponised SARS, H5N1 fails an engineered parasite is now unleashed in ASEAN  

THE LANCET
By Mallika Imwong, Tran T Hien, Nguyen T Thuy-Nhien, Arjen M Dondorp, Nicholas J White
10/2017

The spread of artemisinin resistance in Plasmodium falciparum and the subsequent loss of partner antimalarial drugs in the Greater Mekong subregion1 presents one of the greatest threats to the control and elimination of malaria. 


Artemisinin resistance is associated with mutations in the PfKelchgene. 

Initially multiple independent Kelch mutations were observed,1 but in a recent sinister development, a single dominant artemisinin-resistant P falciparum C580Y mutant lineage has arisen in western Cambodia, outcompeted the other resistant malaria parasites, and subsequently acquired resistance to piperaquine.2 .



Cambodia had adopted dihydroartemisinin-piperaquine as first-line antimalarial treatment, but has now been forced to switch its first line artemisinin combination treatment back to artesunate-mefloquine as a consequence3. 

This dominant multidrug-resistant parasite lineage, identified first in Pailin in western Cambodia and tentatively denoted as PfPailin, then spread to northeastern Thailand and southern Laos2. 


Transnational spread of multidrug resistant PfPailin. The artemisinin resistant Plasmodium falciparum C580Y lineage (PfPailin) was detected first in Pailin, Western Cambodia, in 2008.2 It later acquired piperaquine resistance and spread east. 8 years later it has now reached the south of Vietnam encompassing all four countries of the Eastern Greater Mekong subregion.

We now find that the PfPailin lineage, with associated piperaquine resistance (evidenced by amplification in the PfPlasmepsin2 gene), has spread to the south of Vietnam where it is responsible for alarming rates of failure of dihydroartemisinin-piperaquine—the National first-line treatment (figure).4 Microsatellite typing of 86 of 152 P falciparum isolates from the Binh Phuoc locality in 2016 shows the same flanking sequence surrounding the PfKelch C580Y gene as that observed in parasites from the affected areas of the other three Greater Mekong subregion countries.2 

The evolution and subsequent transnational spread of this single fit multidrug-resistant malaria parasite lineage is of international concern.

We declare no competing interests. This study was supported by Mahidol University, Thailand and the Wellcome Trust. Some of the samples were from the TRAC study supported by the UK Department for International Development (DFID).

References:

Ashley, EA, Dhorda, M, Fairhurst, RM et al. Tracking Resistance to Artemisinin Collaboration (TRAC). Spread of artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med. 2014; 371: 411–423

Imwong, M, Suwannasin, K, Kunasol, C et al. The spread of artemisinin-resistant Plasmodium falciparum in the Greater Mekong Subregion: a molecular epidemiology observational study. Lancet Infect Dis. 2017; 17: 491–497

Thanh, NV, Thuy-Nhien, N, Tuyen, NT et al. Rapid decline in the susceptibility of Plasmodium falciparum to dihydroartemisinin-piperaquine in the south of Vietnam. Malar J. 2017; 16: e27.




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ANDREW KREIG: EXPERTS REJECT FIRE AS CAUSE FOR 9/11 WTC COLLAPSES

The real truth on 9/11 slowly continues to bleed out

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Technical experts are mounting major challenges to official U.S. government accounts of how three World Trade Center skyscrapers collapsed in near-freefall after the 9/11 attacks 15 years ago.

Many researchers are focusing especially on the little-known collapse of

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The Geopolitics Of The United States, Part 1: The Inevitable Empire

The Empire and the inevitable fall of the Obama criminal regime

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STRATFOR Editor’s Note: This installment on the United States, presented in two parts, is the 16th in a series of STRATFOR monographs on the geopolitics of countries influential in world affairs.

Like nearly all of the peoples of North and South America, most Americans are not originally from the territory that became the United States.

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Geopolitics Of The United States Part 2: American Identity And The Threats of Tomorrow

A look back at 2011 predictions for the future in order to put events of today into perspective

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We have already discussed in the first part of this analysis how the American geography dooms whoever controls the territory to being a global power, but there are a number of other outcomes that shape what that power will be like. The first and most critical is the impact of that geography on the American mindset.

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By Robert S. Finnegan

This e-mail outlines and confirms the acts of espionage against Indonesia and Indonesians by Akiko Makino and the others involved both in Kobe University and in AI Lab at University of Airlangga, Surabaya; Bahasa Indonesia original follows English translation...

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UPDATED 01/07/2015 : New Analysis Challenges Tamiflu Efficacy; Hong Kong Corona Virus Outbreak

UPDATED 01/07/2015 : FOX NEWS CORPORATE PHARMA SHILL MEGAN KELLY AND FOX NEWS QUACK DOCTOR NOW PUSHING TAMIFLU FOR PREGNANT WOMEN AND CHILDREN;

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THE 5TH ESTATE UNEQUIVOCALLY WARNS THE PUBLIC NOT TO TAKE OR GIVE THIS PROVEN DANGEROUS, INEFFECTIVE DRUG TO ANYONE

Obama criminals now resulting to biowarfare in quest to destroy Chinese and ASEAN economy; "novel virus substrain" points directly to a Kawaoka / Fouchier / Ernala-Ginting Kobe lab virus weaponized and genetically altered to specifically target and infect the Asian population: Ribavirin...

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The 5th Estate has just purchased a library on H5N1 "Novel" virus pandemics, there are dozens of PDF and Exel documents we feel will assist you in saving lives following intentional releases of the H5N1 and now MERS viruses; we will begin by printing those that appear to be extremely relevant here: H5N1 Kobe-Kawaoka-Ernala series continues soon with more "Smoking Gun" e-mails from Teridah Ernala to The 5th Estate . . .

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By Robert S. Finnegan

On October 12, 2002 the Indonesian island of Bali experienced a terrorist attack that rocked the world. It was unquestionably well-coordinated and executed, the largest in the country's history.

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