Abstract
Human malaria is a disease characterized by its long duration and chronicity. A typical infection with Plasmodium vivax lasts 2 to 3 years with periodic remissions and relapses. There is now good evidence to indicate that the relapses, whose frequency varies with the strain of parasite, originate from dormant forms, called hypnozoites. These are derived from inoculated sporozoites and lie in hepatic cells until somehow stimulated to develop into preerythrocytic schizonts, which then produce merozoites that invade red blood cells and initiate the relapse. Nothing is known as to whether the parasites of successive relapses differ antigenically. Immunity develops only slowly. The relapses, after a time, tend to be less severe clinically, even though more parasites may be present. Such a partially immune person may be walking around with a parasitemia of 50,000 per μl blood, whereas a nonimmune individual will be extremely ill with so few parasites (10 or even less per |μl) that diagnosis by slide examination may be difficult. P. ovale infections resemble those with P. vivax and may have even longer latent periods. With the quartan parasite P. malariae, latent inapparent infection has been known to persist for 50 years. This has been shown by the accidental infection with this species of recipients of blood transfusions from donors who had left a malarious region 50 years earlier and had never been back. In such people the parasite and host are in a state of equilibrium. This may resemble the situation with experimental infection with P. inui in the rhesus monkey, where the spleen seems to play a positive role in maintaining the parasite (see Chapter 15).
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Trager, W. (1986). Immunity to Malaria and Related Intracellular Protozoa. In: Living Together. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-9465-9_19
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