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Good Reading : November 2010
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But these rings were not to be treasured. Feeding on the nutrients in the food vacuole, ring-shaped trophozoites grew larger in the bo doi's [soldier's] red blood cells and lost their spherical shape, spreading out to look more like amoebae. As they grew, they produced waste products -- golden brown pigment that was recognised as a flag for malaria before anyone knew what caused the disease. After just a few hours, there was enough pigment in the blood to be easily visible through a microscope. The infected bo doi was likely feeling a bit under the weather at this point: he may have suspected he had a touch of the flu, suffering fatigue, headache, and aching joints, or he may have known exactly what was happening, having seen others succumb. Either way, his health was about to deteriorate frighteningly. In the next stage of development, trophozoites multiply inside red blood cells, producing a dozen or more merozoites, and then destroy the cell as they burst into the surrounding blood plasma. Millions of infected red blood cells disintegrate simultaneously.Then each merozoite invades a new red blood cell and begins the process all over again. Eventually, some merozoites mature into gametocytes, the stage that can infect another mosquito. When legions of red blood cells break down at once, the stricken human suffers a malarial attack, or paroxysm. Each time a paroxysm strikes, the victim suddenly feels bitterly cold. He shivers with chill as his body temperature shoots up past 40°C. In the relative comforts of home, a bo doi might retire to bed with chattering teeth, wrapping himself in blankets, or huddle by the stove in chilled misery, but none of these comforts were available along the Ho Chi Minh Trail, and nights could be cool. In any case, neither would have helped. Within an hour, everything would change: a ter rible headache would set in, and the bo doi would be roaring hot and incoherent, collapsing on the trail or lying helpless in a hammock at one of the campsites. Several hours would pass before his fever eased; then he would find himself soaked with sweat and utterly exhausted. Afterward, perhaps, he could sleep, but like a recurring nightmare, the paroxysm would return with a vengeance every twenty-four to forty-eight hours as the next generation of sporozoites spilled out of decimated red blood cells and invaded new ones. For both Vietcong and American soldiers, the disease sometimes took a frightening tur n, causing the victim to slide into unconsciousness, with involuntary flailing of limbs, muscle spasms, and grinding of teeth. In the brain, red blood cells infested with parasites crowded small blood vessels and lined the walls of larger ones, casting a strange plum-colored pall over the brain tissue. Deprived of oxygen, the brain faltered.Without swift and competent medical treatment, the patient died.The Vietcong suffered severe losses from malaria just like the Americans. The bo dois car ried antimalarials, but not enough, and like the American pills, the drugs were not always effective against the parasite. Plasmodium falciparum had seen the drug before, and it had evolved a way to evade the medicine. Parasites: Tales of humanity's most unwelcome guests by Rosemary Drisdelle is published by University of California Press, rrp $44.95. Da Nang Phnom Penh Saigon GULF OF THAILAND GULF OF TONKIN SOUTH CHINA SEA CAMBODIA CHINA LAOS NORTH VIETNAM SOUTH VIETNAM THAILAND N 0 0 200 300 km 100 100 200 mi Map of Southeast Asia. The network of paths that formed the Ho Chi Minh Trail in Laos, bridging North and South Vietnam, is circled. NOVEMBER 2010 ı goodreading 51
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