Malaria

Background
Malaria, which predominantly occurs in tropical areas, is a potentially life-threatening disease caused by infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito vector. Individuals with malaria may present with fever and a wide range of symptoms.

The 4 Plasmodium species known to cause malaria include Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. A fifth species, Plasmodium knowlesi, has recently been identified as a clinically significant pathogen in humans. Timely identification of the infecting species is extremely important, as P falciparum infection can be fatal and is often resistant to standard chloroquine treatment. In some cases, individuals with malaria are infected with multiple Plasmodium species. P falciparum and P vivax are responsible for most new infections. Each Plasmodium species has a defined area of endemicity, although geographic overlap is common. Species can usually be distinguished by morphology on a blood smear. P falciparum is distinguished from the rest of plasmodia by its high level of parasitemia and the banana shape of its gametocytes.

Malaria in travelers typically manifests weeks after the individual leaves the endemic area. Presentation more than 4 weeks after returning from the endemic area is unusual. In some individuals, disease manifests months or years later, usually due to the presence of P vivax or P ovale hypnozoites, which can remain dormant in the liver and reactivate years after infection. Relapse with P vivax or P ovale infection is rare more than 5 years after initial infection. Because symptomatic delay is common, history of even a remote exposure to an endemic area should be elicited. Symptoms of malaria are nonspecific, and, because timely diagnosis and treatment are necessary, malaria should be considered in all patients from tropical areas who present with fever. Read more »

Boston Cabs and Credit Cards

Ready to book your Boston transportation? To learn more about car service Boston option and finding a Boston car service that is right for you (or a Logan car service to Logan airport or back from it), read below.

Over two years ago, the city of Boston mandated that every taxi cab be equipped with a credit card reader for customer convenience. Today, one in every four Boston taxi cab passengers pay with credit. This installation has numerous advantages for passengers, but has created tensions between law enforcement and drivers.

Collected from registered taxi cabs, meters show that Boston cab usage has greatly increased since the credit card devices were installed. Taxis now carry more passengers, make more profitable fares, and travel longer distances. Analysts attribute the credit card readers, which were fully installed in Boston’s taxis in mid-2009, to some of the success.

Boston cab credit card processors, which are positioned in the rear seat, are attractive to passengers for various reasons. Obviously, passengers do not require cash money for their fare. This is particularly advantageous for customers after-hours, when banks or ATMs might be closed or in inclement weather, which Boston often experiences. In addition, taxi cab credit card machines are highly convenient. Many people might not carry substantial amounts of money, and cab fares in Boston can be relatively expensive. Instead, one simply needs to swipe a credit card through the taxi’s machine, and the fare and tip are accounted for without requiring cash.

However, the view from the front seat is quite different. Some taxi drivers and cab companies argue that the radio dispatch companies, which installed the machines, are profiting from the credit card readers, not the drivers.