You can get paid to catch malaria

How far would you go to help wipe out one of the world's worst scourges?

Seattle-area residents will soon be able to go all the way: allowing themselves to be bitten by malaria-infected mosquitoes to aid in the quest for new vaccines and drugs.

Seattle Biomedical Research Institute (SBRI) is announcing plans today for a facility where volunteers will be exposed to the deadliest form of the disease, which kills at least a million people a year. Most victims are African children.

But scientists are quick to point out that participating in the clinical trials won't be a life-threatening experience.

While many volunteers will actually contract malaria, the cloned strain used in the experimentscan be quickly cured, and does not cause a recurring form of the disease.

More than 900 people have participated in malaria trials at Walter Reed Army Institute of Research in Maryland, which pioneered the use of human tests more than 30 years ago. The only other two labs that conduct similar experiments are in England and the Netherlands.

There have been no deaths or hospitalizations in the trials, said Lt. Col. James F. Cummings, M.D., chief of Walter Reed's clinical trials center.

He volunteered for a trial and contracted malaria.

"I felt like I had the flu — chills and shakes for the first few hours," Cummings said. Within eight hours of treatment, he was on the mend. But symptoms will vary. One study found the average volunteer felt bad for about three days.

"It's really important for people to understand how well-controlled this process is," said Dr. Patrick Duffy, head of SBRI's malaria research programs. "The disease follows a predictable course, and it's treated very early — as soon as parasites show up in the blood."

It's highly unusual for medical researchers to intentionally expose people to a disease — particularly one as serious as malaria. The standard approach is to recruit a large group, give half a drug, half a placebo — then wait to see who gets sick.

But there's a long history of infecting people with malaria, first to induce fever and cure syphilis, and later for the studies that yielded many modern malaria drugs. The Army refined and standardized the process, developing a strain of parasite with no drug resistance.

The trials are time-consuming and will require several nights under medical supervision in a hotel. Volunteers will be compensated, probably in line with the $2,000 to $4,000 paid at Walter Reed. The initial trials will begin within 18 months, Duffy said.

A private lab in Seattle's South Lake Union district, SBRI has become a top malaria research center, largely because of funding from the Bill & Melinda Gates Foundation. The world's richest philanthropy has devoted more than $1 billion to a multipronged attack on malaria, including $350 million for one of its top priorities: development of a vaccine.

The bulk of the vaccine money goes to the PATH Malaria Vaccine Initiative (MVI), a program that aims to accelerate studies on vaccine candidates. Being able to conduct early trials with volunteers allows scientists to quickly weed out vaccines that don't work, and fast-track those that do, said MVI director Dr. Christian Loucq.

With several promising vaccines and drugs in the pipeline — and Walter Reed's facility maxed out — it was important to establish another center for human trials, Loucq said.

SBRI was picked because the lab already has a high-security insectary, where researchers raise malaria-infected mosquitoes for research. Contained within three nested rooms, the mosquito lab is equipped with double doors and an air-pressure system designed to suck any escapees back inside.

"It looks like a jail up there," said SBRI founder and director Ken Stuart.

SBRI scientists are working on a vaccine that uses genetic engineering to render malaria parasites harmless. They also will analyze blood from the human volunteers to learn more about the body's immune response to the disease.

Seattle is a good place to recruit volunteers because of the region's growing reputation as a center of global health programs and charitable enterprises, Stuart said.

"This is an opportunity for this community to make a major — possibly even huge — contribution to the health of the world," he said.

Eliminated long ago in wealthy nations, malaria remains one of the top killers in the developing world. The parasite that causes the disease has evolved resistance to many drugs, contributing to a resurgence.

Use of bed nets and insecticides is helping, but experts say a vaccine is key for long-term control or eradication. One promising vaccine developed by the Army and pharmaceutical company GlaxoSmithKline is undergoing field trials in Africa now — but is expected to offer only partial protection.

With $4.8 million from the Malaria Vaccine Initiative, SBRI will add a clinical center to its headquarters on Westlake Avenue. Between 100 and 200 volunteers a year will be exposed there to mosquitoes infected with Plasmodium falciparum, the type of malaria most common in Africa. Some participants will get experimental drugs or vaccines, while others will get placebo.

The volunteers will be closely monitored, checking into a hotel around five or six days after their mosquito bites. Medical staff from the University of Washington will take blood samples every morning and night. At the first sign of parasites in the blood, volunteers will begin taking the anti-malaria drug chloroquine, which completely eliminates the disease.

The first "demonstration trial" will simply show that the researchers can infect six healthy volunteers with malaria, Duffy said.

"My guess is the first people to volunteer will be the malaria scientists here," he added with a laugh.

All of the human trials will be reviewed for safety and approved by the U.S. Food and Drug Administration.

Sandi Doughton: 206-464-2491 or sdoughton@seattletimes.com