Abstract
To the Editor: The phenomenon of long-term relapse is familiar to many persons who have contracted malaria, and to their doctors. Attacks of Plasmodium vivax malaria (so-called benign tertian malaria) in particular can occur after symptomatic illness has been absent in the patient for months or years. Recurrent clinical P. vivax manifestations have been thought to originate from a dormant liver form, the discovery of which1 has become recognised as a classic landmark in the history of parasitology and tropical medicine. I correctly predicted the existence of the stage concerned (extrapolating from my rodent-associated research while a PhD student at Imperial College London) and coined the term 'hypnozoite' for it. For the past three decades, medical students worldwide have been taught that hypnozoites give rise to malarial relapse. However, new findings indicate that there might well be a second cause of recurrent P. vivax malaria.
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