document_title: Malaria

question_text: which form of malaria is both the most common and the most severe

question_tokens: which form of malaria is both the most common and the most severe

text: Malaria

text: Signs and symptoms

text: The signs and symptoms of malaria typically begin 8–25 days following infection;[12] however, symptoms may occur later in those who have taken antimalarial medications as prevention.[5] Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms,[13] and can resemble other conditions such as sepsis, gastroenteritis, and viral diseases.[5] The presentation may include headache, fever, shivering, joint pain, vomiting, hemolytic anemia, jaundice, hemoglobin in the urine, retinal damage, and convulsions.[14]

text: The classic symptom of malaria is paroxysm—a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days (tertian fever) in P. vivax and P. ovale infections, and every three days (quartan fever) for P. malariae. P. falciparum infection can cause recurrent fever every 36–48 hours, or a less pronounced and almost continuous fever.[15]

text: Severe malaria is usually caused by P. falciparum (often referred to as falciparum malaria). Symptoms of falciparum malaria arise 9–30 days after infection.[13] Individuals with cerebral malaria frequently exhibit neurological symptoms, including abnormal posturing, nystagmus, conjugate gaze palsy (failure of the eyes to turn together in the same direction), opisthotonus, seizures, or coma.[13]

text: Complications

text: Malaria has several serious complications. Among these is the development of respiratory distress, which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis, noncardiogenic pulmonary oedema, concomitant pneumonia, and severe anaemia. Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women.[16] Coinfection of HIV with malaria increases mortality.[17] Renal failure is a feature of blackwater fever, where hemoglobin from lysed red blood cells leaks into the urine.[13]

text: Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy. It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever.[18] Enlarged spleen, enlarged liver or both of these, severe headache, low blood sugar, and hemoglobin in the urine with renal failure may occur.[13] Complications may include spontaneous bleeding, coagulopathy, and shock.[19]

text: Malaria in pregnant women is an important cause of stillbirths, infant mortality, abortion and low birth weight,[20] particularly in P. falciparum infection, but also with P. vivax.[21]

text: Cause

text: Malaria parasites belong to the genus Plasmodium (phylum Apicomplexa). In humans, malaria is caused by P. falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi.[22][23] Among those infected, P. falciparum is the most common species identified (~75%) followed by P. vivax (~20%).[5] Although P. falciparum traditionally accounts for the majority of deaths,[24] recent evidence suggests that P. vivax malaria is associated with potentially life-threatening conditions about as often as with a diagnosis of P. falciparum infection.[25] P. vivax proportionally is more common outside Africa.[26] There have been documented human infections with several species of Plasmodium from higher apes; however, except for P. knowlesi—a zoonotic species that causes malaria in macaques[23]—these are mostly of limited public health importance.[27]

text: Global warming is likely to affect malaria transmission, but the severity and geographic distribution of such effects is uncertain.[28][29]

text: Life cycle

text: In the life cycle of Plasmodium, a female Anopheles mosquito (the definitive host) transmits a motile infective form (called the sporozoite) to a vertebrate host such as a human (the secondary host), thus acting as a transmission vector. A sporozoite travels through the blood vessels to liver cells (hepatocytes), where it reproduces asexually (tissue schizogony), producing thousands of merozoites. These infect new red blood cells and initiate a series of asexual multiplication cycles (blood schizogony) that produce 8 to 24 new infective merozoites, at which point the cells burst and the infective cycle begins anew.[30]

text: Other merozoites develop into immature gametocytes, which are the precursors of male and female gametes. When a fertilized mosquito bites an infected person, gametocytes are taken up with the blood and mature in the mosquito gut. The male and female gametocytes fuse and form an ookinete—a fertilized, motile zygote. Ookinetes develop into new sporozoites that migrate to the insect's salivary glands, ready to infect a new vertebrate host. The sporozoites are injected into the skin, in the saliva, when the mosquito takes a subsequent blood meal.[31]

text: Only female mosquitoes feed on blood; male mosquitoes feed on plant nectar and do not transmit the disease. The females of the Anopheles genus of mosquito prefer to feed at night. They usually start searching for a meal at dusk and will continue throughout the night until taking a meal.[32] Malaria parasites can also be transmitted by blood transfusions, although this is rare.[33]

text: Recurrent malaria

text: Symptoms of malaria can recur after varying symptom-free periods. Depending upon the cause, recurrence can be classified as either recrudescence, relapse, or reinfection. Recrudescence is when symptoms return after a symptom-free period. It is caused by parasites surviving in the blood as a result of inadequate or ineffective treatment.[34] Relapse is when symptoms reappear after the parasites have been eliminated from blood but persist as dormant hypnozoites in liver cells. Relapse commonly occurs between 8–24 weeks and is commonly seen with P. vivax and P. ovale infections.[5] P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite.[35] Reinfection means the parasite that caused the past infection was eliminated from the body but a new parasite was introduced. Reinfection cannot readily be distinguished from recrudescence, although recurrence of infection within two weeks of treatment for the initial infection is typically attributed to treatment failure.[36] People may develop some immunity when exposed to frequent infections.[37]

text: Pathophysiology

text: Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter the bloodstream and migrate to the liver where they infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days.[38]

text: After a potential dormant period in the liver, these organisms differentiate to yield thousands of merozoites, which, following rupture of their host cells, escape into the blood and infect red blood cells to begin the erythrocytic stage of the life cycle.[38] The parasite escapes from the liver undetected by wrapping itself in the cell membrane of the infected host liver cell.[39]

text: Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their host cells to invade fresh red blood cells. Several such amplification cycles occur. Thus, classical descriptions of waves of fever arise from simultaneous waves of merozoites escaping and infecting red blood cells.[38]

text: Some P. vivax sporozoites do not immediately develop into exoerythrocytic-phase merozoites, but instead, produce hypnozoites that remain dormant for periods ranging from several months (7–10 months is typical) to several years. After a period of dormancy, they reactivate and produce merozoites. Hypnozoites are responsible for long incubation and late relapses in P. vivax infections,[35] although their existence in P. ovale is uncertain.[40]

text: The parasite is relatively protected from attack by the body's immune system because for most of its human life cycle it resides within the liver and blood cells and is relatively invisible to immune surveillance. However, circulating infected blood cells are destroyed in the spleen. To avoid this fate, the P. falciparum parasite displays adhesive proteins on the surface of the infected blood cells, causing the blood cells to stick to the walls of small blood vessels, thereby sequestering the parasite from passage through the general circulation and the spleen.[41] The blockage of the microvasculature causes symptoms such as in placental malaria.[42] Sequestered red blood cells can breach the blood–brain barrier and cause cerebral malaria.[43]

text: Genetic resistance

text: According to a 2005 review, due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history. Several genetic factors provide some resistance to it including sickle cell trait, thalassaemia traits, glucose-6-phosphate dehydrogenase deficiency, and the absence of Duffy antigens on red blood cells.[44][45]

text: The impact of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the hemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries; however, when the modified hemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to sickle or distort into a curved shape. In these strands the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces the frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal hemoglobin beta allele) have sickle-cell anaemia, while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavor the trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form.[45][46]

text: Liver dysfunction

text: Liver dysfunction as a result of malaria is uncommon and usually only occurs in those with another liver condition such as viral hepatitis or chronic liver disease. The syndrome is sometimes called malarial hepatitis.[47] While it has been considered a rare occurrence, malarial hepatopathy has seen an increase, particularly in Southeast Asia and India. Liver compromise in people with malaria correlates with a greater likelihood of complications and death.[47]

text: Diagnosis

text: Owing to the non-specific nature of the presentation of symptoms, diagnosis of malaria in non-endemic areas requires a high degree of suspicion, which might be elicited by any of the following: recent travel history, enlarged spleen, fever, low number of platelets in the blood, and higher-than-normal levels of bilirubin in the blood combined with a normal level of white blood cells.[5] Reports in 2016 and 2017 from countries were malaria is common suggest high levels of over diagnosis due to insufficient or inaccurate laboratory testing.[48][49][50]

text: Malaria is usually confirmed by the microscopic examination of blood films or by antigen-based rapid diagnostic tests (RDT).[51][52] In some areas, RDTs need to be able to distinguish whether the malaria symptoms are caused by Plasmodium falciparum or by other species of parasites since treatment strategies could differ for non-P. falciparum infections.[53] Microscopy is the most commonly used method to detect the malarial parasite—about 165 million blood films were examined for malaria in 2010.[54] Despite its widespread usage, diagnosis by microscopy suffers from two main drawbacks: many settings (especially rural) are not equipped to perform the test, and the accuracy of the results depends on both the skill of the person examining the blood film and the levels of the parasite in the blood. The sensitivity of blood films ranges from 75–90% in optimum conditions, to as low as 50%. Commercially available RDTs are often more accurate than blood films at predicting the presence of malaria parasites, but they are widely variable in diagnostic sensitivity and specificity depending on manufacturer, and are unable to tell how many parasites are present.[54]

text: In regions where laboratory tests are readily available, malaria should be suspected, and tested for, in any unwell person who has been in an area where malaria is endemic. In areas that cannot afford laboratory diagnostic tests, it has become common to use only a history of fever as the indication to treat for malaria—thus the common teaching "fever equals malaria unless proven otherwise". A drawback of this practice is overdiagnosis of malaria and mismanagement of non-malarial fever, which wastes limited resources, erodes confidence in the health care system, and contributes to drug resistance.[55] Although polymerase chain reaction-based tests have been developed, they are not widely used in areas where malaria is common as of 2012, due to their complexity.[5]

text: Classification

text: Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO).[5] It is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated.[56]

text:
Decreased consciousness
Significant weakness such that the person is unable to walk
Inability to feed
Two or more convulsions
Low blood pressure (less than 70 mmHg in adults and 50 mmHg in children)
Breathing problems
Circulatory shock
Kidney failure or hemoglobin in the urine
Bleeding problems, or hemoglobin less than 50 g/L (5 g/dL)
Pulmonary oedema
Blood glucose less than 2.2 mmol/L (40 mg/dL)
Acidosis or lactate levels of greater than 5 mmol/L
A parasite level in the blood of greater than 100,000 per microlitre (µL) in low-intensity transmission areas, or 250,000 per µL in high-intensity transmission areas

text: Cerebral malaria is defined as a severe P. falciparum-malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale greater than 3), or with a coma that lasts longer than 30 minutes after a seizure.[57]

text: Various types of malaria have been called by the names below:[58]

text:
Name
Pathogen
Notes

algid malaria
Plasmodium falciparum
severe malaria affecting the cardiovascular system and causing chills and circulatory shock

bilious malaria
Plasmodium falciparum
severe malaria affecting the liver and causing vomiting and jaundice

cerebral malaria
Plasmodium falciparum
severe malaria affecting the cerebrum

congenital malaria
various plasmodia
plasmodium introduced from the mother via the fetal circulation

falciparum malaria, Plasmodium falciparum malaria, pernicious malaria
Plasmodium falciparum

ovale malaria, Plasmodium ovale malaria
Plasmodium ovale

quartan malaria, malariae malaria, Plasmodium malariae malaria
Plasmodium malariae
paroxysms every fourth day (quartan), counting the day of occurrence as the first day

quotidian malaria
Plasmodium falciparum, Plasmodium vivax
paroxysms daily (quotidian)

tertian malaria
Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax
paroxysms every third day (tertian), counting the day of occurrence as the first

transfusion malaria
various plasmodia
plasmodium introduced by blood transfusion, needle sharing, or needlestick injury

vivax malaria, Plasmodium vivax malaria
Plasmodium vivax

text: Prevention

text: Methods used to prevent malaria include medications, mosquito elimination and the prevention of bites. There is no vaccine for malaria. The presence of malaria in an area requires a combination of high human population density, high anopheles mosquito population density and high rates of transmission from humans to mosquitoes and from mosquitoes to humans. If any of these is lowered sufficiently, the parasite will eventually disappear from that area, as happened in North America, Europe and parts of the Middle East. However, unless the parasite is eliminated from the whole world, it could become re-established if conditions revert to a combination that favors the parasite's reproduction. Furthermore, the cost per person of eliminating anopheles mosquitoes rises with decreasing population density, making it economically unfeasible in some areas.[59]

text: Prevention of malaria may be more cost-effective than treatment of the disease in the long run, but the initial costs required are out of reach of many of the world's poorest people. There is a wide difference in the costs of control (i.e. maintenance of low endemicity) and elimination programs between countries. For example, in China—whose government in 2010 announced a strategy to pursue malaria elimination in the Chinese provinces—the required investment is a small proportion of public expenditure on health. In contrast, a similar program in Tanzania would cost an estimated one-fifth of the public health budget.[60]

text: In areas where malaria is common, children under five years old often have anemia which is sometimes due to malaria. Giving children with anemia in these areas preventive antimalarial medication improves red blood cell levels slightly but did not affect the risk of death or need for hospitalization.[61]

text: Mosquito control

text: Vector control refers to methods used to decrease malaria by reducing the levels of transmission by mosquitoes. For individual protection, the most effective insect repellents are based on DEET or picaridin.[62] Insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS) have been shown to be highly effective in preventing malaria among children in areas where malaria is common.[63][64] Prompt treatment of confirmed cases with artemisinin-based combination therapies (ACTs) may also reduce transmission.[65]

text: Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find a way past the net. Insecticide-treated nets are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net.[66] Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa.[67] About 13% of households in Sub-Saharan countries owned ITNs in 2007[68] and 31% of African households were estimated to own at least one ITN in 2008. In 2000, 1.7 million (1.8%) African children living in areas of the world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected[69] and to 68% African children using mosquito nets in 2015.[70] Most nets are impregnated with pyrethroids, a class of insecticides with low toxicity. They are most effective when used from dusk to dawn.[71] It is recommended to hang a large "bed net" above the center of a bed and either tuck the edges under the mattress or make sure it is large enough such that it touches the ground.[72]

text: Indoor residual spraying is the spraying of insecticides on the walls inside a home. After feeding, many mosquitoes rest on a nearby surface while digesting the bloodmeal, so if the walls of houses have been coated with insecticides, the resting mosquitoes can be killed before they can bite another person and transfer the malaria parasite.[73] As of 2006, the World Health Organization recommends 12 insecticides in IRS operations, including DDT and the pyrethroids cyfluthrin and deltamethrin.[74] This public health use of small amounts of DDT is permitted under the Stockholm Convention, which prohibits its agricultural use.[75] One problem with all forms of IRS is insecticide resistance. Mosquitoes affected by IRS tend to rest and live indoors, and due to the irritation caused by spraying, their descendants tend to rest and live outdoors, meaning that they are less affected by the IRS.[76]

text: There are a number of other methods to reduce mosquito bites and slow the spread of malaria. Efforts to decrease mosquito larva by decreasing the availability of open water in which they develop or by adding substances to decrease their development is effective in some locations.[77] Electronic mosquito repellent devices which make very high-frequency sounds that are supposed to keep female mosquitoes away, do not have supporting evidence.[78]

text: Other methods

text: Community participation and health education strategies promoting awareness of malaria and the importance of control measures have been successfully used to reduce the incidence of malaria in some areas of the developing world.[79] Recognizing the disease in the early stages can prevent the disease from becoming fatal. Education can also inform people to cover over areas of stagnant, still water, such as water tanks that are ideal breeding grounds for the parasite and mosquito, thus cutting down the risk of the transmission between people. This is generally used in urban areas where there are large centers of population in a confined space and transmission would be most likely in these areas.[80] Intermittent preventive therapy is another intervention that has been used successfully to control malaria in pregnant women and infants,[81] and in preschool children where transmission is seasonal.[82]

text: Medications

text: There are a number of drugs that can help prevent or interrupt malaria in travelers to places where infection is common. Many of these drugs are also used in treatment. Chloroquine may be used where chloroquine-resistant parasites are not common.[83] In places where Plasmodium is resistant to one or more medications, three medications—mefloquine (Lariam), doxycycline (available generically), or the combination of atovaquone and proguanil hydrochloride (Malarone)—are frequently used when prophylaxis is needed.[83] Doxycycline and the atovaquone plus proguanil combination are the best tolerated; mefloquine is associated with death, suicide, and neurological and psychiatric symptoms.[83]

text: The protective effect does not begin immediately, and people visiting areas where malaria exists usually start taking the drugs one to two weeks before arriving and continue taking them for four weeks after leaving (except for atovaquone/proguanil, which only needs to be started two days before and continued for seven days afterward).[84] The use of preventative drugs is often not practical for those who live in areas where malaria exists, and their use is usually only in pregnant women and short-term visitors. This is due to the cost of the drugs, side effects from long-term use, and the difficulty in obtaining anti-malarial drugs outside of wealthy nations.[85] During pregnancy, medication to prevent malaria has been found to improve the weight of the baby at birth and decrease the risk of anemia in the mother.[86] The use of preventative drugs where malaria-bearing mosquitoes are present may encourage the development of partial resistance.[87]

text: Treatment

text: Malaria is treated with antimalarial medications; the ones used depends on the type and severity of the disease. While medications against fever are commonly used, their effects on outcomes are not clear.[88]

text: Simple or uncomplicated malaria may be treated with oral medications. The most effective treatment for P. falciparum infection is the use of artemisinins in combination with other antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance to any single drug component.[89] These additional antimalarials include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine.[90] Another recommended combination is dihydroartemisinin and piperaquine.[91][92] ACT is about 90% effective when used to treat uncomplicated malaria.[67] To treat malaria during pregnancy, the WHO recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and ACT in later stages (2nd and 3rd trimesters).[93] In the 2000s (decade), malaria with partial resistance to artemisins emerged in Southeast Asia.[94][95] Infection with P. vivax, P. ovale or P. malariae usually do not require hospitalization. Treatment of P. vivax requires both treatment of blood stages (with chloroquine or ACT) and clearance of liver forms with primaquine.[96] Treatment with tafenoquine prevents relapses after confirmed P. vivax malaria.[97]

text: Severe and complicated malaria are almost always caused by infection with P. falciparum. The other species usually cause only febrile disease.[98] Severe and complicated malaria are medical emergencies since mortality rates are high (10% to 50%).[99] Cerebral malaria is the form of severe and complicated malaria with the worst neurological symptoms.[100] Recommended treatment for severe malaria is the intravenous use of antimalarial drugs. For severe malaria, parenteral artesunate was superior to quinine in both children and adults.[101] In another systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as quinine in the treatment of cerebral malaria in children.[102] Treatment of severe malaria involves supportive measures that are best done in a critical care unit. This includes the management of high fevers and the seizures that may result from it. It also includes monitoring for poor breathing effort, low blood sugar, and low blood potassium.[24]

text: Resistance

text: Drug resistance poses a growing problem in 21st-century malaria treatment.[103] Resistance is now common against all classes of antimalarial drugs apart from artemisinins. Treatment of resistant strains became increasingly dependent on this class of drugs. The cost of artemisinins limits their use in the developing world.[104] Malaria strains found on the Cambodia–Thailand border are resistant to combination therapies that include artemisinins, and may, therefore, be untreatable.[105] Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years and the availability of substandard artemisinins likely drove the selection of the resistant phenotype.[106] Resistance to artemisinin has been detected in Cambodia, Myanmar, Thailand, and Vietnam,[107] and there has been emerging resistance in Laos.[108][109]

text: Prognosis

text: When properly treated, people with malaria can usually expect a complete recovery.[110] However, severe malaria can progress extremely rapidly and cause death within hours or days.[111] In the most severe cases of the disease, fatality rates can reach 20%, even with intensive care and treatment.[5] Over the longer term, developmental impairments have been documented in children who have suffered episodes of severe malaria.[112] Chronic infection without severe disease can occur in an immune-deficiency syndrome associated with a decreased responsiveness to Salmonella bacteria and the Epstein–Barr virus.[113]

text: During childhood, malaria causes anemia during a period of rapid brain development, and also direct brain damage resulting from cerebral malaria.[112] Some survivors of cerebral malaria have an increased risk of neurological and cognitive deficits, behavioural disorders, and epilepsy.[114] Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups.[112]

text: Epidemiology

text: The WHO estimates that in 2015 there were 214 million new cases of malaria resulting in 438,000 deaths.[116] Others have estimated the number of cases at between 350 and 550 million for falciparum malaria[117] The majority of cases (65%) occur in children under 15 years old.[118] About 125 million pregnant women are at risk of infection each year; in Sub-Saharan Africa, maternal malaria is associated with up to 200,000 estimated infant deaths yearly.[20] There are about 10,000 malaria cases per year in Western Europe, and 1300–1500 in the United States.[16] About 900 people died from the disease in Europe between 1993 and 2003.[62] Both the global incidence of disease and resulting mortality have declined in recent years. According to the WHO and UNICEF, deaths attributable to malaria in 2015 were reduced by 60%[70] from a 2000 estimate of 985,000, largely due to the widespread use of insecticide-treated nets and artemisinin-based combination therapies.[67] In 2012, there were 207 million cases of malaria. That year, the disease is estimated to have killed between 473,000 and 789,000 people, many of whom were children in Africa.[2] Efforts at decreasing the disease in Africa since the turn of millennium have been partially effective, with rates of the disease dropping by an estimated forty percent on the continent.[119]

text: Malaria is presently endemic in a broad band around the equator, in areas of the Americas, many parts of Asia, and much of Africa; in Sub-Saharan Africa, 85–90% of malaria fatalities occur.[120] An estimate for 2009 reported that countries with the highest death rate per 100,000 of population were Ivory Coast (86.15), Angola (56.93) and Burkina Faso (50.66).[121] A 2010 estimate indicated the deadliest countries per population were Burkina Faso, Mozambique and Mali.[118] The Malaria Atlas Project aims to map global endemic levels of malaria, providing a means with which to determine the global spatial limits of the disease and to assess disease burden.[122][123] This effort led to the publication of a map of P. falciparum endemicity in 2010.[124] As of 2010, about 100 countries have endemic malaria.[125][126] Every year, 125 million international travellers visit these countries, and more than 30,000 contract the disease.[62]

text: The geographic distribution of malaria within large regions is complex, and malaria-afflicted and malaria-free areas are often found close to each other.[127] Malaria is prevalent in tropical and subtropical regions because of rainfall, consistent high temperatures and high humidity, along with stagnant waters in which mosquito larvae readily mature, providing them with the environment they need for continuous breeding.[128] In drier areas, outbreaks of malaria have been predicted with reasonable accuracy by mapping rainfall.[129] Malaria is more common in rural areas than in cities. For example, several cities in the Greater Mekong Subregion of Southeast Asia are essentially malaria-free, but the disease is prevalent in many rural regions, including along international borders and forest fringes.[130] In contrast, malaria in Africa is present in both rural and urban areas, though the risk is lower in the larger cities.[131]

text: History

text: Although the parasite responsible for P. falciparum malaria has been in existence for 50,000–100,000 years, the population size of the parasite did not increase until about 10,000 years ago, concurrently with advances in agriculture[132] and the development of human settlements. Close relatives of the human malaria parasites remain common in chimpanzees. Some evidence suggests that the P. falciparum malaria may have originated in gorillas.[133]

text: References to the unique periodic fevers of malaria are found throughout recorded history.[134] Hippocrates described periodic fevers, labelling them tertian, quartan, subtertian and quotidian.[135] The Roman Columella associated the disease with insects from swamps.[135] Malaria may have contributed to the decline of the Roman Empire,[136] and was so pervasive in Rome that it was known as the "Roman fever".[137] Several regions in ancient Rome were considered at-risk for the disease because of the favourable conditions present for malaria vectors. This included areas such as southern Italy, the island of Sardinia, the Pontine Marshes, the lower regions of coastal Etruria and the city of Rome along the Tiber River. The presence of stagnant water in these places was preferred by mosquitoes for breeding grounds. Irrigated gardens, swamp-like grounds, runoff from agriculture, and drainage problems from road construction led to the increase of standing water.[138]

text: The term malaria originates from Medieval Italian: mala aria—"bad air"; the disease was formerly called ague or marsh fever due to its association with swamps and marshland.[139] The term first appeared in the English literature about 1829.[135] Malaria was once common in most of Europe and North America,[140] where it is no longer endemic,[141] though imported cases do occur.[142]

text: Scientific studies on malaria made their first significant advance in 1880, when Charles Louis Alphonse Laveran—a French army doctor working in the military hospital of Constantine in Algeria—observed parasites inside the red blood cells of infected people for the first time. He, therefore, proposed that malaria is caused by this organism, the first time a protist was identified as causing disease.[143] For this and later discoveries, he was awarded the 1907 Nobel Prize for Physiology or Medicine. A year later, Carlos Finlay, a Cuban doctor treating people with yellow fever in Havana, provided strong evidence that mosquitoes were transmitting disease to and from humans.[144] This work followed earlier suggestions by Josiah C. Nott,[145] and work by Sir Patrick Manson, the "father of tropical medicine", on the transmission of filariasis.[146]

text: In April 1894, a Scottish physician Sir Ronald Ross visited Sir Patrick Manson at his house on Queen Anne Street, London. This visit was the start of four years of collaboration and fervent research that culminated in 1897 when Ross, who was working in the Presidency General Hospital in Calcutta, proved the complete life-cycle of the malaria parasite in mosquitoes. He thus proved that the mosquito was the vector for malaria in humans by showing that certain mosquito species transmit malaria to birds. He isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds.[147] For this work, Ross received the 1902 Nobel Prize in Medicine. After resigning from the Indian Medical Service, Ross worked at the newly established Liverpool School of Tropical Medicine and directed malaria-control efforts in Egypt, Panama, Greece and Mauritius.[148] The findings of Finlay and Ross were later confirmed by a medical board headed by Walter Reed in 1900. Its recommendations were implemented by William C. Gorgas in the health measures undertaken during construction of the Panama Canal. This public-health work saved the lives of thousands of workers and helped develop the methods used in future public-health campaigns against the disease.[149]

text: The first effective treatment for malaria came from the bark of cinchona tree, which contains quinine. This tree grows on the slopes of the Andes, mainly in Peru. The indigenous peoples of Peru made a tincture of cinchona to control fever. Its effectiveness against malaria was found and the Jesuits introduced the treatment to Europe around 1640; by 1677, it was included in the London Pharmacopoeia as an antimalarial treatment.[150] It was not until 1820 that the active ingredient, quinine, was extracted from the bark, isolated and named by the French chemists Pierre Joseph Pelletier and Joseph Bienaimé Caventou.[151][152]

text: Quinine became the predominant malarial medication until the 1920s when other medications began to be developed. In the 1940s, chloroquine replaced quinine as the treatment of both uncomplicated and severe malaria until resistance supervened, first in Southeast Asia and South America in the 1950s and then globally in the 1980s.[153]

text: The medicinal value of Artemisia annua has been used by Chinese herbalists in traditional Chinese medicines for 2,000 years. In 1596, Li Shizhen recommended tea made from qinghao specifically to treat malaria symptoms in his "Compendium of Materia Medica". Artemisinins, discovered by Chinese scientist Tu Youyou and colleagues in the 1970s from the plant Artemisia annua, became the recommended treatment for P. falciparum malaria, administered in combination with other antimalarials as well as in severe disease.[154] Tu says she was influenced by a traditional Chinese herbal medicine source, The Handbook of Prescriptions for Emergency Treatments, written in 340 by Ge Hong.[155] For her work on malaria, Tu Youyou received the 2015 Nobel Prize in Physiology or Medicine.[156]

text: Plasmodium vivax was used between 1917 and the 1940s for malariotherapy—deliberate injection of malaria parasites to induce a fever to combat certain diseases such as tertiary syphilis. In 1927, the inventor of this technique, Julius Wagner-Jauregg, received the Nobel Prize in Physiology or Medicine for his discoveries. The technique was dangerous, killing about 15% of patients, so it is no longer in use.[157]

text: The first pesticide used for indoor residual spraying was DDT.[158] Although it was initially used exclusively to combat malaria, its use quickly spread to agriculture. In time, pest control, rather than disease control, came to dominate DDT use, and this large-scale agricultural use led to the evolution of resistant mosquitoes in many regions. The DDT resistance shown by Anopheles mosquitoes can be compared to antibiotic resistance shown by bacteria. During the 1960s, awareness of the negative consequences of its indiscriminate use increased, ultimately leading to bans on agricultural applications of DDT in many countries in the 1970s.[75] Before DDT, malaria was successfully eliminated or controlled in tropical areas like Brazil and Egypt by removing or poisoning the breeding grounds of the mosquitoes or the aquatic habitats of the larva stages, for example by applying the highly toxic arsenic compound Paris Green to places with standing water.[159]

text: Malaria vaccines have been an elusive goal of research. The first promising studies demonstrating the potential for a malaria vaccine were performed in 1967 by immunizing mice with live, radiation-attenuated sporozoites, which provided significant protection to the mice upon subsequent injection with normal, viable sporozoites. Since the 1970s, there has been a considerable effort to develop similar vaccination strategies for humans.[160] The first vaccine, called RTS,S, was approved by European regulators in 2015.[161]

text: Society and culture

text: Economic impact

text: Malaria is not just a disease commonly associated with poverty: some evidence suggests that it is also a cause of poverty and a major hindrance to economic development.[9][10] Although tropical regions are most affected, malaria's furthest influence reaches into some temperate zones that have extreme seasonal changes. The disease has been associated with major negative economic effects on regions where it is widespread. During the late 19th and early 20th centuries, it was a major factor in the slow economic development of the American southern states.[162]

text: A comparison of average per capita GDP in 1995, adjusted for parity of purchasing power, between countries with malaria and countries without malaria gives a fivefold difference ($1,526 USD versus $8,268 USD). In the period 1965 to 1990, countries where malaria was common had an average per capita GDP that increased only 0.4% per year, compared to 2.4% per year in other countries.[163]

text: Poverty can increase the risk of malaria since those in poverty do not have the financial capacities to prevent or treat the disease. In its entirety, the economic impact of malaria has been estimated to cost Africa US$12 billion every year. The economic impact includes costs of health care, working days lost due to sickness, days lost in education, decreased productivity due to brain damage from cerebral malaria, and loss of investment and tourism.[11] The disease has a heavy burden in some countries, where it may be responsible for 30–50% of hospital admissions, up to 50% of outpatient visits, and up to 40% of public health spending.[164]

text: Cerebral malaria is one of the leading causes of neurological disabilities in African children.[114] Studies comparing cognitive functions before and after treatment for severe malarial illness continued to show significantly impaired school performance and cognitive abilities even after recovery.[112] Consequently, severe and cerebral malaria have far-reaching socioeconomic consequences that extend beyond the immediate effects of the disease.[165]

text: Counterfeit and substandard drugs

text: Sophisticated counterfeits have been found in several Asian countries such as Cambodia,[166] China,[167] Indonesia, Laos, Thailand, and Vietnam, and are an important cause of avoidable death in those countries.[168] The WHO said that studies indicate that up to 40% of artesunate-based malaria medications are counterfeit, especially in the Greater Mekong region and have established a rapid alert system to enable information about counterfeit drugs to be rapidly reported to the relevant authorities in participating countries.[169] There is no reliable way for doctors or lay people to detect counterfeit drugs without help from a laboratory. Companies are attempting to combat the persistence of counterfeit drugs by using new technology to provide security from source to distribution.[170]

text: Another clinical and public health concern is the proliferation of substandard antimalarial medicines resulting from inappropriate concentration of ingredients, contamination with other drugs or toxic impurities, poor quality ingredients, poor stability and inadequate packaging.[171] A 2012 study demonstrated that roughly one-third of antimalarial medications in Southeast Asia and Sub-Saharan Africa failed chemical analysis, packaging analysis, or were falsified.[172]

text: War

text: Throughout history, the contraction of malaria has played a prominent role in the fates of government rulers, nation-states, military personnel, and military actions.[173] In 1910, Nobel Prize in Medicine-winner Ronald Ross (himself a malaria survivor), published a book titled The Prevention of Malaria that included a chapter titled "The Prevention of Malaria in War." The chapter's author, Colonel C. H. Melville, Professor of Hygiene at Royal Army Medical College in London, addressed the prominent role that malaria has historically played during wars: "The history of malaria in war might almost be taken to be the history of war itself, certainly the history of war in the Christian era. ... It is probably the case that many of the so-called camp fevers, and probably also a considerable proportion of the camp dysentery, of the wars of the sixteenth, seventeenth and eighteenth centuries were malarial in origin."[174]

text: Malaria was the most significant health hazard encountered by U.S. troops in the South Pacific during World War II, where about 500,000 men were infected.[175] According to Joseph Patrick Byrne, "Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns."[176]

text: Significant financial investments have been made to procure existing and create new anti-malarial agents. During World War I and World War II, inconsistent supplies of the natural anti-malaria drugs cinchona bark and quinine prompted substantial funding into research and development of other drugs and vaccines. American military organizations conducting such research initiatives include the Navy Medical Research Center, Walter Reed Army Institute of Research, and the U.S. Army Medical Research Institute of Infectious Diseases of the US Armed Forces.[177]

text: Additionally, initiatives have been founded such as Malaria Control in War Areas (MCWA), established in 1942, and its successor, the Communicable Disease Center (now known as the Centers for Disease Control and Prevention, or CDC) established in 1946. According to the CDC, MCWA "was established to control malaria around military training bases in the southern United States and its territories, where malaria was still problematic".[178]

text: Eradication efforts

text: Several notable attempts are being made to eliminate the parasite from sections of the world, or to eradicate it worldwide. In 2006, the organization Malaria No More set a public goal of eliminating malaria from Africa by 2015, and the organization plans to dissolve if that goal is accomplished.[179] Several malaria vaccines are in clinical trials, which are intended to provide protection for children in endemic areas and reduce the speed of transmission of the disease. As of 2012[update], The Global Fund to Fight AIDS, Tuberculosis and Malaria has distributed 230 million insecticide-treated nets intended to stop mosquito-borne transmission of malaria.[180] The U.S.-based Clinton Foundation has worked to manage demand and stabilize prices in the artemisinin market.[181] Other efforts, such as the Malaria Atlas Project, focus on analysing climate and weather information required to accurately predict the spread of malaria based on the availability of habitat of malaria-carrying parasites.[122] The Malaria Policy Advisory Committee (MPAC) of the World Health Organization (WHO) was formed in 2012, "to provide strategic advice and technical input to WHO on all aspects of malaria control and elimination".[182] In November 2013, WHO and the malaria vaccine funders group set a goal to develop vaccines designed to interrupt malaria transmission with the long-term goal of malaria eradication.[183]

text: Malaria has been successfully eliminated or greatly reduced in certain areas. Malaria was once common in the United States and southern Europe, but vector control programs, in conjunction with the monitoring and treatment of infected humans, eliminated it from those regions. Several factors contributed, such as the draining of wetland breeding grounds for agriculture and other changes in water management practices, and advances in sanitation, including greater use of glass windows and screens in dwellings.[184] Malaria was eliminated from most parts of the USA in the early 20th century by such methods, and the use of the pesticide DDT and other means eliminated it from the remaining pockets in the South in the 1950s as part of the National Malaria Eradication Program.[185] Bill Gates has said that he thinks global eradication is possible by 2040.[186]

text: Research

text: The Malaria Eradication Research Agenda (malERA) initiative was a consultative process to identify which areas of research and development (R&D) needed to be addressed for the worldwide eradication of malaria.[187][188]

text: Vaccine

text: A vaccine against malaria called RTS,S, was approved by European regulators in 2015.[161] It is undergoing pilot trials in select countries in 2016.

text: Immunity (or, more accurately, tolerance) to P. falciparum malaria does occur naturally, but only in response to years of repeated infection.[37] An individual can be protected from a P. falciparum infection if they receive about a thousand bites from mosquitoes that carry a version of the parasite rendered non-infective by a dose of X-ray irradiation.[189] The highly polymorphic nature of many P. falciparum proteins results in significant challenges to vaccine design. Vaccine candidates that target antigens on gametes, zygotes, or ookinetes in the mosquito midgut aim to block the transmission of malaria. These transmission-blocking vaccines induce antibodies in the human blood; when a mosquito takes a blood meal from a protected individual, these antibodies prevent the parasite from completing its development in the mosquito.[190] Other vaccine candidates, targeting the blood-stage of the parasite's life cycle, have been inadequate on their own.[191] For example, SPf66 was tested extensively in areas where the disease is common in the 1990s, but trials showed it to be insufficiently effective.[192]

text: Medications

text: Malaria parasites contain apicoplasts, organelles usually found in plants, complete with their own genomes. These apicoplasts are thought to have originated through the endosymbiosis of algae and play a crucial role in various aspects of parasite metabolism, such as fatty acid biosynthesis. Over 400 proteins have been found to be produced by apicoplasts and these are now being investigated as possible targets for novel anti-malarial drugs.[193]

text: With the onset of drug-resistant Plasmodium parasites, new strategies are being developed to combat the widespread disease. One such approach lies in the introduction of synthetic pyridoxal-amino acid adducts, which are taken up by the parasite and ultimately interfere with its ability to create several essential B vitamins.[194][195] Antimalarial drugs using synthetic metal-based complexes are attracting research interest.[196][197]

text:
(+)-SJ733: Part of a wider class of experimental drugs called spiroindolone. It inhibits the ATP4 protein of infected red blood cells that cause the cells to shrink and become rigid like the aging cells. This triggers the immune system to eliminate the infected cells from the system as demonstrated in a mouse model. As of 2014, a Phase 1 clinical trial to assess the safety profile in human is planned by the Howard Hughes Medical Institute.[198]
NITD246 and NITD609: Also belonged to the class of spiroindolone and target the ATP4 protein.[198]

text: Other

text: A non-chemical vector control strategy involves genetic manipulation of malaria mosquitoes. Advances in genetic engineering technologies make it possible to introduce foreign DNA into the mosquito genome and either decrease the lifespan of the mosquito, or make it more resistant to the malaria parasite. Sterile insect technique is a genetic control method whereby large numbers of sterile male mosquitoes are reared and released. Mating with wild females reduces the wild population in the subsequent generation; repeated releases eventually eliminate the target population.[66]

text: Genomics is central to malaria research. With the sequencing of P. falciparum, one of its vectors Anopheles gambiae, and the human genome, the genetics of all three organisms in the malaria lifecycle can be studied.[199] Another new application of genetic technology is the ability to produce genetically modified mosquitoes that do not transmit malaria, potentially allowing biological control of malaria transmission.[200]

text: In one study, a genetically-modified strain of Anopheles stephensi was created that no longer supported malaria transmission, and this resistance was passed down to mosquito offspring.[201]

text: Gene drive is a technique for changing wild populations, for instance to combat insects so they cannot transmit diseases (in particular mosquitoes in the cases of malaria and zika).[202]

text: Other animals

text: Nearly 200 parasitic Plasmodium species have been identified that infect birds, reptiles, and other mammals,[203] and about 30 species naturally infect non-human primates.[204] Some malaria parasites that affect non-human primates (NHP) serve as model organisms for human malarial parasites, such as P. coatneyi (a model for P. falciparum) and P. cynomolgi (P. vivax). Diagnostic techniques used to detect parasites in NHP are similar to those employed for humans.[205] Malaria parasites that infect rodents are widely used as models in research, such as P. berghei.[206] Avian malaria primarily affects species of the order Passeriformes, and poses a substantial threat to birds of Hawaii, the Galapagos, and other archipelagoes. The parasite P. relictum is known to play a role in limiting the distribution and abundance of endemic Hawaiian birds. Global warming is expected to increase the prevalence and global distribution of avian malaria, as elevated temperatures provide optimal conditions for parasite reproduction.[207]


document_title: Petition to the King

question_text: who petitioned the king of england to recognize the rights of colonists

root

text: Petition to the King

text: Political background[edit]

text: Following the end of the French and Indian War (the North American theater of the Seven Years' War) in 1763, relations between the colonies and Britain had been deteriorating. Because the war had plunged the British government deep into debt, Parliament enacted a series of measures to increase tax revenue from the colonies. These acts, such as the Stamp Act of 1765 and the Townshend Acts of 1767, were seen as legitimate means of collecting revenues to pay off the nearly two-fold increase in British debt stemming from the war.[2]

tag: p

text: Many colonists in the Americas, however, developed a different conception of their role within the British Empire. In particular, because the colonies were not directly represented in Parliament, colonists argued that Parliament had no right to levy taxes upon them.[3] After colonists destroyed thousands of pounds of British-taxed tea during the Boston Tea Party, Parliament passed the Coercive Acts in 1774, punishing the colonies for their actions. These punitive Acts were vehemently opposed by the colonists, leading the newly formed Continental Congress to seek redress with King George III, in an attempt to reach a common understanding.

text: Development of the document[edit]

text: Conception[edit]

text: Resolved unanimously, That a loyal address to his Majesty be prepared, dutifully requesting the royal attention to the grievances that alarm and distress his Majesty's faithful subjects in North-America, and entreating his Majesty's gracious interposition for the removal of such grievances, thereby to restore between Great-Britain and the colonies that harmony so necessary to the happiness of the British empire, and so ardently desired by all America.

text: On October 1, 1774, in response to the deteriorating relationship between the American Colonies and Britain, the First Continental Congress decided to prepare a statement to King George III of Great Britain. The goal of the address was to persuade the King to revoke unpopular policies such as the Coercive Acts, which were imposed on the Colonies by the British Parliament. The committee appointed to prepare the Address consisted of Richard Henry Lee, John Adams, Thomas Johnson, Patrick Henry, and John Rutledge, with Lee designated as the committee chairman.[5]

text: Resolved, That the Committiee appointed to prepare an Address to his Majesty, be instructed to assure his Majesty, that in case the colonies shall be restored to the state they were in, at the close of the late war, by abolishing the system of laws and regulations-for raising a revenue in America-for extending the powers of Courts of Admiralty-for the trial of persons beyond sea for crimes committed in America-for affecting the colony of the Massachusetts-Bay and for altering the government and extending the limits of Canada, the jealousies which have been occasioned by such acts and regulations of Parliament, will be removed and commerce again restored.

text: On October 5, 1774, Congress once more returned to the subject of the Address, stressing to the committee that the document should assure the King that following the successful repeal of the Coercive Acts, the Colonies would restore favorable relations with Britain.

text: Approval by Congress[edit]

text: The Congress resumed the consideration of the address to his Majesty, and the same being debated by paragraphs, was, after some amendments, approved and order to be engrossed.

text: On October 25, 1774, the petition came before Congress in its draft form. After the document was debated over and formally amended, it was then approved to be engrossed and sent to England to be presented to the King.

text: Annotated text of the petition[edit]

text: The petition, when written, was not divided into formal parts. However, the structure of the document allows it to be classified into sections, including an introduction, the list of grievances, reasons for attention, and a conclusion.

text:
Introduction

States the represented Colonies, as well as the nature of the document.

To the King's Most Excellent Majesty:
Most Gracious Sovereign: We, your Majesty's faithful subjects of the Colonies of New-Hampshire, Massachusetts Bay, Rhode-Island and Providence Plantations, Connecticut, New-York, New-Jersey, Pennsylvania, the Counties of New-Castle, Kent, and Sussex, on Delaware, Maryland, Virginia, North Carolina, and South Carolina, in behalf of ourselves and the inhabitants of those Colonies who have deputed us to represent them in General Congress, by this our humble Petition, beg leave to lay our Grievances before the Throne.

List of Grievances

Lists the grievances that the Colonies wish for King George III to redress.

A Standing Army has been kept in these Colonies ever since the conclusion of the late war, without the consent of our Assemblies; and this Army, with a considerable Naval armament, has been employed to enforce the collection of Taxes.
The authority of the Commander-in-Chief, and under him of the Brigadiers General has, in time of peace, been rendered supreme in all the Civil Governments in America.
The Commander-in-chief of all your Majesty's Forces in North America, has, in time of peace, been appointed Governour of a Colony.
The charges of usual offices have been greatly increased; and new, expensive, and oppressive offices have been multiplied.
The Judges of Admiralty and Vice Admiralty Courts are empowered to receive their salaries and fees from the effects condemned by themselves.
The Officers of the Customs are empowered to break open and enter houses, without the authority of any Civil Magistrate, founded on legal information.
The Judges of Courts of Common Law have been made entirely dependent on one part of the Legislature for their salaries, as well as for the duration of their commissions.
Counsellors, holding their commissions during pleasure, exercise Legislative authority.
Humble and reasonable Petitions from the Representatives of the People, have been fruitless.
The Agents of the People have been discountenanced, and Governours have been instructed to prevent the payment of their salaries.
Assemblies have been repeatedly and injuriously dissolved.
Commerce has been burthened with many useless and oppressive restrictions.
By several Acts of Parliament made in the fourth, fifth, sixth, seventh, and eighth years of your Majesty's Reign, Duties are imposed on us for the purpose of raising a Revenue; and the powers of Admiralty and Vice Admiralty Courts are extended beyond their ancient limits, whereby our property is taken from us without our consent; the trial by jury, in many civil cases, is abolished; enormous forfeitures are incurred for slight offences; vexatious informers are exempted from paying damages, to which they are justly liable, and oppressive security is required from owners before they are allowed to defend their right.
Both Houses of Parliament have resolved, that Colonists may be tried in England for offences alleged to have been committed in America, by virtue of a Statute passed in the thirty-fifth year of Henry the Eighth, and, in consequence thereof, attempts have been made to enforce that Statute.
A Statute was passed in the twelfth year of your Majesty's Reign, directing that persons charged with committing any offence therein described, in any place out of the Realm, may be indicted and tried for the same in any Shire or County within the Realm, whereby the inhabitants of these Colonies may, in sundry cases, by that Statute made capital, be deprived of a trial by their peers of the vicinage.
In the last sessions of Parliament an Act was passed for blocking up the Harbour of Boston; another empowering the Governour of the Massachusetts Bay to send persons indicted for murder in that Province, to another Colony, or even to Great Britain, for trial, whereby such offenders may escape legal punishment; a third for altering the chartered Constitution of Government in that Province; and a fourth for extending the limits of Quebec, abolishing the English and restoring the French laws, whereby great numbers of British Freemen are subjected to the latter, and establishing an absolute Government and the Roman Catholick Religion throughout those vast regions that border on the Westerly and Northerly boundaries of the free Protestant English settlements; and a fifth, for the better providing suitable Quarters for Officers and Soldiers in his Majesty's service in North America.

Reasons for Attention

State why the aforementioned grievances are important enough to warrant an address to the monarchy.

To a Sovereign, who glories in the name of Briton, the bare recital of these Acts must, we presume, justify the loyal subjects, who fly to the foot of his Throne, and implore his clemency for protection against them.
From this destructive system of Colony Administration, adopted since the conclusion of the last war, have flowed those distresses, dangers, fears, and jealousies, that overwhelm your Majesty's dutiful Colonists with affliction; and we defy our most subtle and inveterate enemies to trace the unhappy differences between Great Britain and these Colonies, from an earlier period, or from other causes than we have assigned. Had they proceeded on our part from a restless levity of temper, unjust impulses of ambition, or artful suggestions of seditious persons, we should merit the opprobrious terms frequently bestowed upon us by those we revere. But so far from promoting innovations, we have only opposed them; and can be charged with no offence, unless it be one to receive injuries and be sensible of them.
Had our Creator been pleased to give us existence in a land of slavery, the sense of our condition might have been mitigated by ignorance and habit. But, thanks be to his adorable goodness, we were born the heirs of freedom, and ever enjoyed our right under the auspices of your Royal ancestors, whose family was seated on the British Throne to rescue and secure a pious and gallant Nation from the Popery and despotism of a superstitious and inexorable tyrant. Your Majesty, we are confident, justly rejoices that your title to the Crown is thus founded on the title of your people to liberty; and, therefore, we doubt not but your royal wisdom must approve the sensibility that teaches your subjects anxiously to guard the blessing they received from Divine Providence, and thereby to prove the performance of that compact which elevated the illustrious House of Brunswick to the imperial dignity it now possesses.
The apprehension of being degraded into a state of servitude, from the pre-eminent rank of English freemen, while our minds retain the strongest love of liberty, and clearly foresee the miseries preparing for us and our posterity, excites emotions in our breasts which, though we cannot describe, we should not wish to conceal. Feeling as men, and thinking as subjects, in the manner we do, silence would be disloyalty. By giving this faithful information, we do all in our power to promote the great objects of your Royal cares, the tranquillity of your Government, and the welfare of your people.
Duty to your Majesty, and regard for the preservation of ourselves and our posterity, the primary obligations of nature and of society, command us to entreat your Royal attention; and, as your Majesty enjoys the signal distinction of reigning over freemen, we apprehend the language of freemen cannot be displeasing. Your Royal indignation, we hope, will rather fall on those designing and dangerous men, who, daringly interposing themselves between your Royal person and your faithful subjects, and for several years past incessantly employed to dissolve the bonds of society, by abusing your Majesty's authority, misrepresenting your American subjects, and prosecuting the most desperate and irritating projects of oppression, have at length compelled us, by the force of accumulated injuries, too severe to be any longer tolerable, to disturb your Majesty's repose by our complaints.
These sentiments are extorted from hearts that much more willingly would bleed in your Majesty's service. Yet, so greatly have we been misrepresented, that a necessity has been alleged of taking our property from us without our consent, "to defray the charge of the administration of justice, the support of Civil Government, and the defence, protection, and security of the Colonies." But we beg leave to assure your Majesty that such provision has been and will be made for defraying the two first artiticles [sic], as has been and shall be judged by the Legislatures of the several Colonies just and suitable to their respective circumstances; and, for the defence, protection, and security of the Colonies, their Militias, if properly regulated, as they earnestly desire may immediately be done, would be fully sufficient, at least in times of peace; and, in case of war, your faithful Colonists will be ready and willing, as they ever have been, when constitutionally required, to demonstrate their loyalty to your Majesty, by exerting their most strenuous efforts in granting supplies and raising forces.[8]
Yielding to no British subjects in affectionate attachment to your Majesty's person, family, and Government, we too dearly prize the privilege of expressing that attachment by those proofs that are honourable to the Prince who receives them, and to the People who give them, ever to resign it to any body of men upon earth.
Had we been permitted to enjoy, in quiet, the inheritance left us by our forefathers, we should, at this time, have been peaceably, cheerfully, and usefully employed in recommending ourselves, by every testimony of devotion, to your Majesty, and of veneration to the state, from which we derive our origin. But though now exposed to unexpected and unnatural scenes of distress by a contention with that Nation in whose parental guidance on all important affairs, we have hitherto, with filial reverence, constantly trusted, and therefore can derive no instruction in our present unhappy and perplexing circumstances from any former experience; yet, we doubt not, the purity of our intention, and the integrity of our conduct, will justify us at that grand tribunal before which all mankind must submit to judgment.
We ask but for Peace, Liberty, and Safety. We wish not a diminution of the prerogative, nor do we solicit the grant of any new right in our favour. Your Royal authority over us, and our connection with Great Britain, we shall always carefully and zealously endeavour to support and maintain.

Conclusion

Restates the ultimate goal of the petition, while reaffirming the Colonies' loyalty to the British monarchy.

Filled with sentiments of duty to your Majesty, and of affection to our parent state, deeply impressed by our education, and strongly confirmed by our reason, and anxious to evince the sincerity of these dispositions, we present this Petition only to obtain redress of Grievances, and relief from fears and jealousies, occasioned by the system of Statutes and Regulations adopted since the close of the late war, for raising a Revenue in America—extending the powers of Courts of Admiralty and Vice Admiralty—trying persons in Great Britain for offences alleged to be committed in America—affecting the Province of Massachusetts Bay—and altering the Government and extending the limits of Quebec; by the abolition of which system the harmony between Great Britain and these Colonies, so necessary to the happiness of both, and so ardently desired by the latter, and the usual intercourses will be immediately restored. In the magnanimity and justice of your Majesty and Parliament we confide for a redress of our other grievances, trusting, that, when the causes of our apprehensions are removed, our future conduct will prove us not unworthy of the regard we have been accustomed in our happier days to enjoy. For, appealing to that Being, who searches thoroughly the hearts of his creatures, we solemnly profess, that our Councils have been influenced by no other motive than a dread of impending destruction.
Permit us then, most gracious Sovereign, in the name of all your faithful People in America, with the utmost humility, to implore you, for the honour of Almighty God, whose pure Religion our enemies are undermining; for your glory, which can be advanced only by rendering your subjects happy, and keeping them united; for the interests of your family depending on an adherence to the principles that enthroned it; for the safety and welfare of your Kingdoms and Dominions, threatened with almost unavoidable dangers and distresses, that your Majesty, as the loving Father of your whole People, connected by the same bands of Law, Loyalty, Faith, and Blood, though dwelling in various countries, will not suffer the transcendent relation formed by these ties to be farther violated, in uncertain expectation of effects, that, if attained, never can compensate for the calamities through which they must be gained.
We therefore most earnestly beseech your Majesty, that your Royal authority and interposition may be used for our relief, and that a gracious Answer may be given to this Petition.
That your Majesty may enjoy every felicity through a long and glorious Reign, over loyal and happy subjects, and that your descendants may inherit your prosperity and Dominions till time shall be no more, is, and always will be, our sincere and fervent prayer.

Signatures

The first signature on the engrossed copy is that of Henry Middleton, the then appointed President of the Continental Congress. The fifty-one signatories who represented the Colonies (Georgia did not participate) are given, in order.

President of Congress: Henry Middleton
New-Hampshire: John Sullivan, Nathaniel Folsom
Massachusetts Bay: Thomas Cushing, Samuel Adams, John Adams, Robert Treat Paine
Rhode-Island: Stephen Hopkins, Samuel Ward
Connecticut: Eliphalet Dyer, Roger Sherman, Silas Deane
New-York: Philip Livingston, John Alsop, Isaac Low, James Duane, John Jay, William Floyd, Henry Wisner, Simon Boerum
New-Jersey: William Livingston, John De Hart, Stephen Crane, Richard Smith
Pennsylvania: Edward Biddle, Joseph Galloway, John Dickinson, John Morton, Thomas Mifflin, George Ross, Charles Humphreys
Delaware: Caesar Rodney, Thomas McKean, George Read
Maryland: Matthew Tilghman, Thomas Johnson, William Paca, Samuel Chase
Virginia: Richard Henry Lee, Patrick Henry, George Washington, Edmund Pendleton, Richard Bland, Benjamin Harrison
North-Carolina: William Hooper, Joseph Hewes, Richard Caswell
South-Carolina: Thomas Lynch, Christopher Gadsden, John Rutledge, Edward Rutledge

tag: table

text: Delivery of the document[edit]

text: On November 2, the petition departed Philadelphia on board the ship Britannia, captained by W. Morwick. However, a storm forced the ship to return to port, delaying the delivery of the petition. It was later discovered that the paper was unfit to be presented. The second copy left port on November 6 on board the ship Mary and Elizabeth, captained by N. Falconer. It was confirmed on November 14 that the document successfully arrived in London.[9]

text: In Britain, a number of London merchants expressed interest in joining the Americans when the petition was presented, although Benjamin Franklin advised against the proposition.[10] On December 21, Benjamin Franklin, Lee, and Bollan were notified by Lord Dartmouth that the petition was "decent and respectful" and that it would be presented as soon as possible to the Houses of Parliament. However, Franklin wrote two days later that the petition could not be presented to Parliament until after the Christmas recess.[11]

text: Response[edit]

text: On January 19, 1775, the petition was presented to the House of Commons by Lord North, and was also presented to the House of Lords the following day.[11]

text: It came down among a great did not Heap of letters of Intelligence from Governors and officers in America, Newspapers, Pamphlets, Handbills, etc., from that Country, the last in the List, and was laid upon the Table with them, undistinguished by any particular Recommendation of it to the Notice of either House; and I do not find, that it has had any further notice taken of it as yet, than that it has been read as well as the other Papers.

text: Because the petition was intermingled with many other documents, and given the increasing turmoil of the times, little attention was given to the petition by Parliament.[11] Likewise, the King never gave the Colonies a formal reply to their petition.

text: Publication[edit]

text: When the official papers of Congress were published in October and November 1774, the Petition to the King was omitted, because it was preferred that the address be read by the King before being made public. It was not until January 17 or 18, 1775 that the papers were officially released by Charles Thomson, for publication.[13]

text: Surviving drafts[edit]

text: Three drafts of the Petition to the King survive to this day: one written by Patrick Henry, one written by Henry Lee, and one by John Dickinson.[14]

text: Patrick Henry[edit]

text: The Henry draft is written with very few corrections on its four portfolio pages. Compared to the final version of the Address, the draft contains more rhetorical descriptions of the contested Acts, and focuses less on the Colonies' past loyalty to Britain.[14]

text: Henry Lee[edit]

text: The Lee draft is neatly written, with minor changes, on three portfolio pages. Compared to the Henry draft, the descriptions of the grievances were brief.[14] It does contain, however, a harsh attack on the King's ministers, most notably Bute, Mansfield, and North. Because of the inflammatory language in this draft, it is argued that this is the version that was rejected by Congress on October 21, 1774.[15]

text: John Dickinson[edit]

text: The Dickinson draft is a rough composition, rite with many changes, including entire paragraphs designated to be transposed. The document is nine and a half portfolio pages, numbered 1-9 and 12, with pages 10 and 11 left blank. The text found in this draft is virtually identical to the document adopted by Congress, with the main difference lying in the list of grievances in the adopted version, which resembled those found the other two drafts.[15]

text: Historical significance[edit]

text: The Petition to the King reflected the Colonies' desire to maintain relations with Britain, given that certain demands were met. In particular, it showed that the Colonies viewed themselves as loyal to the British monarchy rather than to Parliament.

text: Notes[edit]

text:
Jump up ^ Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied", 199.
Jump up ^ Christie and Labaree, Empire or Independence, 31.
Jump up ^ Bailyn, Ideological Origins, 162
Jump up ^ Journal of the proceedings of the Congress, 47.
Jump up ^ Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied", 190.
Jump up ^ Journal of the proceedings of the Congress, 48-49.
Jump up ^ Journal of the proceedings of the Congress, 116.
Jump up ^ An Estimate of the number of Souls in the following Provinces, made in Congress, September, 1774: In Massachusetts 400,000; New-Hampshire 150,000; Rhode-Island 59,678; Connecticut 192,000; New-York 250,000; New-Jersey 130,000; Pennsylvania, including the Lower Counties, 350,000; Maryland 320,000; Virginia 650,000; North Carolina 300,000; South Carolina 225,000. Total 3,026,678.
Jump up ^ Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied, 192.
Jump up ^ Smyth, Writings of Franklin, 344.
^ Jump up to: a b c Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied, 193.
Jump up ^ Smyth, Writings of Franklin, 304.
Jump up ^ Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied, 201.
^ Jump up to: a b c Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied, 197.
^ Jump up to: a b Wolf, Edwin, The Authorship of the 1774 Address to the King Restudied, 198.

tag: ol


document_title: Bilaspur district, Himachal Pradesh

question_text: before merger with himachal pradesh on 1st july 1954 bilaspur was a

text: Bilaspur district, Himachal Pradesh

text: History[edit]

text: The area that is now Bilaspur District was formerly known as Kahlur, a princely state of British India. The ruler acceded to the Government of India on 12 October 1948, and Bilaspur was made an Indian state under a chief commissioner. The state of Bilaspur was merged with Himachal Pradesh on 1 July 1954, and became Bilaspur District.

text: Bilaspur was the capital of a state founded in the 7th century, and known as Kahlur after its earlier capital, or as Bilaspur after its later capital. The ruling dynasty were Chandela Rajputs, who claimed descent from the rulers of Chanderi in present-day Madhya Pradesh. The town of Bilaspur was founded in 1663. The state later became a princely state of British India, and was under the authority of the British province of Punjab.

text: On 13 May 1665, Guru Tegh Bahadur went to Bilaspur to attend the mourning for Raja Dip Chand of Bilaspur. The Dowager Rani Champa of Bilaspur offered to give the Guru a piece of land in her state. The Guru bought the site on payment of Rs500 (Five Hundred Ruppees). The land consisted of the villages of Lodhipur, Mianpur and Sahota. Here on the mound of Makhowal, Guru Tegh Bahadur raised a new habitation. The ground was broken on 19 June 1665, by Baba Gurditta Randhawa. The new village was named after the Guru's mother, Nanaki. Chakk Nanaki later became famous as Anandpur Sahib.

text: In 1932 state was made part of the newly created Punjab States Agency, and in 1936 the Punjab Hill States Agency was separated from the Punjab States Agency. India became independent in 1947, and on 12 October 1948 the ruler, HH Raja Sir Anand Chand, acceded to the Government of India. Bilaspur became a separate state of India under a chief commissioner, and on 1 July 1954 Bilaspur state was made a district of Himachal Pradesh state by an act of the Indian Parliament. The historic town was submerged in 1954 when the Sutlej River was dammed to create the Govind Sagar, and a new town was built upslope of the old.

text: Most of the Rajputs in Bilaspur are Chandels, that is they belong to different branches of the ruling family. These families are numerous, and all enjoyed jagir pensions from state amounting in aggregate to Rs.40,000 a year in 1933. They are called 'the Mian families', and the chief names are: Ajmerchandia, Kaliyanchandia, Tarahandia and Sultanchandia.[2]

text: Administration[edit]

text: Administratively, the district is divided into three tehsils, Ghumarwin, Bilaspur Sadar, and Jhandutta. Jhandutta was created out of Ghumarwin in January 1998. Naina Devi is a sub-tehsil of Bilaspur Sadar, and was created in January 1980.

text: Geography[edit]

text: Bilaspur has a hilly terrain.Whole district is situated in shivalik range of lower himalayas. It is surrounded by hills on all sides.In south and west,it is bordered by Punjab.Summers are hot and winters are cold, with fog along banks of river satluj. Rainy season lasts from early July to mid September. Summer are hottest in month of May and June.

text: Demographics[edit]

text:
Religions in Bilaspur District

Religion

Percent

Hindus

97.39%

Muslims

1.83%

text: According to the 2011 census Bilaspur district, Himachal Pradesh has a population of 382,056,[1] roughly equal to the nation of Maldives.[3] This gives it a ranking of 562nd in India (out of a total of 640).[1] The district has a population density of 327 inhabitants per square kilometre (850/sq mi).[1] Its population growth rate over the decade 2001-2011 was 12.08%. Bilaspur has a sex ratio of 981 females for every 1000 males,[1] and a literacy rate of 85.67%.[1] Hindi and the Bilaspuri dialect of Punjabi are the most widely spoken languages in the district.[4]

text:
Rank
Language
1981 census[5]

1
Hindi
61.79%

2
Punjabi
37.35%

3
Others
0.86%

text: Tourist Attraction[edit]

text: Bilaspur has most of catchment area of Gobind Sagar Lake formed by Bhakra Dam on satluj river. Lake is full after rainy season, and is a good place for water sports.one can do kayaking, motorboating and sailing among other things. Fort of bahadurgarh was fort of kings of bilaspur. Bridge at Kandraur on satluj river was once highest bridge in Asia. Bandla hill is also famous for paragliding.

text: Transportation[edit]

text: Road transport is main mode to travel within district. There is no railway line or airport in district.

text: Language[edit]

text: Bilaspuri or Kahluri which belongs to Western Pahari family is main language spoken. Hindi , english is also widely understood.

text: Forts[edit]

text:
Kahlur Fort, (Few kilometers from Ganguwal Hydro Electric Station, in Naina Devi Hill). Raja Bir Chand, an ancestor of Raja Kahal Chand, built a palace-cum-fort called Kot Kahlur. It is in ruin now. The state was called Kahlur till such time the seat of Government was shifted to Bilaspur. Among the local population the district is still known as Kahlur. The fort is a square structure built of stones, each side about thirty meters long and as much high. Its walls are about two metres thick. It has two storeys each about fifteen metres high. The floor of the second storey, supported on numerous high stone pillars. About twelve meters above the floor of the second storey there were certain window shaped places with small peeping holes for the garrison to reconnoitre and, if need be to shoot at besiegers. Most of these hollows have now been closed with cement or iron-mesh. Within the fort, in the upper storey, is a small temple to Naina Devi with a stone idol. There are seven small ancient fortresses in the district at Bacchretu, Bahadurpur, Basseh, Fatehpur, Sariyun, Swarghat and Tiun. Sunhani is small village on the bank of Seer Khad is yet another place which claims the distinction of being a state headquarters for some period.
Fort of Bahadurpur, (On the top of Bahadurpur hill, the highest point (1,980 m) in the district, near Tepra Village in Paragana Bahadurpur Tehsil Sadar, about 40 km from Bilaspur, Himachal Pradesh). The range derives its name from the Bahadurpur fort. Due to its comparatively greater height it receives occasional snow fall in winter. The range is embellished by a beautiful small wood of deodar and ban trees. Almost in the centre of this range, in picturesque surroundings, is perched a rest-house. The fort is said to have been built by Raja Keshab Chand (c A.D. 1620). It is just 6 km above Namhol. From this high place the Ratanpur Fort, Swarghat, the Fatehpur Fort, the Naina Devi hill, plains near Ropar and the mountains of Shimla can be seen and look beautiful. Baron Charles Hugel, a German traveler, passing through Bilaspur in 1835 has left on record a vivid picture of this fort. It is, therefore, obvious from the account that this fort was built prior to 1835, but now is in its ruins.
Fort of Sariun, (To the eastern side of the Tiun range, on the lifty range and peak of Sariun, at an elevation of about 1,500 m, about 58 km from Bilaspur, Himachal Pradesh). Played its usual role in the struggle between the erstwhile State of Bilaspur and Kangra during the minority rule of Mohan Chand. Nothing now remains of the fort except its ruin. It appears to be rectangular edifice made of stones. Its main gate faces west. From the relics it can be said that the fort was about twelve meters high. The thickness of the walls is about one metre. Within its walls a part of the area is marked by the ruins of what might be once the living rooms numbering about fifteen. The walls of the fort contain places shaped like a window with certain holes across the wall to facilitate showering of lead upon the besiegers. Tradition holds that the fort was originally built by the same Raja of the erstwhile Suket State and was subsequently wrested by the ruler of Bilaspur, the local people entertain a superstition according to which, the stones once forming part of the Fort are not used in any residential building.
Fort of Tiun, (On the top of a hill known as the Tiun range, 17 km in length, at distance of about 45 km from Bilaspur, Himachal Pradesh, on the Ali Khad crossing Ghumarwin-Ladraur motorable road, about 10 km from Ghumarwin proper). Relics of this fort still serves to remind of the ancient turbulent times when wars in this area were perhaps a routine feature. Raja Kahn Chand got it constructed in 1142 Vikrami. The area of the fort around 14 hectare. It is rectangle in shape. The length of the fort was 400 meters with a breadth 200 meters. The height of the wall is varies from 2 meters to 10 meters. The main gate of the fort is 3 meters height and 5 and a 1/2 meters breadth. There were two water tanks inside the fort. Also there were two granary which contains 3000 kg grain. The fort is said to have once served as a prison to an uncle of Raja Kharak Chand.
Fort of Bachhretu, (In Kot Hill, on the western slope of Kotdhar just 3 km southward to Shahtalai, it is 3000 ft above sea level). Magnificent and sweeping view of Gobind Sagar and the surrounding hills. The fort was constructed by Raja Ratan Chand of Bilaspur who ruled from 1355 to 1406. Obviously the relics are as old as about six hundred years and indicate that the stronghold was of a rectangular shape, the longer arms about 100 metres and shorter about 50 meters, built of hammer-dressed stones. From the portions of the enclosing walls, still existing here and there, it can be assumed to have been about 20 meters in height. The thickness of its walls must have been one metre tapering towards the top. The space inside was, perhaps, divided into numerous room-shaped compartments out of which about fifteen can be traced even now. Walls of one of the room are exceedingly high, measuring about ten to twelve metres. A water tank is also said to have existed. A very interesting small temple, housing two busts of the goddess Ashta Bhuja (eight armed) and some other deities is still extant. A pipal tree has now grown within the fort.

tag: ul

text: Other[edit]

text:
Thakurdwara of Sunhani, (On the bank of Seer Khad, just 3 km behind Barthin, on Bhager- Barthi & Ghumarwin road, just 8 km from Ghumarwin). Shunhani is very attractive and historical place. Raja Vikram Chand (1555-1593 AD) made Sunhani its capital this area got the credit of being Kehloor's capital for more than 100 years. Chandel kings have a tradition that where ever they went & settled, they constructed temple of Nahar Singh Ji (Nar Singh Devta) and worshiped the deity. According to this tradition they made Thakurdwara of Sunhani where they made Narsingh Devta (there Istdev) temple. On the doors of thakurdwara, there is Gupta period architecture & drawing. There are many jarokhas on the backside of thakurdwara where sculptures of various gods and goddesses are made. Today also, people of this area offer new harvest as Nasrawan. Buffalo milk’s ghee is firstly offered here newly married couple move around Ficus (Pipple) tree. Shitla Mata’s temple is present near it though now this region is not that famous, its popularity still persists. edit
Thakurdwara of Auhar, (In the middle of the district Bilaspur). It was an important town of the princely state Bilaspur. Due to its importance Rani Naggar Dei built the famous Thakurdwara of Auhar. She also constructed on water tank with roof known as chhatwain and an inn for the stay of the travelers. In the Thakurdwara idols of ‘Shaligram’ and ‘Narsingha’ were installed. The walls of the temple have beautiful mural paintings. The Language and Culture department has given financial assistance for the repair of the Thakurdwara. edit
Bhakra Dam, (In Naina Devi Sub-Tehsil about 14 km from Nangal town). The highest straight gravity dam in the world occupies the predominant position amongst the places of tourist interest. The idea for the construction of this dam was conceived by Sir Louis Dane the then Lieutenant Governor of Punjab, who travelled from Sunni to Bilaspur and then onward to Ropar. The project could not make headway due to prohibitive cost of construction. In the year 1938-39 the districts of Rohtak and Hissar of the then Punjab State experienced severe drought resulting in great loss of human life and cattle. The scheme was again mooted out but was not executed due to second world war. It was only after independence in March, 1948 that the work was taken in hand for execution. On the historic day of 17 November 1955 later Prime Minister Shri Jawahar Lal Nehru placed the first bucket of concrete at the foundation. The construction of dam was completed in October, 1962. The height of the dam is 226 metres, length at the top is 518 metres and width 9 metres. It has a length of 99 metres at the bottom and width 402 metres. The project derives its name from two villages Bhakhra and Nangal situated on the foot hills of the low Himalayan ranges. Bhakhra occupies a very important place on the India’s tourist map and has rightly been described as a "New Temple of Resurgent India", by the late Prime Minister Mr. Nehru. The project authorities have set up a Public Relation Office in Nangal Township which provides necessary help and guidance to the tourists. edit
Gobind Sagar Lake, (On river Sutlej). Has been created by the huge hydel dam at Bhakra and is named in honour of Gobind Singh the Tenth Sikh guru. One of the world's highest gravity dams, the Bhakra rises 225.5 m above its lowest foundations. Under the supervision of the famous American dam-builder, Harvey Slocum, work began in 1955 and was completed in 1962. Incidentally, Slocum had no formal training as an engineer, but his conceptions and designs have proven successful. To maintain the level of water, the flow of river Beas was also channeled to Gobind Sagar by the Beas-Sutlej link which was completed in 1976. Today, this dam feeds electricity and water to a large area the Gobind Sagar reservoir is 90 km long and encompasses an area of approximately 170 km2. There are provisions for water sports speed boats and ferry rides. In October and November, when the water level of the reservoir is at its peak, a series of regattas are also organizing by the department of Tourism and Civil Aviation. Water-skiing, sailing, kayaking and water scooter racing are popular water sports activities during this period. edit
New Bilaspur Town. The old Bilaspur town, has now been submerged in the Gobind Sagar, was founded in year 1663 when the capital of the state was shifted from Sunhani to this place, it was situated on the south east side of the Satluj. New Bilaspur Town is situated just above the old town of Bilaspur at a height of 670 metres above the mean sea level. The New Township Bilaspur has been conceived, planned and built on modern lines and should be regarded as the first planned hill town of the country. The new planned township, 64 km from Kiratpur on the Manali National Highway No. 21, has come up which is the seat of district headquarters. The pleasure of a visit will be enhanced manifold when a motor launch is preferred as the means of travel, gliding through cool and enchanting waters of the lake. The best months from visiting this place are from September to December. The Nalwari or Annual cattle fair is held at Bilaspur for four or five days in March months, the occasion is marked by wrestling and other amusements. A good trade is usually done. Cattle are brought from Nalagarh and neighboring parts of Punjab sell over here. It is easily approachable as regular bus services are maintained from and to Shimla, Mandi, Hamirpur and Chandigarh. The places of interest were the temples of Sri Naina Devi Ji, Raghu Nath Ji, Gopal Ji, Khan Mukheshwar and Deomati where fairs are held.
Kandrour Bridge, (8 kilometres from Bilaspur on National Highway No-88, across the river Satluj). Very beautiful and fascinating bridge. Its construction was started in April,1959 and was completed in 1965. The total cost of construction came to Rs. 28,12,998. The span of the bridge is about 280 meters with a breadth of about seven meters and the height above the lowest river bed below is about 80 meters, making it one of the highest bridge in the world. It is ranked first in Asia for its height. It has provided a link between Bilaspur, Ghumarwin and Hamirpur district, and is a marvellous engineering feat. The pillars supporting the bridge are hollowed. The bridge was opened by Shri Raj Bahadur, Minister of Transport in 1965.
Deoli Fish Farm, (15 km from New Bilaspur township towards Mandi just below the Shimla-Mandi Road). Comprising 4.4 hectares comes in existence 1962. It consists of two big brood stock tanks and 14 nursery ponds. The total outlay on setting up this hatchery was 3.68 lacks. In beginning the farms activities were limited to meet the seed stocking requirements of Gobind Sagar reservoir, but its targets were increased year to year and research, training, technique and demonstration brought under the farm programmed. During 1978 fish species being record at the farm were demonstrated to the people by constructing a small aquarium and its aim was to apprise the popular. During 1989 a training center and Hostel were constructed within the farm premises so that training course be imparted to the departmental personnel and interested fish farmers. Now training camps are being conducted with modern fish breeding and culture technique training are imparted. This farm has not only historic importance but is can be known as a center breeding excellent training in fish culture and research programmed. Keeping in view the commendable work done in the field of breeding, the Punjab University extended its recognition for undertaking research work at this farm. The Deoli fish farm has played a major role in breeding fish population in Gobind Sagar reservoir, income of the reservoir fishermen and their lives prosperous. For the first time Silver Carp fish was stocked in Gobind Sagar reservoir from Deoli farm. Every year 30-40 lacks mirror carp fingerlings are being produced at the farm and these are stocked in Gobind Sagar reservoir and other water bodies in the State and distributed to the private fish farms. Due to regular stocking in Gobind Sagar reservoir for the last decade at has a unique capacity of fish production per hectare in the country and this credit goes to Deoli farm. The scientists of ICAR and State Fisheries Department initiated a joint research project viz. ‘Genetic Rejuvenation of Fish Stock in HP’. The ‘Bio-Science Department’ started this project entire funded about 18.00 lacks. A quality strain of fish is being reared under this project and distributed to the fish farmers. Under this technique demonstration programme a new scheme namely ‘Fish Culture in Running Water’ was introduced for the first time at the farm. This scheme was observed suitable especially in high altitude of Himachal Pradesh on the basis of success of this technique the Govt of India incorporated this scheme under the Centrally Sponsored Fish Farmers’ Development Agency subsidy programme. The NABARD Bank has also approved this scheme namely ‘Fish Culture in Running Water’ which resulted in setting up of about 1000 units in the State. In recent years sport fisheries is fostering in the Gobind Sagar reservoir which clearly indicates vast potential of attracting tourists. The Deptt regularly organizes angling completions every year. In Gobind Sagar and Mahseer fish which is a famous and most liked fish of the anglers is an important fish of this reservoir. As the breeding of Mahseer fish is not an easy job hence the Punjab University and State Fisheries Department jointly prepared a project of Rs. 19.00 lacks it was got approved from ICAR. Present hatchery set up at the Deoli farm has been constructed under this scheme. Under this scheme matured Mahseer fish would be brought from his habitat and bred in comfortable situation.
Namhol, (About 24 km from Bilaspur and 68 km from Shimla on the Bilaspur-Shimla motorable road on which regular bus service is maintained). Small hamlet. There is a Thakurdwar which was built by Raja Amar Chand in 1883 A.D. Brass idols of Ram, Lakshman, Sita and Hanuman are installed in the temple. The place is the main centre of ginger trade. There are a Police Post, a Senior Secondary School, an Ayurvedic Dispensary, a Branch Post Office, a State Bank of India and a PWD Rest House.

text: Notable individuals[edit]

text:
Gambhari Devi, Folk Artist
Suresh Chandel, Politician
JP Nadda, Politician
Rattan Chand, Bureaucrat
Sanjay Kumar (soldier), Param Vir Chakra
Bhandari Ram,Victoria Cross
Meena Kumari (sport shooter)
Yami Gautam