Malaria immunity in infants: a special case of a general phenomenon?

Newborn infants in endemic areas are markedly resistant to Plasmodium falciparum malaria. Consequently, severe disease is rare during the first few months of life, and infections tend to be low density and relatively asymptomatic during this period. Although this is generally ascribed to passively transferred immunity, attempts to identify the targets and mechanisms of this protection have been unsuccessful. The implications of the hypothesis that the progression from resistance through susceptibility and back to resistance during infancy and early childhood reflects the gradual acquisition of IgG to variant surface antigens (VSAs), while protection from maternal VSA-specific IgG steadily fades, are discussed here.