Mosquito mischief put me on the path to my CAD diagnosis

Malaria test results opened my eyes to an issue in my blood

by Mary Lott | October 22, 2025

Lurking out there amid my tropical splendor is a hidden foe. Don’t try to find it in the picture. This creature is too small to see unless you’re close to it. Yet, it is the world’s deadliest animal. My family and I have had a few run-ins with it.

A light blue house sits amid a lush landscape in Papua, Indonesia.

There is danger in every step in my peaceful-appearing yard. (Photo by Mary Lott)

Papua, Indonesia, where I live, is home to many dangerous critters. We assume as a rule of thumb that any snake we encounter is poisonous. And sometimes the cousin of the Komodo dragon, the Papuan monitor, wanders through our yard. This lizard is aggressive and large and has many deadly bacteria in its mouth. A single bite can make a person sick before dying a painful death a few days later.

Then there are cassowaries, the flightless birds that live here. They’re not poisonous, but they have a kick that can rip out your intestines. Many of our pilots won’t land their plane if they see a cassowary nearby, as they’re too unpredictable.

The mosquito: the deadliest of all

But none of these creatures is nearly as deadly as the simple, almost-invisible mosquito. Mosquitos here carry dengue fever and malaria. I will not describe the joys of dengue — a disease that still causes me to shudder and groan in sympathy when I learn that someone has developed it. Fortunately, dengue fever isn’t as pervasive as malaria.

Malaria is everywhere here. If someone begins feeling “off” or “not quite well,” the assumption is that they are in the beginning stages of malaria until the disease is conclusively eliminated. A blood smear is quickly prepared — we used to do this ourselves — and taken to the laboratory for analysis. Then, we learn it is either negative, meaning no malaria present, or positive, with accompanying types and stages so we can begin treatment.

Many times, I would receive a different response from the blood lab: “Negative for malaria. High white blood cell count present.” We assumed I had a hidden infection that was making me feel yucky, but this finding really pointed to my cold agglutinin disease (CAD).

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Unraveling the mystery of CAD

After eliminating malaria as the source of all my woes, we had to look deeper. And by we, I mean me. Here in Papua, checking a person’s blood for malaria doesn’t involve a doctor any more than treating a cold does back in the States.

I tried to become more specific in my quest for treatment. That led to tests for breathing irregularities, intestinal diseases, and urinary tract problems. Most of the time, these were also negative, and years went by without an answer.

Since I continued to live in a malaria area, I still tested for that parasite. The results continued to be a source of humor for my husband and me: Negative, but with a high white blood cell count. I kept going from doctor to doctor, insisting on more thorough checks to find out why I had an irregular result. Finally, in 2016, a doctor in Singapore put me on the right track.

I was finally diagnosed with CAD in 2018 and learned that some symptoms of the blood disorder overlap with those of malaria. Both can cause anemia and affect a person’s energy, thinking processes, and organs.

An unexpected ally in mosquitoes

I have reason to thank the malaria-carrying mosquitos, though. It was through the bite of the world’s deadliest creature that I knew I needed to check my blood carefully. Malaria tests didn’t give me the answers, but they did point me in the right direction.

Several years ago, I sat down with my family and friends to eat a spaghetti dinner. When I raised my head after requesting the Lord’s blessing, I saw a mosquito had become stuck in the sauce and cheese over my noodles. I sat in silence for a moment, contemplating whether to throw the food out or simply eat around the beast.

My friend encouraged, “Go ahead and eat. After all, it doesn’t hesitate to bite you.”

I didn’t even notice it when it entered my mouth. Revenge is a meal with no taste at all.

Note: Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cold Agglutinin Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cold agglutinin disease.

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About the Author

Mary Lott is a southern girl from Auburn, AL, living in Sentani, Papua, Indonesia, where she and her husband have worked for almost 30 years. She has taught sixth grade to missionary kids. Now, she designs websites, gardens, SCUBA dives as often as possible, and uses a motorcycle as her primary mode of transport. Their three kids have grown, but this gap is filled by two Papuan boys from one of the island’s interior villages. Mary is a surrogate “mom” while the boys attend a private school in town. Since her diagnosis at age 63, Mary juggles life and living at her home, “Ivy Manor East.”