THE HISTORY OF MALARIA

Main source of information: The Malaria Capers by Robert S. Desowitz

• Deadly fevers - probably malaria - have been recorded since the beginning of the written word (6000-5500 B.C.) References can be found in the Vedic writings of 1600 B.C. in India and by Hippocrates some 2500 years ago.
• There are no references to malaria in the "medical books" of the Mayans or Aztecs. It is likely that European settlers and slavery brought malaria to the New World and the awaiting anophelines within the last 500 years.
• Quinine, a toxic plant alkaloid made from the bark of the Cinchona tree in South America, was used to treat malaria more than 350 years ago.
• Jesuit missionaries in South America learned of the anti-malarial properties of the bark of the Cinchona tree and had introduced it into Europe by the 1630s and into India by 1657.
• Malaria existed in parts of the United States from colonial times to the 1940s. One of the first military expenditures of the Continental Congress, around 1775, was for $300 to buy quinine to protect General Washington's troops.
• In the summer of 1828 "swamp fever" broke out in the settlement of Bytown (Ottawa) and along the construction route of the Rideau Canal. According to some accounts, the "malaria" was not native to North America but had been introduced by infected British soldiers who had returned from India. Numerous deaths had occurred by the time the epidemic subsided in September when the mosquitoes disappeared.
• During the American Civil War (1861-65), one half of the white troops and 80% of the black soldiers of the Union Army got malaria annually.
• More than an estimated 600,000 cases of malaria occurred in the U.S. in 1914, according to information from the Centers for Disease Control and Prevention in Atlanta, Georgia.
• In 1927, J. Wagner von Jauregg was awarded the Nobel Prize in Medicine for his work in treating syphilis using malaria. Patients were inoculated with a type of malaria to produce fevers that would literally burn up the temperature-sensitive syphilis bacteria. After three or four cycles of the fever, the patient was administered quinine for a relatively rapid parasitological cure for the malaria.

• Malaria therapy for syphilis, using monkey and human parasites, continued until the mid-1950s when it was replaced by antibiotic chemotherapy.
• The Dutch bought Cinchona seeds from British trader, Charles Leger, who brought them from Peru. They established Cinchona plantations in Java (Indonesia) in the mid 1800s and soon had a virtual monopoly on quinine.
• When the Japanese captured Java during the second World War, quinine, except for some old stocks became unavailable. The need for a new synthetic antimalarial became a priority at that time.
• In 1880, the first true sighting of the malaria parasite was made in Algeria by a French Army physician, Charles-Louis-Alphonse Laveran, while viewing blood slides under a microscope. Laveran's discovery was rejected by the medical community and it was not until 1886 that his discovery was accepted by Italian scientists, the leaders in the field at the time.
• In 1882 the mosquito transmission hypothesis - guilt by association - was first made.
• The December 18, 1897 issue of the British Medical Journal reported that Dr. Ronald Ross discovered malaria cysts in the stomach wall of anopheline mosquitoes that fed on a malaria patient.
• By July 1898, malaria transmission through the mosquito was established. At that time, Italian scientist Giovanni Batista Grassi traced the course of the parasite through the mosquito, and proved that human malarias were transmitted by species of Anopheles.
• Experiments in India in 1932, showed that the monkey malaria, Plasmodium knowlesi, which produced no clinical signs of malaria in Indian rhesus monkeys, was fatal to Malayan irus monkeys and produced a 24-hour fever cycle in humans that terminated in self cure.
• Unlike botanical quinine, chloroquine is a synthetically manufactured product that belongs to a class of compounds known as 4-amino quinolines, first developed in 1934 by a German pharmaceutical company.
• The first 4-amino quinoline was called Resochin. A slight modification a few years later produced Sontochin. In 1943, Sontochin was acquired by the Americans when Tunis was liberated from the Germans. Its composition was again changed slightly and it was renamed Chloroquine.

• 1950 saw the launch of a pilot project for the control of malaria by spraying with DDT.
• WHO initiated strategies for the global eradication of malaria in the mid-1950s.
• In the 1960s, chloroquine resistant strains of Plasmodium falciparum had arisen; the result of over usage and probably under dosage. At the time, there was no drug to treat chloroquine-resistant malaria except the ancient antimalarial, quinine.
• By 1966, it had been shown that 10 species of Plasmodium, naturally present in monkeys and apes, were capable of infecting humans. Often an infection in one species that produces no clinical signs of malaria can cause severe illness and death when transferred, through inoculation, to another.
• Quinine has now been completely synthesized. Its synthetic analogue is called mefloquine.
• A "new" antimalarial is a drug called Qinghaosu that is derived from the sweet wormwood (Qinghao) plant (genus Artemisia). It has been used in China for more than two thousand years to treat fevers associated with malaria. The drug has been shown to be effective in the treatment of the most deadly forms of falciparum malaria and has been effective against strains of Plasmodium falciparum that are solidly resistant to chloroquine.
• From 1956 to 1969, the United States, through the U.S. Agency for International Aid, (USAID) gave $790 million to the Global Eradication of Malaria Program. From 1955 to about 1970, USAID gave approximately $1 billion to WHO and various national malaria eradication programs.
• In 1967, WHO realized that the global eradication of malaria was impossible for a variety of reasons and the focus shifted to control of the deadly disease. In 1972, the Global Eradication of Malaria Program was formally declared dead.
• In 1987, Dr. Manuel Elkin Patarroyo, a biochemist from Colombia, developed the first synthetic vaccine against the Plasmodium falciparum parasite. The vaccine is still being developed and has not yet proven to reduce deaths in Africa. In 1992, Dr. Patarroyo donated the vaccine to the World Health Organization.

Desowitz, Robert S. The Malaria Capers (More Tales of Parasites and People, Research and Reality). W.W. Norton & Company, New York, 1991.

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