World War One &Malaria 

At least 1.5 million solders were infected 

With case fatality ranging from 0.24--5.0%

As more countries become engaged in the 

War ,the problem grew in size ,

Leading to major epidemics in Mesopotamia

Italy  Macedonia and Palestine. Trans--

Continental passages of parasite  and human

reservoirs of infection created ideal 

Circumstances for passive evolution.

 Clinical treatment primarily dependent 

On quinine although efficacy was poor as

relapsing P.vivax and recrudescent Plasmodium

falciparum infections were not distinguished

and managed appropriately .

       An unexpected adversary in the first 

World war was malaria .It attacked all 

combatant armies ,with adverse consequences

for vast number of troops ,and devasted large

Civilian populations as a result of the environmental civil and demographic efforts

Of troop dispersions and activities .

The world war malaria describes this

Paradigm.

       By 1914  parts of Europe had made considerable progress in malaria control,

Particularly in Italy and Greece which

was

a major achievement considering that around

1900 the anopheline mosquito cycle was only

Just becoming a accepted ,and the important

Vectors as the development cycle in the red

Cell, were only recently recognized  .

      Soldiers tended to burrow

Underground which is conducive to  

Water --logging and favourable to mosquito

Breeding.

            The lack of knowledge of the hepatic

Stage of development of the P.vivax malaria

which was described  in1948, compounded 

the situation and was instrumental in

recurrently ineffective treatment being

Prescribed ,and evacuations of vast number

Sick troops from combat zones.

             

     

 Malaria epidemics during the first

World war:Occurred in the regions 

of Macedonia ,Palestine ,and Egypt 

and  western Europe , Italy and elsewhere.

           An increased  in vectorial capacity

due to high production of  Anopheline

Mosquitoes was probably critical.

This could have resulted from more

Breading places (or deterioration of larval 

Control ),prolong  mosquito survival or

Increased man--vector contact .

In desert fringe regions rain fall and malaria

transmission are often  connected.

               The movement of infected persons,

as troops migrated from India and Sub  --

Saharan , combined with the immigration

Of non immune European soldiers further

Created ideal conditions for the explosive

Epidemics  which occurred .

Malaria control approaches ;

The greatest experience of preventive 

measures was derived from activities

in Macedonia ,and these were applicable

To all theatres of the war and could be classified

as drug  prophylaxis and treatment , mosquito

deterrents , personal protection ,or mosquito

Destruction .

      Personal prophylaxis with quinine 

Was chaotic with weak understanding of

medicines  in management ,problems in

drug delivery due to night operations ,enemy 

bombs and attacks .

           The British questioned the use of 

quinine for prevention and place more 

emphasis on preventing contact with 

mosquitoes.

           Personal anti --mosquito ointments

were messy and head nets and Gloves were

Very restrictive especially in active combat.

         In the UK during 1916 the total

Issue of  quinine exceeds 25tons or

66million 5-gr doses.

         Quinine prophylaxis was  defined 

BY Ross as treatment of persons who have

not yet shown signs of illness but may possibly

Become infected.

Ref Malaria J 2014 :13 :497

Published on line 2014 Dec

16doi :10.1186/1475-2875-13-497