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An Eighth Year's Observations on Malaria in Panama

As mentioned in our seventh report "the time should not be far distant when another epidemic outbreak is to be expected." However, another year has passed since these words were written, and the curve has continued to descend. Therefore the methods used during the past year were practically the same as those in force during the past three seasons, and it is proposed to continue them during the next year of observation. However, we have had to abandon one group of people formerly used as a control, for the reasons cited in this report. The two groups used during the past year were treated with atabrine and plasmochin, and with quinine and plasmochin. The results, as shown in percentages of infection, did not favor either combination. More adequate supervision of the atabrine-plasmochin group undoubtedly accounts for the somewhat better results of treatment obtained.

As in past years, no correlation with rainfall is shown in our monthly parasite rates. The blood-parasite rate, cumulative for the 12 months, shows that slightly fewer individuals examined at every monthly survey had parasites in their blood during the past year (36.8 per cent) than in a similar group in 1936–1937 (43.5 per cent) (see table 3).

The parasite rates during the past year are the lowest so far recorded. These low rates are believed to be caused by a combination of the normal decline in rates, and treatment of all positives.

The incidence of the various species of parasites found in the positives was nearly the same as in previous years, with P. falciparum constituting nearly 75 per cent of all types found.

Transmission, as might be expected, was not active during the past year, as is shown by the fact that only 1 infant under a year of age was found infected, of a total of 53 infants examined. No toxic results have followed the use of atabrine during the year or in any previous year of our work.

Under our present conditions, the method of control we have adopted has been successful in reducing to the vanishing point clinical illness from malaria. However, we have not been successful in completely eradicating the disease, and it is extremely doubtful whether under our conditions such a result will be possible. The ever-present mosquito, the newly-arrived carrier, the year-long transmission season, all conspire to prevent complete success, but undoubtedly much has been accomplished in reducing the ravages of the disease, and doubtless our methods would have wide applicability under similar conditions.