• 1.

    Kendrick DB , Heaton LD Medical Department United States Army in World War II. Washington, DC: US Government Printing Office.

  • 2.

    US Army , 2016. Hospital Admission Cards Korean War. Washington, DC: US National Archives.

  • 3.

    Zottig VE , Shanks GD , 2021. Historical perspective: the evolution of post-exposure prophylaxis for vivax malaria since the Korean War. MSMR 28: 810.

    • Search Google Scholar
    • Export Citation
  • 4.

    Lepes T , 1965. Induced malaria in Yugoslavia transmitted accidentally by blood transfusion. Bull World Health Organ 33: 856.

  • 5.

    Hossain MS et al.2020. The risk of Plasmodium vivax parasitaemia after P. falciparum malaria: an individual patient data meta-analysis from the WorldWide Antimalarial Resistance Network. PLoS Med 17: e1003393.

    • Search Google Scholar
    • Export Citation
  • 6.

    Sundet M , Heger T , Husum H , 2004. Post‐injury malaria: a risk factor for wound infection and protracted recovery. Trop Med Int Health 9: 238242.

    • Search Google Scholar
    • Export Citation
  • 7.

    Shanks GD , 2015. Historical review: does stress provoke Plasmodium falciparum recrudescence? Trans R Soc Trop Med Hyg 109: 360365.

    • Search Google Scholar
    • Export Citation
  • 8.

    Archambeault CP , 1954. Mass antimalarial therapy in veterans returning from Korea. J Am Med Assoc 154: 14111415.

  • 9.

    Gozzelino R et al.2012. Metabolic adaptation to tissue iron overload confers tolerance to malaria. Cell Host Microbe 12: 693704.

  • 10.

    White NJ , 2011. Determinants of relapse periodicity in Plasmodium vivax malaria. Malar J 10: 136.

  • 11.

    Chughlay MF et al.2020. Liver enzyme elevations in Plasmodium falciparum volunteer infection studies: findings and recommendations. Am J Trop Med Hyg 103: 378.

    • Search Google Scholar
    • Export Citation
  • 12.

    Lacerda MV et al.2019. Single-dose tafenoquine to prevent relapse of Plasmodium vivax malaria. N Engl J Med 380: 215228.

  • 13.

    Myint HY , Berman J , Walker L , Pybus B , Melendez V , Baird JK , Ohrt C , 2011. Improving the therapeutic index of 8-aminoquinolines by the use of drug combinations: review of the literature and proposal for future investigations. Am J Trop Med Hyg 85: 1010.

    • Search Google Scholar
    • Export Citation
  • 14.

    Alving A , Eichelburger L , Arnold J , Edgcomb J , 1949. The Clinical Testing of Antimalarial Drugs at Statesville Penitentiary. Chicago, IL: Rush University.

    • Search Google Scholar
    • Export Citation
  • 15.

    Olliaro PL , Barnwell JW , Barry A , Mendis K , Mueller I , Reeder JC , Shanks GD , Snounou G , Wongsrichanalai C , 2016. Implications of Plasmodium vivax biology for control, elimination, and research. Am J Trop Med Hyg 95 (Suppl 6): 4.

    • Search Google Scholar
    • Export Citation
  • 16.

    Feachem RG et al.2019. Malaria eradication within a generation: ambitious, achievable, and necessary. Lancet 394: 10561112.

Past two years Past Year Past 30 Days
Abstract Views 2885 2885 51
Full Text Views 41 41 5
PDF Downloads 45 45 3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Malaria Relapses Following Parasite-Free Blood Transfusions in the U.S. Army during the Korean War

G. Dennis ShanksAustralian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia;
University of Queensland, School of Public Health, Brisbane, Australia

Search for other papers by G. Dennis Shanks in
Current site
Google Scholar
PubMed
Close
and
Michael WallerUniversity of Queensland, School of Public Health, Brisbane, Australia

Search for other papers by Michael Waller in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Latent Plasmodium vivax parasites in the liver known as hypnozoites activate causing malaria relapses months after the original infection. The putative initiation signal is unknown. Plasmodium falciparum infections appear to trigger P. vivax relapses and initiation of relapse may be triggered by hemolysis or fever. The U.S. Army hospital records from the Korean War (> 500,000 individual records) were used to determine whether there was an association between blood transfusion and vivax malaria relapse. Importantly, blood for transfusion was collected in the United States, so the risk of transmission of malaria parasites was minimal. Blood transfusion (largely for combat trauma) was a risk factor for subsequent vivax malaria (relative risk 2.54, 95% CI 2.15–2.99, P < 0.0001). As expected, blood transfusion was not a risk factor for subsequent dysentery, but transfusion was a risk factor for subsequent hepatitis. Blood transfusion causing an increased heme delivery to the liver and a subsequent redox signal within hepatocytes may partially explain hypnozoite activation leading to relapses of vivax malaria.

Author Notes

Address correspondence to G. Dennis Shanks, Australian Defence Force Malaria and Infectious Diseases Institute, Weary Dunlop Dr., Gallipoli Barracks, Enoggera, 4051 Queensland, Australia. E-mail: dennis.shanks@defence.gov.au

Financial support: G. D. S. is an employee of the Australian Defence Organization and a retired U.S. Army Medical Corps Officer. No specific funding was given for this epidemiological study.

Disclaimer: The opinions expressed are those of the authors and do not necessarily reflect those of the Australian Defense Force or the U.S. Department of Defense.

Authors’ addresses: G. Dennis Shanks, Australian Defence Force Malaria and Infectious Disease Institute, Gallipoli Barracks, Enoggera, Queensland, Australia, and University of Queensland School of Public Health, Brisbane, Queensland, Australia, E-mail: dennis.shanks@defence.gov.au. Michael Waller, University of Queensland, School of Public Health, Herston, Queensland, Australia, E-mail: m.wallter@uq.edu.au.

Save