• 1.

    Baker B , 1963. The suppression of malaria. Coates J , ed. Internal Medicine in World War II. Washington, DC: Office of the Surgeon General U.S. Army, 466470.

    • Search Google Scholar
    • Export Citation
  • 2.

    Long P , 1963. The treatment of malaria. Coates J , ed. Internal Medicine in World War II. Washington, DC: Office of the Surgeon General U.S. Army, 493524.

    • Search Google Scholar
    • Export Citation
  • 3.

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

  • 4.

    Wells TN , Burrows JN , Baird JK , 2010. Targeting the hypnozoite reservoir of Plasmodium vivax: the hidden obstacle to malaria elimination. Trends Parasitol 26: 145151.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Borden W , 1933. A study of malarial relapses in the United States Army. Am J Hyg 17: 136.

  • 6.

    Boyd MF , Kitchen S , 1944. Renewed clinical activity in naturally induced vivax malaria. Am J Trop Med 1: 221234.

  • 7.

    Fairley NH , 1946. Malaria in the south-west Pacific, with special reference to its chemotherapeutic control. Med J Aust 2: 145162.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Sinton J , 1930. A suggested standard treatment of malaria based upon the results of the controlled investigation of over 3,700 cases. Ind Med Gaz 65: 603619.

    • Search Google Scholar
    • Export Citation
  • 9.

    Mowrey F , 1963. Statistics of malaria. Coates J , ed. Internal Medicine in World War II. Washington, DC: Office of the Surgeon General U.S. Army, 449463.

    • Search Google Scholar
    • Export Citation
  • 10.

    Fowler CD , Roberts DM , Dillon ED , 1945. A statistical report of malaria during one year on island “X.” Naval Medical Bulletin 43: 797809.

    • Search Google Scholar
    • Export Citation
  • 11.

    Wilson T , Reid J , 1949. Malaria among prisoners of war in Siam (“F” Force). Trans Royal Soc Trop Med 43: 257272.

  • 12.

    Downs W , 1946. Results in an infantry regiment of several plans of treatment for vivax malaria. Am J Trop Med Hyg 1: 6786.

  • 13.

    Hardgrove M , Applebaum IL , 1946. Plasmochin toxicity: analysis of 258 cases. Ann Intern Med 25: 103112.

  • 14.

    Coggeshall L , 1945. Certain experiences with malaria during World War II. Rev Inst. Salubridad y Infermedades Trop 6: 229237.

  • 15.

    Gordon H , Lippincott S , Marble A , Ball A , Ellerbrook L , Glass W Jr , 1945. Clinical features of relapsing Plasmodium vivax malaria in soldiers evacuated from the South Pacific area. Arch Intern Med 75: 159167.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Coggeshall L , 1945. Malaria and filariasis in the returning serviceman: the ninth Charles Franklin Craig Lecture. Am J Trop Med Hyg 1: 177184.

    • Search Google Scholar
    • Export Citation
  • 17.

    Hill E , Amatuzio DS , 1949. Southwest Pacific vivax malaria. Clinical features and observations concerning duration of clinical activity. Am J Trop Med 29: 203214.

    • Search Google Scholar
    • Export Citation
  • 18.

    Boyd MF , Kitchen S , 1948. On the homogeneity or heterogeneity of Plasmodium vivax infections acquired in highly endemic regions. Am J Trop Med Hyg 28: 2934.

    • Search Google Scholar
    • Export Citation
  • 19.

    Noe W Jr , Greene C Jr , Cheney G , 1946. The natural course of chronic southwest Pacific malaria. Am J Med Sci 211: 215219.

  • 20.

    Blackburn CRB , 1948. Observations on the development of resistance to vivax malaria. Trans R Soc Trop Med Hyg 42: 117162.

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Plasmodium vivax Relapse Rates in Allied Soldiers during the Second World War: Importance of Hypnozoite Burden

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

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ABSTRACT.

Allied soldiers suffered repeated relapses of Plasmodium vivax malaria during and immediately after the Second World War. This surprised many military medical officers who had underestimated the huge casualties produced by P. vivax malaria. Tropical (Philippines) strains of P. vivax were known to relapse more frequently than those from temperate regions (the United States). Intense exposure to mosquito infection likely increased the absolute number of hypnozoites in soldiers’ livers. Both quinine and quinacrine were used as chemosuppressive agents, but their inconsistent use until at least 1943 promoted intermittent parasitological failures. Fear of hemolytic reactions after a mass casualty event in 1943 engendered fear and avoidance of the only 8-aminoquinoline pamaquine then available to cure relapses. Variable chemosuppression likely prevented acquisition of effective parasitological immunity. Unexpectedly high relapse rates in soldiers were likely an indirect measure of the high hypnozoite burden and suggest how difficult it will be to eliminate P. vivax malaria from endemic areas.

Author Notes

Address correspondence to G. Dennis Shanks, Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, QLD 4051, 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 author and do not necessarily reflect those of the Australian Defence Force or the U.S. Department of Defense.

Author’s address: G. Dennis Shanks, Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia, and University of Queensland, School of Public Health, Brisbane, Australia, E-mail: dennis.shanks@defence.gov.au.

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