bob10
9th December 2015, 07:48 AM
100 years of fighting killer bites
MALARIA and how to deal with it has preoccupied the ADF since World War I.
According to the World Health Organisation, more than half the world's population is at risk of this potentially fatal disease spread by female anopheles mosquitoes, known as vectors.
Malarial cases were reported in the AN&MEF in Rabaul in 1914, at Gallipoli and particularly the Desert Mounted Corps in Palestine where 100 deaths were attributed to the disease.
Malaria was endemic in parts of Australia, particularly Far North Queensland where it was not declared eradicated until 1981.
At the start of the Pacific war, 90 per cent of quinine supplies came from the Dutch East Indies, then under Japanese threat, so the Australian Army established a malarial research unit to discover alternate prophylaxes in Cairns, where malaria remained ?endemic.
Malarial prevention has ?always been a combination of controlling the vector, ?guarding against bites when vectors were most active and a regimen of suppressive medicines in affected areas followed by an eradication regimen on departure.
Atabrine became the suppressant of choice though suspicious Diggers spread rumours it made them impotent as it also coloured their complexions yellow.
Many chose to risk infection rather than the supposed side effects.
The malarial plasmodium parasite lives in the human liver so choosing a suitable prophylaxis has always been a balance between effective prevention while minimising potential liver damage.
The malarial research unit, disbanded in 1946, was again raised in 1967 at Sydney University to counter the disease in Borneo and Vietnam.
The drug of choice then was paludrin, one tablet per day consumed under supervision though typically those in malarial areas including PNG were advised to take two.
A weekly dose of chloroquine later replaced paludrin until its efficacy was reduced by resistant malarial strains.
Malarial areas including barracks and married quarters were subject to regular fogging via two-stroke engines which delivered a mix of carbon monoxide and insecticide at dusk and dawn supposedly as vectors rose and settled.
Malarial incidence decreased but there were ?inevitably other adverse health and environmental implications, particularly from the widespread use of insecticide DDT.
It's fair to say control of anti-malarial drugs and their administration were haphazardly supervised, apart from notations in roll books which were more often used for disciplinary than medical purposes.
As malarial parasites developed resistance to widely used prophylaxes, new drugs and regimes were tried, often on a 'suck it and see? methodology rather than properly supervised trials.
In recent years the drugs of choice have been doxycycline, malarone and mefloquine, the latter distributed under the tradename Larium.
Larium has well documented side effects, including vivid dreams, sleep disturbance, disorientation, depression or anxiety.
It is not recommended for those with a history of ?psychiatric disorders.
Not all these were recognised when it was first recommended for use and it is possible some veterans 'diagnosed with extreme PTSD were instead suffering from untreatable mefloquine -toxicity.
It could explain otherwise inexplicable behaviour and some adverse outcomes including deaths.
MALARIA and how to deal with it has preoccupied the ADF since World War I.
According to the World Health Organisation, more than half the world's population is at risk of this potentially fatal disease spread by female anopheles mosquitoes, known as vectors.
Malarial cases were reported in the AN&MEF in Rabaul in 1914, at Gallipoli and particularly the Desert Mounted Corps in Palestine where 100 deaths were attributed to the disease.
Malaria was endemic in parts of Australia, particularly Far North Queensland where it was not declared eradicated until 1981.
At the start of the Pacific war, 90 per cent of quinine supplies came from the Dutch East Indies, then under Japanese threat, so the Australian Army established a malarial research unit to discover alternate prophylaxes in Cairns, where malaria remained ?endemic.
Malarial prevention has ?always been a combination of controlling the vector, ?guarding against bites when vectors were most active and a regimen of suppressive medicines in affected areas followed by an eradication regimen on departure.
Atabrine became the suppressant of choice though suspicious Diggers spread rumours it made them impotent as it also coloured their complexions yellow.
Many chose to risk infection rather than the supposed side effects.
The malarial plasmodium parasite lives in the human liver so choosing a suitable prophylaxis has always been a balance between effective prevention while minimising potential liver damage.
The malarial research unit, disbanded in 1946, was again raised in 1967 at Sydney University to counter the disease in Borneo and Vietnam.
The drug of choice then was paludrin, one tablet per day consumed under supervision though typically those in malarial areas including PNG were advised to take two.
A weekly dose of chloroquine later replaced paludrin until its efficacy was reduced by resistant malarial strains.
Malarial areas including barracks and married quarters were subject to regular fogging via two-stroke engines which delivered a mix of carbon monoxide and insecticide at dusk and dawn supposedly as vectors rose and settled.
Malarial incidence decreased but there were ?inevitably other adverse health and environmental implications, particularly from the widespread use of insecticide DDT.
It's fair to say control of anti-malarial drugs and their administration were haphazardly supervised, apart from notations in roll books which were more often used for disciplinary than medical purposes.
As malarial parasites developed resistance to widely used prophylaxes, new drugs and regimes were tried, often on a 'suck it and see? methodology rather than properly supervised trials.
In recent years the drugs of choice have been doxycycline, malarone and mefloquine, the latter distributed under the tradename Larium.
Larium has well documented side effects, including vivid dreams, sleep disturbance, disorientation, depression or anxiety.
It is not recommended for those with a history of ?psychiatric disorders.
Not all these were recognised when it was first recommended for use and it is possible some veterans 'diagnosed with extreme PTSD were instead suffering from untreatable mefloquine -toxicity.
It could explain otherwise inexplicable behaviour and some adverse outcomes including deaths.