Biology Reference
In-Depth Information
completely undermined by insurance companies' definition of insurable
disease excluding tuberculosis and venereal diseases, which gave family
members and physicians a powerful financial incentive to certify deaths due
to other infections as being caused by malaria (
Faust et al., 1947
). Malaria
was actually being largely extinguished by economic development, which
moved families out of marginal housing in river valleys to more urban
areas into houses with window screening. This epidemiological shift was
not appreciated until the Malaria Control in War Areas (direct forerunner
of the US Centers for Disease Control) was established in Atlanta to deal
with the expected malaria epidemics that would be caused by putting large
military training camps in the southern USA during the Second World War
(
Williams, 1963
;
Lisansky, 1958
;
Andrews et al., 1950
). By eliminating the
use of death certificates noting malaria and clinical diagnoses of malaria
through the use of blood smear microscopy, actual malaria endemicity was
found to be much less than predicted. An IRS program over 5 years follow-
ing the end of the Second World War largely completed malaria eradication
in the USA (
Andrews et al., 1950
).
Of particular concern in the USA was the possibility that soldiers
returning either from Italy or the Southwest Pacific would reinfect
mosquitoes from vivax malaria relapses (
Garrison et al., 1952
;
Archam-
beault, 1954
). This did not happen in spite of primaquine being still
under development and, thus, unavailable in 1945, resulting in the large
numbers of ex-soldiers with relapsing vivax malaria in the USA. This
potential problem was repeated during the Korean War when >10,000
vivax malaria infections were documented in USA soldiers returning
from Korea to the USA. Still relatively few autochthonous infections
were seen. The most likely explanation for this lack of transmission from
returning soldiers is that improved housing left relatively few ex-soldiers
exposed to night mosquitoes in formerly endemic areas. A compulsory
program of chloroquine/primaquine given during the return sea voy-
age from Korea to the West Coast of the USA killed most hypnozoites,
stopped the epidemic of Korean malaria relapsing in the USA and elimi-
nated the risk of reintroduction of vivax malaria (
Coatney et al., 1953
;
Archambeault, 1954
).
6.3. Former Soviet Union Post Afghan War
Failure of established malaria control programs often occurs during the pop-
ulation movements and social disruptions associated with war.Vivax malaria
was almost entirely eliminated from the southern republics of the Soviet
