History of an Ancient Plague
Malaria is not a disease of modern times. It has plagued people for centuries.
The first descriptions of the disease appear in writings from ancient China. Egyptian papyri contain information on it. Sanskrit writings even attribute the disease to insects. The Greek physician Hippocrates recognized malaria, detailing the symptoms in his writings. The Romans knew it well; they believed that gases emanating from swamps and marshes caused the disease. In fact, the name malaria comes from the Italian words mal, meaning “bad,” and aria, meaning “air.” The Romans were not too far from the truth when they blamed the air in swamps—they just didn’t know enough about disease transmission.
Treatments for malaria date equally far back in history. Galen, a Greek physician in ancient Rome, suggested bloodletting and purging, or vomiting, to treat the fevers of malaria. European physicians pursued these and other useless and even dangerous treatments for hundreds of years.
Quinine, made from the bark of the cinchona tree, has long been used by natives of South America to treat malaria.
Photo courtesy of CDC.
French physician Alphonse Laveran noted live organisms in the blood of malaria patients. This was the first step towards identifying the malaria parasite.
Spanish explorers in South America found the natives there using a medicine derived from the bark of the cinchona tree to treat malaria. This bark produced the antimalarial medicine quinine. To this day quinine remains a very effective drug against the disease.
Starting in 1880, a series of discoveries helped doctors understand the nature of this disease. While stationed in Algeria, French military physician Charles Louis Alphonse Laveran found organisms moving in the blood of malaria patients. He realized that this parasite caused the disease. He named that parasite Oscillaria malariae.
In 1886, Italian doctor Camillo Golgi concluded that there were at least two variants of the disease, with different fever patterns. He also noted that fever occurred whenever new parasites entered the bloodstream.
Although Laveran thought that malaria was caused by one parasite, researchers soon discovered that there were actually four different parasites. Italian researchers Giovanni Batista Grass and Raimondo Filetti differentiated the parasite into two species in 1890, naming them Plasmodium vivax and P. malariae. American researcher William H. Welch found a third species, P. falciparum, in 1897. In 1922, British scientist John William Watson Stephens discovered a fourth parasite, P. ovale.
Photo courtesy of CDC.
Sir Ronald Ross, Mrs. Ross, Mahomed Bux and laboratory assistants at the laboratory in Calcutta where the life history of the malaria parasite in birds was fully worked out in 1898.
In 1897, Ronald Ross, a British doctor in India, noted that the malaria parasites could move from infected people to mosquitoes. He continued his research and in 1898 linked the parasites to the female Anopheles mosquito. He outlined the life cycle of the parasite, which involves important stages in humans and in mosquitoes.
With the cause of malaria understood, efforts to control the disease began in earnest. The building of the Panama Canal proved the possibilities of preventing malaria. Almost all the workers—about 85%—got the disease in the first two years of work (1905-06). William C. Gorgas, a U.S. Army medical corps physician, started an insect-control program. This included draining pools of standing water, cutting brush, oiling the edges of remaining swamps to prevent mosquitoes from breeding, killing off the remaining larvae, providing quinine as a preventive to all workers, putting in window and door screens, and hiring people to collect and kill adult mosquitoes. By 1912, only 10% of workers got sick with malaria, a dramatic decrease.
The United States applied some of these same techniques to southern regions of that country, where malaria still thrived. The programs succeeded, and to this day malaria remains rare in the United States. The U.S. Centers for Disease Control and Prevention (CDC) tracks malaria cases in the United States. Most cases occur in people who recently returned from a trip to a country where the illness is common. Each year in the United States only a few infections cannot be attributed to overseas travel.
Now we know that a parasite causes malaria, and even some ways to prevent people from getting infected. Let’s take a closer look at the disease itself.