Nature Bulletin No, 275-A    September 23, 1967
Forest Preserve District of Cook County
Richard B. Ogilvie, President
Roland F. Eisenbeis, Supt. of Conservation

****:MALARIA

Here in the Middle West, until World War II when about a million 
service men were treated for it in other parts of the world, we had 
almost forgotten about malaria, or ague. In early days, people in many 
localities considered themselves fortunate if everyone in the family did 
not suffer "chills and fever" at the same time. Then, for weeks or 
months during late summer and autumn of each year, these attacks 
repeated every second day or, in some cases, every third day, They 
were so regular that many a pioneer knew the exact hour to finish the 
morning's work and sit down to await the first chill or "lague fit".

The typical attack, lasting 6 to 12 hours, begins with yawning and 
stretching. Chilliness increases until the whole body shivers, the teeth 
chatter, the fingers become dead-white and the nails blue. This is 
followed by a dry fever, with the skin burning hot and flushed after 
which the victim is drenched with sweat and is finally left weak and 
exhausted. Next day the patient feels fairly well but his health is 
gradually undermined by repeated attacks.

Malaria has a higher world-wide sickness rate and death rate than any 
other human disease. It is especially prevalent in the tropics and other 
warm parts of the world where it is also called intermittent fever, jungle 
fever, blackwater fever, marsh fever and hill fever. The malaria germ is 
a microscopic one-celled animal parasite which attacks the red blood 
cells of man and destroys them, causing the victim to become weak and 
sallow. There are three main types, differing in the length of time 
required for their development in the blood cells, the number of days 
between attacks, the time of day when the attacks begin, and their 
severity. The commonest form in the Middle West is called "tertian" 
and causes attacks which start about noon on alternate days. "Quartan" 
malaria produces attacks every 72 hours, starting about sundown.

Malaria is spread from person to person entirely by mosquitoes and, 
furthermore, only by the bites of the females of certain common kinds 
of mosquitoes, known as Anopheles. The germ, which the mosquito 
acquires when she bites an infected person, must spend from one to two 
weeks in her body to complete an essential part of its life cycle. After 
that, when she bites another person, these parasites are injected into the 
blood stream where each enters a red cell, multiplies until the cell is 
destroyed, and the numerous young are set free to attack other blood 
cells. These swarms of young break out in waves at regular intervals, 
producing the periodic chills and fevers characteristic of malaria. This 
is the only time when drugs have any effect.

The bark of the cinchona tree, also called Peruvian bark or Jesuit's bark, 
was brought to Europe from Peru in the 1600's and used to combat 
fevers, but it was not until 1820 that two Frenchmen made pure quinine 
from it. Soon, factories in Philadelphia and Cincinnati began making it 
and Dr. Henry Perrine of Ripley, Illinois, published the first American 
article advocating its use during the feverish stages of malaria. Medical 
men violently opposed it, but, in 1832, Dr. John Sappington of Arrow 
Rock, Missouri, began to advertise and sell his "Anti-Fever Pills" of 
quinine and gradually it became the accepted remedy. Until that time, 
malaria epidemics halted normal life in whole communities. Now, we 
have synthetic quinine, atabrine and other substitutes, Now, only a few 
cases are reported from Illinois each year and none from the Chicago 
region.

When you shiver and shake, then sweat and ache -- that's "ager".