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Contents
MEDICAL DEPARTMENT UNITED STATES ARMY IN WORLD WAR II
MEDICAL DEPARTMENT, UNITED STATES ARMY
PREVENTIVE MEDICINE
IN WORLD WAR II
Volume VI
COMMUNICABLE DISEASES
Malaria
Prepared and published under the direction
of
Lieutenant General LEONARD D. HEATON
The Surgeon General, United States Army
Editor in Chief
Colonel JOHN BOYD COATES, Jr., MC, USA
Editor for Preventive Medicine
EBBE CURTIS HOFF, Ph. D., M.D.
Assistant Editor
PHEBE M. HOFF, M.A.
OFFICE OF THE SURGEON GENERAL
DEPARTMENT OF THE ARMY
WASHINGTON, D.C., 1963
PREVENTIVE MEDICINE IN WORLD WAR II
Advisory Editorial Board
Brigadier General JAMES STEVENS SIMMONS,
USA (Deceased), Chairman, 1948-54
Brigadier General STANHOPE BAYNE-JONES,
USA (Ret.), Chairman
JOHN E. GORDON, M.D.
WILLIAM A. HARDENBEEGH, B.E.
ANTHONY J. LANZA, M.D.
ELLIOTT S. A. ROBINSON, M.D. (Deceased)
PAUL F. RUSSELL, M.D.
THOMAS B. TURNER, M.D.
DOUGLASS W. WALKER, M.D.
COLONEL TOM F. WHAYNE, MC, USA (Ret.)
COLONEL ADAM J. RAPALSKI, MC, USA (Ex
officio)
EBBE CURTIS HOFF, Ph. D., M.D., Editorial
Director (ex officio)
Colonel JOHN BOYD COATES, Jr., MC, USA
(ex officio)
The Historical Unit, United States Army Medical Service
Colonel JOHN BOYD COATES, Jr., MC, USA
, Director
Colonel REX P. CLAYTON, MSC, USA,
Executive Officer
Colonel R. L. PARKER, MSC, USA, Special
Assistant to Director
Lieutenant Colonel R. J. BERNUCCI, MC,
USA, Special Assistant to Director
Major WARREN W. DABOLL, MSC, USA,
Special Assistant to Director
Lieutenant Colonel DOUGLAS HESFORD,
MSC, USA, Chief, Special Projects Branch
CHARLES M. WILTSE, Ph. D., Litt. D.,
Chief, Historians Branch
ERNEST ELLIOTT, Jr., Chief, Editorial
Branch
Lieutenant Colonel LEONARD L. COLLIER,
MSC, USA, Chief, Information Activities Branch
Major ALBERT C. RIGGS, Jr., MSC, USA,
Chief, General Reference and Research Branch
HAZEL G. HINE, Chief, Administrative
Branch
Library of Congress Catalog Number:
55-63522
Volume VI
COMMUNICABLE DISEASES
Malaria
MEDICAL DEPARTMENT, UNITED STATES ARMY
The volumes comprising
the official history of the Medical Department of the United States Army
in World War III are prepared by The Historical Unit, United States Army Medical
Service, and published under the direction of The Surgeon General, United
States Army. These volumes are divided into two series: (1) The administrative
or operational series; and (2) the professional, or clinical and technical,
series. This is one of the volumes of the latter series.
VOLUMES PUBLISHED
ADMINISTRATIVE SERIES
Hospitalization and Evacuation, Zone
of Interior
CLINICAL SERIES
Internal Medicine in World War II:
Vol. I. Activities
of Medical Consultants
Vol. II. Infectious
Diseases
Preventive Medicine in World War II:
Vol. II. Environmental
Hygiene
Vol. III. Personal
Health Measures and Immunization
Vol. IV. Communicable
Diseases Transmitted Chiefly Through Respiratory and Alimentary Tracts
Vol. V. Communicable
Diseases Transmitted Through Contact or By Unknown Means
Surgery in World War II:
Activities of
Surgical Consultants, vol.1
General Surgery,
vol. II
Hand Surgery
Neurosurgery,
vol. 1
Neurosurgery,
vol. II
Ophthalmology
and Otolaryngology
Orthopedic Surgery
in the European Theater of Operations
Orthopedic Surgery
in the Mediterranean Theater of Operations
The Physiologic
Effects of Wounds
Vascular Surgery
Miscellaneous:
Cold Injury, Ground
Type
Dental Service
in World War II
Veterinary Service
in World War II
Wound Ballistics
Chapter
I
Introduction (Paul F. Russell, M.D., MPH., Sc. D.)
Malaria in Past Wars
Basic Malaria Epidemiology
Malaria Lessons From World War II
Advances in Malariology in World War II
II
War Department Provisions for Malaria Control (Oliver R. McCoy, M.D
.)
Organization in the Office of The Surgeon General
Organization for Malaria Control
Drugs for Suppressive Treatment of Malaria
Supplies and Equipment for Insect Control
Educational Activities
Precautions Against the Introduction of Tropical Diseases into the United
States
Summary
III
Experience in the United States (Justin M. Andrews, Sc. D., and Jean S.
Grant )
Military Mobilization in Potentially Malarious Areas of the United States
Malaria Incidence in the United States Before World War II
Civilian Reservoir of Infection
Mosquito Vectors
Development of Military Malaria Control Plan and Policy
Malaria Control Activities Within Military Areas
Malaria Control Activities Around Military Areas
Conclusions end Recommendations
IV The South
Atlantic and Caribbean Areas (Luther S. West, Ph. D.)
Part I. General Considerations
Incidence
Antimalaria Organization
Control Activities
Military Development
Area Characteristics
Part II. Experience in South Atlantic Command
Extent of Command
Prevalence of Malaria on Brazilian Coast
Summary of Administrative History (Medical)
Organization
Activities at Various Bases
Extramilitary Relations
Part III. Experience in the Caribbean Defense Command
Organization
Panama Canal Department
Antilles Department
Problems of 11.5. Army Air Forces in the Caribbean Defense Command
Cooperating Organizations (Nonmilitary)
Miscellaneous Matters
V
North Africa, Italy, and the Islands of the Mediterranean (Justin M. Andrews,
Sc. D. )
Military Development
Area Characteristics
Malaria Experience
Antimalaria Policy and Organization
Antimalaria Activities
Conclusions and Suggestions for the Future
VI
Africa-Middle East Theater (John W. H. Rehn, Ph. D.)
Military Development
Area Characteristics
Local Population
Malaria Endemicity and Potentialities
Vectors
Malaria Experience
Antimalaria Organization
Survey Activities
Antimosquito Measures
Personal Preventive Measures and Malaria Discipline
Suppressive Medication
VII
China-Burma-India Theater (John W. H. Rehn, Ph. D .)
Military History
Area Characteristics
Local Population and Malaria Endemicity
Malaria Vectors
Malaria Experience
Antimalaria Organization
Antimalaria Activities
Summary
VIII New Hebrides, Solomon Islands,
Saint Matthias Group, and Ryuhyu Islands (Paul A. Harper, M.D., Wilbur
C. Downs, M.D., Paul W. Omen, Ph. D., and Normon D. Levine, Ph. D.
)
Part I. New Hebrides, Solomon Islands, and Saint
Matthias Group
General Considerations
Military Development
Area Characteristics as They Pertain to Malaria and Its Control
Malaria Experience
Antimalaria Policy and Organization
Antimalaria Activities
Other Activities of the Antimalaria Organization
Part II. Okinawa and Other Islands of Ryukyus
General Considerations
Military Development
Area Characteristics
Malaria Experience
Antimalaria Policy and Organization
Antimalaria Activities
Other Activities of the Antimalaria Organization
IX
Malaria and the Defense of Bataan (Maj. Gen. James O. Gillespie, MC, USA
(Ret.))
Epidemiology of Malaria
Pre-Worid War II Malaria Control Measures
Medical War Planning
Military Operations
The Malaria Problem
Impact on Defense Forces
Impact on Civilian Refugees
Impact on the Japanese Forces
Impact on the Filipino-American Prisoners of War
Comment
X
The Southwest Pacific Area. (Thomas A. Hart, Ph. D., and Col. William
A.Hardenbergh, MSC, USAR (Ret.))
Area Characteristics
Medically Important Mosquitoes of the Southwest Pacific
Establishing a Control Organization
Important Factors in Developing the Control Program
Malaria Control Activities
Malaria Control Measures
Sixth U.S. Army Training Center
Malaria Research Group
Personnel Training
Combat Experiences and Lessons
Case Study of Malaria Incidence
Case Reporting
Reduction in Hospitalization
Japanese Malaria Experience
Other Activities of the Malaria Control Organization
Survey and Control Units
Final Results
A
Standard Operating Procedure for Control of Malaria and Other Insect-borne
Diseases During a Combat Operation
B
Directive on Malaria Control
Figure
1 Army School of Malariology, Fort Clayton, C.
Z
.
2 Parasitology classroom, Army School of Malariology,
Fort Clayton C. Z
.
3 Class in field exercises in anopheline breeding
area, Chagres River
4 Malaria control unit receiving instructions in
drainage procedures
5 Field laboratory established by malaria survey
unit during training exercises
6 Aerosol insecticide dispensers
7 Mixing DDT in the field
8 Preparation of DDT oil solution for use as a
mosquito larvicide
9 B-25 airplane spraying DDT oil solution over
jungle area in Panama
10 Cover and opening page of booklet explaining
the facts about malaria
11 Antimalaria poster
12 Antimalaria poster
13 Anopheles quadrimaculatus, the vector of malaria
in the eastern and southern regions of the continental United States
14 Anopheles freeborni, the vector of malaria west
of the Rocky Mountains in the continental United States
15 Area of Army installation before and after mosquito
control drainage
16 Knapsack-type sprayer developed by the Corps
of Engineers for applying insecticides for mosquito control
17 Portable power sprayer, gasoline engine driven,
skid mounted, for application of insecticides for mosquito control
18 Stearman biplane applying DDT to control anopheles
over Stuttgart, Ark., Army Air Base
19 Hand-spraying residual DDT in Army barracks
20 Airplane application of larvicide over a waterchestnut
infested area of the Potomac River
21 Application of DDT residual spray in the interior
of a rural home
22 Aedes aegypti, the vector of yellow fever and
dengue along the coastal areas of the continental United States from Virginia
to Texas
23 Anopheles albimanus breeding along the edges
of a quiescent stream
24 Bromeliad attached to tree, a typical breeding
place for Anopheles bellator Dyar and Knab
25 Horizontal section through a bromeliad to show
water-holding area among leaf bases
26 Parasitology class, Army School of Malariology
27 Gypsy moth sprayer in use against bromeliads
28 Dawn trap used in mosquito survey at Fort Read,
Trinidad, B.W.I
.
29 Adult female of Anopheles maculipennis Meigen
30 Enemy demolished pumping station near Licola,
northwest of Naples
31 Flooded area near Licola
32 Allied Force Malaria Control School at Anzio-Nettuno
beachhead
33 Group at Anzio-Nettuno beachhead receiving field
instructions in malaria control
34 Power oil sprayer used to apply petroleum products
35 A-20 airplane dusting paris green over flooded
areas northwest of Naples
36 A-20 dusting planes flying in formation
37 Paris green mixing plant near Naples
38 Filling 55-gallon drums with freshly mixed 5
percent DDT in kerosene
39 A-20 airplane discharging DDT in oil over a
small canal near Pisa
40 PT-17 (Stearman) spraying a canal in Italy with
DDT in oil
41 DDT residual spraying with power spray
42
Improvised paris green duster
43 Dusting with paris green
44 Type of barracks housing U.S. troops at Acera
Airport
45 Tank with aquatic vegetation, vicinity of Calcutta,
Bengal, showing Anopheles philippinensis
breeding area
46 DDT air spraying at Myitkyina, Burma
47 DDT residual spraying in native quarters, using
spray gun with power spray, vicinity of Ledo, Assam
48 DDT residual spraying in native quarters, using
back pack spray with extension nozzle, vicinity of Ledo, Assam
49 DDT residual spraying in native quarters, using
hand spray, vicinity of Ledo, Assam
50 DDT residual spraying in latrine, using continuous
hand spray
51 Mosquitoproofed tents, vicinity of Ledo,
Assam
52 Mosquitoproofing basha-type building, vicinity
of Ledo, Assam
53 Principal vectors of malaria in the South Pacific
Area
54 Recording results of microscopic examinations
of blood smears
55 Anopheles sinensis
56 Open stream with grassy margins, in slight shade,
a typical breeding place for Anopheles farauti
, 17th Malaria Survey Unit, New Guinea
57 Refilling knapsack sprayers with oil, 8th Malaria
Control Unit, New Guinea
58 Malaria control ditching and clearing crews
furnished by the Australia New Guinea Administrative Unit to 12th Malaria
Control Unit, New Guinea
59 Digging drainage ditch, 8th Malaria Control
Unit, New Guinea
60 Completed drainage ditch, 8th Malaria Control
Unit, New Guinea
61 Cartoon, "Dont Be A Dunce"
62 Cartoon, "Patch That Net Hole Today"
63 Cartoon, "Watch Out for This Chow Hound"
Number
1 Projected status of malaria control organization
for the oversea theaters, 13 February 1943
2 Status of malaria control organization in oversea
theaters, 15 July 1943
3 Status of malaria units in oversee theaters,
15 February 1944
4 Status of malaria control organization in oversea
theaters, 30 September 1944
5 Status of malaria control organization in oversee
theaters, 1 April 1945
6 Summary of continental mosquito control operations
on military property, fiscal years 1941-45
7 Summary of continental (and Puerto Rico) mosquito
control operations near areas of military importance, fiscal years 1942-46
8 Summary of entomological surveys on the extended
(residual spray) program, 1945-46
9 Admissions and attack rates of malaria acquired
by U.S. Army personnel in continental United States, by month and year,
1917-21 and 1941-45
10 Malaria as a reported cause of death in Central and
South American Republics and neighboring States, with selected examples
11 Number of cases and attack rates of malaria in the
U.S. Army, worldwide and Latin America, by type of Plasmodium and year, 1942-45
11 Continued
12 Incidence of malaria in the U.S. Army, by area
and year, 1940-41
13 Deaths due to malaria in U.S. Army, by area and
year, 1940-41
14 Deaths due to malaria in the U.S. Army, worldwide
and Latin America, by type of Plasmodium and year 1942-45
15 Admissions and deaths from fever of undetermined
origin in the total U.S. Army and in the Latin American area, by year, 1942-45
16 Distribution of major mosquito vectors by zoogeographic
subdivisions in the neotropical region
17 Total cases of malaria in U.S. Army Forces, South
Atlantic, by months, January 1943-August 1945
18 Malaria in U.S. Army Forces, South Atlantic,
1943-45
19 Average temperatures, relative humidity, and
precipitation in the Canal Zone, 1943-45
20 Malaria rates for primary and recurrent cases
among U.S. Army personnel, Panama Canal Department, 1939-41
21 Malaria rates for primary and recurrent cases
among U.S. Army personnel, Panama Canal Department, by month 1941
22 Malaria rates for primary cases only, in U.S.
Army personnel, in permanent (sanitated posts) and outposts (unsanitated)
areas, Panama Canal Department, January-November 1942
23 Malaria rates of primary and recurrent cases
among U.S. Army personnel, Panama Canal Department, by month, 1943
24 Malaria rates of primary and recurrent cases
among U.S. Army personnel, Panama Canal Department, by month, 1944
25 Malaria rates of primary and recurrent cases
among U.S. Army personnel, Panama Canal Department, by month, 1945
26 Attack rates for malaria among U.S. Army personnel,
Panama Canal Department, 1936-45
27 Medical installations, Pan American Highway
28 Malaria data for U.S. Army enlisted personnel
in Puerto Rico, continental troops, and insular troops 1941
29 Admissions for malaria, 161st General Hospital,
San Juan, P.R., 1942-45
30 Incidence of malaria, by months, in the U.S.
Army in the Mediterranean (formerly North African) theater, 1942-45
31 Admission rates, by weeks, hospital and quarters,
for malaria and fever of undetermined origin in the Seventh U.S. Army, by
major command, during the Sicilian Campaign, 16 July-20 August 1943
32 Primary and total malaria attack rates in MTOUSA,
hospital and quarters, by months, per 1,000 per annum, 1944-45
33 Incidence of toxic reactions from Atabrine at
the 59th Evacuation Hospital, 1943
34 Results of winter DDT spraying in an endemic
area, 1945
35 Average rainfall in inches at selected localities,
for various time periods
36 Average temperature in degrees Fahrenheit at
selected localities
37 Malaria parasite index, Liberia, 1931
38 Malaria parasite index, Liberia, 1942
39 Attack rates for malaria and fever of undetermined
origin, among U.S. Army personnel, Africa-Middle East area, 1942-45
40 Attack rates for malaria and fever of undetermined
origin, among U.S. Army personnel in Africa, 1942-43
41 Attack rates for malaria and fever of undetermined
origin, among U.S. Army personnel in Middle East, 1942-43
42 Attack rates for malaria among U.S. Army troops,
French West Africa, January 1944-December 1944
43 Attack rates for malaria among U.S. Army troops,
in the Gold Coast and Nigeria, British West Africa, January 1943-December
1944
44 Attack rates for malaria and fever of undetermined
origin, among U.S. Army personnel, Africa-Middle East area, January 1944-December
1945
45 Attack rates for malaria and fever of undetermined
origin, among U.S. Army personnel, Persian Gulf Command, January 1944-December
1945
46 Attack rates for malaria among U.S. Army personnel,
Liberia, 1942-45
47 Average precipitation (in inches) at selected
localities in China, Burma, and India for various time periods
48 Average temperatures in degrees Fahrenheit, in
selected localities, in China, Burma, and India
49 Distribution of some of the important anopheline
vectors of malaria in selected portions of India
50 Distribution of important anopheline vectors
of malaria in selected portions of Burma
51 Distribution of important anopheline vectors
of malaria in selected provinces of South China
52 Attack rates for malaria and for fever of undetermined
origin, China-Burma-India theater, 1942-45
53 Attack rates for malaria and fever of undetermined
origin, India-Burma theater and China theater, 1944-45
54 Attack rates for malaria, Base Section, India-Burma
theater, 1944-45
55 Attack rates for malaria, Intermediate Section,
India-Burma theater, 1944-45
56 Attack rates for malaria, Advance Section, India-Burma
theater, 1943-45
57 Attack rates for malaria along the Stilwell Road,
1943
58 Epidemic malaria in Karachi, India, July through
December 1944
59 Prevalence of malaria parasitemia on South Pacific
islands
60 Plasmodium species in South Pacific surveys
61 Admission rates for malaria in combined Army,
Navy, Marine, and Allied troops in selected areas of the South Pacific, by
month and year, April-December 1942
62 Admission rates for malaria in combined Army,
Navy, Marine, and Allied troops in selected areas of the South Pacific, by
month and year, January-December 1943
63 Admission rates for malaria in combined Army,
Navy, Marine, and Allied troops in selected areas of the South Pacific, by
month and year, January-December 1944
64 Admission rates for malaria in combined Army,
Navy, Marine and Allied troops in selected areas of the South Pacific, by
month and year, January-June 1945
65 Malaria and insect control personnel, South Pacific
Area, 15 May 1944
66 Personnel available for work of malaria control
units, South Pacific Area
67 Estimated percent of quarters screened, South
Pacific Area, June 1944
68 Strength of Tenth U.S. Army and marine and naval
forces, in the Ryukyus Campaign, 30 April-30 June 1945
69 Air temperatures, Naha, Okinawa, 30-year observation
period
70 Rainfall (measurement in inches) and rainy days,
Naha, Okinawa
71 Results of blood examinations of natives during
malaria outbreak in northern Okinawa, August-September 1945
72 Airplane spraying activities, Okinawa, May-July
1945
73 Splenic indices in natives of Netherlands New
Guinea
73 Continued
74 Distribution of anopheline species of the Australasian
Region
74 Continued
75 Comparison of gametocyte rate and malaria rate
in selected troops. 1944
76 Mosquito dissections (Anopheles punctulatus)
77 Malaria attack rates in the 126th and 128th Infantry
Regiments, January-July 1944
78 Number of cases of malaria in the 41st Infantry
Division, June-August 1944
79 Number of cases and attack rates of malaria among
U.S. Army personnel in the Southwest Pacific Area, by type of Plasmodium
and year, 1942-45
80 Deaths due to malaria among U.S. Army personnel
admitted in the Southwest Pacific Area, by type of Plasmodium and year of
death, 1942-45
1 Admission rates for malaria, U.S. Army, continental
United States, World War I and World War II
2 Admission rates for malaria, U.S. Army, by year,
1941-45
3 Morbidity and mortality rates for malaria in
all States reporting cases and deaths, 1926 to 1940 inclusive
4 Malaria Control in War Areas, lines of authority
and interrelations
5 Headquarters organization of the Office of Malaria
Control in War Areas
6 Trend of dengue cases compared with rainfall
and the Aedes breeding index during the dengue epidemic in Honolulu, T.H.,
1943-44
7 Table of organization, Headquarters, Medical
Section, U.S. Army Forces, South Atlantic
8 Special malaria control organization, North African
theater, 15 August 1944
9 Attack rates for malaria among U.S. Army personnel,
Africa-Middle East area, 1942-4
5
10 Attack rates for malaria among U.S. Army personnel
in Africa and the Middle East, June 1942-August 1943
11 Attack rates for malaria among U.S. Army personnel
in the Africa-Middle East area (excluding Persian Gulf Command) and in the
Persian Gulf Command, 1944-45
12 Attack rates for malaria among U.S. Army personnel
in Liberia, 1942-45
13 Attack rates for malaria, China-Burma-India theater,
1942-45
14 Attack rates for malaria, China theater, 1944-45
15 Attack rates for malaria, Base Section, India-Burma
theater, 1944-45
16 Attack rates for malaria, Intermediate Section,
India-Burma theater, 1944-45
17 Attack rates for malaria, Advance Section, India-Burma
theater, 1943-45
18 Malaria control organization, Headquarters, China-Burma-India
theater, 1943
19 Malaria control organization, India-Burma theater,
after October 1944
20 Incidence of malaria in the Americal Division,
January 1943 to May 1944, inclusive
21 Incidence of malaria in the 147th Infantry,
December 1942 to October 1944, inclusive
21 Continued
22 Incidence of malaria in the 25th Infantry Division,
January 1943 to October 1944, inclusive
23 Malaria and Insect Control Organization, South
Pacific Area, 1 June 1944
24 Island organization and command channels, Joint
Army-Navy malaria and insect control
25 Guadalcanal Malaria and Insect Control Organization
26 Japanese and U.S. admission rates during February
1943
Number
1 Areas of the continental United States believed
to be malarious in 1882
2 Areas of the continental United States believed
to be malarious in 1912
3 Areas of the continental United States believed
to be malarious in 1932
4 Areas of the continental United States believed
to be malarious in 1934-35
5 Geographic distribution of three species of anophelines
associated with malaria transmission in the continental United States
6 Location of Army installations in the continental
United States, where mosquito control was carried out in 1941
7 Location of Army installations in the continental
United States, where mosquito control was carried out in 1945
8 Geographic distribution and types of projects
being carried on by Malaria Control in War Areas, 1 July 1943
9 Geographic distribution and types of Malaria
Control in War Areas control operations in 1945-46
10
Caribbean area and South Atlantic theater
11
North African Theater of Operations, 1944
12
Principal cities of NATOUSA (MTOUSA), 1944
13
Distribution of malaria in Italy, Sicily, and Sardinia, 1944, and in Corsica,
1925
14
U.S. Army Forces in the Middle East, jurisdictional map, 1942
15
U.S. Army Forces in the Middle East, jurisdictional map, 1943
16
U.S. Army Forces in the Middle East, jurisdictional map, 1944
17
Air Communications, U.S. Army Forces, Africa and the Middle East, 1941-45
18
Regional map of Africa
19
Southeast Asia, showing India-Burma theater with major administrative divisions
and China theater in 1945
20
Southeast Asia, showing geographic divisions in portions of India and Burma
occupied by U.S. troops
21
Malaria in India
22
Malaria in Burma
23
Pacific Ocean Area
24
Malarious islands of the South Pacific Area
25
Espiritu Santo, New Hebrides
26
Guadalcanal, Solomon Islands
27
Bougainville Island
28
Okinawa Islands, showing localization of malaria outbreak of 1945
29
Situation on Bataan, 8 January 1942, approximate U.S. battle positions
30
New Guinea
31
Distribution of the Anopheles punctulatus series
32
Admiralty Islands