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Query: UMLS:C0024530 (malaria)
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From an obscure frontier surgeon George Crawford Gorgas became internationally acclaimed as a preventive medicine genius. By his initiative in translating the known scientific facts made possible during the blossoming of bacteriology, he performed service not only in the United States but in Cuba, Central and South America, South Africa, and Eastern Europe. He fought for 10 years successfully against yellow fever, malaria, and other diseases during the construction of the Panama Canal, and continued triumphs against disease in other world situations. This is a rather concise account emphasizing his continued devotion and dedication as a humanitarian. He fashioned the Army Medical Department into an efficient machine as Surgeon General, and following his amazing military career of over 38 years, made further contributions in preventive medicine with the Rockefeller Foundation.
Mil Med 1997 May
PMID:The achievements of William Crawford Gorgas. 915 1

During Operation Assured Response in Liberia and Sierra Leone, between May and July 1996, five confirmed cases of falciparum malaria occurred in U.S. Navy personnel. The threat of malaria in west central Africa was recognized from the outset, and preventive medicine guidance was given to all the units participating in Operation Assured Response. The use of personal protective measures as well as drug chemoprophylaxis (daily doxycycline) was stressed. Among these cases, all patients admitted to either not using personal protective measures or not taking the medication as directed. This report serves to review the individual cases and remind the reader of the need to comply with prophylaxis, daily use of doxycycline, when prescribed.
Mil Med 1997 Dec
PMID:Five cases of Plasmodium falciparum malaria in active duty Navy personnel participating in Operation Assured Response. 943 90

The goal of our study was to determine the epidemiological and clinical features of imported malaria seen at our military hospital in Hawaii. We reviewed the records of malaria cases seen from January 1, 1979, to December 31, 1995, and compared our results with published reviews from civilian hospitals in North America. Seventy-nine patients were diagnosed with malaria by blood smears. All acquired malaria abroad, mostly in southeast Asia. Sixty-seven percent of cases were vivax malaria, 22% were falciparum malaria, and 11% were caused by undetermined species. Common symptoms were fever (100%), alternate day fever (41%), rigors (91%), headache (59%), nausea (41%), fatigue (39%), dark urine (32%), and vomiting (31%). Ninety-one percent had fever during hospitalization, but 39% were afebrile on admission. Splenomegaly was detected in 49% of cases. The white blood cell count was normal in 65%, low in 31%, and elevated in 4% of cases. Other laboratory findings were anemia (58%), thrombocytopenia (74%), and mild hyperbilirubinemia (64%). Military physicians initially considered the diagnosis of malaria in only 54% of patients. The epidemiological features of our patients differ from those described in the civilian hospitals. Most of our patients were nonimmune, U.S.-born, military personnel infected in southeast Asia, whereas patients described in reviews from U.S. civilian hospitals were usually foreign-born civilians who were infected in Africa or India. The clinical features of malaria, and the problems of initial misdiagnosis in our patients, were similar to those reported from civilian hospitals. Military physicians, like their civilian colleagues, need more training and experience in malaria.
Mil Med 1998 Feb
PMID:A review of 79 patients with malaria seen at a military hospital in Hawaii from 1979 to 1995. 950 98

As part of an operational effort to control the transmission of malaria after its reemergence in the Republic of Korea, a number of U.S. military and Korean civilian health workers assessed the situation at a large training site where two cases had been transmitted. The vector mosquitoes (Anopheles sinensis) probably had a limited flight range (< 1 km) in this situation based on low numbers in permanent light traps and biting collections at the billeting area compared with collections from light traps and larval surveys where the mosquito was abundant. The threat of malaria was proven by the presence of infected local Korean residents (13 of 105 sampled). However, only a small proportion of U.S. soldiers (39 of 78 surveyed) at the training site used personal protective measures. Further efforts should include improved techniques for informing and motivating soldiers to use personal protective measures and cooperation with Korean authorities to perform vector control in civilian areas bordering the training area.
Mil Med 1999 Sep
PMID:Evaluation of the malaria threat at the multipurpose range complex, Yongp'yong, Republic of Korea. 1057 82

The control of yellow fever, malaria, and other tropical diseases was essential for the successful completion of the Panama Canal. COL William C. Gorgas, Chief Sanitary Officer, found Ancon Hospital quite satisfactory as a site from which to direct his sanitation efforts. Ancon Hospital played an important role during the period of the excavation of the canal (1904-1914). In 1928, Ancon Hospital was renamed Gorgas Hospital to commemorate this achievement. After more than a century of clinical and research activities in Panama, Ancon Hospital closed its doors in 1997.
Mil Med 1999 Oct
PMID:Ancon Hospital: an American Hospital during the construction of the Panama Canal, 1904-1914. 1054 28

U.S. military forces are frequently deployed with little warning to regions of the world where chloroquine-resistant malaria is endemic. Doxycycline is often used for malaria chemoprophylaxis in these environments. The use of doxycycline can be complicated by esophageal injury. Two cases of esophageal ulceration will be discussed, followed by a review of the literature. Doxycycline causes esophageal injury through a combination of drug-specific factors, the circumstances of drug administration, and individual patient conditions. Patients with dysphagia attributable to esophageal ulceration are managed by intravenous fluid support and control of gastric acid reflux until their symptoms resolve over 5 to 7 days. The risk of esophageal injury can be minimized by use of fresh capsules, drug administration in the upright position well before lying down to sleep, and drinking at least 100 ml of water after swallowing the medication.
Mil Med 2000 Apr
PMID:Doxycycline-induced esophageal ulceration in the U.S. Military service. 1126 18

Poliomyelitis remains a disease of significance to military medicine. The medical branches of the military of many nations have much to contribute in the final 4 years of the campaign to eradicate poliomyelitis from the world. The service requirements of immunization remain a logistic charge on the defense health services of all nations. Risks to unimmunized troops remain current in the poliomyelitis endemic regions of Europe, Asia, and Africa; and recent epidemics in India, West Africa, and Albania have involved military personnel in containment programs. The 20th century has seen global attempts to eradicate seven diseases--hookworm, yellow fever, yaws, malaria, smallpox, dracunculiasis, and poliomyelitis. The first four of these were total failures, in spite of huge military logistic resources, especially in the case of yellow fever and malaria. But the global eradication of smallpox, achieved in 1979, led to the World Health Organization's Declaration of a Smallpox-Free World in 1980. Its success ranks as one of the greatest achievements in the history of medicine. Lessons learned and encouragement derived from that program led to the institution of the Poliomyelitis Global Eradication Program in 1988. Following the Declaration of a Polio-Free America, the target date for the Declaration of a Poliomyelitis-Free World has been set for 2004. Regional surveillance programs use the quality-control portal of acute flaccid paralysis to monitor every potential clinical case of acute poliomyelitis. In the Western Pacific region, a region of 22 countries with a recent history of significant operational deployments, 15 countries had experienced endemic poliomyelitis before 1990. In this region, the last case of poliomyelitis (in Cambodia) was reported in March 1997. Such audit, together with massive point vaccination programs, many using massive military support, conducted since 1997 hold realistic promise that the world may be declared poliomyelitis-free by 2004. Poliomyelitis will be more difficult to eradicate than smallpox; and the current world campaign will succeed only with the logistic and professional input of the military of many nations.
Mil Med 2000 Oct
PMID:Poliomyelitis: the role of the military in the final campaign. 1105 Aug 66

Malaria in the Americas is a reemerging health issue. In 1969, the World Health Organization shifted policy from malaria eradication to malaria control. With this shift, vector control (house spraying with dichlorodiphenyltrichloroethane [DDT]) was deemphasized. Since that time, house spray rates have decreased and malaria rates have increased. Using malaria data collected since 1959 by the Pan American Health Organization, this relationship was examined with an ecological regression model. Malaria control was found to be a function of policy, disease burden, and vector control (R2 = 0.75, p < 0.001). Policy must address both disease burden and vector control. Treatment of disease burden is unquestioned; however, vector control is debated. An argument for the judicious and enlightened resumption of house spraying with DDT is presented.
Mil Med 2000 Dec
PMID:Malaria in the Americas: a model of reemergence. 1114 57

The number of patients presenting with malaria in the United States has increased. This is attributable to the growing ease and popularity of overseas travel. We present a 41-year-old man diagnosed with Plasmodium vivax malaria after a 9-month symptom-free interval following return from an endemic area. The clinical picture was complicated by the results of neurological imaging that proved to be incidental and unrelated findings. Unfortunately, there are no pathognomonic signs or symptoms of malaria. The presenting complaints are often nonspecific and may be associated with a broad differential diagnosis. Thus, physicians must have a high index of suspicion and elicit a complete travel history to arrive at the correct diagnosis.
Mil Med 2002 Dec
PMID:Diagnosis of Plasmodium vivax malaria complicated by abnormal neurological imaging. 1250 81

A questionnaire was completed by 955 Australian Defense Force soldiers from two battalion groups to determine their usage of mosquito repellents and bed nets during peacekeeping duties in East Timor. The survey showed that most soldiers (84%) used repellents, but only 19% used them daily. The soldiers used a number of repellent formulations; however, few soldiers used the Australian Defense Force deet (diethyl methylbenzamide) formulation containing 35% deet in a gel. Most soldiers preferred several commercial formulations, which contained 7 to 80% deet. The occurrence of mosquito-borne disease in soldiers was not affected by repellent usage, as the use of repellents was comparable between infected and noninfected individuals. The overall frequency of bed net usage differed in the two battalion groups. The occurrence of malaria in soldiers from one battalion group who did not sleep under a bed net every night of their deployment was significantly (p = 0.007) higher than those who did.
Mil Med 2003 Mar
PMID:Survey of personal protection measures against mosquitoes among Australian defense force personnel deployed to East Timor. 1268 89


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