Malaria remains the greatest obstacle to the success
of military operations* in the tropics. In some highly
malarious combat areas ten men have been rendered
non-effective by malaria for each battle casualty. The
importance of any disease which constitutes such a
serious threat to the success of military operations
cannot be overemphasized. This simplified question-and-answer
article on malaria will be found useful for
the instruction of units in training or en route to
malarious areas or to those units already in such areas.
The article was prepared by the Office of the Surgeon General.
2. THE ARTICLE
a. What is malaria?
Malaria is a disease caused by very small parasites.
These parasites, or germs, feed on red blood cells and
b. When should a man suspect he has malaria?
A man should suspect malaria when he has a chill
followed by fever and sweating. The chills and fever
may come at regular intervals, sometimes every
day, sometimes every second day, and sometimes
every third day, depending on which kind of malaria
parasite is in the blood.
c. Does malaria always behave the same way?
No. The symptoms of malaria vary greatly in different
persons and at different times. The symptoms
of malaria may be anything from a headache to a delirious
fever, or even sudden unconsciousness. In
places where malaria is common, any fever or severe
headache should suggest the possibility of malaria.
d. How can a man be sure whether or not he has malaria?
The only way to be certain that one has malaria is
to have a drop of blood examined by microscope for
parasites. Sometimes an experienced medical officer
can recognize malaria without examining the blood.
e. Is malaria a serious disease?
Yes. Malaria destroys a man's blood and makes him
weak. It may keep him in a hospital for ten days or
longer. It may make him a chronic invalid for a year
or more. It may kill one or two out of every hundred
persons who catch it, if they are not properly treated.
f. Is malaria serious for armies?
Yes, malaria may be more serious for an army than
its opposition. In the last world war British and
French armies faced German armies in Macedonia for
three years with neither side able to advance because
of malaria. In one of these armies, which had an
average strength of 124,000 men, there were more than
160,000 hospital cases of malaria in three seasons.
Over 25,000 soldiers had to be evacuated because of
chronic malaria in the spring of 1918. Malaria was
far more important than the enemy, who caused a total
of only about 27,000 casualties in the three years,
g. Has malaria appeared in this war?
Yes. Malaria has been a serious difficulty in the
Caribbean area, in Africa, in the Southwest Pacific, in
India, and elsewhere.
h. How does a man catch malaria?
A man catches malaria from a mosquito. Mosquitoes
act like airplane transports for malaria parasites. They
ferry these germs from one man to another. This is
the only way in which malaria spreads.
i. Do all mosquitoes carry malaria?
No. Fortunately, only certain kinds of mosquitoes,
called Anopheles, can carry malaria.
j. How do the Anopheles mosquitoes carry malaria?
Anopheles mosquitoes not only give the malaria
parasites a free ride but also a comfortable home where
they can breed. Anopheles mosquitoes stand on their
heads on a man's skin, with their tails pointing up.
They suck up a drop of blood, which they need for food,
and then they fly away. If there are malaria germs in
that drop of blood, these germs are taken with the blood
into the mosquito's stomach. Then the malaria germs
raise a large family in the mosquito's body. It is interesting
that all other mosquitoes except Anopheles destroy
the malaria germs in their stomachs. The Anopheles don't
have the right kind of digestion to do this.
k. How soon can an Anopheles mosquito infect another man after it has fed on someone who has malaria?
Usually in about ten days. By this time the young
family of malaria germs has grown up and is waiting
in the mosquito's spit or saliva glands for a chance to
infect a man.
l. How does the Anopheles mosquito infect a man?
Every time the mosquito drills a hole into a man's
skin for blood it drools some saliva into the hole, and
if malaria parasites are in the saliva they go into the
hole and so into the man's blood.
m. How soon after a mosquito infects a man does malaria show up in this man?
Usually in from 8 to 14 days. It takes this long for
the parasites to increase in numbers enough to throw
their weight around and make a man ill.
n. How is malaria cured?
There are drugs called quinine and atabrine, either
of which when given by a medical officer for a week
will often cure malaria. A third drug, called plasmochin,
is also used to treat malaria in some cases.
But sometimes, even though a man feels well after
treatment, the drugs have not destroyed all the germs.
Some may hide away in the internal organs. Then,
after ten days or a month, or sometimes longer, the
disease appears again. There may be three or even
more such attacks (called relapses) which have to be
treated each time like a new infection.
o. Can malaria be prevented by keeping fit?
No. Malaria is one of the diseases that will hit the
strongest as quickly as the weakest, and hit him just
as hard. Mosquitoes are defeated by brain work, not
p. Can malaria be prevented by keeping a camp clean?
No. Ordinary camp cleanliness, which is necessary
to prevent bowel diseases, has no effect in preventing
malaria. It takes special measures, to prevent malaria.
q. What is malaria control?
There are two kinds of malaria control in the Army.
One kind includes measures which Medical and Sanitary
Corps officers and the engineers carry out for the
soldiers. The other kind includes measures which the
soldier does for himself and which no one else can do
r. How does the Army control malaria?
The Army controls malaria by attacking and outwitting
the mosquito. It knows that the Anopheles mosquito
must spend the first week or ten days of its
life swimming in certain kinds of water collections,
such as streams, ditches, ponds, and pits, so whenever
possible this water is eliminated by draining or filling.
It also knows that oil and Paris green will kill the
young mosquito wrigglers in water, so, when filling or
draining is not advisable, one or the other of these
poisons is spread where it will do the most harm to
mosquitoes. It also knows that adult flying mosquitoes
cannot pass through screens, so the right size screening
is put on barracks and hutments. It also knows that
certain sprays will kill adult mosquitoes, so there is a
program for spraying places where the mosquitoes are
roosting. Finally, it knows that most malaria mosquitoes
can fly only a mile or two, so camp sites are
chosen which, if possible, are not near mosquito breeding
s. What can the soldier himself do to prevent malaria?
The soldier himself can use sleeping nets, protective
clothing, and repellents, and he can stay out of
malarious villages and get behind screens at night. The
soldier must be able to think faster than a mosquito
to prevent infection.
t. What are sleeping nets?
Sleeping nets are cloth nets used to protect a soldier
when he is sleeping. This is the time most malaria is
caught. The malaria Anopheles mosquito usually bites
at night and, of course, can bite more easily when a
man is asleep. It is important to use sleeping nets
properly. They must be put up so that mosquitoes
cannot get inside, and so arranged that a man does not
sleep up against the side and thus allow the mosquitoes
to feed on him through the net. Holes must be repaired
promptly with adhesive tape or by sewing.
u. What is meant by protective clothing?
Protective clothing is any clothing which gives protection
against mosquito bites. For example, leggings
will prevent bites around the ankles, and rolling down
the shirt sleeves at night will protect the forearms.
There are also gloves for guard duty at night and head
veils which, although sometimes hot and uncomfortable,
will keep mosquitoes from drilling holes in the
skin of the neck and face. Don't wear shorts at night
or at any time in the jungle. Don't sit around with
your shirt off at night outside screens. Don't go bathing
at a malarious beach, swimming hole, or unscreened
bathhouse at night.
v. What are repellents?
Repellents are chemicals which when spread over
the skin will keep mosquitoes from biting. The standard
Quartermaster repellents will keep mosquitoes
from biting for from three to four hours after being
spread over the skin. When needed, the repellent should
be used liberally at night on all exposed skin. It should
also be put on the clothing wherever it is thin enough
or tight enough so that the mosquito can drill through
it (for example, at the shoulders or seat). The repellent
should be used as often and as freely as necessary.
w. Are native villages dangerous?
Yes. Stay out of malarious native villages after
dark. They are deadly. Most natives in malarious
places have malaria parasites in their blood, even if
they look fairly healthy. The mosquitoes in such places
are full of malaria.
x. What about taking drugs to prevent malaria?
Atabrine or quinine in small doses will postpone the
chills and fever of malaria. But even large doses of
these drugs will not prevent the mosquito from infecting
a man. Sometimes it is very necessary to keep fit
when away from base camps and in places where it is
not possible to get sufficient protection from bed nets,
clothing, and repellents. Under these conditions atabrine
(or quinine) is taken in small doses to postpone
any attacks of chills and fever. When the mission is
completed, the atabrine (or quinine) doses are stopped.
Then in about ten days or so, if a man has caught
malaria, the chills and fever will show up and he can
be given a regular treatment in a hospital.
y. Is all this talk about malaria important?
Yes. Malaria in an army can spoil a campaign. This
is fact, not fiction. The Japanese know it and so do
the Germans. They try to prevent malaria. Wherever
they do a better job of malaria control than we do, they
stand a good chance of winning a battle. In malarious
places it is just as necessary to beat the mosquito as
to beat the enemy. The mosquito's brain is smaller than
a pinhead. We should be able to outsmart a mosquito
if we use the brains with which we were born.