Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia.
University of Queensland, School of Public Health, Brisbane, Australia.
Am J Trop Med Hyg. 2022 Nov 7;107(6):1173-1177. doi: 10.4269/ajtmh.22-0546. Print 2022 Dec 14.
Allied soldiers suffered repeated relapses of Plasmodium vivax malaria during and immediately after the Second World War. This surprised many military medical officers who had underestimated the huge casualties produced by P. vivax malaria. Tropical (Philippines) strains of P. vivax were known to relapse more frequently than those from temperate regions (the United States). Intense exposure to mosquito infection likely increased the absolute number of hypnozoites in soldiers' livers. Both quinine and quinacrine were used as chemosuppressive agents, but their inconsistent use until at least 1943 promoted intermittent parasitological failures. Fear of hemolytic reactions after a mass casualty event in 1943 engendered fear and avoidance of the only 8-aminoquinoline pamaquine then available to cure relapses. Variable chemosuppression likely prevented acquisition of effective parasitological immunity. Unexpectedly high relapse rates in soldiers were likely an indirect measure of the high hypnozoite burden and suggest how difficult it will be to eliminate P. vivax malaria from endemic areas.
在第二次世界大战期间和之后，盟军士兵反复感染间日疟原虫疟疾。这让许多低估了间日疟原虫疟疾造成的巨大伤亡的军事医务人员感到惊讶。已知来自热带（菲律宾）的间日疟原虫比来自温带地区（美国）的间日疟原虫更容易复发。强烈暴露于蚊子感染可能会增加士兵肝脏中的休眠疟原虫数量。奎宁和氯喹都被用作化学抑制药物，但直到 1943 年至少它们的使用不一致，导致寄生虫学间歇性失败。1943 年发生大规模伤亡事件后，人们担心发生溶血性反应，导致对当时唯一可用的 8-氨基喹啉类药物帕马喹（pamaquine）的恐惧和回避，以治疗复发。化学抑制的变化可能会阻止获得有效的寄生虫免疫。士兵中出乎意料的高复发率可能是休眠疟原虫负担高的间接衡量标准，这表明从流行地区消除间日疟原虫疟疾将是多么困难。
