Verhave J P
Faculty of Medical Sciences, University of Nijmegen, The Netherlands.
Trop Geogr Med. 1995;47(6):252-8.
The manufacturing of quinine in The Netherlands began shortly after 1820; large scale production started with the foundation of the Amsterdam Chinine Factory in 1881. The quantity of sold quinine in the Province of North-Holland leads retrospectively to the conclusion that an epidemic of malaria had occurred around 1880. At the start of a new epidemic in 1899, it was demonstrated that quinine killed the bloodforms of tertian malaria immediately. However, 50% of the patients experienced a relapse, particularly after interruption of treatment. The length--f the course did not change the chance of relapse. With the beginning of another epidemic in 1919, scientific work and education of the people started in an organized fashion and patients were urged to use quinine only at the prescription of physicians. Because of the inability to prevent relapses, an alternative to quinine was badly needed. In 1930 plasmochin became available, which proved to be useful in combination with quinine. It was not until 1934 that the asymptomatic carriers were recognized as a problem for control because their unobserved parasitic relapses were considered a major source of infection for mosquitoes. In 1939 it was proposed to apply autumnal quininization, which meant a scrupulous screening of the population. The early forties brought yet another major epidemic. Both quinine and Quiniplex were used until the fifties, when endemic malaria disappeared. The new schizonticidal drugs came too late to challenge the primate of quinine in the era of temperate zone Plasmodium vivax in The Netherlands.
1820年后不久，荷兰便开始生产奎宁；1881年阿姆斯特丹奎宁工厂成立，大规模生产由此开始。回顾北荷兰省奎宁的销售数量可得出结论，1880年左右曾发生过疟疾流行。1899年新一轮疫情开始时，已证实奎宁可立即杀死间日疟的血内原虫。然而，50%的患者出现复发，尤其是在治疗中断后。疗程长短并未改变复发几率。1919年另一轮疫情开始时，科学工作和民众教育有组织地开展起来，同时敦促患者仅在医生处方下使用奎宁。由于无法预防复发，急需一种替代奎宁的药物。1930年扑疟喹啉问世，事实证明它与奎宁联合使用很有用。直到1934年，无症状携带者才被视为控制方面的一个问题，因为他们未被察觉的寄生虫复发被认为是蚊子感染的主要来源。1939年有人提议采用秋季奎宁疗法，这意味着要对人群进行严格筛查。20世纪40年代初又出现了一次大流行。在20世纪50年代地方性疟疾消失之前，奎宁和复方奎宁都一直在使用。在荷兰温带地区间日疟流行的时代，新型裂殖体杀灭药物出现得太晚，无法挑战奎宁的首要地位。
