Malaria

[Sue Light]

I don't know off-hand - as Bruce senior was so firmly associated with Malta, it could be that a son was seconded to the RAMC locally during the war. Bruce junior doesn't appear to have been a regular officer of the R.A.M.C.

Sue

[CarylW]

Not me googling but an official Maltese government report I'all post chapter and verse when I'm back on my desktop tomorrow. I have to say I find your attitude unfortunate.

Try as I might, I can't see any attitude, unfortunate or otherwise in Sue's post about the account by medical officers. You are so quick to try to undermine anyone, as you also did with me here. Jumping in without even reading my post properly. Completely misunderstanding it, even though you'd quoted it fully, and telling me to look at a map!

[Chris Henschke]

Here are some extracts from History of the Great War, Medical Services. Diseases of the War, Vol. 1. Malaria was seen as such a serious issue that this volume devotes over 60 pages to it.

"ÆTIOLOGY, INCIDENCE AND DISTRIBUTION.

Of all diseases responsible for casualties during the war malaria probably holds first place. To realise this fully one has only to look at the figures for admissions for malaria for the three years 1916, 1917 and 1918. In Macedonia they reached the total of about 160,000 ; in Egypt, about 35,000 ; in East Africa 107,000 between June 3rd, 1916 and October 27th, 1917 ; and in Mesopotamia about 20,000. Other places, such as the Cameroons, German South-West Africa, France and even England itself, contributed to the total, but the numbers are insignificant in comparison with these figures.

Palestine and Egypt.

Malaria became of great importance after active operations in Palestine had commenced in 1917-18. In 1916 there were scarcely more than 1,000 cases reported from Egypt. In 1917, during the latter part of which the operations against Palestine had commenced, there were 8,480 cases, while in 1918 there were over 28,000. In 1919, after the operations were over the number fell to about 6,400.

East Africa

...the incidence of malaria amongst the troops was very high, for during the period 3rd June, 1916, to 27th October, 1917, the admissions for malaria were 3,036 officers and 104,666 men.

There was a mortality of 10 amongst officers and 639 amongst the men. Malaria was responsible for 57.4 per cent. of the total admissions for sickness.

Mesopotamia

Malaria in Mesopotamia was not such a serious disease as in these other theatres of war. The admissions for the three years, 1917, 1918 and 1919 were 6,723, 10,331 and 5,261 respectively. The great bulk of infections took place in the district between Basra and Kurna, but many infections occurred during the expedition into North Persia in 1918."

To answer part of the original question regarding Egypt, according to this history, the malaria of 1916 occurred chiefly in the Canal Zone, the Fayoum (Senussi campaign), and the Western Oasis (Dakkla).

Chris Henschke

[Stoppage Drill]

I'm sorry that you find my attitude unfortunate. You made an ambiguous statement about what I had said and what I had posted. I replied pointing out that what I had posted was quite correct, whether or not you agreed with it. You are a great example of the male dinosaurs of this forum who cannot bear to be contradicted about anything, let alone by one of the few women who continue to post here against all the odds.

Sue

I think many people may cough politely, avert their gaze and walk on by, but for what it's worth, I'll nail my colours to your mast.

Try as I might, I can't see any attitude, unfortunate or otherwise in Sue's post about the account by medical officers. You are so quick to try to undermine anyone, as you also did with me here. Jumping in without even reading my post properly. Completely misunderstanding it, even though you'd quoted it fully, and telling me to look at a map!

. . . . your mast too.

[centurion]

There was a major outbreak of Malaria in Malta in 1904 which was investigated on behalf of the authorities in 1905 by Dr Themistocles Zammit who determined that the vector was a particular species of mosquito Anopheles maculipennis. Regular surveys of mosquitos to be found on the island were carried out on a yearly basis and are still carried out today by the University of Malta (who are the source of this information). There were eight species of this insect present but only Anopheles maculipennis was a carrier. This malaria carrying mosquito continued to be present on the island until 1943 when it vanished and it has not been reported since. Its disappearance appears to be connected with the drainage of some small swamps

Malaria carrying mosquitoes were present during WW1

[David_Underdown]

But the the presence of mosquitos capable of carrying the parasite is not the same as there being active malaria on Malta. There are Anopheles mosquitos in parts of the UK, but it is not regarded as a malarial area. If those mosquitos had happened to bite one of those patients with malaria (contracted elsewhere), it might have become endemic.

[centurion]

But the the presence of mosquitos capable of carrying the parasite is not the same as there being active malaria on Malta. There are Anopheles mosquitos in parts of the UK, but it is not regarded as a malarial area. If those mosquitos had happened to bite one of those patients with malaria (contracted elsewhere), it might have become endemic.

There are Anopheles species in the UK but not Anopheles maculipennis which is regarded as a major reservoir of the disease. The mosquito population can carry and transmit the parisite witin its own population - it doesn't have to bite an infected human first to transmit it

[Guest]

The presence of a mosquito species that can carry malaria does not necessarily mean there is malaria. It's a bit like saying because dogs can carry rabies, and there are dogs in England there are regular outbreaks of rabies in England. That aside, quinine is not a particularly effective preventative. Some years ago when serving in Borneo (for a number of years) we had daily parades where every man had to swallow quinine tablets (and the Sgt Major made sure they did) and yet we still had cases of malaria. The Australian Army who we were working with did not have the same parades and the number of malaria cases was significantly higher. Quinine was a decent preventative but not a guarantee.

Back to the Great War - the diaries of men who served in Macedonia (Salonika) are full of accounts of men suffering from malaria. I was slightly surprised by the medical stats as the diaries intimate that almost everyone had malaria at some stage, but the official stats don't really support this. The history of the Derbyshire Yeomanry which spent 3 years in Macedonia makes it quite clear that the Regiment at times could barely function due to the high number of cases of malaria, particularly in the swampy Doiran valley. The man in the avatar suffered from the long-term effects of malaria for the rest of his life.

MG

[centurion]

The presence of a mosquito species that can carry malaria does not necessarily mean there is malaria.

This was a species that did carry malaria. If the population was carrying it in 1904/5 it would still have the parasite circulating within it until the last one died in 1943.To use your analogy - like having a population of rabid dogs in the woods. Believe me having suffered badly from malaria in the 1980s its a subject I've taken considerable interest in.It's a disease that it is very difficult to eradicate.

[bushfighter]

In East Africa overall debilitation due to the disease was a major factor in degenerating the health of soldiers to the point where many died or were moved out to convalescent hospitals in South Africa.

Most European men repeatedly suffered from malaria, yet some avoided it.

Disciplinary measures appear to have been effective in the 2nd Bn The Loyal North Lancashire Regiment in one instance where a remarkable officer (MC & DSO) imposed them on the shores of Lake Victoria. His sub-unit did not lose one man to the disease, presumably because he explained and enforced the long-sleeves and long-trousers rule during certain hours, and he ensured that quinine was swallowed.

All the other companies who served there were decimated by the disease.

The totals of deaths listed to relevant diseases have to be specific & proven, and so I am sure that the degenerative aspects of malaria actually caused more deaths that would be listed under other headings.

Harry

[centurion]

In East Africa overall debilitation due to the disease was a major factor in degenerating the health of soldiers to the point where many died or were moved out to convalescent hospitals in South Africa.

Actually the statistics show that whilst many suffered very few died. In East Africa the number of British forces admitted to hospital with it between June and December 1916 was 50,768 of these 263 died. In the same period there were 8,902 cases of dysentery hospitalised of which 3,795 died (The First World War in Africa Hew Strachan p 9). The major problem is that the damn thing keeps recurring and you may never be rid of it [in my own personal case the first attack was followed by severe bouts at four week intervals for some months but I had minor mildish recurrences almost randomly down the years for another 15 years]

[Guest]

This was a species that did carry malaria. If the population was carrying it in 1904/5 it would still have the parasite circulating within it until the last one died in 1943.To use your analogy - like having a population of rabid dogs in the woods. Believe me having suffered badly from malaria in the 1980s its a subject I've taken considerable interest in.It's a disease that it is very difficult to eradicate.

Centurion - I am now very confused. I am not sure what you are saying. 'Did' then? When? in 1904? 1905? every year up to 1943?...or just because some of the population had had malaria, it means that malaria was prevalent in Malta right through to 1943? .... In the Govt of Malta tome you mention, does it mention how many cases of malaria have there been annually in Malta between 1904 and 1943 aside from the Great War? I would be fascinated to see the supporting data.

Separately - you said in post #18 in response to a post on malaria in Macedonia "dysentery was a much bigger killer" [than malaria] which is simply not the case where both were prevalent and particularly not the case in Macedonia where malaria killed 53% more men than dysentery did in the Great War. I would be grateful for the source of the claim that "dysentery was a much bigger killer" as it is at odds with the official (British Army) statistics.

MG

[Guest]

Actually the statistics show that whilst many suffered very few died. In East Africa the number of British forces admitted to hospital with it between June and December was 50,768 of these 263 died. In the same period there were 8,902 cases of dysentery hospitalised of which 3,795 died (The First World War in Africa Hew Strachan p 9). The major problem is that the damn thing keeps recurring and you may never be rid of it [in my own personal case the first attack was followed by severe bouts at four week intervals for some months but I had minor mildish recurrences almost randomly down the years for another 15 years]

Centurion... Again, I am afraid to say that this is incorrect. Anyone with the slightest understanding of dysentery in the Great War would immediately challenge the dysentery death rate. It is clearly nonsense. The idea that 42.6% of dysentery cases admitted to hospital ended in death is simply wrong. There is no easy way of saying it. Hew Strachan can't read - he has mixed up the hospital cases of the followers with the deaths of the troops. The actual numbers for dysentery in East Africa for Jun-Dec [1916] are:

Dysentery:........Admissions............Deaths

Troops...............8,902....................306

Followers...........3,795..................1,008

Source: History of the Great War: Medical Services: Casualties and Medical Statistics - Chapter XVIII page 259 Table 13.

Edit: which gives a death rate (for Troops admitted to hospital with dysentery) of 3.4% not 42.6%.

Strachan is only out by a factor of twelve. The higher death rate among the Followers was simply due to the significantly poorer medical support relative to that available for the Troops. It just goes to show that one needs to double-check sources. Out of interest does Strachan actually provide the reference? MG

[michaeldr]

Allenby was very conscious of the malaria threat to his forces and took active steps to try and control it. His to letters to Wilson (CIGS) in 1918 refer on more than one occasion to “draining, clearing, burning etc” and to “oiling”

Later in 1918 as the campaign moved northwards the situation deteriorated rapidly – 22OCT1918 to Wilson “Now I'm in Turkish territory, and malignant malaria is laying a lot of people by the heels. I've a good acting DMS now; one Luce; and he is doing all he can, but his beds are all full.”

The British OH (Part II, p. 597) has

“The causes were very simple. The British had advanced from an area wherein every precaution known to science had been taken, strait into one in which little or nothing had been done to fight the mosquito. As a result, from the date of the capture of Damascus the admissions to hospital from the EEF of men suffering from malaria , fairly high in the month preceding the attack, were doubled at abound, rising from 2.85 to 5.51 per cent. The disease was, moreover, for the most part of a malignant type.”

[centurion]

Malaria persists in humans for years - even decades with sufferers having recurrences of the fever. If you are lucky these get milder and eventually vanish (but you may still be capable of passing it on via a mosquito) but there is no guarantee of this. If there was a severe out break in 1904 then Malta would still have some people with the disease in WW1. The parasite that causes it lives in certain species of mosquitos and once the population has it it doesn't go away but passes on from generation to generation although the virulence may decline. If someone had an attack it would be impossible without the benefits of modern DNA analysis to say if it was a recurrence of the infection picked up years before (possibly somewhere else) or a new one from a fresh bite. However if Malta had had a major outbreak in 1904 and the carrying species of mosquito was still around then in essence the disease was still present. I would suspect that even after 1943 there would be some Maltese with the parasite still in their system but without the mosquito there was fortunately no way to pass it on. This is why it is so persistent in Africa - it is very difficult to break the cycle. Attempts were originally based on killing the carrier mosquitoes but the insecticides involved had deeply undesirable ecological and environmental side effects and in any case the mosquitoes are a vital pollinator for many food crops and a food for many important species in the biosphere. Efforts are now based on finding a vaccine against the parasite involved

[centurion]

Centurion... Again, I am afraid to say that this is incorrect. Anyone with the slightest understanding of dysentery in the Great War would immediately challenge the dysentery death rate. It is clearly nonsense. The idea that 42.6% of dysentery cases admitted to hospital ended in death is simply wrong. There is no easy way of saying it. Hew Strachan can't read - he has mixed up the hospital cases of the followers with the deaths of the troops. The actual numbers for dysentery in East Africa for Jun-Dec [1916] are:

Dysentery:........Admissions............Deaths

Troops...............8,902....................306

Followers...........3,795..................1,008

Source: History of the Great War: Medical Services: Casualties and Medical Statistics - Chapter XVIII page 259 Table 13.

Edit: which gives a death rate (for Troops admitted to hospital with dysentery) of 3.4% not 42.6%.

Strachan is only out by a factor of twelve. The higher death rate among the Followers was simply due to the significantly poorer medical support relative to that available for the Troops. It just goes to show that one needs to double-check sources. Out of interest does Strachan actually provide the reference? MG

Strachen's figures come from Medical Services: Casualties and Statistics of the Great War Mitchel and Smith p 259

[Guest]

....So I assume there is no supporting data with actual cases between 1904 and 1943 aside from those relating to the Great War?

MG

[Guest]

Strachen's figures come from Medical Services: Casualties and Statistics of the Great War Mitchel and Smith p 259

So are we agreed that Strachan can't read and the numbers are nonsense? ...or are we still hanging on to the idea that "dysentery was a much bigger killer" ? MG

P.S. Happy to post an image of the original if in doubt. MG

[bushfighter]

Centurion (Post 38)

The point I was trying to make and didn't articulate correctly was that, in my humble ex-military opinion (and I also have had recurrent malaria - even after eating Marmite as a prophylactic!), was that the debilitation effects of malaria doubtless helped to kill many soldiers whose death was recorded under a different medical heading.

A relevant unit is the South African Labour Corps in East Africa. The men died, and I doubt that too much attention was given as to why, in large numbers, even on the boat home.

I believe that malaria was a bigger killer than the precise medical statistics suggest. Harry

[Guest]

For anyone wanting to read up on malaria in the Great War, I would strongly recommend "The Medical War: British Military Medicine in the First World War" by Prof Mark Harrison FRHS (Professor of the History of Medicine and Director of the Wellcome Unit for the History of Medicine at the University of Oxford). It is meticulously researched and has a whole chapter on malaria in Salonika, East Africa and the Middle East....which starts:

"Of all the diseases encountered by the British Army in its long history of overseas campaigns, malaria inflicted more casualties than any other...."

MG

[David_Underdown]

No sources cited directly here, but an interesting comment on malaria in malta during the war http://maltaramc.com/ramcoff/1910_1919/ramcoff1918.html, looks like a relevant letter in Times of Malta too, but it's subscription to read the whole thing http://www.timesofmalta.com/articles/view/20040815/letters/does-the-malaria-mosquito-occur-in-malta.115197#.UmExAhdumeY

[stevem49]

I actually found papers today for a chap being treated for malaria which he had contracted whilst in India with the regulars.

I was wondering how many of these cases would have made it to the various lists/reports.

Steve M

[keithmroberts]

There is absolutely no need for unfortunate remarks.

Members are entirely capable of debating politely, and on occasion, where they feel rightly or wrongly that others are in error, it is possible to advance views firmly but using terms that are not going to cause offence. That is the respect for others that we seek to maintain.

Discussion over a beer or a glass or three of wine, can perhaps be more forthright without causing offence, but words on a screen do need to be measured and preferably cordial. I'm not going back to nitpick, but please can we remember that these are and should be debates among friends with similar or overlapping interests who I trust all seek to arrive at a correct understanding, rather than to impose a viewpoint regardless of alternative evidence.

The exact phrases use do matter.They can cause offence, sometimes where none is intended, and basically that helps none of us. Back to the subject.

Keith Roberts

[hazelclark]

I actually found papers today for a chap being treated for malaria which he had contracted whilst in India with the regulars.

I was wondering how many of these cases would have made it to the various lists/reports.

Steve M

I think most of them. Have been reading the medical diaries for the Meerut Division for the year and a bit they were in France and they have lists of the men who went down with malaria. It was a serious problem with both the British and the Indians in the Division. Next to self inflicted wounds to the hands, the incidence of which was VERY high in the Indian Bns. i seem to remember it was the biggest problem.

Hazel

[bigjohn]

My Grandfather who was an ex regular RGA (applied for discharge sept 1913)had served in India. According to his pension records was invalided sick to UK early Dec 1916. Then in May 1917 posted to German East Africa (Lindi) He was hospitalised with malaria at Capetown 10/12/18. He suffered from this the rest of his life calling it the `ague` he died in 1956. I often wonder if he originally contracted it in India and because he was a sufferer already that was the reason for his posting there?

John