In the early 1700s in what is now modern-day Peru, the Spanish learned that Quechea tribesmen would strip the bark off of cinchona trees and grind it into a powder to use in the treatment of fever-related shivering. It didn’t take long for the Spanish to start using the treatment, whose active ingredient is quinine, to fight malaria,
After it was discovered that quinine could also be used to prevent malaria, the British Medical Department of the Army began using quinine as a prophylaxis in 1848. The British government spent £53,000 importing cinchona bark annually until British geographer Sir Clements Markham introduced it to India in 1861.
The remedy made its way to the English and French and was being used around the world by the British government to maintain colonial order in India. While the French mixed their chicona with wine, the British preferred to mix theirs with gin, sugar, and lemon. Indian companies were manufacturing their own soda water and lemon tonics by 1869.
As armies battled malaria through the decades, America’s low point came in 1942 with its troops being ravaged in the Pacific fighting the Japanese. Infection rates were high as the world found that all sources of natural quinine were in the hands of the Axis powers. This forced the Allies to turn to other anti-malarials to combat the disease.
Ongoing research in the 1920s and 1930s produced a synthetic compound called chloroquine, which proved to be highly effective against the parasite that causes malaria, causing it to die quickly before it could reach the stage of full symptoms or infectiousness.
Postwar testing and research would go on to prove that chloroquine could actually be safe and effective in humans.
To prevent malaria, between 500-1,000 milligrams of quinine needs to be consumed, but an entire liter of tonic water today only contains about 83-87 milligrams, meaning you’d need to drink a dozen liters of Schweppes per day!
Quinine alone isn’t even an effective treatment for that disease anymore, as malarial parasites you encounter in the jungle have grown resistant to the drug. (But you can make it at home via steeping the peels of grapefruit!)
These days, a drug cocktail is more effective, hence HCQ.
Approved for use against malaria in 1955, Hydroxychloroquine was prescribed to military abroad ever since, most notably in Vietnam where the hot jungle climate was particular nasty to our soldiers raised in more temperate climes at home.
In 1984, the Navy published its Malaria “Blue Book,” prompted by the threat to health and readiness of sailors and Marines posed by malaria.
Prevention and treatment of malaria is more complex due to the emergence of drug resistance, pesticide resistant mosquito vectors, and large populations of infected people in many areas of the world.
The World Health Organization, at the center of today’s news about discounting HCQ, estimates that two billion people are at risk for malaria infection. Each year, malaria causes more than 300 million clinical cases and over two million deaths. In 1995, children under the age of five accounted for 800,000 of those deaths. The direct and indirect costs associated with malaria infections are enormous; costs were over $1.8 billion dollars in 1995 in Africa alone.
Malaria strikes during war, during deteriorating social and economic conditions, and after natural disasters; all situations where the military is called to serve.
Deployed forces cannot afford loss of personnel or depletion of resources for cure and
convalescence. Protecting and improving the health of airmen, soldiers, sailors, and Marines while serving in such operations requires thorough understanding of the prevention and treatment of malaria.
For sailors in malaria-stricken regions, the Navy recommends Chloroquine, or CQ, taken weekly, starting two weeks prior to entering the area of risk. Continue weekly dosing while the area of risk and four weeks after leaving. Chloroquine is usually well tolerated, and the few personnel who have side effects may tolerate the drug better by taking it with meals, or in divided twice weekly doses. Hydroxychloroquine, or HCQ, is an alternative and may be better tolerated. It is available by open purchase under the trade name Plaquenil R.
Atovaquone/proguanil, doxycycline, or mefloquine are also effective alternatives.
For areas where chloroquine-resistant P. falciparum exists, the Navy recommends three other drugs.
Mefloquine (LariamR), but it should not be taken by personnel with a history of seizures, severe psychiatric disorders, or those with cardiac conduction abnormalities. Aviators are
prohibited from using it. Personnel on flight status and divers are prohibited from
using Mefloquine. Or, Doxycycline, 100mg daily, starting two days prior to entry into area of risk. One of the most common side effects of doxycycline is adverse gastrointestinal symptoms, usually nausea or vomiting. These side effects may be avoided by taking doxycycline with a meal. Other side effects include photosensitivity manifested by a severe sunburn reaction, and an increased frequency of monilial vaginitis. The sunburn
reaction can be prevented by avoiding prolonged exposure to sunshine, or sunscreen use. Females taking doxycycline should be supplied with nystatin suppositories to treat possible yeast infections when they occur. Another alternative is Atovaquone and Proguanil (MalaroneR), 250mg/100mg, two days prior to entering area of risk. It’s not recommended for children, pregnant women, and women breastfeeding.
The short of it is, for most people, HCQ is the answer for malaria.
I've been trying to tell people this, Quinine/Chloroquine/HCQ have been used by the military for as long as I can remember. My father and uncle took it during WW2, survived malaria and dengue. Was given to troops daily during Viet Nam. It's very easy to research.
— janet mignatti (@MignattiJanet) May 20, 2020
Today the drug is a mainstay of the Veterans Administration hospitals, where it fights infection in our older vets. For the past 25 years, HCQ has also been studied as a potentially life-saving remedy against cancers, arthritis and diabetes.
There is so much more to learn about this wonder drug.
Thank you @realDonaldTrump The VA has been using up to 42000 doses a day of Hydroxychloroquine to protect our US veterans to save lives at all costs. Fauci lied, the media lied!!! The military has been using this drug for 65 years!! pic.twitter.com/qYCZnFZjEL
— Jack Dollars (@dittoditto1111) May 20, 2020