Did Julius Caesar suffer from malaria? By Carl Muller
Those who survive often suffer from regular relapses. The only good to have so far come of the disease was the 1917 discovery that it was possible to treat tertiary syphilis by infecting patients with a less virulent strain of malaria.
Malaria has possibly been the most lethal infection in history. The disease is caused by a parasite Plasmodium falciparum - which only two living organisms can carry: the anopheles mosquito and human beings. The parasite has been using humans ever since the advent of agriculture when enough people gathered in one place to act as a reservoir for the disease.
References to malaria-type fevers date back to the ancient Greeks. In 600BC, Hippocrates noticed that intermittent fever seemed to go with stagnant water and swamps. Malaria was also the saviour of ancient Rome on two occasions: Attila's invading armies were halted by the disease, and Alaric the Goth died of a mosquito bite while laying siege on Rome. But it is now thought that malaria was responsible for the deaths of the Roman emperors Hadrian, Vespasian and Titus, while both Augustus and Julius Caesar suffered from recurring bouts of the disease.
In Europe alone, by the beginning of the 20th century, malaria was still killing hundreds of thousands. More than 100,000 British soldiers and an equal number of German soldiers contracted malaria in the Balkans between 1916 and 1917 and it was only eradicated in Rome in the 1930s when Mussolini drained the Pontine Marshes. Today, the disease is endemic from Afghanistan to Indonesia, Brazil to Mexico, and there are still 300 to 500 million cases every year. Of the three million who die yearly, 75% are African children under five.
Malaria was first known as the 'ague' and it was the leading cause of death among southern England's marshland communities. Between 1550 and 1700, child death rates were more than one in 10 in coastal Essex and Kent. As the writer Daniel Defoe noted, the men in those areas seemed to have an immunity. He wrote: "They always went into the hilly country for a wife who presently got an ague or two." Even Oliver Cromwell is thought to have died of malaria, and the last cases in Britain were recorded in the 1950s on the Isle of Sheppey.
Up to the 19th century, the treatments - induced purging and blood-letting - were largely ineffective. There were some imaginative remedies too: eating live spiders with butter... embracing a bald-headed Brahmin widow at dawn... even placing a copy of the fourth book of Homer's "mad" under a patient's head! The one really effective remedy was quinine, from the bark of the cinchona tree that was first found in Equador around 1630. The Jesuits used the bark first and it was thus regarded with suspicion by Protestant England - which was Oliver Cromwell refused it and failed to be cured. French chemists extracted the quinine, the active alkaloid in cinchona and by 1820 there were other equivalents of quinine such as paludrine, chloroquine and mefloquine. They all worked by poisoning Plasmodium falciparum in its own waste.
I recall how in the 1940s, engine drivers in the Ceylon Government Railway had to serve time in "malarial" stations that included Anuradhapura, Maho, Trincomalee. As a boy, I spent two years in Anuradhapura. That was the time when DDT was widespread. This was widely applied and it did kill the mosquitoes. In fact, we even had little trays of DDT powder under the legs of the dining table at home, to prevent ants invading the top of the table! Going to the source of the problem, however, lay in the draining of marshes and better public health, but this was rarely followed here. However, with DDT, it seemed that by the 1950s or 60s, malaria could be eradicated entirely, but in the Seventies the use of DDT was banned or curbed everywhere. Studies showed that it was highly poisonous and not only destroyed the mosquitoes but also all the insects on which birds fed.
In recent years the malaria bearing mosquitoes have also begun to show an alarming resistance to the drugs that are commonly used to treat the disease. As a result, the incidence of malaria has suddenly begun to rise dramatically in places like Africa and Southeast Asia, leaping over the sub-Sahara regions to the very edge of Europe. Dozens of people have died in eastern Turkey and doctors are now on alert in Italy in the event of a locally generated outbreak.
The discovery of the DNA sequence of the mosquito and its parasite can be a turning point in the fight against malaria. We now look forward to a prompt development of new drugs, vaccines, repellents and insecticides. But a recent report in "Nature" magazine warned that Plasmodium falciparum switches on a different subset of genes in its life cycle. In other words, it changes form. It goes through several transformations. When an infected mosquito bites you, it releases thread-like sporozoites into your bloodstream. These then meet at your liver where they remain and multiply by a factor of 10,000. Ten days later, this horde bursts out of the liver and into the blood again. They have now become merozoites, and within minutes they invade the red blood cells, feeding like vampires on haemoglobin. This is when you begin to feel that something is wrong. In a few hours, merozoites can suck a quarter of a pound of haemoglobin out of your red blood cells. The result: acute anaemia.
| Permalink | E-mail this post 
