Mosquitoes have a place in every culture's history. Mosquitoes and humans have been co-existing (although not exactly peacefully) for thousands of years. Even the names of the sources I've been using for this project tell the story: "Mosquito: the story of man's deadliest foe," "Have we conquered malaria?" and "The most deadly creature on earth." For an insect that is 1/8 to 3/4 inch long and weighs an average of 0.000088 oz, that's pretty impressive (National Geographic, n.d.). Mosquitoes have had a significant impact on human history: the examples I discuss here are only a fraction of the tiny mosquito's importance in our history.
Malaria has been spreading panic and misery for thousands of years. The symptoms were first described in Chinese medical writings (the Nei Ching) in 2700 BC (Mandal, 2013; CDC, Feb 2010). It may have been present as long as 12,000 years ago or “only” 4,000 years ago as some controversy exists on the exact time it first developed (Mandal, 2013; CDC, Feb 2010). Malaria has played a role in shaping human history. Mosquitoes are responsible for more human deaths than all the wars in our history (IDPH, 2007). Today, malaria kills roughly two million people per year (Miller & Walton, 2014). Malaria symptoms are documented in the Roman empire; the word malaria is derived from Latin words meaning bad air – “mal” and “aria” (Mandal, 2013). The disease posed a problem to the Roman Empire: a local population might have gained immunity to malaria but soldiers sent from other parts of the empire to maintain or expand the empire’s borders would not have that immunity. This both helped and hurt the Roman Empire: invading armies attacking Italy were decimated by the “mysterious, killing illness” but Roman soldiers in Scotland were decimated as well (Spielman, A., & D'Antonio, M., 2001, p. 50). Italy was a dangerous area for outside armies long after the Roman Empire as well; armies failed and popes died of the unconquerable sickness (Mandal, 2013). Although conclusive evidence that the disease was carried by mosquitoes did not come out until the 1890s, physicians in history (including Hippocrates) correctly blamed travel, swamps, and stagnant water (Spielman, A., & D'Antonio, M., 2001, p. 51; CDC, Feb 2010). Although they arrived at incorrect conclusions as to what exactly caused the symptoms, they were aware those were common factors. It was also known that staying indoors and sealing the home at night helped to prevent the disease, although the effectiveness of these techniques was attributed to preventing swamp gases from coming into the home and causing sickness (Mandal, 2013).
Medicinal remedies for malaria began in Greece with
bloodletting and induced vomiting to restore the balance of the humors. As one of the symptoms of malaria is severe
anemia, bloodletting was not the most beneficial treatment. In addition, the dehydration suffered by many
people with malaria was not improved by induced vomiting, which was another common treatment (Kakkilaya, 2008). The first
medically useful treatment was the herb Artemisia
annua, or sweet wormwood, discovered in early (340 AD) Chinese medicine
(Kakkilaya, 2008; Premji, 2009). Even some
of the anti-malaria medications we use today are derived from artemisinin, the
active component in sweet wormwood (Premji, 2009). These include Coartem, which was approved by
the FDA in 2009 and has been included on the WHO’s list of essential medicines
since 2002 (Premji, 2009). Cinchona bark
is the other major historical treatment for malaria. Cinchona bark was discovered by Europeans in South America in 1630.
Jesuit missionaries were closely associated with the bark, so much that
it was often referred to as Jesuit’s Bark (Premji, 2009). The bark contained quinine, which was
eventually isolated in 1820 (Cambridge University Library, 2009). Resistance to quinine grew in the early 20th
century but it is still considered a generally effective 2nd line
treatment for many countries (CDC, 2012; Cambridge University Library, 2009). Today, there is a cornucopia of synthetic antimalarials
available in the United
States and other developed countries. These include chloroquine,
atovaquone-proguanil, artemether-lumefantrine, mefloquine, quinide,
doxycycline, clindamycin, artesunate, and primaquine (CDC, 2012).
Early treatments for yellow fever included bloodletting and high doses of mercury, as seen in the Philadelphia epidemic in 1793 (Harvard University “Yellow fever,” 2002). In that epidemic there were differences of opinion in proper treatment – with physicians either following the beliefs of Dr. Benjamin Rulf or Dr. Jean Deveze. Dr. Rulf initially did not believe insects were involved in transmission and did believe the illness was contagious (Harvard University ”Yellow fever,” 2002). Dr. Rulf favored mercury and bloodletting while Dr. Deveze favored light diet, rest, bathing to reduce fevers, and various poultices and concoctions to drink (Arnebeck, 1999). Even today there is no specific treatment, just treatment to lessen symptoms and keep the patient safe until the illness resolves (Doerr & Nettleman, 2014). These treatments include fluids, oxygen, blood transfusion, antibiotics (not for yellow fever itself but for opportunistic infections), and other treatments in case of organ failure or respiratory problems (Doerr & Nettleman, 2014). There is also now a prophylactic vaccine to protect against yellow fever that is highly recommended for tourists heading to high-risk areas or people who live in some parts of the world (Mayo Clinic, 2011). Yellow fever and malaria most likely came to the Americas on slave ships, either as mosquitoes on the ship or eggs in the water supply (Spielman, A., & D'Antonio, M., 2001, p. 55). They were two of the diseases that decimated native populations as native lacked built up immunity to protect against the invaders and their diseases. Outbreaks of yellow fever and malaria were disastrous to the native populations in the New World but the Europeans were also vulnerable. Mosquitoes may have enabled the revolt on the slave ship “Amistad” as the crew of the ship contracted yellow fever while the slave cargo were mostly immune (Spielman, A., & D'Antonio, M., 2001, p. 55). Also notable was the Haitian slave revolt – the French military might sent to retake the island killed hundreds of thousands of Haitians but were ultimately defeated by the rebels and their very effective allies - mosquitoes, yellow fever, and malaria (Peterson, 1995). Stories of malaria and yellow fever outbreaks decimating European forces in the New World are numerous. Although clear numbers are difficult to find, outbreaks of malaria and yellow fever killed hundreds of thousands of Europeans in the New World (Peterson, 1995).
In more recent history, the Panama canal is a prime example of mosquitoes and the diseases they transmit influencing human events. In the 1880s France attempted to build a canal across the Panama isthmus. However the canal was eventually built by the US and opened decades later in 1914 (Harvard University, 2002). Why the delay? Why the change in ownership? Yellow fever and malaria, transmitted by mosquitoes, prevented the French attempts to build a canal by incapacitating their workforce. Over 20,000 workers died during that canal attempt (Harvard University, 2002). The US effort, which began in 1904, took advantage of the increased understanding of mosquito-vector diseases – namely that a mosquito vector was responsible. Although some physicians and scientists still believed the miasma theory, more were being swayed by new studies proving mosquitoes were responsible (CDC, Feb 2010; PBS, 2013). The US embarked on a grand, multilayered project to wipe out mosquitoes in the canal zone. They drained pools, installed ditches, cut and maintained brush and grass, added oil to kill mosquito larvae to water sources not capable of being drained, fumigated and used larvacide extensively (DDT was not created at this time), prescribed quinine to the entire workforce, installed screens, isolated the sick with screens and netting, created a water system less hospitable to mosquitoes, and even created a bounty system to pay people to trap and collect adult mosquitoes (CDC, Feb 2010; Harvard University, 2002). The sanitation efforts cost 20 million dollars and it worked (Harvard University, 2002). According to the CDC, the death rate from malaria was 11.59/1000 in November 1906 and was reduced to 1.23/1000 by December 1959 (Feb 2010). Although malaria and yellow fever were never completely wiped out in the area, deaths were substantially reduced. Yellow fever was wiped out, malaria was well-controlled, and work on the canal could continue much more safely and effectively (PBS, 2013). The video below is a segment of the PBS documentary on the Panama Canal specifically discussing malaria. I apologize for the poor quality of the video but it was the only video available of this segment and the information is quite interesting! For those interested, the entire documentary in excellent quality is available on the PBS website here: http://www.pbs.org/wgbh/americanexperience/films/panama/player/ |