A morphological and molecular approach to investigating infectious disease in early medieval Iberia: The necropolis of La Olmeda (Palencia, Spain).

OBJECTIVE: Here we investigate infectious diseases that potentially contribute to osteological lesions in individuals from the early medieval necropolis of La Olmeda (6th-11th c. CE) in North Iberia. MATERIALS AND METHODS: We studied a minimum number of 268 individuals (33 adult females; 38 adult males, 77 unknown/indeterminate sex; and 120 non-adults), including articulated and commingled remains. Individuals with differential diagnoses suggesting chronic systemic infectious diseases were sampled and bioinformatically screened for ancient pathogen DNA. RESULTS: Five non-adults (and no adults) presented skeletal evidence of chronic systemic infectious disease (1.87% of the population; 4.67% of non-adults). The preferred diagnoses for these individuals included tuberculosis, brucellosis, and malaria. Ancient DNA fragments assigned to the malaria-causing pathogen, Plasmodium spp., were identified in three of the five individuals. Observed pathology includes lesions generally consistent with malaria; however, additional lesions in two of the individuals may represent hitherto unknown variation in the skeletal manifestation of this disease or co-infection with tuberculosis or brucellosis. Additionally, spondylolysis was observed in one individual with skeletal lesions suggestive of infectious disease. CONCLUSIONS: This study sheds light on the pathological landscape in Iberia during a time of great social, demographic, and environmental change. Genetic evidence challenges the hypothesis that malaria was absent from early medieval Iberia and demonstrates the value of combining osteological and archaeogenetic methods. Additionally, all of the preferred infectious diagnoses for the individuals included in this study (malaria, tuberculosis, and brucellosis) could have contributed to the febrile cases described in historical sources from this time.

Ancient Plasmodium genomes shed light on the history of human malaria.

Malaria-causing protozoa of the genus Plasmodium have exerted one of the strongest selective pressures on the human genome, and resistance alleles provide biomolecular footprints that outline the historical reach of these species1. Nevertheless, debate persists over when and how malaria parasites emerged as human pathogens and spread around the globe1,2. To address these questions, we generated high-coverage ancient mitochondrial and nuclear genome-wide data from P. falciparum, P. vivax and P. malariae from 16 countries spanning around 5,500 years of human history. We identified P. vivax and P. falciparum across geographically disparate regions of Eurasia from as early as the fourth and first millennia BCE, respectively; for P. vivax, this evidence pre-dates textual references by several millennia3. Genomic analysis supports distinct disease histories for P. falciparum and P. vivax in the Americas: similarities between now-eliminated European and peri-contact South American strains indicate that European colonizers were the source of American P. vivax, whereas the trans-Atlantic slave trade probably introduced P. falciparum into the Americas. Our data underscore the role of cross-cultural contacts in the dissemination of malaria, laying the biomolecular foundation for future palaeo-epidemiological research into the impact of Plasmodium parasites on human history. Finally, our unexpected discovery of P. falciparum in the high-altitude Himalayas provides a rare case study in which individual mobility can be inferred from infection status, adding to our knowledge of cross-cultural connectivity in the region nearly three millennia ago.

How Racism and "Tropical Medicine" Built the Panama Canal.

At the turn of the 20th century, the physician William Gorgas led work that substantially mitigated mortality from mosquito-borne diseases among workers building the Panama Canal. The waterway launched the United States to political and economic superpower status by eliminating the need for risky maritime travel around the southern tip of South America, expediting exportation of US goods in international markets. Yet, as this article explains, innovations that curbed malaria and yellow fever were deeply rooted in racist foundations of capital and empire.

CONTRIBUTION TO THE UNDERSTANDING OF THE HEALTH SITUATION WITHIN THE POPULATION IN SLAVONIA AND SRIJEM DURING THE SECOND WORLD WAR WITH AN EMPHASIS ON INFECTIOUS DISEASES / Prilog poznavanju zdravstvenih prilika stanovnistva u Slavoniji i Srijemu tijekom Drugoga svjetskog rata, s naglaskom na zarazne bolesti

During World War II, the population of agricultural areas of Slavonia and Srijem lived in privation, but there was no famine. A more serious threat was infectious diseases, such as malaria, typhoid fever, and dysentery, which were also present within the population in the post-war period. Major epidemics broke out mostly in areas under partisan control, especially in the areas of western and central Slavonia, where major epidemic typhus contagious broke out. Venereal diseases, less common in the Slavonian area before the war, were also on the rise. Two factors had an impact on the health situation within the population ­ state medical institutions and partisan medical corps. Health care and measures to combat infectious diseases were provided by state authorities, and that is still an insufficiently explored area in historiography. During the first years of the war, the partisan medical corps personnel, initially mostly semiskilled and lacking necessary medical equipment and medications, relied on the support from the population to a greater extent than they were able to provide medical care to them. With the arrival of professional staff and the acquisition of medicines and medical equipment, mainly sourced from medical institutions in areas under partisan control, they assumed a more active role in supporting civilian authorities under the "people's rule"­specifically, the people's liberation committees. Their focus shifted to healthcare for the civilian population, primarily aimed at suppressing and preventing infectious diseases. Further research on this topic will contribute to a more realistic perception of the civilian population's everyday life during the war, which was presented in memoir literature and historiography of the socialist period as a heroic act of resistance rather than a struggle for survival in the conditions of privation and diseases; it will also complete the picture of the human losses of the civilian population caused by infectious diseases.

[Understanding the mode of transmission of malaria agents: an astonishing series of hypotheses, observations, research and controversy]. / Compréhension du mode de transmission des agents du paludisme: une étonnante suite d'hypothèses, d'observations, de recherches et de controverses.

In 1880, Laveran observed the causative agent of malaria. As early as 1884, he considered that mosquitoes could be responsible for the transmission of haematozoa, a hypothesis which resulted from the observation and reflection of an informed hygienist. But, as Laveran himself said, "the opinion that I defended was considered by most observers to be highly unlikely".Nearly 15 years after the discovery of the haematozoan, the elucidation of the mechanism of transmission still proved difficult to establish. A link with the existence of swamps had been established a long time before, but the true mode of transmission remained a mystery until the end of the 19th century. The implication, by Manson in 1877, of mosquitoes in the cycle of the Bancroftian filaria, then other observations of the same order, ended up attracting the attention of malariologists. Laveran himself was quickly convinced of the role of mosquitoes in carrying out the natural cycle and propagating Plasmodium, but this theory had as many detractors as supporters.In 1897, Ross showed the presence of oocysts on the stomach of mosquitoes previously gorged on a malaria patient, then in 1898, of sporozoites of bird plasmodia in mosquitoes. He was convinced that, through their bite, these insects were responsible for the transmission of human malaria agents, without being able to prove it. The results obtained by Ross were immediately confirmed in Italy by Grassi and his collaborators who, in November 1898, described the stages of Plasmodium in man and, through various experiments carried out in collaboration with British researchers, showed the role of Anopheles, a result far from being accepted by all. Skepticism persisted for a long time.An excellent protozoologist, Laveran was not an entomologist. He was however among the first defenders of the anopheline theory. He worked extensively on establishing the relationships between Anopheles mosquitoes and malaria and took a close interest in the environmental conditions of the transmission. In his mind, malaria fever should henceforth be classified as a preventable disease. An era of hope thus dawned: malaria prophylaxis, based on fight against mosquitoes, could begin.

[Laveran, the military doctor]. / Laveran, le médecin militaire.

Son of Louis-Theodore Laveran, holder of the Chair of Diseases and Epidemics in the Armies at the Val-de-Grâce and grandson of an artillery commander through his mother, Alphonse, born in Paris on June 18, 1845, follows in his father's footsteps by entering the Imperial School of Military Health in Strasbourg at the age of 18.After his thesis, he participated in 1870 in the war against Prussia. He was taken prisoner in Metz. He then prepared for the competitive examination to become a professor, which he passed in 1874. He was appointed to the Chair of the Val-de-Grâce, which his father had created. He then went to Algeria. It was at the military hospital in Constantine on November 6, 1880 that he indisputably discovered the haematozoa responsible for malaria in the blood of a soldier in the crew train.In 1884, he was appointed to the Chair of Military Hygiene and Legal Medicine at Val-de-Grâce. At the end of his professorship in 1894, after being refused a posting to Paris to continue his research and not being consulted for the preparation of the Madagascar expedition, which turned into a health disaster in 1895, he retired prematurely in 1897. Hosted by Émile Duclaux and Émile Roux at the Pasteur Institute in Paris, he continued his research mainly on protozoa as agents of human and animal diseases until his death. His work in medical protozoology earned him the Nobel Prize in Physiology or Medicine in 1907. During the Great War, with the benefit of his experience, he warned the Minister of War in January 1916 about the risk of malaria incurred by the army of the East in the delta of the Vardar River in Salonika. The spring would prove him right.An illustrious military doctor and scientist of international renown, Laveran died on May 18, 1922 in Paris.

[Laveran and the French Academy of Medicine]. / Laveran et l'Académie nationale de médecine.

In November 1880, Alphonse Laveran, stationed at the Constantine military hospital, addressed to the Academy of Medicine a "Note on a new parasite found in the blood of several patients with malaria fever". Léon Colin, professor at the Val-de-Grâce school, is the rapporteur, but he is not convinced by these observations, nor by two additional notes sent by Laveran in December 1880 and October 1881. This skepticism is shared by other academicians such as Joseph Laboulbène and Émile Duclaux.Twelve years will be necessary for Laveran to overcome the disbelief of the French scientific community. Three fundamental books donated to the Academy testify to the tenacity with which he gradually succeeded in convincing most of his colleagues: Traité des fièvres palustres avec la description des microbes du paludisme in 1884, Des hématozoaires du paludisme in 1887, and Du paludisme et de son hématozoaire in 1891.Laveran was elected to the Academy of Medicine on December 26, 1893. His resignation from the Military Health Corps enabled him to participate assiduously in meetings and to intervene in debates concerning infectious and tropical diseases, hygiene and prophylaxis. Obtaining the Nobel Prize in 1907 for his work on malaria, trypanosomiasis and colonial diseases crowned his work while honoring the Academy. Laveran was elected vice-president for the year 1919 and president for 1920, the year of the centenary of the Academy, the celebration of which he organized to the detriment of his health. He died two years later, having fulfilled his duty to the end of his strength.

[In the wake of Alphonse Laveran]. / Dans le sillage d'Alphonse Laveran.

Alphonse Laveran (Nobel Prize 1907) played a pioneering role in discovering the causative agent of malaria, a disease that has existed since time immemorial, and long emblematic of the miasma theory until the end of the 19th century. In 1880, this unknown military doctor discovered the role of a hematazoan in malaria, designated Plasmodium. This was the first protozoan to be discovered in an infectious disease, at a time when bacteria were mainly suspected. This major discovery led to the identification of the role of mosquitoes in the spread of malaria by Ronald Ross (Nobel Prize 1902) and Battista Grassi. The recurrence of malaria attacks over many years was for a long time an enigma only solved after the Second World War by the discovery of the exo-erythrocytic cycle of Plasmodium. Progress was then made in treatment, from cinchona bark, quinine and chloroquine, to the recent discovery of artemisinin in 1972 by the Chinese researcher Tu Youyou (Nobel Prize 2015).

An ordinary malaria? Intermittent fever in Denmark, 1826-1886.

Intermittent fever is a historical diagnosis with a contested meaning. Historians have associated it with both benign malaria and severe epidemics during the Early Modern Era and early nineteenth century. Where other older medical diagnoses perished under changing medical paradigms, intermittent fever 'survived' into the twentieth century. This article studies the development in how intermittent fever was framed in Denmark between 1826 and 1886 through terminology, clinical symptoms and aetiology. In the 1820s and 1830s, intermittent fever was a broad disease category, which the diagnosis 'koldfeber'. Danish physicians were inspired by Hippocratic teachings in the early nineteenth century, and patients were seen as having unique constitutions. For that reason, intermittent fevers presented itself as both benign and severe with a broad spectrum of clinical symptoms. As the Parisian school gradually replaced humoral pathology in the mid-nineteenth century, intermittent fever and koldfeber became synonymous for one disease condition with a nosography that resembles modern malaria. The nosography of intermittent fever remained consistent throughout the second half of the nineteenth century. Although intermittent fever was conceptualized as caused by miasmas throughout most of the nineteenth century, the discovery of the Plasmodium parasite in 1880 led to a change in the conceptualization of what miasmas were. The article concludes that the development of how intermittent fever was framed follows the changing scientific paradigms that shaped Danish medicine in the nineteenth century.

Malaria as a Papal Disease.

OBJECTIVES: In this study, we aimed to investigate the effects of malaria on the lives of Roman pontiffs. MATERIALS AND METHODS: The histories of all 264 popes from Saint Peter to John Paul II were extensively studied. RESULTS: Malaria affected the lives of Roman pontiffs. Between 999 AD and 1644 AD, 21 of 99 popes were affected by malaria (21.4%). The first affected was Gregory V and the last was Urban VII, the 138th and the 235th pope, respectively. There were 15 deaths (15.2%). Six pontiffs (6.1%) were infected but survived. Many cardinals and their assistants, especially those coming from northern countries, contracted malaria during conclaves, and many died. CONCLUSIONS: By about 450 BC, malaria had arrived in Rome. By the second century BC, malaria was endemic. It affected the lives of Roman people. To prevent infection, the popes adopted the custom of ancient affluent Romans who used to spend summer months in high plains far from Rome. The first to adopt the custom was Paul I in 767, who just moved his residence to Saint Paul, out of the walls. Sixtus V started the Congregation of Waters and Streets, which was routinely reinforced by his successors until 1860, when the Kingdom of Italy was born.

Analysing malaria events from 1840 to 2020: the narrative told through postage stamps.

The role played by postage stamps in the history of malaria control and eradication has largely gone unrecognized. Scientific investigators of malaria, especially Nobel laureates, were commemorated with special issues, but the work of the World Health Organization (WHO), which promoted an ambitious and global philatelic initiative in 1962 to support global eradication, is generally overlooked. This review examines the philatelic programme that helped to generate international commitment to the goal of malaria eradication in 1962 and established philatelic malaria icons that had worldwide recognition. Malaria-related postage stamps have continued to be issued since then, but the initial failure of malaria eradication and the changing goals of each new malaria programme, inevitably diluted their role. After the first Global Malaria Eradication Campaign was discontinued in 1969, few Nations released philatelic issues. Since the Spirit of Dakar Call for Action in 1996 a resurgence of postage stamp releases has occurred, largely tracking global malaria control initiatives introduced between 1996 and 2020. These releases were not co-ordinated by the WHO as before, were more commercialized and targeted stamp collectors, especially with attractive miniature sheets, often produced by photomontage. Having a different purpose, they demonstrated a much wider diversity in symbolism than the earlier stylized issues and at times, have been scientifically inaccurate. Nonetheless postage stamps greatly helped to communicate the importance of malaria control programmes to a wide audience and to some extent, have supported preventive health messages.

THE TERMINAL APHONIA OF ALEXANDER THE GREAT, A SILENT HERALD OF AN ORDINARY DEATH

Even though the absence of the body prevents sure conclusions, the death of Alexander the Great remains a hot topic of retrospective diagnosis. Due to the serious mishandling of ancient sources, the scientific literature had Alexander dying of every possible natural cause. In previous works, the hypothesis that typhoid fever killed Alexander was proposed, based on the presence of the remittent fever typical of this disease in the narrations of Plutarch and Arrian. Here we provide additional evidence for the presence of stupor, the second distinctive symptom of typhoid fever. In fact, based on the authority of Caelius Aurelianus and Galen, we demonstrate that the word ἄφωνος, used to describe the last moments of Alexander, is a technical word of the lexicon of the pathology of Hippocrates. Used by him, the word defines a group of diseases sharing a serious depression of consciousness and motility. The association of stupor with the remittent fever strengthens the typhoid fever hypothesis.

Prevention of re-establishment of malaria: historical perspective and future prospects.

Prevention of re-establishment (POR) refers to the prevention of malaria outbreak/epidemic occurrence or preventing re-establishment of indigenous malaria in a malaria-free country. Understanding the effectiveness of the various strategies used for POR is, therefore, of vital importance to countries certified as "malaria-free" or to the countries to be thus certified in the near future. This review is based on extensive review of literature on both the POR strategies and elimination schemes of countries, (i) that have reached malaria-free status (e.g. Armenia, Mauritius, Sri Lanka), (ii) those that are reaching pre-elimination stage (e.g. South Korea), and (iii) countries at the control phase (e.g. India). History has clearly shown that poorly implemented POR programmes can result in deadly consequences (e.g. Sri Lanka); conversely, there are examples of robust POR programmes that have sustained malaria free status that can serve as examples to countries working toward elimination. Countries awaiting malaria elimination status should pre-plan their POR strategies. Malaria-free countries face the risk of resurgence mostly due to imported malaria cases; thus, a robust passenger screening programme and cross border collaborations are crucial in a POR setting. In addition, sustained vigilance, and continued funding for the national anti-malarial campaign programme and for related research is of vital importance for POR. With distinct intrinsic potential for malaria in each country, tailor-made POR programmes are built through continuous and robust epidemiological and entomological surveillance, particularly in countries such as Sri Lanka with increased receptivity and vulnerability for malaria transmission. In summary, across all five countries under scrutiny, common strengths of the POR programmes are (i) a multipronged approach, (ii) strong passive, active, and activated passive case detection, (iii) Indoor residual spraying (IRS), and (iv) health education/awareness programmes.

History of the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine: research on malaria and leishmaniasis.

This review presents the 100-year history of the Martsinovsky Institute of Medical Parasitology and Tropical Medicine in Moscow, Russia, starting with its foundation and early activities, and also describes the impact of its leading scientists, some of whom became internationally known. The institute headed a network of nine tropical institutes in the various Soviet republics from the 1920s to 1990. The extensive body of literature on the history and research accomplishments of this institute has mainly been published in Russian; our goal here is to introduce these achievements and this expertise to the international scientific and medical community, focusing on malaria and leishmaniasis and the development of measures to control and monitor these diseases in the USSR.

History of malaria control in Rwanda: implications for future elimination in Rwanda and other malaria-endemic countries.

BACKGROUND: Malaria was first reported in Rwanda in the early 1900s with significant heterogeneity and volatility in transmission over subsequent decades. Here, a comprehensive literature review of malaria transmission patterns and control strategies in Rwanda between 1900 and 2018 is presented to provide insight into successes and challenges in the country and to inform the future of malaria control in Rwanda. METHODS: A systematic literature search of peer-reviewed publications (Web of Knowledge, PubMed, Google Scholar, and the World Health Organization Library (WHOLIS) and grey literature on malaria control in Rwanda between 1900 and 2019 was conducted with the following search terms: "malaria"", "Rwanda", "epidemiology", "control", "treatment", and/or "prevention." Reports and other relevant documents were also obtained from the Rwanda National Malaria Control Programme (NMCP). To inform this literature review and evidence synthesis, epidemiologic and intervention data were collated from NMCP and partner reports, the national routine surveillance system, and population surveys. RESULTS: Two hundred sixty-eight peer-reviewed publications and 56 grey literature items were reviewed, and information was extracted. The history of malaria control in Rwanda is thematically described here according to five phases: 1900 to 1954 before the launch of the Global Malaria Eradication Programme (GMEP); (2) Implementation of the GMEP from 1955 to 1969; (3) Post- GMEP to 1994 Genocide; (4) the re-establishment of malaria control from 1995 to 2005, and (5) current malaria control efforts from 2006 to 2018. The review shows that Rwanda was an early adopter of tools and approaches in the early 2000s, putting the country ahead of the curve and health systems reforms created an enabling environment for an effective malaria control programme. The last two decades have seen unprecedented investments in malaria in Rwanda, resulting in significant declines in disease burden from 2000 to 2011. However, in recent years, these gains appear to have reversed with increasing cases since 2012 although the country is starting to make progress again. CONCLUSION: The review shows the impact and fragility of gains against malaria, even in the context of sustained health system development. Also, as shown in Rwanda, country malaria control programmes should be dynamic and adaptive to respond and address changing settings.

History of the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine: research on malaria and leishmaniasis / História do Instituto E.I. Martsinovsky de Parasitologia Médica e Medicina Tropical: pesquisa sobre malária e leishmaniose

Abstract This review presents the 100-year history of the Martsinovsky Institute of Medical Parasitology and Tropical Medicine in Moscow, Russia, starting with its foundation and early activities, and also describes the impact of its leading scientists, some of whom became internationally known. The institute headed a network of nine tropical institutes in the various Soviet republics from the 1920s to 1990. The extensive body of literature on the history and research accomplishments of this institute has mainly been published in Russian; our goal here is to introduce these achievements and this expertise to the international scientific and medical community, focusing on malaria and leishmaniasis and the development of measures to control and monitor these diseases in the USSR.

Resumo O artigo analisa a história centenária do Instituto Martsinovsky de Parasitologia Médica e Medicina Tropical em Moscou, Rússia, desde sua fundação e primeiras atividades, e descreve a influência de seus principais cientistas, alguns dos quais viriam a conquistar renome internacional. O instituto liderou uma rede de nove institutos tropicais em diversas repúblicas soviéticas entre as décadas de 1920 e 1990. A vasta literatura sobre o trabalho de história e pesquisa desse instituto foi publicada sobretudo em russo; nosso objetivo aqui é apresentar esse trabalho e conhecimento à comunidade médica e científica internacional, concentrando-se na malária e na leishmaniose e no avanço de medidas de controle e monitoramento dessas doenças na URSS.

Historical epidemiology and global health history.

The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).

"Debordering" public health: the changing patterns of health border in modern Europe.

According to David Fidler, the governance of infectious diseases evolved from the mid-nineteenth to the twenty-first century as a series of institutional arrangements: the International Sanitary Regulations (non-interference and disease control at borders), the World Health Organization vertical programs (malaria and smallpox eradication campaigns), and a post-Westphalian regime standing beyond state-centrism and national interest. But can international public health be reduced to such a Westphalian image? We scrutinize three strategies that brought health borders into prominence: pre-empting weak states (eastern Mediterranean in the nineteenth century); preventing the spread of disease through nation-building (Macedonian public health system in the 1920s); and debordering the fight against epidemics (1920-1921 Russian-Polish war and the Warsaw 1922 Sanitary Conference).