{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:48:58Z","timestamp":1777589338982,"version":"3.51.4"},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,14]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Allied soldiers suffered repeated relapses of <jats:italic>Plasmodium vivax<\/jats:italic> malaria during and immediately after the Second World War. This surprised many military medical officers who had underestimated the huge casualties produced by <jats:italic>P. vivax<\/jats:italic> malaria. Tropical (Philippines) strains of <jats:italic>P. vivax<\/jats:italic> were known to relapse more frequently than those from temperate regions (the United States). Intense exposure to mosquito infection likely increased the absolute number of hypnozoites in soldiers\u2019 livers. Both quinine and quinacrine were used as chemosuppressive agents, but their inconsistent use until at least 1943 promoted intermittent parasitological failures. Fear of hemolytic reactions after a mass casualty event in 1943 engendered fear and avoidance of the only 8-aminoquinoline pamaquine then available to cure relapses. Variable chemosuppression likely prevented acquisition of effective parasitological immunity. Unexpectedly high relapse rates in soldiers were likely an indirect measure of the high hypnozoite burden and suggest how difficult it will be to eliminate <jats:italic>P. vivax<\/jats:italic> malaria from endemic areas.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0546","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T12:29:36Z","timestamp":1667824176000},"page":"1173-1177","source":"Crossref","is-referenced-by-count":5,"title":["Plasmodium vivax Relapse Rates in Allied Soldiers during the Second World War: Importance of Hypnozoite Burden"],"prefix":"10.4269","volume":"107","author":[{"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia;"},{"name":"University of Queensland, School of Public Health, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Internal Medicine in World War II","first-page":"466","author":"Baker","year":"1963"},{"key":"b2","series-title":"Internal Medicine in World War II","first-page":"493","author":"Long","year":"1963"},{"key":"b3","series-title":"J Am Med Assoc","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1001\/jama.1954.02940510011005","article-title":"Mass antimalarial therapy in veterans returning from Korea","volume":"154","author":"Archambeault","year":"1954"},{"key":"b4","series-title":"Trends Parasitol","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.pt.2009.12.005","article-title":"Targeting the hypnozoite reservoir of Plasmodium vivax: the hidden obstacle to malaria elimination","volume":"26","author":"Wells","year":"2010"},{"key":"b5","series-title":"Am J Hyg","first-page":"1","article-title":"A study of malarial relapses in the United States Army","volume":"17","author":"Borden","year":"1933"},{"key":"b6","series-title":"Am J Trop Med","first-page":"221","article-title":"Renewed clinical activity in naturally induced vivax malaria","volume":"1","author":"Boyd","year":"1944"},{"key":"b7","series-title":"Med J Aust","doi-asserted-by":"publisher","first-page":"145","DOI":"10.5694\/j.1326-5377.1946.tb34205.x","article-title":"Malaria in the south-west Pacific, with special reference to its chemotherapeutic control","volume":"2","author":"Fairley","year":"1946"},{"key":"b8","series-title":"Ind Med Gaz","first-page":"603","article-title":"A suggested standard treatment of malaria based upon the results of the controlled investigation of over 3,700 cases","volume":"65","author":"Sinton","year":"1930"},{"key":"b9","series-title":"Internal Medicine in World War II","first-page":"449","author":"Mowrey","year":"1963"},{"key":"b10","series-title":"Naval Medical Bulletin","first-page":"797","article-title":"A statistical report of malaria during one year on island \u201cX.\u201d","volume":"43","author":"Fowler","year":"1945"},{"key":"b11","series-title":"Trans Royal Soc Trop Med","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/0035-9203(49)90003-6","article-title":"Malaria among prisoners of war in Siam (\u201cF\u201d Force)","volume":"43","author":"Wilson","year":"1949"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"67","article-title":"Results in an infantry regiment of several plans of treatment for vivax malaria","volume":"1","author":"Downs","year":"1946"},{"key":"b13","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"103","DOI":"10.7326\/0003-4819-25-1-103","article-title":"Plasmochin toxicity: analysis of 258 cases","volume":"25","author":"Hardgrove","year":"1946"},{"key":"b14","series-title":"Rev Inst. 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