{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:52:51Z","timestamp":1775695971134,"version":"3.50.1"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The U.S. Civil War (1861\u20131865) pre-dated modern understanding of malaria. Yet, malarial diseases (remittent fever, intermittent fever, typho-malarial fever) were frequently reported as causes of morbidity and mortality in soldiers. Modern readers find Civil War-era descriptions of malaria contradictory or paradoxical. For example, although the concept of race-specific immunity to tropical diseases was widely accepted, malaria mortality rates were reportedly more than three times higher among Black than White Union soldiers (16\/1,000\/year versus 5\/1,000\/year). Also, malaria rates were reportedly lower among prisoners of war at the infamous Andersonville, GA, prison camp than among Confederate soldiers in the same area. Literally tons of quinine were given prophylactically to Union soldiers deployed in the southern United States, but blackwater fever was not reported by medical officers. All three paradoxes have reasonable modern explanations that give credence to the astute clinical observations of our scientific predecessors during the U.S. Civil War.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0672","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T13:47:55Z","timestamp":1678110475000},"page":"646-649","source":"Crossref","is-referenced-by-count":1,"title":["Malaria Paradoxes of the U.S. Civil War"],"prefix":"10.4269","volume":"108","author":[{"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Queensland, Australia;"},{"name":"School of Public Health, University of Queensland, Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"The Medical and Surgical History of the War of the Rebellion (1861\u201365)","first-page":"77","author":"Smart"},{"key":"b2","series-title":"The Medical and Surgical History of the War of the Rebellion (1861\u201365): Pt. 1\n Medical History","author":"Woodward","year":"1879"},{"key":"b3","series-title":"Mil Surg","first-page":"593","article-title":"Malarial fevers in the United States Army and at selected stations","volume":"58","author":"Love","year":"1926"},{"key":"b4","series-title":"The Negro as a Soldier in the War of the Rebellion\n The Military Historical Society of Massachusetts","author":"Hallowell","year":"1897"},{"key":"b5","series-title":"Outlines of the Chief Camp Diseases of the United States Armies: As Observed during the Present War","author":"Woodward","year":"1863"},{"key":"b6","series-title":"Bull Hist Med","first-page":"317","article-title":"Andersonville\u2014a Southern surgeon\u2019s story","volume":"47","author":"Breeden","year":"1973"},{"key":"b7","author":"Jones","year":"1867"},{"key":"b8","series-title":"A List of the Union Soldiers Buried at Andersonville: Copied from the Official Record in the Surgeon\u2019s Office at Andersonville","author":"Atwater","year":"1866"},{"key":"b9","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":"b10","series-title":"J Med Entomol","first-page":"607","article-title":"Distribution of members of Anopheles quadrimaculatus Say s.l. (Diptera: Culicidae) and implications for their roles in malaria transmission in the United States","volume":"41","author":"Levine","year":"2004"},{"key":"b11","series-title":"Fievre Bilieuse Melanurique des Pays Chauds","author":"Berenger-Faraud","year":"1874"},{"key":"b12","author":"Hicks","year":"2013"},{"key":"b13","series-title":"Clin Infect Dis","first-page":"1274","article-title":"Blackwater fever in southern Vietnam: a prospective descriptive study of 50 cases","volume":"23","author":"Tran","year":"1996"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"1804","article-title":"The multifactorial epidemiology of blackwater fever","volume":"97","author":"Shanks","year":"2017"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/108\/4\/article-p646.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/108\/4\/article-p646.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/108\/4\/article-p646.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T14:30:35Z","timestamp":1680705035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/108\/4\/article-p646.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,5]]},"references-count":14,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.22-0672","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,5]]}}}