{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T05:27:54Z","timestamp":1738819674389,"version":"3.37.0"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Despite their colonial experience with tropical medicine, Allied (United States, United Kingdom, Australia, and India) Armies in the Indo-Pacific region were surprised by the large number of <jats:italic>Plasmodium vivax<\/jats:italic> infections in their soldiers during the Second World War. Even after the institution of effective chemoprophylaxis with quinacrine, multiple cycles of clinical relapses often occurred when months of medication was discontinued. Nearly monthly symptomatic relapses (&gt;10) were not unusual and resulted in important manpower losses after each campaign. Retrospective consideration suggests that small splenic size was associated with the risk of recurrent clinical episodes of vivax malaria. Potential non\u2013mutually exclusive explanations for frequent relapses of vivax malaria in soldiers are reviewed. These include decreased retention of parasitized red blood cells by small spleens through greater filtration stringency preventing relapses from becoming clinically patent; small spleen size being a marker of lower innate and\/or acquired immunity, modulating the risk of clinically patent recurrences; or small spleen size increasing the number of relapses through decreased removal of triggers of hypnozoite activation. Apparent splenic modulation of vivax malaria relapses suggests a complex interaction between the parasite and host that might be amenable to manipulation to facilitate malaria elimination.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0465","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T14:27:45Z","timestamp":1732631265000},"page":"247-249","source":"Crossref","is-referenced-by-count":0,"title":["Splenic Modulation of Plasmodium vivax Relapses and Hypnozoite Activation during the Second World War?"],"prefix":"10.4269","volume":"112","author":[{"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia;"},{"name":"School of Public Health, University of Queensland, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"year":"1918","author":"Ross","series-title":"Malaria in Macedonia: Clinical and Haematological Features and Principles of Treatment","key":"b1"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"51","article-title":"High risk of Plasmodium vivax malaria following splenectomy in Papua, Indonesia","volume":"68","author":"Kho","year":"2019"},{"key":"b3","series-title":"N Engl J Med","first-page":"2067","article-title":"Hidden biomass of intact malaria parasites in the human spleen","volume":"384","author":"Kho","year":"2021"},{"key":"b4","series-title":"Trends Parasitol","first-page":"573","article-title":"The biology and pathogenesis of vivax malaria","volume":"40","author":"Anstey","year":"2024"},{"key":"b5","series-title":"J Hist Biol","first-page":"781","article-title":"Malaria: Origin of the term \u201chypnozoite.\u201d","volume":"44","author":"Markus","year":"2011"},{"year":"1957","author":"Walker","series-title":"The Island Campaigns","key":"b6"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"1173","article-title":"Plasmodium vivax relapse rates in allied soldiers during the Second World War: Importance of hypnozoite burden","volume":"107","author":"Shanks","year":"2022"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"5","article-title":"Lessons in malariology from World War II","volume":"26","author":"Russell","year":"1946"},{"key":"b9","series-title":"Lancet Infect Dis","first-page":"900","article-title":"The activation of vivax malaria hypnozoites by infectious diseases","volume":"13","author":"Shanks","year":"2013"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"1237","article-title":"Malaria relapses following parasite-free blood transfusions in the U.S. Army during the Korean War","volume":"106","author":"Shanks","year":"2022"},{"key":"b11","series-title":"Am J Trop Med Hyg","first-page":"964","article-title":"Historical 8-aminoquinoline combinations: Not all antimalarial drugs work well together","volume":"107","author":"Shanks","year":"2022"},{"key":"b12","series-title":"Med J Aust","first-page":"145","article-title":"Malaria in the South-West Pacific, with special reference to its chemotherapeutic control","volume":"2","author":"Fairley","year":"1946"},{"key":"b13","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":"26","author":"Downs","year":"1946"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"177","article-title":"Malaria and filariasis in the returning serviceman: The ninth Charles Franklin Craig Lecture","volume":"25","author":"Coggeshall","year":"1945"},{"key":"b15","series-title":"Am J Trop Med","first-page":"221","article-title":"Renewed clinical activity in naturally induced vivax malaria","volume":"24","author":"Boyd","year":"1944"},{"key":"b16","series-title":"Am J Hyg","first-page":"361","article-title":"Studies on benign tertian malaria. 8. 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