This post will explore a part of our panhandle history that is often not thought about when considering our ancestors’ lives. Acute illnesses were ever present for our ancestors. From Yellow Fever to Tuberculosis to Rheumatic Fever to Pneumonia, our ancestors struggled with these diseases because there wasn’t a good understanding of how they occurred or what might help prevent them and there weren’t medications that effectively treated them. Malaria was one of the worst of the diseases afflicting our Southern and panhandle Florida ancestors. It could not only be lethal, it was endemic and chronic in the South and in the Florida panhandle. Most cases were debilitating rather than lethal. Let’s look at this disease and its presence in the Florida panhandle.

Background

Malaria is carried and transmitted to humans by certain mosquitoes. There are four varieties: falciparum, vivax, malariae, and ovale. Only two of these were present in the U.S. in the past; falciparum and vivax. These two varieties of malaria present themselves differently in terms of severity. Falciparum is the more severe form of malaria. It causes intermittent high fevers, severe headaches, excessive thirst and painful body aches. It can also be accompanied by abdominal cramping, diarrhea, and vomiting. Children can develop seizures in a very short period of time. Liver, kidney, and brain may be impacted and the parasite can reach levels in the body that can cause arteries to clog. In the brain and heart, this can cause death. Mortality ranges from 20 to 40 percent when untreated.

Vivax is certainly unpleasant but it is more benign. The mortality rate is usually under 5 percent. It also causes a high fever, severe headache, and pains throughout the body but Vivax generally just causes misery, not death. Malaria has a pattern of development of the parasite in the body that causes intermittent fevers. The fever comes and goes at 48-hour intervals.

It is believed that Europeans brought Vivax to the Americas and that the Africans brought to the Caribbean and Americas as enslaved persons came with the parasite Falciparum. Africans had lived with Falciparum for so long that they had developed some level of immunity to its effects and the trait for sickle-cell anemia if only provided by one parent also provided some protection from the parasite. In addition, they experienced minimal effects from Vivax. Falciparum prefers warmer temperatures and just did not survive in latitudes above the middle Atlantic states. It, however, thrived in the South and contributed to the impression that the early southern states were unhealthy and probably increased the dependence on slavery (because blacks suffered less than whites) to produce those products only the south could produce: cotton and sugar cane. Vivax made itself at home throughout the U.S. It was not uncommon for both varieties to be found in hospitable locations in the South. Slow moving water and swampy areas allowed the mosquitoes that carried these parasites to flourish. Heavy rains that left standing water would be a welcome mat for both parasites. Poorly constructed houses with large cracks allowed mosquitoes into the house further exacerbating the situation.

Finding Evidence Where Your Ancestors Lived

The problem for interested historians looking for information about the incidence of malaria in the past is that our ancestors really didn’t have much of an understanding of diseases and didn’t make an effort to distinguish fevers. The term “ague” was often used by our ancestors to reference chills and fever and if the description included “intermittent” it was likely malaria and not some other cause of fever, of which there were many.

The Florida panhandle had, and still has, more than its share of waterways with swampy areas along the banks, periods of heavy rain, and subsequent standing water to breed mosquito larvae. The mosquitoes then found their way into people’s homes or found a tasty meal in a field near the river and occasionally the victim would have one of the above varieties of malaria and infect the mosquito. If the mosquito lived long enough, it then infected another person with the parasite and malaria would then occur in a new human.

The Slow Demise in the South

After the Civil War, malaria began to disappear from the north, probably a factor of economic improvement, better housing, more urbanization that often led to drainage of swampy areas, better access to health care, and better health in general. But in the South, and in Florida, malaria continued to be a problem in the rural areas until the mid-20th century. By the early 20th century, it was known that quinine would decrease the effects of malaria and that mosquitoes were the vector.

Because malaria was endemic in many rural areas of the South, and both varieties were present, one person could be re-infected over multiple years. This sapped their energy and made it difficult for them to function productively. The re-occurring chills and fevers could be so violent that the person would literally shake and nothing would seem to warm them. The cycling chills and fevers would continue until winter. Then the person could be re-infected the following year and it would start again. Quinine lessened the symptoms but tasted awful. It was very bitter, making it difficult to give daily to a child.  Grove’s Chill Tonic tasted a bit better, I am told, than straight quinine but may not have been as effective.

During the administration of Franklin Roosevelt, the government made the decision to spray the swampy areas of the South to kill the mosquitoes and attempt to intercept the transmission of the parasite. They sprayed DDT repeatedly through the early part of the 1940s. The spraying worked to kill the mosquitoes, at least temporarily and did interrupt transmission, but DDT created some new problems that time has only begun to resolve.  With hindsight, we also know that the incidence of the disease was already dropping in many parts of the South so it is hard to evaluate whether the spraying was more than moderately helpful.  But for those plagued by the disease, it seemed a good idea.

My Interest is Personal

I have always been interested in the issue of malaria in the panhandle because a number of my Mom’s sisters had malaria as children and my Mom was severely impacted by it for a number of years. She remembers being at school and having chills and fever so bad that the teacher piled all of the kids’ coats on her to try and warm her. The quinine and Grove’s Chill Tonic was ever present at my grandparent’s house. Years later when my Mom moved back home, she ran into one of her teachers from those early years and after saying hello, her teacher asked if Mama still had malaria. She didn’t, but in her early thirties, there was still enough evidence in her bloodstream that she was quarantined for a while until the doctor was assured by the CDC that she wasn’t infected with a new and deadly disease and not contagious.

It is very likely that if your ancestors lived near rivers, creeks or ponds and they lived in the South, one or more of them had malaria at some point in their lives. Searching newspapers for intermittent ague may tell you if the area they lived in would have yearly increases in fevers that killed some and debilitated others. Do a little research on how malaria was treated. Try to put yourself in an ancestor’s shoes and try to understand how you might function if every 48 hours you had to contend with violent chills and fevers, a splitting headache and a whole body ache. This could go on for months before it subsided but you knew it might happen again next year. It does make you wonder how they ever got things done.

Malaria is still with us, it is just that most infections are contracted outside the U.S. and brought back home. Medicine is better now and if diagnosed and treated, malaria doesn’t win the battle. Occasionally, there will be native infections and that always brings about more attention from the Public Health System at the state and federal level. For the time being, we’ve won this battle but like most bacteria, viral, and parasitic diseases, they could always return if the conditions are right.

Until Next Time.

Resources:

• Malaria: Poverty, Race, and Public Health in the United States by Margaret Humphreys
• Early Florida Medicine, Florida Memory Exhibit
• Florida Department of Health, Malaria
• History of Malaria in the USA
• History of Malaria, Wikipedia