The Malaria Project: The U.S. Government's Secret Mission to Find a Miracle Cure
384
The Malaria Project: The U.S. Government's Secret Mission to Find a Miracle Cure
384eBook
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Overview
American war planners, foreseeing the tactical need for a malaria drug, recreated the German model, then grew it tenfold. Quickly becoming the biggest and most important medical initiative of the war, the project tasked dozens of the country’s top research scientists and university labs to find a treatment to remedy half a million U.S. troops incapacitated by malaria.
Spearheading the new U.S. effort was Dr. Lowell T. Coggeshall, the son of a poor Indiana farmer whose persistent drive and curiosity led him to become one of the most innovative thinkers in solving the malaria problem. He recruited private corporations, such as today's Squibb and Eli Lilly, and the nation’s best chemists out of Harvard and Johns Hopkins to make novel compounds that skilled technicians tested on birds. Giants in the field of clinical research, including the future NIH director James Shannon, then tested the drugs on mental health patients and convicted criminals—including infamous murderer Nathan Leopold.
By 1943, a dozen strains of malaria brought home in the veins of sick soldiers were injected into these human guinea pigs for drug studies. After hundreds of trials and many deaths, they found their “magic bullet,” but not in a U.S. laboratory. America 's best weapon against malaria, still used today, was captured in battle from the Nazis. Called chloroquine, it went on to save more lives than any other drug in history.
Karen M. Masterson, a journalist turned malaria researcher, uncovers the complete story behind this dark tale of science, medicine and war. Illuminating, riveting and surprising, The Malaria Project captures the ethical perils of seeking treatments for disease while ignoring the human condition.
Product Details
| ISBN-13: | 9780698140134 |
|---|---|
| Publisher: | Penguin Publishing Group |
| Publication date: | 10/07/2014 |
| Sold by: | Penguin Group |
| Format: | eBook |
| Pages: | 384 |
| File size: | 11 MB |
| Note: | This product may take a few minutes to download. |
| Age Range: | 18 Years |
About the Author
Read an Excerpt
PROLOGUE
A decade ago I knew as much about malaria as I did about professional football—that is to say almost nothing.
This killer disease occupied little of my thinking as I chased down U.S. senators and congressional leaders and wrote daily political stories from Capitol Hill for the Houston Chronicle. Little did I know that I would soon cross the globe, go back to school, and spend hours in reading rooms flipping through archived boxes of moldy records. (One box at the National Archives smelled so strongly of ammonia I closed it and returned it to the counter unread.) I did all this to understand why malaria is still around. It is probably the most studied disease of all time, and yet it persists, even in the face of the hottest new science in Western medicine. It’s both preventable and curable. We’ve even deciphered its genetic codes. Still, it remains among the top killers of African children—at a rate of two per minute.
By a fluke, malaria crept into my intellectual pursuits. I had quit my job as a national reporter to explore my interests in science and medical writing, both of which I had done before coming to Washington. I accepted a teaching fellowship at Johns Hopkins University, where I studied the history of medicine, and I took a course in mining the National Archives to learn how to find its buried historical treasures.
There, in a hushed reading room of the agency’s annex in College Park, Maryland, I learned how to call up records from the building’s two million cubic feet of storage space. As an exercise, I searched for archived records on World War II blood plasma replacement studies involving Linus Pauling—two-time Nobel laureate for chemistry and peace activism. My call slips came back with a box marked with the correct record group number and bearing the letter “P,” for Pauling. But the contents were all wrong. Thinking his papers were mixed in under other headings, I thumbed through the entire box, reading through random letters.
One turned my blood cold.
The 1943 letter was to the Massachusetts surgeon general from a physician named George Carden. In it, Carden laid out what sounded like a sinister plan: Federal researchers would use blood transfusions and lab-raised mosquitoes to give malaria to brain-damaged syphilitics and schizophrenics held at Boston Psychopathic Hospital so new drugs could be tested against the resulting infections. No less than the war’s outcome was at stake, he wrote, explaining that the military desperately needed a new drug to counter malaria’s devastating attacks on U.S. forces in the South Pacific.
I reread the letter a dozen times before my blood warmed to the possibility that I had just stumbled onto a fascinating, if horrifying story. That night I went home and ran Google searches, which, back in 2004, turned up very little. The next day I returned to the archives and met with a specialist in World War II medical research. She helped me navigate the Byzantine reference catalogs used to pinpoint exact call numbers for relevant records. Over the next three days, I retrieved a dozen boxes from the bowels of the archives, each filled with letters, reports, and data sheets on the war’s antimalaria program—information that had been classified during and after the war, and, as far as I could tell, hadn’t been touched in decades. I also tracked down historian of medicine Leo Slater, who, at the time, was working at the National Institutes of Health. He had an unpublished manuscript on the war’s malaria-related work that tracked the involvement of American pharmaceutical companies—a history that has since been published by Rutgers University Press.
With Leo’s help, I slowly pieced together a fairly clear picture of what had gone on. The War Department and White House had launched a Manhattan Project–style program to find a cure for malaria, born out of wartime necessity and run by a small army of well-intentioned scientists, many of whom knew precious little about the tricky parasites they studied. All they knew for sure was that U.S. military leaders feared this one disease would force them to surrender to the Japanese—an unacceptable outcome in a war destined to determine the fate of the world.
I hunted for a published history or popular narrative on the subject, and found nothing. The more I searched the more I realized I was in uncharted territory. But to know whether this was something worth pursuing, I needed context and content. When I got to Hopkins that fall, I wrote my schedule to include public health courses that covered the epidemiology and medical history of malaria. I continued my treks to the National Archives—unearthing more and more documents—and took a microbiology course to understand the nature of microbial diseases.
Needing more background, I sought and was awarded a Knight Foundation public health journalism fellowship that funded me to work for three months in the Malaria Branch of the U.S. Centers for Disease Control and Prevention. In CDC’s labs just outside of Atlanta, I dissected mosquitoes, studied their salivary glands, and watched under a microscope the sticklike germs that enter the human body when a female anopheles mosquito bites for blood.
My teacher was Bill Collins, a seventy-six-year-old icon in malaria research who, at the time, was the only federally employed malariologist who had been at it long enough to remember what it was like to infect madmen with the disease. He did it in the 1950s and early 1960s for the Public Health Service at the South Carolina State Hospital, where drug experiments begun during World War II were continued.
He still used many of the techniques he learned from his state asylum days. The main difference was that at CDC he infected monkeys instead of humans. He recalled this with remorse. The “good old days,” as he called them, allowed scientists to observe malarial parasites in the blood of sick people. He and his colleagues gleaned data that helped the world better understand the microbes’ behavior and complex life cycle, ultimately resolving many mysteries that had shrouded the parasites in a type of protective secrecy. The intelligence gave scientists needed insights to develop ideas for a possible vaccine. That he gave a painful and potentially deadly disease to witless syphilitics posed no moral dilemma for Bill. Up until penicillin became available in the 1940s, the madness that came with untreated syphilis could be reversed by malarial fevers—as the fevers ramped up the immune system to kill syphilis spirochetes interfering with brain function. Two decades after penicillin, Bill still used this outmoded malaria treatment—which worked on only a fraction of cases, the rest having no benefit—in South Carolina. He was doing God’s work, trying to find a final solution to one of the world’s most menacing diseases, until an absence of syphilis patients and ethical concerns shut him down in 1962.
Four decades later, his mission hadn’t changed; it just got a lot more difficult. Even though monkeys are our cousins, they are hard to infect with human malaria. So Bill and his colleagues raised parasites to infect primates, and then ran experiments that attempted to extrapolate the extent to which a given drug or vaccine might also work against human malaria.
At CDC’s run-down campus on Buford Highway—miles from the glitzy labs that characterize its cutting-edge work on AIDS, Ebola, childhood obesity, and other hot topics—I was trained in the intricacies of manhandling these dangerous microbes. My education started in the insectary, where I helped a Kenyan researcher named Atieli breed colonies of the world’s most efficient malaria-carrying mosquitoes. We separated pupae from larvae in a screened-in room set at eighty-four degrees and 80 percent humidity. Just before the pupae molted into mosquitoes, we caught them in netting, put them in small cages with gauze lids, carried them to the primate house, and turned them over to technicians, who pressed the cages against the shaved bellies of monkeys sick with malaria.
After the mosquitoes gorged on infected blood, the insects went to Bill’s lab to be placed in refrigerator-size incubators. There the insects stayed while the parasites in their guts sexually reproduced, leaving behind tiny egg sacs. In less than two weeks’ time, the sacs burst with offspring that were circulated into the insects’ salivary glands. There they awaited an opportunity to escape—which happened whenever the mosquitoes sank their needlelike noses into the flesh of warm-blooded mammals.
I sat next to Bill every morning, watching him handle spherical cardboard cages that held hundreds of highly infectious mosquitoes. They hung inside like razor stubble, bursting into black clouds every time he tried to catch them. This involved pushing a rubber hose through a small opening in the cardboard, with the other end of the hose in his mouth. With a single breath, he’d suck in five or six mosquitoes and then blow them into a small glass jar filled with chloroform—which knocked them out cold. That’s when I’d pick up one with tweezers, place it under a magnifying machine, chop off its head, and pull away the gut. Then, under a stronger microscope, he counted the egg sacs to determine the “parasite load” of each batch of mosquitoes. Knowing the load helped Bill determine which were the most likely to induce infections in monkeys primed with experimental vaccines. In this way, CDC ran the first line of tests on potential vaccines developed by the U.S. military and private pharmaceutical companies.
This process was anything but safe—for man or beast.
The monkeys’ lives were obviously at risk. They got hit with unnaturally high doses of parasites. If the experimental vaccine or drug being tested was bad or ineffectual, the poor creatures often died. This agitated Bill, but not out of compassion. He was a scientist, which by definition meant he controlled his emotions toward his animals. But an avoidable death angered him. The monkeys were expensive—as much as $5,000 each—and increasingly hard to buy. To Bill, even the most tattered and overused primate could be good for one more experiment. Losing even one to an ill-conceived vaccine preparation concocted by dim-witted drug companies bugged him to no end.
But the process was also dangerous for people. One day in early 2005, while Bill captured mosquitoes infected with a type of human malaria called Plasmodium vivax—the same one that crippled World War II forces in the South Pacific—one escaped and bit his lab assistant Doug. He fell sick two weeks later with a high fever and screaming headache. When I asked Doug about it, he shrugged. Sure, vivax malaria is horrible. He was seriously ill for more than a week. And he had to report the incident to disease investigators at the CDC. But contracting the disease is a rite of passage worn like a badge of honor, with a history as old as malaria research. Turn-of-the-century photos show professors with cages of mosquitoes strapped to their bare chests, hoping to induce an infection. In this tradition, Doug didn’t think of this mishap as a problem. CDC’s administrators, however, did. They immediately ordered another layer of screening between Bill and the rest of the world.
Shortly thereafter I joined Bill in the lab. One morning we were dissecting mosquitoes infected with a malarial parasite called Plasmodium inui. As Bill sucked the insects into his tube, one flew off over my head. I already knew P. inui was a type of monkey malaria capable of jumping species and infecting humans. As I nervously watched the escapee make a U-turn in my direction, I tapped Bill on the shoulder to show him we had a problem. In true Bill Collins form, he looked up from his microscope, spotted the mosquito, and said, “Gosh, ya hate to see that.” He then hunched back over his machine, as if enough were said.
I’d been at CDC about a month and tried to assimilate with the culture there, something I’ve always been good at. But this was different. I couldn’t be like the fellow researchers; I couldn’t be casual about malaria. I had no interest in living through chills intense enough to rattle my teeth and fevers high enough to damage my organs. I sat paralyzed, scanning the air, knowing that a featherweight bug could at any moment inject devilish microbes into my blood. Next to me, Bill went about his business, clicking slides of mosquito gut under the long arm of his microscope. When I finally locked onto the mosquito’s flight pattern and lunged forward to slap the life out of it, I saw the corners of Bill’s mouth turn up in a grin—which I took as tacit approval. No matter how skittish my actions looked to seasoned malariologists, I assumed Bill breathed relief: His reporter friend would walk away from his lab without the drama of contracting malaria.
Years later I learned the true meaning of Bill’s grin. P. inui, I discovered while researching this book, could indeed jump species, but only in rare circumstances, usually requiring an artificial concentration of the microbes injected directly into the bloodstream. Mosquitoes usually are incapable of transmitting a high enough dose of P. inui to infect people. The day I read that enlightening journal article I smiled, and remembered the privilege of having spent time sitting next to Bill.
Bill was a round man with bad hips and white hair. His acerbic humor, when he was tickled, would send his voice into a pitch high enough to pass for a girl’s. But he also was funny and happy and easy to spend time with. He was extremely generous to anyone who cared enough about his disease to ask questions, and always gave good thought to even the most basic and simplistic inquiries. He wanted everyone to understand his disease, especially the history of it. He hated that malaria in the 1990s got so little respect from global funding outlets, like U.S. AID and the World Health Organization. He remembered malaria’s heyday, back when developed nations still had malaria, and, after the war, when U.S. AID and WHO made malaria eradication their top priority. In 1970, when the effort failed and funding dried up, malaria experts were forced to switch fields. There just weren’t enough jobs for all the people trained during the eradication era.
Back when Bill was forced to stop his work at the South Carolina State Hospital and move it to CDC, the disease control agency was still flush with cash for malaria research, so this was a good move for him. After 1970, however, malaria jobs there were halved and then halved again. As the agency grew and expanded into stunning new glass buildings with high-tech machines for researching other diseases, malaria moved into the dumpy old buildings. There was no room for the insectary, so it was housed in a trailer on-site.
For anyone researching this disease, Bill was a treasure. He taught me how to induce a malaria infection using methods that had hardly changed since the 1940s. He displayed an attitude toward human experiments that gave me insights into the U.S. Public Health Service’s action during World War II. My own anachronistic view of the time was quite critical: The very agency dedicated to the public’s good health had reached into state hospitals and penitentiaries to infect the insane and imprisoned with a disease that, at the time, had no cure. The nuances, however, are far more interesting than the headlines. Bill lived those nuances until the early 1960s when he was forced to stop giving malaria to syphilis patients in South Carolina. Bill’s personal experiences with and deep knowledge of the war’s program—backed by a roomful of his own archived materials—neutralized my biases. And I hope it has allowed me to fairly and accurately retell this seventy-year-ago story, for which there are few remaining witnesses.
Table of Contents
Prologue 1
Introduction: A Brief History 11
Chapter 1 Lowell T. Coggeshall 23
Chapter 2 Fever Therapy 33
Chapter 3 Making of a Malaria Warrior 42
Chapter 4 From Insects to Medicine 56
Chapter 5 A Nobel Prize 60
Chapter 6 Divided Loyalties 68
Chapter 7 Germany and Magic Bullets 74
Chapter 8 Eradication 88
Chapter 9 Claus Schilling 96
Chapter 10 A New Plan 106
Chapter 11 Africa 120
Chapter 12 Bataan 130
Chapter 13 War on Mosquitoes 136
Chapter 14 Guadalcanal 147
Chapter 15 A Malaria Manhattan Project 156
Chapter 16 Better to Be Yellow 164
Chapter 17 The Other Side 176
Chapter 18 Taking Tunis 188
Chapter 19 Mosquito Brigades 193
Chapter 20 The Jump 206
Chapter 21 Malaria and the Madmen 217
Chapter 22 The Convicts 228
Chapter 23 Supply and Demand 233
Chapter 24 Whoville 248
Chapter 25 The Breakthrough 255
Chapter 26 Stateville 266
Chapter 27 Taking Command 284
Chapter 28 Klamath Falls 292
Chapter 29 Victory of Sorts 307
Chapter 30 A Miracle of Sorts 320
Epilogue 336
Acknowledgments 343
Bibliography 347
Notes 359
Index 391
What People are Saying About This
“Masterson’s gripping tale unfolds seamlessly.”—The Wall Street Journal
“A fascinating story of the hunt for a killer as medical science emerges from its own dark ages.”—Joel Achenbach, Author of A Hole at the Bottom of the Sea
“Part detective tale, part history . . . [with] characters as diverse as Hitler and Dr. Seuss.”—Thomas Frank, Investigative Reporter and Pulitzer Prize Finalist
