Falciparum Malaria and PTSD

Persons carrying the sickle cell gene have some protection against malaria. Persons with a gene for hemoglobin C (another abnormal hemoglobin like sickle hemoglobin), thalassemia trait or deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD) are thought also to have partial protection against malaria.

• It is now widely believed that falciparum malaria contributed in no small way to the final fall of the Roman Empire. DNA evidence supports this concept.

Most who had malaria in VN had one type or the other, but it is possible to have both types and to have them simultaneously.

Various strains of falciparum malaria exist, and the one common to VN is the deadliest of the bunch.

Vivax produces the traditional fever and chills commonly associated with malaria and makes the victim feel as if he is going to die, but he usually doesn't die of this variety.

Falciparum malaria doesn't produce alternating fever and chills. It produces a fever which rises steadily and rapidly until the victim looses consciousness. The body temperature continues to rise, and death commonly results from brain damage.

Since the practice in the field was not to evacuate malaria victims until the fever reached a high level (usually more than 102 degrees F.), some brain damage had already occurred to the sub-cortical white matter before the victim reached medical help and treatment began.

Falciparum (cerebral) malaria gives symptoms which can be confused with PTSD, such as irritability, memory loss, rage, sleeplessness, tendency toward violence, flashbacks, etc. Bad news for someone who has PTSD and has to deal with a condition which aggravates the PTSD.

The good news in all of this is that falciparum malaria does not re-occur unless the victim is reinfected. Getting even better, there is a simple treatment which reduces most, if not all, the damage done by falciparum malaria and gives most of the victims substantial relief.

A recent study done at the University of Iowa on VN Vets is the basis for the summary given above.

Any vet who has both PTSD and has had falciparum malaria should see what can be done to treat the malaria residuals. This may result in a lowering of his rating for PTSD but should give a compensating rating increase for malaria. The end result should be that the vet has a better life and still has the same VA rating.

More information available upon request.

Malaria Linked to Post Traumatic Stress Disorder

In the June 2002 issue of VIETNAM magazine is an article "Perspectives" written by Steven J. Lloyd. His convincing article suggest that some PTSD symptoms may be cause by malaria.

Plasmodium falciparum (P. falciparum or falciparum malaria) is likely to account for 90 percent of malaria illnesses reported in Vietnam. Because it primarily effects the brain it is the most feared.

The cerebral malaria infection produces uncontrollable physical shaking, fever, chills, night sweats, nightmares, anger, rage and impaired judgment. The article also suggests that there may be a decease in mental capacity and lowering of the IQ.

If you have not been tested for malaria by the VA it is highly suggested that you do so immediately. If your VA doctor hesitates or balks at the suggestion, insist that a test for malaria be done. A trip to see the Medical Center's VA "patient representative" might be necessary to convince your doctor to comply.

It is your right to have any reasonable testing done by the VA that may uncover any illnesses or diseases that you may have as a result of your military service.

The Relation Between Malaria & PTSD
PTSD AND MALARIA
April 10, 1998
Malaria as a cause of the Vietnam Post Traumatic Stress Syndrome?

ANCHOR LEAD: Some Vietnam veterans with bizarre symptoms lumped under the post-traumatic stress syndrome may actually be having the lingering problems of malaria according to new research. For some this could be good news - thas a treatment different from the usual, and a better level of success. Nineteenth century British soldiers in India had the same symptoms as Vietnam era soldiers - often thought psychiatric, but maybe due more to malaria than stress.
(* Doctors at the University of Iowa have recently published a study looking at 80 veterans. Half of them had actual combat wounds - gun shots - shrapnel - the other half with no physical injury but a history of malaria. Guess what - the malaria soldiers had more of the symptoms associated with Post Traumatic Stress Syndrome than the guys who had been injured. Malaria causes lingering depression, memory problems, emotional instability, and seizure like symptoms. The new study is important, because post malaria syndrome has a more successful treatment *) Malaria acquired through mosquito bites may be a more common problem than we think - more common than Agent Orange. I'm Dr. Bob Lanier
ANCHOR TAG: Over 250,000 American Soldiers suffered some form of malaria during the Vietnam campaign.

REFERENCE: , Nils R.Varney, Journal of Nervous and Mental Disease adjunct professor of psychology and a staff neuropsychologist at the VAMC in Iowa City
http://www.newswise.com/articles/VIETNAM.UIM.html
University of Iowa College of Medicine
8-Jan-98

• UI/VAMC study says patient's history of malaria may be a clue to many Vietnam vets' psychological and other health problems

Library: MED Keywords: VETERANS MALARIA CEREBRAL VIETNAM PTSD PSYCHOLOGY VA

IOWA CITY, Iowa -- Cerebral malaria should be considered as seriously as post- traumatic stress disorder (PTSD) or Agent Orange exposure as an underlying cause of long-term medical and psychological problems faced by some Vietnam War veterans, according to a study by a University of Iowa and Veterans Affairs Medical Center (VAMC) psychologist.

In an article published in the November issue of the Journal of Nervous and Mental Disease, Nils R. Varney, UI adjunct professor of psychology and a staff neuropsychologist at the VAMC in Iowa City, and his colleagues report that many cerebral malaria survivors from the Vietnam War have a number of neuropsychiatric symptoms that can persist for years after the acute illness has been treated.

It is estimated that as many as 250,000 Vietnam veterans suffered cerebral malaria. Contracted from mosquitoes, the illness causes an encephalitis, or inflammation of the brain. This can result in damage to cerebral nerve tissue in the frontal-temporal areas of the neocortex.

"Cerebral malaria does a number of different things to a patient's brain that cause a variety of neurological problems," Varney says. "Clinical reports from 500 B.C. through the 20th century noted that patients who survived the illness frequently developed depression, impaired memory loss, personality change and proneness to violence as long-term effects of the disease. These are symptoms that have been reported by many Vietnam veterans for years and are often treated strictly as PTSD."

The researchers compared the neuropsychiatric status of 40 Vietnam combat veterans who contracted cerebral malaria between 1966-1969 with 40 Vietnam veterans with similar wartime experience who suffered gunshot or shrapnel wounds during the same period. The participants underwent numerous tests for sensory, cognitive and behavioral symptoms.

Findings indicated that, when compared to wounded combat veterans who did not contract cerebral malaria during their service, the veterans who had malaria reported more problems with depression, subjective distress, auditory information processing, memory, emotional instability and seizure-like symptoms.

• Interestingly, Varney notes, the malaria-related health concerns among Vietnam veterans are similar to what British troops faced in 19th century India during the height of the British Empire.

 Nineteenth-century physicians documented these cases and considered malaria a leading cause of mental illness in British-occupied regions.
"It's well-chronicled in the medical literature from that period, but basically it's been forgotten, since malaria has not been a major problem in industrialized western nations for decades," Varney says.

The study results may offer new hope to many Vietnam veterans with neurological and psychological problems that have not responded to previous treatments. The findings suggest that doctors consider a history of malaria in any medical, psychological or psychiatric workup of Vietnam veterans because a positive response could change diagnosis and treatment. Anticonvulsant medications can be beneficial in treating symptoms that affect cerebral malaria survivors. "I would suspect that doctors who treat Vietnam veterans with unexplained and untreatable neurological or psychological problems would find a significant number of them with a history of malaria," Varney says. "And that means there's a different way to assess these cases. It's not solely PTSD or Agent Orange exposure that's causing these problems, which are the only explanations these veterans have had to hang their hats on. Now we may be able to move these patients into a category where their problems make sense, what is wrong with them is known and well-documented, and it's treatable."
The study was funded by the U.S. Department of Veterans Affairs.

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