Did you know that mosquitoes and the diseases they transmit are so dangerous that there are not one – but two – international observance days regarding them and preventing malaria?
Mosquitoes and malaria:
April 25th is World Malaria Day: an annual international observance which recognizes global efforts to control malaria.
According to Malaria No More, a charity that Rentokil Initial supports globally, in 2017 there were 435,000 lives lost from malaria and 219 million cases of the disease. Added to which, malaria also accounts for half of the missed days in African schools. Healthy children can go to school and learn more effectively, ultimately impacting their ability to earn a living. Keeping children healthy enables parents to go to work and reduce the need to spend their wages on malaria treatments and health care, so eliminating malaria is not only an issue of health but also of breaking the cycle of poverty.
Mentions of malaria can be found in the ancient Roman, Chinese, Indian and Egyptian manuscripts and later in numerous Shakespearean plays. The belief that mosquitoes transmit disease also is an ancient one, although it was only in 1897 that British doctor Sir Ronald Ross scientifically proved that the female Anopheles mosquito transmits malaria.
August 20th is World Mosquito Day, which marks Ross’s discovery. His findings provided the foundation for scientists across the world to better understand the deadly role of mosquitoes in disease transmission. They also earned Ross the second ever Nobel Prize in Medicine in 1902 “for his work on malaria, by which he has shown how it enters the organism and thereby has laid the foundation for successful research on this disease and methods of combating it”. (Interestingly, Dr Ross also attempted to eradicate malaria from England by forming ‘mosquito brigades’ to eliminate mosquito larvae from stagnant pools and marshes).
In the post we wrote for World Mosquito Day we took a look at the science behind fighting malaria, and some of the new antimalarials that are emerging from current research. But what about the oldest anti-malarial in the book? Gin and Tonic… Was Sir Winston Churchill correct or is it simply and an old wives tale that drinking gin and tonic can help prevent malaria?
To understand whether the classic British cocktail might have any benefits in preventing malaria, we need to understand where the combination originated, and why.
Jesuit missionaries in South America in the 1600s were the first to discover that the bark of the Cinchona (quina-quina) tree could be used in treating and preventing malaria. They referred to it as “Jesuits’ bark,” “cardinal’s bark,” or “sacred bark”. In the 1700s a Scottish doctor named George Cleghorn discovered that the effective, active component of the bark was quinine, and then in 1820 French chemists isolated quinine as a compound, which allowed for its expanded availability and use.
Prophylactic rations of quinine were tried by the British/Indian Army during campaigns in China in the 1860s and multiple comparative tests of quinine versus no medication were tried by enthusiastic medical officers in various military units in India, often with indeterminate results.
The origins of Indian Tonic Water:
The quinine was provided as a powder that was mixed with water, however, troops found the bitter taste unpleasant. British officers in India in the early 19th century therefore added sugar to the mixture of quinine and water, creating the first Indian Tonic Water. It was made even more palatable when they added some gin and lime to the mixture, creating the classic gin and tonic cocktail. Quinine remained the mainstay of malaria treatment until the 1920s when more effective synthetic antimalarials became available. The most important of these drugs was chloroquine, which was used extensively from the 1940s.
So does that mean a stiff gin and tonic every evening can prevent malaria?
The sad news for cocktail bars around the tropics is that tonic water today contains far less quinine than its original 1860’s counterpart (and a lot more sugar). According to the Travel Doctor, you’d need to drink 67 litres of tonic water to ingest a preventative dose (1 gram) of quinine! This is because (according to a paper in “Malaria: Parasite Biology, Pathogenesis and Protection (1998, ed Sherman) modern tonic water contains only 15mg of quinine per litre – and thus has little antimalarial effect.
Drinking a glass of a decoction of Cinchona bark (made by soaking the bark in brandy or gin for 5 or 6 days) two or three times a day would have provided at least 1-2 grams of quinine per day. This amount would have protected against malaria, but would also have probably made you quite drunk!
Despite the fact that modern tonic water doesn’t contain enough quinine to be considered effective at preventing malaria, it does still make a great drink on a hot summers evening. Quinine is the key ingredient that creates a gentle bitterness in tonic water. However, you certainly don’t want to be drinking your gin and tonic whilst being plagued by mosquitoes, so take a look at one of our previous fact or fiction posts: Do natural remedies work against mosquitoes or visit our website to find out how you can avoid mosquito bites.
You can help fight malaria by uploading a picture of yourself to Twitter, raising a glass of anything wet (how about a gin and tonic) and mention @FeverTreeMixers. The good people at FeverTree have pledged to donate 5 GB pounds to Malaria No More for every image that mentions @FeverTreeMixers
Also add #MalariaMustDie and #MalariaMustDieRI. Cheers to that!