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May 5, 1919: League of Red Cross Societies (now the International Federation of Red Cross and Red Crescent Societies) is formed in Paris, France.
https://www.redcross.org/about-us/who-we-are/history/significant-dates.html
https://www.cabdirect.org/cabdirect/abstract/19422900425
Malaria in the Mountains.
Author(s) : Alexandrov, Y. M.
Miscellaneous : Sovetskaya Meditsina 1940 No.2 pp.19-20 pp.
Abstract : This contribution is based on the experience of the author in the Pamirs in regions at an altitude of not less than 2, 000 m. It has been observed that malarial subjects, be the infection active or latent, generally develop an acute paroxysm or exacerbation on journeying from low levels into the mountains. The quicker and greater the change of altitude the greater is the tendency to and severity of the attack. A journey by air at 4, 000 m. is more likely to precipitate a paroxysm than a car journey. Though the disease is either activated or exacerbated, high altitudes have a favourable influence on the disease; often it is seen to terminate with the precipitated paroxysm or to undergo favourable changes in the symptoms; the enlarged spleen shrinks to its normal size.
The mode of action of the various factors concerned is not sufficiently studied and understood. Heightened ultra-violet radiation, oxygen hunger, rapidity and height of ascent, fatigue of the journey, all have a share in precipitating the paroxysm of malaria. Quartz radiation is known to provoke an attack and is used as a diagnostic test for latent disease. The author attributes the beneficial effect of altitude on the patient to the marked stimulation of vitamin D formation, activation of bone-marrow and haemopoiesis.
The precipitation of the attack is accounted for by the plasmodia thrown into the circulation from the blood squeezed out of the shrinking spleen. The lowered atmospheric pressure explains the epistaxis and copious menses seen in some patients. The water of mountain springs, being rich in salts, sometimes upsets the digestive tract and brings about a relapse of malaria.
The author has often encountered tertian malaria in the Pamirs even in winter. Anopheles are found at altitudes of 2, 000 m.
The author's findings are based on some 200 cases among copper miners and alpinists in this region. Among diseases calling for differential diagnosis he includes typhoid, central pneumonia, miliary tuberculosis, meningitis, typhoidal influenza [sic], typhus, visceral leishmaniasis, syphilitic fever, sandfly fever and brucellosis. He draws special attention to relapsing fever due to Spirochaeta carteri, which is most confused with malaria in this region. The spirochaetal fever is self-limited, ends in immunity of the patient, and is said to have no specific remedy. In some cases both infections may be present. The author states that blood tests cannot be relied on for diagnosis, as they vary with the altitude, but considers that Henry's reaction is of reliable diagnostic value.
To combat malaria in the Pamirs, the author advocates compulsory prophylactic treatment with acri-quinine [atebrin] in all cases of less than three years' freedom from attacks. In active cases, owing to the probability of concurrent infection with both malaria and Spirochaeta carteri, simultaneous treatment with Orasol and plasmocide is recommended. Cardiazol and barbiturates have been valuable in ameliorating the patient's condition. D. V. Giri.