How a Malaria Scare at the Start of World War II Gave Rise to the CDC

You’ve probably heard of The Cat and the Hat, but you may not have heard of “Bloodthirsty Ann.” Ann, another character created by Ted Geisel (aka Dr. Seuss), was a mosquito that transmitted malaria, and she first appeared in a 1943 booklet for American troops during World War II.

By the time Bloodthirsty Ann was introduced to readers, malaria had long been present in the southeastern United States. Cases of this deadly disease rose during the Great Depression and began to decline in the early 1940s. As the country mobilized for World War II, the United States became concerned with preventing its spread in its camps. military training, many of which were in the country’s southern states and overseas territories.

A 1943 illustration by Ted Geisel (aka Dr Seuss) "Bloodthirsty Ann," used to promote malaria control efforts.

A 1943 illustration of ‘Bloodthirsty Ann’, used by the US military to promote malaria control efforts.

In 1942, the United States Public Health Service created the Office of Malaria Control in War Zones to address the problem. The Atlanta-based office was the precursor to the CDC, which opened in 1946 as the Communicable Disease Center (now the Centers for Disease Control and Prevention). The bureau’s efforts may have helped end malaria transmission in the United States in the early 1950s, though modern researchers have questioned whether demographic and socioeconomic changes played a greater role in the decline of the disease.

War highlights malaria in the United States

Historically, disease has been a major killer in wars. During the American Civil War, tens of thousands of soldiers died of diseases such as typhoid, pneumonia, measles and malaria. The researchers also estimated that during World War I more soldiers died from the flu than from combat.

Disease control was a major concern for the United States when it entered World War II. To prevent deaths from bacterial infections, the country has mobilized to produce doses of penicillin. To avert the kind of flu pandemic seen during World War I, the United States funded research into the world’s first flu vaccines. In addition, the country has developed programs to combat malaria, a deadly disease caused by parasites and spread by Anopheles mosquito.

“These efforts during the war were actually successful on many fronts,” says Leo B. Slater, former historian at the National Science Foundation and author of War and disease: biomedical research on malaria in the 20th century. “World War II was the first major conflict the country entered in which casualties from disease were lower than casualties from combat.”

Captain Theodor Seuss Geisel’s “Bloodthirsty Ann” booklet was part of the US military’s malaria response. The pamphlet educated soldiers about malaria and how to avoid mosquito bites by using mosquito nets and insect repellents. In addition to the military’s efforts, the United States Public Health Service opened the Office for Malaria Control in War Zones, the CDC’s predecessor.

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The War Zone Malaria Control Bureau opened in 1942 in Atlanta, Georgia. This new office focused on draining and destroying mosquito breeding sites and spraying insecticides, as well as teaching local and state health departments to use these methods. Around 1943, he began applying a new insecticide called DDT to people’s homes to protect them from mosquitoes (in 1972 the United States banned DDT because of its long-lasting effects on the environment).

Focus expands to become CDC after the war

Like many wartime bureaus, the War Zone Malaria Bureau was scheduled to close at the end of World War II. However, a doctor named Joseph Mountin stepped in to expand the office into a multi-disease center.

Mountin, who at the time worked for the Bureau of State Services within the Public Health Service, “decided that MCWA should do more than malaria,” says Judy Gannt, director of the David J. Sencer CDC Museum in Atlanta. “And so in 1946 it became the Center for Communicable Diseases.”

The CDC continued some of its predecessor’s malaria control efforts while tackling other diseases like typhus and hookworm. Beginning in 1947, the CDC’s National Malaria Eradication Program worked in conjunction with local and state health departments to continue destroying mosquito breeding sites and spraying insecticides.

End of malaria transmission in the United States

A man uses a fogger to spray the pesticide DDT into a pool of standing water to kill mosquitoes, as part of the national malaria eradication program, 1958.

A man uses a fogger to spray DDT into a pool of standing water to kill mosquitoes, as part of the national malaria eradication program, 1958.

In 1951, the CDC considered malaria transmission eliminated in the United States. However, it is difficult to say what role the Office of Malaria Control in War Areas and the CDC played in this elimination. Medical historian Margaret Ellen Humphreys has argued that demographic and socioeconomic changes in the first half of the 20th century played a major role in the decline of malaria in the south.

“In America, malaria thrived where poor, malnourished people lived in porous dwellings near the breeding grounds of Anopheles mosquitoes, and they contracted a disease for which they could not, on the whole, acquire medicine effective for suppression or cure,” writes Humphreys in Malaria: Poverty, Race, and Public Health in the United States.

Access to better housing and medicine contributed to the decline of malaria in the United States, as did the migration of the poor and working class out of rural areas where their risk of contracting malaria was higher. This migration was so crucial in the decline of malaria, writes Humphreys, that “it is difficult to know whether the American DDT spraying campaign would have succeeded without it.”

Although malaria transmission is no longer a danger in the United States, the disease remains a major health risk in parts of the Americas, Asia, and Africa. The World Health Organization estimates that in 2020 there were 241 million cases of malaria and 627,000 deaths from the disease.

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