Atabrine for Malaria, WWII Tactical and Technical Trends, No. 26, June 3, 1943 (Lone Sentry)

Contrary to current popular impression, atabrine is not a brand-new drug for the treatment of malaria (See Tactical and Technical Trends, No. 20, p. 23). It was developed by the German dye industry some 12 years ago and has been in use for more than a decade. Tens of thousands of cases of malaria were treated with atabrine before the present war began. Careful research and extensive field tests were made to compare its effectiveness with that of quinine. It is generally agreed that atabrine is a good antimalarial drug and has no serious toxic effects. Like quinine it does not always cure malaria in one course of treatment, and also like quinine, it does not prevent infection when used as a prophylactic. Both drugs, however, given in small doses, are very useful in suppressing clinical symptoms, especially under emergency conditions such as a period of combat, when men must be kept on their feet in spite of malaria infection.

When the Japanese occupied the Dutch East Indies and thereby captured the source for more than 90 percent of the world's supply of quinine, it became necessary to conserve the present stock of quinine in order that it may continue to be available for the small proportion of malaria cases which require special treatment. To this end it has become the policy of the Army and the Navy, as well as our Allies, to employ atabrine both for suppressive and curative treatment wherever possible. In this connection it should be pointed out that atabrine is used both by the Japanese and by the Germans for the same purposes.

Atabrine is a yellow dye. Its continued use therefore usually causes a yellow coloring of the skin. This has no harmful effects, however, and soon disappears when the drug is discontinued. In a small minority of cases, atabrine may occasionally cause nausea and vomiting. These symptoms are seldom serious and can usually be avoided by taking the drug only after meals. The vast majority of people take atabrine without any unpleasant effects whatsoever.

With American and Allied armies operating in many of the most malarious countries in the world, vast quantities of antimalarial drugs are required. Since new sources of the cinchona bark from which quinine is extracted are meager, it is indeed fortunate that the synthetic drug, atabrine, is available. Without a substitute for quinine it would be impossible to carry out military operations in most parts of the tropics. Facilities for the manufacture of atabrine have been greatly expanded, and supplies for the armed forces are adequate. On the whole, atabrine is just as effective for the suppression and treatment of malaria as is quinine. Thus, the loss of most of the world's supply of quinine to the Japanese has not proved to be a serious handicap to the health of our fighting forces.