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49 Chapter 3 Race, Poverty, and Place At the turn of the twentieth century, malaria was in retreat everywhere in the United States except in the South. Analyzing this phenomenon requires leaving the dynamic, feverish communities of the nineteenth-century frontier for the sharecroppers’ torpid life on the South’s plantations. From 1900 to 1950, the southern economy changed slowly, maintaining a population in the greatest depths of poverty, a population dragged down by malaria, tuberculosis, syphilis, and hookworm. Local and federal public health officials implemented programs for combating these diseases, with varying degrees of success. The region was America’s economic embarassment , and its multiple diseases a blemish on the national escutcheon . Before we can answer the question “Why did malaria ultimately disappear from the United States?” we must ponder why it persisted so long in the states of the old Confederacy. My own approach to malaria’s twentieth-century American career is to argue that malaria has to be understood within a web of socioeconomic as well as biological influences. This topic is part of a broader debate on the causes of malaria and the best way to control it. Stating that malaria is caused by poverty, for example, implies that social welfare programs that improve socioeconomic status will also depress the malaria rates. That experiment had been tried in Italy, without success.¹ A caution is in order, however. It is tempting to see socioeconomic explanations as somehow more moral than ones based on, for example, insect behavior. Poverty is evil and should be condemned, goes this line of thought; any diversion of such condemnation should be seen as abandoning the cause of social reform and improvement. Yet it is a bit fatuous to expect that every component of disease ecology will be traceable to racial and class discrimination. The mosquito’s behavior may be just as relevant. So may the use of insecticides , which are easy to condemn in this post–Silent Spring era but clearly have their place in this story.In understanding malaria’s disappearance from the South in the 1940s, one has to consider many factors, and evaluations of their importance should be based soley on their degree of impact on the parasite’s biography. Malaria’s Ecology Exploring the ecology of the parasite and its host vector is a good place to start in understanding when and why the parasite thrived in the American South. Several strains of anopheles mosquitoes are found in the continental United States, including A. quadrimaculatus, A. punctipennis, A. crucians, and A. maculipennis. (A. maculipennis can be broken down into subspecies, and some authors put A. quadrimaculatus as one of them; such distinctions do not materially change the analysis that follows.) A. crucians and A. punctipennis are southern anophelines capable of transmitting malaria under laboratory conditions but were rarely significant vectors in nature.Both strongly prefer animals as the source of their blood meals, which likely explains this anomaly.A. maculipennis is the mosquito of the northern tier of states, the Great Plains, the mountains, and West Coast. A. quadrimaculatus is the vector of the South and lower Midwest and was the most important actor in malaria transmission there in the twentieth century. A. maculipennis is easily diverted to animals, and Ackerknecht was probably right that such diversion was important in the Old Northwest.² As the only significant malaria vector in the American South, A. quadrimaculatus , with its peculiarities and habits, becomes central to our story. In the 1920s and 1930s, once Lewis Hackett and his colleagues had shown that diversion of mosquitoes from humans to animals could significantly lower malaria rates, malariologists in the United States asked whether A. quadrimaculatus likewise preferred animal blood to that of humans. If it did, then “zooprophylaxis”—locating animals near humans—should work.Hackett pointed out that such a method argued for a pig under every bed rather than a net over it (leaving aside the question of a chicken in every pot).³ Research on this issue was both ingenious and tedious. Following a method devised by J.B.Rice and M.A.Barber, mosquitoes were trapped from a location near animals, such as the area under a farmhouse located next to stables containing livestock. The insects were dissected to see if they had taken a blood meal. If so, through a precipitin test, the researcher could discover if the blood came from a cow, goat, horse, dog, human, or cat. (Although dogs were occasional bite victims...

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