Past Pandemics: Theodore Roosevelt and Malaria
Malaria is a mosquito-borne infectious disease that affects humans and other animals. Its symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma, and even death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. Malaria is most commonly spread by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood and the parasites travel to the liver where they mature and reproduce.
One of the most famous malaria victims was perhaps the most robust and "manly" of all of the Presidents, Theodore Roosevelt. Roosevelt had once been a sick and frail child who suffered from debilitating asthma. He was able to overcome his health problems by embracing what he called "the strenuous life". As a child he hiked with his family in the Alps in 1869, and discovered that physical exertion helped to minimize his asthma symptoms and build his self-confidence. He began a heavy regime of exercise and took up boxing and wrestling as an adolescent.
Roosevelt had two encounters with this disease, one before and one after his presidency. His first experience was in 1898 when Roosevelt served with the famed First US Voluntary Cavalry Regiment better known as the Rough Riders. As the Spanish-American War drew to a close in the summer of 1898, the men of the U.S. Army Fifth Corps which included Colonel Theodore Roosevelt and his famed Rough Riders, were confronted by an outbreak of malaria and yellow fever. Nearly 4,000 of the 4,270 men in Fifth Corps would contract severe illnesses. Many were on the verge of death, and Roosevelt was convinced that if these men remained in Cuba, the Fifth Corps would be wiped out. Roosevelt and the other senior officers met with Maj. Gen. William R. Shafter, commander of the Fifth Corps, and recommended that troops be withdrawn from Cuba posthaste. Roosevelt was tasked with putting the request into writing and he drafted what became known as the Round-Robin Letter. It read:
MAJOR-GENERAL SHAFTER. SIR: In a meeting of the general and medical officers called by you at the Palace this morning we were all, as you know, unanimous in our views of what should be done with the army. To keep us here, in the opinion of every officer commanding a division or a brigade, will simply involve the destruction of thousands.
There is no possible reason for not shipping practically the entire command North at once. Yellow-fever cases are very few in the cavalry division, where I command one of the two brigades, and not one true case of yellow fever has occurred in this division, except among the men sent to the hospital at Siboney, where they have, I believe, contracted it. But in this division there have been 1,500 cases of malarial fever. Hardly a man has yet died from it, but the whole command is so weakened and shattered as to be ripe for dying like rotten sheep, when a real yellow-fever epidemic instead of a fake epidemic, like the present one, strikes us, as it is bound to do if we stay here at the height of the sickness season, August and the beginning of September.
Quarantine against malarial fever is much like quarantining against the toothache. All of us are certain that as soon as the authorities at Washington fully appreciate the condition of the army, we shall be sent home. If we are kept here it will in all human possibility mean an appalling disaster, for the surgeons here estimate that over half the army, if kept here during the sickly season, will die.
This is not only terrible from the standpoint of the individual lives lost, but it means ruin from the standpoint of military efficiency of the flower of the American army, for the great bulk of the regulars are here with you. The sick list, large though it is, exceeding four thousand, affords but a faint index of the debilitation of the army. Not ten per cent are fit for active work.
Six weeks on the North Maine coast, for instance, or elsewhere where the yellow-fever germ cannot possibly propagate, would make us all as fit as fighting-cocks, as able as we are eager to take a leading part in the great campaign against Havana in the fall, even if we are not allowed to try Porto Rico. We can be moved North, if moved at once, with absolute safety to the country, although, of course, it would have been infinitely better if we had been moved North or to Puerto Rico two weeks ago. If there were any object in keeping us here, we would face yellow fever with as much indifference as we faced bullets. But there is no object.
The four immune regiments ordered here are sufficient to garrison the city and surrounding towns, and there is absolutely nothing for us to do here, and there has not been since the city surrendered. It is impossible to move into the interior. Every shifting of camp doubles the sick rate in our present weakened condition, and, anyhow, the interior is rather worse than the coast, as I have found by actual reconnoissance.
Our present camps are as healthy as any camps at this end of the island can be. I write only because I cannot see our men, who have fought so bravely and who have endured extreme hardship and danger so uncomplainingly, go to destruction without striving so far as lies in me to avert a doom as fearful as it is unnecessary and undeserved.
Yours respectfully, THEODORE ROOSEVELT, Colonel Commanding Second Cavalry Brigade.
The letter was delivered to Shafter and a copy was leaked to an Associated Press correspondent. The letter was published on August 4.
When the news broke stateside, President William McKinley was indignant, requesting that “every possible effort [be] made to ascertain the name of the person responsible for its publication.”
Roosevelt became President following the assassination and death of William McKinley in September of 1901. He was elected to the office for a further term in 1904, but initially opted not to run for re-election in 1908. Instead he supported the man who he had hand-picked as his successor, William Howard Taft. When Taft's conservative policies clashed with Roosevelt's progressive ideology, Roosevelt challenged his former friend for the Republican nomination for President. When he failed to win that, he ran against Taft as a third-party candidate in 1912. Neither man on the contest, as Democrat Woodrow Wilson was elected as a result of a split in the Republican vote. In October of 1912, during the campaign, Roosevelt was shot by a would be assassin, electing to finish a speech with a bullet lodged in his body rather than seek immediate medical aid. He survived the assassination attempt, but was left in a weakened condition.
After losing the 1912 election, Roosevelt planned to go on a speaking tour of Argentina and Brazil. This was to be followed by a cruise of the Amazon River organized by his friend Father John Augustine Zahm. His plans changed when representatives of the government of Brazil suggested that Roosevelt accompany the famous Brazilian explorer Cândido Rondon on his exploration of the previously unknown river, named Rio da Dúvida (the River of Doubt). The headwaters of this river had only recently been discovered. Roosevelt saw this as an irresistible challenge. He agreed to go on the journey and invited his second-oldest son, Kermit Roosevelt, to join him. Kermit had recently become engaged and was not enthusiastic about going on the trip. His mother Edith insisted that he go on the journey in order to protect his father.
The expedition began in Cáceres, a small town on the Paraguay River, in December 1913. Roosevelt's party traveled to Tapirapuã, where Rondon had previously discovered the headwaters of the River of Doubt. From Tapirapuã, the expedition traveled northwest, through dense forests and then across the plains on top of the Parecis plateau. They reached the River of Doubt on February 27, 1914.
It was at this point that the Expedition split up because of a shortage of food. One part of the Expedition that included Father Zahm and expedition quartermaster Anthony Fiala, following the Ji-Paraná River to the Madeira River. The remainder of the party, which included the Roosevelts, Colonel Rondon, American naturalist George Kruck Cherrie, and 15 Brazilian porters, traveled down the River of Doubt. Right from the start, the expedition had problems. Mosquitoes carrying malaria and other diseases fed on almost every member of the expedition. The party was left in a constant state of sickness, festering sores and high fevers. The heavy dug-out canoes were unsuitable to the constant rapids and were often lost, requiring days to build new ones. Food provisions were low and the explorers were undernourished. The native Cinta Larga tribe shadowed the expedition and were a constant source of concern. Although this tribe did not attack Roosevelt's party, other expeditions around that time were not as lucky.
Of the 19 men who went on the expedition, three died. One man died by accidental drowning in rapids. His body was never recovered. One man in the party was murdered by another man in the group. The murdered man was buried at the scene, and the murderer was left behind in the jungle where it is believed that he later perished.
The explorers had made it only about one-quarter of the way down the river, by which time they were physically exhausted and sick from starvation, disease, and the constant labor of hauling canoes around rapids, while lacking sufficient food to provide the energy required for this work. Everyone on the expedition except for Colonel Rondon was either sick, injured, or both. During the trip down the river, Roosevelt suffered a leg wound, which he sustained after he jumped into the river to try to prevent two canoes from smashing against the rocks. The wound was minor in itself, but it soon gave him tropical fever that resembled the malaria he had contracted while in Cuba fifteen years before. The bullet that had lodged in his chest from the assassination attempt in 1912 was never removed, and this contributed to worsen the infection that he suffered.
Roosevelt became severely ill as a result of this infection. He had to be attended to day and night by the expedition's physician and his son Kermit. He was unable to walk because of the infection in his injured leg and an injury to the other, which he had injured in a traffic accident involving a trolley a decade earlier. Roosevelt suffered from intense chest pains, and he was fighting a fever that reached 103 °F which made him delirious at times. At one point he was said to be constantly reciting the first two lines of Samuel Taylor Coleridge's poem "Kubla Khan": "In Xanadu did Kubla Khan / A stately pleasure dome decree". Roosevelt intensely disliked the fact that his weakened condition was hampering the expedition and threatening the survival of the others. He insisted that he be left behind to die so that the poorly provisioned expedition could proceed as rapidly as it could, without being a burden. He said that he was prepared to commit suicide with an overdose of morphine. His son persuaded him to continue on the journey.
The group encountered some good fortune when they came upon "rubber men" or "seringueiros", workers who earned a living from the forest trees driven by the new demand for rubber tires in the United States. These men helped the team to travel down the rest of the river. This part of the journey had fewer rapids than the first part of their trip.
The two parts of the expedition were reunited on April 26, 1914. They were met by a Brazilian and American relief party led by Lieutenant Antonio Pyrineus. The party had been pre-arranged by Rondon to meet them at the confluence with the Aripuana River, where they had hoped to emerge from the tributary. It was there that Roosevelt finally received proper medical attention. The group then returned to Manaus.
Roosevelt was considerably weakened by the journey. Three weeks later, Roosevelt arrived home to a hero's welcome in New York Harbor. But his health never fully recovered after the trip. Some in New York doubted Roosevelt's discovery. Even though he was still quite weak and barely able to speak above a whisper, Roosevelt was angered at having his credibility challenged in this manner. He arranged speaking engagements with the National Geographic Society in Washington, D.C. on May 26, and the Royal Geographical Society in London in mid-June. Through these appearances he was able to stifled much of the criticism. In 1927 British explorer George Miller Dyott led a second trip down the river, confirming Roosevelt's discoveries.
One of the most famous malaria victims was perhaps the most robust and "manly" of all of the Presidents, Theodore Roosevelt. Roosevelt had once been a sick and frail child who suffered from debilitating asthma. He was able to overcome his health problems by embracing what he called "the strenuous life". As a child he hiked with his family in the Alps in 1869, and discovered that physical exertion helped to minimize his asthma symptoms and build his self-confidence. He began a heavy regime of exercise and took up boxing and wrestling as an adolescent.
Roosevelt had two encounters with this disease, one before and one after his presidency. His first experience was in 1898 when Roosevelt served with the famed First US Voluntary Cavalry Regiment better known as the Rough Riders. As the Spanish-American War drew to a close in the summer of 1898, the men of the U.S. Army Fifth Corps which included Colonel Theodore Roosevelt and his famed Rough Riders, were confronted by an outbreak of malaria and yellow fever. Nearly 4,000 of the 4,270 men in Fifth Corps would contract severe illnesses. Many were on the verge of death, and Roosevelt was convinced that if these men remained in Cuba, the Fifth Corps would be wiped out. Roosevelt and the other senior officers met with Maj. Gen. William R. Shafter, commander of the Fifth Corps, and recommended that troops be withdrawn from Cuba posthaste. Roosevelt was tasked with putting the request into writing and he drafted what became known as the Round-Robin Letter. It read:
MAJOR-GENERAL SHAFTER. SIR: In a meeting of the general and medical officers called by you at the Palace this morning we were all, as you know, unanimous in our views of what should be done with the army. To keep us here, in the opinion of every officer commanding a division or a brigade, will simply involve the destruction of thousands.
There is no possible reason for not shipping practically the entire command North at once. Yellow-fever cases are very few in the cavalry division, where I command one of the two brigades, and not one true case of yellow fever has occurred in this division, except among the men sent to the hospital at Siboney, where they have, I believe, contracted it. But in this division there have been 1,500 cases of malarial fever. Hardly a man has yet died from it, but the whole command is so weakened and shattered as to be ripe for dying like rotten sheep, when a real yellow-fever epidemic instead of a fake epidemic, like the present one, strikes us, as it is bound to do if we stay here at the height of the sickness season, August and the beginning of September.
Quarantine against malarial fever is much like quarantining against the toothache. All of us are certain that as soon as the authorities at Washington fully appreciate the condition of the army, we shall be sent home. If we are kept here it will in all human possibility mean an appalling disaster, for the surgeons here estimate that over half the army, if kept here during the sickly season, will die.
This is not only terrible from the standpoint of the individual lives lost, but it means ruin from the standpoint of military efficiency of the flower of the American army, for the great bulk of the regulars are here with you. The sick list, large though it is, exceeding four thousand, affords but a faint index of the debilitation of the army. Not ten per cent are fit for active work.
Six weeks on the North Maine coast, for instance, or elsewhere where the yellow-fever germ cannot possibly propagate, would make us all as fit as fighting-cocks, as able as we are eager to take a leading part in the great campaign against Havana in the fall, even if we are not allowed to try Porto Rico. We can be moved North, if moved at once, with absolute safety to the country, although, of course, it would have been infinitely better if we had been moved North or to Puerto Rico two weeks ago. If there were any object in keeping us here, we would face yellow fever with as much indifference as we faced bullets. But there is no object.
The four immune regiments ordered here are sufficient to garrison the city and surrounding towns, and there is absolutely nothing for us to do here, and there has not been since the city surrendered. It is impossible to move into the interior. Every shifting of camp doubles the sick rate in our present weakened condition, and, anyhow, the interior is rather worse than the coast, as I have found by actual reconnoissance.
Our present camps are as healthy as any camps at this end of the island can be. I write only because I cannot see our men, who have fought so bravely and who have endured extreme hardship and danger so uncomplainingly, go to destruction without striving so far as lies in me to avert a doom as fearful as it is unnecessary and undeserved.
Yours respectfully, THEODORE ROOSEVELT, Colonel Commanding Second Cavalry Brigade.
The letter was delivered to Shafter and a copy was leaked to an Associated Press correspondent. The letter was published on August 4.
When the news broke stateside, President William McKinley was indignant, requesting that “every possible effort [be] made to ascertain the name of the person responsible for its publication.”
Roosevelt became President following the assassination and death of William McKinley in September of 1901. He was elected to the office for a further term in 1904, but initially opted not to run for re-election in 1908. Instead he supported the man who he had hand-picked as his successor, William Howard Taft. When Taft's conservative policies clashed with Roosevelt's progressive ideology, Roosevelt challenged his former friend for the Republican nomination for President. When he failed to win that, he ran against Taft as a third-party candidate in 1912. Neither man on the contest, as Democrat Woodrow Wilson was elected as a result of a split in the Republican vote. In October of 1912, during the campaign, Roosevelt was shot by a would be assassin, electing to finish a speech with a bullet lodged in his body rather than seek immediate medical aid. He survived the assassination attempt, but was left in a weakened condition.
After losing the 1912 election, Roosevelt planned to go on a speaking tour of Argentina and Brazil. This was to be followed by a cruise of the Amazon River organized by his friend Father John Augustine Zahm. His plans changed when representatives of the government of Brazil suggested that Roosevelt accompany the famous Brazilian explorer Cândido Rondon on his exploration of the previously unknown river, named Rio da Dúvida (the River of Doubt). The headwaters of this river had only recently been discovered. Roosevelt saw this as an irresistible challenge. He agreed to go on the journey and invited his second-oldest son, Kermit Roosevelt, to join him. Kermit had recently become engaged and was not enthusiastic about going on the trip. His mother Edith insisted that he go on the journey in order to protect his father.
The expedition began in Cáceres, a small town on the Paraguay River, in December 1913. Roosevelt's party traveled to Tapirapuã, where Rondon had previously discovered the headwaters of the River of Doubt. From Tapirapuã, the expedition traveled northwest, through dense forests and then across the plains on top of the Parecis plateau. They reached the River of Doubt on February 27, 1914.
It was at this point that the Expedition split up because of a shortage of food. One part of the Expedition that included Father Zahm and expedition quartermaster Anthony Fiala, following the Ji-Paraná River to the Madeira River. The remainder of the party, which included the Roosevelts, Colonel Rondon, American naturalist George Kruck Cherrie, and 15 Brazilian porters, traveled down the River of Doubt. Right from the start, the expedition had problems. Mosquitoes carrying malaria and other diseases fed on almost every member of the expedition. The party was left in a constant state of sickness, festering sores and high fevers. The heavy dug-out canoes were unsuitable to the constant rapids and were often lost, requiring days to build new ones. Food provisions were low and the explorers were undernourished. The native Cinta Larga tribe shadowed the expedition and were a constant source of concern. Although this tribe did not attack Roosevelt's party, other expeditions around that time were not as lucky.
Of the 19 men who went on the expedition, three died. One man died by accidental drowning in rapids. His body was never recovered. One man in the party was murdered by another man in the group. The murdered man was buried at the scene, and the murderer was left behind in the jungle where it is believed that he later perished.
The explorers had made it only about one-quarter of the way down the river, by which time they were physically exhausted and sick from starvation, disease, and the constant labor of hauling canoes around rapids, while lacking sufficient food to provide the energy required for this work. Everyone on the expedition except for Colonel Rondon was either sick, injured, or both. During the trip down the river, Roosevelt suffered a leg wound, which he sustained after he jumped into the river to try to prevent two canoes from smashing against the rocks. The wound was minor in itself, but it soon gave him tropical fever that resembled the malaria he had contracted while in Cuba fifteen years before. The bullet that had lodged in his chest from the assassination attempt in 1912 was never removed, and this contributed to worsen the infection that he suffered.
Roosevelt became severely ill as a result of this infection. He had to be attended to day and night by the expedition's physician and his son Kermit. He was unable to walk because of the infection in his injured leg and an injury to the other, which he had injured in a traffic accident involving a trolley a decade earlier. Roosevelt suffered from intense chest pains, and he was fighting a fever that reached 103 °F which made him delirious at times. At one point he was said to be constantly reciting the first two lines of Samuel Taylor Coleridge's poem "Kubla Khan": "In Xanadu did Kubla Khan / A stately pleasure dome decree". Roosevelt intensely disliked the fact that his weakened condition was hampering the expedition and threatening the survival of the others. He insisted that he be left behind to die so that the poorly provisioned expedition could proceed as rapidly as it could, without being a burden. He said that he was prepared to commit suicide with an overdose of morphine. His son persuaded him to continue on the journey.
The group encountered some good fortune when they came upon "rubber men" or "seringueiros", workers who earned a living from the forest trees driven by the new demand for rubber tires in the United States. These men helped the team to travel down the rest of the river. This part of the journey had fewer rapids than the first part of their trip.
The two parts of the expedition were reunited on April 26, 1914. They were met by a Brazilian and American relief party led by Lieutenant Antonio Pyrineus. The party had been pre-arranged by Rondon to meet them at the confluence with the Aripuana River, where they had hoped to emerge from the tributary. It was there that Roosevelt finally received proper medical attention. The group then returned to Manaus.
Roosevelt was considerably weakened by the journey. Three weeks later, Roosevelt arrived home to a hero's welcome in New York Harbor. But his health never fully recovered after the trip. Some in New York doubted Roosevelt's discovery. Even though he was still quite weak and barely able to speak above a whisper, Roosevelt was angered at having his credibility challenged in this manner. He arranged speaking engagements with the National Geographic Society in Washington, D.C. on May 26, and the Royal Geographical Society in London in mid-June. Through these appearances he was able to stifled much of the criticism. In 1927 British explorer George Miller Dyott led a second trip down the river, confirming Roosevelt's discoveries.