Vietnam Issue/Anti-malarial Drugs

I remember taking two different pills during my time in the field and then on FSB Nancy where I finished my tour of duty. I think everyone remembers these, the big orange pill once a week and the little white ones once a day.

What the hell were those drugs?

I just did as I was told. I sure didn’t want to get malaria. I did hear guys complaining about side effects. The runs, you know, diarrhea. I did not experience this, but I came to understand quite few GIs weren’t taking their pills.

The best I can make out the big orange pill was a chloriquine-primaquine combination that still is used for the treatment of certain types of malaria. But the US military was concerned the Nam skeeters were carrying a strain of chloriquine resistant malaria.

So now Dapsone comes along. After googling this I found two good websites that I would recommend. One was put up over a long period by a VN veteran of the 25th Inf. Division, John Woelk. That one is VietnamSoldier.com. John has since passed away. The second is a New Zealand government site, VietnamWar.govt.nz.

On the New Zealand site it says in 1968 there was a bad outbreak of malaria among Australian troops in VN that had been clearing bunker complexes. They were being treated with a combination of dapsone, pyrimethamine and quinine after they were ill. It was decided to give all the troops dapsone as a preventive measure. Apparently there was no scientific basis for this, but it seemed like a good idea.

Following suit the US military began requiring soldiers in the field to take a dapsone tablet. I don’t how widespread it’s use was or if there were any trials or “double blind” experiments prior to the distribution of it. I do believe this is the little white pill we were all familiar with. I also understand that this is the one that had more serious side effects than diarrhea. Possibly…headaches, fever, nausea, that type of thing.

I know what you’re thinking… what about Mefloquine? I tried to read up on that as well. This is a well known response by the US Army during the Vietnam War to develop a better preventive drug to help combat all the malaria at that time. It was not available when we were over there, meaning 1969-1970 or so. It was a synthetic compound that was indeed used in the 70’s during the war. It was widely administrated to troops in Iraq and Afghanistan. This is the bad one that apparently has many debilitating side effects. More on that later.

Here is what John “Chris” Woelk had to say:

Upon arriving in Vietnam, I was given a large orange pill to swallow and told that I was to take one of them weekly. It took only three hours for me to have the “runs” that persisted well into the next day, and I got the same problem each Monday thereafter. Acloriquine-primaquine-phosphate tablets caused other intestinal ailments also, and many men decided to forgo taking them. As we left Vietnam, we were given six pills to take for six weeks, and I did that. I have wondered since if the pills worked as promised, but I doubt statistics were kept or could have been.

The exact date escapes me, but we were now issued a small white pill to take the other six days in a week. Dapsone (diaminodiphenyl sulfone) was not well received, so the medic was ordered to be sure we were taking them. His assigned task was to observe each of us taking our pill, and check off our name on a daily record sheet. Doc was not well received on his mission and resorted to marking the list without watching anyone except the officers and NCO’s. Dapsone kept the runs running full bore the other six days. Because of my swamp experience, I took them, with regret, on every trip to the crapper.

From a letter to the VA:

In the late 1970’s  a story in the Kansas City Star noted the National Cancer Institute  determined dapsone caused cancer in male rats and that the pill had been given to some troops in Vietnam. This article disturbed me and I began to investigate. My first step was a call to the Pentagon where I talked to an Army Captain, public relations, who assured me that the pill was given only to troops along the DMZ for the purpose of studying how to distribute the pill, not to test its effectiveness, as this was already known. He had no information about the NCI’s tests. I was struck by several odd points in his explanation: one being that the pill could have been distributed in the same manner as the red one and the second, that our battery was located in III Corps, nowhere near the DMZ.

I called a researcher in the Pharmacology Department at the Kansas University Medical Center who copied some information for me. The parts that struck me were that it was for leprosy…

(Wow!)

and that if given on an ongoing basis the patient should be in a hospital and given blood tests several times a day. Of course none of this was done and no record was kept of who took the dapsone and for how long. Dapsone was made by American Home Products.

I would like for any records or information the Army has to be preserved and the VA to study the vets who took dapsone and if needed to treat the problems caused by the taking of this pill.

I served with A Battery, 7/11 Artillery, 25th Division from August 1968 to August 1969.

Chris Woelk                                                                                                       Lexington, Missouri

As I noted, Chris is no longer with us, but I was sure he would be glad if I shared what he had written.

Several things have occurred to me while writing this:

1. I didn’t get malaria while in SE Asia. So apparently the pills worked considering how many mosquito bites I had there.
2. One thing I hadn’t mentioned was the lackadaisical approach to preventive measures that was noted among the Aussie and New Zealand troops. Things were no better in the US forces I’m sure.
3. I would to hear from the doctors and medics that might see this or for that matter anyone who wants to share their experience.
4. I have some idea of what mechanism is at work with the way the drugs are supposed to interfere with the single cell parasites, but plan to learn more about that and share that info

More on Dapsone

It’s in a class of drugs known as sulfones. It is used in conjunction with other drugs for the treatment of leprosy. It is anti-inflammatory and suppresses growth of bacteria. So it could be used to try to prevent malaria in someone infected with the parasite from a mosquito bite.

Apparently the US military was also concerned about troops near the Vietnam border with Cambodia contracting leprosy. So maybe they tried to accomplish two things with one pill. Who knows? I’m a little curious now about how widespread the distribution of this pill was. Were we given this drug because of our operations along the border?

Known side effects are nausea, vomiting, ringing in the ears, dizziness, headaches, etc. Rare cases of liver failure have occurred.

To be cont’d.

Bird-out