In the spring of 1987, ripley ballou, then a major in the U.S. Army and a specialist in infectious diseases, entertained the delusion that he had beaten malaria. Ballou was part of a research team from the National Institutes of Health and the Walter Reed Army Institute of Research (known as wrair) that had developed a vaccine against Plasmodium falciparum, the parasite that causes the most virulent strain of malaria. The perception was,’’ says Ballou, this is going to be a slam dunk.’’ His teammate Steve Hoffman, a commander in the Navy, shared the delusion, as did Ruth and Victor Nussenzweig, the elder statesmen of the field, who worked out of New York University and had developed a competitive vaccine.
Of the four, the Nussenzweigs were the lucky ones. Although their discoveries had led directly to the development of the two vaccines, they were both pushing sixty at the time, which put them over the age limit for testing the nyu vaccine on themselves. Ballou and Hoffman, however, were then in their thirties and looked like the stars of a television medical drama or perhaps a sequel to M.A.S.H. Fifteen volunteers, Hoffman and Ballou among them, were injected with the vaccine. Hoffman, Ballou, and four other volunteers were then bitten repeatedly by malaria-infected mosquitoes. (Two more volunteers who had not received the vaccine also allowed malaria-infected mosquitoes to bite them, to give the researchers a basis for comparison.) In the parlance of vaccinology, the volunteers were challenged’’ with malaria. They were to be tested regularly for Plasmodium, and the minute the parasite showed up in anyone’s blood, of course, they would be treated with antimalarial drugs.
A couple of weeks passed, which is the time it takes Plasmodium to be fruitful and multiply in the human body. Three of the six vaccinated volunteers fell ill. Not so Ballou and Hoffman, who believed they were protected. It was a heady feeling. Hoffman flew off to San Diego, where he was scheduled to speak at a conference, while Ballou ran six miles, after which he attended a party. One beer in, Ballou was sweating, feverish, and, as he describes it, in trouble.’’
I had chills and then a high fever—a 104-degree temperature—and a bad headache. I’ve never been so sick, he says. The next morning I went into the hospital and, sure enough, the parasites were in my blood. They gave me antimalaria medication, and I was still sick for another day and a half. I wasn’t really well for six weeks after that. In San Diego, Hoffman was going through a public version of the same suffering. I was in the middle of my presentation, Hoffman says, and I developed the malaria rigor, the shaking chills. That was it.
Hoffman and Ballou had painfully relearned the primary lesson in the battle against Plasmodium. As Ballou puts it, Malaria is a hell of a disease. It is very difficult to protect against it.
