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doi: 10.1098/rsta.2011.0602 , 2216-2239 370 2012 Phil. Trans. R. Soc. A Elizabeth Whitcombe malaria Indo-Gangetic river systems, monsoon and References related-urls http://rsta.royalsocietypublishing.org/content/370/1966/2216.full.html# Article cited in: l.html#ref-list-1 http://rsta.royalsocietypublishing.org/content/370/1966/2216.ful This article cites 55 articles, 9 of which can be accessed free Subject collections (43 articles) geology collections Articles on similar topics can be found in the following Email alerting service here in the box at the top right-hand corner of the article or click Receive free email alerts when new articles cite this article - sign up http://rsta.royalsocietypublishing.org/subscriptions go to: Phil. Trans. R. Soc. A To subscribe to on October 1, 2012 rsta.royalsocietypublishing.org Downloaded from

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Indo-Gangetic river systems, monsoon and malariaElizabeth Whitcombe Phil. Trans. R. Soc. A 2012 370, 2216-2239 doi: 10.1098/rsta.2011.0602

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Phil. Trans. R. Soc. A (2012) 370, 22162239 doi:10.1098/rsta.2011.0602

Indo-Gangetic river systems, monsoon and malariaBY ELIZABETH WHITCOMBE*,Earth System Science Interdisciplinary Center (ESSIC), University of Maryland, College Park, MD 20740, USAThe history of the Indo-Gangetic river systems from the late nineteenth to the early twentieth centuries can be reconstructed from the meticulous ofcial records of the survey, meteorological and medical departments of the British Government of India. In contrast with the grand sweep of the geological evidence, these records indicate a complex narrative of oods, droughts and channel shifts. Similarly, the cumulative growth of the GangesBrahmaputra and Indus deltas was overprinted by the effects of the annual monsoon cycle on precipitation, temperature and winds. Malaria, the principal vector-borne disease of the Indian subcontinent, and the deadliest, displayed epidemiological types that ranged between the extremes of stableendemic to unstable epidemic as dened in the classic theory of equilibrium of George Macdonald. Variations in its transmission, incidence and prevalence were closely tied to the different deltaic environments of the Bengal and Indus basins and to the short-sightedness of many irrigation and related engineering schemes.Keywords: Indo-Gangetic deltas; monsoon; malaria

1. IntroductionTo H. F. Blanford, FGS, FRS (18341893), palaeontologist with the Geological Survey of India from 1855 to 1862 and Meteorological Reporter to the Government of India from 1874 to 1888, the subcontinent offered many peculiar advantages for scientic enquiry. As a region dened, to the north, by the Himalaya and to the west and east by the Arabian Sea and Indian Ocean, it presented in its different parts extreme modications of climate and geographic features [1, pp. 563564]. From the mid-1870s, systematic observations on geological phenomena and meteorological events were published in the surveys annual reports. Meanwhile, under the Registration Act of 1865, the district medical ofcers of the provincial Sanitary Commissioners departments collected monthly observations on births and deaths, with specic reference to climate and physiographic conditions. Deaths were registered inter alia by principal causechiey fevers, of which upwards of one-third were malarious.*[email protected] Visiting Senior Research Scholar. One contribution of 10 to a Theme Issue River history.

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Nowhere in British India was the range of variation in physiography and climate more striking, nor more closely observed, than in the north, in the great river basins of the GangesBrahmaputra system to the east and the Indo-Gangetic system to the west. Against a background of the geological past of these great river systems, as established by advances in geoscience, it is possible to reconstruct a recent history, from the mid-nineteenth century, of uvial processes, their climate and their environmental diseases from technical records of the British Government of India, unique in their calibre and consistency. Malaria was British Indias most deadly and debilitating disease. Predominantly a disease aficting the rural poor, malaria was responsible directly for at least 1 000 000 deaths each ordinary year, increased, in epidemic years, by another 25 000. At least 100 000 000 suffered from malaria each year. It probably accounted for an additional indirect morbidity of 2575 000 000. It had a marked adverse effect on the birth rate, and was probably the greatest single cause in retarding the natural increase of the population and the greatest factor in lowering the health, vitality and physical development of the people where it prevailed. Malaria accounted for annual nancial losses ca 80 000 000 to the individual and the family alone. While direct and indirect losses could not be accurately evaluated, there was little reason to doubt that they must run into unbelievable millions of pounds sterling each year [2, p. 158]. When systematic registration of mortality began in 1865, environmental conditionsdampness, defective drainage, waterlogging and swampshad long been regarded as the direct cause of malarious fevers, and were given prominence accordingly in the Sanitary Commissioners reports. Laverans identication of the parasite Oscilleria (later renamed Plasmodium ) malariae as causative organism in Algeria, in December 1880, established an intermediate step between environment and human host. By the end of the decade, two further plasmodia had been discovered in the blood of malarious patients and the association of each species with periodicity of malarial feverPlasmodium vivax with benign tertian, P. falciparum with malignant tertian and P. malariae with quartandetermined. The passage of plasmodium to host, and the role of environmental conditions, awaited elucidation. In China, in 1878, Patrick Manson, parasitologistthe father of tropical medicinehad shown how the agent of lariasis, the parasitic worm, Filaria sanguinis hominis, was transmitted by Anopheles mosquitothe female, since the anatomical arrangement of the males proboscis and appendages prevented it from penetrating the skin. The mosquito ingested the larial embryos, nursed them to maturation, then reinjected them into the animal host [3]. Might not the female Anopheles, favoured by the environmental conditions long associated with malarious fevers, be the nurse of the malarial parasite? In discussions from 1894 to 1897, Manson discussed his hypothesis with Surgeon-Major Ronald Ross, Indian Medical Service, physician, artist and mathematician. In Calcutta, in August 1897, Ross demonstrated, by experiments of an elegance to match Mansons hypothesis, the transmission of the plasmodium associated with benign tertian malaria (P. vivax ) by the female Anopheles mosquito to an avian host [46]. In 1900, Manson, in association with Italian colleagues, conrmed by experiment the transmission of plasmodium by Anopheles to human hosthis physician son, whose recording of his symptoms of benign tertian malaria daily and in detail perfected the demonstration [7].Phil. Trans. R. Soc. A (2012)

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Subsequent investigations into the parasitology and transmission of malaria, the environmental conditions that favoured it and pioneering efforts at control and prevention are described by Bruce-Chwatt [8]. Distilling eld and experimental observations on malaria as the prototype of vector-borne disease into a probabilistic theory of transmissibility, generalized as pathometry, Ross [9,10] laid the foundations of the mathematical epidemiology of vector-borne disease. Some 40 years later, George Macdonald, malariologist and mathematician, followed Ross probabilistic method in his classic paper on theory of equilibrium in malaria [11]. His theory was derived from half a centurys eld and experimental observations, given mathematical expression and translated back into epidemiological terms. Macdonald [11] identied three factors as essential to the epidemiology of malaria: (i) the duration of the extrinsic cycle of the parasite (in the vector); (ii) the vectors biting habitspecically, the frequency with which it fed on man; and (iii) the vectors normal longevity. Factors (ii) and (iii) could be related as the average number of feeds on man that an insect took in its lifetime. These factors affected the probability of an insect becoming infected and thus the density of insects needed to maintain continuous transmission: they determined the critical density of insects in relation to man, below which the disease tends to disappear. If the critical density was exceeded, then Macdonald considered that these factors would act to curb progressive multiplication of human cases. Macdonald [11, p. 824] described the variability of transmission of malaria between vector and host as a dynamic equilibrium, continually adjusted between stability and instability (see table 1):according to the degree of the controlling factors, the epidemiology of the resultant malaria corresponds to some point on the scale between the extremes described as stable and unstable malaria.

In stableendemic areas, transmission of malaria was more or less constant, building up a rm immunity in the host population and thus preventing epidemics. In areas prone to epidemics, transmission was interrupted and immunity fell. The resumption of transmission led to an epidemic, followed by a signicant level of immunity for several years [11]. It was well recognized that endemic malaria, despite its relatively low death rate, sapped the strength of the populationand may exercise in the long run a more harmful effect upon the public health than even the most severe epidemic [12, p. 418]. Recent exercises in the mathematical epidemiology of malaria have amended and enlarged on Macdonalds analysis with a variety of modelling techniques [13]. A simulation of the dynamics of transmission of malaria in association with variation in weather, the Liverpool Malaria Model, designed by Hoshen & Morse [14], has lately been updated by Morse and co-workers [15]. From eld studies throughout India on which Macdonald built his theory of equilibrium of transmission, with the rate of enlarged spleens and later parasitaemia in a given population taken as the index of malarial infection, variation between stableendemic and unstableepidemic types of malaria was localized to specic regions of the Indian subcontinenta remarkable achievement of the Malaria Survey of India within 6 years of its establishment in 1920 (gure 1).Phil. Trans. R. Soc. A (2012)

Table 1. Epidemiological types of malaria, according to Macdonalds theory of equilibrium [11].

type very high: anophelism without malaria also found slight: complete termination of transmission unlikely despite conditions unfavourable to breeding or prolonged adult survival (temperature 15 C, favouring rapid completion of extrinsic plasmodial cycle, all altitudes, latitudes

very low: 0.025 man-bites per night

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II unstable transmission irregular, with gross variations, by vector Anopheles of relatively infrequent man-biting habit, short-lived, at low altitudes only

relatively high: 1 to 10 man-bites per night

variation, lowmoderate, may be high

very marked response to variations in temperature, low humidity, other unfavourable vector breeding conditions. Virtual cessation of transmission in some years. Seasonal, severe epidemics: abrupt onset at relatively high temperatures; rapid cessation as temperatures fall

very marked: mean value of transmission moderate-low, seasonal epidemics exaggerated, endemicity exacerbated by increase in favourable breeding conditions. Major regional epidemics, invasion of previous non-malarial areas where/when climatic factor(s) favour vector longevity, breeding over large areas

very variable: signicant proportion of population not immune, no resistance to upswing in transmission in unstable conditions

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80 Punjab: malaria epidemic hyperepidemic

90

a30 30

b

Sindh: focal epidemic malaria

cBengal: Maleria endemic endemicmalaria hyperendemic

20

20

70

80

90

Figure 1. Epidemiological types of malaria prevalent in Punjab, Sindh and Bengal. From Christophers & Sinton [16].

The association of these contrasting epidemiological types of malaria and the great river basins of northern India is apparent. In the northeast (NE), humid subtropical region of the subcontinent of south Asia, the western part of the Bengal foreland basin (the oldest, least active region of the inland delta of the GangesBrahmaputra system) has a history of stableendemic, stable malaria, with hyperendemic foci. The death rate was constant, but small, associated with a constantly high spleen rate and a relatively low birth rate [12]. Immunity levels were consistently moderate to high. The semi-arid region of the Indus foreland basin to the northwest (NW), characterized by recent, dramatic river shift particularly in its eastern part, has a history of unstableepidemic malaria, with hyperepidemic foci. The death rate was high, but for short periods only, with a remarkable freedom from mortality during inter-epidemic periods [12]. In the Indo-Gangetic river systems, a dynamic equilibrium between relative stability and instability is adjusted and readjusted by phases of progradation and aggradation, at rates of greater or lesser activity according to the balance of forcesuvial and, at the coastal deltas, tidal processes, on a seasonal, interannual and interdecadal scale, complicated by the anomalies of the Asia monsoon cycle and constrained by tectonic movements. The systems arose inPhil. Trans. R. Soc. A (2012)

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Indian rivers, monsoon and malariahigh High pressure dry

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dry NE phase

transitional phase Nov Oct

Dec Jan Feb

Sept

Mar

Aug July SW phase thermal Low low pressure pressure wet June May

April

transitional phase

2000 km

Figure 2. The Asia monsoon cycle. From data in Pithawala [18] and Kump et al. [19].

the Himalayasouthern Tibet with the progressive collision of the Indian and Eurasian plates during the Tertiary. The convergence of the plates, together with gravitational spreading, unleashed forces that uplifted the Himalayan ranges and east Asian plateauxmovements that continue at the present day. In the Himalayansouth Tibetan drainage basin, the action of eroding forces towards the head of the rivers is counteracted by northward migration of rivers north of the rising Himalaya [17]. In their passage south, the forerunners of the IndoGangetic system have cut great gorges in the south Tibetan plateau and in the foothills through which they debouch, abruptly into the plains of the northern subcontinent, to form vast, braided fans of inland and coastal deltas. Delta building continues, in phases of greater or lesser activity and forcefulness of uvial and tidal processes, subject below to tectonic movements and above to the vagaries of the monsoon (gure 2; table 2).Phil. Trans. R. Soc. A (2012)

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E. WhitcombeTable 2. History of the Asia monsoon system [20,21].

chronology (Ma) 98 ca 5 3.62.6 ca 2.6

events aridity in Asian interior increases onset of Asian, East African monsoons intensication of Asian monsoon intensication of East Asian NE and SW monsoons continues dust transport to North Pacic Ocean increases increased variability in monsoons: continued strengthening of East Asian NE monsoon, weakening of Asian and East Asian SW monsoons

The modern Asia monsoon system is a complex, cyclical weather system in dynamic equilibrium, varying with regular or irregular regularity about a relatively stable norm to unstable anomaly in wind speed and direction, barometric pressure, precipitation, temperature and relative humidity, over years, decades, centuries and aeons [2125]. But the dening variability of a monsoon system is its seasonal character [26, p. 203]. The strongly dened seasonal cycle marks out the Asian monsoon system from others with their weaker annual cycles [27]. The NE monsoon of the Asian cycle, in the NE and NW of the Indian subcontinent, a relatively low-grade wind bringing gentle patchy precipitation, associated with mild temperatures, is in evidence at the turn of the calendar year and dies away through March into a transitional phase, abruptly interrupted, during MayJune, by the onset, commonly tumultuous, of the southwest (SW) monsoon winds, in an east to NW progression, the date of regular onset varying according to location. The SW monsoon provides up to ca 80 per cent of the annual discharge of the Indo-Gangetic rivers, augmented by snow-melt. In September, the SW winds are exhausted and come gradually to cessation. A transitional phase follows, to the close of the year. Within the cycle, there is much intraseasonal variabilityin onset and duration of monsoon wind, between weak and strong spells, in amount and distribution of precipitation, in coincident temperatures and in relative humidity [23,26].

2. Bengal: the GangesBrahmaputra river systemThe dynamic equilibrium of the Bengal delta (gure 3; table 3) is most evident where it is least stable, at its marginssouth, in the tidal delta of the Bengal coast; north, where the mountain torrents emerge from the gorges into the plains. In the tidal delta, as Hunter, Statistical Ofcer to the Government of Bengal observed in the course of his eld surveys of Bengal (and every district in British India) for the Imperial Gazetteer [32, p. 20]:An eternal war goes on between the rivers and the sea, the former struggling to nd a vent for their columns of water and silt, the latter repelling them with its sand-laden currents.

From the Early Holocene, the shoreline has lost ground to the rivers and retreated south over some 80 kyr, with marked acceleration in pace between 80 and 6 kyr, to its present position (gure 3). The sluggish end-streams of thePhil. Trans. R. Soc. A (2012)

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Indian rivers, monsoon and malaria88 89 90 91

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Jamuna

Bhagirathi

24

Gange

sPa

24

dm a

moribund delta 23 mature delta active deltaaa nn hh g Meg M

23

tidal delta 22gli

22 subaqueous deltaof Bay Ben gal

present shoreline palaeo-shoreline 6000 yr BP palaeo-shoreline 80 000 yr BP

Hu

90

40 km

Figure 3. Bengal basin. Delta zones and palaeo-shorelines. From data in Lindsay et al. [28], Kuehl et al. [29] and Geological Survey of India [30].

Ganges now debouch into the NW reach of the Bay of Bengal. The deposition of their sediment load varies with their rate of discharge by an order of magnitude corresponding to the seasonal variation in precipitation of NE and SW monsoons. Fluvial processes are here counteracted by the eroding forces of tides with a diurnal variation of 1.9 m range, compounded by a periodic variation at 1415 day intervals, stirred alternately by the clockwise and anti-clockwise gyre of the monsoon wind systems and funnelled 8 km or more into the estuary and the network of tidal creeks, relicts of the old Ganges in its migration eastnortheast [33].Phil. Trans. R. Soc. A (2012)

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Table 3. History of the GangesBrahmaputra river system, Bengal delta. Sources: Lindsay et al. [28], Kuehl et al. [29] and Goodbred & Kuehl [31].

age initial

geological era

stage in delta formation events

Phil. Trans. R. Soc. A (2012)

>126 Ma

Early Cretaceous

12649.5 Ma

CretaceousEarly Eocene

proto-delta

49.510.5 Ma 10.5 Mapresent

Early EoceneMid-Miocene Mid-MioceneHolocene

transitional delta modern delta

1.5 Ma

Early Pleistocene

E. Whitcombe

117 ka 7 ka 126 Ma 75 Ma 5737.5 Ma geological era Early Cretaceous Late Cenozoic Eocene events fragmentation of Gondwanaland: northward drift of Indian plate, colliding with Eurasian plate palaeo-Indus north, west of present location parallel, west-owing streams south and north (palaeo-Indus) of Himalaya continued uplift of Himalaya, Suleiman Rangecorresponding exion of Indian plate, formation of Indus foreland basin ca 18 Ma: diversion of upper Indus south, through Himalaya close to Nanga Parbat massif, into foreland basin and east, into Ganges separation of Indus, Ganges last glacial maximum expansion of Ganges basin contraction of Indus basin westward migration of major Indus tributaries main depositional lobe of Indus (coastal) delta formed: westward shift in main channel in westward shift, obsoleteobsolescent channels abandoned by main streams, forming riverains shift of upper and lower Indus to west constrained by uplifting western ranges running north from Karachi

24.55 Ma

MiocenePliocene

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