Mash Season 9 Episode 16: The Red/White Blues

Alternate, in case that link has issues:

(Both are gorilla but 2 separate uploads)

Start at 7:11 to play; if you have time, watch until the end as a health note finishes the episode. (Each episode is only about 23-25 minutes long) In this episode Springtime has come in Korea which means malaria. Unfortunately not everyone can take the medicine…for reasons you’ll have to see.

Still slightly confused about the outcome of the video? A medication that reacts poorly to people and communities of African and Mediterranean decent? Primaquine was created in 1946, it was tested during WWII on volunteers, soldiers, and prisoners of war. It was seen early on that those who were African-American had a hemolytic reaction to the medication, (though it was also noted there there were a few cases of Caucasion reactions also). After that doctors were given the warning not to use Primaquine or only in sparing amounts in those of African decent. It became a ‘race warning’, later by the time of the Korean war those who had Mediterranean background were included and recently those in the Middle East (Iraq and Iran) have been added to the list…. But is it a race issue? In fact it is not, what the Primaquine is reacting to is an allele called Glucose-6-Phosphate Dehydrogenase. Those with the allele have a hemolytic reaction when they use Primaquine. To make it very clear…. EVERYONE has the ability to have this allele. So why does it appear to create a race affect visually in those that have a shared community background for lineage or decent? Those who read my previous post may know where this is going…. that’s right! Cross-Protection! James V. Neel explains it in his article Are Genetic Factors Involved in Racial and Ethnic Differences in Late-Life Health?

‘The sickling alleles and the G-6-PD deficiency alleles are representatives of balanced polymorphisms. Homozygosity for the hemoglobin S allele is usually inconsistent with reproduction because the homozygotes usually die in childhood. Homozygosity for a G-6-PD deficiency allele (or hemizygosity in the case of a male) by no means confers the handicap of sickle cell anemia but must still be regarded as impairing the fitness of the homozygote. But in both cases, the alleles have a positive side, conferring resistance to malaria, and the frequency of the allele in a population is determined by a balance between positive and negative selective forces.’

Translation? Environment, environment, environment! This allele provides a protection against Malaria. So those in a community that have the allele and Malaria in their environment will see an upsurge of the allele in procreated generations because those without the allele may not to survive as well without the added protection. Non-alleles will be less likely to procreate a new generation when dead from the extra benefit of protection.  When more members of a community, line of decent, or group heritage have an allele it can make it appear that their ‘race’ may be more or less susceptible then others to things, when in fact this is a result of environment messing with allele spikes. Nor does it matter that the allele itself may be what causes a separate disease or condition. Its protection might be an unintentional side effect of the primary disease or condition or a protection mechanism against other diseases wiping out the primary disease or condition. So the appearance that Primaquine is not advised in certain ‘races’ is deceptive. The health label has since been changed to read that it is not advised in those with the Glucose-6-Phosphate Dehydrogenase allele else wise hemolytic shock may occur or those with similar conditions. For a long time though it was treated as a race issue from the naked eye when in truth the culprit was microscopic…. but universal.

Additional Readings…