Why is quinine being discussed in COVID-19 times?


It is World Malaria Day on April 25. An anti-malarial drug that left an indelible impression on those that consumed it is on everybody’s lips; its efficacy and advantages hotly discussed in the pandemic local weather we discover ourselves in. The artificial modification of the “wonder drug” quinine often known as hydroxychloroquine is being utilized by some international locations as experimental therapy in the battle towards COVID-19.

It was endorsed by USA President Donald Trump as a “game changer”, though no peer-reviewed examine proves its efficacy. There is inadequate medical information to advertise or forestall its use.

Most needed drug

A throwback on quinine must go way back to the 1600s, in response to Thiruvananthapuram-based Emeritus Professor of Neurology Dr Okay Rajasekharan Nair. “There was a time in history when quinine was a panacea for all ailments,” he says. Extracted from the bark of the cinchona tree, it grew to become probably the most needed drug in the world to deal with malaria which was killing folks. “Malaria did not have a medicine until 1635, when quinine, an alkaloid obtained from the bark of a cinchona tree, was found to be effective,” explains Dr Nair, who is additionally a medical historian.

Even after a long time, Kochi-based Jacob Varghese Kunthara, a retired Professor in Botany, distinctly remembers the bitterness of the ‘koyina vellam’ that was administered to him on the General Hospital in Pala, Kerala. It was the early ’60s; the bitter liquid was quinine. Though malaria was on the decline in India by then, quinine was nonetheless used as the primary line of defence towards the dreaded illness. “Quite a few children those days, especially those who lived in areas where malaria was common, would associate fever with the bitterness of quinine,” Kunthara says. The bitterness has tinged most of her childhood recollections too, says Priti S, a communications skilled based mostly in Kochi. “My father was in the Army, and when he was posted in areas known to have malaria, we were given a spoonful of quinine every morning as a prophylactic.”

Tracing roots

It is believed that the Countess of Chinchon, spouse of the Viceroy of Peru, was cured of malaria by taking an extract from the bark of a Peruvian tree in 1630. The tree subsequently got here to be often known as Cinchona in her honour, as she took the initiative to introduce the medicinal plant to Europe and promote its cultivation, says Dr Nair. However, one other story regarding its reputation is attributed to Jesuit monks who, after realising its medicinal worth, inspired its cultivation. A number of consider that the tree was dropped at Rome from Peru by Augustino, a Jesuit priest.

The tremendous drink

  • Quinine’s bittersweet historical past is not full with out its function in cocktails. Gin and tonic can hint its roots to British colonisers in India, who blended the anti-malarial quinine (with its bitter style) with their gin. Today, tonic waters have low portions of quinine in them and are primarily used as a flavour enhancer. “The resurgence of quinine in cocktails is an interesting trend that we have seen in the past few years. As palates are evolving, people are moving away from the previous trend of overly sweet drinks to more classic, sophisticated tastes,” says mixologist and Dewar’s India model ambassador Greg Benson. “If anything, the rise of bitter ingredients represents a bit of liquid history as we can trace their use in drinks back to hundreds of years. These ingredients work really well with the cinnamon and honey notes,” he provides.

Whatever the story, quinine rose to reputation and its sale flourished. Its negative effects, which included irregular heartbeat, lack of listening to and a decreasing of the blood platelet depend, created the necessity for an alternate. Later, artificial modifications of it resulted in chloroquine and hydroxychloroquine, and quinine grew to become out of date. However, regardless of its negative effects, quinine was most well-liked as a treatment for leg cramps till 1994, when the US authorities banned using quinine besides in the therapy of malaria. As demand for pure quinine declined, the plantations of the cinchona tree declined too. Native to Ecuador, the cinchona tree was launched to British India in the 1800s and was cultivated in the Nilgiris and Darjeeling. Cinchona is believed to have been cultivated together with tea and occasional in the hills of Munnar, now in Kerala, by the British who leased the land from Poonjar Raja (the king of the Poonjar area).

Currently, the one present cinchona plantation in the nation is in Darjeeling. According to Dr Samuel Rai, director, Directorate of Cinchona and Other Medicinal Plants, at current, the plantation covers 6,900 acres and produces 1,50,00zero to 2,00,00zero kilograms of cinchona bark yearly, which is bought by way of a authorities public sale. Started in 1862, the plantation used to have a manufacturing unit that manufactured quinine sulphate. The manufacturing unit, nonetheless, was closed down in 2001.

A cinchona tree can develop as much as 20 metres, Kunthara says. Quinine is extracted from the bark of a seven or eight-year-old tree, when the yield is highest. In addition to quinine, over 35 alkaloids have been remoted from the cinchona bark, that are used for varied functions.

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