Pestilence, aka Death, is one of the terrifying Four Horsemen of the Apocalypse, a group of End of Days riders described in Chapter 6, verses 1-8 in the Book of Revelation of the Bible. They each ride on a colored horse and represent some aspect of impending doom.

In the Book, a heavenly being called the Lamb opens seven seals that portend the Second Coming of Christ. Biblical analysts are divided as to whether the passage was meant to be an actual prediction, some sort of moral allegory, or a commentary during the period when the Christian Church was being heavily persecuted by the Roman Empire.

However you look at it, it’s scary stuff that has provided great fodder for fantasy/horror novels, as well as on television in the Sleepy Hollow series.

The rider of the white horse wears a crown, holds a bow, and rides as a conqueror. Opinions on its identity is also divided between Christ and the Antichrist. The red horse is fiery, and its rider holds a large sword and causes War. Riding the black horse, the rider carries a set of scales to measure wheat and barley, and is believed to represent Famine, possibly as a result of War.

The fourth horseman is described as riding a “pale” horse and is given the name Death. He’s closely followed by Hades, the Greek god of the underworld, and has the power to kill by sword, famine, and plague, and also by the wild beasts of the earth (Rev. 6:7-8). Chloros is the actual description for the horse in the Bible, Greek for a yellowish-green but with an ashen cast – it was translated into “pale”, the hue of the very ill and dead.

Many widespread plagues have killed millions of people throughout history, but in modern times we’re much better at conquering them, thankfully, even though they still strike fear into humans. Happily, one of the long-standing diseases plaguing much of Africa, Asia and South America – malaria – now has a new foe in the battle: a vaccine!

My hubby and I have been travelling for decades to countries with a variety of endemic diseases, most of which had prevention through some form of vaccination, either oral or through injection. Malaria, however, wasn’t one of them, and it’s a scary disease that has been killing more than 400,000 people a year, even though insecticides and netting for beds have been widely in use.

Malaria is a parasite, transmitted through a bite from an infected Anopheles mosquito. The parasites travel to a person’s, or animal’s, liver through the bloodstream, where they reproduce and cause all kinds of problems. They manifest primarily as an initial period of intense chills, shivering and fever, followed by sweating, headache, muscle pain, and other increasingly worse conditions. Symptoms usually don’t show up until ten days to two weeks after infection, so it’s one of those sneaky delayed diseases.

Preventative medication works – hubby and I have taken it many times – but it’s always been a cumbersome regimen. Up to now, travellers have had to start taking the medication for one to two weeks before arrival in the country where the disease is present (depending on the drug), all the way through the trip, and for four to eight weeks after returning home, to make sure that all the parasites you might have picked up have been killed in all stages of their life cycle.

Quinine was the first medication created to treat and prevent malaria. It comes from the bark of a tree in Peru called cinchona, and as early as the 1600s was brought back to Spain by Jesuit missionaries. Tropical outposts of the British Empire mixed quinine with soda and sugar to mask the bitterness of the quinine, and then put it into gin cocktails to get soldiers to take it – hence the classic Gin and Tonic. Now you know what gives tonic its somewhat bitter taste – never been a favourite of mine, but I do know some people who like the cocktail.

Malaria, once you’ve gotten it, is never fully cured. Symptoms can recur for years. One of the pharmacies I worked in as a technician years ago had a number of older war veterans as clients who continued to suffer bouts of the disease from time to time.

As a form of pestilence, malaria ranks with the best due to its pervasiveness. At one time it infested every continent except Antarctica – even Canada and the U.S., where it flourished in swampy areas that mosquitoes love to breed in. In my province of Ontario, it spread through early settlers from Newark (now Niagara-on-the-Lake) to Cataraqui (now Kingston). It was so common that it was considered unusual if a newcomer didn’t develop ‘fever and ague’ within a year or two of arriving. In both countries, drainage of large tracts of marshy breeding grounds was the main weapon in eradicating malaria as an endemic disease, but other countries continue to battle it.

You see the scale of the problem, and why the development of a vaccine is such great news, and is being hailed as “world-changing”. It’s the work of scientists at Oxford University, and trials have shown up to 80% protection. In addition, it’s not expensive to produce and can be widely deployed, lessening the number of people who get it and then infect more mosquitoes. It’s expected to prevent 1,7 billion cases and save 10.6 million lives.

So, knocking on wood (literally) as I write this, we’ll hopefully force the fourth Horsemen to remove one piece of pestilence from his roster.

For more information on the fight against the disease, visit the website of Malaria No More.