Books and Documents

MEDICAL DEPARTMENT, UNITED STATES ARMY

PREVENTIVE MEDICINE IN WORLD WAR II

Volume IV

COMMUNICABLE DISEASES

Transmitted Chiefly Through

RESPIRATORY AND ALIMENTARY TRACTS

Prepared and published under the direction of

Major General S. B. HAYS
The Surgeon General, United States Army

Editor in Chief

Colonel JOHN BOYD COATES, Jr., MC

Editor for Preventive Medicine

EBBE CURTIS HOFF, Ph. D., M. D.

Assistant Editor

PHEBE M. HOFF, M. A.

OFFICE OF THE SURGEON GENERAL

DEPARTMENT OF THE ARMY

WASHINGTON, D. C., 1958

PREVENTIVE MEDICINE IN WORLD WAR II

Advisory Editorial Board on the History of Preventive. Medicine

Brig. Gen. JAMES STEVENS SIMMONS, USA (Deceased), Chairman, 1948-54

Brig. Gen. STANHOPE BAYNE-JONES, USA (Retired), Chairman

JOHN E. GORDON, M. D.     PAUL F. RUSSELL, M. D.

WILLIAM A. HARDENBERGH     THOMAS B. TURNER, M. D.

ANTHONY J. LANZA, M. D.    DOUGLASS W. WALKER, M. D.

ELLIOTT S. A. ROBINSON, M. D.    Col. TOM F. WHAYNE, MC, USA (Ret.)

Colonel ARTHUR P. LONG, MC (ex officio)

EBBE CURTIS HOFF, Ph. D., M. D., Editorial Director (ex officio)

Colonel JOHN BOYD COATES, Jr., MC (ex officio)

The Historical Unit, United States Army Medical Service

Colonel JOHN BOYD COATES, Jr., MC, Director

Colonel OTHMAR F. GORIUP, MSC, Executive Officer

Lieutenant Colonel R. J. BERNUCCI, MC, Special Assistant to Director

Lieutenant Colonel R. L. PARKER, MSC, Special Assistant to Director

JOSEPHINE P. KYLE, Special Assistant to Director

Lieutenant Colonel C. A. PENDLYSHOK, MSC, Chief, Special Projects Branch

DONALD O. WAGNER, Ph. D., Chief, Historians Branch

WILLA B. DIAL, Chief, Editorial Branch

WILBOUR C. LOWN, Chief, Promotion Branch

LUCY W. LAZAROU, Chief, Research and Archives Branch

HAZEL G. HINE, Chief, Administrative Branch

Volume IV

COMMUNICABLE DISEASES

Transmitted Chiefly Through

RESPIRATORY AND ALIMENTARY TRACTS

MEDICAL DEPARTMENT, UNITED STATES ARMY

The volumes comprising the official history of the Medical Department of the United States Army in World War II are prepared by The Historical Unit, United States Army Medical Service, and published under the direction of The Surgeon General, United States Army. These volumes are divided into two series: (1) The administrative or operational series; and (2) the professional, or clinical and technical, series. This is one of the volumes published in the latter series.

VOLUMES PUBLISHED

ADMINISTRATIVE SERIES

Hospitalization and Evacuation, Zone of Interior

CLINICAL SERIES

Preventive Medicine in World War II:

Vol. II. Environmental Hygiene

Vol. III. Personal Health Measures and Immunization

Surgery in World War II:

General Surgery, vol. II

Hand Surgery

Ophthalmology and Otolaryngology

Orthopedic Surgery in the European Theater of Operations Orthopedic Surgery in the Mediterranean Theater of Operations The Physiologic Effects of Wounds

Vascular Surgery

Miscellaneous:

Cold Injury, Ground Type

United States Army Dental Service in World War II

Contents

FOREWORD 

PREFACE

CONTRIBUTORS

Part I

INTRODUCTION

Chapter

I General Considerations of Modes of Transmission

Communicable Disease in Military Practice

Disease as a Factor in Military Operations

The Specific Infectious and Parasitic Diseases

Internationally Quarantinable Diseases

Infectious and Parasitic Diseases of Essential Military Significance

Achievements and Challenges

Part II

DISEASES TRANSMITTED CHIEFLY THROUGH RESPIRATORY TRACT

Diseases Caused by Viruses

    II Chickenpox

Historical Note

Control Measures

Incidence

III  Common Respiratory Diseases

Reporting of Common Respiratory Diseases

Epidemiology

Incidence Among Recruits

Respiratory Infections Aboard Transports

Association With Other Diseases

Etiologic Studies

Prevention and Control

IV Influenza

Epidemiology

Research With Influenza Virus

V Measles

Historical Note

Reduction of the Military Problem in World War II

Incidence of Measles in World War II

VI Mumps

Historical Note

Military Problem of Mumps

Research Developments

Experience During World War II

VII Psittacosis

   Epizootics

VIII Rubella

Historical Note

Control Measures

Incidence

IX Smallpox

Epidemiology

Influence on Past Wars

Military Experience

Civilian Experience

Diseases Caused by Bacteria

X Diphtheria

Experience in the Continental United States

Experience in European Theater of Operations

Experience in North Africa, the Middle East, and Italy

Experience in the Pacific

Experience in India-Burma Theater

Experience in Other Areas

Incidence Among Prisoners of War

Types of Virulent C. diphtheriae Encountered

Control Measures

XI Meningococcal Meningitis

Period Up To and Including World War I

Period Between World War I and World War II

Army Experience During World War II

XII The Pneumonias

 Section I. Primary Atypical Pneumonia

Recognition of the Disease

Epidemiologic Aspects

Special Studies

Summary

Section II. Bacterial Pneumonia

Epidemiology

Prevention of the Disease

Conclusions

XIII Hemolytic Streptococcal Infections

The Military Problem

Statistical Information

Epidemiology

Diagnosis

Control of Streptococcal Infection

Summary

    XIV Tuberculosis

Tuberculosis in World War I

Tuberculosis Between the Two World Wars

Tuberculosis in World War II

    Summary

XV Whooping Cough

Disease Caused by Fungus

XVI Coccidioidomycosis

Historical Note

Incidence of Coccidioidomycosis

Coccidioidomycosis in the Army Air Forces

Coccidioidomycosis in the Army Ground Forces

Coccidioidomycosis Among Prisoners of War

Services Provided by the Commission on Epidemiological Survey

Collaboration of Armed Forces Organizations With the Preventive Medicine Service

Control Measures

Research During World War II

Summary

Part III

DISEASES TRANSMITTED CHIEFLY THROUGH ALIMENTARY TRACT

    XVII Diarrhea and Dysentery

Army Experience With Diarrheal Disorders Before World War II

Army Experience With Diarrheal Disorders During World War II

Diarrheal Disorders in Theaters of Operations and Other Oversea Areas

General Summary of Experience

Food Poisoning

XVIII Salmonellal Infections

Historical Note

Typing and Classification

Control of Salmonellosis

Research

Epidemiologic Aspects of Salmonellosis

Relative Incidence of Salmonella Species

Laboratory Advances in Diagnosis of Salmonellosis

Evaluation of the Army's Experience

XIX Staphylococcal and Streptococcal Food Poisoning and Botulism

Staphylococcal Food Poisoning

Streptococcal Food Poisoning

Botulism

Bacterial Infections

XX Brucellosis

Wartime Incidence

XXI Cholera

Historical Note

Administrative Preventive Measures

Army Experience in Theaters and Areas

Summary

XXII Typhoid and Paratyphoid Fever

Historical Note

World War II Experience With Typhoid and Paratyphoid Fevers

Advances in Control During World War II

Parasitic Infections

XXIII Amebiasis

Incidence

Amebiasis in Overseas Theaters and Areas

Prevention and Control

Research on Water Purification

Research on Sewage Treatment

Recommendations

XXIV Nematode and Cestode Infections

Nematode Infections

Cestode Infections

Introduction of Infections Into the United States

Summary

Illustrations

Figure

1. Culturing the environment of a ward

2. Board for the Investigation and Control of Influenza and Other Epidemic Diseases in the Army.

3. Use of matting and leaves to shield vaccine refrigerator

4. Oiling floor of a barrack

Tables

1. Admissions and deaths, by classification, U. S. Army, 1942-45

2. Deaths from disease and battle deaths in principal wars, foreign armies and U.S. Army, 1846-1945

3. Number and percentage of man-days lost, by classification of casualties, U. S., Army,1942-45.

4. Separation from service, by cause, enlisted men only, U. S. Army, 1942-45

5. Deaths, all causes, and deaths from infectious and parasitic diseases for 1900, 1925, and,1950

6. Average annual deaths, all causes, and deaths from infectious and parasitic diseases, total United States, by age groups, 1948-52

7. Admissions and deaths from infectious and parasitic diseases, U. S. Army, in four major wars, 1861-1945

8. Admissions for all disease and incidence of infectious and parasitic diseases, 1942-45.

9. Deaths from all disease and from infectious and parasitic diseases, 1942-45

10. Cases and deaths due to certain infectious and parasitic diseases, 1942-45
10.  Cases and deaths due to certain infectious and parasitic diseases, 1942-45- Continued
10. Cases and deaths due to certain infectious and parasitic diseases, 1942-45 - Continued
10. Cases and deaths due to certain infectious and parasitic diseases, 1942-45- Continued

11. Incidence and deaths from infectious and parasitic diseases, 1942-45

12. Incidence rates for infectious and parasitic diseases, 1942-45

13. Internationally quarantinable communicable diseases, U. S. Army, 1942-45

14. Incidence of chickenpox, 1940-45

15. Morbidity rates for common respiratory diseases and influenza in the Army in the United States, 1942-45

16. Admission rates for common respiratory diseases and influenza, 1940-45

17. Admission rates for common respiratory diseases and influenza, 1942-45

18. Admission rates for common respiratory diseases in selected units

19. Incidence rates for influenza and common colds in the Army in the United States,1943-44

20. Incidence of influenza in the U. S. Army, 1942-45

21. Average antibody titers at intervals after vaccination

22. Summary of clinical evaluation of vaccination against influenza, 1943

23. Admissions for influenza in vaccinated Army units and unvaccinated units

24. Incidence rates for measles, mumps, and scarlet fever in the Army in continental, United States,1930-45

25. Incidence of mumps in U. S. Army, 1942-45

26. Incidence of rubella in the U. S. Army, 1942-45

27. Incidence of diphtheria in the U. S. Army, 1942-45

28. Deaths due to diphtheria in the U. S. Army, 1942-45

29. Diphtheria in England and Wales, 1939-45

30. Incidence of diphtheria in civilian populations of Germany and Axis-occupied, countries in Europe,1939-43

31. Diphtheria carriers in U. S. Army personnel and German civilians in the European theater, April and May 1946

32.Incidence of diphtheria in civilian populations in North African countries, 1942-45

33. Serologic classification of meningococcemia and meningitis case strains isolated from Army personnel

34. Admissions for primary atypical pneumonia in the U. S. Army, 1942-45

35. Admissions for other pneumonia in the U. S. Army, 1942-45

36. Incidence of pneumonia in immunized and nonimmunized groups

37. Interval between injection and the development of the several types of pneumonia

38. Distribution of individual types of Pneumococci

39. Incidence of rheumatic fever in the U. S. Army, 1943

40. Incidence rates of scarlet fever, streptococcal sore throat, and rheumatic fever in the U. S. Army,1944-45

41. Incidence of scarlet fever in the U. S. Army, 1942-45

42. Incidence of streptococcal sore throat in the U. S. Army, 1944-45

43. Admissions for rheumatic fever in the U. S. Army, 1942-45

44. Incidence rates of scarlet fever and rheumatic fever in continental United States, 1943-44

45. Incidence rates of scarlet fever and rheumatic fever in continental United States,1944

46. Incidence rates of scarlet fever and rheumatic fever, 1942-45

47. Incidence of whooping cough, U. S. Army, 1940-45

48. Incidence of coccidioidomycosis in the U. S. Army, 1942-45

49. Deaths from coccidioidomycosis in the U. S. Army, 1942-45

50. Distribution of primary coccidioidal infections at Minter, Gardner, and Lemoore, Fields

51. Distribution of primary coccidioidal infections in white personnel at Minter, Gardner, and Lemoore Fields

52. Monthly incidence of coccidioidomycosis at San Joaquin Valley Army airfields and monthly precipitation, 1941-45

52. Monthly incidence of coccidioidomycosis at San Joanquin Valley Army airfields and monthly precipitation, 1941-45 - Continued

53. Annual coccidioidal rates at Army airfields in the San Joaquin Valley, and precipitation at Bakersfield, Calif., 1941-45

54. Incidence of diarrhea and dysentery in the U. S. Army, 1940-45 and total for the years1942-45

54. Incidence of diarrhea and dysentery in the U.S. Army, 1940-45 and total for the years 1942-45

55. Incidence of intestinal infections including common diarrhea and dysentery (all types), peacetime Army, 1935-39

56. Deaths due to diarrhea and dysentery, including gastroenteritis, ulcerative, colitis, and ileitis,1942-45

57. Time lost in treatment of various types of diarrhea and dysentery in selected, years

58. Admissions for certain diseases of the gastrointestinal tract in the U. S. Army, 1942-45

58. Admissions for certain diseases of the gastrointestinal tract in the U.S. Army, 1942-45

59. Incidence of bacillary dysentery in the U. S. Army, 1942-45

60. Incidence of amebic dysentery in the U. S. Army, 1942-45

61. Incidence of unclassified dysentery in the U. S. Army, 1942-45

62. Incidence rate of diarrhea and dysentery in the several theaters and areas, 1942-45

63. Deaths from dysentery in the U. S. Army, 1942-45

63. Deaths from dysentery in the U.S. Army, 1942-45

64. Incidence and rates of diarrheas and dysenteries, enemy prisoners of war, September1944 to June,1945

65. Number of cases and percent distribution of intestinal infections in the U. S. Army in the Mediterranean theater, January 1943 through August 1945

66. Dysentery organisms isolated at the 15th Medical General Laboratory during 1944

67. Admission and noneffective rates due to diarrhea and dysentery in the U. S. Army, compared with respective rates for all disease, 1943

68. Mass treatment with sulfadiazine in field organizations having high bacillary dysentery carrier rates

69. Summary of Shigella species

70. Degree of severity of bacillary dysentery at the 2/7th Australian General Hospital

71. Occurrence of paratyphoid A and paratyphoid B in World War I

72. Chronological list of salmonella outbreaks in World War II

72. Chronological list of salmonella outbreaks in World War II- Continued

73. Persistence of salmonellal infection as determined by positive fecal cultures

74. Salmonellosis outbreaks and isolations of Salmonella species and types in New Guinea, 1944-45

75. Salmonellosis outbreaks and isolations of Salmonella species and types in the Philippines, 1945-46

76. Incidence of brucellosis in the U. S. Army, 1942-45

77. Cholera cases and deaths among enlisted personnel in British and Indian Armies in India, 1940-46

78. Occurrence of typhoid and paratyphoid fevers in U. S. Army, 1900-41

79. Admissions for typhoid and paratyphoid carriers in the U. S. Army, 1942-45

80. Incidence of typhoid fever in the U. S. Army, 1942-45

81. Incidence of paratyphoid fever in the U. S. Army, 1942-45

82. Admissions for typhoid and paratyphoid fevers and diarrhea and dysentery, World War I and World War II

83. Immunization status of 42 cases of typhoid fever among Army personnel in the United States, 1942-45

84. Incidence of amebic dysentery in the U. S. Army, 1942-45

85. Admissions for amebic dysentery in the IT. S. Army, 1944-45

86. Admissions for amebic dysentery carriers in the U. S. Army, 1942-45

87. Incidence of amebic dysentery carrier state in the U. S. Army, 1944-45

88. Prevalence of infection with Endamoeba histolytica among troops at time of separation from service, January to May 1946

89. Admissions for selected nematode and cestode infections in the U. S. Army, 1942-45

90. Admissions for selected nematode and cestode infections in the U. S. Army,1944

91. The calculated number of human helminthic infections

91. The calculated number of human helminthic infections- Continued

Charts

1. Admissions to hospitals and quarters for diseases, nonbattle injuries, and battle casualties ETOUSA, 1942-45

2. Admissions to hospitals and quarters for all diseases, ETOUSA, 1942-45

3. Average daily noneffective rates, ETOUSA, February 1942 to June 1945, inclusive

4. Average daily noneffective rates for disease, nonbattle injury, and battle casualty, ETOUSA, January 1944 to June 1945, inclusive

5. Deaths from infectious and parasitic diseases, 1900-50

6. Admission and death rates for infectious and parasitic diseases, in the U. S. Army, 1895-1954

7. Incidence rates for common respiratory diseases and influenza, 1942-45

8. Incidence rates for common respiratory diseases and influenza, 1942-45

9. Incidence rates for common respiratory diseases and influenza, 35th Infantry Division, 1941-44

10. Incidence rates for common respiratory diseases and influenza, 99th Infantry Division.,1942-45

11. Incidence rates for common respiratory diseases, 1941-45

12. Incidence rates for influenza among white enlisted men in the United States, 1920-40

13. Incidence rates for common respiratory diseases and influenza in the Army in theUnited States, 1925-46

14. Variations in incidence rates for common respiratory diseases in the Army in the United States,1940-46

15. Incidence of common respiratory diseases and influenza in the Army and the Navy in the United States, 1943-46

16. Incidence of common respiratory diseases and influenza in the United States in selected service commands, 1945-46

17. Spread of mumps in 1,378 cases admitted to the station hospital at Camp McCoy, Wis., over a 31-week period

18. Spread of mumps in 29 cases from one company admitted to the station hospital at Camp McCoy, Wis., over a 17-week period

19. Meningococcal meningitis in the Army and in the total U. S. population in selected periods

20. Meningococcal infections by duration of Army service

21. Seasonal incidence of scarlet fever in the Army in continental United States,1942-45

22. Seasonal incidence of rheumatic fever in the Army in continental United States, 1942-45

23. Incidence of tuberculosis in United States Army, continental United States, World War I and World War II

24. Incidence of tuberculosis among U. S. Army troops, January 1942 to June 1946, inclusive

25. Incidence of tuberculosis in the U. S. Army, 1942-45

26. Withdrawals from separation processing for pulmonary tuberculosis, July 1945 toAugust,1946

27. Incidence of diarrhea and dysentery in the Army in the continental United States,1930-42

28. Incidence of diarrhea and dysentery in the U. S. Army, 1940-45

29. Incidence of diarrhea and dysentery in the Army in continental United States, January1942 to July,1943

30. Incidence of diarrhea and dysentery in U. S. Army troops in Europe, 1942-45

31. Intestinal infections in the U. S. Army in the United Kingdom, 1 January 1943 to 30 June 1944

32. Intestinal infections in the U. S. Army in continental Europe, 23 June 1944 to 29 June,1945 33. Intestinal infections, in the European Theater of Operations, during selected periods

34. Intestinal infections, in Negro and white U. S. troops in Europe, 9 July 1943 to 29 June,1945

35. Incidence of diarrhea and dysentery in the U. S. Army in the Mediterranean Theater of Operations, September 1942 through December 1945

36. Diarrhea and dysentery in the U. S. Army in North Africa, November 1942 to July1944

37. Diarrhea and dysentery in the Fifth U. S. Army in Italy, 1944

38. Diarrhea and dysentery in the U. S. Army in the Middle East, July 1942 to July 1944

39. Incidence of diarrhea and dysentery in the U. S. Army in the total Africa-Middle East theater, 1942-45

40. Incidence of diarrhea and dysentery in the U. S. Army in the total China-Burma-India theater,1942-45

41. Diarrhea and dysentery in the U. S. Army in the China-Burma-India theater, September1942 to July 1944

42. Incidence of diarrhea and dysentery in the U. S. Army in the total Pacific Ocean, Area, 1940-45

43. Diarrhea and dysentery in the U. S. Army in the South Pacific Area, October 1942 to June 1944

44. Incidence of diarrhea and dysentery in the U. S. Army in the South Pacific Area and certain islands, October 1942 to July 1943

45. Incidence of diarrhea and dysentery in the U. S. Army in the total Southwest Pacific Area, 1940-45

46. Incidence of diarrhea and dysentery in the U. S. Army in the total Latin American area, 1940-45

47. Incidence of diarrhea and dysentery in the U. S. Army in the North American area, 1941-45

48. Typhoid fever among prisoners of war in European theater, May and June 1945.