Contents

Preventive Medicine in World War II

Volume V

Communicable Diseases

Transmitted Through Contact or By Unknown Means

Contents

FOREWORD

PREFACE

Chapter

I.  Actinomycosis (David T. Smith, M.D.)

II. Epidemic Keratoconjunctivitis (Murray Sanders, M.D.)

     Historical Note

     Clinical Description
     Investigation of the Etiology
     Epidemiology
     Treatment
     Epidemic Keratoconjunctivitis as a Military Problem

III. Hookworm (Clyde Swartzwelder, Ph. D.)

     Historical Note
     Incidence of Hookworm Infection in World War II
     Summary

IV. Leprosy (James A. Doull, M.D., Dr. P.H.)
     Epidemiology
     Leprosy in the Army Before World War II
     Preventive Measures During World War II
     Incidence in Military Personnel During and Subsequent to World War II
     Progress in Therapy During World War II
     Summary

V. Leptospirosis (Thomas B. Turner, M.D., and Hugh Tatlock, M.D.)

Part I. General and Leptospiral Jaundice (Weil's Disease)

Part II. Leptospiral Pretibial Fever (Fort Bragg Fever)

VI. Schistosomiasis (Malcolm S. Ferguson, Ph. D., and Frederik B. Bang, M.D.)

     Activities in Zone of Interior
     Experience in Oversea Theaters
     Conclusions and Summary
 

VII. Skin Infections (Col. Franklin H. Grauer, MC, Samuel T. Helms, M.D., and Theodore H. Ingalls, M.D.)

Part I. Fungus Infections

     General Considerations
     Early Concept of the Control of Fungus Infection
     Chlorine Disinfection
     Changing Concepts
     Research Studies
     U.S. Navy Studies
     Footgear Studies
     Fungus Infections in Special Areas
     Summary

Part II. Impetigo

     Incidence

     Treatment

Part III. Scabies

Incidence

Treatment and Research, 1941-45
Civilian-Military Interrelations
Summary

VIII. Trachoma (Thomas C. Ward, M.D., Dr. P.H.)
     Epidemiology
     Etiology
     Clinical Symptoms
     Treatment
     Summary

IX. Tularemia (Raymond A. Keiser, D.V.M., Ph. D.)
     Epidemiology
     Clinical Description
     Incidence
     Laboratory Diagnosis
     Therapy

X. Venereal Diseases (Thomas H. Sternberg, M.D., Ernest B. Howard, M.D., Leonard A. Dewey, M.D., and Paul Padget, M.D.)

Part I. Zone of Interior

     Significant Policies in Prevention and Control

     Organization and Programs, Office of the Surgeon General

     Organization and Programs in the Field

     Collaboration With Civilian Agencies
     Special Programs and Activities
     Special Problems of Control Among Negro Troops
     Prophylaxis

Part II. Mediterranean (Formerly North African) Theater of Operations

     Organization and Administration

     Prostitution and Its Control
     Prophylaxis
     Cooperation With Civil Authorities
     Education
     Summary

Part III. European Theater of Operations

     Basic Concepts of Control
     Experience in the United Kingdom
     Experience on the Continent
     Prevalence and Incidence of the Venereal Diseases

Part IV. Other Oversea Areas and Theaters

     U.S. Army Forces in the Middle East
     Persian Gulf Command
     The Pacific and the Asiatic Mainland
     The South Atlantic
     Alaska

Part V. Immediate Postwar Period

     Concepts of Control
     Worldwide Experiences
 

XI. Yaws (James H. Dwinelle, M.D.)
     Historical Note
     Experience in World War II

XII. Bullis Fever (Dwight M. Kuhns, M.D., and Capt. Donald L. Learnard, MSC)

     Characteristics and Control
     Military Experience
     Postwar Research
     Summary

XIII. Infectious Mononucleosis (Alfred S. Evans, M.D., and John R. Paul, M.D.)

     Historical Note
     Developments Between World War I and World War II
     History of the Disease, 1940-46

XIV. Lymphocytic Choriomeningitis (Aaron F. Rasmussen, Jr., M.D., and Joseph E. Smadel, M.D.)

     Recent Description
     Incidence 
     Etiology of Aseptic Meningitis Not Caused by the Virus of Lymphocytic Choriomeningitis

XV. Poliomyelitis (Albert B. Sabin, M.D.)

     Historical Note

     Knowledge of the Disease and Control Measures
     Experience During World War II
     Summary and Evaluation

XVI. Q Fever (John H. Dingle, M.D., Sc. D.)

     Historical Note
     Experience in World War II
     Summary and Evaluation of the Future Importance of Q Fever

XVII. Viral Hepatitis (John R. Paul, M.D., and Horace T. Gardner, M.D.)

     Evolution of Concepts of Hepatitis
     Historical Note
     The Serum Hepatitis Epidemic of 1942
     Importance as a Military Problem
     Research by Army Epidemiological Board Commissions
     Mediterranean Area and Middle East Theater
     European Theater of Operations
     Tropical and Subtropical Areas
     Summary and Evaluation of Experience

APPENDIXES

A. Scabies Instructions, Replacement and Training Command, MTOUSA

B. The Interdepartmental Agreement

C. Public Law 163-77th Congress, Chapter 287 -1st Session, H.R. 2475

D. A Summary of Venereal Disease Statistics During World War II

Illustrations

Figure

1. Actinomycosis, jaw, observed at Letterman General Hospital, San Francisco, Calif., in a sergeant who had punctured the floor of his mouth with a weed stem while picking his teeth
2. Patient with lepromatous leprosy
3. The epidemiology of schistosomiasis and the infection of military personnel
4. Warning sign posted by a malaria control detachment
5. Filipinos washing clothing in grassy marsh where molluscan host of S. japonicum, O. quadrasi, was abundant
6. Bridge built by combat engineers over stream whose tributaries drained marshes in which the molluscan host of S. japonicum was plentiful
7. Combat engineers repair bridge over a stream choked with water hyacinth where molluscan host of S. japonicum was plentiful
8. Cartoon dealing with schistosomiasis, used in educational program conducted by the Office of the Surgeon, 81st Infantry Division, for the prevention of schistosome infection
9. Mobile laboratory and lecturer giving a demonstration on the prevention of schistosomiasis before a group of soldiers 
10. Photograph of War Department poster prepared at request of Office of the Surgeon General for distribution to Army units in Far East

11. Detachment C, 50th Station Hospital, Ponte a Evola, Italy, 1945
12. Tularemia lesions following tick bite observed in soldier at Army-Navy General Hospital, Hot Springs, Ark
13. U.S. Public Health Service bus clinic demonstrates method used in taking blood specimens
14. Scene from American Social Hygiene Association film, "With These Weapons," produced for war effort
15. President of American Social Hygiene Association confers with the three Surgeons General

16. Poster publicizing Social Hygiene Day, 2 February 1944

17. Participants in Social Hygiene Day meeting in Boston, 1944

18. An investigator of the Chicago Health Department checks with a bartender, information supplied in a venereal disease contact report

19. The Chicago Health Department enters float urging fight against venereal disease in the annual Chicago Defender parade, 1943

20. Opening of sports center at Camp Forrest at about the time the May Act was invoked in areas surrounding this camp

21. Soldiers' and Sailors' Room at Union Station, Nashville, Tenn.

22. Use of privacy, persuasiveness, persistence, and visual aids in contact-tracing interview
23. Contact-tracing program results

24. WAAC personnel arrive at Fort Huachuca

25. Group of predominantly Negro patients at a rapid-treatment center receive instruction as a part of their rehabilitation

26. Old Medina, native section of the city of Casablanca, declared off limits to U.S. Army personnel

27. A market street in Palermo, Sicily

28. Destitute and desperate, many women in Naples turned to the streets
29. Soliciting in Naples

30. A brothel in Naples

31. Soldiers arrive at a Fifth U.S. Army venereal disease treatment center

32. Soldier seeking diversion and recreation in Naples

33. Comprehensive educational program in venereal disease control, Naples
34. Excellent, well-kept and well-operated prophylactic station at Staging Area No. 1, Naples, Italy, April 1944

35. Civilian examination and treatment clinic in Naples, operated with U.S. Army personnel

36. The mother motive, used by the Office of the Chief Surgeon, ETOUSA, in the venereal disease educational program

37. The British public house, colloquially "pub," was the soldier's club as well as the club of the common man of Britain

38. The American soldier finds Britain to his liking

39. France welcomes America

40. The liberated takes her liberator down a dark street

41. Language difficulties were not insurmountable barriers to the soldier in France

42. American soldiers in Germany take a dim although not disinterested view of the nonfraternization policy

43. Lovely companions made beach lounging a "must" for combat soldiers visiting the Riviera Recreational Area during the last stages of the war and thereafter

44. Athletic activities, fostered as a form of substitutive activity, Garmisch-Parten­kirchen, Germany, June 1945

45. Early preparation for the arrival of American troops in Liberia, Africa, mid-1942

46. Typical street scene in Liberian city

47. Liberian girls in dancing costumes and makeup

48. Group of girls in "Bandtown"

49. Girls in a "palaver" hut-community center for the village

50. Sign warning soldiers of venereal disease at Camp Amirabad, Iran, November 1943

51. Interior facilities of a prophylactic station at Andimeshk, Iran

52. Fort and King Streets, Honolulu, Hawaii, February 1945

53. Many U.S. soldiers and sailors enjoyed the hospitality and companionship of Australian women at an American Red Cross club in Brisbane, Australia, March 1945

54. A section of war-ravaged Manila which provided unlimited opportunities for clandestine prostitution

55. House of prostitution with signs proclaiming hours of operation and indicating the nearest U.S. Army prophylactic station

56. A poor and inadequate prophylactic station in Manila

57. U.S. Navy personnel look for entertainment in Manila

58. Social Hygiene Clinic and Hospital No. 3 in Manila

59. U.S. Army personnel assisting in the checking, examination, and treatment of hostesses and prostitutes

60. U.S. Army military police patrol brothel area of Karachi, India

61. Photographic miniature poster received in the CBI theater from the Office of the Surgeon General

62. Howrah rest camp for Negro soldiers, Calcutta, India

63. Brothel area declared off limits in K'un-ming, China A. Entrance to the area. B. Quarters of one of the prostitutes.
63a. Brothel area declared off limits in K'un-ming, China. C. A typical brothel.

64. A 1959 photograph of Red Dog Saloon and Annex Rooms, World War II thriving house of prostitution known as Ferry Way Rooms, Juneau, Alaska

65. Section of the "line" at Juneau, Alaska 

66. Isolated Chilkoot Barracks at Haines, Alaska

67. Postwar photograph of buildings that constituted the "line" at Anchorage, Alaska

68. The old "line" in Juneau, which was cleared away after the creation of Alaskan statehood

69. Dermatology and venereal disease treatment center at Stuttgart, Germany, May 1946

70. So-called "Geisha" girls, ready to lavish their attention on the American occupation soldier

71. High-class Japanese establishment, which was judiciously placed off limits to U.S. Army troops

72. Primary yaws of the heel before treatment and one week after treatment with penicillin

73. Secondary yaws before treatment and one week after treatment with penicillin

74. Secondary yaws (condylomata) before treatment and one week after treatment with penicillin

Tables

Number

1. Extent of neutralization to the virus of epidemic keratoconjunctivitis shown by selected serums

2. Incidence of epidemic keratoconjunctivitis by occupational group

3. Admissions for hookworm infection in the U.S. Army

4. Total cases of leprosy in the U.S. Army 

5. Cases of leprosy occurring in the Armed Forces and in veterans, 1 January 1942 to 31 July 1951

6. Cases of leprosy occurring in the Armed Forces and in veterans, 1 January 1942 to 31 July 1951

7. Patients in whom leprosy was diagnosed in the U.S. Army during World War II or between time of Army service and 31 July 1951

8. Incidence of schistosomiasis in the U.S. Army, 1942-45

9. Admissions and admission rates for impetigo in the U.S. Army, 1942-45

10. Admissions for scabies in the U.S. Army, 1942-45

11. Admissions for scabies in the U.S. Army, by area and month, 1944
12. Results of treatment of 273 patients with scabies

13. Admissions for trachoma in the U.S. Army, 1942-45

14. Cases of tularemia in the U.S. Army, 1942-45

15. Results of serologic tests for syphilis of U.S. Army personnel at time of separation, November 1944 through October 1946

16. Results of followup examinations by the U.S. Public Health Service of Armed Forces separatees with positive or doubtful serologic reactions for syphilis

17. Distribution of followup cases of syphilis in Armed Forces separatees brought to treatment by diagnosis

18. Results of serologic tests for syphilis of U.S. Army personnel at time of separation, by race, May-September 1945

19. Incidence rates for venereal disease, all forms, in the U.S. Army in Great Britain, 1 January 1943 to 30 June 1944

20. Incidence rates for venereal disease, all forms, in the U.S. Army, by major commands in continental Europe, 1 September 1944 to 29 June 1945

21. Incidence rates for venereal diseases, U.S. Army Base Sections, SOS, in United Kingdom, 1 January 1943 to 30 June 1944

22. Incidence rates for venereal diseases, U.S. Army Base Sections of the Communi­cations Zone in continental Europe, 1 September 1944 to 29 June 1945

23. Incidence rates for venereal diseases, U.S. Army Air Forces, 1 September 1944 to 29 June 1945

24. Incidence rates for venereal diseases, U.S. armies in continental Europe, 1 September 1944 to 29 June 1945

25. Venereal diseases in the U.S. Army, in the United Kingdom and on the Continent, by month, September 1944 to June 1945

26. Venereal diseases, European theater, Negro and white, February 1944 to June 1945

27. Incidence of venereal disease in the U.S. Army, European theater, by clinical form and year

28. Incidence of syphilis in the U.S. Army, European theater, by month

29. Incidence of gonorrhea in the U.S. Army, European theater, by month

30. Incidence rates for venereal disease in the U.S. Army, by area and year, January 1942 to June 1945

31. Admissions for yaws in the U.S. Army, by area and year, 1942-45

32. Comparison of Bullis fever and infectious mononucleosis

33. Transmission of chick-embryo-propagated Bullis fever agent from a febrile case

34. Admission rates for infectious mononucleosis in the U.S. Army, by broad geographic area and year, 1940-46

35. Admission rates for infectious mononucleosis in the U.S. Army, by area and year, 1942-46  

36. Admissions for infectious mononucleosis, by Army Area in the United States, 1945 and 1946

37. Admissions for lymphocytic choriomeningitis in the U.S. Army, by area and year, 1943-45

38. Incidence of poliomyelitis in the U.S. Army, by area and year, 1920-41

39. Cases of poliomyelitis in the U.S. Army, by tentative diagnosis, final diagnosis, and year, 1942-45

40. Incidence of poliomyelitis in the U.S. Army, by area and year, 1942-45

41. Incidence of poliomyelitis among civilians, Cincinnati, Ohio, 1945-59

42. Poliomyelitis among civilians of all ages and among those in the 20- to 44-year age group during 4 epidemic years, Cleveland, Ohio

43. Incidence of poliomyelitis in the U.S. Army in the Philippines, 1944-46

44. Admissions for cholangitis in the U.S. Army, by year, 1931-41

45. Admissions for and deaths due to hepatitis in the U.S. Army, by area, 1942

46. Admissions for hepatitis in the U.S. Army, 1942-45

47. Results of administration, to volunteers, of materials obtained from patients in the acute phase of infectious hepatitis

48. Results of administration, to volunteers, of materials obtained from patients during the incubation period and convalescence of infectious hepatitis

49. Results of attempts to demonstrate immunity in volunteers convalescent from experimentally induced infectious hepatitis, in 1946

50. Results of administration, to volunteers, of materials obtained from patients in the acute phase of serum jaundice

51. Results of attempts to demonstrate immunity and cross-immunity in volunteers convalescent from experimentally induced serum jaundice

52. Results of administration, to volunteers, of materials obtained from patients with serum jaundice

53. Admissions for hepatitis among U.S. troops in the Mediterranean and Middle East theaters, 1942-45

54. Infectious hepatitis in the U.S. Army in the China-Burma-India theater, 1942-45

55. Infectious hepatitis in the U.S. Army in Latin America, 1942-45 

Appendix Tables

1. Incidence of venereal diseases in the U.S. Army, by diagnosis and area; 1941
2. Incidence of venereal diseases in the U.S. Army, by diagnosis, broad geographic area, and year, 1942-45
3. Incidence of venereal diseases in the U.S. Army, by diagnosis, theater or area, and year, 1942-45
4. Noneffectiveness caused by venereal diseases in the U.S. Army, by diagnosis, 1941
5. Noneffectiveness caused by venereal diseases in the U.S. Army, by diagnosis, 1942
6. Average duration for venereal diseases, with and without cases carded for record only, in the U.S. Army, 1945
7. Venereal diseases in the U.S. Army, by diagnosis, 1944-45
8. Deaths due to venereal diseases in the U.S. Army, by diagnosis and year, 1941­-45
9. Incidence of venereal diseases in the U.S. Army, by diagnosis and race, 1942-44
10. Incidence of gonorrhea in the U.S. Army, 1942
11. Incidence of gonorrhea in the U.S. Army, 1943
12. Admissions for gonorrhea in the U.S. Army, 1944
13. Incidence of syphilis in the U.S. Army, by area and month, 1942
14. Incidence of syphilis in the U.S. Army, by area and month, 1943
15. Admissions for syphilis in the U.S. Army, by area and month, 1944
16. Incidence of chancroid in the U.S. Army, by area and month, 1942
17. Incidence of chancroid in the U.S. Army, by area and month, 1943

18. Admissions for chancroid in the U.S. Army, by area and month, 1944

Charts

1. Comparative admission rates for scabies, U.S. and British troops in the United Kingdom, 1942-44
2. Human whole blood transmission experiments
3. Reported weekly admissions for jaundice, total U.S. Army, 1 January to 31 December 1942
4. Variation in incubation period of 1,004 cases of serum jaundice following uniform single inoculation with yellow fever vaccine at Camp Polk, La., 27 February 1942
5. Comparison of incubation periods of infectious hepatitis and homologous serum jaundice in a series of experimental cases
6. Monthly incidence rates for infectious hepatitis in British troops in the Middle East
7. Monthly incidence rates for infectious hepatitis among U.S. Army troops in the North African theater
8. Monthly attack rate for infectious hepatitis in troops in the North African and Mediterranean theaters
9. Monthly attack rates for infectious hepatitis in the Fourteenth Army (German), 1944
10. Monthly incidence rates for hepatitis in the European theater
11. Hepatitis cases and incidence rates in the Southwest Pacific Area
12. Monthly incidence rates for infectious hepatitis and for diarrhea and dysentery in China-Burma-India theater
 

Maps

1. Geographic distribution of Schistosoma japonicum
2. Geographic distribution of Schistosoma haematobium and Schistosoma mansoni
3. General distribution of Amblyomma americanum in the Western Hemisphere
4. Areas of the United States where Amblyomma americanum is known to have been found