Tropical Diseases

Malaria, dysentery, yellow fever head the list of tropical diseases to be fought in World War II by the U.S. Medical Corps. Of the three, malaria, against which there is no true prophylactic, is Medical Enemy No. 1. How to protect U.S. soldiers from the rats, lice, mosquitoes, fleas and flies that carry malaria, dysentery, yellow fever, cholera is again a major problem.

Last week the New York Society of Tropical Medicine met to discuss the progress of their subject, from the Crimean War to 1942. The speakers: Dr. Henry Edmund Meleney of New York University; Dr. Thomas Turley Mackie of Columbia; Dr. John Snyder of the Rockefeller Institute.

Medical Heroes. Both tropical and military medicine, said Dr. Mackie, began with Florence Nightingale during the Crimean War. In 1854 that determined British spinster took a handful of nurses to Scutari, cleaned up the filthy, stinking, overcrowded hospitals, organized a system of sanitary supplies, bathed, clothed and fed the thousands of victims of typhoid, cholera, dysentery. Bitterly opposed by hard-bitten generals, she pulled down the hospital death rate from diseases from 315 to 22 per 1,000. After the war, she persuaded the British Government to set up the world's first school of military medicine, organize sanitary rules, military hospitals. Said she: "You cannot improvise the sanitary care of an Army in the field." After Florence Nightingale came other medical heroes. In 1900, a brave band of doctors and volunteers in Cuba, headed by Dr. Walter Reed, allowed themselves to be bitten by infected mosquitoes, proved Dr. Carlos Finlay's contention (announced in 1881) that yellow fever was carried by Aedes aegypti. A few years later, by draining and oiling swamps, Dr. William Crawford Gorgas rid Panama of yellow fever, reduced malaria, made possible the building of the Canal.

Since 1913, research in tropical diseases has been given a great push by the cooperative efforts of the Rockefeller Foundation, which has spent over $70,000,000 in 30 years. Most important diseases on which the Rockefeller Foundation and the Army are concentrating:

Malaria, the most widespread and destructive, is caused by a microscopic parasite, the Plasmodium, carried by many species of the Anopheles mosquito. The chills, fever and delirium of malaria may recur for many years. Malaria can be treated by constant doses of quinine, and a newer drug, stabrine. But there is no immunization against malaria. Warned Dr. Meleney: "We may expect a tremendous morbidity and mortality from malaria in the armed forces during the present conflict. . . ."

Dysentery, long known as the "Bloody Flux," is Menace No. 2. There are two varieties: one, caused by bacilli, used to kill ten to 40%, can now be successfully treated with sulfaguanidine; the other, caused by Endameba histolytica, a one-celled parasite, often produces lifelong intestinal ailments. Dysentery temporarily incapacitated almost 2,000,000 men in the Civil War. Since dysentery organisms dwell in contaminated food and water, the disease can be prevented, as it was in World War I, by rigid cleanliness in cooking, strict inspection of food handlers, water and supplies.

Yellow Fever has been wiped off urban portions of the Western Hemisphere since 1927, but still exists as "jungle yellow fever" in the interior of South America, the interior of Africa, as far east as the Sudan. An excellent vaccine has been developed against the disease, but the Army is worried that the disease may spread among civilians.

Cholera, still widespread and deadly in India and China, can be prevented among the soldiers by vaccination. So can bubonic plague, carried by rat fleas, although protection is not complete.

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