Preventive Medicine in World War II

Most histories, novels, and films of World War II are preoccupied with bullets, bombs, and shells and the means of delivering them, and great emphasis is placed on personal courage. They ignore the most subtle, incapacitating and often deadly enemy which the allied armed forces had to conquer if they were to defeat their human opponents. This enemy was malaria, against which bullets and personal courage were useless. In this volume there is the record of a battle as difficult and decisive as any conventional military action. Indeed victory was not achieved until it was treated as a military action demanding research, strategy, training, discipline, and logistics as complex as those needed in any field. There were 500,000 casualties (hospital admissions) due to malaria in the U. S. Army in World War II. In Sicily there were 21,482 casualties from malaria compared with 17,375 from battle. In some places the rates climbed to 2,000, 3,000 and even 4,000 per thousand. General MacArthur is quoted as saying, "This will be a long war if for every division I have facing the enemy I must count a second division in hospital with malaria and a third convalescing from this debilitating disease." The book was written by thirteen authors, all of whom were intimately associated with the work described and all experts in their field. Planned and edited by an Advisory Editorial Board under the Chairmanship of Dr. Stanhope Bayne-Jones, with special responsibility devolving upon Dr. Paul F. Russell both as a member of the Board and as the author of a masterly introductory chapter, it has an authority and a wealth of detail which renders it invaluable to all malariologists as well as those interested in the lessons to be learnt from the standpoint of the epidemiologist, ecologist, public health specialist, or military strategist. The experiences described provided much of the knowledge on which the present policy of world-wide malaria eradication adopted by the World Health Organization was based. Whether or not final eradication can be achieved, that program has already been of immense benefit to populations living in malarious countries all over the world. Above all, the essential need for a rigorous military type of organization for successful control is abundantly illustrated. This is too often forgotten in national programs after the first flush of enthusiasm is over. To the epidemiologist, the danger of introducing susceptibles into infested areas will be reminiscent of Topley's experimental epidemiologic studies on mice, an old but often forgotten story. To the public health specialist, the account of the dengue outbreak in Honolulu in 1943 may serve to reinforce the lesson of the epidemics in Puerto Rico and Jamaica in 1963, that the simultaneous presence of a vector in quantity and a susceptible population is just as dangerous as the existence of an infectious agent since that agent