How World War 1 changed global attitudes to war and infectious diseases

• Published in: The Lancet (British edition) Vol. 384; no. 9955; pp. 1699 - 1707
• Main Author: Shanks, G Dennis, Prof
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier 08.11.2014; Elsevier Limited
• Subjects: Antibiotics; Antitoxins; Attitude of Health Personnel; Bacteria; Biological and medical sciences; Clinical trials; Communicable Diseases - history; Drug resistance; Epidemics; General aspects; History, 20th Century; Humans; Infections; Infectious diseases; Influenza; Influenza, Human - history; Internal Medicine; Malaria; Malaria - history; Medical sciences; Microorganisms; Military Medicine - history; Military personnel; Miscellaneous; Mycobacterium; Pasteur, Louis (1822-95); Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; R&D; Research & development; Sanitation; Sexually transmitted diseases; Sexually Transmitted Diseases - history; STD; Surveillance; Tetanus - history; Tropical diseases; Tuberculosis, Pulmonary - history; Typhoid Fever - history; Vaccines; Vector-borne diseases; War; Warfare; World War I; World; Infection; Medicine; War; Attitude; Public health; International
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(14)61786-4

Summary World War 1 was a key transition point towards scientific medicine. Medical officers incorporated Louis Pasteur's discoveries into their understanding of microorganisms as the cause of infectious diseases, which were therefore susceptible to rational control and treatment measures even in the pre-antibiotic era. Typhoid vaccination led to the successful evasion of the disastrous epidemics of previous wars. The incidence of tetanus was probably decreased by giving millions of doses of horse antitoxin to wounded soldiers. Quinine treated but could not control malaria; its use required mass compulsion. Tuberculosis was not a great military problem during World War 1, although mortality in civilian populations increased substantially. Treatment of sexually transmitted infections remained a matter of aversive conditioning, with invasive antiseptics used in the absence of antibiotics. Pandemic influenza in 1918–19 killed more people than died during the entire war, showing how much remained beyond the capability of the scientists and doctors who fought infectious diseases during World War 1.