A forgotten epidemic that changed medicine: measles in the US Army, 1917–18

Abstract

A US army-wide measles outbreak in 1917-18 resulted in more than 95,000 cases and more than 3000 deaths. An outbreak investigation implicated measles and streptococcal co-infections in most deaths, and also characterised a parallel epidemic of primary streptococcal pneumonia in soldiers without measles. For the first time, the natural history and pathogenesis of these diseases was able to be well characterised by a broad-interdisciplinary research effort with hundreds of military and civilian physicians and scientists representing disciplines such as internal medicine, pathology, microbiology, radiology, surgery, preventive medicine, and rehabilitation medicine. A clear conceptualisation of bronchopneumonia resulting from viral-bacterial interactions between pathogens was developed, and prevention and treatment approaches were developed and optimised in real time. These approaches were used in the 1918 influenza pandemic, which began as the measles epidemic waned. The outbreak findings remain relevant to the understanding and medical management of severe pneumonia.

Memory effects on epidemic evolution: The susceptible-infected-recovered epidemic model

“…However, some loss of information about some period of time in the past may lead one to consider that the influence of memory might not need to be considered as continuous. It may happen, in many social networks, that individuals do not have enough information about the history of a disease, as recent cases and studies indicate; e.g., see [64][65][66][67]. Only after several individuals have already been infected, do people start to increase their knowledge about the disease and take different precautions.…”

The Mother of All Pandemics Is 100 Years Old (and Going Strong)!

“…Although scientific data are not available to answer this question, those who pondered it in 1918 cited nutrition, rest, warmth, fluids, fresh air, the comforting presence of another, and in many instances the maintenance of protective isolation of ill persons. US military camps demonstrated that high influenza mortality resulted in great part from "colonization epidemics" of pneumopathogenic bacteria associated with men living in close quarters 23 ; when incident influenza infection damaged respiratory epithelium, silently colonizing nasopharyngeal bacteria with pneumopathogenic potential were able to spread into the lungs to cause fatal pneumonias. Early patient isolation and effective nursing of ill persons may have lowered mortality in 1918 by preventing other persons from transmitting pneumopathogenic bacteria to them, as was documented in military camps.…”

Mapping the evolutionary trajectories of morbilliviruses: what, where and whither

“…Measles killed significant proportions of Pacific Island dwellers and became the first verifiable global morbillivirus. However, even at the start of the 20 th Century large numbers of adolescents had not been exposed to MV, demonstrating the importance of population movements and transportation in the global spread [48]. Distemper was identified as being caused by a filterable agent in 1905 by Henri Carré [49] and the English love of the domestic dog, particularly the foxhound, spurred the development of the first morbillivirus vaccine and introduced the ferret as a tractable small animal model for respiratory viruses [50 ].…”