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

Summary 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 with...

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Bibliographic Details
Published in:The Lancet infectious diseases 2015-07, Vol.15 (7), p.852-861
Main Authors: Morens, David M, Prof, Taubenberger, Jeffery K, Prof
Format: Article
Language:English
Subjects:
Acquisitions & mergers
Coinfection - epidemiology
Deaths
Epidemics - history
Epidemiology
Fatalities
History, 20th Century
Hospitals
Humans
Infection Control - history
Infections
Infectious Disease
Infectious diseases
Laboratories
Measles
Measles - epidemiology
Measles - history
Medicine
Mens health
Military personnel
Military Personnel - history
Mortality
National libraries
Pneumonia, Pneumococcal - epidemiology
Pneumonia, Pneumococcal - history
Spanish-American War
Streptococcus
Streptococcus pneumoniae
Streptococcus pyogenes
United States - epidemiology
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Summary:Summary 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.
ISSN:1473-3099
1474-4457
1474-4457
DOI:10.1016/S1473-3099(15)00109-7