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Epidemiological Isolation as an Infection Mortality Risk Factor in U.S. Soldiers from Late Nineteenth to Early Twentieth Centuries
It remains uncertain why most infectious disease mortalities disappeared before modern medical interventions. Historical epidemiology using prospectively collected U.S. Army data from the Civil War (1860–1861), Spanish–American War (1898–1899), and First World War (1917–1918) suggests that epidemiological isolation was a major mortality risk factor for soldiers. Morbidity and mortality due to common infections decreased progressively from 1860 to 1918, except for influenza during the 1918 pandemic. Adult measles or mumps infections are indicative of isolated rural populations and correlated with disease mortality by U.S. state. Experiencing infections before adulthood may equip the immune system to better resist infections and decrease mortality rates.
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Author Notes
Disclaimer: The opinions expressed are those of the author and do not necessarily reflect those of the Australian Defence Force or the U.S. Department of Defense.
Author’s addresses: G. Dennis Shanks, Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia, and School of Public Health, University of Queensland, Brisbane, Australia, E-mail: dennis.shanks@defence.gov.au.