History of U.S. Military Contributions to the Study of Vaccines against Infectious DiseasesMD, Andrew W. Artenstein,;PhD, Jason M. Opal,;MD, Steven M. Opal,;(Ret.), Edmund C. Tramont, MC USA;MD, Georges Peter,;(Ret.), Phillip K. Russell, MC USA
doi: 10.7205/MILMED.170.4S.3pmid: 15916278
ABSTRACT The U.S. military has a long and illustrious history of involvement with vaccines against infectious diseases. For more than 200 years, the military has been actively engaged in vaccine research and has made many important contributions to the development of these products for use in disease prevention and control. Through the efforts of military researchers, numerous serious threats to the health of American troops and their families have been mitigated. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of MalariaUSA, Christian F. Ockenhouse, MC;USA, Alan Magill, MC;PhD, Dale Smith,;(Ret.), Wil Milhous, MS USA
doi: 10.7205/MILMED.170.4S.12pmid: 15916279
ABSTRACT More so than any other infectious disease, malaria has all too often affected the conduct of military operations in war and in some cases has disproportionately influenced the outcome. From Napoleon’s defensive action at Walcheren, to the Union Army’s attempts to take control of the Mississippi River at Corinth and Vicksburg, to the dreadful numbers of malaria casualties suffered by U.S. Marines on the islands of Efate and Guadalcanal during World War II and more recently in Liberia in 2003, malaria has extracted a heavy toll. In this article, we summarize a few of the significant contributions to malaria control by U.S. military personnel throughout its history. We review examples of scientific achievements, medical breakthroughs, and lessons learned from preceding wars that continue to drive the quest for effective antimalarial therapies and preventive vaccines. This review is by no means comprehensive or complete but serves as a testament to the skill, courage, self-sacrifice, and devotion to duty of the many who have faithfully served their country in the past and to those today who continue the struggle against this disease. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Parasitic DiseasesUSN, Nancy F. Crum, MC;USA, Naomi E. Aronson, MC;USN, Edith R. Lederman, MC;MC, Janice M. Rusnak, USAF;PhD, John H. Cross,
doi: 10.7205/MILMED.170.4S.17pmid: 15916280
ABSTRACT U.S. military researchers have made major contributions to the discovery, diagnosis, treatment, and prevention of a number of parasitic diseases. We review the paramount U.S. military contributions to the understanding of leishmaniasis, filariasis, schistosomiasis, trypanosomiasis, gastrointestinal parasites, intestinal capillariasis, and angiostrongyliasis. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Diarrheal DiseasesUSN, Matthew L. Lim, MC;USN, Gerald S. Murphy, MC;USN, Margaret Calloway, MC;MPH, David Tribble, MD
doi: 10.7205/MILMED.170.4S.30pmid: 15916281
ABSTRACT Diarrhea, a scourge upon humanity since preliterate times, has been the particular nemesis of military forces. The Armed Forces of the United States have been in the forefront in the diagnosis, treatment, and prevention of diarrheal illness. U.S. military scientists and physicians implemented the first mandatory typhoid inoculation program, contributed to advances in water chlorination, and pioneered the use of antibiotics for typhoid fever. U.S. Navy physicians refined the intravenous treatment of cholera, reducing the death rate from 20% to less than 1%. Their studies of electrolyte and fluid balance in cholera, and the subsequent development of oral rehydration therapy for cholera and other diarrheal illness, have saved millions of lives worldwide. U.S. Army researchers refuted the desquamation theory of cholera pathogenesis, isolated the cholera exotoxin, and developed improved cholera vaccines. U.S. Army and Navy researchers pioneered the use of antibiotics for the treatment of typhoid fever, made major contributions to the treatment of dysentery, developed algorithms for the treatment of traveler’s diarrhea, and continue active development of traveler’s diarrhea and dysentery vaccines. U.S. military diarrheal research has directly contributed to the welfare of hundreds of millions of people. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Bacterial ZoonosesMC, George W. Christopher, USAF;MC, Brian K. Agan, USAF;USA, Theodore J. Cieslak, MC;(Ret.), Patrick E. Olson, USN MC
doi: 10.7205/MILMED.170.4S.39pmid: 15916282
ABSTRACT Bacterial zoonoses have afflicted campaigns throughout military history, at times playing an important role in determining their outcomes. In addition, zoonotic bacteria are among the leading biological warfare threats. The U.S. military medical services have been at the forefront of research to define the basic microbiology, ecology, epidemiology, and clinical aspects of these diseases. This historical review discusses the military significance of plague, Q fever, anthrax, leptospirosis, bartonellosis, tularemia, and brucellosis and the U.S. military medical research counteroffensive. These contributions have ranged from basic molecular biology to elegant epidemiological surveys, from defining pathogenesis to developing new vaccine candidates. In an era of emerging diseases and biological weapons, the U.S. military will continue to lead a dynamic research effort to counter these disease threats. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Rickettsial DiseasesUSNR, Mary F. Bavaro, MC;(Ret.), Daryl J. Kelly, MS USA;PhD, Gregory A. Dasch,;USNR, Braden R. Hale, MC;(Ret.), Patrick Olson, MC USN
doi: 10.7205/MILMED.170.4S.49pmid: 15916283
ABSTRACT Rickettsial diseases have affected the military throughout history. Efforts such as those of the Joint U.S. Typhus Commission near the beginning of World War II and of military researchers since have reduced the impact of these diseases on U.S. and Allied forces. Despite the postwar development of effective antibiotic therapies, the newly emerging antibioticresistant scrub typhus rickettsial strains of the Asian Pacific region mandate continued research and surveillance. Similarly, tick-infested training areas in the United States and similar exposure abroad render the spotted fevers and the ehrlichioses problematic to deployed troops. The military continues to work on countermeasures to control the arthropod vectors, as well as actively participating in the development of rapid accurate diagnostic tests, vaccines, and improved surveillance methods. Several rickettsial diseases, including epidemic typhus, scrub typhus, the ehrlichioses, and the spotted fevers, are reviewed, with emphasis on the military historical significance and contributions. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Sexually Transmitted DiseasesMC, Mark S. Rasnake, USAF;MC, Nicholas G. Conger, USAF;USA, C. Kenneth McAllister, MC;PhD, King K. Holmes, MD;(Ret.), Edmund C. Tramont, MC USA
doi: 10.7205/MILMED.170.4S.61pmid: 15916284
ABSTRACT Sexually transmitted diseases have posed a threat to military service members throughout history. Among these diseases, syphilis, gonorrhea, and human immunodeficiency virus infections have accounted for the most significant morbidity and mortality rates in the U.S. military. In response, military researchers have made significant contributions to the treatment and prevention of these diseases. We review the impact of these diseases through the history of the U.S. Armed Forces and review selected sexually transmitted disease-oriented publications of U.S. military researchers. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Respiratory InfectionsMC, Martin G. Ottolini, USAF;USA, Mark W. Burnett, MC
doi: 10.7205/MILMED.170.4S.66pmid: 15916285
ABSTRACT History reveals a tremendous impact of respiratory pathogens on the U.S. military, dating back to the time of the Revolutionary and Civil Wars, during which 90% of casualties were for nonbattle injury, including several respiratory illnesses such as measles, whooping cough, and complicated pneumonia. The devastating impact of the influenza pandemic at the end of World War I led to a more proactive approach to research into the etiologies and potential preventive measures for such diseases. The development of the Armed Forces Epidemiological Board, with its subordinate commissions, coincided with the massive mobilization for World War II. Efforts of the board during and after the war led to significant progress against many common pathogens, such as the landmark studies of group A Streptococcus among young trainees at Warren Air Force Base, which led to the development of highly effective prophylactic and therapeutic strategies to prevent rheumatic fever. Military pediatricians contributed greatly to this work, as well as subsequent investigations into both the pathogenesis of and prophylactic therapy for a variety respiratory pathogens, including pertussis and respiratory syncytial virus. The momentum of this work continues to this day, among researchers from all three military branches. Reprint & Copyright © by Association of Military Surgeons of U.S.
History of U.S. Military Contributions to the Study of Viral HepatitisUSA, David P. Dooley, MC
doi: 10.7205/MILMED.170.4S.71pmid: 15916286
ABSTRACT Epidemic jaundice, although known by armies since ancient times, became a concern of the U.S. military only after outbreaks occurred during World War II. Early work by military investigators defined, for the first time, the existence of two different forms of hepatitis. Subsequently, investigators described the effective prevention of symptomatic hepatitis using immune serum globulin. Military researchers contributed to the isolation of and testing for the virus of infectious hepatitis, work that was then instrumental in the designing and fielding of a hepatitis A vaccine. Hepatitis B contributions included the elaboration of community-based epidemiology and description of the efficacy of immune serum globulin prophylaxis. Most recently, studies on hepatitis E defined the epidemiology, performed genomic sequencing, and developed a DNA vaccine currently being tested against the disease. Major research contributions to the understanding of and protection against viral hepatitis have been made by the military medical establishment over the past 60 years. Reprint & Copyright © by Association of Military Surgeons of U.S.