War Surgery and Medicine
CHAPTER 11 — Poliomyelitis
ADESCRIPTION of an epidemic amongst 2 NZEF troops in Egypt from November 1940 to July 1941 was given by Majors Caughey and Porteous. There were 40 cases, with 4 deaths and 19 cases of paralysis.
The cases were spread widely throughout the base camps, but three battalions supplied the majority of them. There was no correlation with the incidence of dysentery and no indication of the method of spread.
The incidence was higher than in civilian epidemics in New Zealand, but the course milder. The commonest symptoms were headache, neck rigidity, backache, dry tongue, and vomiting. Cases with high fever were generally more severe in type.
Paralysis generally ensued in four to six days, and though more common in the leg was almost as common in the trunk and arm. It was not so common as in the New Zealand civilian epidemics, when nearly three-quarters of the cases developed paralysis. The cerebro-spinal fluid findings showed marked variation in the cell counts, which varied in type. As the disease progressed the cell count fell as polymorphonuclear cells were displaced by lymphocytes.
The conclusions arrived at were:
The seasonal incidence was similar to New Zealand experience.
The early symptoms gave no clue to the seriousness of the attack.
Apart from the fact that all the patients were adults, that the incidence was high, and the disease very mild, there was no cardinal difference from the epidemics of the disease in New Zealand experiences.
Nothing was learnt with regard to the mode of the spread of infection, though spread by intestinal infection was suspected in many cases.
Apart from this epidemic there was no serious outbreak, only occasional cases arising during the remainder of the war in 2 NZEF. Altogether there were 3 cases in 1940, 41 cases in 1941, 5 in 1942, 8 in 1943, 3 in 1944, and 6 in 1945—of which 4 occurred in August. In all, there were 66 cases with 8 deaths.