New Zealand Medical Services in Middle East and Italy
Health of the Troops
Health of the Troops
The troops of the First Echelon arrived in Egypt in good health, but mild epidemics of both influenza and rubella had been present since leaving New Zealand, and many cases of dysentery, later found to be Flexner in type, had occurred after leaving Colombo. The epidemics continued in Egypt, 213 cases of influenza and 147 cases of rubella being admitted to the camp and general hospitals up to the end of March, and 70 cases of rubella in April.
Epidemic diseases of the common types experienced in New Zealand did not occur in the troops in Egypt, but throughout the war the reinforcements brought over these infections with them. One reinforcement had to be strictly quarantined on arrival for this reason, but there was never any spread of serious infection in the camp. Fortunately, the First Echelon arrived in the winter when flies and intestinal infections were relatively uncommon. Extensive outbreaks of 80-100 cases of mild gastro-enteritis, however, occurred in units in March, and there were 23 cases of dysentery. In April there was a marked increase in intestinal infections and up to 300 cases were treated at sick parades in a single day. One outbreak was experienced of food poisoning, due to keeping meat too long after cooking, but the sixty men affected all recovered. Some 98 cases of dysentery were reported. Precautions were tightened up, with some improvement in the incidence of infection. In May there was a decrease in intestinal infections and fewer cases of true dysentery.
Pneumonia, which had been dreaded owing to its marked prevalence and high mortality in Egypt during the First World War, proved to be infrequent, only 38 cases occurring up to the end of April, and the cases responded well to treatment by sulphonamides, no deaths being recorded.
Many cases thought to be sandfly fever occurred, though very few phlebotomus sandflies were seen in the base camp.
There was a steady increase in the daily average of hospital cases from 97 in February to 178 in March and 276 in April, but at the end of May there were only 242. Nasal and antral infections and cases of otitis media and externa were common and the baths were thought to be largely responsible. Contrary to expectations, Egypt proved to have an unsatisfactory climate for asthmatics.
During July there was an increase of hospital admissions to 557 following the employment of units in the Western Desert, where there were more flies and dust-storms and also rigid rationing of water. Throughout the period in the Western Desert the health of the New Zealand troops remained good, and the field ambulance was called upon to care only for cases of upper respiratory tract infections, some cases of diarrhoea and clinical dysentery, otitis page 80 media and externa, and fairly common skin infections such as desert sores and tinea. In hospital most of the dysentery cases proved to be bacillary of the Flexner type, while a small percentage were amoebic. The cause of septic sores gave much food for speculation. They were common throughout the desert and also in Palestine, where the Australians carried out some research into the problem. Their conclusions were that the sores were in no way connected with a vitamin deficiency. They were able in nearly all cases to grow low-grade streptococci from the lesions. Almost invariably with the sores there was a history of trauma—a scratch, a cut, or insect bite. It was found that if men reported early for treatment the incidence could be much reduced. Profuse sweating and the ever-present dust and sand were no doubt factors in the persistence of the condition.
In August there was an improvement in health with only 462 admissions to hospital. Intestinal infection was less common as the troops became seasoned. Flies had become fewer in Maadi though they were still troublesome in the desert. Cases of malaria were first noted at the time of the Nile flood in August, 12 of the BT type being notified, and mosquito nets were issued and instructions given for the wearing of dress covering the limbs after sunset. The malarial cases increased to 29 in September, but there had been only 63 cases of dysentery in hospital during the previous three months. The daily average of patients in hospital was: June 213; July 300; August 330; September 335.
The incidence of sickness was remarkably low throughout 1940, apart from the mild dysenteric infections to which the troops steadily acquired an immunity. The sulphonamides made a marked contribution to the cure of both gonorrhoea and pneumonia as they did later to the treatment of dysentery. Their use gave great relief to the hospitals compared with conditions experienced in Egypt in the First World War.