War Surgery and Medicine
EPIDEMICS of dengue fever have occurred frequently in the Pacific area over many years, and it is not surprising that our troops in New Caledonia and Fiji suffered from this disease. There was no dengue recorded in the Middle East Forces.
Dengue fever is endemic in the Pacific area and is present in the Philippines, Hawaii, New Guinea, New Britain, the Solomons, Fiji, and Samoa. It is highly contagious and the virus is transmitted by mosquitoes—the Aedes aegypti in Australia and New Caledonia, and the Aedes scutellaris in New Guinea. Its prevention depends on the eradication of the vector by the removal of breeding places and the destruction of adult mosquitoes by spraying, as well as by the protection of the individual by protective clothing and repellent lotions during the day and by mosquito nets at night. All febrile dengue patients should be kept under mosquito nets day and night.
The major epidemics experienced by the New Zealand Expeditionary Force in the South-West Pacific were in New Caledonia, where there were 483 cases from April to July 1943 and 200 cases from March to May 1944. In the Royal New Zealand Air Force in the Pacific there was a high incidence of dengue at Espiritu Santo shortly after the establishment of the RNZAF station there. There were over 440 cases in the area in the twelve months April 1943 to March 1944. As the mosquito population was reduced the incidence of dengue fell away. From January to March 1945 there was an epidemic of dengue at Funafuti—43 cases were reported in a Catalina flight of about 130 men. Otherwise that area was almost completely free from dengue, there being only about 50 cases in the first eight months of 1945.
The Pacific Force was fortunate in the low incidence of dengue fever, and the disease had little or no influence on military operations. Nevertheless, the disease is important because of the danger of infection in endemic areas, and this demands adequate preventive measures.
The considerable epidemic that occurred among New Zealand troops in New Caledonia in the middle of 1943 was carefully page 549 studied by Colonel Sayers, Major Riley, and Captain Gatman. Of the 483 cases reported from April to July 1943, 176 cases were admitted to 4 NZ General Hospital, and of these 100 consecutive cases were selected for special study; detailed haematological studies of 50 cases were carried out.