As October draws to a close men all over the world are getting ready for Movember, an annual event that gives them a chance to raise money and awareness for men’s health issues by sporting a moustache in the month of November. However, in the era before safety razors and shaving foam personal grooming was a much more difficult affair. Men faced many challenges whilst attempting to maintain their facial hair in the trenches of WW1 as this post by Dr Alun Withey explains.
Before publishing his famous children’s books under the pen-name Dr Seuss, Theodor Geisel started out as an illustrator for advertising agencies and during WW2 worked as a political cartoonist. He used his talents to support the war effort by illustrating military materials for the US Treasury Department and War Production Board. To see a pamphlet he created to educate American soldiers about the risk of malaria and read more about this publication take a look at the post on this topic at the Contagions blog.
Thousands died in 2009 with the outbreak of swine flu that swept the globe. However that figure pales in comparison to the estimated 50 to 100 million deaths that resulted from the 1918-1919 influenza pandemic that followed World War One.
The disease was unusual from an epidemiological standpoint as it attacked in 3 separate waves across a 12 month period. While influenza usually peaks in winter, the first wave began in the spring of 1918. It spread rapidly across the globe and closely resembled seasonal flu. A second wave from September to November was highly deadly and the final wave in early 1919 was less virulent than either of the previous two outbreaks.
An exceptionally severe virus, it was contracted by about 500 million people. This means one third of the global population at the time was affected. The loss of life was unprecedented; the fatality rate was over 2.5% compared to the rate of 0.01% of seasonal outbreaks. The illness came on suddenly and quickly progressed to respiratory failure. In cases that developed more slowly people often died from secondary bacterial infections.
The 1918 flu also targeted sufferers differently to milder strains. Normally the people worst affected by influenza are either the very young, the elderly or the immunocompromised. In the 1918 pandemic healthy young adults aged 20-35 were the hardest hit. In America, the death rate for 15-34 year olds was 20 times higher in 1918 than in previous years.
Although the origin of the virus is unknown, it spread worldwide along trade routes and shipping lines. Even remote Pacific islands and parts of the Arctic were affected. The mass movement of people associated with the war and demobilisation of troops afterwards is thought to have helped spread the illness. Quarantines were introduced to reduce the spread of the disease, however they were of limited effectiveness.
Medical services were stretched to their limits and public health measures attempted to control the outbreak. Public gatherings were suspended and many shops stayed closed during the worst periods of the pandemic. People took to wearing gauze masks and stayed indoors until as quickly as it had appeared, the pandemic ended.
While the exact strain that caused the 1918 pandemic hasn’t been identified, it is thought to have evolved from an avian virus. Genomic sequencing of the entire virus is yet to be completed, however it is known that the H1N1 strains circulating today are descended from the influenza of the 1918 pandemic.
Navy Medicine. (1918). Influenza [Image]. Retrieved from https://www.flickr.com/photos/navymedicine/7839585384
Taubenberger, J. K. & Morens, D. M. (2006). 1918 influenza: the mother of all pandemics. Emerging Infectious Diseases, 12(1), 69-79.
This week news reports on the ongoing conflict in the Middle East got me thinking about the ways that warfare can impact human health. In particular, I began to wonder about the effects violence and political turmoil may have upon the children living in affected areas.
At the population level, childhood growth patterns are often seen as markers of overall health and periods of warfare have historically been associated with morbidity and delayed childhood growth. Studies in Sudan, Somalia, Ethiopia, Rwanda, Afghanistan, Sierra Leone, Congo, Liberia, Bosnia, Croatia and Iraq have shown deficits in immune function, cognition and growth in children who lived through recent conflicts. These effects are likely due to a combination of nutritional and psychological factors, as poor childhood health is linked to malnutrition, intense violence and the death of close family members.
Importantly, historical data shows that exposure to these conditions early in life has a marked impact on adult well being. Those who are underweight and of short stature in childhood are consistently more likely to suffer from health problems later in life.
These effects are not just limited to children who grew up during difficult wartime conditions. Exposure to environmental stressors during foetal development also plays a role. Analyses of children whose mothers were pregnant during the well-documented Dutch Hunger Winter of 1944-45 show a predisposition to cardiovascular disease, obesity and diabetes in adulthood.
This evidence suggests that the impacts of war on civilian populations extend well beyond the most obvious repercussions of death, injury and psychological trauma and into more subtle aspects of biology. The current Gaza-Israel Conflict and Syrian Crisis will no doubt leave significant health impacts that will be felt for decades.
Erol, T. (2010). Children of Palestine [Image]. Retrieved from https://www.flickr.com/photos/tijen_erol/4742024133
Akresh, R., Lucchetti, L., & Thirumurthy, H. (2012). Wars and child health. Journal of Developmental Economics, 99(2), 330-340. Retrieved from JSTOR.
Kyle, U.G., & Pichard, C. (2006). The Dutch famine of 1944-1945: a pathophysiological model of long-term consequences of wasting disease. Current Opinion in Clinical Nutrition and Metabolic Care, 9(4), 388-394. Retrieved from JSTOR.
Minoiu, C., & Shemyayinka, O.N. (2014). Armed conflict, household victimisation and child health. Journal of Developmental Economics, 108, 237-255. Retrieved from JSTOR.