Asia and the Far East: Emerging and Re-emerging Diseases

In the last chapter, our consideration of camp epidemics ended with an examination of a strange and debilitating illness that, prior to World War II, was hardly known to medical science—Q fever or ‘Balkan grippe’. Historically, Q fever is one of many seemingly ‘new’ diseases that have suddenly and unexpectedly erupted into military conciousness. In Chapter 2, for example, we saw how maladies such as the mysterious English sweating sickness, along with venereal syphilis, typhus fever, and yellow fever, appeared—ostensibly for the first time—in association with wars of the fifteenth, sixteenth, and seventeenth centuries. More recently, trench fever (World War I, 1914–18), scrub typhus (World War II, 1939–45) and Korean haemorrhagic fever (Korean War, 1950–3) provide twentieth-century examples of the emergence phenomenon (Macpherson et al., 1922–3; Philip, 1948; Gajdusek, 1956). At the same time, wars have also served to fuel the epidemic re-emergence of many classical diseases, of which human plague (Vietnam War, 1964–73), visceral leishmaniasis (Sudanese Civil War, 1956–), and diphtheria (Tajikistan Civil War, 1992–) are recent instances (Velimirovic, 1972; Seaman et al., 1996; Keshavjee and Becerra, 2000). In the present chapter, we develop the theme of war and disease emergence and re-emergence, taking selected conflicts and diseases in the Asian and Far Eastern theatres to provide examples. We begin in Sect. 9.2 by locating war within the broader conceptual framework of emerging and re-emerging diseases. Subsequent sections examine the wartime emergence of three zoonoses which, on their novel appearance in deployed western troops, prompted a series of landmark epidemiological investigations into the diseases concerned: scrub typhus among Allied forces in Burma–India during World War II (Sect. 9.3) and Japanese encephalitis and Korean haemorrhagic fever in the UN Command during the Korean War (Sect. 9.4). We then turn to the wartime re-emergence of classical diseases, illustrating the theme with reference to US troops (malaria) and Vietnamese civilians (human plague) during the Vietnam War (Sect. 9.5). The chapter is concluded in Section 9.6.