Meningitis and War

Meningococcic meningitis is on the upswing again. So far this year nearly 3,000 cases have appeared in the U.S., compared to 2,072 in 1941, 1,631 in 1940. Last week Colonel William B. Borden and Captain Paul S. Strong of the Army Medical Corps reported that "sporadic cases have now begun to appear in the Army camps in this country; and, in a few of the larger cities, the number of cases . . . approaches epidemic proportions."

This bacterial disease, characterized by inflammation of the membranes enclosing the spinal cord and brain, flares up at irregular intervals, especially during wars. British cases soared from 1,500 in 1939 to a record 12,500 in 1940. In World War I the disease hit Army camps in the U.S., France and Britain. Relatively few (5,839) U.S. soldiers were stricken, but the disease gave Army doctors a disproportionate amount of trouble--as it is doing now. "Certain peculiarities of the disease--the apparent lack of interconnection between cases, the mysterious manner of spread .. . the ineffectiveness of control measures, and the terrifying effect on the morale of the post," were noted by Borden & Strong at a Virginia camp recently. "The hysteria caused by the meningitis," they found, "is almost as difficult to handle as the disease itself."

For this reason Borden & Strong took a number of quarantine and sanitary measures which, they admit, are of doubtful medical value but which were helpful in allaying panic and salvaging the camp's morale. Early diagnosis of the disease is difficult since the first symptoms are variable and confusing until the appearance of a characteristic rash, delirium, painful stiffness of neck muscles, partial deafness and blindness.

During a bad U.S. epidemic in 1928, mortality was so high that many physicians lost faith in the serums which were then widely used. But about 1935 improved serums and antitoxins were developed. The sulfa-drugs have also reduced meningitis mortality. In World War I, meningitis killed 39% of the U.S. soldiers who came down with it. Using both the improved serum and sulfa-compounds in the recent Virginia outbreak, Borden & Strong held mortality to 5%.

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