A Plague on Both Houses

War and disease have always been fellow travelers. U.S. troops in Viet Nam are fighting malaria as well as the human enemy. But now, according to a report jointly issued by the U.S. Army Medical Research Team in Viet Nam and the Institut Pasteur of Saigon, another killer is mounting a virulent attack. Bubonic plague, the Black Death that slaughtered a third of Western Europe during the 14th century, has suddenly started claiming casualties by the thousands. In 1961, only eight cases were reported in South Viet Nam. Last year some 4,500 cases were recognized, and there were upwards of 200 deaths. So far this year, half of the republic's provinces have registered plague cases.

When it is administered, preventive vaccine is effective, but fresh batches must be kept under refrigeration and administered within two weeks before they go stale--a schedule that is all too easily missed in the war-weary countryside. Massive doses of antibiotics such as streptomycin and chloramphenicol often save those stricken with plague, but without early diagnosis and treatment, the chance of recovery is slim.

The disease produces high fever, delirium, and painfully swollen lymph glands form dark discolorations called buboes; death follows massive internal bleeding. People infected with the most virulent, pneumonic form can infect others by sneezing. The villain is a bacillus, Pasteurella pestis, which thrives in rats, the fleas that bite them, and humans exposed to either pest. Destroying fleas and keeping rats from migrating curb the plague, but Viet Nam's fleas have grown more resistant to available insecticides; and, for example, there are only four quarantine inspectors to see that busy harbor ships keep a constant guard against invading rats.

Plague has no significant effect on U.S. troops, since every man receives two shots before arriving in Viet Nam and boosters every four months. For Vietnamese living under government control, vaccine and treatment are almost always near by. But for the enemy Viet Cong, North Vietnamese troops, and those living in V.C.-held areas, the plague may well become a more deadly killer than either side expected.

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