'Trench Fever'

[Guest Ian Bowbrick]

Can anyone give a medical breakdown of what trench fever was & how you got it?

Somewhere I recall hearing it came from drinking dirty water that rats had been in

Ian

[bmac]

I have this from a web site that I cannot currently identify (doh!).

TRENCH FEVER

The louse was not recognised as the transmitter (or vector) until after the war, however a paper by McNee, Renshaw and Brent was published in 1916 entitled "Trench Fever: a Relapsing Fever Occurring with the British Forces in France". This described human experimentation on enlisted volunteers and showed that the disease was transmitted by whole blood and was most likely carried "by one of the common flies or parasites found in the trenches."

(Lice infestation) was almost universal in the front lines, infestation of the officers and men ran at about 97%. Lice carried the organism that caused trench fever and the very high infestation rate explains why this disease was so common.

Trench fever had a latent period of 8-30 days before a sudden onset. This was with fever, severe headache, pains in the muscles of trunk and leg and characteristic shin pains. Shivering attacks were common and there was a variable short lived pink rash, sometimes lasting only a few hours so that the diagnosis was often confused with influenza.

Graham's description of trench fever refers to a sudden onset of the illness with headache and giddiness, this giddiness was sometimes so severe that the patient would fall down. There was muscular and shin pain, Graham wrote: "...before the pains concentrate in the shins, which they do eventually and give great distress towards evening and into the night, there is usually a sense of stiffness and soreness about the whole of the lower extremities. The lumbar pain sets in early, is severe, and in some cases quite as unbearable as it is in the invasion period of smallpox. ... The exhaustion following the acute stages of this disease is very marked."

A good description of Trench fever is to be found in the 1948 Lord Horder's Encyclopedia of Medical Practice. There is an incubation period of 8-30 days before the sudden onset with severe headache, pains in the muscles of trunk and leg and the characteristic shin pains. Shivering attacks were common and there was sometimes a short lived pink rash, sometimes lasting only hours.

The fever was exceedingly variable, but commonly lasted for about five days, (sometimes the illness was called "Five Day Fever"). The fever was followed by a remission and then a recurrence after 5-6 days. These recurrences were single or multiple and up to 12 recurrences every 5 or 6 days were not uncommon. This resulted in a prolonged disability. Unlike typhus, trench fever was fairly benign, the only late complication being a profound, debilitating depression that occurred in the more prolonged attacks.

Treatment was only symptomatic and very little could be done for the sufferers except admission to hospital for nursing care. Although few men, if any, died from the disease, 80% of infected men remained unfit for duty for up to 3 months Trench Fever was usually benign, the main complication was depression and this occurred in the more prolonged attacks, however during 1916 to 1918, 80% of infected men were found to be unfit for duty for 3 months.

After the war, the infective agent was discovered to be a rickettsial infection due to Rickettsia Quintana (so called because trench fever typically had a five day period of fever).

As some 800,000 cases of trench fever were reported during the war, the disease greatly reduced the numbers of soldiers available to fight. Colonel Butler commented that trench fever had "extraordinary epidemic potentialities as a cause of wastage" through non battle casualties, and "During 1917 ... an army of 1,000,000 would lose in a year at least 45,000 casualties from trench fever. Of these casualties, at least 80% would lose on an average, at least three months off duty." This great 'wastage of men' was very unfortunate from the point of view of the higher command. However, from the men's point of view, it seems that trench fever, with its low mortality, could also be regarded as a very advantageous disease. This was because hospitalisation for trench fever actually saved many thousands of men from the death or maiming that were such a horrific feature of the futile attrition battles of the Somme and Passchendaele.

[bmac]

PS Thoroughly suitable that this subject should be raised in 'chit chat'....

"There are three varieties of lice; head lice, or 'nits', (pediculus capitis), pubic lice, or 'crabs', (Phthirius pubis), and body lice, or 'chats' (pediculus corporis)..... the soldiers had to attempt to remove the lice as best they could. This removal, a procedure known as "chatting up" was usually by hand, picking out the lice from the clothes, or with the flame from lighted candles run up and down the seams of the clothes. (This was the origin of the verb "to chat" as the soldiers made the removal of their lice into a social event). "

[Guest Ian Bowbrick]

Bill,

Very many thanks for the comprehensive answer.

The case I know of is a Gunner in the RFA who was in hospital from 10 April 1917 to 15 May 1917 & convalescence from 15 May 1917 to 12 June 1917, a total of 57 days off sick.

Ian

[charlesmessenger]

Trench Fever was first identified in France in early summer 1915 and occupied the RAMC's mobile laboratories for the next three years in attempts to pinpoint the cause. In October 1917 the Allies set up a Trench Fever Committee in France and 150 soldiers were used as guinea pigs in experiements at St Pol. Lice were finally confirmed as the source in March 1918, but the German offensives prevented the immediate introduction of countermeasures.

The key to these were `delousing pits', literally pits with stoves made of brick in them. Clothes were hung in the pits and the lice killed by the heat. Because they were simple to construct, units could now carry out delousing rather than relying on the divisional laundry. More frequent baths were another preventative measure. The more mobile warfare of the last nine months also played its part.

While the medical authorities were certain that there was a significant reduction in Trench Fever cases, they found it difficult to quantify because the Spanish Flu that swept the armies had many the same symptoms.

Charles M

[Guest Ian Bowbrick]

Interesting to note that just before the German Spring offensive in 1918, one British unit had been in the line for 45 days without a change of clothes

Ian