War Epidemics An Historical Geography of

Down the ages, war epidemics have decimated the fighting strength of armies, caused the suspension and cancellation of military operations, and have brought havoc to the civil populations of belligerent and non-belligerent states alike. This book examines the historical occurrence andgeographical spread of infectious diseases in association with past wars. It addresses an intrinsically geographical question: how are the spatial dynamics of epidemics influenced by military operations and the directives of war? The term historical geography in the title indicates the authors'primary concern with qualitative analyses of archival source materials over a 150-year time period from 1850, and this is combined with quantitative analyses less frequently associated with historical studies.Written from the viewpoints of historical geography, epidemiology, and spatial analysis, this book examines in four parts the historical occurrence and geographical spread of infectious diseases in association with wars. Part I: War and Disease, surveys war-disease associations from early times to1850. Part II: Temporal Trends studies time trends since 1850. Part III: A Regional Pattern of War Epidemics, examines grand themes in the war-disease complex. Part IV: Prospects, considers a series of war-related issues of epidemiological significance in the twenty-first century.

Matthew Smallman-Raynor is Professor of Analytical Geography at the University of Nottingham. Andrew Cliff is Professor of Theoretical Geography at the University of Cambridge.

List of Figures and Plates

xvii

List of Tables

xxvii

Acknowledgements

xxxiii

Prologue

xxxv

PART I War and Disease

1. Wars and War Epidemics

3

(61)

1.1 Introduction

3

(5)

1.2 Wars

8

(17)

1.3 War Epidemics

25

(19)

1.4 Epidemiological Data Sources

44

(9)

1.5 Organization of the Book

53

(11)

2. Epidemics in Early Wars

64

(59)

2.1 Introduction

65

(1)

2.2 Antiquity (1500 BC-AD 500)

66

(7)

2.3 The Middle Ages (AD 500-1500)

73

(10)

2.4 The Old World, I: European Theatres (AD 1500-1850)

83

(27)

2.5 The Old World, II: European Engagements in Africa and Asia (AD 1700-1850)

110

(1)

2.6 War Epidemics in the New World (AD 1500-1850)

111

(8)

2.7 Conclusion

119

(4)

PART II Temporal Trends

3. Mortality and Morbidity in Modern Wars, I: Civil Populations

123

(52)

3.1 Introduction

123

(1)

3.2 Twentieth-Century Trends in Mortality: Australia and England and Wales

124

(6)

3.3 Twentieth-Century Trends in Mortality: International Patterns

130

(13)

3.4 The Causes of Epidemic Disease Decline

143

(12)

3.5 The Changing Disease Environment

155

(12)

3.6 Controlling Epidemic Spread

167

(7)

3.7 Conclusion

174

(1)

4. Mortality and Morbidity in Modern Wars, II: Military Populations

175

(56)

4.1 Introduction

175

(1)

4.2 Mortality and Morbidity, 1850-1914

176

(8)

4.3 Measles in the American Civil War

184

(12)

4.4 World War I, 1914-1918

196

(22)

4.5 Patterns since 1918

218

(3)

4.6 HIV in the US Army, 1985-1989

221

(7)

4.7 Conclusion

228

(3)

5. Mortality and Morbidity in Modern Wars, III: Displaced Populations

231

(72)

5.1 Introduction

232

(1)

5.2 Background

233

(5)

5.3 Global Patterns of Displacement, 1950-1999

238

(8)

5.4 Epidemiological Consequences of Displacement

246

(7)

5.5 Wartime Evacuation in the United Kingdom, 1939-1945

253

(24)

5.6 Palestinian Refugees

277

(12)

5.7 Ethnic Conflict, Displacement, and Disease in Central Africa

289

(7)

5.8 Conclusion

296

(7)

PART III A Regional Pattern of War Epidemics

Introduction to Part III

303

(4)

6. Tracking Epidemics

307

(42)

6.1 Introduction

308

(1)

6.2 Cholera and the Philippine-American War, 1902-1904

309

(4)

6.3 Map Sequences

313

(3)

6.4 Epidemics in Space

316

(5)

6.5 Epidemics in Time and Space

321

(3)

6.6 Complex Epidemic Spaces

324

(5)

6.7 Time Series and Epidemic Models

329

(10)

6.8 Conclusion

339

(10)

7. Pan America: Military Mobilization and Disease in the United States

349

(66)

7.1 Introduction

349

(2)

7.2 Recruiting Fields in the American Civil War (1861-1865)

351

(19)

7.3 Mobilization and Typhoid Fever in the Spanish-American War(1898)

370

(26)

7.4 US Mobilization and the World Wars

396

(17)

7.5 Conclusion

413

(2)

8. Europe: Camp Epidemics

415

(65)

8.1 Introduction

415

(2)

8.2 Crimean War: Cholera in the Field Camps of the British Army, 1854-1855

417

(35)

8.3 Prisoner of War Camps: Smallpox Transmission in the Franco-Prussian War, 1870-1871

452

(17)

8.4 Camp Epidemics in the World Wars

469

(6)

8.5 Conclusions

475

(5)

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

480

(47)

9.1 Introduction

480

(1)

9.2 Emerging and Re-emerging Diseases

481

(8)

9.3 Scrub Typhus (Tsutsugamushi Disease) in the Burma-India Theatre, 1942-1945

489

(9)

9.4 UN Forces, Emergent Viruses, and the Korean War

498

(13)

9.5 Re-emergent Diseases and the Vietnam War

511

(13)

9.6 Conclusion

524

(3)

10. Africa: Soldiers, Sexually Transmitted Diseases, and War

527

(39)

10.1 Introduction

527

(3)

10.2 Historical Patterns: French Troops in Algeria-Tunisia, 1875-1929

530

(7)

10.3 Sexually Transmitted Diseases in World War II

537

(12)

10.4 Civil War and the Spread of HIV/AIDS in Central Africa

549

(13)

10.5 Conclusion

562

(4)

11. Oceania: War Epidemics in South Pacific Islands

566

(46)

11.1 Introduction

566

(4)

11.2 Old World Diseases and South Pacific Wars, 1850-1900

570

(9)

11.3 World War I, Demobilization, and the Spread of Influenza in Australasia

579

(14)

11.4 The United States and the Pacific War, 1942-1945

593

(17)

11.5 Conclusion

610

(2)

12. Further Regional Studies

612

(77)

12.1 Introduction

613

(1)

12.2 Africa: Population Reconcentration and Disease in the South African War

613

(12)

12.3 Americas: Peace, War and the Epidemiological Integration of Cuba, 1888-1902

625

(14)

12.4 Asia: Prisoners of War, Forced Labour, and Disease in the Far East, 1942-1944

639

(6)

12.5 Europe: Civilian Epidemics and the World Wars

645

(38)

12.6 Conclusion to Part III

683

(6)

PART IV Prospects

13. War and Disease: Recent Trends and Future Threats

689

(44)

13.1 Introduction

690

(1)

13.2 Late-Twentieth and Early Twenty-First-Century Conflicts

690

(12)

13.3 War, Disease Eradication, and Control

702

(4)

13.4 Biological Warfare and Bioterrorism

706

(8)

13.5 Further Issues

714

(14)

13.6 Conclusion: The Future Disease Burden of Conflict

728

(5)

Epilogue

733

(1)

References

734

(41)

Index

775

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War Epidemics An Historical Geography of Infectious Diseases in Military Conflict and Civil Strife, 1850-2000

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