Trench Diseases of the First World War

Introduction to the Western Front

In late 1914, belligerent nations established complex trench lines from the North Sea to the Swiss Border.
The trenches created harsh living conditions with climate extremes and frequent rain.
Historically, military concentrations have faced outbreaks of diseases like typhus, malaria, and influenza.
On the Western Front, three main diseases gained prominence: Trench Foot, Trench Fever, and Trench Mouth.
These diseases significantly affected the troops' morale and fighting efficiency.

Causes: Long exposure to wet and cold conditions in trenches leading to waterlogged and chilled feet.
Symptoms: Painful, swollen, blistered, numb feet; potential fungal infection and gangrene.
Solutions:
- Foot inspections by medical officers.
- Provision of dry socks and use of whale oil to stimulate circulation and prevent waterlogging.
- Implementation of better drainage, waterproof boots, and duck-boards.
Impact: Over 20,000 cases in winter 1914/15; 74,000 recorded cases throughout the war.

Causes: Spread by body louse (Pediculus humanus), the vector of Rickettsia quintana.
Symptoms: Severe headache, muscle pains, particularly in shins, recurring fever.
Duration: Typically lasted 5 days, but could reoccur multiple times.
Impact: 800,000 cases in the British Army; up to 80% of affected men unfit for duty for months.
Prevention: Focused on reducing louse infestation through fumigation, hot baths, and sterilized clothing.

The aftermath of the war saw many toothless ex-soldiers due to the impact of Trench Mouth.

Trench Foot: Fungus and gangrene.
Trench Fever: Rickettsia quintana (different from Rickettsia prowazekii which causes epidemic typhus).
Trench Mouth: Bacillus fusiformis and buccal spirochaetes.

Article by Dr. David Payne