Trench warfare
Disease

The predominant disease in the trenches of the Western Front was trench fever. Trench fever was a common disease spread through the faeces of body lice, which were rampant in trenches. Trench fever caused headaches, shin pain, splenomegaly, rashes and relapsing fevers – resulting in lethargy for months. First reported on the Western Front in 1915 by a British medical officer, additional cases of trench fever became increasingly common mostly in the frontline troops. In 1921, microbiologist Sir David Bruce reported that over one million Allied soldiers were infected by trench fever throughout the war. Even after the Great War had ended, disabled veterans in Britain attributed their decreasing quality of life to trench fever they had sustained during wartime.

Early in the war, gas gangrene commonly developed in major wounds, in part because the Clostridium bacteria responsible are ubiquitous in manure-fertilized soil (common in western European agriculture, such as France and Belgium), and dirt would often get into a wound (or be rammed in by shrapnel, explosion, or bullet). In 1914, 12% of wounded British soldiers developed gas gangrene, and at least 100,000 German soldiers died directly from the infection. After rapid advances in medical procedures and practices, the incidence of gas gangrene fell to 1% by 1918.

Entrenched soldiers also carried many intestinal parasites, such as ascariasis, trichuriasis and tapeworm. These parasites were common amongst soldiers, and spread amongst them, due to the unhygienic environment created by the common trench, where there were no true sewage management procedures. This ensured that parasites (and diseases) would spread onto rations and food sources that would then be eaten by other soldiers.

Trench foot was a common environmental ailment affecting many soldiers, especially during the winter. It is one of several immersion foot syndromes. It was characterized by numbness and pain in the feet, but in bad cases could result in necrosis of the lower limbs. Trench foot was a large problem for the Allied forces, resulting in 75,000 British and 2,000 American casualties. Mandatory routine (daily or more often) foot inspections by fellow soldiers, along with systematic use of soap, foot powder, and changing socks, greatly reduced cases of trench foot. In 1918, US infantry were issued with an improved and more waterproof ' Pershing boot ' in an attempt to reduce casualties from trench foot.

To the surprise of medical professionals at the time, there was no outbreak of typhus in the trenches of the Western Front, despite the cold and harsh conditions being perfect for the reproduction of body lice that transmit the disease. However, on the Eastern Front an epidemic of typhus claimed between 150,000 – 200,000 lives in Serbia. Russia also suffered a globally unprecedented typhus epidemic during the last two years of the conflict that was exacerbated by harsh winters. This outbreak resulted in approximately 2.5 million recorded deaths, 100,000 of them being Red Army soldiers. Symptoms of typhus include a characteristic spotted rash (which was not always present), severe headache, sustained high fever of 39 °C (102 °F), cough, severe muscle pain, chills, falling blood pressure, stupor, sensitivity to light, and delirium; 10% to 60% die. Typhus is spread by body lice.
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