A War without Epidemic

Abstract

During the war years, when not only "social distance", but even the choice of medicines was out of the question and had to make do with meager weapons like penicillin, potassium permanganate, streptocide. Soviet medicine had to pass serious examinations and strength tests. And she went through it.

Full Text

We won the victory with the wounded
K. Rokossovsky

After the outbreak of the war, when, due to the displacement, often chaotic, of huge masses of the population, it became impossible to observe even basic sanitary standards, the epidemic situation immediately worsened: acute intestinal diseases and dysentery, typhus, malaria, viral hepatitis, tularemia and other infections began to spread.
It was impossible to allow the spread of diseases. The People's Commissariat of Health and the People's Commissariat of Railways CCCP issued a "Regulation on medical and sanitary services for the population evacuated from threatened areas", which described the actions of the territorial health authorities and the medical and sanitary transport service.
The decree prescribed to vaccinate "conscripts" and residents of large cities against acute enteritis, as well as to diagnose and promptly hospitalize patients with infectious diseases.
For the relief of intestinal infections, a formol vaccine was used, or trivaccine — against typhus, paratyphoid, A and B, or pentovaccine — the same components plus two dysentery antigens.
In 1941, the immunologists of the couple Nikolai Alexandrov and Nina Gefen developed the world's first multivaccine against seven infections — cholera, typhoid fever, tetanus, two types of paratyphoid and two types of dysentery.
The role of this vaccine cannot be overestimated [1]. The vaccine allowed for rapid vaccination, whereas conventional methods were unsuitable for operational warfare, requiring three doses of the vaccine and 30 days to complete the entire course.
A live vaccine of Nikolai Gaisky and Boris Elbert was used against tularemia, a vaccine of Maria Yatsimirskaya—Krontovskaya and Mikhail Mayevsky was used against typhus, a live vaccine of Nikolai Ginzburg was used against anthrax, a live anti-plague vaccine of Nikolai Zhukov—Verezhnikov, Magdalina Pokrovskaya, Elena Korobkova and Mikhail Faibich.
As a result, the epidemiological burden at the front and at home was significantly reduced and, above all, outbreaks of diseases among the troops and the population were prevented.
Reserve regiments were created, in which all conscripts were trained in sanitary literacy before going to the front. Sanitary control points were organized at large and junction railway stations, medical services of units and formations had to identify infectious patients in a timely manner, diagnose the disease, and then isolate and treat the patient.
Much attention was paid to sanitary and disinfection work in the units, sanitary and epidemiological intelligence. In 1942, the position of chief epidemiologist and the position of epidemiologist of units and formations was established in each military district.
Mobile epidemiological detachments were equipped with means for rapid sanitary treatment of people, clothing and property in epidemic foci.
We monitored the freshness and vitamin composition of the food. For example, in order to prevent vitamin deficiency C, infusions of pine needles were prepared and given to the personnel in the units.
Sometimes cases of vitamin deficiency, A — "chicken blindness" were recorded. Such fighters were obliged to collect wild sorrel, which was added to the first dishes. It was necessary to eat 100-150 grams of sorrel.
To disinfect the water in individual flasks, the soldiers were given pantocide tablets. In general, every source of water, according to the rules of wartime, a priori had to be considered doubtful, so the water was necessarily chlorinated and boiled.
If the troops were located on some territory for a significant period of time, then the water was purified - defended, coagulated and filtered. Since 1942, where there was only salt water, there was an "Instruction on desalination of water by freezing".
The water was disinfected with chlorine preparations, potassium permanganate or hydrogen peroxide, then it was boiled and the taste was improved with citric acid and other additives.
The duties of the sanitary department of the medical battalion included organizing two or three times a month, as far as the combat situation allowed, "washing of personnel with a change of underwear." For this purpose, there were mobile baths.
The divisions had their own laundries. The epidemiologist monitored the quality of washing and made sure that the streams of dirty and clean laundry did not mix. If the epidermis was complicated, the linen began to be impregnated with antiparasitic compounds.
Of course, infectious diseases, especially dysentery, which most often affected the young replenishment, could not do without. In this case, it was important to prevent the development and increase of infections [2].
That is why the evacuation of infectious patients to rear hospitals, as a rule, was not allowed: their treatment was carried out in infectious mobile field hospitals.
Sanepidrazvedka also provided sanitary services for troops when traveling by rail, road, and water transport. This became especially important when the troops began to move forward.
In the liberated territories, where infrastructure was often completely destroyed, polyclinics and hospitals were destroyed, there was a direct threat of the spread of parasitic typhus and other infectious diseases. Sometimes the Nazis resorted to deliberately infecting the population, so that the infection incapacitated the advancing troops.
In these cases, the institute of emergency anti-epidemic commissions was widely used, especially the strenuous work of the military medical service was required to detect, isolate and provide treatment for patients, disinfect the territory, create and equip field hospitals for the treatment of soldiers.
In May 1942, in each polyclinic, the post of deputy head physician for epidrabot was introduced, training of activists — sanitary inspectors was organized, who conducted yard rounds, sent to hospitalization of all temperature-related patients, disinfected foci of infectious diseases.
They actively participated in the work of polyclinics and sanitary stations, the number of which increased from 1,760 to 2,400 during the first two years of the war. Public health inspectors and employees of the Red Cross and Red Crescent Society were involved in the work.
Thus, a system was created to ensure the reliability of the quarantine barrier for railway communication.
The fact that the work of military epidemiologists, hygienists and sanitary services was successful is evidenced by the figures: the share of infectious diseases in the total incidence was only 9%, of which dysentery — 4.4%, typhus — 2.7%, typhoid and paratyphoid — 0.6%. During the war, 72.3% of the wounded and more than 90% of the sick were cured.
The efforts of doctors and health workers did not go unnoticed. CCCP orders and medals for the period 1941-1945 were awarded to more than 116 thousand military doctors and 30 thousand civil health workers. 47 people were awarded the highest award — the title of Hero of the Soviet Union. More than 20 military doctors during the Great Patriotic War became laureates of the CCCP State Prize.
It was their work and the superiority of prevention that led to the successful elimination of the plague in the Great Patriotic War.