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A forgotten epidemic that changed medicine: measles in the US Army, 1917-18

David M Morens1, Jeffery K Taubenberger2

  • 1Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.

The Lancet. Infectious Diseases
|June 14, 2015
PubMed

Insights

A 1917-18 measles outbreak revealed deadly co-infections, particularly streptococcal pneumonia. This research advanced understanding of viral-bacterial pneumonia, informing treatments used during the 1918 influenza pandemic.

Area of Science:

  • Military medicine
  • Infectious disease epidemiology
  • Pathogenesis of pneumonia

Background:

  • A significant US army measles outbreak occurred in 1917-18, causing over 95,000 cases and 3,000 deaths.
  • The outbreak highlighted the critical role of measles and streptococcal co-infections in mortality.
  • A concurrent epidemic of primary streptococcal pneumonia in non-measles-infected soldiers was also observed.

Observation:

  • A comprehensive, interdisciplinary research effort involving hundreds of medical and scientific professionals characterized the diseases.
  • The study provided detailed insights into the natural history and pathogenesis of measles and associated bacterial pneumonias.
  • A conceptual framework for bronchopneumonia resulting from viral-bacterial interactions was established.

Findings:

  • Measles and streptococcal co-infections were identified as major contributors to pneumonia-related deaths.
  • The research elucidated the mechanisms of viral-bacterial interactions in severe pneumonia.
  • Prevention and treatment strategies were developed and refined in real-time during the outbreak.

Implications:

  • The findings significantly advanced the understanding of severe pneumonia, particularly in contexts of co-infections.
  • Developed strategies were applied during the subsequent 1918 influenza pandemic, demonstrating their efficacy.
  • The research remains relevant for contemporary medical management of severe pneumonia and infectious disease outbreaks.

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