The conflict between Russia and Ukraine has been going on for more than a month, and in addition to the superficial military conflict, it actually implies more hidden dangers that we can't see with the naked eye - infectious diseases.
According to the World Health Organization, testing for COVID-19 in Ukraine stopped after the conflict began, coupled with low vaccination rates (only 20% in some areas) and the gathering of people in bunkers during wartime and the gathering of soldiers in the army, either side has a very high risk of COVID-19.
The end of February, when the conflict began, coincided with the outbreak of the local Omicron variant in Ukraine | Source: WHO Coronavirus (COVID-19) Dashboard
Coupled with the risk of infectious diseases such as polio, tuberculosis and AIDS, the outbreak of war has serious impacts on the health of civilians and soldiers, and the operation of health care facilities will be serious.
Why? Because such things have happened repeatedly since thousands of years ago, mankind has suffered enough and should have suffered enough in the contagion of war.
Infectious diseases cause the destruction of nations, and even nations
In the Biblical Book of Revelation, the Four Horsemen of the Apocalypse are prophesied to bring about the destruction of the world: plague, war, famine, and death. It can be seen that as early as two thousand years ago, people began to associate plague and war, two things that often happened at the same time.
The Four Horsemen of the Apocalypse prophesied in the book of Revelation for the end of the world, although religious, can also reflect people's understanding of disaster
| Source: Russian painter Victor Vasnetsov
The earliest accounts of the contagious diseases of war date back to 430 BC, the Peloponnesian War in Athens and Sparta. Just as the Athenian army was in control, a great plague suddenly broke out in the city of Athens, causing 25% of the entire population of Athens, about 75,000 to 100,000 deaths, known as the Plague of Athens.
Tracing back to its roots, a reinforcement from Ethiopia, Africa, carried the pathogens and carried them all the way to Libya, Egypt, Persia and Athens. According to historians' descriptions of the plague, modern biologists speculate that it may have been smallpox, typhoid fever, or viral hemorrhagic fever (a symptom similar to Ebola disease), but it is difficult to verify exactly.
It was also the contagion of this war that made Athens, the "cradle of Western civilization", collapse from then on.
... the catastrophe was so overwhelming that men, not knowing what would happen next to them, became indifferent to every rule of religion or law.
...... The catastrophe (the plague) was so overwhelming that no one knew what would happen next, and no one cared about religion or the letter of the law.
―Thucydides, History of the Peloponnesian War
The end of February, when the conflict began, coincided with the outbreak of the local Omicron variant in Ukraine | Source: WHO Coronavirus (COVID-19) Dashboard
In distant China, infectious diseases also appeared with war.
In 208 AD, the Battle of Chibi during the Three Kingdoms period, in addition to the familiar fire, infectious diseases were also one of the main reasons for the defeat of Cao Cao's army.
Gong (Cao Cao) went to Chibi, and prepared for war, which was unfavorable. So the great plague, the officials and soldiers died, but the army was returned.
- Chronicle of the Three Kingdoms, Wei Shu, And The Chronicle of Emperor Wu
But based on the description of this fragment, we cannot know where the pathogen of this infectious disease comes from. In the thousands of years before and after this, China has recorded as many as 826 records of infectious diseases, many of which are also related to large-scale wars.
In addition, the events that accompany wars and infectious diseases in the world can be said to be innumerable:
The Byzantine Empire, which flourished in the 15th century, introduced the plague (Black Death) carried by rats because of the need to transfer food from Africa because of the war, resulting in the collapse of the Byzantine Empire;
The expansion of the Mongol Empire in the 13th century, while opening up Eurasia, also brought the plague to Europe again, and the countries of medieval Europe, which lacked a complete health system, fell into the fear of the Black Death, and florence, Italy, reached a third mortality rate in just six months;
In the 16th century, when Europeans opened up the New World to the Americas and went to war with the Aztec Empire, they also brought smallpox into the Americas, and tens of millions of Native Americans who had never experienced smallpox died...
Outbreak of the Black Death in Europe in the 13th-14th centuries
| Source: Wikipedia, Roger Zenner
Why were these ancient wars often accompanied by the spread of terrible infectious diseases?
On the one hand, the large number of people gathered during the war, coupled with the extremely incomplete public health conditions in ancient times, provided an excellent "hotbed" for dangerous pathogenic microorganisms such as smallpox virus and plague bacillus.
On the other hand, large-scale movement of people will bring pathogens from different regions to new populations, in other words, to bring pathogens to new "hotbeds", such as smallpox entering the Americas in the 16th century, or Cao Cao's army in the north entering the south to have a "great epidemic", or the 1918 flu we will mention later.
The emergence of infectious diseases in this war has created modern medicine
When it comes to war, the most famous is the two world wars of the 20th century, which not only caused the deaths of thousands of people, but also brought the most turbulent years to the world. Among them, the occurrence of the First World War (hereinafter referred to as "World War I") has left an indelible mark on the history of medicine and microbiology.
Before World War I, microbiologists Louis Pasteur and Robert Koch discovered the relationship between microbes: the former elucidated the existence of microorganisms and developed various vaccines against pathogenic microorganisms; the latter proposed Koch's law for diagnosing microbial diseases and delved into Mycobacterium tuberculosis and Vibrio cholerae.
The founders of microbiology, Louis Pasteur (left) and Robert Koch (right), | Image source: Wikipedia
By the beginning of the 20th century, the theories of microbiology were just beginning to be accepted by the medical community: doctors gradually realized that this invisible bacteria could cause serious infectious diseases, and began to use vaccines to prevent infectious diseases, and also knew some limited knowledge of drugs - quinine can treat malaria, arsenic can treat syphilis, and so on.
At this time, modern medicine, which had just emerged, was in a hurry to face its most severe test: the First World War.
Large armies of tens of thousands of people are fighting across continents, and public health is still in its infancy, and the situation is basically the same as the factors of the outbreak of infectious diseases in ancient wars that we have just mentioned. But modern medicine has finally delivered a fairly passable answer.
Soldiers in the trenches in 1917 were being vaccinated, possibly against typhoid fever
| Image Source:
The first is salmonella, which has caused a large number of deaths in the past, which can spread with feces, flies and cockroaches, causing typhoid fever. The beginning of typhoid vaccination in the army in the late World War I and the ensuring of clean drinking water led to a rapid decrease in the prevalence of typhoid fever. In the past, hundreds of people were infected with typhoid fever in every thousand people in wars, and by the time of World War I, less than one person per thousand people was infected on average.
The second is the malaria parasite, which is transmitted by mosquitoes, which causes deadly malaria. Quinine was used extensively and heavily in the army, and soldiers were even required to take quinine powder under the supervision of their commanders. Coupled with mosquito control, malaria did not eventually spread during World War I.
Soldiers, under the supervision of officers, took a certain daily dose of quinine | Source: Ariel Varges, Imperial War Museum
In addition, screening potential tuberculosis patients through recruit physical examinations has avoided the spread of tuberculosis bacteria to a certain extent; reduced the sexual behavior of male soldiers through the persuasion of priests, and also weakened the spread of syphilis and gonorrhea; rapid wound cleaning and the use of antitoxins have made the prevalence of tetanus extremely low... From all sides, doctors have tried their best to minimize the spread of infectious diseases and to make full use of microbiology knowledge.
However, in the face of the pandemic, modern medicine at that time lost badly.
In early 1918, a sudden flu illness spread to Europe, the Americas, and Asia in just three months, and by September the mortality rate of the disease had risen sharply, killing young and old people in large numbers.
At that time, researchers exhausted the known methods of isolating bacteria, and could not curb the spread of the flu, and could only watch the patients die one by one. Eventually, the pandemic took around 50 million lives and disappeared silently with the end of World War I.
A temporary hospital set up to deal with the pandemic | Image source: BBC
Decades later, people learned that it was an infectious disease caused by the flu virus, and to this day, we are still battling these viruses.
But it is undeniable that this war is both a "civil war" of mankind itself and a brave battle against infectious diseases.
Reflections on Infectious Diseases in Modern Warfare
So today, will war and infectious diseases still be the problems we have to consider?
Although the world war is over, the conflict between human beings has never stopped, and the people in the conflict are still suffering from the threat of infectious diseases:
During the civil unrest in Afghanistan that began in 1979, the previously controlled Plasmodium falciparum began to spread again, resulting in 2-3 million cases of malaria in Afghanistan every year;
The constant conflict and war in the Republic of the Congo has made the control of trypanosomiasis unstable, and in the 1960s it was controlled at about 1,000 cases, but then the conflict broke out again, and the number of cases reached tens of thousands;
The 1994 Genocide in Rwanda displaced a large number of refugees, and sudden outbreaks of cholera and dysentery killed more than 12,000 refugees in the absence of basic living conditions and health protection;
The conflict in Syria a few years ago caused millions of people to live in limbo, and also caused infectious diseases such as measles, hepatitis A, polio, leishmaniasis and other infectious diseases to take advantage of the situation, posing a huge threat to refugees...
Health workers fighting Ebola in Uganda in 2000
| Image source: WHO
Today, we already know how to deal with plague, typhoid fever, malaria; it is also different from the ignorance of facing the pandemic 100 years ago, knowing what a flu virus is, and designing vaccines every year to prevent influenza; and also learning to use antibiotics to fight most bacterial infectious diseases... But have we really defeated infectious diseases?
The resistance of microorganisms has made antibiotics lose their effectiveness, the earliest use of penicillin has long been eliminated by bacteria; AIDS, tuberculosis, influenza, including the new crown that has just appeared in the past two years, we have still not been completely cured...
In addition to the endless evolution of new pathogens, the culprit behind this is war.
Looking back at existing research on infectious diseases of war, developing countries are already struggling to cope with a wide range of infectious diseases, and the conflicts of war have increased the burden on these countries, the breakdown of public health systems, the decline in pathogen detection capacity, and the lack of shelter for refugees, which are the reasons for the spread of infectious diseases.
Will the epidemic of war, which has lasted for thousands of years, continue in the future? This may require us in the future to give the answer.
Resources
Roberts L. Surge of HIV, tuberculosis and COVID feared amid war in Ukraine[J]. Nature, 2022, 603(7902): 557-558.
WHO Coronavirus (COVID-19) Dashboard https://covid19.who.int/
Roy K, Ray S. War and epidemics: A chronicle of infectious diseases[J]. Journal of Marine Medical Society, 2018, 20(1): 50.
ZHANG Zhibin. Epidemiological chronology of epidemics in ancient China. 2007.
Shanks G D. How World War 1 changed global attitudes to war and infectious diseases[J]. The Lancet, 2014, 384(9955): 1699-1707.
Pennington H. The impact of infectious disease in war time: a look back at WW1[J]. Future Microbiology, 2019, 14(3): 165-168.
john k John M. Barry. The Great Flu – The Epic of the Deadliest Plague.
Connolly M A, Heymann D L. Deadly comrades: war and infectious diseases[J]. The Lancet, 2002, 360: s23-s24.
Sharara S L, Kanj S S. War and infectious diseases: challenges of the Syrian civil war[J]. PLoS Pathogens, 2014, 10(11): e1004438.
Goniewicz K, Burkle F M, Horne S, et al. The Influence of War and Conflict on Infectious Disease: A Rapid Review of Historical Lessons We Have Yet to Learn[J]. Sustainability, 2021, 13(19): 10783.
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