Second, I describe TB trends within both military and civilian populations. ![]() First, I examine screening and other control measures used by the US military to prevent TB infection and disease. 6 This historical review instead focuses on the evolution of screening practices, the changing epidemiology of TB, and the differences in TB risk among US military service members serving overseas during major armed conflicts from 1885 to the present. 5Ī superb account of TB in the US military during World Wars I and II has recently been published. A few, very few, catch the disease in infected billets or barracks.” 4 In fact, TB was never noted to be one of the “war epidemics” first described by Prinzing. The French Army physician Jean-Antoine Villemin found that TB was more frequent among soldiers stationed in barracks than among troops in the field, stating that “we observe that the army, decimated by TB in garrison, is almost free in war conditions.” 3 Similarly, during World War I, Sir William Osler declared that “In a majority of cases, the germ enlists with the soldier. TB also has a long and well-established association with military populations, but the association of increased TB risk during armed conflict is less certain. Studies demonstrating increased morbidity and mortality from TB during war have largely focused on civilian populations. 2 These crises result in conditions that promote the transmission and reactivation of TB, including population crowding and immunosuppression from famine and other infectious conditions. 1 Increases in TB infection, disease, and death are seen in times of war, forced population displacement, and natural disasters. ![]() War and armed conflict have a long and well-established impact on morbidity and mortality from tuberculosis (TB).
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