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Public health at Anzac Cove

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Gastrointestinal diseases in the trenches at Gallipoli

An outstanding feature of the trend in mortality of combatants in major wars waged by European and American armies between 1792 and 1918 is that the ratio of deaths from communicable diseases (CDs), especially gastrointestinal infections, to deaths from wounds (much complicated by septic infections) declined steadily despite the increasing lethality of weapons. However, the turning point in the trend was World War I, when the ratio of deaths resulting from CDs to deaths resulting from wounds was reversed (Box 1).1

For centuries during which records and documents are available, illness and deaths from CDs were much greater than from battle casualties. Consequently, modern military medicine focused much more on the prevention of CDs. As the field of bacteriology expanded in the late 19th century, the causative pathogens for CDs like typhoid and dysentery that had ravaged armies for centuries were discovered; and epidemiology showed how the spread of such diseases might be prevented.

The ratio of deaths from infectious diseases to battle-related deaths was considerably better in the Australian Imperial Force in 1915 than for troops in the South African War, 1899–1902 (Box 2).

By the end of World War I, the new preventive medicine and associated…