• U.S.

Diseases: Viet Nam’s Time Bomb

3 minute read

In every war, disease far outranks combat wounds as a cause of casualties. The situation is no different in Viet Nam, where three out of every four hospitalized U.S. soldiers are sick rather than injured. Despite the fact that American battlefield medicine is the best in history, the illness rate remains high because an Iowa-born sergeant or a Georgia-born lieutenant has developed no immunity to the indigenous diseases of Viet Nam.* Worse still, there are occasional cases of disease that a U.S. trained Army doctor has never seen before.

One such mystery illness has now been isolated and identified by the Army Surgeon General’s office. Known as melioidosis, it was first discovered in Southeast Asia in 1911, but it is practically brand-new to Americans. Though some of its symptoms (cough, fever, weight loss, chest pain and spotting on lung X rays) are similar to those of tuberculosis, it is an entirely unrelated illness. Caused by bacteria of the Pseudomonas family, which grow easily in the moist soil of Southeast Asia, melioidosis develops after invasion of the system through open wounds, the mouth or the nose. One helicopter crew chief came down with it apparently as a result of inhaling some of the mud kicked up by his whirling blades.

The noncontagious disease has been positively diagnosed in only 32 servicemen so far, but nine of them have died. And doctors fear that the worst is still to come. Melioidosis has the unpleasant ability to lie dormant in a victim for as long as six years. When it flares up, death occasionally follows within a few days or weeks. The “Vietnamese time bomb,” as it has been grimly nicknamed, can be effectively treated by Chloromycetin. The drug, which is used against typhoid, must be given in large doses for at least a month. The prolonged period is essential but not without risk of side effects (including possibly fatal anemia). Since little or no effect is noted at the beginning of treatment, the doctor must be confident enough of his diagnosis to continue the dosage.

While tropical diseases have added to the medical problems, a U.S.-South Vietnamese report finds that the number of psychiatric cases is “remarkably low for the number of troops involved.” Only 1.5% of the U.S. troops have psychiatric complaints; the comparable rate in Korea was 6.6%, World War II 10.1%. Among the reasons: combat fatigue has been drastically reduced by the sporadic nature of the fighting and by the one-year tour of duty. The incidence of psychiatric disability seems to be highest at the beginning and near the end of the tour, says one Navy doctor, who notes that some men become “obsessed about the possibility of getting hit at the very last moment.”

* Figures on South Vietnamese disease casualties are not meticulously kept, but their rate is markedly lower since the soldiers have resistance to local illnesses. The Viet Cong are naturally saying nothing, but the same can be presumed true of them.

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