Since ancient times, the war against epidemics has gone hand in hand. If a person survived on the battlefield, then he had a high probability of contracting a serious infectious disease. The epidemics also brought great suffering to the civilian population. These are primarily acute intestinal infections, dysentery, malaria, tetanus and, of course, the king of all military conflicts - typhus. For example, in the First World War, typhus claimed several million lives, and tetanus affected more than 1% of all wounded. That is why, almost from the first days of the war, measures were taken to control the incidence of diseases in the territories of hostilities.
The first sign was the "Regulations on the medical and sanitary services for the population evacuated from threatened areas", adopted on June 30, 1941 by the People's Commissariats of Health and Communications. In accordance with it, it was forbidden to transport sick (or simply in contact with sick) people and healthy people in one echelon. Also, in each evacoelon, an isolator was supposed to be installed. The evacuation points provided for bath rooms, rooms for thermal disinfection, designed for an average of 250 people. On the way of evacuation trains, sanitary control points were organized at the stations, of which there were 435 by the end of the war.
But by the fall of 1941, the flow of refugees from the west was so voluminous that not all new arrivals could undergo sanitization.
There was an acute shortage of qualified doctors, hygienists and epidemiologists. For example, the historian Yulia Melekhova cites data that in February 1942 in the city of Barnaul there were 2 surgeons, 1 otolaryngologist, 3 psychiatrists, in other cities and districts of the region there were no narrow specialists. The system of sanitary control at evacuation echelons did not always work effectively. In 1942, an outbreak of typhoid fever was recorded in Western Siberia. The commission investigating the causes of the epidemic in the Novosibirsk region concluded that
“Most of the trains … that passed through the junction stations did not undergo sanitization at the places of formation, and many of them - at large stations on the way. Suffice it to say that from July 20, 1941 to January 14, 1942, 407 trains with 356 thousand evacuees traveled through the Novosibirsk station, of which only 43 thousand people were sanitized. (about 12%).
In the "Report on the work of the political department of the Tomsk railway" for October 1941, the head of I. Moshchuk noted:
"Medical care is poorly organized … The passing trains with the evacuated population are in an unsanitary condition, there is a high percentage of lice, they are not subject to sanitization along the way and in places of unloading."
The "reverse" order of the USSR People's Commissariat for Health, regulating the transportation of the population to the west, to places of permanent residence, was issued on September 1, 1944 and was titled "On medical and sanitary services for the re-evacuated population and migrants." The re-evacuation took place in a more organized manner, the echelons were provided with a sufficient number of medicines and sanitary units. If 300 people sat on the echelon, then one nurse stood out, up to 500 people. - one paramedic, up to 1 thousand people - one doctor and one nurse, over a thousand people. - one doctor and two nurses.
On February 2, 1942, the State Defense Committee issued a decree "On measures to prevent epidemic diseases in the country and in the Red Army", prescribing, among other things, universal immunization of the population. Toxoid was used to combat tetanus, which reduced the incidence to 0.6-0.7 cases per 1000 injuries. It was more difficult to fight against typhus. In Perm, a group of microbiologists worked on the problems of preventing typhoid and creating a vaccine. Using the epidermomembrane method, Doctor of Medical Sciences A. V. Pshenichnikov together with Associate Professor B. I. Raikher in 1942 created a new effective vaccine, which soon came in handy.
The Germans in the occupied territories, either deliberately or through an oversight, allowed a massive infection of the civilian population with typhus - up to 70% of the population of the occupied regions fell ill. A particularly difficult situation developed in the concentration camps that were liberated by the Red Army. Formally, our army had to face a prepared bacteriological sabotage - the Nazis deliberately spread typhus to the camps on the eve of liberation. As a result, the State Defense Committee created special emergency commissions to combat typhus, engaged in vaccination, disinfection and washing of the population and those released from the camps. The troops in the liberated territories were fenced off from the local quarantine zone, especially near the concentration camps. Emergency anti-epidemic commissions became an effective tool that managed to stop large outbreaks of diseases. And in exceptional cases, representatives from the People's Commissariat for Health went to the territory to closely monitor the work of local health authorities.
The development of new vaccines during the war peaked in 1942. In addition to the typhus vaccine based on the lungs of infected mice, live anti-tularemia, anti-plague and anthrax vaccines have been developed.
Prevention on all fronts
“I believe in hygiene; this is where the true progress of our science lies. The future belongs to preventive medicine. This science, going hand in hand with the state, will bring undoubted benefits to mankind."
These golden words of the great Nikolai Pirogov became the motto of the sanitary and epidemiological service on the fronts of the Great Patriotic War. In November 1942, a new position appeared in the troops - sanitary inspectors, who, among other things, monitored the state of the field kitchen and food products on all fronts of the warring Red Army. The regime of heat treatment of meat and fish, as well as supervision over the duration of storage of finished food products, made it possible to successfully prevent food poisoning and epidemics in the troops. So, in the prevention of gastrointestinal infections, a glass of hot tea with sugar after each meal has become common. In addition to the traditional control over the distribution of food among the fighters, specialists from the army sanitary and epidemiological units monitored the content of vitamins in the products. Particular attention was paid to vitamins of groups A, B and C, the lack of which led to hemeralopia, beriberi and scurvy. In the summer, greens were added, up to the leaves of birch, clover, alfalfa and linden. In winter, the well-known decoctions of coniferous trees were used. Modern researchers argue that in the event of a lack of vitamins and the complete impossibility of replenishing the deficit with natural resources, the units were fully supplied with vitamin tablets. Thiamine or vitamin B1 deficiencies were managed with the help of yeast grown on sawdust and other non-food waste. At the same time, yeast milk also possessed considerable nutritional value due to the high proportion of protein.
Control over the quality of water in the territories of the deployment of troops was also among the priorities of the hygienists of the Red Army. In the overwhelming majority of cases, the water supply was organized from wells, which were completely (sometimes even without preliminary control) disinfected with calcium hypochlorite, potassium permanganate, hydrogen peroxide, sodium bisulfate and pantocide. After such a harsh chemical disinfection, the water, naturally, did not taste the most pleasant. For this, "flavors" were proposed - tartaric and citric acids. This work acquired particular relevance with the army's transition to the offensive - the Germans often left the wells in an unusable state. And in the conditions of a shortage of fresh water, a whole desalination algorithm was developed - in 1942, the "Instructions for desalination of water by freezing" appeared.
One of the conditions for preventive work on the fronts was the creation of sanitary and epidemiological barriers, excluding the admission of infected recruits to the active army. These are spare shelves, in which the conscripts were in a kind of quarantine, as well as sanitary control points at large transport hubs. At many objects of sanitary control, not only doctors-epidemiologists worked, but researchers from medicine. Burdenko N. N. mentioned that none of the armies of the world had so many scientists at the front. So, for six months in 1942, the microbiologist Zinaida Vissarionovna Ermolyeva fought against an outbreak of cholera in besieged Stalingrad. She later recalled:
“The city was preparing for defense. Hundreds of thousands of soldiers passed through it in transit directly to the front, to the bend of the Don, where an unprecedented battle unfolded. The hospitals received thousands of wounded every day. From the city, overcrowded with troops and evacuated population, steamers and echelons continuously departed to Astrakhan …"
It is difficult to imagine what the spread of cholera along the front and rear at that time would have led to. It was possible to stop the outbreak only due to the general phage of the anti-cholera bacteriophage of civilians and military personnel in Stalingrad. Zinaida Vissarionovna was awarded the Order of Lenin for this heroic work.
Together with the successful military medical service of the Red Army, hygienists and epidemiologists returned to service 72, 3% of all wounded and about 90% of patients. In absolute terms, this is more than 17 million people! Do not forget that the medical and sanitary services lost 210 601 personnel at the fronts, while 88.2% of the dead served in the front line. At the same time, the combat work for the sanitary and epidemiological service of the Red Army did not end in May 1945 - for another five years, specialists came to eliminate the consequences of the war. And, for example, outbreaks of malaria, brucellosis and typhus (a legacy of the war) were eliminated only by the 60s.
