The information in this section was prepared under
the direction of the Surgeon General of the U.S. Army, in a
War Department pamphlet titled "Health Precautions
for the Far East." Extracts from the pamphlet
are reproduced below in order to insure a wide dissemination
of this information among enlisted men and
In connection with this section, reference should be
made to a similar article, "Some Health Rules for
North Africa and the Middle East," which appeared in
Intelligence Bulletin, Vol. I, No. 9,
pages 65 to 78. That article dealt mainly with the
health aspects of water supply, foods, clothing, and
housing in the North African and Middle East areas. Since
this information is also applicable to the Far East
areas, it will not be repeated here.
2. INSECT CARRIERS OF DISEASES
The most important insect carriers of disease are
listed below, together with brief discussions of the
diseases that they may carry and applicable precautionary
Malaria, which is spread only by the bite of the female
anopheles mosquito, is a serious disease, and its danger
cannot be overestimated. Anopheles mosquitoes feed
during dusk or night periods, and possibly during the
day when the light is greatly reduced, as in deep, shaded
jungles or inside of dwellings. With the exception of a
few of the mountainous areas, great numbers of mosquitoes,
many of which may act as carriers of malaria, are
found throughout the Far East.
Man is the reservoir of malaria. Eighty to 90 percent
or more of the native inhabitants of some regions
are infected with this disease. Anopheles mosquitoes
become infected when they feed on (bite) a human being
who has malaria. After an incubation period of
from 14 to 40 days, these mosquitoes are
capable of transmitting the disease. While most
anopheles mosquitoes breed in slow-moving streams,
lagoons, and swamps, several varieties of malaria-carrying
mosquitoes breed in small collections of water about
houses. Unless care is taken, they may enter buildings
through carelessly opened screen doors, torn screens, cracks
at the junction of tiled or corrugated roofs with
walls, and so forth. During the day these mosquitoes
hide in corners and other parts of the house where
there is little light but come out to feed after dark.
Preventive measures include the following:
(a) Sleep in screened rooms or under mosquito nets. Inspect
screens, doors, and mosquito nets at regular intervals, and
search for live mosquitoes in those parts of the house
where there is little light.
(b) After dark, stay indoors in properly screened
buildings as much as possible.
(c) When it is necessary to be out of doors after dark, move
(d) If possible, select camp sites on wind-swept ground
away from areas infested with mosquitoes and far removed (at
least 1 1/2 miles) from native villages (the
inhabitants of which are usually infected and act
as a reservoir of malaria).
Additional measures that may be applicable include:
(a) The use of head nets, gloves, and mosquito boots, along
with other mosquito-proof clothing covering the entire
body. Mosquitoes are able to bite through the material
ordinarily used in shirts and other lightweight clothing.
(b) Mosquito repellents applied to all exposed parts
of the body at regular intervals.
(c) Insecticide sprays used inside airplanes and in
living quarters in the early morning and late afternoon,
and at other times when necessary.
(d) Quinine and atabrine do not prevent malaria. However, these
drugs are of definite military value in that they do prevent
clinical symptoms of malaria as long as they are
taken, and thus afford a means of keeping troops fit
during periods of emergency in the field. Such drugs should be
used only under special conditions and when advised by medical
officers, flight surgeons, or local health authorities. The present
War Department policy advocates 0.1 gram of atabrine (1 1/2 grains
or one tablet) once daily at the evening meal for six
days each week (total, 0.6 gram or six tablets per week). An
alternative method of administration which has been found
satisfactory in some areas is to give 0.05 grain of
atabrine (one-half tablet) once daily at the evening meal for
six days each week, and a dose of 0.1 gram (one tablet) at
the evening meal on the seventh day (total, 0.4 grain or 4 tablets
per week). If atabrine is not available, take
quinine sulfate 0.6 gram (10 grains or two tablets) after the
evening meal each day. (Circular Letter No. 153, Surgeon General's
Office, dated 19 August 1943.)
(e) The estive-autumnal type of malaria may give
rise to strange symptoms, entirely different from the
usual chills and fever. It is therefore advisable, when
residing in or traveling from malarial areas, to suspect
malaria when the cause of an illness is unknown, regardless
of whether or not there is fever. A medical
officer should be consulted and advised of the recent
possibility of exposure.
(2) Dengue Fever
Dengue fever, or breakbone fever, is apt to occur in
any part of southern Asia and is common in eastern
India, the Netherlands East Indies, and along the coast
and on the islands of the China Sea and
the Sea of Japan. The "yellow fever mosquito," Aedes aegypti,
is the carrier in southern Asia, whereas Aedes albopictus most
commonly carries dengue fever in China and
Japan. These mosquitoes feed (bite) during the day
but usually not in bright sunlight. Although this disease
is rarely fatal, it may be the cause of much disability
among troops. The precautionary measures outlined
in (1) (a) and (d) and (a), (b), and (c) above, under
preventive measures for malaria, are also applicable
for protection against dengue fever.
(3) Filariasis (elephantiasis)
This disease, often called elephantiasis, is caused by
several different types of small worms that can be injected
into man by the bite of mosquitoes. These worms
travel through the lymphatic channels, frequently blocking
them. While the disease ordinarily does not cause
any serious incapacity, chronic swelling of the legs and
scrotum may develop, and it seems certain that sooner
or later all individuals affected will suffer some ill
Since the disease is prevalent throughout the Par East
and chances for exposure are great, it is likely that considerable
numbers of soldiers will be affected by it. Methods for
protection against malaria as outlined in (1) (a), (b), (c),
and (d), (a), (b), and (c) above, also will prove valuable in
(4) Yellow Fever
Yellow fever has never been reported from Asia. However, the
Aedes aegypti mosquito (the carrier of
yellow fever) is found throughout the East, The transportation
of infected individuals or of infected mosquitoes
by airplane or ship from an area where yellow
fever is present is a serious hazard, for by either of
these means the disease could be introduced into the
Far East. If it were introduced, its spread undoubtedly
would be rapid.
Body lice are small, gray, flat, six-legged, wingless insects. In
the Far East they are the carriers of the
epidemic form of typhus fever (not to be confused with
typhoid fever) and louse-borne relapsing fever. Typhus fever
is prevalent in the hill country of India and throughout all
of China. It occurs sporadically in other parts of the Far East.
To keep from getting lice, the following measures are advised:
(1) Frequent bathing (when a satisfactory water supply is available);
(2) Frequent changes into freshly laundered and pressed clothing;
(3) Careful selection of sleeping quarters so that clean bed clothing is used;
(4) Avoidance of native habitations and close contact with
louse-infested individuals (sleep and eat only in the best
(5) Use of Army-issue insecticide powder on the seams of
clothing and on bedding as indicated; and
(6) In the presence of mass louse infestation, group delousing
methods as outlined in paragraphs 57 to 66, inclusive, FM 21-10, and
additional instructions on delousing that are issued from
time to time, may be employed.
Fleas are small, wingless, brown or black insects with
a flat body, small head, and large legs. In addition to
being annoying, rat fleas are the carriers of bubonic plague
and endemic or flea-borne typhus fever. Rats and other wild rodents
suffering from these diseases infect the fleas. At death the
fleas leave the rat in search of a new host and infect man. The
finding of dead rats or other dead rodents may indicate that
these diseases, especially plague, are prevalent.
Plague in man (human plague or bubonic plague) was reported
throughout most of 1942 from the Dutch East Indies, Java,
Madura, West Java, New Caledonia, parts of China, India,
French Indo-China, and Burma. Although not reported
recently, the disease is known to be present in many of
the towns and villages of central China and the seaports of Japan.
Plague in wild rodents is known to be present constantly
in several large areas in central Asia, in northeastern
China, and in Manchuria.
Endemic or flea-borne typhus fever is found in the
Malay Peninsula, the Dutch East Indies (where it is
called shop typhus), the lowlands of India, and ports of
the China Sea.
Neither the plague nor the endemic form of typhus fever is
likely to be of importance to individuals if the precautionary
measures outlined under "Lice" (b above) are followed, and
rats and rat-infested buildings are avoided.
Ticks can be identified by their flat, oval body, small
head, and comparatively large abdomen. In the Far East
ticks are carriers of tick-borne relapsing fever, a
disease which is found in Western and Central Asia and
in China. In Northern India they transmit Indian
Precautionary measures include:
(1) Measures outlined under "Lice" (b above).
(2) Avoid native homes, especially at night, when the ticks come out of the walls.
(3) Avoid sleeping on the ground, particularly in long grass, or
resting near the trunks of trees (ticks hide in grass and under
the bark of trees during the day).
(4) Always examine your bed for ticks before turning in.
(5) Examine skin and clothing for ticks at least
twice daily. Remove all ticks and kill them. Never
squash a tick on the skin or attempt to pull it out. Cover
the tick with a good coating of oil, vaseline, gasoline,
paraffin, or even spit. After a few moments the
tick will let go and be easy to remove. The tick should
then be killed by burning or by crushing between two
(6) The site of the tick bite should be cleaned and
treated with an antiseptic such as iodine or alcohol.
Mites are small insects resembling fleas. In different
parts of the Orient they are the carriers of various
forms of mite typhus. These diseases are common in
Java, New Guinea, Malaya, Japan, India, and Burma. In
Southern China their bite causes a skin disease
known as "coolie's itch."
Mites are usually found in association with rodents
(particularly rats), with birds, and possibly in the
flowers of certain palm trees. They are most commonly
found in areas that are subject to flood and in
recently cut-over jungle lands; they are most numerous
in the late spring and early summer.
(1) When possible, avoid mite-infested areas.
(2) Wear clothing that protects the skin, such as long trousers
tucked into boots, long sleeves, and so forth.
(3) Use Army-issue insecticide powder and insect
repellents on skin and clothing.
Certain fly-borne diseases are of importance in Asia.
(1) Common House Fly
By mechanical means, flies are capable of carrying
intestinal disease germs from filth and fecal matter to
the food of man. Infectious material from the ulcers
of yaws and Oriental sore may be carried by flies in the
same manner, and eye diseases may be transmitted
mechanically by these insects.
General precautionary measures (see par. 35, FM 21-10; also AR 40-205):
(a) Destruction of flies by swatting, trapping, poisoning, and so forth;
(b) Elimination of fly breeding places by careful and
complete disposal of wastes and refuse (human excreta, manure,
garbage, rotten fallen fruit, and other organic matter);
(c) Use of insect repellents (sprays);
(d) Use of nettings and/or screens; and
(e) Protection of foods.
(2) Myiasis (fly boils)
The bites of certain types of flies (especially botflies
and gadflies) may cause deep-seated abscesses or boils
that heal with difficulty in the absence of medical attention. In
the process of biting or alighting, the flies deposit
their eggs or larvae (maggots, grubs) in or on the
skin, open wounds, nostrils, or ear canals. The eggs of
some of these flies may be carried by other insects,
mosquitoes, for example. The development of the maggots
in these locations is accompanied by bacterial infection
and subsequent boil formation. Surgical removal of
the growing fly larvae is necessary for cure.
Sandflies transmit a virus disease known as pappataci fever
or sandfly fever. This disease is of a mild
nature but is prevalent over practically all the
Far East, where it may cause considerable disability. Evidence
indicates that sandflies also are capable of transmitting
the organisms causing Oriental sore, and may
be responsible for the spread of kala-azar or Dumdum fever, a
serious disease affecting many people in the Orient.
3. ANIMALS; DISEASES ACQUIRED FROM THEM
Animals are not only the hosts of insect carriers of
disease (par. 2: rat fleas, lice, dog ticks, and so forth), but
also may be directly responsible for the spread to
man of diseases which these animals themselves contract. The
following animal-borne diseases are likely to be encountered
in this part of the world:
a. Rabies (mad-dog bite, hydrophobia)
This can be acquired from both wild and domestic
animals. This disease is of great importance throughout
southern Asia, especially in India, and also in parts
of the Dutch East Indies, where great packs of dogs are
kept as food. In the case of a bite by an animal thought
to be rabid, the wound should be cleansed as thoroughly
as possible, any available antiseptic applied, and a physician
consulted as soon as possible. If practicable, save
the animal for observation and examination.
b. Snake Bite
Poisonous snakes are found throughout tropical and
temperate Asia. The majority of them do not attack
man unless disturbed. Cobra venom contains a powerful
poison which affects the nervous system, while the
venom of the vipers affects the red blood cells. In case
of snake bite, identification of the offending snake is
less important in the Far East than in other areas, since
the antivenom usually available is effective against both
types (polyvalent). The presence of an undigested or
partially digested "ball" of food in the snake's stomach
may indicate the amount of venom injected into the
victim. When a venomous snake kills, a part of its
venom is used up; thus the presence of a visible food ball
in its stomach may mean that its poison sacs were relatively
empty and therefore that probably only a small
amount of venom was injected at the time of biting the
Take the following precautions:
(1) Wear boots when required to walk in snake-infested areas.
(2) Avoid the careless touching of shrubs, brush, trees, tree
branches, and so forth, or walking near ledges where snakes
may be hiding.
(3) Examine clothing and shoes before getting dressed, and
always look in cupboards, drawers, and other dark places
before reaching into them.
(4) Have a flashlight or other source of light available
at the bedside so that the floor may be examined
before getting out of bed in the night.
(5) If bitten by a snake, the following procedures are
(a) Immediately apply pressure or a tourniquet (rubber
tubing, belt, piece of shirt, string, vine, or weed) above
the bite, no tighter than a snug garter. This will
stop the venous-blood return toward the heart and keep
the poison from getting into the general circulation. The
tourniquet should be released for a few seconds
every 10 or 15 minutes to permit some circulation.
(b) Under field conditions, and in the absence of
medical care, do not make an incision, but instead
place a 3- or 4-inch square sheet of thin rubber (rubber from
a condom or similar material) over the site of the fang
punctures, and, by vigorously sucking and kneading
with the teeth, remove as much venom as possible during
a period of 5 minutes. The rubber sheeting will prevent
sucking the venom into the mouth. Wash the wound and the
rubber sheeting and repeat the sucking and kneading at
frequent intervals while removing the patient to the
nearest medical officer or other physician. If no rubber
sheet is available, blood from the fang-punctures may
be sucked into the mouth directly. In this case, the person
sucking should rinse out his mouth with water at frequent
intervals to lessen any danger of his becoming poisoned
from the venom.
(c) If practicable, kill the snake and take it to the
physician for inspection.
(d) Whisky or other alcoholic drinks must not be given.
(e) Keep the patient from exerting himself, for this
will increase blood flow and thus cause more venom to
Leeches look like thick, short worms. They are
troublesome in India, the Malay Peninsula, and the
Dutch East Indies. They are of two types, the large
"horse" leech found in fresh water, and a small jungle
leech found on shrubs and in tall grass in the vicinity of
streams and rivers. They attach themselves to man for
the purpose of sucking blood, and, although they are not
dangerous in themselves, the site of their bite frequently
(1) Wear long trousers tucked into high shoes. The
leech is capable of slipping through the eye-holes in
shoes, or through coarse stockings; therefore the
tongues of shoes should be sewn to the sides.
(2) Do not pull off the leech, for if the mouth parts
are left in the wound, an infection may take place. Remove
the leech by touching it with the lighted end of a
cigarette, by prodding it with a knife, or by applying
common table salt, wet tobacco, or other chemical irritant
harmless to the skin.
(3) To prevent infection, immediately apply a suitable antiseptic to the bite.
4. VENEREAL DISEASES
Venereal diseases are prevalent throughout Asia. In
some areas, up to 100 percent of the native population
may be infected with one or more of these diseases, which
include the following: Syphilis, gonorrhea, chancroid (or
soft chancre), lymphogranuloma venereum (tropical
bubo), and granuloma inguinale.
Briefly, it may be said that in the vast majority of
cases venereal diseases are contracted through sexual
contact, although syphilis may be acquired by kissing.
5. SUNBURN, SUNSTROKE, AND HEAT EXHAUSTION
Personnel accustomed to climatic conditions in the
United States fail to evaluate the intensity of the sun's
rays nearer the equator. As a consequence, serious skin
burns and sunstroke may occur after relatively short
exposure. It also must be remembered that severe sunburn
may be acquired from the reflection of the sun, although
protected overhead, when in small boats on
tropical waters. Exertion in hot and/or humid climates, with
resulting loss of fluid and salt by sweating
may cause heat exhaustion even in physically fit
individuals. Glare from water or sand in intense sunlight
often results in severe eye irritation, and mechanical
irritation may be produced by wind and blowing
sand and dust.
Precautions: The following precautions are suggested:1
(a) Wear suitable headgear (sun helmet) when exposed to the sun.
(b) Do not expose large areas of the body surface to
direct rays of the sun for more than a few minutes at a
time unless a thorough tan has been acquired and then
only during the early morning or the late afternoon.
(c) The use of a superior grade of dark sun glasses
is advisable. The Calabar lenses now widely used by
Army Air Forces personnel are satisfactory.
(d) Early recognition of the warning signs of heat stroke
and heat exhaustion (dizziness, headache, blurring of
vision, nausea and/or vomiting) and early first-aid
treatment of these conditions. Medical attention
should be obtained as soon as possible.
(e) Avoid or reduce to a minimum the consumption of alcohol.
6. MINOR WOUNDS
Wounds do not heal rapidly in tropical climates and
infection is likely to take place. Minor wounds (cuts,
scratches, abrasions, insect bites, and so forth) should
be treated by application of iodine or other antiseptics. Burns
should be covered with boric-acid ointment or sulfanilamide
powder and a dry dressing applied. All wounds should receive
medical attention as soon as practicable. See FM 21-11.
1 Reference should be made to the list of precautions
given on pages 71 and 72 of Intelligence Bulletin,
Vol. I, No. 9.