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Consequences of captivity: health effects of far East imprisonment in World War II

Robson, D., Welch, E., Beeching, Nicholas and Gill, Geoff (2009) 'Consequences of captivity: health effects of far East imprisonment in World War II'. Qjm-an International Journal of Medicine, Vol 102, Issue 2, pp. 87-96.

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Abstract

Though medical consequences of war attract attention, the health consequences of the prisoner-of-war (POW) experience are poorly researched and appreciated. The imprisonment of Allied military personnel by the Japanese during the World War II provides an especially dramatic POW scenario in terms of deprivation, malnutrition and exposure to tropical diseases. Though predominantly British, these POWs also included troops from Australia, Holland and North America. Imprisonment took place in various locations in Southeast Asia and the Far East for a 3.5-year period between 1942 and 1945. Nutritional deficiency syndromes, dysentery, malaria, tropical ulcers and cholera were major health problems; and supplies of drugs and medical equipment were scarce. There have been limited mortality studies on ex-Far East prisoners (FEPOWs) since repatriation, but these suggest an early (up to 10 years post-release) excess mortality due to tuberculosis, suicides and cirrhosis (probably related to hepatitis B exposure during imprisonment). In terms of morbidity, the commonest has been a psychiatric syndrome which would now be recognized as post-traumatic stress disorderpresent in at least one-third of FEPOWs and frequently presenting decades later. Peptic ulceration, osteoarthritis and hearing impairment also appear to occur more frequently. In addition, certain tropical diseases have persisted in these survivorsnotably infections with the nematode worm Strongyloides stercoralis. Studies 30 years or more after release have shown overall infection rates of 15. Chronic strongyloidiasis of this type frequently causes a linear urticarial larva currens rash, but can potentially lead to fatal hyperinfection if immunity is suppressed. Finally, about 5 of FEPOW survivors have chronic nutritional neuropathic syndromesusually optic atrophy or sensory peripheral neuropathy (often painful). The World War II FEPOW experience was a unique, though often tragic, accidental experiment into the longer term effects of under nutrition and untreated exotic disease. Investigation of the survivors has provided unique insights into the medical outcome of deprivation in tropical environments.

Item Type: Article
Additional Information: 398GZ Times Cited:0 Cited References Count:86
Uncontrolled Keywords: strongyloides-stercoralis infection posttraumatic-stress-disorder former prisoners follow-up helminth infections vietnam veterans british troops ex-prisoners japanese world-war-2
Subjects: WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 100 General works
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Disorders and Injuries of Environmental Origin > WD 600 General works
WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 280 Dysentery
QX Parasitology > Helminths. Annelida > QX 200 Helminths
WM Psychiatry > WM 100 General works
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WM Psychiatry > WM 141 Psychiatric examination. Diagnosis
WI Digestive System > WI 140 Diseases (General)
WW Ophthalmology > Manifestations of Disease. Poor Vision > WW 475 Eye manifestations of general disease
QX Parasitology > Helminths. Annelida > QX 243 Strongyloidea
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
QT Physiology > Human Physiology > QT 150 Hot climates
WC Communicable Diseases > Virus Diseases > Viral Hemorrhagic Fevers. Other Virus Diseases > WC 536 Human viral hepatitis
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
WZ History of Medicine. Medical Miscellany > History, By Period, Locality, etc. > WZ 80 History (Special groups)
WM Psychiatry > WM 140 Mental disorders (General)
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1093/qjmed/hcn137
Depositing User: Users 43 not found.
Date Deposited: 17 Mar 2010 17:40
Last Modified: 06 Feb 2018 12:59
URI: http://archive.lstmed.ac.uk/id/eprint/371

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