5-2. Disease Incidence Following the Use of Nuclear, Biological, and Chemical Weapons
_a._ _Determining Factors._ Factors of prime importance in determining the nature and severity of the disease effects are--
· Degree of industrialization in the operational area.
Finally, the manner and situation in which nuclear weapons are used are of importance. A single weapon detonated in a socially stable area will have far less serious effects than a detonation in an area where combat has already disrupted the social stability. At Hiroshima and Nagasaki, Japan (excellent examples of the first type of situation), the survivors who could get away were able to obtain food, shelter, and care from surrounding intact areas. With prolonged combat operations, such intact areas would not be available, resulting in no food, shelter, or care for survivors. There will be a breakdown in social order and there will be a lack of effective medical support; including PVNTMED functions and facilities.
_b._ _Disease Incidence._ Without PVNTMED capabilities, increased incidence and morbidity from diseases will follow. Some diseases will predominate in incidence, depending upon the geographical areas involved and the endemic diseases present.
(1) In urban areas in temperate climates, several diseases are epidemic threats. These epidemic threats may include--
· Dysentery (due to a variety of pathogens).
· Rickettsial diseases, particularly typhus and scrub typhus.
· Malaria and cholera (in many parts of the world).
(2) There are several reasons for the increased risk of disease including, but not limited to--
· Crowding of surviving populations with limited sanitary facilities, such as was seen in Europe at the end of World War II.
· A lack of prophylaxis and immunizations with resultant increases in the susceptible faction of a given population.
· The effect of irradiation on susceptibility to infection. With the high levels of fallout covering wide areas, a large number of people will sustain sublethal whole-body doses of irradiation. The interaction of irradiation with infections is not clear; but it may be the result of latent infections manifesting and decreased resistance to infection. The result is an increased incidence of disease.