Throughout most of history, military forces during times of war have traditionally lost more men to sickness, disease, and infection than to battlefield action. So during World War II, the treatment of wounds and the containment of disease were top priorities of the US Army and Navy. Even though penicillin had been developed by this time, the miracle drug had not gone into widespread production. Instead, physicians relied on the only antibiotics available: the recently discovered sulfa drugs.

When the United State entered the war in 1941, sulfanilamide was the drug of choice for meningitis within the US Army. Sulfa drugs were also used to treat diarrhea and dysentery; fever; and wounds, burns, and related infections.

By 1943, however, the US Navy was fighting a losing battle against crowding, poor living conditions, and a rapid spread of Streptococcus bacteria that caused scarlet fever and strep throat. The navy cleaned and disinfected barracks, isolated people who were thought to be carriers, and moved training camps away from areas of high incidence.

When these methods failed to reduce the virus’s spread, the navy decided on a mass chemoprophylaxis (the act of administering medication in hopes of preventing disease spread) with sulfa drugs. Recruits at five naval training centers received small daily doses of sulfadiazine, while others at the same centers were observed as control subjects. In as little as 1 week, the illness rate in the medicated groups had dropped dramatically—to just 15 percent of the control group’s rate at one center. Within 3 months, the navy opened up the treatment to all recruits at the test centers and expanded the program to three additional facilities.

The program was a striking success, saving the navy an estimated 1 million man days and between $50 million and $100 million in 1944 dollars. In less than a year, however, bacteria had become resistant to the drugs, and in the last months of the war, the navy abandoned its daily medication program. Safer antibiotics, including penicillin, became available soon after, and the use of sulfa drugs declined after the war.

ADDITIONAL FACTS

  1. On December 5, 1941, the New York City surgeon John Moorhead gave a lecture in Honolulu advising the treatment of wartime wounds with sulfa drugs. Two days later, Pearl Harbor was attacked, and Moorhead and members of his audience put these guidelines into practice caring for the injured.
  2. Sulfa drugs helped bring the US military death rate from meningitis down to a mere 4 percent in World War II, compared with 31 percent in World War I.
  3. Between December 1943 and June 1944, about 1 million men participated in the sulfa drug chemoprophylaxis program, 600,000 as recipients and 400,000 as controls.