Before World War II, soldiers died more often of disease than of battle injuries. The ratio of disease-to-battle casualties was approximately 5-to-1 in the
Spanish-American War and 2-to-1 in the
Civil War. Improved sanitation reduced disease casualties in World War I, but it could not protect troops from the 1918 influenza pandemic. During the outbreak, flu accounted for
roughly half of US military casualties in Europe.
As the Second World War raged in Europe, the US military recognized that infectious disease was as formidable an enemy as any other they would meet on the battlefield. So they forged a new partnership with industry and academia to develop vaccines for the troops. Vaccines were attractive to the military for the simple reason that they reduced the overall number of sick days for troops more effectively than most therapeutic measures.
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