The unseen casualties of the First World War: insights from a randomly selected military sample.

AIMS: Studies of the morbidity burden of military personnel participating in the First World War (WWI) have tended to focus on specific outcomes (e.g., injuries). Therefore, we aimed for a more complete assessment. METHODS: From a random sample of active war service-exposed New Zealand WWI veterans used in previously published work, we examined a random subsample of 200 personnel. Data on diagnoses, hospitalisations and outcomes were extracted from the online archival military files. RESULTS: These personnel experienced a very high morbidity burden with 94% having at least one new condition diagnosed during their military service (mean: 2.4 per individual; range: 0 to 8). The relative severity of these conditions was reflected by the high level of hospitalisation (89% at least once; mean: 1.8 hospitalisations for new conditions per individual) and 59% of personnel being deemed no longer fit for military service at some stage. More of the new diagnoses were for infectious diseases than for conflict-related injuries (117 vs 50 cases per 100 personnel). Respiratory conditions such as influenza, pneumonia and tuberculosis affected 33% of personnel, and 14% were diagnosed with sexually transmitted infections. Diseases reflecting hazardous environmental conditions were relatively common e.g., for dysentery/gastroenteritis in 12% and scabies in 5% of personnel. Diagnoses suggestive of post-traumatic stress disorder (PTSD) were present in 10% and chemical warfare injuries in 6%. CONCLUSIONS: The overall morbidity burden of this military force in WWI was very high, and much higher than the previous official estimates.

Health impacts for New Zealand military personnel from the South African War of 1899-1902.

AIM: We aimed to update and provide more complete epidemiological information on the health impacts of the South African War on New Zealand military personnel. METHODS: Mortality datasets were identified and analysed. Systematic searches were conducted to identify additional war-attributable deaths in the post-war period. To estimate the morbidity burden, we analysed a random sample of archival military files of 100 military personnel. Lifespan analyses of veterans included those by level of combat exposure (eg, a non-combat sample came from a troopship that arrived at the time the war ended). RESULTS: We identified 10 additional war-attributable deaths (and removed three non-attributable deaths) to give a new New Zealand total of 239 war-attributable deaths. Given the average age of death of 26 years, this equates to the loss of 10,300 years of life. Most deaths (59%) were from disease rather than directly from the conflict (30%). Over a third (39%; 95%CI: 30%-49%) of personnel were estimated to have had some form of reported illness (26%) or injury (14%). The lifespan analysis of veterans suggested no substantive differences by exposure to combat (68.5 [combat] vs 69.1 years [non-combat]) and similarly when compared to a matched New Zealand male population. CONCLUSIONS: The mortality burden was larger and the morbidity impacts on the New Zealand military personnel in this war were much more substantive than revealed in the prior historical literature. There is a need to more fully describe historical conflicts so that their adverse health impacts are properly understood.

New Zealand's peak year for wartime mortality burden: the important role of the Battles of Messines and Third Ypres (Passchendaele) in 1917.

At a total of 5,547 deaths among New Zealand's military personnel, the year 1917 was the worst year from a mortality perspective in the country's military history. This year had a third of the deaths in the whole of the First World War for this military population. Major drivers of this mortality burden were the Battles of Messines and Third Ypres (Passchendaele) in June and October 1917 respectively. The contribution of disease deaths to the mortality burden was relatively small at 4.5%. Disease deaths were significantly more common in the Northern Hemisphere's winter months (p=0.007), and some may have been related to crowding.

Genetic variants of Banana streak virus in Mauritius.

Genetic variations among isolates of Banana streak virus (BSV) were assessed using two sets of primers. The virus, found in banana accessions in Mauritius, was compared to a Nigerian isolate from cultivar Obino l'Ewai (BSOEV). On the basis of the observed size of amplicons, some Mauritius strains were different from l'Ewai BSOEV. Both Southern blot hybridization and the nucleotide sequences of the PCR products confirmed that they were of episomal BSV origin. An isolate of sugarcane bacilliform virus (SCBV) was found to be also very similar to the BSV isolated from banana samples. Nucleotide sequence analysis showed that even the same size PCR products had differing sequences. The dendrogram placed the isolates from Mauritius in a cluster separate from BSV and SCBV from other geographical locations.

Viral sequences integrated into plant genomes.

Sequences of various DNA plant viruses have been found integrated into the host genome. There are two forms of integrant, those that can form episomal viral infections and those that cannot. Integrants of three pararetroviruses, Banana streak virus (BSV), Tobacco vein clearing virus (TVCV), and Petunia vein clearing virus (PVCV), can generate episomal infections in certain hybrid plant hosts in response to stress. In the case of BSV and TVCV, one of the parents contains the integrant but is has not been seen to be activated in that parent; the other parent does not contain the integrant. The number of integrant loci is low for BSV and PVCV and high in TVCV. The structure of the integrants is complex, and it is thought that episomal virus is released by recombination and/or reverse transcription. Geminiviral and pararetroviral sequences are found in plant genomes although not so far associated with a virus disease. It appears that integration of viral sequences is widespread in the plant kingdom and has been occurring for a long period of time.

Banana streak virus is very diverse in Uganda.

Banana streak virus (BSV) is a badnavirus that causes a viral leaf streak disease of banana and plantain (Musa spp.). Identified in essentially all Musa growing areas of the world, it has a deleterious effect on the productivity of infected plants as well as being a major constraint to Musa breeding programmes and germplasm dissemination. Banana is a staple food in Uganda which is, per capita, one of the worlds largest banana producers and consumers. BSV was isolated from infected plants sampled across the Ugandan Musa growing area and the isolates were analysed using molecular and serological techniques. These analyses showed that BSV is very highly variable in Uganda. They suggest that the variability is, in part, due to a series of introductions of banana into Uganda, each with a different complement of infecting viruses.

Detection of petunia vein-clearing virus: model for the detection of DNA viruses in plants with homologous endogenous pararetrovirus sequences.

A number of cases of plant virus sequence integration into host plant genome have been reported. In at least two cases, endogenous pararetrovirus sequences are correlated strongly with subsequent episomal virus infection and there is circumstantial evidence that this also occurs for Petunia vein-clearing virus (PVCV). The detection of viruses is a critical component of plant health and therefore, it is important to have diagnostic procedures that differentiate between the detection of encapsidated viral DNA and homologous sequences in the host genome. PCR-based detection methods targeted at PVCV DNA have been tested and particular attention was paid to design controls that would indicate the existence of host DNA in the reaction. The use of ion-exchange chromatography for the partial purification of plant viruses from other cellular components, including chromosomal DNA, is described. The methods tested for PVCV detection are used to illustrate general principles for the specific detection of virus infections in host plants that carry homologous virus sequences in their genomes.

Mortality of first world war military personnel: comparison of two military cohorts.

OBJECTIVE: To identify the impact of the first world war on the lifespan of participating military personnel (including in veterans who survived the war). DESIGN: Comparison of two cohorts of military personnel, followed to death. SETTING: Military personnel leaving New Zealand to participate in the first world war. PARTICIPANTS: From a dataset of the New Zealand Expeditionary Forces, we randomly selected participants who embarked on troopships in 1914 and a comparison non-combat cohort who departed on troopships in late 1918 (350 in each group). MAIN OUTCOME MEASURES: Lifespan based on dates of birth and death from a range of sources (such as individual military files and an official database of birth and death records). RESULTS: A quarter of the 1914 cohort died during the war, with deaths from injury predominating (94%) over deaths from disease (6%). This cohort had a significantly shorter lifespan than the late 1918 "non-combat" cohort, with median ages of death being 65.9 versus 74.2, respectively (a difference of 8.3 years shown also in Kaplan-Meier survival curves, log rank P<0.001). The difference for the lifespan of veterans in the postwar period was more modest, with median ages of death being 72.6 versus 74.3, respectively (a difference of 1.7 years, log rank P=0.043). There was no evidence for differences between the cohorts in terms of occupational class, based on occupation at enlistment. CONCLUSIONS: Military personnel going to the first world war in 1914 from New Zealand lost around eight years of life (relative to a comparable military cohort). In the postwar period they continued to have an increased risk of premature death.

A nutritional analysis of New Zealand military food rations at Gallipoli in 1915: likely contribution to scurvy and other nutrient deficiency disorders.

BACKGROUND: Amongst New Zealand soldiers in Gallipoli in 1915 there were reports of poor food quality and cases of scurvy. But no modern analysis of the military food rations has ever been conducted to better understand potential nutritional problems in this group. METHODS: We analysed the foods in the military rations for 1915 using food composition data on the closest equivalents for modern foods. We compared these results with other plausible diets and various optimised ones using linear programming. RESULTS: Historical accounts provide evidence for poor food quality supplied to these soldiers. The nutrient analysis suggested that the military rations were below modern requirements for vitamins A, C and E; potassium; selenium; and dietary fibre. If military planners had used modest amounts of the canned vegetables and fruit available in 1915, this would probably have eliminated four of these six deficits. The results from the uncertainty analyses for vitamin C (e.g., 95% uncertainty interval [UI]: 5.5 to 6.7 mg per day), was compatible with the range known to cause scurvy, but the UI for vitamin A intake was only partly in the range for causing night blindness. To indicate the gap with the ideal, an optimised diet (using foods available in 1915), could have achieved all nutrient requirements for under half the estimated purchase cost of the 1915 military rations. CONCLUSIONS: There is now both historical and analytic evidence that the military rations provided to these soldiers were nutritionally inadequate in vitamin C, and probably other nutrients such as vitamin A. These deficits are likely to have caused cases of scurvy and may have contributed to the high rates of other illnesses experienced at Gallipoli. Such problems could have been readily prevented by providing rations that included some canned fruit or vegetables (e.g., as manufactured by New Zealand at the time).

Fatal injury epidemiology among the New Zealand military forces in the First World War.

BACKGROUND: Despite the large mortality burden of First World War (WW1) on New Zealand (NZ) military forces, no analysis using modern epidemiological methods has ever been conducted. We therefore aimed to study injury-related mortality amongst NZ military forces in WW1. METHODS: An electronic version of the Roll-of-Honour for NZ Expeditionary Force (NZEF) personnel was supplemented with further coding and analysed statistically. We also performed literature searches to provide context. RESULTS: Out of a total of 16,703 deaths occurring during the war (28 July 1914 to 11 November 1918), injury deaths predominated: 65.1% were "killed in action" (KIA), 23.4% "died of wounds" (DOW), 1.0% were other injuries (e.g. "accidents", drownings, suicides and executions), and 10.5% were other causes (mainly disease). During the course of the war, the annual mortality rate from injury (for KIA + DOW) per 10,000 NZEF personnel in the North Hemisphere peaked at 1335 in 1915 (Gallipoli campaign) and then peaked again in 1917 at 937 (largely the Battle of Passchendaele). Some of the offensive campaigns involved very high mortality peaks (e.g. 2 days with over 450 deaths per day in October 1917). CONCLUSIONS: Participation in First World War was by far the worst fatal injury event in New Zealand's history. Many of these injury deaths could be considered to have been preventable through: better diplomacy (to prevent the war), improved military planning to reduce failed campaigns (e.g. Gallipoli, Passchendaele), earlier use of protective equipment such as helmets, and improved healthcare services.

Banana contains a diverse array of endogenous badnaviruses.

Banana streak disease is caused by several distinct badnavirus species, one of which is Banana streak Obino l'Ewai virus. Banana streak Obino l'Ewai virus has severely hindered international banana (Musa spp.) breeding programmes, as new hybrids are frequently infected with this virus, curtailing any further exploitation. This infection is thought to arise from viral DNA integrated in the nuclear genome of Musa balbisiana (B genome), one of the wild species contributing to many of the banana cultivars currently grown. In order to determine whether the DNA of other badnavirus species is integrated in the Musa genome, PCR-amplified DNA fragments from Musa acuminata, M. balbisiana and Musa schizocarpa, as well as cultivars 'Obino l'Ewai' and 'Klue Tiparot', were cloned. In total, 103 clones were sequenced and all had similarity to open reading frame III in the badnavirus genome, although there was remarkable variation, with 36 distinct sequences being recognized with less than 85 % nucleotide identity to each other. There was no commonality in the sequences amplified from M. acuminata and M. balbisiana, suggesting that integration occurred following the separation of these species. Analysis of rates of non-synonymous and synonymous substitution suggested that the integrated sequences evolved under a high degree of selective constraint as might be expected for a living badnavirus, and that each distinct sequence resulted from an independent integration event.

Induction of infectious petunia vein clearing (pararetro) virus from endogenous provirus in petunia.

Infection by an endogenous pararetrovirus using forms of both episomal and chromosomal origin has been demonstrated and characterized, together with evidence that petunia vein clearing virus (PVCV) is a constituent of the Petunia hybrida genome. Our findings allow comparative and direct analysis of horizontally and vertically transmitted virus forms and demonstrate their infectivity using biolistic transformation of a provirus-free petunia species. Some integrants within the genome of P.hybrida are arranged in tandem, allowing direct release of virus by transcription. In addition to known inducers of endogenous pararetroviruses, such as genome hybridization, tissue culture and abiotic stresses, we observed activation of PVCV after wounding. Our data also support the hypothesis that the host plant uses DNA methylation to control the endogenous pararetrovirus.