their reported history of tobacco use (“ever smoked”) was a very striking 82 percent. This high rate is attributed to the distribution of free cigarettes to WW II soldiers.

In the paper by LeDuc et al., we learn of a “very interesting set of sera” collected by the Hemorrhagic Fever Commission, formed by the Army during the Korean conflict to deal with the “new” disease encountered by U.S. troops in Korea. In the subsequent decades, the cause of this new disease was identified and named (“hantaan virus,” after the Hantaan River in the endemic area of Korea), and a serologic test for the agent was developed. Thus did these sera become very interesting: it was now possible to test them with the new assays and determine whether the Korean conflict epidemic was actually due to the newly identified hantaan virus. LeDuc et al. report that it was--some 94 percent of the time the original clinical diagnoses were accurate. Having verified the clinical diagnosis, it is now possible to follow up the men who provided these sera and study the long-term sequelae of hantaan virus infection.

Moreover, not only is all of this fascinating from a medical point of view, but there are also potential public health ramifications. Specifically, studies of Korean patients residing in urban centers and diagnosed as having hemorrhagic fever with renal syndrome led to the identification of a new virus, now named the Seoul virus, related to but distinct from the hantaan virus. Of special interest was the fact that this new virus had been found in domestic rats rather than in its usual vector, the striped fieldmouse. Studies of the rat population in the inner city of Baltimore have shown that these Seoul-like viruses are also common there, and studies of inner-city Baltimore residents done at Johns Hopkins Hospital found that they had a five-fold higher prevalence rate of seropositivity for this virus; the most common diagnosis among seropositives in the group was hypertensive renal disease. If past hantaan viral infection is associated with subsequent development of chronic renal disease, as the evidence in this paper suggests, then such illnesses represent a multi-million-dollar public health problem.

The paper of Engdahl and Page reports data from one of the unique cohorts discussed earlier. Data are presented on depressive symptoms showing that former prisoners of war (POWs) still have notable psychiatric sequelae nearly forty years after their release from captivity, a three- to five-times-higher prevalence of depressive symptoms than expected. More important, this higher rate of depressive symptomatology is statistically linked with severity of treatment during captivity and with demographic factors such as years of education and age at capture. Such results not only have relevance to the current medical treatment of POWs but also



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement