Trench fever is a nonfatal, acute disease first described in 1915 during World War I, when it afflicted at least 1 million soldiers on both sides of the conflict. Although initially known by several names, including Polish fever, Meuse fever, and Russian intermittent fever, the descriptive appellation trench fever given to the disease by the British armies in northern France has endured.

Clinical Manifestations

After an incubation period lasting between 14 and 30 days, trench fever elicits typical typhuslike symptoms: sudden onset, chills, headache, dizziness, and body aches and pains. Two of its descriptive names, shin fever and shank fever, recall its characteristic leg pains. Although also known as 5-day fever or quintan fever, the disease usually disables its victims for 5 or 6 weeks. About half of those afflicted suffer only one bout of fever, but the other half may have a number of relapses. Although trench fever is never fatal, it caused a greater loss of manpower during World War I than did any other malady except influenza.

History and Geography

Also known as Wolhynian fever and His-Werner disease, trench fever occurred in Russia, England, France, the Middle East, Italy, Germany, and Austria. It is carried by body lice; hence it follows the pattern of its more deadly relative, epidemic typhus fever, in plaguing armies where hygiene is substandard. The disease became quiescent after World War I ended, but it appeared again on the eastern European front during the second global conflict.