Communicable diseases, particularly gastrointestinal ailments, took an enormous toll on Australian and New Zealand troops at Gallipoli in 1915, according to an article published in the Anzac Day issue of the Medical Journal of Australia.
Dr Milton Lewis, Honorary Senior Research Fellow at the University of Sydney, and Professor Stephen Leeder, Editor-in-Chief of the MJA, wrote that a review of accounts of the summer of 1915 revealed that a fly-borne epidemic of intestinal infection ravaged the troops.
The spread of the illness was attributed to failed public health measures.
"Regimental and divisional staffs and general headquarters were slow to appreciate the causes of the epidemic: seriously inadequate handling of rubbish disposal; the Army Medical Service's excessive focus on water purity as a safeguard against such infections; and the military commanders' concern to retain troops with less serious cases of the infection on the front", they wrote.
Diagnostic dilemmas, limited antimicrobials and insufficient beds in hospital facilities plagued the medical management and control of these communicable diseases.
At its most virulent, diarrhoeal disease claimed as many men through sickness each fortnight "as would be placed out of action in a general assault".
"Flies swarmed from May until October. Latrines were built, rubbish burned and bodies buried, but incompletely so and disease continued to spread, especially as the troops' nutritional status began to wane", Lewis and Leeder wrote.
Dental problems, lice infestations and a limited diet added to the challenges of the Anzac fighting men. "Battle fatigue, illness and the risk of death - these were the realities daily confronting the Anzacs", Lewis and Leeder concluded.
"We need to be clear in our understanding of the variety and depth of challenges faced by those troops 100 years ago."