Preserving Our Past, Capitalizing on the Present, Embracing the Future

Army Nursing Caring for Hemorrhagic Fever Patients
during the Korean War

© Constance J. Moore
Colonel, ANC (Retired), ANCA Historian

In the fall of 1951, along the 38th parallel in Korea there was an outbreak of an unknown febrile disease that caused illness-ravaged soldiers to be taken to aid stations and hospitals. The acute, self-limited infectious disease, called hemorrhagic fever, was characterized by a tortuous multitude of acute symptoms, including headache, nausea, blood seepage from weakened vascular walls, delirium, and kidney failure.1 Army nurses were challenged to learn quickly how to care for these violently ill patients in order to help save their lives.

24-Hour Urine CollectionHemorrhagic Fever Centers were set up at hospitals such as the 45th Evacuation Hospital2 in Seoul or 48th Mobile Army Surgical Hospital (MASH)3 just northwest of Seoul. To monitor patients carefully, units were staffed to give one-to-one nursing care. Nurses ensured that patients maintained bed rest, since it slowed the nausea and pain. They discovered the keystone of the therapy was fluid management (hydration and electrolyte levels), and vital sign levels. Weights, intakes and outputs were scrupulously monitored throughout the course of the illness. To regulate body temperatures, patients were sponged and given antipyretics. Trendelenberg bed positioning was used to decrease the blood flow to the extremities.4

Since every patient developed some degree of kidney failure, fluid restriction was required. Cases became critical when patients went into kidney failure from septic shock. Patients deemed good candidates for dialysis were quickly transferred to the 11th Evacuation Hospital’s Renal Insufficiency Center where dialysis was used to hopefully correct severe fluid overload, minimize the effects of shock, and reverse the kidney failure. There were two nurses assigned to the dialysis unit, monitoring three 8-hour dialysis procedures round the clock.5 They also sterilized equipment and tubing, and trained newly assigned corpsmen who were served with them. The dramatic changes in the conditions of these patients was chronicled by Lieutenant Mary T. Burley: "The first patient I saw who went on the artificial kidney was near death. The next morning he sat up in bed and read a magazine!"6

Once patients began to recover, Army nurses carefully managed the 8- to 12-week process. Usually patients had lost 30-50 pounds so they were given 5-7 meals each day as well as nutritional supplements and progressive exercises to regain their weight and strength. During this critical period, Nurses did their best to maintain patients’ morale and keep them occupied with entertainment, games and other activities.

Army nurses took the initiative, making quick decisions, and adopting innovative solutions to a broad range of medical-related problems associated with the disease. Because of the care they provided, many soldiers returning home with no ill effects of the disease.

  1. George Hoffman, “The Korean War’s Silent Killer Strikes Again,” USA Today (Society for the Advancement of Education): 56.
  2. Robert Markelz, “Hemorrhagic Fever 1. Medical Care,” American Journal of Nursing, 56(1): 39.
  3. ______, “48th Portable Surgical Hospital,” CBI Order of Battle Lineage and History,, (accessed April 29, 2011).
  4. Katrina Johnson, Hemorrhagic Fever 2. Nursing Care, American Journal of Nursing, 56(1): 41.
  5. Duggan Maddux, “Dr. Paul Maddux,” Nephrology Oral History Project, (2007): 5,
  6. ______, “48th Portable Surgical Hospital,” CBI Order of Battle Lineage and History,, (accessed April 29, 2011).
  7. Katrina Johnson, Hemorrhagic Fever 2. Nursing Care, American Journal of Nursing, 56(1): 41.