The First World War, which for Italy did not start until 24 May 1915, taxed the strength and health not only of soldiers but also of civilians. The war had severe consequences demographically and in terms of infectious diseases and their registration, apart from constituting a setback for the former medical and socio-medical strategies to maintain and improve public health. Malaria, tuberculosis and syphilis developed new dynamics due to socio-political factors like the mass-concentration of soldiers, transports, shortage of medical supplies and malnutrition. Morbidity and mortality due to the "Spanish Flu" were also extremely high in Italy. The army benefited from preferential treatment as far as food supplies were concerned, but served also as a multiplier for infectious diseases. Overall, the war exposed the deficiencies and underfunding within the Italian healthcare system.
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