El Alamein: the battle in the battle. How infectious disease management changed the fate of one of the most important battle of the World War II.

El Alamein, on Egypt's Mediterranean coast, was the theater of war for one of the most important and decisive battles of the Second World War. The Allied victory in November 1942 opened the end of the Western Desert Campaign. The battle revived the morale of the Allies, being the first big success against the Axis since Operation Crusader in late 1941. The German threat to Egypt, the Suez Canal and the Middle Eastern and Persian oil fields was eliminated and the doors for Mediterranean advance were opened. Fighting in the desert under extreme human conditions exposed all the involved armies to health hazards going beyond those arising from common battle injuries. The outcome of the battle was influenced by a gap in morbidity and mortality derived from different approaches in infectious disease management between armies. The attention of the British for medical research, pharmacological experimentation, hygiene strategies and prevention may have been as important as warfare strategies in deciding the fate of the battle. Examples of some of these advances include wound nursing, control of endemic diseases, surveillance of difficult hygienic conditions, prevention of faecal-oral transmission diseases. During El Alamein Battle soldiers on both fronts where engaged in two wars: the first one, vertical, was against the enemy uniform; the second one, horizontal, was against invisible enemies called pathogens. Only surviving the horizontal war meant preserve enough units and morale in order to win El Alaman Battle.