Gulf War and Health Volume 5: Infectious Diseases (2007) / Chapter Skim
Currently Skimming:
4 Infectious Diseases Diagnosed in U.S. Troops Who Served in the Persian Gulf War, Operation Enduring Freedom, or Operation Iraqi Freedom
4 Infectious Diseases Diagnosed in U.S. Troops Who Served in the Persian Gulf War, Operation Enduring Freedom, or Operation Iraqi Freedom
Pages 61-100
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 61... ...
This chapter summarizes information about the infectious diseases and pathogens identified in US troops who served or are serving in ODSh, ODSt, OIF, or OEF. That information comes from several sources, including published scientific literature, medical surveillance monthly reports published by the Army Medical Surveillance Activity, the Centers for Disease Control and Prevention (CDC)
|
From page 62... ...
In addition, gastroenteritis with vomiting as a primary symptom occurred both sporadically and epidemically throughout the war. Ground Troops Laboratory Analysis Hyams and colleagues collected clinical and epidemiologic data from male US troops stationed in northeastern Saudi Arabia to determine the causes and prevalence of diarrheal disease among the troops, risk factors for diarrheal disease in the field, and the effectiveness of pharmacologic treatments (Hyams et al.
|
From page 63... ...
TABLE 4.2 Summary of Test Results for Viral Enteropathogens and Enterotoxins in Stool or Serum from Subsetsa of US Military Personnel with Gastroenteritis During Operation Desert Shield Identified Enteropathogen Yes (No. patients)
|
From page 64... ...
TABLE 4.3 Bacterial Enteropathogens Identified in Stool Specimens from 214a U.S. Military Personnel with Gastroenteritis Enteropathogen No.
|
From page 65... ...
. TABLE 4.4 Toxin distribution Among 132 ETEC Isolates from 124 US Troops with Gastroenteritis during Operation Desert Storm Toxin No.
|
From page 66... ...
Initially stationed in Saudi Arabia, and then relocated to Kuwait, the subjects lived in remote, rugged, desert camps. US military personnel prepared most of their food, which came from the United States except for local fresh produce.
|
From page 67... ...
. After the Gulf War, Hyams and colleagues demonstrated the incidence of NV infection among troops deployed to Saudi Arabia and Kuwait from late December 1990 through May 1991 (Hyams et al.
|
From page 68... ...
Shipboard Military Personnel About 46% of the 870 military personnel deployed to the Persian Gulf aboard the hospital ship USNS Mercy T-AH 19 had at least one episode of diarrhea in the period August 1990January 1991 (Paparello et al.
|
From page 69... ...
Gastroenteritis in Operation Enduring Freedom and Operation Iraqi Freedom Epidemiologic Investigations of Gastroenteritis An epidemiologic survey of 15,459 deployed troops conducted in January-March 2004 revealed that 74.5% of military personnel had experienced at least one episode of diarrhea while serving in OEF, OIF, or both (Sanders et al.
|
From page 70... ...
Table 4.8 contains additional salient data obtained through the survey about the occurrence of diarrheal illness among US forces during OEF and OIF. TABLE 4.8 Impact of Diarrhea Among US Military Personnel Deployed to Iraq and Afghanistan, 2003-2004 No.
|
From page 71... ...
TABLE 4.9 Demographics and Diarrheal Illness Characteristics of US Military Personnel Deployed to Iraq and Afghanistan Occurrence Among Troops Occurrence Among Troops Stationed in Iraq (N = 3915) Stationed in Afghanistan Characterizationa of Diarrhea [N (%)
|
From page 72... ...
. Located in a city about 175 km south of Baghdad, the laboratory collected and analyzed stool samples and other clinical specimens from 30 First Marine Expeditionary Force battalion aid stations and several other medical stations in the area.
|
From page 73... ...
TABLE 4.10 Major Findings from 129 Stool Specimens Obtained from Marines with Gastroenteritis During Operation Iraqi Freedom and Percentage of Bacterial Isolates Resistant to Antimicrobial Agents as Determined by Disk-Diffusion Assay No. Units No.
|
From page 74... ...
1995a. Ground Troops Richards and colleagues conducted epidemiologic, clinical, and environmental studies to determine the prevalence of risk factors for and severity of acute respiratory disease among US ground troops stationed in northeastern Saudi Arabia during ODSh (Richards et al.
|
From page 75... ...
Blood and oropharyngeal-swab specimens were obtained from 68 military personnel who presented with acute respiratory symptoms at any of five medical facilities from October 1990 to January 1991. Using immunofluorescence, latex agglutination, and standard culture techniques, investigators identified bacterial and viral pathogens in 10 of the patients' specimens (Table 4.11)
|
From page 76... ...
. Respiratory Disease in Operation Enduring Freedom and Operation Iraqi Freedom About 70% of military personnel deployed to Iraq and Afghanistan in 2003 and the first quarter of 2004 contracted a respiratory infection during their tour of duty, according to the
|
From page 77... ...
. TABLE 4.12 Impact of Respiratory Illness Among US Military Personnel Deployed to Iraq or Afghanistan, 2003-2004 95% Percentage Confidence of Troops Interval No.
|
From page 78... ...
pneumoniae Antigen detected in urine Suspect 3 Coxiella burnettii Serologic evidence Suspect 4 Acinetobacter baumanii Evidence in bronchoscopic culture Suspect SOURCE: CDC 2003a. INSECT-BORNE DISEASES Despite the endemicity of a number of insect-borne diseases in Saudi Arabia, Kuwait, and Iraq in 1990-1991, epidemiologic and laboratory surveillance for such diseases by military medical personnel identified very few cases among US troops who participated in the Gulf War (Richards et al.
|
From page 79... ...
. A cluster of these patients apparently became infected near the city of Dhahran along the Persian Gulf coast of Saudi Arabia about 200 miles south of the Saudi-Kuwaiti border (Magill et al.
|
From page 80... ...
Cutaneous Leishmaniasis in Operation Enduring Freedom and Operation Iraqi Freedom As of May 2005, military medical personnel had diagnosed and confirmed CL in more than 1,000 military personnel who served in OEF or OIF and were deployed to Afghanistan, Kuwait, or Iraq (Magill 2005; Willard et al. 2005; Zapor and Moran 2005)
|
From page 81... ...
Genus-specific PCR analysis of the bone-marrow specimen also was negative. Clinicians then evaluated patient A for noninfectious diseases and evidence of infection by other etiologic agents.
|
From page 82... ...
Malaria in Operation Enduring Freedom and Operation Iraqi Freedom As of May 2005, 52 cases of vivax malaria had been reported in US troops who served either exclusively in Afghanistan or in both Afghanistan and Iraq (Kilpatrick 2005)
|
From page 83... ...
Delayed presentation of vivax malaria is well described, primarily in people who fail to take primaquine as terminal prophylaxis after returning from malaria-endemic areas of the Middle East (Gasser et al.
|
From page 84... ...
West Nile Fever in Operation Enduring Freedom and Operation Iraqi Freedom As of December 2005, there were no reported cases of West Nile fever in military personnel deployed to OEF or OIF. BRUCELLOSIS Brucellosis is a serious zoonotic disease endemic in many parts of the world including southwest and south-central Asia (Mandell et al.
|
From page 85... ...
MENINGOCOCCAL DISEASE Infectious diseases reportedly caused only one death among US troops deployed to ODSh or ODSt: a fatal case of meningococcal meningitis (Hyams et al. 2001a; Writer et al.
|
From page 86... ...
Cases Walter Reed Army Medical Center 2 (2001-2002) 45 2,150 Landstuhl Regional Medical Center 1 (2000-2002)
|
From page 87... ...
baumannii bloodstream infections in 102 patients at five military hospitals where active-duty military personnel injured in OEF or OIF received treatment (CDC 2004c)
|
From page 88... ...
LRMC (N = 33) Imipenem 82 87 Amikacin 48 80 Ampicillin/sulbactam 35 8 Piperacillin/tazobactam 27 0 Cefepime 22 0 Ciprofloxacin 20 3 NOTE: WRAMC = Walter Reed Army Medical Center, LRMC = Landstuhl Regional Medical Center.
|
From page 89... ...
Q Fever Contracted During Operation Enduring Freedom and Operation Iraqi Freedom Ten cases of Q fever have been diagnosed in troops serving in OIF as of December 2005. All the patients became infected in northern Iraq (Kilpatrick 2005)
|
From page 90... ...
. Among military personnel deployed to OEF and OIF, approximately 2.5 percent of those given pre- and post-deployment TSTs converted from negative to positive (Kilpatrick 2005)
|
From page 91... ...
. The request included searching for infectious diseases diagnosed in military personnel deployed to the Gulf War, OIF, and OEF.
|
From page 92... ...
pneumonitis 1 052.7 Chickenpox with other specified complications 1 052.8 Chickenpox with unspecified complication 3 052.9 Varicella without mention of complication 64 053.8 Herpes zoster with unspecified complication 1 053.9 Herpes zoster without mention of complication 11 054.10 Genital herpes, unspecified 2 054.19 Other genital herpes 1 054.2 Herpetic gingivostomatitis 2 054.43 Herpes simplex disciform keratitis 3 054.79 Herpes simplex with other specified complications 1 054.9 Herpes simplex without mention of complication 1 055.9 Measles without mention of complication 1 057.8 Other specified viral exanthemata 1 057.9 Viral exanthem, unspecified 1 066.0 Phlebotomus fever 5 070.10 Viral hepatitis A without mention of a hepatic coma, lab test confirmed 4 Viral hepatitis B without coma, acute/ unspecified without hepatic delta, 070.30 lab test confirmed 6 070.9 Unspecified viral hepatitis without hepatic coma 3 072.9 Mumps without mention of complication 1 074.1 Epidemic pleurodynia 1 075 Infectious mononucleosis 27 077.8 Other viral conjunctivitis 3 078.10 Other diseases due to viruses and chlamydiae, viral warts, unspecified 29 078.11 Other diseases due to viruses and chlamydiae, condyloma acuminatum 9 078.19 Other diseases due to viruses and chlamydiae, other specified viral warts 6 079.89 Other specified viral infections 5 079.98 Unspecified chlamydial 1 079.99 Unspecified viral infections 299 084.1 Vivax malaria (benign tertian) 7 084.6 Malaria, unspecified 4 085.0 Leishmaniasis visceral (kala-azar)
|
From page 93... ...
. Predeployment and postdeployment serum samples are required for all deployments outside the continental United States that are longer than 30 days and to areas without fixed US medical treatment facilities (Kilpatrick 2006)
|
From page 94... ...
Emerging Infectious Diseases 11(8)
|
From page 95... ...
Clinical Infectious Diseases 16(4)
|
From page 96... ...
1995a. The impact of infectious diseases on the health of US troops deployed to the Persian Gulf during operations Desert Shield and Desert Storm.
|
From page 97... ...
1994. Visceral infection due to Leishmania tropica in a veteran of Operation Desert Storm who presented 2 years after leaving Saudi Arabia.
|
From page 98... ...
1993a. Respiratory disease among military personnel in Saudi Arabia during Operation Desert Shield.
|
From page 99... ...
1996. Comparative mortality among US military personnel in the Persian Gulf region and worldwide during Operations Desert Shield and Desert Storm.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.