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Both in Iraq and in Afghanistan, a relatively high incidence rare diseases has occurred in our troops. It reminds me of H. G. Wells' "War of the Worlds" where the invading martians are superior militarily, but succumb to disease.

When is enough enough?

More below, quoted from reuters, via PROMED.

PNEUMONIA, EOSINOPHILIC - USA MILITARY
**************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Tue, 21 Dec 2004
From: George Robertson <robertson@pda.org>
Source: Reuters UK
<http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=7153331>

Rare pneumonia found among USA soldiers in Iraq
-----------------------------------------------
A rare and sometimes deadly pneumonia has hit 18 USA soldiers deployed
in
Iraq, and Army medical investigators are at a loss to explain the
cause,
according to a study published on Tue, 21 Dec 2004.

In a report appearing in the Journal of the American Medical
Association,
researchers from the Walter Reed Army Medical Center said 2 of the
soldiers
had died from the rare illness, called acute eosinophilic pneumonia, or
AEP.

No common source was found for the outbreak that occurred between Mar
2003
and Mar 2004 among the soldiers in Iraq. The study covered only that
time
period and there was no indication whether cases have continued to show
up
since then.

The 18 victims studied ranged in age from 19 to 47 and all used
tobacco,
with 75 percent recently taking up the habit. All but one reported
"significant exposure to fine airborne sand or dust" while in Iraq.

While only 18 cases have been reported among 183 000 troops deployed in
Iraq during the time period involved, the authors said the cases are
still
significant because the disease is very rare in the general population.

The illness was not immediately diagnosed in several victims, who
suffered
fever and respiratory failure. Several had to be put on mechanical
ventilators to help them breathe and were administered corticosteroids.
Months later, a few reported continued breathing problems or wheezing.

"Inquiries to the Iraqi health officials did not suggest that AEP was
occurring in the local population or that there has been an unusual
increase in the incidence of pneumonia of any kind during the study
period," the report said.

The report's author, Dr. Andrew Shorr, warned the illness can strike
suddenly and mimic more common ailments such as acute respiratory
distress
syndrome or community pneumonia.

The report follows another battle zone study in November 2004 that
found an
unexpectedly high number of USA soldiers injured in the Middle East and
Afghanistan had tested positive for a rare, hard-to-treat blood
infection.

Army doctors at that time said 102 soldiers were found to be infected
with
the bacteria Acinetobacter baumannii. The infections occurred among
soldiers at Walter Reed Army Medical Center in Washington, Landstuhl
Regional Medical Center in Germany and 3 other sites between Jan 2002
and
Aug 2004.

85 of the bloodstream infections occurred among soldiers serving in the
Middle East and Afghanistan, the report said. Normally military
hospitals
see only one such case every year, it added.
  --
George A. Robertson, PhD
Vice President Science & Technology
PDA
Bethesda, MD, USA
<robertson@pda.org>

Originally posted to dnamj on Tue Dec 21, 2004 at 05:52 PM PST.

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Comment Preferences

  •  Keep your head down, Al (none)
    we need you on Air America
  •  More here (none)
    Here's a basic rundown of eosinophilic pneumonia.

    Note in particular that in it's acute primary form it's both idiopathic (no known/obvious cause) and rare. It's not an infectious pneumonia.

    Also as noted, "The term eosinophilic pneumonia (EP) refers to a heterogenous group of lung diseases characterized by pulmonary eosinophilia and infiltrates, with or without increased peripheral eosinophils in the blood. Primary, or idiopathic, EP includes acute eosinophilic pneumonia (AEP) and chronic eosinophilic pneumonia (CEP). EP can lead to irreversible damage to the lungs."

    The 18 cases in 183,000 soldiers (1 per 10,000) significantly exceeds the documented frequency of "probably less then 0.1 case per 100,000 (1 per 1,000,000) population per year"

    The email implicates environmental exposure (fine sand/dust), and mentions cigarette smoking. The linked article notes "Cigarette smoking has been reported to trigger AEP with respiratory failure."

    You can also read more about acinetobacter. It's an infectious organism most frequently found in hospitalized patients who have multiple portals of entry (endotracheal tubes, central venous and/or urinary catheters).

    Another reason to stay away from hospitals (that's where the germs are), but that's not often a choice available to those who've been wounded.

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