Operation United Assistance: Infectious Disease Threats to Deployed Military Personnel

Murray, Clinton K.; Yun, Heather C.; Markelz, Ana E; Okulicz, Jason F.; Vento, Todd J.; Burgess, Timothy; Cardile, Anthony P.; Miller, Ryan S.

doi:10.7205/milmed-d-14-00691

Cited by 59 publications

(14 citation statements)

References 198 publications

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“…Despite reconnaissance, the scarcity of available epidemiological data meant that a comprehensive causality estimate was not conducted prior to the mission. The health threats to travelers is well described in previous assessments [ 1 – 4 ], including some tailored for military audiences [ 5 ]. Tropical infectious diseases predominate, a finding reinforced in case reports of outbreaks, medical repatriations, and illnesses in returning travelers.…”

Section: Introductionmentioning

confidence: 99%

Infectious diseases during the European Union training mission Mali (EUTM MLI) – a four-year experience

et al. 2018

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BackgroundThe European Union Training Mission Mali (EUTM MLI) is a multinational military training deployment to the Western African tropical nation of Mali. Based on routinely collected disease and non-battle injury surveillance data, this study quantifies the true impact of infectious diseases for this tropical mission and potential seasonal variations in infectious disease threats.MethodsCategorized health events during the EUTM MLI mission and associated lost working days were reported using the EpiNATO-2 report. Infection-related health events were descriptively analyzed for a 4-year period from the 12th week in 2013 to the 13th week in 2017. Aggregated EpiNATO-2 data collected from all missions other than EUTM MLI were used as a comparator.ResultsAmong the infectious diseases reported by EUTM MLI, non-severe upper respiratory infections and gastrointestinal diseases dominated quantitatively, accounting for 1.65 and 1.42 consultations per 100 person-weeks, respectively. The number of recorded infectious disease-associated lost working days during the whole study interval was 723. Seasonal changes in disease frequency were detectable. More gastrointestinal infections were seen in the rainy season, and more respiratory infections occurred in the dry season; these were associated with peaks of more than 2.5 consultations per 100 person-weeks for both categories.ConclusionsDespite initial concerns focused on tropical infectious diseases during this mission in tropical Mali, upper respiratory tract and gastrointestinal infections predominate. The relatively low number of reported lost working days may indicate that these infections are at the milder end of the spectrum of infectious diseases despite a likely reporting bias.Electronic supplementary materialThe online version of this article (10.1186/s40779-018-0166-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Infectious diseases during the European Union training mission Mali (EUTM MLI) – a four-year experience

et al. 2018

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“…The DoD responded with providing military members to build Ebola treatment units, provide logistics support, and diagnostics teams and assays in-country under Operation United Assistance. 6 Multiple different investigational countermeasures were employed during the outbreak and NIAID led a multi-center group to prioritize the potential countermeasures and develop a randomized controlled trial to study the most promising options. IDCRP investigators participated in the prioritization effort and the IDCRP's team at the Walter Reed National Military Medical Center served as the only DoD site participating in the protocol: a randomized controlled trial of the monoclonal antibody ZMapp for treatment of Ebola virus disease.…”

Section: Viral Hemorrhagic Feversmentioning

confidence: 99%

Emerging Infectious Diseases and Antimicrobial Resistance (EIDAR)

2019

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Introduction The Infectious Disease Clinical Research Program’s (IDCRP) Emerging Infectious Diseases and Antimicrobial Resistance (EIDAR) Research Area is a Department of Defense (DoD) clinical research capability that is responsive and adaptive to emerging infectious disease (EID) threats to US military readiness. Among active-duty and other Military Health System (MHS) beneficiaries, EIDAR research is largely focused on evaluating the incidence, risk factors, and acute- and long-term health effects of military-relevant EIDs, especially those caused by high-consequence pathogens or are responsible for outbreaks among US military populations. The EIDAR efforts also address Force Health Protection concerns associated with antimicrobial resistance and antimicrobial stewardship practices within the MHS. Methods The EIDAR studies utilize the approach of: (1) Preparing for emergent conditions to systematically collect clinical specimens and data and conduct clinical trials to assist the military with a scientifically appropriate response; and (2) Evaluating burden of emergent military-relevant infectious diseases and assessing risks for exposure and development of post-infectious complications and overall impact on military readiness. Results In response to the Ebola virus epidemic in West Africa, the IDCRP partnered with the National Institutes of Health in developing a multicenter, randomized safety and efficacy study of investigational therapeutics in Ebola patients. Subsequently, the EIDAR team developed a protocol to serve as a contingency plan (EpICC-EID) to allow clinical research activities to occur during future outbreaks of viral hemorrhagic fever and severe acute respiratory infections among MHS patients. The EIDAR portfolio recently expanded to include studies to understand exposure risks and impact on military readiness for a diversity of EIDs, such as seroincidence of non-Lyme disease borreliosis and Coccidioides fungal infections among high-risk military populations. The team also launched a new prospective study in response to the recent Zika epidemic to conduct surveillance for Zika and other related viruses among MHS beneficiaries in Puerto Rico. Another new study will prospectively follow U.S. Marines via an online health assessment survey to assess long-term health effects following the largest DoD Shiga Toxin-Producing Escherichia coli outbreak at the U.S. Marine Corps Recruit Depot-San Diego. In cooperation with the Trauma-Related Infections Research Area, the EIDAR Research Area is also involved with the Multidrug-Resistant and Virulent Organisms Trauma Infections Initiative, which is a collaborative effort across DoD laboratories to characterize bacterial and fungal isolates infecting combat-related extremity wounds and link lab findings to clinical outcomes. Furthermore, the EIDAR team has developed an Antimicrobial Resistance and Stewardship Collaborative Clinical Research Consortium, comprised of Infectious Disease and Pharmacy specialists. Conclusions The EIDAR Research Area is responsive to military-relevant infectious disease threats that are also frequently global public health concerns. Several new EIDAR efforts are underway that will provide Combatant Command Surgeons, Infectious Diseases Service Chiefs, and other Force Health Protection stakeholders with epidemiological information to mitigate the impact of EIDs and antimicrobial resistance on the health of U.S. military service members and their dependents.

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“…and 2.7% converting after their deployment to Afghanistan. This implies that it may be possible for these personnel to carry the disease to the United Kingdom [30].…”

Section: Tick Bornementioning

confidence: 99%

“…CCHF has been shown to be present in Afghanistan, where military operations, led by the North Atlantic Treaty Organization (NATO), have been occurring since 2003, where the risk for CCHF exposure is high. US military personnel deployed to Afghanistan are at risk for contracting CCHF, with one US military member contracting the disease in Afghanistan, which ultimately led to his death [30]. Evidence exists which indicates CCHF can be imported to new geographic regions via the movement of individuals coming from areas endemic for the disease.…”

Section: Tick Bornementioning

confidence: 99%

The Impact of National Militaries on Global Health

Thompson¹

2018

Current Issues in Global Health

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Historically, the movement of military personnel has had serious consequences on global health. From the decimation of native people in the western hemisphere through the introduction of smallpox to the cholera epidemic in Haiti, militaries and military operations have served to spread disease and facilitate the emergence or re-emergence of novel disease organisms. This chapter provides historical insight into these impacts and reviews the impacts of more recent military activities, especially, recent military operations, on the global burden of disease and health to include vector borne disease, infectious diseases, and emerging diseases across the globe. Emphasis will be placed on current military operations.

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Operation United Assistance: Infectious Disease Threats to Deployed Military Personnel

Cited by 59 publications

References 198 publications

Infectious diseases during the European Union training mission Mali (EUTM MLI) – a four-year experience

Infectious diseases during the European Union training mission Mali (EUTM MLI) – a four-year experience

Emerging Infectious Diseases and Antimicrobial Resistance (EIDAR)

The Impact of National Militaries on Global Health

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