UK Role 4 military infectious diseases and tropical medicine cases in 2005–2013

Burns, D S; Riley, Mark; Mason, Andrew N.; Bailey, M S

doi:10.1136/jramc-2017-000815

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…Infectious diseases have long been a significant cause of morbidity and mortality to the British military 3. Previous data have demonstrated that, second to infective gastroenteritis, UFI presented a significant caseload for deployed MTFs in both Iraq4 and Afghanistan,5 as well as at Role 4 6. The recent response to the Ebola crisis in West Africa demonstrated that UFI continues to be a significant reason for admission 7.…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017

et al. 2020

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Undifferentiated febrile illnesses present diagnostic and treatment challenges in the Firm Base, let alone in the deployed austere environment. We report a series of 14 cases from Operation TRENTON in South Sudan in 2017 that coincided with the rainy season, increased insect numbers and a Relief in Place. The majority of patients had headaches, myalgia, arthralgia and back pain, as well as leucopenia and thrombocytopenia. No diagnoses could be made in theatre, despite a sophisticated deployed laboratory being available, and further testing in the UK, including next-generation sequencing, was unable to establish an aetiology. Such illnesses are very likely to present in tropical environments, where increasing numbers of military personnel are being deployed, and clinicians must be aware of the non-specific presentation and treatment, as well as the availability of Military Infection Reachback services to assist in the management of these cases.

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Section: Discussionmentioning

confidence: 99%

Undifferentiated febrile illnesses in South Sudan: a case series from Operation TRENTON from June to August 2017

et al. 2020

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“…UK personnel have recently deployed to Iraq, Afghanistan, Sierra Leone, South Sudan and many other tropical regions of the world, with diseases endemic to each of these areas being represented in referrals to the UK military’s Role four infectious diseases and tropical medicine service 13. Diseases such as malaria, infectious gastroenteritis and cutaneous leishmaniasis remain prevalent during current contingency operations 14.…”

Section: Epidemiologymentioning

confidence: 99%

“…In addition, moving location means people are exposed to new endemic diseases, for which individual immunity is less likely. However, British military personnel deployed to unfamiliar locations with no inherent resistance or tolerance have a low rate of malaria infection,13 demonstrating that prevention can be effective in reducing disease during population movement.…”

Section: Epidemiologymentioning

confidence: 99%

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Communicable diseases in humanitarian operations and disasters

Murphy¹

2020

BMJ Mil Health

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Military organisations have battled communicable disease for millennia. They have pioneered disease prevention from the Crusades to the World Wars and continue to do so today. Predeployment vaccinations and chemoprophylaxis are effective in preventing communicable disease, as is reliable vector destruction and bite prevention, especially in the era of multidrug resistant organisms. These measures are unlikely to be fully possible in disasters, but reactive vaccination and efforts to reduce exposure to communicable disease should be a priority. Communicable diseases can be challenging to diagnose—the UK Defence Medical Services have become familiar with tools such as multiplex PCR and mass spectrometry. These have the potential to accurately identify organisms and sensitivity patterns in austere environments. Management of communicable diseases depends on accurate diagnosis and has a largely well-established evidence base but can be limited by a lack of resources and skills in an austere setting, therefore telemedicine can assist diagnosis and treatment of infections by projecting specialist skill. Systems such as EpiNATO2 are useful in monitoring diseases and identifying trends in order to establish control measures. Many of these tools and techniques are effective in austere environments and offer learning opportunities for those providing care in similar settings. Further research is ongoing into diagnostic tools as well as remote management.

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