Humans can contract the disease by ingesting unpasteurized dairy products, by way of infected aerosols inhaled or inoculated into the conjunctival sac of the eyes, and through direct contact between animals or their secretions and cut or abraded skin.

Among all US soldiers who participated in the Gulf War, OEF, and OIF, only one case of brucellosis has been diagnosed (Andrews 2004). An Army helicopter pilot became ill in July 2004 about a week after he completed a 5-month tour of duty in Iraq and returned to his unit in Würzburg, Germany. His initial symptoms of malaise, intermittent chills and fevers as high as 103.9°F, and profuse sweating worsened during the next 5 days despite unspecified “symptomatic treatment” and a day of hospitalization. The patient was readmitted to Würzburg Army Hospital on day 5. Antibodies to B. abortus were identified through laboratory analysis of an unspecified tissue specimen. In addition, a Brucella isolate later identified as B. melitensis was isolated from the patient’s blood. Medical personnel then diagnosed brucellosis. The case report on this patient lacks a description of the course of treatment administered, but the report notes that the patient completed a 14-day course of primaquine after redeploying (presumably to Iraq). The report also notes that the patient had taken chloroquine as malaria prophylaxis but missed his last weekly dose. Epidemiologic questioning of the patient identified only one possible source of the infection: observing the slaughter of a sheep in Iraq.

CHICKENPOX (VARICELLA)

Seventy-five US military personnel who served in ODSh or ODSt were hospitalized for chickenpox during their deployment (Smith et al. 2004). Although it is typically benign in children, chickenpox may cause a more severe disease in adults that might include pneumonitis, hepatitis, and encephalitis. Indeed, the disease kills one in 5,000 infected adults (Heymann 2004). A common complication is bacterial suprainfection, usually of the skin (Military Vaccine Agency 2005b). In 1995, the US Food and Drug Administration licensed a vaccine for this disease.

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. 1996). No further information has been published about the death. The literature mentions a second, nonfatal case of meningococcal disease during ODSh or ODSt (Hyams et al. 1995a), but validating evidence is absent. The committee is unaware of other published literature on cases or outbreaks of meningococcal disease among US troops deployed to southwest and south-central Asia during the conflicts discussed in this report.

NOSOCOMIAL INFECTIONS

Gulf War

The committee is unaware of any reports of nosocomial infection among US troops deployed to the Persian Gulf region for ODSh or ODSt. About 470 military personnel who served in those operations suffered nonmortal wounds (Department of Defense 2005).



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