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Military Disease Surveillance, Leishmaniasis at Epinews

Posted by defensebaseactcomp on May 26, 2010

US Army reports fewer cases of leishmaniasis, but a complex threat persists

Rates of a disfiguring infection seem to be plummeting among soldiers in Iraq. But much of that decline is due to a failure to report new cases—and civilian doctors could miss a life-threatening form of the disease among returning vets and contractors

Returning soldiers and contractors who harbor infections could go undiagnosed by civilian doctors unfamiliar with leishmaniasis

‘It will be difficult to estimate the true number of infected soldiers’

Global Distribution of Leishmaniasis

by Bryant Furlow

June 3, 2007—The US Army has received markedly fewer reports of soldiers with leishmaniasis in Iraq and Afghanistan since a major outbreak in 2003, according to a report by the Army Medical Surveillance Activity (AMSA) office. But medical experts caution that much of the change may actually be due to incomplete case reporting rather than fewer infections.

Known as the “Baghdad boil” among troops, leishmaniasis is caused by a protozoan parasite spread by biting sand flies. It is usually a disfiguring, nonlethal skin disease, but sometimes spreads to the spleen and liver, causing a life-threatening visceral disease known as kala-azar or black fever.

According to the AMSA report, at least 1,300 soldiers have been diagnosed with “clinically significant” cases of leishmaniasis since deployment to Afghanistan or Iraq. Other reports put the number at 2,500. Many more are infected but have not developed skin lesions. Mercifully few have developed visceral leishmaniasis. Army sources are vague about the number of visceral cases, but agree that it is “very low.” No soldiers have died of the disease, according to Jaime Cavazos, an Army Medical Command (MEDCOM) spokesman.

Ninety-six percent of soldiers affected are male, according to the AMSA report, and 90 percent were infected in Iraq. The number of civilian contractors with leishmaniasis is unknown.

Medical intelligence warnings ignored
In October 2002, well prior to the invasions of Iraq and Afghanistan, the US Defense Intelligence Agency’s Armed Forces Medical Intelligence Center (AFMIC) warned that leishmaniasis would be a danger for troops. However,military sources say that insect repellant and bed nets were frequently in short supply, and that many unit commanders failed to emphasize the risk to their troops.

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4 Responses to “Military Disease Surveillance, Leishmaniasis at Epinews”

  1. Brit guy said

    When we returned to the UK we were given a card that showed what the symptoms could be. It listed all the things to look out for it had a warning on the back for doctors should you have to go into hospital. We were told to carry the card for at least two years. I wonder if any of your troops had the same thing?

    As most of the contractors I worked with were all ex-military and had been deployed to the gulf before we all knew of the risk. At the interview for private work we were again told of the risks and at our in theatre orientation we were again told of the risk.

    They told us the time of year you were most at risk with simple advice like keep your selves rolled down and use lots of insect repellent on exposed skin and wear a hat or cap. I find it hard to believe that companies cannot warn people of the risks or run a decent orientation programme the company I worked for did.

    Before we were allowed to go to work we spent two weeks doing in theatre training warned of the risks and tested for fitness skill set before deploying to our relevant areas. Those not up to standard were sent home and those who had second thoughts through the orientation also went home no problems at all did not cost them a penny all paid for by the company.

    We were well prepared for what we were up against working in Iraq the orientation pulled no punches it showed the horrors prepared you for the risks and all the time we were out there we had constant updates for risks from disease and how the threat levels were changing with daily briefings.

    What they could not prepare us for is the battle with the insurance company on our return.

    • Pleased to learn that this company has been so responsible.
      By early 2004 when I started contacting contract companies to warn them about Leishmaniasis no one I talked with had heard a thing about it.
      Certainly the company my husband worked for did not. They also did not make any effort to take precautions once they knew.
      With the DBA’s Exclusive Remedy in place there is no financial incentive, nothing for the companies to concern themselves with.
      Unless of course they care about their people on the ground.

      • Brit guy said

        We were briefed about it in our pre-deployment training with the military prior to going out in 2003. All of the training team with the company I was with were ex-military. It was the military that gave us the cards when we got home. You are right that companies have no incentive to look after their employees. I was lucky and was employed by a good company. I did however search and look around at all the companies and did not just take a job. People need to be careful and ask the right questions before going. It is easy to be blinded by the rewards but does anybody want to be the richest person in the graveyard.

        The one thing nobody could have anticipated was the actions by the insurers. I asked about insurance at the interview and was told. You are working for the US government and will be well taken care of if the worst happens you and your family will have nothing to worry about.

        I must be honest the company I was working for are as disgusted at our treatment as those of us injured. The company even have a welfare team who visited us in hospital made regular phone calls to check on our well being and even liased with the insurers to try and sort out issues that arose. They only stop when guys are forced to appoint attorneys but they still keep in touch to check on our well-being.

        So they are not all bad it just that they have no control over the insurance industry and I have to be honest it seems to be mainly the American insurance companies although I bet there are others.

  2. anonymous on purpose said


    WOW, I would have loved to receive training like that Brit Guy…

    Hell, the first week on the job at Z-Lake I saw two guys one right after another get burned horribly with Sulfuric Acid! I had just graduated with a degree and knew more than the guys training me!!

    The company I worked for had no training at all when I started, then when they finally did get a program going it was taught by a self righteous jackass who thought he knew it all…..

    The “training” we received before deploying was a joke…wait in line…get your picture taken…listen to a moron drone on for hours about useless nonsense and basically test everyone’s ability to be incredibly bored for hours and not go off of the deep end for at least two weeks.

    I do not regret my experiences…I would still be there if at all possible…

    Sucks being disabled and needing surgeries for years…..

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