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GI, respiratory, skin disease top list among troops in Ebola response
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SAN DIEGO — Complaints of upper respiratory, gastrointestinal and skin disease symptoms accounted for the majority of clinical visits by United States military personnel during their response to the 2014 Ebola virus outbreak in West Africa, according to researchers.
The same three complaints have been common in other military theaters, including combat missions in Iraq and Afghanistan, they said at ID Week in San Diego. The data can help the military prepare for and prevent familiar enemies of the microscopic variety, they concluded.
“I think what we want ultimately is rapid diagnostics,” researcher Ana Markelz, MD, of the SAUSHEC Infectious Disease Fellowship program at Brooke Army Medical Center in San Antonio, Texas, told Infectious Disease News. “Knowing that these are the biggest targets, we can make sure that we have diagnostics available to address these conditions … and that way, we can better sustain the mission, because we know what it is, we know how to treat it and we can prevent further transmission.”
The military deployed roughly 3,000 troops to West Africa in November 2014. Their missions included constructing Ebola clinics, training health care workers and improving laboratory operations.
The researchers monitored disease and injury-related troop visits from Dec. 1, 2014, to Feb. 25, 2015. The visits were made by those deployed to eight locations in Liberia and Senegal. The researchers said diagnostic testing consisted of routine laboratory tests, rapid malaria tests and Ebola screening.
The number of personnel involved in the Ebola response ranged from 1,057 to 2,983. The study by Markelz and colleagues included 2,493 clinical visits in all, with more than half occurring in the study period’s first month. The number of patients, numbers of illnesses and injuries and rates of illness and injury declined over the study period, the researchers said.
Upper respiratory, gastrointestinal and skin complaints were the reason for 373, 325 and 306 visits, respectively. Those complaints declined as the study period progressed. The first month alone saw 51% of injury complaints and 73% of gastrointestinal complaints.
Diagnoses of enterovirus meningitis, norovirus gastroenteritis and chikungunya were made in patients after medical evacuation or redeployment, the researchers said.
They said that the use of Malarone (atovaquone/proguanil, GlaxoSmithKline) and vector control accounted for the lack of malaria cases.
“Our big focus was how to mitigate and prevent malaria, and I think that was done very well,” Markelz said. “And the reason that was done very well was that we spent a lot of time educating people before they were deployed and getting the commanders to support us and to buy into the importance of malaria prevention.” – by Joe Green
Reference:
Markelz A, et al. Abstract 285. Presented at: ID Week. Oct. 4-8, 2017, San Diego.
Disclosures: The researchers report no relevant financial disclosures.