Document Detail


An outbreak of malaria in US Army Rangers returning from Afghanistan.
MedLine Citation:
PMID:  15644548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: With numerous US military personnel currently deployed throughout the world, military and civilian health care professionals may encounter imported malaria from this population.
OBJECTIVE: To identify malaria in US Army personnel deployed to a combat zone.
DESIGN, SETTING, AND PATIENTS: Case series in the US Army health care system. A total of 38 cases of malaria were identified in a 725-man Ranger Task Force that deployed to eastern Afghanistan between June and September 2002.
MAIN OUTCOME MEASURES: Identification of malaria cases and soldiers' self-report of compliance with antimalarial measures.
RESULTS: A total of 38 patients were infected with Plasmodium vivax, yielding an attack rate of 52.4 cases per 1000 soldiers. Diagnosis was confirmed a median of 233 days (range, 1-339 days) after return from the malaria endemic region, with additional laboratory findings noting anemia and thrombocytopenia. One case was complicated with acute respiratory distress syndrome during the patient's primary attack and a spontaneous pneumothorax during relapse. This case accounted for 1 of 2 relapse cases in the study population. From an anonymous postdeployment survey of 72% (521/725) of the task force, the self-reported compliance rate was 52% for weekly chemoprophylaxis, 41% for terminal (postdeployment) chemoprophylaxis, 31% for both weekly and terminal chemoprophylaxis, 82% for treating uniforms with permethrin, and 29% for application of insect repellent.
CONCLUSIONS: Delayed clinical presentation can occur with P vivax. Symptoms are often vague, but malaria should be included in the differential diagnosis for soldiers returning from an endemic region. Suboptimal compliance with preventive measures can result in a malaria outbreak.
Authors:
Russ S Kotwal; Robert B Wenzel; Raymond A Sterling; William D Porter; Nikki N Jordan; Bruno P Petruccelli
Related Documents :
20494478 - Hansen's disease (leprosy) complicated by secondary mycobacterial infection.
6632778 - Hepatitis-b virus infection in patients with leprosy--a brief communication.
9672578 - Tuberculosis case detection in a state prison system.
17367478 - The safety and tolerance of atovaquone/proguanil for the long-term prophylaxis of plasm...
24518398 - Environmental toxicants and autism spectrum disorders: a systematic review.
16715428 - Successful management of esophageal perforation diagnosed 3 days after injury caused by...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JAMA     Volume:  293     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-12     Completed Date:  2005-02-02     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  212-6     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Afghanistan
Antimalarials / therapeutic use
Disease Outbreaks*
Hematologic Tests
Humans
Insect Repellents / administration & dosage
Insecticides
Malaria, Vivax / epidemiology*,  prevention & control
Male
Military Personnel*
Permethrin
Treatment Refusal
United States
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Insect Repellents; 0/Insecticides; 509F88P9SZ/Permethrin
Comments/Corrections
Erratum In:
JAMA. 2005 Feb 9;293(6):678

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Mortality in overweight and underweight children with acute myeloid leukemia.
Next Document:  Preventing foot ulcers in patients with diabetes.