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PubMed2004

Update: Cutaneous leishmaniasis in U.S. military personnel--Southwest/Central Asia, 2002-2004.

Cutaneous leishmaniasis (CL) is a sand fly-borne parasitic infection. Preliminary data about cases of CL in military personnel deployed to three countries (Afghanistan, Iraq, and Kuwait) in Southwest/Central Asia have been published previously. During August 2002-February 2004, Department of Defense (DoD) staff identified 522 parasitologically confirmed cases of CL in military personnel. Leishmania major was the etiologic agent for all 176 cases for which species data, obtained by isoenzyme electrophoresis of cultured parasites, are available. This update focuses on the 361 cases (69% of 522) in patients whose demographic data were collected systematically under treatment protocols for therapy with the pentavalent antimonial compound sodium stibogluconate (Pentostam(R); GlaxoSmithKline, United Kingdom) at Walter Reed Army Medical Center, District of Columbia. U.S. health-care providers should consider CL in persons with persistent skin lesions who were deployed to Southwest/Central Asia or who were in other areas where leishmaniasis is endemic.

Adult↗
PubMed1997

Dengue fever in US military personnel in Haiti.

OBJECTIVE: To describe clinical manifestations and public health implications of an outbreak of dengue fever (DF) during Operation Uphold Democracy, Haiti, 1994. DESIGN: Consecutive sample. SETTING: Military combat support hospital, Port-au-Prince, Haiti. PATIENTS: A total of 101 US military personnel with acute febrile illnesses. INTERVENTIONS: A disease surveillance team collected clinical and epidemiologic data from US military clinics throughout Haiti. Febrile patients admitted to the combat support hospital were evaluated with standardized clinical and laboratory procedures. The surveillance team followed patients daily. MAIN OUTCOME MEASURES: Arbovirus isolation and specific antibody determination and symptoms and physical findings. RESULTS: Febrile illnesses accounted for 103 (25%) of the 406 combat support hospital admissions during the first 6 weeks of deployment. All patients with febrile illness recovered. A total of 30 patients had DF; no patient had evidence of infection with malaria. Dengue virus serotypes 1, 2, and 4 were isolated from 22 patients, and 8 patients developed IgM antibody to dengue virus. Patients with DF could not be distinguished from other febrile patients on clinical grounds alone. No arboviruses other than dengue were identified. CONCLUSIONS: Active surveillance, with clinical and laboratory evaluation directed by an epidemiologic team, led to the timely recognition of an outbreak of febrile illness among US troops in Haiti. Viral isolation and serological studies were essential in confirming DF. During the surveillance period, DF accounted for at least 30% of the febrile illnesses among hospitalized US troops. Dengue fever is a significant threat to military personnel and civilian travelers in Haiti and has the potential for introduction to and transmission in the United States.

Adult↗
PubMed2005

Diarrheal illness among deployed U.S. military personnel during Operation Bright Star 2001--Egypt.

In the fall of 2001, approximately 15,000 U.S. military personnel participated in a military exercise in the northwestern Egyptian desert. To assess the prevalence and impact of diarrhea and enteropathogen distribution, we conducted a post-deployment survey and a case series study. A departure convenience sampling (n = 3725) was used in the post-deployment survey. Overall, 9.3% reported diarrhea, 2.6% sought medical care, and 2.8% stopped or decreased their work for at least a day. Among those reporting diarrhea, 41.7% had symptoms for less than 2 days, 43.5% had symptoms from 2-5 days, and 14.8% had symptoms for more than 5 days. In the case series study, pathogens were identified in 53.6% of the 129 cases enrolled. Pathogens identified included enterotoxigenic E. coli (n = 53), enteroaggregative E. coli (n = 13), Cryptosporidium (n = 9), Campylobacter jejuni (n = 7), noroviruses (n = 7), Shigella flexneri (n = 2), rotavirus (n = 2), and Entamoeba histolytica (n = 2). Among those seeking care for diarrhea, two thirds reported a decreased ability or inability to perform their jobs for at least one day, but overall, diarrhea was much less prevalent than in past surveys in this region, with minimal impact on the mission.

Adult↗
PubMed2004

Clinical characteristics of unexpected death among young enlisted military personnel: results of a three-decade retrospective surveillance.

STUDY OBJECTIVE: To explore the causes of sudden and unexpected death in a young and healthy military population, to examine the various patterns of diseases associated with these tragic events, and to investigate the factors found to be associated with this grave outcome. DESIGN: We retrospectively investigated 151 cases of Israeli military personnel who died unexpectedly over a 30-year period. We collected all the available medical records, autopsy results, and investigation committee reports. RESULTS: A total of 151 cases of sudden and unexpected death occurred among enlisted military personnel during the period. Cardiac disorders caused 47% of deaths, followed by neurologic causes (17%) and pulmonary causes (11%). In 30 events (20%), the cause of death remained undetermined. Symptoms (eg, syncope, chest pain, palpitations, and others) occurred prior to death in 52 cases (34%). Asthma was the most common risk factor in our study population having been previously recognized in 10 cases (6.7%). Eight of the 13 subjects with asthma died following an acute asthmatic attack. CONCLUSION: Cardiac events are the leading cause of unexpected death in young healthy people. The frequency of subjects with asthma was found to be higher than that in the general age-adjusted population.

Adolescent↗
PubMed1999

The prevalence and treatment of dental caries among Israeli permanent force military personnel.

A survey was conducted to determine dental caries prevalence and treatment among 1,095 25- to 44-year-old permanent force Israeli military personnel. Caries experience, by decayed, missing, and filled permanent teeth (DMFT), was 11.66, with an average of 1.37 untreated caries, 2.40 extracted teeth, and 7.90 treated teeth. Caries was positively associated with age (p < 0.001). Females demonstrated statistically higher DMFT levels than males (p = 0.009). Negative associations were detected for education levels and untreated and extracted components (p < 0.001), and a positive association was detected for the treated caries component (p < 0.001). Permanent military personnel treated by private dentists exhibited 17.6% untreated caries, compared with 9.4% among personnel treated in the army. Officers had lower levels of untreated caries (8.6%) than others (13.3%). Among the present population, 77% had attended a dental clinic in the preceding 2 years. Permanent force personnel are offered free, comprehensive, and accessible dental treatment. The data emphasize a need for further dental health education.

Adult↗
PubMedDate not supplied

Respiratory diseases among U.S. military personnel: countering emerging threats.

Emerging respiratory disease agents, increased antibiotic resistance, and the loss of effective vaccines threaten to increase the incidence of respiratory disease in military personnel. We examine six respiratory pathogens (adenoviruses, influenza viruses, Streptococcus pneumoniae, Streptococcus pyogenes, Mycoplasma pneumoniae, and Bordetella pertussis) and review the impact of the diseases they cause, past efforts to control these diseases in U.S. military personnel, as well as current treatment and surveillance strategies, limitations in diagnostic testing, and vaccine needs.

Adenoviridae Infections↗
PubMed1981

Radioactivity measurements of former military personnel exposed to weapon debris.

Sixteen former military personnel who were present at the "Smoky" atmospheric nuclear weapon test have been investigated for internal deposits of radioactivity. Whole-body and thorax gamma-ray measurements, thorax and skeletal actinide measurements, and urinalyses for plutonium-239 and strontium-90 indicated no evidence of radioactivity in excess of that found in the general population.

Adult↗
PubMed2002

The impact of commuter war on military personnel.

BACKGROUND: The U.S. armed forces recently experienced a reduction in forces along with an increase in operational tempo. The Air Force and other branches supporting its mission share this common military burden and also experience a unique stressor. The Air Force has developed a military force that can fight by night and return home by day. The relatively new phenomenon of "commuter war" was especially evident during Operation Allied Force over Kosovo. METHODS: Military personnel (N = 540) participating in Operation Allied Force were administered a survey measuring morale, wellness behaviors, and work-family conflict. RESULTS: The deployment had adverse effects on wellness behaviors of permanent party and temporary duty assignment populations. Additionally, levels of morale and motivation varied between the two groups. Permanent party personnel also reported increased rates of work-family conflict. CONCLUSIONS: Commuter war affects wellness behaviors, morale, and work-family conflicts of military personnel.

Adult↗
PubMedDate not supplied

Weight gain as a barrier to smoking cessation among military personnel.

PURPOSE: To assess the relationships between active-duty military status, military weight standards, concern about weight gain, and anticipated relapse after smoking cessation. DESIGN: Cross-sectional study. SETTING: Hospital-based tobacco cessation program. SUBJECTS: Two hundred fifty-two enrollees, of 253 eligible, to a tobacco cessation program in 1999 (135 men, 117 women; 43% on active duty in the military). MEASURES: Independent variables included gender, body mass index (weight/height2), and military status. Dependent variables included about weight gain with smoking cessation and anticipated relapse. RESULTS: In multivariate regression analyses that controlled for gender and body mass index, active-duty military status was associated with an elevated level of concern about weight gain (1.9-point increase on a 10-point scale; 95% confidence interval [CI], 1.0- to 2.8-point increase), as well as higher anticipated relapse (odds ratio [OR] = 3.6; 95% CI, 1.3 to 9.8). Among subjects who were close to or over the U.S. Air Force maximum allowable weight for height, the analogous OR for active-duty military status was 6.9 (p = .02). CONCLUSIONS: Occupational weight standards or expectations may pose additional barriers for individuals contemplating or attempting smoking cessation, as they do among active-duty military personnel. These barriers are likely to hinder efforts to decrease smoking prevalence in certain groups.

Adult↗
PubMed2003

Psychosocial and health correlates of types of traumatic event exposures among U.S. military personnel.

The prevalence of lifetime exposure to violence, natural disaster, or major accidents involving injuries or fatalities was examined in the largest population-based epidemiologic survey of U.S. military personnel to date. The psychosocial and health effects of types of exposure experience (witness only, victim/survivor, relief worker), gender differences, and social support were also evaluated. Over 15,000 active duty U.S. military personnel from stratified random samples of active duty U.S. personnel from all services responded to either mail questionnaires and/or worksite surveys. The lifetime exposure to one or more traumatic events was 65%; the most prevalent trauma for men was witnessing a major accident, and for women, witnessing a natural disaster. Victims of any traumatic event were at twice the risk of having two or more physical and mental health problems than nonexposed controls. Health outcomes of trauma exposure vary by type of traumatic event: type of exposure experience, rank, and gender.

Adult↗
PubMed1989

Smoking and tobacco use by U.S. military personnel.

Findings regarding smoking behavior for the 1985 survey of military personnel were compared to findings from earlier surveys. A decline in the percentage of cigarette smokers was evident for all ranks and ages. Reported use of smokeless tobacco and cigar/pipe smoking indicated that one-fifth of the cigarette smokers also use smokeless tobacco and that two-fifths of the cigarette users smoke a pipe or cigar. Among non-smokers of cigarettes, about one-tenth of the respondents used smokeless tobacco and/or smoked a pipe or cigars. Using self-evaluation of health status, non-smokers reported "excellent" health significantly more than smokers.

Adolescent↗
PubMed1999

Quality of life and health-services utilization in a population-based sample of military personnel reporting multiple chemical sensitivities.

We sought to assess quality of life and health-services utilization variables in persons with symptoms suggestive of multiple chemical sensitivity/idiopathic environmental intolerance (MCS/IEI) among military personnel. We conducted a cross-sectional telephone survey of a population-based sample of Persian Gulf War (PGW) veterans from Iowa and a comparison group of PGW-era military personnel. A complex sample survey design was used, selecting subjects from four domains: PGW active duly, PGW National Guard/Reserve, non-PGW active duty, and non-PGW National Guard/Reserve. Each domain was substratified by age, gender, race, rank, and military branch. The criteria for MCS/IEI were developed by expert consensus and from the medical literature. In the total sample, 169 subjects (4.6%) of the 3695 who participated (76% of those eligible) met our criteria for MCS/IEI. Persons who met the criteria for MCS/IEI more often reported the following than did other subjects: more than 12 days in bed due to disability, Veteran's Affairs disability status, Veteran's Affairs disability compensation, medical disability, and unemployment. MCS/IEI cases also had higher outpatient rates of physician visits, emergency department visits, and inpatient hospital stays. Subjects who met the criteria for MCS/IEI more often reported impaired functioning on each Medical Outcomes Study 36-Item Short Form subscale, compared with those who did not meet the criteria. We concluded that although the diagnosis of MCS/IEI remains controversial, the persons who met our criteria for the disorder are functionally impaired.

Cross-Sectional Studies↗
PubMed1993

Fort Polk Heart Smart Program. Part IV: Lifestyles of military personnel and their families.

Lifestyles are major determinants in development of heart disease. Tobacco and alcohol use, physical activity, and hostility, a component of type A, were assessed in a sample of active military men and their wives at Fort Polk, Louisiana. Findings included: (1) a greater frequency of cigarette smoking at Fort Polk compared to national surveys; (2) a higher frequency of alcohol consumption in ages 30-39, and more blacks reported alcohol use than other race groups; (3) a greater frequency of alcohol use at Fort Polk compared to a worldwide military survey; (4) no consistent differences in lipid or blood pressure levels for high and low activity groups of wives; and (5) wives' hostility scores were low, and were not correlated with other cardiovascular risk factors. The implication of lifestyle descriptions is the need for intervention and health promotion, not only for military personnel, but also for their families. The significance of health promotion programs is the eventual reduction of health care costs and the well-being of families and fitness of military personnel.

Adolescent↗
PubMed2003

The health effects of peacekeeping (Bosnia, 1992-1996): a cross-sectional study--comparison with nondeployed military personnel.

OBJECTIVE: Our goal was to test the hypothesis that United Kingdom soldiers who were deployed to Bosnia had worse health than a nondeployed control group. METHODS: We used data from a cross-sectional study designed to examine the health effects of service in the Persian Gulf War, which collected data in 1997 to 1998. We compared the two control groups--(personnel who were deployed to Bosnia and a nondeployed control group of military personnel (Era))--on a number of health-related outcomes, including physical functioning, symptoms and ailments, psychological health, fatigue, and post-traumatic stress reactions. RESULTS: The response rate for the Bosnia cohort was 62.9% and for the Era group 61.9%. A proportion of the Bosnia group had served in the Persian Gulf War and was found to have considerably worse health outcomes than the remaining Bosnia group or the Era group. The Bosnia group who had not served in the Persian Gulf War had broadly similar health outcomes to the Era group. The main differences were that the Bosnia-only group consumed more alcohol and reported more fatigue, hay fever, weight gain, irritability, avoidance, and night sweats. Apart from heavy alcohol consumption, the magnitude of these differences was small. The Bosnia-only group had slightly better physical functioning than the Era group, and there were two other symptoms and one ailment which were less common in the Bosnia-only group than in the Era group. CONCLUSIONS: This study indicates that the health of United Kingdom military personnel who served in Bosnia from 1992 to 1996 was generally good in 1997 to 1998. However, further surveillance of veterans of the Balkan's War is required in the light of recent concerns.

Adult↗
PubMed1995

Seroepidemiology of infections due to spotted fever group rickettsiae and Ehrlichia species in military personnel exposed in areas of the United States where such infections are endemic.

A prospective, seroepidemiologic study of spotted fever group rickettsiae (SFGR) and Ehrlichia infections was done among 1194 US military personnel exposed in a heavily tick-infested area of Arkansas in 1990. Seroconversion (4-fold) and seroprevalence rates were determined by indirect immunofluorescent antibody assays. Seroconversions to SFGR occurred in 30 persons (2.5%), whereas seroconversion to Ehrlichia species occurred in 15 (1.3%). The majority of seroconverters did not report symptoms (22/30 [73%] of SFGR seroconverters; 10/15 [67%] of Ehrlichia species seroconverters). History of tick attachment was associated with seroconversion to SFGR (relative risk [RR] = 4.3, P < .001) and Ehrlichia species (RR = 3.6, P < .05). Use of permethrin-impregnated uniforms significantly decreased risk of infection (P < .01); use of bed nets increased risk by 4-fold. Tickborne infections represent a significant threat to military personnel training in areas in which these infections are endemic.

Adolescent↗
PubMed2006

Hypercholesterolemia and smoking habits of Lithuanian military personnel.

OBJECTIVE: To investigate the prevalence of risk factors for cardiovascular disease, namely, hypercholesterolemia and current smoking, among 25- to 54-year-old men and women among Lithuanian active duty military personnel. METHODS: Serum cholesterol levels were measured enzymatically for 200 persons (126 men and 74 women). Interviews regarding smoking habits were performed for 82.5% of those persons (98 men and 67 women). RESULTS: Hypercholesterolemia (total cholesterol level of > or = 6.2 mmol/L) was determined for 45.2% of men and 40.5% of women. After distribution of men and women into three age groups (25-34, 35-44, and 45-54 years), it was determined that the rate of hypercholesterolemia increased with age (among groups of men, 29.6%, 46.7%, and 74.0%; among groups of women, 18.8%, 51.5%, and 40.0%, respectively). The proportion of current smokers among men was 2.6 times higher than that among women (45.9% vs. 17.9%; p < 0.001). The highest rate of current smoking was in the 35- to 44-year group of men (64.5%). The coexistence of hypercholesterolemia and current smoking among men was 3.1 times higher than that among women (23.5% vs. 7.5%; p < 0.01). The highest rates of current smoking with hypercholesterolemia were in the 35- to 44-year and 45- to 54-year groups of men (32.2% and 31.8%, respectively). CONCLUSION: The data demonstrated a relatively high rate (32.1%) of coexistence of two independent risk factors for cardiovascular disease (hypercholesterolemia and current smoking) among men 35 to 54 years of age from Lithuanian military personnel.

Adult↗
PubMed2003

Hernia operations using laparoscopic hernioplasty on military personnel with a short hospitalization time.

OBJECTIVE: Laparoscopic hernioplasty was performed by either transabdominal preperitoneal or totally extraperitoneal approaches, The purpose of this study was to demonstrate that laparoscopic hernioplasty is a way to treat military personnel in the army with less pain and for the patients to return to an active lifestyle in a short time. METHODS: A total of 217 laparoscopic hernioplasty were performed in 192 patients. Eighty-eight hernias were operated by transabdominal preperitoneal and the 146 hernias were operated by totally extraperitoneal approach hernioplasty. RESULTS: The mean +/- SD operation times were 69.4 +/- 23.94 and 58.3 +/- 24.13 minutes for the transabdominal preperitoneal and the totally extraperitoneal approach, respectively (p = 0.42). Postoperative pain was monitored by the visual analog scale. Hospitalization time for patients without complications was significantly shorter (p = 0.02). CONCLUSION: Laparoscopic hernioplasty could be performed on military personnel who need to return to work quickly with a short hospitalization time, less pain, and lower recurrence rate.

Adult↗