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Pneumonia again hits troops in Middle East

by Sandra Jontz
Stars and Stripes, European Edition

ARLINGTON, Va. — Cases of pneumonia continue to plague troops deployed to the Middle East, and the number of “severe” cases, in which troops are put on ventilators, mirrors the number of this same time last year when the disease baffled health officials.

Eight servicemembers this year have contracted pneumonia and have shown a higher than usual number of a white blood cell type called eosinophils, one of the few facts that has linked the various cases, said Dr. (Col.) Bruno Petruccelli, director of the Epidemiology and Disease Surveillance Directorate at the Army Center for Health Promotion and Preventive Medicine.

Of the eight, six had to be placed on ventilators, he said.

The body produced eosinophils to fight infection or when a person suffers from asthma, hay fever or other types of allergies.

Last year, between March and August, 19 servicemembers contracted the illness and were treated in intensive care units and placed on ventilators. Of those 19, 10 showed a higher than usual number of eosinophils. Two of the pneumonia cases were fatal. This year, there have been no fatalities.

Pneumonia is an infection or inflammation of the lungs in which air sacs fill with liquid and prevents oxygen from reaching the body’s blood supply.

What is different this year from last, is that doctors are treating pneumonia patients earlier with steroids, which decreases the time they must spend in intensive care units and hospitals, said Petruccelli, whose specialty is preventive medicine.

While he can’t make a medical connection between steroids being use earlier and the fact that there have been no fatalities, “indirectly, the earlier use of steroids means shorter hospital stays and shorter hospital stays reduces the chance of complications from medical care.”

In spite of aggressive medical efforts to keep troops from contracting the disease, Petruccelli said he’s “not surprised at all” by the number of cases. “It’s relatively few people when you think we have about 150,000 people there.”

The Army, for example, sees about 400 to 500 cases of pneumonia worldwide each year. Between 1998 and 2002, 17 soldiers worldwide died of pneumonia or complications of pneumonia.

The number of cases in the theater seems to be more prevalent in the spring and summer months, however, the Army did log its first case this year in January after a four-month lull at the end of 2003.

“It looked like it mysteriously came to a halt,” Petruccelli said.

The cases involving eosinophils baffles medical experts because there is no known cause, no known pre-existing condition that might make one person more susceptible than other, nor any guaranteed preventions, he said.

However, experts have noted that among the more severe cases, troops not only were smokers, but had started smoking once arriving in theater, which might have made their bodies slightly more susceptible to contracting the pneumonia, he said.
Respiratory problems are common among troops serving in Iraq, Kuwait and Afghanistan, enhanced in part because of the powder-fine dust and sandstorms in the region.

Army health officials have circulated a list of recommendations to help stave off contracting the illness:

• Stay hydrated
• Don’t smoke; or at least smoke American cigarettes
• Wash hands frequently
• Use a cravat or dust mask to reduce dust inhalation
• Use wet mops when cleaning dust in living and work areas
• Seek medical care immediately for fever, chills and cough

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