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This paper is an assessment of the impact of infectious
diseases (ID) on the operations in the Persian Gulf based upon reviews
of published reports and data on the surveillance of 40,000 Marine Corps
personnel deployed to northeastern Saudi Arabia. Disease and non-battle
injury rates were the lowest of any U.S. military campaign. No deaths
due to ID were reported during the operations. Diarrheal disease was the
leading cause of ID morbidity among U.S. troops. The most frequent major
intestinal pathogens were enterotoxigenic E. coli and Shigella sonnei.
Principal sources were fruits and vegetables from the region. Limited
outbreaks of Norwalk virus infection occurred in scattered units. Acute
upper respiratory infections were common during the periods of initial
deployment and crowding. Troops living in fixed facilities had higher
rates of respiratory infections than troops in the field. Although cutaneous
leishmaniasis was expected to be a problem (19 cases reported), unexpected
were the 12 cases of viscerotropic disease due to L. tropica. The anticipated
serious threat from sandfly fever never materialized. No other endemic
arthropod-borne viral diseases were detected except for one case of West
Nile fever. Seven cases of malaria (Plasmodium vivax) were reported among
soldiers who had entered southern Iraq, a known endemic region. There
were reported three cases of Coxiella burnetii infection (Q fever) but
none of brucellosis, both endemic infections. Two cases of meningococcal
disease occurred. The post-war occurrence of unexplained symptoms in GW
veterans is discussed in terms of what is known about the threats of infectious
disease (through both natural acquisition and biological warfare) specific
to the region. The favorable experience with infectious diseases is attributed
to a robust medical infrastructure for care, extensive preventive medicine
activities, and the fortuitous circumstances of desert locations for most
troops and mostly cooler weather. All future military operations can be
expected to have problems with diarrheal and respiratory diseases until
effective vaccines are developed. |
