Leishmania Comes Home with Troops

Medical Author: Frederick Hecht, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.

Oct 24, 2003 -- Americans returning from Iraq have been told not to give blood for a year to prevent the possible spread of a parasite into the US blood supply.

The parasite is called Leishmania and causes a disease called leishmaniasis. The parasite is transmitted to people by sand flies. Persons who travel to areas of the tropics, subtropics, and southern Europe are at risk for developing the disease.

22 known cases of the disease

A report was issued yesterday by the CDC (Centers for Disease Control and Prevention) on 22 confirmed cases of Leishmania skin infection in US military personnel deployed during 2002-2003 to Afghanistan, Iraq, or Kuwait. Of the 22 cases of leishmaniasis reported yesterday in US military personnel, 18 cases were contracted in Iraq and 2 each in Kuwait and Afghanistan.

The 22 US servicemen with leishmaniasis were treated at Walter Reed Army Medical Center from August 2002 to September 2003. All 22 patients were treated intravenously for 20 days with a drug called sodium stibogluconate. The patients uniformly responded to this therapy. However, they had a number of reversible side effects from the therapy such as fatigue, arthralgia (joint aches), myalgia (muscle aches), headache, and pancreatitis.

The blood ban

Transmission of Leishmania parasites through blood transfusion has not been reported in the US. However, as a precautionary measure, the Armed Services Blood Program Office of the Department of Defense and the American Association of Blood Banks are implementing policies to defer prospective blood donors who have been in Iraq from donating blood for 12 months after the last date they left Iraq.

Military travel medicine

One cost of the US intervention in countries such as Iraq, Kuwait and Afghanistan is disease. Americans encounter and contract illnesses that are normally never seen in the US. Travel medicine applies to all travelers, including the military. Disease and death know no rank.

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Source: Centers for Disease Control (www.cdc.gov)
Last Editorial Review: 10/24/2003




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