A rare and sometimes deadly pneumonia has hit 18 U.S. soldiers deployed in Iraq, and Army medical investigators are at a loss to explain the cause, according to a study published on Tuesday. In a report appearing in the Journal of the American Medical Association, researchers from the Walter Reed Army Medical Center said two of the soldiers had died from the rare illness, called acute eosinophilic pneumonia, or AEP. No common source was found for the outbreak that occurred between March 2003 and March 2004 among the soldiers in Iraq. The study covered only that time period and there was no indication whether cases have continued to show up since then. The 18 victims studied ranged in age from 19 to 47 and all used tobacco, with three-quarters recently taking up the habit. All but one reported "significant exposure to fine airborne sand or dust" while in Iraq.
| That's not going to help narrow it down. |
While only 18 cases have been reported among 183,000 troops deployed in Iraq during the time period involved, the authors said the cases are still significant because the disease is very rare in the general population.
| This is true. We see about one case a year in a university referral practice. The leading causes are 1) drug reactions 2) parasitic infections 3) certain fungal infections 4) asthma (rare but it happens) 5) certain immunological disorders and 6) idiosyncratic (e.g., we don't know). I can get way more technical but you get the point. It's a favorite for the pulmonary board exam because it's very uncommon. |
| Is this what they call a "minicluster"? |
The illness was not immediately diagnosed in several victims, who suffered fever and respiratory failure. Several had to be put on mechanical ventilators to help them breathe and were administered corticosteroids. Months later, a few reported continued breathing problems or wheezing. "Inquiries to the Iraqi health officials did not suggest that AEP was occurring in the local population or that there has been an unusual increase in the incidence of pneumonia of any kind during the study period," the report said. The report's author, Dr. Andrew Shorr, warned the illness can strike suddenly and mimic more common ailments such as acute respiratory distress syndrome or community pneumonia.
| That's why a few were missed, and I'll bet they have a few more that never got properly diagnosed. |
The report follows another battle zone study in November that found an unexpectedly high number of U.S. soldiers injured in the Middle East and Afghanistan had tested positive for a rare, hard-to-treat blood infection. Army doctors at that time said 102 soldiers were found to be infected with the bacteria Acinetobacter baumannii. The infections occurred among soldiers at Walter Reed Army Medical Center in Washington, Landstuhl Regional Medical Center in Germany and three other sites between January 2002 and August. Although it was not known where the soldiers contracted those infections, the Army at that time said the outbreak highlighted a need to improve infection control in military hospitals. Eighty-five of the bloodstream infections occurred among soldiers serving in the Middle East and Afghanistan, the report said. Normally military hospitals see only one such case every year, it added.
| AEP and acinetobacter infection aren't related. I'll bet we see a few more strange illnesses come out of our soldiers in Iraq before we're done. |
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