WASHINGTON – The Army is telling troops to take precautions as it tries to figure out the cause of pneumonia (search) cases, including two deaths, among forces in the Afghan and Iraqi campaigns.
Officials are investigating the cause of some 100 cases of the illness counted since March, focusing on 15 cases so serious the patients had to be put on ventilators and flown to Europe, defense officials said at a Pentagon press conference Tuesday.
"We're deeply concerned about the deaths," David N. Tornberg, a deputy assistant secretary for health policy, said of the two fatal cases. "We'd like a comprehensive understanding to be available to the families, to the husbands, to the wives of our servicemen so they better understand the nature of these conditions."
So far, officials have pretty much ruled out exposure to anthrax, smallpox or any other biological or chemical weapon; to Legionnaires' disease; or to SARS (search), severe acute respiratory syndrome, said Col. Robert DeFraites, chief of preventive medicine in the Army surgeon general's office.
DeFraites said officials believe two of the cases were streptococcal pneumonia (search), caused by common bacteria. The cause of the rest of the cases remains a mystery.
The 15 serious cases — among 14 men and one woman — have been spread throughout Southwest Asia. Ten of the 15 were in Iraq, but others were as far away as Uzbekistan (search), DeFraites said. Fourteen of the victims were Army members and one a Marine.
There was no apparent connection between the 15 most serious cases. They were from different units, and their cases were spread over time — two in March, two in April, one in May, six in June and four in July. The last confirmed case was July 30, DeFraites said.
A two-person investigative team has gone to Landstuhl Regional Medical Center in Germany, where most of the cases were treated after evacuation. A six-person team en route to Iraq includes infectious disease experts, laboratory workers and people who will take samples of soil, water and air as well as medical samples from patients.
The two teams will review patient records and laboratory results and interview health care workers and patients, if possible.
In the meantime, officials also are hoping to limit the number of new cases. Soldiers are being told to avoid becoming dehydrated in the intense heat and dust; protect themselves against breathing dust by wearing masks; and water down dusty surfaces before they sweep. Heavy dust storms have been a problem in Iraq.
"And finally, we all know that definitely cigarette smoking is a risk factor for pneumonia no matter what age, no matter what population," DeFraites said. "We emphasize that normally to the troops anyway, but this is even more a reason to avoid cigarette smoking."
Armywide, pneumonia cases serious enough to warrant hospitalization happen in about 9 of 10,000 soldiers per year, so the 100 cases are not unexpected. It is the severity of the 15 cases that has caused special concern.
Between 400 and 500 soldiers get pneumonia every year in the Army worldwide, DeFraites said, though it might surprise some that "otherwise young, healthy adults" get the illness.
From 1998 through 2002, 17 soldiers have died from complications from pneumonia, he said.
"So even in this day and age, we still, unfortunately, lose some soldiers due to pneumonia," he said.