Soldiers in Iraq coming down with parasitic disease

From Miami, Fla., at a meeting of the American Society of Tropical Medicine and Hygiene

Hundreds of soldiers serving in Iraq and Afghanistan have contracted leishmaniasis, a parasite-borne infection spread by sand flies, according to military physicians.

Symptoms usually are limited to skin ulcers, but two soldiers serving in each conflict have come down with a potentially lethal form of leishmaniasis that attacks internal organs, reports Otha Myles of the Walter Reed Army Medical Center in Washington, D.C. This form of the disease is marked by sporadic weight loss, abdominal pain, and fever.

Definite diagnoses took several months and required blood tests, liver biopsies, and bone marrow samplings. With standard treatment using an antimony-based drug, all four have recovered.

The more common form of leishmaniasis that shows up on skin has afflicted 669 military personnel, nearly all serving in Iraq, says physician Naomi E. Aronson of the Uniformed Services University of the Health Sciences in Bethesda, Md.

This form is seldom fatal, though scarring is common. Roughly 500 of the soldiers were treated at Walter Reed Army Medical Center. These patients averaged three skin sores apiece, but one soldier had 47 lesions.

At times, the hospital’s staff was treating between 50 and 80 leishmaniasis patients, says Walter Reed’s Glenn Wortmann.

The disease is caused by the protozoan Leishmania (SN: 7/24/04, p. 53: Available to subscribers at Parasite Pursuit: Sand fly coughs up leishmania protozoan’s secrets of proliferation). Most infections occurred in two regions in northern Iraq during the warm months, when sand flies are most prevalent.

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