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VA Service Officers Column |
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Notes From The Veterans Service Officer
IRAQI FREEDOM TROOPS INFECTED WITH LEISHMANIASIS
Healthcare providers at Walter Reed Army Medical Center have treated almost 400 patients infected with leishmaniasis since the beginning of Operation Iraqi Freedom last year. Patients receiving, or who have received care at Walter Reed for leishmaniasis, have been treated as outpatients, without having to spend any nights in the hospital. Most receive antibiotics for 10 days and are then able to return to duty or go on leave.
Leishmaniasis is a disease spread by the bite of a sand fly, occurring most frequently in tropical areas around the world such as in Iraq, Kuwait, Saudi Arabia, Afghanistan, Pakistan and other countries in Southwest Asia. The peak season for the sand flies is March through October. There are two kinds of leishmaniasis: cutaneous and visceral. There have been no cases of visceral leishmaniasis (the more serious infection of the two) detected among patients from Iraq.
People who contact the cutaneous form of leishmaniasis have sores on their skin that may not heal for several weeks. The lesions form weeks after an infected sand fly bites the person. The sores initially appear as bumps on the skin, then form an open, flat, circular sore with raised edges. Sometimes they have a scab and may be tender. If left untreated, the skin sores can last for years and leave permanent scars, but are not life-threatening. Cutaneous leishmaniasis is not contagious.
Visceral leishmaniasis is much more serious, infecting the liver, spleen and other internal organs and may be fatal if not treated.
Because there is no vaccine to protect against leishmaniasis, service members who deploy to areas where there's a chance of contracting the disease are briefed about preventive measures to possibly avoid getting it. These measures include:
· Limiting outdoor activity at dusk and during the evening when sand flies are most active, especially during warmer weather.
· Wearing protective clothing and insect repellent.
· Treating uniforms with permethrin.
· Using permethrin-treated bed netting.
While a rare occurrence, some forms of leishmaniasis can be transmitted through blood transfusion. However, there has been no case of the disease transmitted through blood transfusion in the United States and personnel deployed to Iraq have been deferred from donating blood for one year after departure from Iraq. The deferral, put in place by the Armed Services Blood Program office, is a precautionary measure to ensure the safety of the blood supply.
People diagnosed with leishmaniasis are permanently deferred from donating blood. In many cases, it takes two to six months for symptoms of leishmaniasis to show up. Service members returning from Iraq may have been bitten by the sand fly that causes the disease and may theoretically have the parasite in the blood stream, but they may not know it.
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