The enemy within: U.S. troops in the Gulf also face disease

January 22, 1991|By Robert C. Toth | Robert C. Toth,Los Angeles Times

WASHINGTON — Washington

The possibility of contracting infectious diseases is looming as a serious threat to U.S. troops in the Middle East, according to military and Veterans Administration physicians.

Many of the 400,000 American troops deployed there are likely to come down with diseases -- mostly mundane, but some exotic -- that are found in the region.

With the outbreak of war, the toll from disease will undoubtedly be higher as health precautions take a back seat to the battle, medical authorities say.

Experts say the good news is that the overall impact of parasitic and other diseases -- carried mostly by mosquitoes, worms, flies and fleas -- in Saudi Arabia will probably be much less than it was on the 550,000 Americans who served in Vietnam.

"Saudi Arabia is drastically different from the wet areas in Southeast Asia," says Gary Roselle, chief of medicine at the Veterans Hospital in Cincinnati, Ohio, who has taken the lead in preparing veterans hospitals as reserve facilities for casualties from the gulf. "The difference between a tropical desert and a tropical jungle is very great."

In addition, drug use in the U.S. military now is "minuscule compared to Vietnam," says Pitt Tomlinson, a physician in the U.S. Surgeon General's office of disease control.

As a result, the incidence of hepatitis B, which traditionally is transmitted with dirty needles, is expected to be almost non-existent -- unless there is a resurgence of drug abuse during the Gulf deployment, military experts say.

This wouldn't be the first time that disease has served as a decisive factor in war. Historically, one medical expert says, "infections have debilitated more soldiers and kept them from fighting than actual battle."

Tales of armies that were defeated by disease rather than by the enemy stretch back to the Middle Ages, when the forces of King Henry V were beset by marsh fever. During World War II, malaria ravaged allied forces in the Pacific.

Closer to the Middle East, the North African army of German Field Marshal Erwin Rommel, "the Desert Fox," was decimated by hepatitis and other diseases. Disease contributed greatly to Rommel's defeat at El Alamein and elsewhere.

So far, American GIs in Saudi Arabia have suffered relatively few illnesses, although some have already been evacuated from the region.

"All in all, we've been very successful from a public health standpoint -- but things can change," Dr. Tomlinson says.

Some physicians familiar with the situation credit the good health of the troops so far primarily to the fact that the armed forces are importing virtually all food and water, including sealed ready-to-eat meals.

But as the size of the force increases, more and more supplies will be purchased locally, raising significantly the risk of infection from contaminated food and water.

With time, too, more of the troops will take rest and recreation leaves in the area, increasing their exposure to local populations and their diseases.

What is more, U.S. troops will be vulnerable to a variety of illnesses that occur naturally in the region, from diarrhea to anthrax and botulism, which often can be so lethal that they are among the standard weapons stored in the world's biological warfare arsenals.

Already about 4,000 cases of dysentery a week are reported among U.S. servicemen, according to Army physicians.

There are other problems peculiar to the region. During January and February, desert winds that continually blow the fine sandy dust about can produce pneumonia. Many local diseases are transmitted by sand flies, which are widespread.

Some of these illnesses are relatively benign, such as a flu-like fever that lasts up to a week. But others, including several forms of parasite-caused leishmaniasis, are more serious.

One type causes skin ulcers, which can leave disfiguring scars, while another invades internal organs such as the liver and can cause death. Six or seven leishmaniasis cases have already occurred, including one involving internal organs.

Sand fleas also carry a variety of diseases, including the plague (much as they did in Vietnam). But against these, proper clothing (tight sleeves) and use of insect repellents are usually effective, doctors say.

Worms, both hook and round varieties, are also potential problems, but seldom fatal.

Most worms enter the body in food but some can bore through the skin, so soldiers are told not to go barefoot in the sand. They are also told to avoid wading in any fresh water, lest a snail-carried parasite infect them.

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