Hepatitis B and C in the Armed Forces

Chikungunya Virus Infections in Military Deployments in Tropical Settings-A Narrative Minireview

Chikungunya fever is a vector-borne viral disease in subtropical and tropical areas of endemicity. Apart from the burden on local populations, chikungunya virus infection also poses a risk for travelers and, in particular, soldiers during prolonged deployment-associated outdoor activities. The absence of rapid diagnostic tests makes surveillance challenging during military deployments in war and crisis zones with restricted medical infrastructure. Consequently, both historical and up-to-date surveillance data from battlefields are scarce. From several studies and postdeployment assessments, some information on the epidemiology of chikungunya virus infections in deployed military personnel is nevertheless available. The few published data homogeneously suggest a low infection risk in the endemic setting. During outbreaks, however, the infection risk of military personnel is comparable to that of the local population. Infection clusters of soldiers without pronounced outdoor activity have been reported under such circumstances as well. In spite of efforts focusing on the development of a chikungunya virus vaccine, no licensed product is available so far.

UK Role 4 military infectious diseases and tropical medicine cases in 2005-2013

INTRODUCTION

Infectious diseases are a frequent cause of morbidity among British troops. The aim of this paper is to describe the spectrum of infectious diseases seen when UK service personnel are evacuated for definitive care to the Role 4 Medical Treatment Facility based at Birmingham Heartlands Hospital.

METHOD

A retrospective analysis of all military patients presenting with infectious diseases and treated at Birmingham Heartlands Hospital between 14 April 2005 and 31 December 2013 was undertaken.

RESULTS

During this period, 502 patients were identified. Infections originated in 49 countries, most commonly Afghanistan (46% cases), the UK (10% cases) and Belize (9% of cases). The most common presentations were dermatological conditions, gastroenterological illnesses and undifferentiated fevers.

CONCLUSION

UK service personnel in significant numbers continue to suffer a wide range of infectious diseases, acquired throughout the globe, which often require specialist tertiary infection services to diagnose and manage. Future prospective data collection is recommended to identify trends, which in turn will inform military training needs and future research priorities in the Defence Medical Services (DMS) and allows development of appropriate policies and clinical guidelines for management of DMS personnel with infectious diseases.