View Full Version : Tap Broader Expertise To Tackle New Gulf Illness

08-23-03, 08:50 AM
USA Today, August 19, 2003
Pg. 10

Our View

Tap Broader Expertise To Tackle New Gulf Illness

Army Spc. Joshua Neusche, a strapping former high school track star, died
July 12. The 20-year-old was one of two soldiers to succumb to a mysterious
outbreak of pneumonia that has affected more than 100 U.S. troops in Iraq
and the region since March 1. Though the Pentagon has dispatched two
emergency medical teams to investigate, Neusche's parents in Missouri worry
that the investigation may not find the truth.

The Neusches' fears echo frustrations voiced in 1991, when veterans of that
Gulf War began to fall ill with what came to be known as Gulf War Syndrome.
For years, the Pentagon dismissed the mysterious symptoms, from fatigue to
neurological problems, that eventually plagued about one-third of all
veterans of the first Gulf War.

Twelve years later, much separates the pneumonia outbreak from Gulf War
Syndrome, which emerged more gradually and with less-identifiable symptoms.
To date, the pneumonia outbreak is far more limited. And with two medical
teams currently conducting an investigation, the Pentagon is taking it

But the military is repeating one mistake from its Gulf War experience. It
is limiting the involvement of the federal Centers for Disease Control and
Prevention. The CDC could provide the best comprehensive probe into the
pneumonia cases and head off suspicions that the Pentagon is putting troops'
health at risk or hiding information.

The Pentagon missed that opportunity once; it shouldn't again. When early
symptoms of Gulf War Syndrome surfaced, the Pentagon failed to ask for a
full CDC investigation. Yet, CDC teams are trained to move quickly to
identify illnesses, their causes and how to treat them. Their expertise and
their independence from the Pentagon make them best qualified to:

Ensure proper data collection. Congress in 1997 mandated thorough health
screenings for troops being deployed in any conflict as well as detailed
monitoring of battlefield conditions. The aim is to avoid a lack of
comprehensive data from the second Gulf War. The Pentagon insists that it
has fully complied, but Gulf War veterans' groups disagree.

Accurately assess the outbreak. The Pentagon says the more than 100 cases of
pneumonia do not "exceed expectations," since 400 to 500 U.S. military
personnel are hospitalized with pneumonia every year. Still, it's concerned
that two soldiers have died and 18 have been sick enough to require a
ventilator. The CDC can best evaluate whether, as the Pentagon maintains so
far, no evidence suggests the cases are linked and there is no indication
they are caused by chemical or biological weapons, SARS or environmental

A CDC spokesman said teams were ready to deploy to Iraq if asked. But a
Pentagon spokesperson said that the CDC's current role is sufficient. It is
using CDC experts as consultants, including one who last week joined a team
analyzing data from hospitalized patients in Iraq and Germany.

In the 1990s, the Pentagon's refusal to give the CDC a key role in
investigating Gulf War Syndrome needlessly added to the suspicions and
questions about how the military handled the illness.

The Neusches wrote Defense Secretary Donald Rumsfeld last week and asked for
an independent assessment of how their son died. Honoring the request would
help put their worries - and the public's - to rest.

"Support Our Soldiers"
United We Stand
God Bless America
Were it not for the brave,
there would be no Land of the Free!
Remember our POW/MIA's
I'll never forget!


also see DOD web site



08-23-03, 08:52 AM
DoD Reports Progress in Pneumonia Investigation

No. 621-03
Aug 22, 2003

DoD Reports Progress in Pneumonia Investigation

The Department of Defense announced today progress on the investigation of a number
of cases of pneumonia among military members deployed for military operations in
Southwest Asia.

"From what we have learned so far, it appears there are a series of unusual
pneumonia cases that have occurred in Southwest Asia. These cases do not represent
an epidemic, and it is not being spread through person-to-person contact. We are
making significant progress in eliminating a number of possible causes, such as SARS
and vaccines. Our investigatory process is helping to determine if there is a
single explanation, or if there are multiple cases," said Dr. William Winkenwerder,
assistant secretary of defense for health affairs. "Understanding the cause is
important to prevent future cases."

To date, the investigation has found evidence that two of the non-fatal cases were
associated with *Streptococcus pneumoniae*, the most common cause of bacterial
pneumonia. Col. Bruno Petruccelli, director, epidemiology and disease surveillance
at the U.S. Army Center for Health Promotion and Preventive Medicine, said, "There
is evidence that 10 of the cases have shown a higher than usual number of blood
cells of one specific type called eosinophils. An increase in this type of white
blood cell can occur in a variety of medical conditions, for example, infections,
asthma, hay fever and allergies. Medical personnel are trying to determine why some
of the 19 patients with severe pneumonia showed an increase in these cells."

Petruccelli also said, "It is our duty to patients and family members to ensure that
we have done everything we can to understand what has happened. We must take
whatever time is needed to do a thorough job of gathering and analyzing information
about these pneumonia cases. Our work is progressing well."

No other common infectious agents, evidence of exposure to chemical or biological
weapons, severe acute respiratory syndrome (SARS), or environmental toxins have been
identified. Among the several hundred thousand deployed servicemembers in Southwest
Asia over the past six months, approximately 100 have developed pneumonia. The rate
is consistent with what might be expected for a healthy population of similar ages
to our service members. The concern, however, is about the smaller number of
servicemembers, now identified as 19 cases, who developed severe pneumonia. Two
servicemembers have died from the disease, the first in Iraq on June 17 and the
second in Germany on July 12. The Office of the Armed Forces Medical Examiner is
determining specific cause or causes of death.

From March - August 2003, 17 soldiers, one Marine, and one sailor have developed
pneumonia serious enough to warrant medical evacuation for ventilator (respirator)
support. Fourteen of these members responded to standard treatment for pneumonia,
recovered from their illness, and returned to duty. Three remain hospitalized.

Two of the 19 serious cases became ill in March, two in April, one in May, six in
June, four in July, and four so far in August. Of the serious cases no two
individuals (18 men and one woman) were from the same unit. Thirteen of the cases
became ill in Iraq and six were in other Central Command countries, including
Kuwait, Qatar, Uzbekistan, and Djibouti.

Among the investigative efforts underway are two Army Epidemiological Consultation
(EPICON) teams. One team is in Iraq looking for commonalities among the cases-for
example, time, place or symptoms-and whether anything in the nature of the cases is
unusual when compared with similar DoD members, whether deployed or not, and U.S.
civilian populations. A second team has been at Landstuhl Regional Medical Center,
Germany, where most of the pneumonia cases have been treated following medical
evacuation from Southwest Asia.

A scientist from the Centers for Disease Control and Prevention (CDC) has joined the
consultative team at the Walter Reed Army Institute of Research, where all
information from the Germany and Iraq EPICON teams is being gathered, analyzed and
evaluated. The Department also has engaged the expertise of several members of the
Armed Forces Epidemiology Board (AFEB), which is an advisory committee of eminent
civilian scientists and physicians. These Board members are providing the
Department with consultative expertise during the investigation. The CDC's
associate director for epidemiologic science, and a member of the AFEB, is also
involved in this investigative review. The EPICON teams and other investigators
will make preventive or corrective recommendations based upon their findings.

Pneumonia is a common illness worldwide in all populations. In the Army, for
example, pneumonia is serious enough to warrant hospitalization for about 9 of every
10,000 soldiers each year, resulting in 450-500 total cases Army-wide. According to
U.S. medical statistics for the year 2000, this rate is very similar to the rate for
the general population of those between the ages of 15 and 45 (10.5 of 10,000 per
year). Therefore, the approximately 100 total cases of pneumonia do not exceed a
normal, expected rate for this disease, despite the harsh environmental conditions
found in Southwest Asia. While death from pneumonia is rarely seen in young,
otherwise healthy populations -- such as the military, it does occur. For example,
from 1998 through 2002, 17 Army members (worldwide) have died from pneumonia or from
complications of pneumonia.

Winkenwerder said, "Our work is progressing well in the continuing investigation of
these pneumonia cases. So far, we are able to rule out several sources of this
illness -- such as SARS. However, we are deeply saddened at the loss of our service
members, and we share in the desire of their families, friends and commanders to
identify the cause of this illness. We are committed to providing world-class care
for our people and we will pursue this pneumonia investigation until answers are

News Releases: http://www.defenselink.mil/releases/
-- DoD News: http://www.defenselink.mil/news/dodnews.html

"Support Our Soldiers"
United We Stand
God Bless America
Were it not for the brave,
there would be no Land of the Free!
Remember our POW/MIA's
I'll never forget!