Serological evidence of arboviral infection and self-reported febrile illness among U.S. troops deployed to Al Asad, Iraq.

Understanding the epidemiology of current health threats to deployed U.S. troops is important for medical assessment and planning. As part of a 2004 study among U.S. military personnel deployed to Al Asad Air Base, in the western Anbar Province of Iraq, over 500 subjects were enrolled, provided a blood specimen, and completed a questionnaire regarding history of febrile illness during this deployment (average approximately 4 months in country). This mid-deployment serum was compared to pre-deployment samples (collected approximately 3 months prior to deployment) and evaluated for seroconversion to a select panel of regional arboviral pathogens. At least one episode of febrile illness was reported in 84/504 (17%) of the troops surveyed. Seroconversion was documented in nine (2%) of deployed forces tested, with no association to febrile illness. Self-reported febrile illness was uncommon although often debilitating, and the risk of illness due to arbovirus infections was relatively low.

Influenza: the next pandemic?: A review.

OBJECTIVES: To examine existing information on the recent influenza outbreaks in order to create awareness of a possible influenza pandemic and to suggest future research areas in developing control strategies in Kenya. DATA SOURCES: Review of literature via Internet, articles, journals and un-refereed features from the media and personal communications. DATA SELECTION: Most published data from 1979 to March 2005 found to reveal cases of influenza outbreaks were included in the review. Also, selected articles on the recent outbreaks and professional guidance on influenza infections were critically examined and analyzed. DATA EXTRACTION: Abstracts and articles identified were accessed, read to establish relevance to this review. DATA SYNTHESIS: Important points were prioritised and then included as subtitles; below each subtitle, published works were included. Finally, a table of influenza outbreaks and the strains of the viruses involved were drawn as summary. CONCLUSION: Influenza is a highly contagious, acute respiratory disease that may spread rapidly and pervasively through a population. Due to the diversity of susceptible reservoirs of influenza viruses and the interspecies transmission recently reported, a mutated strain of the virus to which people have no immunity could cause an influenza pandemic once the virus gains efficient and sustained human-to-human transmission. The fear that avian influenza could be a precursor to the next pandemic is real and inevitable, given the extremely high case-fatality ratio among confirmed cases and that genetic sequencing of influenza A (H5N1) viruses from human cases in Thailand and Vietnam show resistance to the antiviral medication amantadine and rimantadine. This calls for a high level of preparedness to avoid a public health emergency. Nowhere is this paradigm more real than in Africa.