Afghanistan: Linking Military Operations & Sandfly Fever

Research Paper Title

Sandfly fever in Afghanistan-a sometimes overlooked disease of military importance: a case series and review of the literature.

Abstract

Sandfly fever, sometimes known as pappataci fever or Phlebotomus fever, is a vector transmitted viral illness with a history of affecting naïve military formations that travel through or fight in areas in which the infection is endemic.

The researchers present a series of 4 hospitalised cases of sandfly fever (2 presumptive, 2 laboratory confirmed) that were admitted to a Role 3 hospital in Afghanistan for evaluation and treatment following medical evacuation from a forward area for marked fevers and malaise.

Laboratory evaluation of these cases was significant for leukopenia and thrombocytopenia, consistent with historical descriptions of sandfly fever. In the correct geographic and clinical setting, the finding of mild leukopenia among a cluster of febrile patients should prompt the clinician to at least consider a diagnosis of sandfly fever.

A cluster investigation conducted by preventive medicine personnel identified numerous other presumed cases of sandfly fever in this forward special operations camp. Response efforts emphasized enforcement of standard vector-borne disease control measures by operational leadership in order to limit effect on tactical operations.

The researchers review historical instances of sandfly fever affecting military operations, and present a review of clinical presentation, transmission, management, and prevention.

Reference

Downs, J.W., Flood, D.T., Orr, N.H., Constantineau, J.A. & Caviness, J.W. (2017) Sandfly fever in Afghanistan-a sometimes overlooked disease of military importance: a case series and review of the literature. US Army Medical Department Journal. 2017 Oct-Dec;(3-17), pp.60-66.

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