A malaria outbreak following a British military deployment to Sierra Leone

Tuck, Jeremy; Green, A.D.; Roberts, K. I.

doi:10.1016/s0163-4453(03)00063-x

Cited by 32 publications

(20 citation statements)

References 17 publications

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“…Two of the outbreaks seemed to be associated with the water supply at a particular military camp where detailed assessments indicated that this was not remediable and alternative accommodation was found. Overall the DNBI mitigation measures worked well with lower reported cases of malaria and diarrhoeal disease than published historical experience 8 9 11 13…”

Section: Observations and Eventsmentioning

confidence: 73%

“…The UK DMS have a long and extensive knowledge of the health threats and medical challenges associated with military operations in Sierra Leone; the 1915 edition of the J R Army Med Corps contained a report on the incidence of malaria among European troops in Sierra Leone8 and there was an outbreak of over 200 cases of malaria among a short-notice deployment of nearly 3000 UK troops to Sierra Leone in 2000 9. There are other significant health threats present in West Africa, but with good planning and the use of well-established procedures it was envisaged that these could be mitigated to tolerable levels 10…”

Section: Overall Fhp Conceptmentioning

confidence: 99%

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Health protection during the Ebola crisis: the Defence Medical Services approach

Bricknell¹,

Terrell²,

Ross³

et al. 2016

J R Army Med Corps

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This paper is a narrative of the policies, procedures, mitigations and observations of the application of Force Health Protection measures applied by the Ministry of Defence (MOD) for the deployment of military personnel to West Africa as part of the UK contribution to the international response to the Ebola crisis from July 2014 to July 2015. The MOD divided the threat into three risk categories: risk from disease and non-battle injury, Ebola risk for non-clinical duties and Ebola risk for healthcare workers. Overall risk management was directed and monitored by the OP GRITROCK Force Health Protection Board. There were six cases of malaria, four outbreaks of gastrointestinal disease, two needlestick injuries in Ebola-facing healthcare workers, one MOD Ebola case and five non-needlestick, high-risk exposures. This experience reinforces the requirement for the Defence Medical Services to have a high level of organisational competence to advise on Force Health Protection for the MOD.

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Section: Observations and Eventsmentioning

confidence: 73%

Section: Overall Fhp Conceptmentioning

confidence: 99%

Health protection during the Ebola crisis: the Defence Medical Services approach

Bricknell¹,

Terrell²,

Ross³

et al. 2016

J R Army Med Corps

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“…They have also trialled text messaging to successfully confirm the daily ingestion of malaria chemoprophylaxis in a deployed setting 14. Many of these measures have been effectively implemented by the UK Armed Forces in the past15 and when these standards have slipped malarial outbreaks have occurred 16 17. In the case of this patient, as a civilian healthcare worker for an NGO, none of these measures were used, aside from the use of mosquito nets.…”

Section: Discussionmentioning

confidence: 99%

A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness: Table 1

et al. 2015

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We present a 27-year old British nurse admitted to the Kerry Town Ebola Treatment Unit, Sierra Leone, with symptoms fitting suspect-Ebola virus disease (EVD) case criteria. A diagnosis of Plasmodium falciparum malaria and heat illness was ultimately made, both of which could have been prevented through employing simple measures not utilised in this case. The dual pathology of her presentation was atypical for either disease meaning EVD could not be immediately excluded. She remained isolated in the red zone until 72 h from symptom onset. This case highlights why force protection measures are important to reduce the incidence of both malaria and heat illness in deployed military and civilian populations. These prevention measures are particularly pertinent during the current EVD epidemic where presenting with these pathologies requires clinical assessment in the 'red zone' of an Ebola treatment unit.

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“…This may have been true for established military operations with good facilities in areas where exotic, emerging or re-emerging infections did not occur. However, during operations in Sierra Leone (1999–2002), there were outbreaks of malaria47 and intestinal helminths;48 in Iraq (2003–2009), there were outbreaks of viral gastroenteritis (Figure 6)49 50 and bacterial gastroenteritis (L Lines, personal communication); and in Afghanistan (2001 onwards) there were outbreaks of viral gastroenteritis,51 bacterial gastroenteritis (E Hutley, personal communication), cutaneous leishmaniasis52 and ‘Helmand Fever’ caused by sandfly fever, acute Q fever or rickettsial infections (including typhus) 43 53. In Iraq and Afghanistan, complex trauma-related wound infections with multi-drug resistance have also occurred and these create new challenges for surgeons, medical microbiologists, infectious disease physicians and infection control practitioners 54 55.…”

Section: British Military Experiences In the 21st Centurymentioning

confidence: 99%

A brief history of British military experiences with infectious and tropical diseases

Bailey

2013

J R Army Med Corps

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Infectious and tropical diseases have been a problem for British expeditionary forces ever since the Crusades. Outbreaks were especially common on Navy ships from the 16th to 18th centuries due to poor living conditions and travel to the tropics. However, since these occurred in small, isolated and controlled environments it meant that naval medical practitioners were able to keep detailed records and develop empirical approaches for their prevention. The first Royal Naval Hospitals were established in response to these diseases and Royal Navy doctors made valuable early contributions towards understanding them. Even larger outbreaks of infectious and tropical diseases occurred in the Army during the Napoleonic, Crimean and Boer Wars and throughout the colonial era, which strongly influenced the formation of the Army Medical Services including provision for teaching and research. The establishment of germ theory led to a golden era of discovery regarding these diseases and British Army doctors made numerous important contributions. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from infectious and tropical diseases during the World Wars, but they remained a significant problem in the non-European campaigns and also the numerous ‘small wars’ that followed. Even in the 21st century some of these diseases still cause outbreaks with significant morbidity and impact on deployments, but the military clinical and academic resources to deal with them are now much reduced. Preventive measures such as hygiene, sanitation, infection control, vaccination and chemoprophylaxis are invaluable, but history shows that these can become neglected over time and disrupted or overwhelmed during the early or most intense stages of military operations. This is why military specialists in infectious diseases, tropical medicine, sexual health, medical microbiology and communicable diseases control are still required.

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A malaria outbreak following a British military deployment to Sierra Leone

Cited by 32 publications

References 17 publications

Health protection during the Ebola crisis: the Defence Medical Services approach

Health protection during the Ebola crisis: the Defence Medical Services approach

A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness: Table 1

A brief history of British military experiences with infectious and tropical diseases

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