Overseas Civilian Contractors

News and issues relating to Civilian Contractors working Overseas

Military superbug, quiet civilian epidemic

What this article fails to point out is that Acinetobacter baumannii infections were extremely rare in the US prior to the invasion of Iraq.  The Iraq Infections website mapped the spread of this Superbug from the military medical system to community hospitals across our country beginning in 2004. Acinetobacter baumannii spread from Landstuhl and the three main military hospital centers, to the VA hospitals, to the community hospitals.

Severely injured Civilian Contractors were repatriated via the military medical evacuation system then delivered to unsuspecting community hospitals in the US, the UK, Australia, Canada, and the many third world countries the TCN’s come from.

The quiet civilian epidemic was allowed to propagate due to the DoD and CDC‘s concerted effort to cover up this disaster that the Military had created themselves.  The DoD promoted such notions as the insurgents were putting Acinetobacter on bombs and the Main Stream Media (here and here) parroted the propaganda.   The CDC claimed they were not “authorized” to talk about it.

The military knew all along that Acinetobacter baumannii was a hospital acquired organism yet promoted the lie that it came from the soil in Iraq.  The original strains of Ab infecting soldiers and contractors were matched to the European (Landstuhl) strains which were already fast becoming a problem there.

See some of the Casualties of Acinetobacter baumanii

Military superbug, quiet civilian epidemic

(Notice even this reporter cannot escape the notion that the dust in Iraq was responsible)

A thick layer of dust covers the blazing hot combat fields of Afghanistan and Iraq, getting under soldiers’ helmets, chalking up their fatigues and covering exposed skin. When enemy fire hits, troops often sustain severe burns and open wounds with shredded surrounding skin. Medical aid is generally faster than in any other U.S. wars, thanks to technology and a transport chain designed for high speed. When medics come, there’s an efficient process of lifting wounded troops onto open transport vehicles, prodding them with devices to assess vitals, wrapping their wounds and giving them fluids and blood. But during all that activity, the dust, the many hands and bandages, open wounds and needle punctures give other enemies — microscopic superbugs — an opportunity to attack from the inside.

For troops wounded in the wars in Iraq and Afghanistan, one of the most prolific superbugs has been an almost exclusively hospital-bred strain of bacteria known as “Iraqibacter,” a mutated version of the common acinetobacter baumannii. While military hospitals have waged a somewhat successful internal battle against the bacteria, for civilian hospitals in the U.S. and around the world, these bugs are a formidable foe.

“The data we were seeing shocked us into action,” (is five years the normal reaction time?) said Colonel Dr. Duane Hospenthal, Infectious Diseases Consultant for the U.S. Army Surgeon General.

What Duane Hospenthal previously told the press:

Hospenthal added that he believes there is little cause for concern. “It’s a low-grade, low-virulence pathogen that can be recovered from soil and water. Without having it blasted into you or your being immunocompromised, it’s not going to hurt you. We still see Acinetobacter, but
now that it’s been recognized, people are less excited about it here.
It’s hard for me to even understand if this is a big issue.”

In fall 2008, the military expanded its infection monitoring and control system, also known as GEIS (Global Emerging Infectious Surveillance), to include acinetobacter and other multidrug-resistant organisms. This overhaul followed a spate of high-profile stories in Wired magazine and on the PBS program “Nova” about the prevalence of acinetobacter at Walter Reed Medical Center.

Please read the entire story here

August 21, 2011 Posted by | Acinetobacter, Afghanistan, Civilian Contractors, Contractor Casualties, Department of Defense, Iraq, Pentagon, Propaganda | , , , , , , , , | 1 Comment

U.S. Army misled public about Acinetobacter outbreak’s origins, report shows

Injured Civilian Contractors were infected with Acinetobacter baumannii in the military medical evacuation system causing many to lose limbs and some their lives.  At a minimum, treatment for an Acinetobacter baumannii infection causes a much longer recovery time and life long implications.

If you suffered a Traumatic Brain Injury your freshly compressed brain cells were bathed in the huge doses of highly nuerotoxic antibiotics prophylacticly whether or not you had this infection creating a hostile environment for recovery at the very least.

by Bryant Furlow at EpiNewsWire  May 30, 2011

The U.S. Army Public Health Command has released an incomplete list of epidemiological consultation (EPICON) studies from the past decade to epiNewswire, without mentioning the fact that the titles of some studies were not on the list.

One politically-sensitive Army report excluded from the disclosed list is a 2005 EPICON study detailing the spread of multidrug-resistant Acinetobacter infections from contaminated military hospitals in Iraq throughout the military hospital system.

That report details evidence that that improper use of antibiotics and unsanitary conditions at U.S. military hospitals were responsible for the deadly outbreak of Acinetobacter infections among wounded troops, and that the outbreak had spread to civilian patients in the U.S. and Germany, killing several of them.

But for several years after the study’s completion, Army health officials continued to downplay the risk to civilians and to make misleading statements to soldiers and the public, claiming Acinetobacter infections were from Iraqi soil in soldiers’ blast wounds.

In reality, Acinetobacter “wound infections were relatively uncommon,” the 2005 Acinetobacter EPICON report states. “Pre-hospital, primary wound infections in-theater are not likely to have a significant role in transmission.”

In Iraq, military surgeons were using broad-spectrum antibiotics as prophylactics against infection, “introducing a greater risk of multi-drug resistant organisms (MDRO) evolving as a result,” the report notes.

Hand hygiene practices were inconsistently observed by military healthcare workers, the report states.

“Proper hand washing has been the single most important measure in controlling hospital spread of Acinetobacter,” the report states.

All seven military hospitals in Iraq were found to be “contaminated” with Acinetobacter, the report states.

Civilians were at much greater risk from infections than soldiers, the report states.

The report recommended adoption of standardized infection control practices at military hospitals and the air evacuation system, including disinfection and hand washing practices – and noted a pressing need for improved medical record-keeping “at all levels of care, particularly in-theater.”

A German hospital accepting U.S. troops on a referral basis, experienced an Acinetobacter outbreak that spread to German patients, the report states. That outbreak “reflects the potential importance that the outbreak can have, and probably has had, outside of the direct chain of evacuation,” the report states. Similar outbreaks had occurred in British hospitals where UK troops had been treated, the report notes.

Missing and incomplete medical records complicated the study, the report states.

“Relatively few surveillance and infection control data are available from in-theater, although progress has been made,” the report states. “Data quality from patient chart reviews indicates large variation in data available and no standardization.”

The “absence of good documentation either precludes any ability to draw scientific conclusions or significantly complicates investigations and analyses that are critical for prioritizing interventional resources and saving lives,” the report states.

epiNewswire’s Bryant Furlow first reported on an Acinetobacter outbreak among Iraqi and U.S. patients on the U.S. Navy’s hospital ship Comfort in July 2006, in the International Affairs Journal’s International Update newsletter.

In February 2007, Wired magazine writer Steve Silberman subsequently broke the story of Acinetobacter’s spread to Europe, Walter Reed Army Medical Center, and elsewhere. Silberman’s report details how the family of a U.S. Marine who died of his infection, was initially told he had died of his wounds.

That summer, citing two medical journal publications based on parts of the EPICON research effort,  Reuters reported that “new research” showed that contaminated hospitals, not Iraqi soil, caused the Acinetobacter outbreak.

In reality, military medical officials had suspected as much since spring 2003, the EPICON report indicates — and had known it to be the case since the first, 2004 symposium on the project’s initial findings.

Further reading:

EPICON #12-HA-01-JK-04, “Investigating Acinetobacter baumannii infections at U.S. Army military treatment facilities 27 August 2004 to 27 May 2005.” (View here, via Document Cloud.)

Steve Silberman. “The invisible enemy.” Wired magazine, February 2007.

Reuters Health. “Field hospitals source of soldier infections.” June 18, 2007.

The Iraq Infections

Please see the original at EpiNewswire

June 1, 2011 Posted by | Acinetobacter, Contractor Casualties, Department of Defense, Friendly Fire, Safety and Security Issues, Traumatic Brain Injury | , , , , , , | Leave a comment

Road to defense contracting led through the battlefield

By Marjorie Censor at The Washington Post

It wasn’t until Dawn Halfaker had to put an Army uniform back on to greet soldiers returning from Iraq that she knew she had to find a new career

Despite losing her right arm during a tour in Iraq, Halfaker had hoped she could stay in the military. After recovering at Walter Reed Army Medical Center in Washington, she was invited to meet her returning unit but required to don her uniform again. The realization that she was unable to pin her medals on or to salute drove home Halfaker’s loss.

“This just isn’t going to work,” she recalled thinking.

Halfaker, who had played college basketball and trained military police in Iraq, went on to found Halfaker & Associates, an Arlington-based contractor that provides a range of consulting and information technology services primarily to military customers, including helping the Army modernize its recruiting practices and manning operations and intelligence centers. Halfaker said the company brought in $15.5 million in revenue last year. She’s among other soldiers who, motivated by their experiences on the battlefield and aided by their personal connections, have launched their own companies.

Halfaker was drawn to the U.S. Military Academy at West Point when she was recruited to play basketball. She graduated in 2001, and, after a yearlong stint in Korea, went to Fort Stewart, Ga., to get ready for deployment. In February 2004, she traveled to Baqubah, Iraq, where she lived among and trained Iraqi police.

In June 2004, Halfaker was on a routine patrol when a rocket-propelled grenade came through her vehicle’s window. She was flown out of Iraq and kept in a medically induced coma until she eventually ended up at Walter Reed. There, her parents broke the news that she had lost her arm. Read the entire story here

Six days later, Halfaker was a patient at Walter Reed Army Medical
Center here, about to lose her arm to a life-threatening infection.

More Women Bear the Wounds of War

January 17, 2011 Posted by | Acinetobacter, Civilian Contractors, Government Contractor | , , , , , , | Leave a comment

“Wikipedia Journalism” Can be Contagious

Many Injured Contractors were repatriated via the Military Medical Evacuation System which was/is badly contaminated with Multi Drug Resistant Acinetobacter baumannii.  Soldiers and Contractors alike lost lives and limbs to this dangerous Superbug.

Injured Contractors played an even larger role in the spread of MDRAb across the US and to every country of the “coalition” than did the soldiers themselves.  Injured Contractors were infected  in field hospitals, Landstuhl, Walter Reed, Bethesda Naval, and then transferred to Civilian Community hospitals.    Civilian hospitals were seldom warned their new transfers were infected with a life threatening highly contagious bacteria.

The DoD’s usual knee jerk reaction was to cover this problem up rather than deal with it.  Lie about to be exact.

Steve Silberman, Investigative Journalist for Wired, has written again, on the spread of this Superbug and the Military and “Wikipedia Journalism’s” aiding and abetting the enemy.

Is Wikipedia Journalism Aiding the Spread of a Deadly Superbug?

By Steve Silberman at NeuroTribes

Japan is in an uproar. Last week, officials at the Teikyo University Hospital admitted that 46 patients in the past year have been infected with an antibiotic-resistant bacterium called Acinetobacter baumannii, and that 27 have died. Today, the number of infected patients was increased to 53, and hospital announced that it would admit no new patients until it checks for the presence of the bacteria in more than 800 patients currently in the hospital. In a contrite press conference, hospital officials admitted that they had not promptly reported the infections to local authorities as they are legally required to do, and that this delay likely contributed to the spread of the bacteria through the wards, and to patient deaths.

Meanwhile, other Tokyo hospitals are also now reporting infections and deaths. Yurin Hospital discovered that eight of its patients — aged 59 to 100 — were colonized by the bacteria, and four of them have died. Three patients at the Metropolitan Geriatric Hospital were also infected, and one has died. The bacteria seems to be spreading rapidly through hospitals in the Japanese metropolis, aided by patient transfers, overuse of antibiotics, lack of sufficient infection control, and failure to report the infections to health authorities. Seeking to place the blame for the seemingly sudden upsurge of the bacteria, The Daily Yomiuri ominously speculated today, “Could medical tourists bring something more sinister than their own health problems with them when they come to Japan?”

Sadly, none of this is a surprise to me: not the rapid spread of the bacteria, not the deaths, and not the failure to acknowledge the problem until numerous patients had died or become colonized, and not the frantic seeking to place the blame by demonizing people from other cultures. The same pattern emerged in an epidemic of Acinetobacter baumannii infections among American and Canadian troops returning from the wars in Iraq and Afghanistan, which I wrote about for Wired magazine in 2007, in an in-depth investigative feature called “The Invisible Enemy.”

Back then, it was the U.S. Defense Department officials who were slow to acknowledge rampant acinetobacter infections in the ranks, and they were not nearly as eager to take responsibility as Japanese officials have been this week. Indeed, there seemed to be a coordinated effort to mislead the press about the true source of the infections. Antibiotic-resistant Acinetobacter baumannii is almost always found in hospitals and other health care facilities. It is a nosocomial infection — like MRSA, Clostridium difficile, and the other horsemen of the post-antibiotic apocalypse, it preys on those who are already sick, elderly, or traumatically injured, piling agony upon agony. That’s why troops and civilians gravely wounded in war are one of acinetobacter’s favorite target demographics: all that fresh, exposed meat, left undefended by already weakened immune systems or immunosuppressive drugs. Particularly among the young — car-crash victims and the like — many acinetobacter infections go undetected, because the primary trauma alone is enough to kill the patient.

The story coming from Washington, however, was that the source of the bacteria was Iraqi insurgents who were intentionally “dosing” improvised explosive devices (IEDs) with the superbug, in the form of dog feces or rotting meat. The alternate version of the official story was that Acinetobacter baumannii lurks in the Iraqi soil itself, waiting to pounce on young American warriors like some kind of microbial jihad. In the fog of war, reporters bought these official story lines and parroted them dutifully, from CNN’s Situation Room to CBS correspondent Kimberly Dozier, who called A. baumanniian Iraqi bacteria” (as if organisms carry passports) after barely surviving an IED attack and subsequent infection in 2006. In the military and the press, the bacteria acquired the catchy nickname “Iraqibacter,” which has a darkly ironic grain of truth to it — wounded Iraqi citizens cared for in our field hospitals in the early days of the war became infected at much higher rates than our troops, and were then released back into a country with a health-care infrastructure that had been bombed back to the Stone Age.

For more information about how the Pentagon conducted a secret war against this bacteria, see my 2007 story. But I knew when I filed it that the saga of the medical battle against Acinetobacter baumannii was just beginning. Since my story ran, there have been numerous outbreaks of the superbug in hospitals in Europe and Asia, with scores of patients — both military and civilian — left dead.

In time, the “dosed IED” story slowly faded away. But one aspect of the misleading press coverage of the bacteria refuses to die: the notion — repeated by the Mainichi Daily News and other Japanese papers this week — that multi-drug resistant Acinetobacter baumannii is commonly found in water and soil. This notion — that A. baumannii is nearly ubiquitous in the natural world — has been reinforced by everyone from local TV news stations to the New York Times.

Multidrug-resistant Acinetobacter baumannii is not commonly found in water and soil. It is found in hospitals and clinics, where the tenacious organisms earn their resistance to the best drugs we can throw at them; it is particularly prevalent in intensive-care units, lurking among those moist places where medical equipment enters the body, such as catheters and breathing tubes.

To put it another way, Acinetobacter baumannii is not a “wild” superbug. It is a thoroughly domesticated superbug, inadvertently trained and evolved by us, living alongside us in a terrible synergy, and thriving on the spoils of war, aging, disease, and the failure to implement proper infection controls.

Beyond misleading shaggy dog-poop stories from Pentagon spokespeople, the source of this problem in journalism may be tragically mundane. Acinetobacter in general — that is, not baumannii — is one of the largest and most diverse genera of bacteria on the planet, comprising more than 30 distinct species, including Acinetobacter baylyi and Acinetobacter haemolyticus. Right up at the top of the Wikipedia entry for Acinetobacter, Googling journalists on deadline are informed that the bacteria is an “important soil organism.” While that’s true of some members of the genus, it’s not true of the species causing these infections. You have to get down in the fine print to realize that A. baumannii — the evolutionary sequel — is a whole other kind of beast, native to hospitals, and worthy of its own Wikipedia entry.

This confusion has resulted in hundreds of news stories — and even a fact sheet [PDF link] put out by the Infectious Diseases Society of America — claiming that Acinetobacter baumannii is “commonly found in water and soil,” when the scientist who discovered antibiotic resistance in the organism, Lenie Dijkshoorn, a senior researcher at Leiden University Medical Center in the Netherlands, told me when I interviewed her for my Wired story, “My colleagues and I have been looking for Acinetobacter baumannii in soil samples for years, and we haven’t found it. These organisms are quite rare outside of hospitals.”

So what’s the big deal?  The big deal is that errors in medical journalism — particularly ones that proliferate everywhere in big media virtually unchallenged — can lead to bad medicine. I felt a chill pass over me when I read a 2006 paper in the Canadian Medical Association Journal that quoted Major Homer Tien, a Canadian trauma surgeon serving in Afghanistan, saying that because he believed the windblown desert sand carries A. baumannii, “There’s talk of building an antechamber to the hospital, so you’d have a double set of doors, to help keep the sand out.”

In any health-care setting, infection-control resources are stretched thin. Hospitals — on the front lines or back home — simply cannot afford this kind of confusion. Every news story that echoes the false claim that Acinetobacter baumannii is “commonly found in soil and water” is part of the problem.

A citizen journalist named Marcie Hascall Clark — the wife of a contractor who picked up the bacteria in a hospital after being wounded in Baghdad — has been sounding the alarm for years, a voice in the online wilderness. By 2007, when I wrote my Wired story, many physicians in the military had already figured out what was really going on, and were starting to implement strict protocols — including rebuilding the field hospitals, increasing disease surveillance, and isolating infected and colonized patients — to minimize colonization and new infections among wounded troops. The US medical establishment and smart science bloggers like Maryn McKenna, author of Superbug, have also awakened to the growing threat of this particularly nasty and adaptive organism. “In the all-star annals of resistant bugs,” McKenna wrote in June, “A. baumannii is an underappreciated player.”

Much of the media, however — from America to Japan — has yet to catch up.

September 8, 2010 Posted by | Acinetobacter, Afghanistan, Civilian Contractors, Contractor Casualties, Iraq, Pentagon, Propaganda | , , , , , , , | Leave a comment

Pentagon to Troop-Killing Superbugs: Resistance Is Futile

By Keith Drummond at Wired’s Danger Room

A super-germ that’s become a lethal threat to troops in Iraq and Afghanistan may have met its match in a novel technique that kills entire bacterial colonies within hours.

Today’s troops have a nine in 10 chance of surviving their battle injuries. But wounds and amputation sites leave them vulnerable to infection, especially by Acinetobacter  — an (opportunistic pathogen) somewhat misleadingly nicknamed “Iraqibacter” for its prevalence in war-zone medical facilities. As Wired magazine reported in 2007, the bacteria has infected at least 700 American troops since 2003, and killed at least seven people exposed to it in military clinics.

Iraqibacter was once treated with common, easy-to-access antibiotic drugs. But in the last few years, the bacteria have developed a powerful resistance to all but one medication, called Colistin, that’s got a bit of a nasty side effect: potentially fatal kidney damage.

Since the illness afflicts relatively few people, Big Pharma companies aren’t exactly lining up to develop new drugs.

But a Pentagon-funded research team at the University of Massachusetts Amherst, along with small biotech firm PolyMedix, are making rapid strides toward a new line of Iraqibacter treatments — and the medications could spur the development of antibiotics that can fend off other drug-resistant ailments.

“We didn’t set out to create a mechanism that could be applied to other illnesses,” Dr. Gregory Tew, the UMass scientist behind the project, told Danger Room. “But it’s an impressive and exciting bonus that’s come of our work.”

The scientists have already used the new type of antibiotics to effectively treat staph infections, which kill thousands of Americans each year.

Common antibiotics work by attaching to a specific molecule (like an enzyme) inside bacterial cells. With some minor adaptive changes, bacteria can alter their cell structure to prevent antibiotic binding, thereby becoming resistant to the drugs. Some infections even develop “persister cells,” which stop growing when the antibiotics are administered, and then turn back on once a round of meds is completed.

But Tew and his team have developed antibiotics that work from the outside to quickly destroy bacterial cells. The drugs work by poking holes in bacterial membranes, killing the cells instantly. Within a few hours, the antibiotics are able to kill off entire colonies of bacterial pathogens. And resistance is futile: Because the meds don’t enter the actual cell, it’s impossible for the bacteria to fight back through structural adaptation.

The method has already proven effective in clinical trials for treating staph infections, and the Pentagon is betting it’ll be effective in combating Iraqibacter too. In 2009 alone, they doled out nearly $8 million to UMass and PolyMedix, to “study its antibiotic compounds for other biodefense applications and bacterial infections.”

Right now, the group is starting animal studies of Iraqibacter antibiotics, though Tew anticipates that human application is several years off. The scientists are also involved in preliminary research on using the membrane-puncture method to address other strains of bacteria.

But a means of mitigating antibiotic-resistant bacteria can’t come a moment too soon. Just last month, federal health officials warned that if resistance keeps growing, Americans could soon be living in “a post antibiotic era.”

See Also The Invisible Enemy by Steve Silberman at Wired

May 29, 2010 Posted by | Afghanistan, Civilian Contractors, Iraq, Safety and Security Issues, Toxic | , , , , , | Leave a comment