Overseas Civilian Contractors

News and issues relating to Civilian Contractors working Overseas

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

Deployment brain injuries, amputations jumped in 2010, U.S. Army reports

There are no numbers available for Contractors though there are more Contractors than Military in the War Zones.

By Bryant Furlow at Epinewswire

Despite the Obama administration’s ramping down of combat operations in Iraq, 2010 saw the highest number of troops with reported traumatic brain injuries (TBIs) for any year of the U.S. occupations of Iraq and Afghanistan — and more than twice the number of deployment-related amputations seen in 2009, according to a newly-released report by the Armed Forces Health Surveillance Center.

2010 saw 7,270 deployed troops hospitalized or treated for TBIs, or about 20 new cases per day, the report shows.

That is more than any other year between 2003 and 2010, and represents a 34 percent jump from 2009′s count of 5,818 soldiers with TBI. Only 2008 came close to matching the 2010 numbers, with 7,263 soldiers with brain injuries during deployment. Between 2003 and 2010, a total of 33,446 soldiers have been hospitalized or treated for TBIs during or within 30 days of deployments, according to the report.

Only raw counts, not incidence rates, were described in the report.

The actual numbers are likely higher than reported, however. Data for 2010 was compiled in January and February 2011, for example, before administrative records for hospitalizations in late 2010 had all been reported. And even though the Pentagon acknowledges TBI symptoms may not emerge, or may not be recognized, until after soldiers return home from combat deployments, the new study only reports TBIs diagnosed during deployment or within 30 days of the end of a soldier’s deployment. Furthermore, a footnote in the report reveals that more than 2,700 soldiers hospitalized or treated for TBI during deployment were excluded from analysis because of pre-deployment histories of TBI.

Only a soldier’s first TBI diagnosis is counted, so the report does not reveal how many soldiers have suffered repeated brain injuries.

Reported brain injuries prior to 2008 are also likely underestimates.  During that time, military physicians noted in memos obtained by epiNewswire that reporting of combat injuries was incomplete. And as epiNewswire revealed in 2007, the Army had not yet implemented by that year a long-standing order to screen returning combat veterans for brain injuries.

Last year also saw a dramatic rise in amputations during or within a year of deployment, from 88 amputations in 2009 to 182 in 2010, the report shows. That’s more than any year of combat operations in Iraq and Afghanistan except 2007, when 205 soldiers underwent deployment-related amputations.

A total of 1,138 soldiers had deployment-associated limb amputations between 2003 and 2010, according to the new report.

The report shows a slight increase in sand fly-vectored leishmaniasis infections (called the “Baghdad boil” by soldiers), from 48 cases in 2009 to 65 cases in 2010. While those numbers likely represent genuine declines from the 622 cases reported in 2003, epiNewswire reported in 2007 that the Army had curtailed field reporting of leishmaniasis infections from Iraq, resulting in underestimations of actual infection rates.

The new report was released March 4, and details the numbers of deployment-associated TBIs, pulmonary emboli and deep-vein thrombosis, amputations, heterotopic ossification (aberrant bone growth following trauma), severe pneumonia, and leishmaniasis between 2003 and 2010.

Source: U.S. Armed Forces Health Surveillance Center. Deployment related conditions of special surveillance interest, U.S. Armed Forces, by month and service, January 2003-January 2011 (data as of 01 March 2011). Medical Surveillance Monthly Report, February 2011;18(2):13. (Report released March 4, 2011.)

Please see the original at Epinewswire

March 6, 2011 Posted by | Afghanistan, Civilian Contractors, Contractor Casualties, Improvised Explosive Devices, Iraq, Leishmaniasis, Traumatic Brain Injury | , , , , , , | Leave a comment

U.S. Army failed to conduct post-deployment health assessments throughout Afghan conflict, records suggest

By Bryant Furlow at Epinewswire

Post-deployment health assessments (recorded using form DD-2796) were frequently not completed by U.S. Army doctors early in the occupation of Afghanistan, according to Army Medical Command “lessons learned” reports obtained by epiNewswire.

“Clinicians had no idea of what the DD-2796 was, nor what to do with it,” one of the unclassified reports states.

The undated report, written between 2003 and 2005, urged that commanders educate soldiers and clinicians about the importance of completing post-deployment health assessments. The assessments are used for statistical analyses of health trends among deployed soldiers and to assess soldiers’ fitness for redeployment.

But a 2009 Government Accountability Office (GAO) report found that five and six years into the Iraq and Afghanistan conflicts, the failure to conduct post-deployment health assessments remained widespread. Nearly a quarter of the assessments were missing for soldiers deployed to combat zones in 2007 and 2008, the GAO reported.

July 27, 2010 Posted by | Afghanistan, Civilian Contractors, Iraq, Pentagon, Veterans | , , , , | Leave a comment

Sanitation, disease control largely ignored by U.S. Army from the outset in Afghanistan, records show

By Bryant Furlow on Jul 26, 2010 at Epinewswire

The U.S. Army’s public health efforts were hindered from the beginning of military deployments to Afghanistan and Iraq by chronic medical equipment shortages — including shortages of antibiotics, disinfectants and hand washing stations, according to U.S. Army Medical Command (MEDCOM) ”lessons learned” documents obtained by epiNewswire.

Sanitation efforts were limited at best, with commanders discounting the importance of hygiene and disease control, sanitation officers complained in unclassified after-action reports.

“Maintaining hand washing stations was an issue that was never resolved,” according to one undated sanitation assessment of early Operation Enduring Freedom (Afghanistan) deployments, written by Capt. Jason Squitier of the U.S. Army Center for Health Promotion and Preventive Medicine (CHPPM; now the Army’s Public Health Command).

July 27, 2010 Posted by | Afghanistan, Civilian Contractors, Contractor Casualties, Iraq, Safety and Security Issues | , , , | 1 Comment