Medical Surveillance Monthly Report (MSMR). Volume 6, Number 2, February 2000

• Main Authors: DeFraite, Robert F., Rubertone, Mark V., Brundage, John F., Kohlhase, Kimmie F., Smith, Yvette E.
• Other Authors: ARMED FORCES HEALTH SURVEILLANCE CENTER SILVER SPRING MD
• Format: Text
• Language: English
• Published: 2000
• Subjects: Anatomy and Physiology; Medicine and Medical Research; *MALARIA; *ACUTE RESPIRATORY DISEASE VIRUS; *HEADACHES; *DEHYDRATION; *PREVENTIVE MEDICINE; *HYDRATION; *SIGNS AND SYMPTOMS; ACTIVE DUTY; HOSPITALS; OUTPATIENT CLINICS; FEVERS; ANTIMALARIALS; ORAL INTAKE; HONDURAS; MEDICINE; CHEMISTRY; TEAMS(PERSONNEL); HEALTH; ARMY PERSONNEL; EMERGENCIES; TEST AND EVALUATION; REPRINTS; Fort McPherson; The Soldier
• Online Access: http://www.dtic.mil/docs/citations/ADA497075; http://oai.dtic.mil/oai/oai?&verb=getRecord&metadataPrefix=html&identifier=ADA497075

In October 1999, a team of seven soldiers and civilians traveled to Honduras to conduct an inspection mission. All team members were experienced travelers and all had been to Central or South America previously. The team did not seek medical advice prior to its departure. This report describes an outbreak of malaria among the inspection team's members approximately four to six weeks after their return to the United States. Case 1: On 11 November 1999, a 49-year-old male soldier experienced fever, chills, and headache. Four weeks prior he had been the inspection team's leader during their 1-week mission in Honduras. He treated himself with Motrin, oral hydration, and rest. His symptoms resolved by the following morning but recurred that night. On the third day of his illness after another symptomatic episode, he presented to a civilian urgent care center. He reported his recent travel to Honduras and asked if he might have malaria. He was diagnosed with "the flu" and released. On the sixth day of recurrent episodes of progressively severe headaches, fevers to 104 F., and chills, he presented to the Lawrence Joel Army Health Clinic (LJAHC) at Fort McPherson, Georgia. His temperature was 103.7 F. oral and he had a positive finding on a tilt test. He reported no uses of antimalarial drugs until his third day in Honduras. At that time, he received doxycycline for chemoprophylaxis, which he took once a day for approximately one week. At the LJAHC, the soldier was presumptively diagnosed with malaria and dehydration. He was given 2 liters of lactated Ringers solution and transported to a civilian hospital where he received another 3 liters of fluids. When his fever had subsided and after a single negative blood smear, he was told that he did not have malaria and was discharged from the emergency room. Pub. in Medical Surveillance Monthly Report (MSMR), v6 n2, p1-16, February 2000. Analysis by Jonathan R. Greifer and Lawrence Joel.