Southern Afghanistan faces a potential reemergence of vector-borne and zoonotic diseases endemic to the region, possibly posing public health threats to military personnel stationed in the area, according to researchers from the United Kingdom.
“Military personnel are at high risk of contracting vector-borne and zoonotic infections, particularly during overseas deployments, when they may be exposed to endemic or emerging infections not prevalent in their native countries,” they wrote.
In the study, the researchers surveilled 467 UK military personnel deployed to Helmand Province, Afghanistan, between 2008 and 2011. They took anonymous pre- and post-deployment serum samples to determine the prevalence of the following vector-borne or zoonotic infectious pathogens: Rickettsia spp., Coxiella burnetii, sandfly fever virus, hantavirus and Crimean-Congo hemorrhagic fever virus. During the post-deployment examination, participants also completed a brief questionnaire documenting flu-like symptoms and contact with livestock, wildlife and insect vectors.
The testing revealed a seroconversion rate of up to 3.1% for infection with Rickettsia spp., C. burnetii, sandfly fever virus or hantavirus. None of the military personnel showed seroconversion for infection with Crimean-Congo hemorrhagic fever virus. Notably, the majority of seroconversions were asymptomatic; for example, 93.5% of sandfly fever virus exposures and 92.6% of Rickettsia spp. exposures occurred in patients who reported no symptoms. The exception was hantavirus, for which almost 70% of the seroconversions were associated with reported symptoms.
According to the researchers, these findings support the need for continued surveillance of military personnel for exposure to or infection with these pathogens, which may go unreported.
“This study highlights and confirms the potential for vector-borne and zoonotic diseases that are endemic in southern Afghanistan to emerge or reemerge to pose substantial public health threats as the country rebuilds its public health infrastructure …” the researchers wrote. “Our findings of seroconversion for four of these pathogens among deployed UK troops reinforce the need for continued surveillance and continued education of health care providers so that, should military operations or environmental factors change in such a way that these modest incidence numbers increase, costly outbreaks can be avoided.”
The researchers also said the study results highlight “the need for rapid, field-capable, point-of-care diagnostics in regions or situations for which full laboratory diagnostic facilities are not practical or available.”
Disclosure: The researchers report no relevant financial disclosures.