American Soldiers Overseas: The Global Military Presence (Perspectives on the Twentieth Century)

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Over the past 60 years, the U. This is the aspect of military service that the majority of soldiers know and remember.

Introduction

Interaction between U. This book looks at the history and impact of American military communities overseas. It discusses how U. Through case studies of communities around the world, Baker shows that the U. In not a few cases, the U. On the other hand, many host nations have successfully circumscribed the activities of military communities, rendering their potentially disruptive presence almost invisible. We will send you an SMS containing a verification code.

Please double check your mobile number and click on "Send Verification Code". Enter the code below and hit Verify. Free Shipping All orders of Cash on Delivery Pay for your order in cash at the moment the shipment is delivered to your doorstep. Log In. Don't have an account? Sign Up. During operations in Afghanistan and Iraq, it is estimated that at least US military personnel have contracted leishmaniasis [ 36 ], an incidence higher than that seen in US military personnel in World War II [ 34 ]. British, Dutch and German forces have also experienced leishmania infections while deployed to Afghanistan [ 15 ].

This implies that military personnel could serve as a reservoir to expand the geographic range of Old World types to the New World if endemic sand flies received the parasite from an infected individual. Sand flies are also competent vectors for an arboviral infection caused by serotypes of the Phlebovirus. This infection, often called sand fly fever or pappataci, is considered a disease of military importance, affecting military personnel deployed to the Middle East and the Mediterranean.

During World War II, sand fly fever was of serious concern to allied forces, with over 19, cases reported. Outbreaks have been reported in allied forces deployed to Afghanistan, although at numbers far fewer than for leishmaniasis [ 15 ]. Of British military personnel deployed to Afghanistan, only 4.

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However, local populations show high rates of seroconversion, indicating the risk to military personnel operating in these areas, and the subsequent risk of importation to other countries remains high [ 15 ]. In the context of this discussion, infectious diseases are those that are spread by means other than vectors. These can include emerging infectious diseases, which are those that are entirely new to a population or geographic region or that have been re-introduced.

The conditions that favor this emergence are often encountered during military conflict, increasing the risk of the disease not only to the civilian populace, but to military personnel mobilized to these areas.


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The emergence of these infectious diseases can often be a two-way street, meaning military personnel may bring diseases with them or local diseases may be transported by military personnel to their home countries or regions. For example, Lassa fever, an often-fatal viral disease, was imported to Germany from Sierra Leone in while a case was imported to the US from Liberia in Additionally, cases were imported to the Netherlands in and the United Kingdom in by military personnel returning from peace keeping missions.

In both countries, war had displaced large numbers of people with aid workers and military personnel moving in and out on a regular basis [ 38 ]. Influenza remains a disease of serious concern for military personnel. As militaries from various countries are mobilized to more and more places, the risks of an influenza pandemic increase.

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Even with higher vaccination rates, military personnel show high rates of infection and seroconversion. For example, in , Even with this high vaccination rate, crew members contracted the flu. The source of the outbreak was a single sailor who had vacationed in North Carolina prior to the ship sailing [ 39 ]. Even with high vaccination rates, the high rate of infection occurred because of the new variant of the virus which was not included in the vaccine. This underscores the capability of highly mobile military personnel to serve as conduits for a rapid spread of novel diseases.

This potential for rapid expansion and emergence of novel strains was apparent in when a Private David Lewis died of influenza while training at Fort Dix, New Jersey. Ultimately, an epidemic did not occur, however it highlighted the potential for a new global influenza pandemic [ 40 ]. Other respiratory diseases shown to be capable of mobilization and transmission by military personnel include pneumonia, pharyngitis and acute rheumatic fever, pertussis and tuberculosis.

Of grave concern is the appearance of bacterial resistant strains of the causative agents for these diseases.

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Many of these strains are not endemic to the country of origin for the military personnel. However, multi-drug resistant strains reported in civilian populations globally have caused outbreaks among US military personnel. Increases in the prevalence of resistant Streptococcus pyogenes have also been noted in US military personnel, even though these strains typically only occur in Europe and Japan, both regions with an active US military presence [ 41 ].

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These strains are rare in US civilian populations but may be introduced by military personnel if not actively monitored and controlled. In , Fort Jackson, South Carolina experienced an outbreak of adenovirus type-4 among its basic trainees. Because graduating basic trainees typically move directly from basic training to their advanced schools at other installations, they may serve as a conduit for disease expansion. One such graduate from Ft. Jackson was shipped to Fort Gordon, Georgia.

Gordon, which then experienced its own installation wide outbreak [ 42 ]. This example highlights the ability of military personnel to transfer infectious diseases from location to location and introduce it to the local population. Alternatively, French soldiers typically do not receive vaccinations against Bordella pertussis as an adult. While deployed in support of International Security Assistance Forces in Afghanistan in and , French soldiers were exposed to the pertussis bacteria.

Because of its public health significance, tuberculosis remains a global disease of concern as multi-drug resistant strains have developed in many parts of the world [ 44 ]. Military activities, due to their cramped living and operating conditions, provide a prime habitat for TB outbreaks to occur. Additionally, because military personnel, especially naval personnel, are often exposed to novel or resistant strains while in contact with the resident population where they embark, they are at risk for contracting and spreading TB.

In , the seroconversion rate for the crew of the USS Saipan was Because of these declining seroconversion rates, it was thought that adequate control measures had been developed, mitigating the risk of TB on ships. Of the approximately crew members on board, 21 members developed active TB and were positive for the Mantoux tuberculin skin test TST. All were thought to be new cases [ 45 ]. During this outbreak, a sailor born in the Republic of the Philippines, who was diagnosed with latent tuberculosis infection LTBI , converted to active TB.

Of the approximately personnel on the ship, had a new TST result, most likely from the recent transmission of tuberculosis from the index case [ 46 ]. Additionally, over civilians were allowed on the ship as it returned to its home port in San Diego, California. Of these, only one exhibited a new positive result. Of more importance, the Navy was unable to locate 33 sailors who may have been exposed due to separation from the Navy. In this instance, the ultimate source of the outbreak was a foreign-born sailor who converted to active TB, meaning the source of the bacteria was not the US, although US personnel potentially brought the strain back to the US.

While respiratory diseases are of major concern, diseases of the gut and intestines may occur at a much greater incidence. Diseases such as norovirus, salmonella, E. Historically, diseases such as cholera, dysentery and typhoid, caused by Salmonella enterica , have caused serious disease morbidity and mortality for military personnel, often by transmission from the local environment to incoming military personnel.

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However, these diseases have also moved among these same personnel. For example, during the Spanish-American War of , typhoid affected more than 24, US military personnel training at camps in preparation for mobilization. This outbreak was used by MAJ Walter Reed to determine the origin of typhoid in the camps and the development of controls to reduce its impact on military operations [ 48 ]. Many of the causative agents, especially bacterial agents, are showing resistance to antimicrobial therapy [ 49 ].

This resistivity varies geographically, as does the primary causative agent. However, in Thailand, the primary agent is Campylobacter species. Of note is the resistance of this particular strain to quinolones and other antibiotics in Thailand. Because resistance is high, relapse is also high [ 49 ].

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One potential outcome of this resistance and relapse is the introduction of this novel strain into other parts of the world as deployed personnel return to their country of origin. This has the potential to change the geographic distribution of this resistant strain of Campylobacter from regional to global.

eylabs.net/editor/221/zucam-software-de-control.php Other bacteria responsible for diarrhea have also shown resistance in deployed military personnel. During Operation Desert Storm, US military forces suffered from high rates of gastrointestinal infections. Other diseases, while not specifically resistant, have shown a propensity for expansion of its geographic distribution through military operations.

Cholera was historically contained to the Indian subcontinent but was brought to other areas of the globe through shipping and trade, including the slave trade. However, the first cholera pandemic occurred from to , caused by the movement of British troops and camp followers in the Indian subcontinent and abroad. A similar pattern occurred during the Crimean War [ 51 ]. Asiatic cholera was first introduced to the US by immigrants arriving at seaports. While rare up until the mids, cholera rapidly expanded in the US, partially by the movement of troops westward.

This westward expansion of military forces, and subsequent expansion of cholera, resulted in outbreaks among civilian populations who would not otherwise have been exposed [ 52 ]. More recently, humanitarian military operations resulted in the introduction of cholera to an area where it had not been endemic. In , a catastrophic earthquake struck Haiti, effectively destroying its infrastructure.