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         Acinetobacter Baumannii:

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The Iraqibacter
American Legion Magazine 
March 2008
 
The Invisible Enemy in Iraq
Wired News - January 22nd, 2007

Walter Reed harrassment of Merlin Clark, bill collection

Iraq still hostile for civilians
 
Drug-resistant 'superbug' traced to war in Iraq
 
AFEB meeting Sept 2004
 
CDC MWMR Report
 
Tricare Conference 2005 
   A Baumannii report 
 
Presentation of LCDR Kyle Peterson on A. Baumannii 
 
VA OIG death Florida 
 
The Iraq Infection 
 
Military Chase Mystery Infection  
 
CDC August 2005 report
 
Focus On Acinetobacter Surveillance in 2005 
 
Iraq Sampling Maps
 
The Walter Reed Army Hospital inspection of Rep. Dennis Moore the behind scenes story of the effort to hide the outbreak by Department of Defense

IOM Gulf War Infectious Disease Report

Leishmaniasis:

Leishmaniasis in Iraq from the Gulf War to OIF 
 
Walter Reed treating 500 cases of leishmaniasis from Iraq
 
Blood Donor Deferral for troops returning from Iraq
 

MRSA:

Personal MRSA Stories | MRSA Resources, the boils of Iraq

Blastocystis Hominis:

Chronic Multisymptom Illness Affecting Air Force Veterans of the Gulf War Blastocystis hominis was found in stool specimens 

http://www.bhomcenter.org

 
Links:
Gulflink.org
 
Technical Advisor / Advocate - Kirt Love working on this issue since 2003  
 
Website started November 2004
 

 

 

Photo source: LCDR Kyle Petersen NEHC lecture 2004

 

 
The Victims remain silent
March 30th, 2008
Congress as well as Veteran Affairs is not under any special pressure to deal with MDR Acinetobacter Baumannii as there is no public outcry to deal with it. 
 
People who survive the infection go on with there lives with no fanfare and reason to speak up.  Even TV reporter Kimberly Dozier had a bad run in with the infection after recovering from a close call but doesnt seem to want to talk much about the infection itself. 
 
What is the stigma of this infection that keeps people from wanting to talk about this. Also, when severe cases do want to talk about the media backs away. As did the Los Angeles Times to a unique case in California. 
 
This hit home for me when my own grandmother contracted this infection. She was about to loose her leg and gave up the will to live. My own family kept this fact from me until after the funeral only because they knew I was so out spoken on the infection. Like there is some personal shame attached to this infection.
If the victims of this infection are not willing to talk then this is ideal for the CDC, DOD, and VA to pretty much ignore this as a common infection not needing special protocols to deal with. That past efforts have done just fine in dealing with this drug resistant infection though it has now spread nation wide to just about every hospital. 
 
The stigma of this drug resistant infection will allow it to go mostly unreported until it attains the death toll of the 19,000 a year MRSA fiasco in 2005. 
 
Hospitals can still hide behind closed doors not telling you there wards are positive for MDR AB. That once you contract it your pretty much on your own if the lab cultures even identify it. That it is a gruesome death for those beaten down by other complications, and often go into renal kidney failure just before the worst of it kicks in. 
 
Those that contract this unique bug arent even told what genome type it is because there is not effort to isolate that. Oh, it didn't come from Iraq - its eeerrr - just some common Acinetobacter. Yet, the CDC, DOD, and VA know this MDR Acinetobacter is a unique strain. 
 
Well, one thing is for sure. It will continue to spread unchecked and uncontrolled until one fine day you end up in a ER and then its your turn to see if you survive it. Then when someone who is rich, in Congress, or just famous dies of this then suddenly it will be important enough to confront. Until then this is a infection of the poor that will run amuck until the death toll rises enough that people will tire of this. 
 
You would think this was a sexually transmitted disease the way people shrug away from it. Yet, ignorance is not bliss when it comes your turn.
 

 
 
Reporting Infections as you would diseases
October 18 2007  
 
The greatest obstacle to date in battling the spread of the Iraqi genotype Acinetobacter Baumannii is that there is no mandatory reporting of secondary infections from hospitals as you would with primary diseases. So without reliable reporting of actual infections then there is no reliable reporting data. 
 
Couple this with the Privacy Act of 1974 and the unwillingness of the military to divulge genomic information to civilian hospitals of this strain - well, you will have more unnecessary deaths. Worse yet the mutation of the Acinetobacter has now grown resistant to Impenium which now makes this superbug impervious to delayed treatment. Time is a critical factor in identification, and PCR/ESI-MS genotyping can identify from 2 to 4 hours what culturing cant do in 2 to 3 days. 
 
Everyday that people delay dealing with this makes this strain worse. Soon it will out flank MRSA in its severity as well as gruesomeness. Dying of this infection is a violent, and disfiguring event bordering on nothing seen before. 
 
Which means we need alternatives when antibiotics are no longer a solution. Its time to turn to Genomics to cripple this bacteria from its ability to replicate. Which would not surprise me that USAMRIID is probably already working on. 
 
Its time to go to Capital Hill and demand new regulations in dealing with Drug resistant infections. The medical industry is unable to manage itself and more will die needlessly until we beef up how we address drug resistant infections. Mandatory reporting, and tracking as well as faster diagnostics for intensive care units. To remove permeable surfaces from ICU's and privacy curtains. To promote strict hygiene standards as well as enforce tracking of healthy carriers, that meaning the colonized carriers versus the blood borne infected.  
 
Darker days wait ahead and it doesn't look like the CDC or DOD Health Affairs is taking REAL preventive measures to control this. 

 
The Battle over multiple drug resistant microbes: MRSA, Acinetobacter, C. Difficile, etc. "Irresponsible medicine"  

Early this year an outbreak of MDR Acinetobacter Baumannii swept over Arizona, 236 cases in just two months. It was reported by the state disease monitoring systems, but ignored on the national level.

Now dubbed "Supergerms", they spread without warning and seemingly without official notices since they are infections instead of diseases. The government is taking advantage of this technicality. 

An ICU nurse at Bethesda Naval in Washington DC leaves work feeling under the weather.  Within 24 hours she is in a community hospital, intubated, with Acinetobacter Baumannii.  It was determined that the bacteria were acquired from a patient at work.  She succumbed to the infection quickly and with no fan fare.  The story went silent. 

At Brook Army Medical Center in Texas a soldier fights for his life, as his combat wounds are made worse by infections the doctors can't seem to handle. The only reason his story is known is that his civilian girl friend speaks up for him.  

This outbreak that is spreading nation wide is largely due to the war in Iraq, and because of a legal technicality in reporting, the military and CDC will not discuss it publicly. 

More people come forward, bit by bit, telling stories of how the hospital played down their infection. The one person who could have done something about it, "Rep. Dennis Moore" has walked away from the issue deciding it wasn't worth getting into even after what he had seen on a visit to Walter Reed. 

This silent killer is continuing to spread, and to an indifferent country until it's YOUR turn.   These bacteria will grow out of control in the near future as it spreads through neglect. 

Every VAMC in this country that had a soldier from Iraq in it is contaminated with MDR AB, as simple as a doorknob or privacy curtain to pass it on.  Doctors often work at VA hospitals and community hospitals also. 

 As long as it doesn't have to be reported it will not be. 

You're on your own America, until you say enough is enough.

Focus On Acinetobacter Surveillance 

Comments posted March 4th 2006

By September 2004 the Department of Defense had collected 934 positive Acinetobacter Baumannii cultures from 432 persons. This reported from the Navy Environmental Health Center in Bethesda.

On September 21st, 2004 the Armed Forces Epidemiology Board met. They talked about Acinetobacter Baumannii with 350 colonized soldiers as well as 200 infections.

Yet, the CDC / DOD only announced 102 infection cases in the November 19th, 2004 MWMR report:

85 of the cases were OIF/OEF

Landstuhl Regional Medical Center   33      

Walter Reed Army Medical Center   45  

U.S. Navy hospital ship Comfort       11 

National Naval Medical Center           8  

Brooke Army Medical Center            5 

By August 2005 Forbes reported that at least 280 cases of infection had been reported.  The DOD stodgily stood by public statements of 112 infections. 

The argument from CHPPM / MEDCOM is that colonized soldiers are a different story from infected soldiers.  A colonized soldier however is still a carrier. CHPPM is also trying to say since this is just an infection they don't have to report it like infectious disease. They are not cooperating to provide any updated statistics on it because of a directive at MEDCOM stating they do not want to expose military vulnerabilities publicly.

So its going to take a Congressional Inquiry to CHPPM in order to get a true idea of just how many cases of Acinetobacter Baumannii there are in the military. That and how many are carriers. Spreading this infection from one hospital to another in America. 

Here is one example:

A soldier dies in VA care at the James A. Haley Medical Center in Tampa Florida, in December 2004. He had extensive surgery in Iraq and was medivac'd to Landstuhl, Germany, Bethesda MD, and finally JHMC. This was head, chest, and abdomen trauma. After his death it was determined that he had tested positive twice for the Acinetobacter, which would have changed the clinical outcome if
they had treated for it. (Page 22 of IG report) 

What about the 7 cases at Tripler Army Medical Center in Hawaii? Why were Chief Warrant Officer 3 Claude Boushey Sr.'s case and others not discussed? That was July 2004.

In other cases, family members cannot get the medical records of their deceased soldiers. Many have died from non-combat injuries that the Pentagon is unwilling to disclose information about even to the parents.  These stall tactics keep anyone but the military from knowing how many died of complications that the Acinetobacter Baumannii contributed too.

More than likely OIF troops walking into any Veteran Affairs Medical Center are possible colonized cases that contaminate that facility.

This is a national threat to public health safety that the Department of Defense has taken a very lax position on. What the public doesn't know wont hurt them, which is certainly not true with a drug resistant bacteria that can be passed with as little as a handshake. 


Superbug hits Canadian soldiers injured in suicide bombing

Thu, 23 Feb 2006

Master Cpl. Paul Franklin of Halifax lost a leg, Cpl. Jeffrey Bailey from Edmonton had devastating head injuries, and Pte. William Salikin of Grand Forks, B.C., also suffered a head injury.
 
The three soldiers were first taken to a U.S. military hospital in Landstuhl, Germany. When they left a week later, all three men were infected with drug-resistant bacteria.
 
Medical specialists aren't certain whether most infections started in the battlefield or the hospital. 
"It's thought that they may have gotten it from going through the hospital in Landstuhl," said Lt.-Col. Henry Flaman, a Canadian military doctor in Edmonton.
 
Acinetobacter baumannii has become one of the most common sources of infections among American troops wounded in Iraq.
The bacteria are found in soil and water in Iraq. When the microbes enter traumatic wounds in the battlefield, the superbug can cause serious damage.

Forbes Magazine - August 2nd 2005
 
NEW YORK - Military doctors are fighting to contain an outbreak of a potentially deadly drug-resistant bacteria that apparently originated in the Iraqi soil. So far at least 280 people, mostly soldiers returning from the battlefield, have been infected, a number of whom contracted the illness while in U.S. military hospitals.
 
Most of the victims are relatively young troops who were injured by the land mines, mortars and suicide bombs that have permeated the Iraq conflict. No active-duty soldiers have died from the infections, but five extremely sick patients who were in the same hospitals as the injured soldiers have died after being infected with the bacteria, Acinetobacter baumannii.

Treating Injured U.S. Service Members, 2002--2004
From January 1, 2002 to August 31, 2004, military health officials identified 102 patients with blood cultures of Acinetobacter baumannii at military medical facilities treating service members injured in Afghanistan and the 
Iraq/Kuwait region. 
 
Most of the infections were reported from 
 
Landstuhl Regional Medical Center, Germany 
 
       33 patients: 32 OIF/OEF casualties, one non-OIF/OEF, and Walter Reed Army Medical Center (WRAMC), District of Columbia 
 
       45 patients: 29 OIF/OEF casualties, 16 non-OIF/OEF.  
 
The Acinetobacter Baumanii strain was isolated to the soil in Iraq, and enters through dirty battle field wounds or  serious infections ( Pneumonia ). The British Health  Protection Agency was the first to publicly identify this in  March 2003, and DOD waited till November 2004 to  recognize it after the CDC posted the findings of the 102 cases.
 
Cases of Cutaneous Leishmaniasis at Walter Reed Army Hospital also showed up with Acinetobacter Baumannii. One person from there wants to meet others who were there to share stories.