title: Outbreak of sandfly fever in central Iraq, September 2007.
abstract: An outbreak of nonspecific febrile illnesses occurred among U.S. Army troops in September 2007 at a remote, newly established, rural-situated patrol base, south of Baghdad, Iraq. Soldiers displayed an acute flu-like syndrome with symptoms of fever, headache, malaise, and myalgia. A total of 14 cases was identified and treated presumptively as query fever. Subsequent convalescent serum specimens confirmed 13 (92.9%) positive for sandfly Sicilian virus and 3 (21.4%) positive for Coxiella burnetii, with two positive for both. One sandfly Sicilian virus case tested positive for Brucella spp. This outbreak emphasizes the potential for multiple simultaneous disease exposures to endemic diseases in nonindigenous military personnel at remote military locations in Iraq. Recommendations include increased theater disease surveillance, medical training, and vector control.
authors.affiliation: Division Preventive Medicine Officer, Third Infantry Division, Fort Stewart, GA 31314, USA.
authors.forename: Shannon B
authors.initials: SB
authors.lastname: Ellis
authors.forename: George
authors.initials: G
authors.lastname: Appenzeller
authors.forename: Heechoon
authors.initials: H
authors.lastname: Lee
authors.forename: Keri
authors.initials: K
authors.lastname: Mullen
authors.forename: Ricardo
authors.initials: R
authors.lastname: Swenness
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pimentel
authors.forename: Emad
authors.initials: E
authors.lastname: Mohareb
authors.forename: Christopher
authors.initials: C
authors.lastname: Warner
mesh_terms: D000208:Acute Disease; D000328:Adult; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D054542:Iraq War, 2003-2011; D008297:Male; D008887:Military Medicine / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000706:statistics & numerical data*; D010217:Phlebotomus Fever / Q000453:epidemiology*; D011159:Population Surveillance; D011778:Q Fever / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology