On the battlefield, something as simple as the flu can spell disaster for soldiers, and they often face much more exotic pathogens. Most deployment-related illnesses arise while soldiers are still in the field, so one of a U.S. Army doctor's main goals is preventing troop illness.
Because soldiers often travel to remote areas, their immune systems aren't always equipped to handle the diseases they encounter. Illness and infectious disease can hinder or cancel military operations and mean sickness or even death for troops. In fact, illness accounts for more medical problems among soldiers than combat-related injuries [source: Murray and Horvath].
Army doctors are constantly working to improve prevention techniques, and they rely on many different approaches, ranging from drugs and vaccines to education and awareness. Here, we'll look at some of those techniques and learn more about how Army doctors work to keep troops healthy.
Unlike medications, vaccines don't attack infections directly. Instead, you're basically being injected with a partial version of the disease, which allows your immune system to build up a resistance. The trouble with severe illnesses is that symptoms can progress too quickly for you to build up the antibodies to fight them. Vaccines train your immune system so that if it encounters the disease again, you'll be ready to fight it off.
Army doctors use vaccines to prevent troops from contracting common -- and some less common -- illnesses. Some vaccines are more general, like measles, mumps, rubella and tetanus, but if troops are headed somewhere with the risk of infectious diseases less common at home, doctors will use vaccines that most of us don't have to worry about. For example, if troops are going to South America or Africa, Army doctors will vaccinate them against yellow fever.
Vaccines can be incredibly helpful in preventing illness. Doctors do as much research as they can on location-specific diseases so they can prepare themselves and the rest of the medical staff for preventing and treating anything the troops might run across.
Knowing as much as they can about where the troops are going is also important. Next, we'll see how doctors educate themselves.
When troops are going to be deployed, the Army doctors that accompany them do research on the location and the enemies they'll be facing to see what sorts of illness soldiers will be encountering in the field.
Many infectious diseases are location specific, so doctors prepare for preventing and treating those illnesses before the troops are deployed. They rely on information from agencies like the Centers for Disease Control and Prevention to get information about what to expect. Depending on where the troops are headed, how long they'll be there and what they'll be doing, Army doctors assess the risk of infectious disease and try to ensure that they have the medical staff and supplies on hand to address any issues that pop up.
Of course, educating the troops is also important! More on that next.
It's important that medical staff know what illnesses to expect, but educating troops in prevention techniques also goes a long way. Think about planning a trip to Mexico. Your doctor would warn you not to drink the water to avoid diarrhea and other water-borne illnesses.
Army doctors educate troops in the same way, alerting them to common illnesses and ways they can avoid getting sick. They also work on general health education issues, like safe sex and how to handle food properly. An STD or food-borne illness can hinder a soldier's ability just as much as an exotic disease.
Education can make a big difference, but there are some diseases that soldiers can't prevent with techniques like hand-washing and proper food preparation. When doctors can't vaccinate, they sometimes rely on preventive drug therapy instead. More on that on the next page.
Army doctors rely on preventive drug therapy, or Chemoprophylaxis, to combat some location-specific diseases. Chemoprophylaxis might sound a lot like vaccination, but while vaccines shore up your body's immune system using parts of the microbes that cause illness, Chemoprophylaxis is a drug treatment that prevents disease or infection.
Malaria prevention is a good example of Chemoprophylaxis at work. It's common in tropical and semitropical locations, and it's a serious illness that can even lead to death. The best way to treat malaria is to never contract it in the first place, so Army doctors administer the drug Doxycycline if troops are in high-risk areas. The Army just started using Doxycycline in 2009. Before that, Army doctors relied on Mefloquine or Lariam, which had much stronger side effects, including lung tissue inflammation, anxiety and depression.
Beyond physical health, soldiers often struggle with psychological problems. Let's look as some common issues that troops face and how Army doctors handle them.
Combat is a stressful situation, and mental illness among troops is common. Many soldiers struggle with issues like anxiety, depression, insomnia and post-traumatic stress disorder. Even before deployment, many soldiers struggle with anxiety and depression, so addressing mental health is an important issue for Army doctors.
Doctors use a combination of talk and drug therapy, both pre- and post-deployment, to try to help soldiers cope. Common medications include antidepressants like Paxil, antianxiety medications like Xanax and Klonopin, and antipsychotic medicines like Thorazine. Unfortunately, psychotropic drugs, which can alter brain function, are often overprescribed, and some say they're threatening soldiers' health and even causing deaths.
On top of keeping an eye out for infectious diseases and psychological problems, Army doctors need to make sure that troops are in good overall health. More on that next.
If you're in good general health, chances are your immune system is better equipped to fight off illness. Army doctors administer annual health exams to make sure that soldiers are up to date on vaccines and in good shape.
Annual checkups are great for prevention, but when troops are in the field, Army doctors are also keeping an eye on troop health to see if any illnesses pop up. These screenings are usually not as in-depth as the annual screenings and involve daily reports from personnel. Catching illness early not only makes it easier to treat the infected person, but it's also a warning sign for doctors who can take extra preventive measures to stop other soldiers from getting sick.
Next we'll look at biowarfare, a relatively recent concern for Army doctors, dating back to World War I.
It's critical that medical staff keep a diligent eye out for signs that soldiers are suffering from the effects of biological weapons, which use bacteria and viruses to infect troops with disease. They're especially dangerous because infection can sometimes spread from one infected soldier to another. Diseases like smallpox and pneumonic plague can cause massive damage to troops if doctors don't catch and treat them early. Even with treatment, soldiers could die from their effects.
Army doctors rely on reports from the Centers for Disease Control and Prevention and the Department of Defense to get a feel for what biological weapons they may be facing, if any. If there's a risk of a biological attack, they do what they can to prevent illness or at least limit its spread. It's critical in situations like this to find the outbreak's source, because early detection can save lives.
As we'll see next, life in the field is hard, and Army doctors work to treat and prevent pain so that soldiers can do their jobs.
Pain treatments can help injured troops or soldiers suffering from "deployment aches," the general aches and pains that come with heavy lifting in the field. Whether they're suffering from illness or injury, pain management is an important issue for military doctors. Managing pain can help reduce an injured person's stress levels and help him heal more quickly.
Just like in Civil War days, morphine is still the most popular pain treatment, but there are some new innovations in pain management that are much safer and less addictive. Doctors can now use treatments that actually block the nerves that are causing pain. They administer numbing medication, such as Novocain, directly to the nerve.
Of course, no doctor has treatments for every disease out there, and next we'll see how Army doctors are working on research to develop innovative drug treatments and vaccines for new, rare and serious infectious diseases.
Unfortunately, not all diseases that soldiers encounter in the field are treatable. Illnesses like Nipah virus don't have a cure, but doctors are making progress toward finding an antiviral drug to treat them. Nipah virus is a contagious disease in Southeast Asia that causes swelling in the brain as well as respiratory problems.
Diseases like these can incapacitate soldiers in the field, and both Army doctors and independent researchers are constantly working on developing new vaccines and treatments for medical issues that soldiers encounter. Army medical facilities like the Walter Reed Army Institute of Research and the U.S. Army Medical Research Institute of Infectious Diseases are dedicated to developing new vaccines and treatments to prevent troop illness.
Army doctors do their best through prevention, education, drug treatments and vaccinations to prevent troop illness, but few preventive medicine techniques are 100 percent effective. What are an Army doctor's priorities when troops do become ill? Find out next.
Despite preventive measures, sometimes troops still fall ill, and the treatments are usually very similar to civilian medicine. Troop illness can devastate a mission, so medics and Army physicians and nurses have to act quickly to treat illness and prevent it from spreading. Something as simple as diarrhea can undermine an entire mission if it spreads through a unit of soldiers.
In a combat situation, Army doctors often have to make tough calls about which patient needs immediate treatment, and technology can be a huge help in these situations. Paper medical records are cumbersome and often just plain impractical, especially for doctors working in the field. The U.S. Army's paperless system, Medical Communications for Combat Casualty Care (MC4), allows Army physicians to keep lifelong medical records for all service members, which helps them to prioritize and treat illness much more easily than in the past.
For links to more great articles, click to the next page.
Preventive medicine in the U.S. Army is similar to civilian medicine. Test your knowledge with the preventive medicine in the U.S. Army quiz.
- Brewin, Bob. "Military's drug policy threatens troops' health, doctors say." Nextgov. Jan. 18, 2011. (March 24, 2011)http://www.nextgov.com/nextgov/ng_20110118_8944.php
- CBC News Online. "Biological Warfare." Feb. 18, 2004. (March 25 2011)http://www.cbc.ca/news/background/bioweapons/
- Centers for Disease Control and Prevention. "Yellow Fever Fact Sheet." June 11, 2007. (March 24, 2011)http://www.cdc.gov/ncidod/dvbid/yellowfever/YF_FactSheet.html
- Department of the Army. "Preventive Medicine." October 19, 2009. (March 24, 2011)http://www.apd.Army.mil/pdffiles/p40_11.pdf
- Henry M. Jackson Foundation for the Advancement of Military Medicine. "2009 Annual Report: Infectious Disease." 2010. (March 24, 2011)http://www.hjf.org/annual-report-2009/infectious-disease.html
- Murray, Clinton K. and Lynn L. Horvath. "An Approach to Prevention of Infectious Diseases during Military Deployments." Oxford Journals: Clinical Infectious Diseases. Sept. 29, 2006. (March 24, 2011)http://cid.oxfordjournals.org/content/44/3/424.full
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- Robbins, Seth. "Military doctors developing new approach to treating pain." Stars and Stripes. June 1, 2010. (March 24, 2011)http://www.stripes.com/news/military-doctors-developing-new-approach-to-treating-pain-1.105121
- U.S. Army. "Redeployment Medical Guide for Missions in Support of Operation Iraqi Freedom." (March 24, 2011)http://docs.google.com/viewer?a=v&q=cache:mkQLHgwTRbsJ:www.pdhealth.mil/downloads/OIF_Redeployment_Medical_Trifold_Army_.pdf
- U.S. Army Medical Department. "Army Behavioral Health." (March 24, 2011)http://www.behavioralhealth.Army.mil/
- U.S. Army Medical Department. "Army Medicine." (March 24, 2011)http://www.Armymedicine.Army.mil/
- War Related Illness & Injury Study Center. "Information on Mefloquine (Lariam)." October 2009. (March 24, 2011)http://www.warrelatedillness.va.gov/docs/mefloquine-veterans.pdf
- World Health Organization. "Nipah virus." July 2009. (March 31, 2011)http://www.who.int/mediacentre/factsheets/fs262/en/