Smoking Cited in Iraq Pneumonia Cases

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Smoking Cited in Iraq Pneumonia Cases

Tue Sep 9, 7:09 PM ET Add U.S. National - AP to My

 

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By MATT KELLEY, Associated Press Writer

 

WASHINGTON - Most of the soldiers in and around Iraq (news - web sites) with

unexplained, severe pneumonia had taken up smoking shortly before falling

ill, military medical authorities said Tuesday.

 

The military is investigating 19 cases of severe pneumonia since March,

including two fatalities. Four of those cases were linked to bacterial

infections. Of the remaining 15, 10 patients, including the two who died,

had elevated levels of a certain type of white blood cells.

 

 

Nine of the 10 reported they had started smoking recently, said Col. Bob

DeFraites, a top Army medical officer. It's unclear whether smoking caused

or contributed to the pneumonia, but since tobacco smoke damages lungs, it's

a chief suspect, DeFraites said.

 

 

" It may be a combination of the desert deployment with heat and dust and

everything else in conjunction with the smoking, " DeFraites told reporters

in a telephone conference call. " It's not a coincidence, the association

with smoking. ... It's a known irritant for lungs and a known risk factor

for pneumonia in general. It may be sensitizing the lungs for the

pneumonia. "

 

 

DeFraites and other military officials said the military has not seen an

unusual number of pneumonia cases but was investigating the 19 illnesses

because they were so severe, requiring the patients to be put on ventilators

to help them breathe. All 17 survivors have fully recovered and are out of

the hospital, DeFraites said.

 

 

Army Sgt. Michael L. Tosto, 24, a tank driver from Apex, N.C., died June 17

from pneumonia that developed rapidly and killed him before he was airlifted

from Baghdad to Germany. Spc. Joshua M. Neusche, 20, of Montreal, Mo., died

July 12 in Germany after falling ill in Iraq.

 

 

Of the 19 affected troops, 13 got sick in Iraq, three in Kuwait and one each

in Qatar, Uzbekistan and Djibouti, DeFraites said. The 18 men and one woman

included 17 Army soldiers, one Navy sailor and one Marine.

 

 

The four soldiers with suspected infections included two with pneumococcal

infections, one with a disease known as " Q fever " and one with a bacterium

called acinetobacter baumannii, DeFraites said. All three bacteria are

common causes of pneumonia.

 

 

It's not surprising that no clear clues to the cause have been found in five

of the pneumonia cases, since the same can be said for many cases in the

civilian health care system, DeFraites said.

 

 

" I wouldn't be a bit surprised if we weren't able to come down with a

definite cause and effect relationship for each of these cases, " DeFraites

said. " I hope we can, but I wouldn't be surprised if we ran a bit short. "

 

 

Military authorities have ruled out some causes. There's no evidence of the

SARS (news - web sites) virus or parasitic infections, for example. There's

also no evidence indicating that vaccinations against smallpox or anthrax

were the cause, said Col. John Grabenstein, deputy director of the military

vaccine office.

 

 

One of the most significant findings is that 10 of the sickened troops had

high levels of white blood cells called eosinophils. Those immune system

cells are associated with a wide range of conditions, including allergies

and parasitic infections.

 

 

Levels of eosinophils in the 10 soldiers ranged from three times to 11 times

higher than normal, DeFraites said.

 

 

In the patients with pneumonia, doctors believe that something — possibly

the cigarette smoke — irritated the lung cells, causing the eosinophils to

come and cause inflammation. That caused pneumonia, the medical name for

fluid filling up the lungs.