- The Washington Times - Monday, September 8, 2003

A dozen Marines who participated in peacekeeping in Liberia last month have been diagnosed with malaria, while another 21 military personnel from their unit are exhibiting symptoms for the mosquito-borne disease, military officials said yesterday.

Of the 33 — 32 Marines and a Navy hospital corpsman — two were sent to a military hospital in Germany and the other 31 flown to the National Naval Medical Center in Bethesda. All are on antibiotics that kill the parasite, Plasmodium falciparum.

“They will be cured of malaria,” said Navy Capt. Gregory Martin, a physician specializing in infectious diseases at Bethesda.

All 33 took, as required, an antimalaria medication, Capt. Martin said. All are members of the three-ship 26th Marine Expeditionary Unit that sailed off the coast of Liberia.

Capt. Martin said three Marines had “complicated” malaria — a high blood count of the parasite. They were admitted to the intensive-care unit, put on respirators and given two drugs intravenously, Quinidine and Doxycycline. Doctors treated the other patients with an oral medication, Malarone, as well as Doxycycline.

Of the three ICU patients, one improved enough to go to a regular ward. One of the others had his respirator removed after his condition improved.

“A lot of pizzas were ordered today by a lot of Marines who had been deployed for six months and now have hospital privileges,” Capt. Martin said.

Liberia is a hotbed of diseases, including malaria. “This is kind of the heart of darkness for infectious diseases,” Capt. Martin said.

Marines are required to take the antimalaria drug Mefloquine several weeks before deployment, during the mission and several weeks afterward. Once inserted into a human by a mosquito, the parasites reside in the liver before entering the victim’s red blood cells, at which point the Mefloquine attacks and kills them.

“We know everybody took their medication,” Capt. Martin said. “We don’t know if somebody missed a dose here or there. Probably so.” He said it is “highly unusual” to see the African parasites resistant to Mefloquine.

Capt. Martin described an Army-Navy team effort. The team consulted with doctors at sea while blood tests were done back in the United States to determine which of four malaria parasites had infected the Marines and sailor.

The 33 developed symptoms and were treated by doctors on the lead ship in their unit, the amphibious assault ship USS Iwo Jima.

Capt. Martin and his team stayed in contact with the ship, while the Army Medical Research Institute of Infectious Diseases at Fort Detrick, Md., determined the group did in fact have malaria, not some other disease.

“The patients were started on therapy aboard the ship and then put on medevac flights,” Capt. Martin said.

In addition to Mefloquine, the Marines were supposed to soak their uniforms in Permethrin, an insect repellant, and also carry additional bug repellents.

The Centers for Disease Control and Prevention says this about malaria:

“Symptoms of malaria include fever and flulike illness, including shaking, chills, headache, muscle aches and tiredness. Nausea, vomiting and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma and death.”

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