Military medicine
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Hamid Karzai International Airport is a NATO military base connected to the international airport in Kabul, Afghanistan. It is one of the larger NATO installations in Afghanistan, and with its location being one of the main hubs for international transit, the base has been at the frontline since the beginning of the COVID-19 pandemic. Hamid Karzai International Airport base commanders and medical staff have been at the forefront, continually developing policies and procedures to mitigate the pandemic in a deployed setting. ⋯ In a military population of mostly young and healthy individuals, the majority of COVID-positive patients will have fewer symptoms, and therefore, the aggressive screening of asymptomatic personnel is necessary. Outbreaks of COVID-19 in a military base could have a detrimental impact on missions but may be contained and controlled with quarantine, isolation, and aggressive contact tracing.
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As of early 2022, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic still represents a worldwide medical emergency situation. The ongoing vaccination programs can slow down the spread of the virus; however, from time to time, the newly emerging variants of concern and antivaccination movements carry the possibility for the disease to remain in our daily lives. After the appearance of SARS-CoV-2, there was scholarly debate whether the virus was of natural origin, or it emerged from a laboratory, some even thinking the agent's potential biological weapon properties suggest the latter scenario. Later, the bioweapon theory was dismissed by the majority of experts, but the question remains that despite its natural origin, how potent a biological weapon the SARS-CoV-2 virus can become over time. ⋯ Our results show that the virus can become a potent bioweapon candidate in the future, achieving a total score of 24 out of 36 on the original 12 criteria. The SARS-CoV-2 has already proven its pandemic generating potential and, despite worldwide efforts, still remains an imminent threat. In order to be prepared for the future possibility of the virus arising as a bioweapon, we must remain cautious and take the necessary countermeasures.
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Creating health alliances to build meaningful networks is critical to combating regional and global burdens of disease. These alliances work by uniting support for elimination efforts through cooperative engagement at the national and international levels. The reduction in malaria-related morbidity and mortality in Africa since 2001 is in part because of investments of international organizations and governments in national level malaria control and prevention-related programs and research. Investment in malaria reduction networks has contributed to this success by strengthening support to overcome the conditions that restrict or prevent change through local laboratory and epidemiological capacity building, thereby resulting in a decrease in burden of disease, increase in economic prosperity, and improvements in stability worldwide.The reformation of local military efforts to combat disease through incorporation into health security alliance networks by the provision of training and financial support is key to reinforcing this success at the national level. One such example of this is the U.S. Africa Command (USAFRICOM) established and partner nation (PN) led Africa Malaria Task Force (AMTF) program. USAFRICOM's mission for AMTF as a health security alliance was to develop sustainable African-led malaria diagnostic, vector surveillance and control capabilities, and to increase collaborations among AMTF military PNs by enabling national and international-level network capacity. ⋯ Findings indicate that the AMTF program symposia positively encouraged malaria prevention and control efforts in all three countries included in the evaluation. Conclusions suggest that learning about the different types of malaria prevention and control efforts underway in other countries helped to contextualize the burden of malaria-related morbidity and mortality not only within their respective countries, but also across the African continent. Participation in the AMTF Symposia and Key Leader Events helped military leadership clarify the purpose and intention of their military objectives related to systemic malaria prevention and control while purposefully contributing to national land international-level malaria reduction capacity.
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Case Reports
Case Report: Soldier With Latrodectism After Black Widow Spider Bite During a Field Training Exercise.
Latrodectism from black widow spider (BWS) bites is rare in the United States. Latrodectism is a severe systemic manifestation of the envenomation that includes severe abdominal pain mimicking acute surgical abdomen and, in rare cases, could lead to acute myocarditis and rhabdomyolysis. ⋯ Military service members often participate in field training exercises during warm weather in wooded areas littered with woodpiles and tree stumps; therefore, they are at an increased risk for bites by arachnids. We report the case of a 26-year-old active duty male soldier evacuated from field training with latrodectism and possible envenomation-induced myocarditis after a suspected BWS bite.
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An anesthesiology intern at Walter Reed National Military Medical Center uses poetry to describe the nuances related to an end-of-life discussion with a terminally ill patient. She was a new admission to the oncology service who had already come to grips with her impending death, but had not yet discovered its identity.