Seroconversion for infectious pathogens among UK military personnel deployed to Afghanistan, 2008-2011

Abstract

Military personnel are at high risk of contracting vector-borne and zoonotic infections, particularly during overseas deployments, when they may be exposed to endemic or emerging infections not prevalent in their native countries. We conducted seroprevalence testing of 467 UK military personnel deployed to Helmand Province, Afghanistan, during 2008-2011 and found that up to 3.1% showed seroconversion for infection with Rickettsia spp., Coxiella burnetii, sandfly fever virus, or hantavirus; none showed seroconversion for infection with Crimean-Congo hemorrhagic fever virus. Most seroconversions occurred in personnel who did not report illness, except for those with hantavirus (70% symptomatic). These results indicate that many exposures to infectious pathogens, and potentially infections resulting from those exposures, may go unreported. Our findings reinforce the need for continued surveillance of military personnel and for education of health care providers to help recognize and prevent illnesses and transmission of pathogens during and after overseas deployments.

Figure 1

Results of antibody testing for 4 infectious pathogens, by tour of duty, among 467 UK service personnel deployed to Helmand Province, Afghanistan, March 2008–October 2011. n values indicate number of volunteers tested from each tour of duty. Assays were run sequentially on samples from all persons tested; some sample sizes were insufficient for testing for all agents.

Figure 2

Percentages of UK service personnel who seroconverted to 1 of 5 infectious pathogens who reported feeling unwell or did not report illness during deployment to Helmand Province, Afghanistan, March 2008–October 2011. A total of 90 (19.3%) of 467 deployed service members reported feeling unwell during deployment. CCHFV, Crimean-Congo hemorrhagic fever virus; SFFV, sandfly fever virus.

Figure 3

Distribution of signs and symptoms among 90 UK service personnel who seroconverted to 1 of 4 infectious pathogens (sandfly fever virus, hantavirus, Coxiella burnetii, Rickettsia spp.) and who reported feeling ill during deployment to Helmand Province, Afghanistan, March 2008–October 2011.