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Monday, July 28

U.S. probing pneumonia incidents among Middle East troops

By Eric Eckert | Springfield (Mo.) News-Leader

The U.S. government is investigating whether the death of a Missouri National Guardsman is related to 11 other incidents of severe pneumonia among soldiers stationed in the Middle East.

The U.S. Army Surgeon General's Office confirmed Friday two teams of epidemiology experts will investigate the 12 cases, two of which were fatal. National Guard Spc. Joshua Neusche, 20, of Montreal, Mo., was one of the two troops who died.

Deploying such teams is rare, said Col. Robert DeFraites, the surgeon general's senior preventative-medicine physician. ``This only happens one or two times every year.''

A two-person team has already been sent to the Landstuhl Regional Medical Center in Germany, where Neusche was treated before his death on July 12. Another six-person team is gearing up to fly to undisclosed areas of Iraq, where other soldiers began suffering from the illness.

The teams will study everything from the soldiers' medical records and tissue samples to soil, water and air samples, DeFraites said.

``Nothing's going to be ruled out,'' DeFraites said. ``When you go into one of these things you keep an open mind. ... There's enough concern about these two fatal cases (occurring) in such a short period of time'' to warrant the investigation.

The colonel said they've not yet been able to identify a specific bacteria or virus that could have caused such severe cases of pneumonia, but added 17 soldiers have died from acute respiratory distress syndrome in the past five years.

``It's not entirely unheard of for this to happen,'' DeFraites said. It is uncommon for pneumonia to cause a breakdown in organs other than the lungs, he said.

Neusche's parents said they were told their son's kidneys, liver and muscles began to deteriorate after contracting the illness.

``The problem with Josh's death was they didn't know what they were fighting,'' the soldier's father, Mark Neusche, said Friday. ``The doctor said (Josh) got into some type of toxin that began degenerating his muscles.''Without releasing specific numbers, DeFraites said there has been a noticeable increase in pneumonia cases among soldiers since the war in Iraq began.

Under normal circumstances, the colonel said, they expect to see 750 cases worldwide each year among troops.

Considering the number of troops in Iraq, DeFraites said the incidents of pneumonia are exceeding military expectations - 10-20 cases among deployed soldiers each month. Most of the patients have served in Kuwait and Iraq.

Since March 1, the 12 soldiers serving overseas in the Central Command's Area of Responsibility have fallen ill with pneumonia and had to be placed on respirators, the doctor said. Two suffered from a serious form of the illness called pneumococcus pneumonia, but lived.

Many of those soldiers have recovered and are back to work, but questions still linger as to what actually killed Neusche and another unnamed soldier, who died June 17.

^Searching for answers

Mark and Cynthia Neusche said they will not accept ``pneumonia'' or ``complications from pneumonia'' as reason for their son's death.

``There has to be more of an explanation than that,'' his mother said. ``Josh was never sick. He was healthy. He ran cross country and track.''

The Neusches said Josh - a heavy-equipment operator with the National Guard's 203rd Engineer Battalion - fell ill on June 30 after returning to his camp in Baghdad. He had just completed a mission which started four days earlier. Fellow soldiers found him unresponsive in his tent.

``Before he went to sleep, he told his friend he was tired and had a sore throat,'' Cynthia Neusche said.

Neusche's parents learned of their son's condition on July 2 and flew to Landstuhl to be with him one day before he died. Doctors there told the couple their son's organs had stopped functioning and he'd have to be transferred to a hospital in Hamburg and placed on dialysis. The soldier was dead by the time he arrived in Hamburg.

Physicians suspected unidentified toxins, Mark Neusche said, and he wants to know more about those substances. He and his wife are scheduled to speak with a medical examiner and a representative with the surgeon general's office Monday at Fort Leonard Wood.

``We're not against the military on this,'' Cynthia Neusche said. ``Josh would just want us to find out what killed him.''

^Toxic exposure

DeFraites said preliminary tests show the illness is not passed from person to person and is not related to severe acute respiratory syndrome, or SARS.

Aside from bacteria and viruses, he said, pneumonia can also be brought on by fungus, parasites and non-infectious causes such as exposure to metal dust.

``We don't think depleted uranium has anything to do with it,'' the colonel said, referring to the element some contend led to soldier illness during the first Gulf War. ``There's nothing to suggest depleted uranium would cause pneumonia in the soldiers we've seen.''

DeFraites said the 12 soldiers' vaccination records will be studied as well as their personal habits.

``No vaccines cause pneumonia as a side effect,'' he said. ``...You look for clues. Where were they? What are their ages? ... There's probably more to be gained by looking at their environment, blood, lab findings and personal habits.''

Infectious agents such as anthrax and smallpox will also be investigated, the doctor said.

Mark Neusche believes his son may have come in contact with some kind of toxin while digging in the Iraqi sand.

``We know there are chemical weapons over there,'' Mark Neusche said. ``Maybe something was leaked into the sand.''

^Keeping soldiers safe

Regarding deployment of the epidemiology teams - a relatively rare occurrence - DeFraites said units were sent last summer to Fort Bragg in North Carolina to investigate a series of murders and to Fort Leonard Wood when the post experienced a meningitis outbreak in early 2002.

The Iraq team will augment medical military personnel already in that country. It includes an epidemiologist, who will study the patterns of disease and health in the targeted population; an infectious-disease specialist, who will diagnose and prescribe treatment for infections; a microbiologist and laboratory technicians.

The team will stay in Iraq for about a month, DeFraites said.

Stephen Robinson, executive director of the National Gulf War Resource Center - a veterans advocacy group - said he has been watching this trend of strange illnesses closely. He said he's encouraged by the military's latest investigative actions.

``We serve veterans of the last Gulf War, many who have had exposures to elements that made them ill,'' Robinson said.

``Our interest in this instance is to make sure we hear the truth and we don't let events like this get buried and never resolved. We're out there fighting for these guys who are fighting for us.''

In his last letter to his parents, Josh Neusche wrote: ``I have millions of stories to tell and I want to tell you in person.''

Mark Neusche said he hopes the investigation will provide safety for those soldiers remaining in Iraq so they can live to tell their stories.

``If there's anything we can do to keep those other soldiers from dying, we'll do it,'' he said. ``Maybe they'll find something and be able to do something about it.''