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TropicalMed
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Military Medicine: An Everlasting War against Tropical and Infectious Diseases
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Military Medicine: An Everlasting War against Tropical and Infectious Diseases

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Travel Medicine".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 9995

Special Issue Editor

Dr. Olivier Aoun

E-Mail Website
Guest Editor
1st Armed Forces Medical Center, Fort de Vincennes, Cours des Maréchaux, 75614 Paris, CEDEX 12, France
Interests: military medicine; tropical medicine; travel medicine; clinical toxinology

Special Issue Information

Dear Colleagues,

For centuries, military medicine has always provided significant scientific contributions to tropical medicine and infectious diseases, Alphonse Laveran, Edmond and Etienne Sergent, Ronald Ross, and Alan Magill for malaria, Walter Reed and William Gorgas for yellow fever, William Leishman for leishmaniasis, Léon Lapeyssonnie for the African meningitis belt, Fabrice Simon for Chikungunya, and Eugène Jamot for African Trypanosomiasis, just to cite a few. Despite major advances in hygiene, sanitation, drugs, vaccines, and infection control, infectious diseases still represent approximately 40% of ailments in deployed troops, as these preventive measures can become neglected over time or disrupted during early or most intense stages of military operations. The emergence of novel microorganisms, new variants, antimicrobial resistance, insecticide resistance, climate change, reemerging infectious diseases, as well as the introduction of new microorganisms into new geographic areas due the exponential increase of travel do not make us foresee a substantial improvement in the near future. Moreover, conflicts are still erupting in tropical areas where deployed military healthcare providers are faced with major diagnostic and management difficulties in remote and resource-limited settings with reduced medical evacuation possibilities. In this context, thorough history-taking and clinical examination, as well as the use of rapid diagnostic tests, are critical. As a consequence, recent advances in molecular biology, such as point-of-care multiplex PCR, will surely improve the identification of causative microorganisms in diarrhea or undifferentiated febrile illnesses for instance. In order to facilitate medical support of deployed troops, updates in the epidemiology, prevention, and treatment of tropical and infectious diseases as well as simple management charts are mostly needed. I thus encourage my military colleagues to submit reviews, meta-analyses, and original research regarding the latest data on tropical medicine and infectious diseases.

Dr. Olivier Aoun
Guest Editor

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Keywords

  • military
  • malaria
  • leishmaniasis
  • schistosomiasis
  • rabies
  • sexually transmitted infections
  • skin diseases
  • antimicrobial resistance

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Published Papers (5 papers)

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Research

Jump to: Review

15 pages, 1417 KB  
Article
Respiratory Illness and Diarrheal Disease Surveillance in U.S. Military Personnel Deployed to Southeast Asia for Military Exercises from 2023–2025
by Sidhartha Chaudhury, Paphavee Lertsethtakarn, Piyawan Chinnawirotpisan, Nattaya Ruamsap, Worachet Kuntawunginn, Chadin Thongpiam, Kingkan Pidtana, Kittijarankon Phontham, Saowaluk Wongarunkochakorn, Montri Arsanok, Kamonporn Poramathikul, Parat Boonyarangka, Paksathorn Kietsiri, Wilawan Oransathit, Siriphan Gonwong, Patcharawalai Wassanarungroj, Panida Nobthai, Nuanpan Khemnu, Thipwipha Phonpakobsin, Wudtichai Manasatienkij, Joonlasak Khajohn, Chonthicha Klungthong, Nillawan Buathong, Sabaithip Sriwichai, Siriporn Sornsakrin, Umaporn Suksawad, Susie Leonardia-Santiago, Maria Theresa Valderama, John Mark Velasco, Paula Corazon Diones, Matthew Pascual, Chris Mahabir, Kathryn A. McGuckin and Daniel M. Boudreauxadd Show full author list remove Hide full author list
Trop. Med. Infect. Dis. 2025, 10(12), 353; https://doi.org/10.3390/tropicalmed10120353 - 17 Dec 2025
Abstract
The Indo-Pacific region hosts several annual military exercises that involve the deployment of thousands of U.S. and partner-nation military personnel. Respiratory and diarrheal diseases pose a significant health risk to exercise participants and represent a substantial portion of medical encounters and lost duty [...] Read more.
The Indo-Pacific region hosts several annual military exercises that involve the deployment of thousands of U.S. and partner-nation military personnel. Respiratory and diarrheal diseases pose a significant health risk to exercise participants and represent a substantial portion of medical encounters and lost duty days. We conducted surveillance for respiratory and diarrheal illness at the Cobra Gold and Balikatan military exercises in Thailand and the Philippines from 2023–2025. Through coordination with health providers in the field, military personnel that reported acute symptoms were asked to provide a nasopharyngeal swab or stool sample. These samples were transported to a field lab and tested by PCR for common respiratory and diarrheal pathogens. Follow-up analyses included bacterial culture, antimicrobial susceptibility testing, and viral whole-genome sequencing. From 84 respiratory and 61 diarrheal samples analyzed, we found that respiratory illness was primarily attributed to rhinoviruses/enteroviruses (23%), common coronaviruses (21%), and SARS-CoV-2 (11%) while diarrheal disease was attributed to a high rate of diarrheagenic E. coli (73%) and norovirus (20%), followed by Salmonella spp. (18%) and Campylobacter spp. (13%). Our findings highlight the distinct etiologies of respiratory and diarrheal disease in military field settings and demonstrate the feasibility of conducting real-time infectious disease surveillance in operational environments. Full article
(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)
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12 pages, 3309 KB  
Article
Assessing the Feasibility of Using a Multiplex Serological Assay to Conduct Serosurveillance for Malaria Exposure in Deployed Military Personnel
by Sidhartha Chaudhury, Jessica S. Bolton, Edwin Kamau and Elke S. Bergmann-Leitner
Trop. Med. Infect. Dis. 2025, 10(1), 13; https://doi.org/10.3390/tropicalmed10010013 - 2 Jan 2025
Viewed by 1268
Abstract
Reproducibly assessing malaria exposure is critical for force health protection for military service members deployed to malaria-endemic regions as well as for civilians making public health decisions and evaluating malaria eradication efforts. However, malaria disease surveillance is challenged by under-reporting, natural immunity, and [...] Read more.
Reproducibly assessing malaria exposure is critical for force health protection for military service members deployed to malaria-endemic regions as well as for civilians making public health decisions and evaluating malaria eradication efforts. However, malaria disease surveillance is challenged by under-reporting, natural immunity, and chemoprophylaxis, which can mask malaria exposure and lead to an underestimation of malaria prevalence. In this study, we determined the feasibility of using a serosurveillance-based approach to measure Anopheles vector exposure, Plasmodium sporozoite exposure, and blood-stage parasitemia using a multiplex serological panel. We tested post-deployment samples obtained from U.S. service members returning from regions with malaria risk to assess the potential of this serosurveillance panel. The results identified that some service members had anti-CSP antibody levels comparable to those found in endemic populations, suggesting exposure to sporozoites while those individuals were on chemoprophylaxis. We also observed isolated cases of anti-MSP1 levels that were as high as those observed in endemic populations and in CHMI studies, suggesting possible cases of clinical or subclinical parasitemia. The study demonstrated the feasibility of implementing a multiplex serology approach for conducting serosurveillance for Anopheles vector exposure and Plasmodium parasite exposure in samples collected following military deployments and its potential to support public health policies. Full article
(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)
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10 pages, 538 KB  
Article
Risk Identification and Mitigation of Skin and Soft Tissue Infections in Military Training Environments
by Rebecca Suhr, Amy Peart, Brian Vesely, Michael Waller, Andrew Trudgian, Christopher Peatey and Jessica Chellappah
Trop. Med. Infect. Dis. 2024, 9(12), 306; https://doi.org/10.3390/tropicalmed9120306 - 14 Dec 2024
Cited by 1 | Viewed by 1698
Abstract
Objective: Staphylococcus aureus (SA), including methicillin-resistant strains (MRSAs), is a major cause of skin and soft tissue infections (SSTIs) in military populations. This study investigated SSTI incidence and SA carriage in a military training site over 16 weeks using a prospective observational cohort [...] Read more.
Objective: Staphylococcus aureus (SA), including methicillin-resistant strains (MRSAs), is a major cause of skin and soft tissue infections (SSTIs) in military populations. This study investigated SSTI incidence and SA carriage in a military training site over 16 weeks using a prospective observational cohort design. Methods: Two training cohorts provided pre- and post-training self-collected swabs for bacterial carriage, and environmental swabs from accommodations, personal items, and training facilities. Hygiene awareness and practices were assessed through questionnaires. Bacteria were identified using culture, mass spectrometry (MALDI-TOF), and genomic sequencing. Results: Nasal carriage of SA increased from 19% to 49% by the end of training. SSTIs requiring treatment occurred in 16% of participants. Steam cleaning reduced but did not eliminate SA on personal bed linen. Additionally, 40% of participants had poor knowledge of antibacterial cleaning practices and wound management. Conclusions: Increased SA carriage was linked to human-to-human transmission in close-quarter military training environments. Implications for Public Health: Improved personal hygiene training, wound management education, and monitored cleaning protocols are essential to mitigate SSTI risks in communal military training environments. Full article
(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)
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Review

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22 pages, 399 KB  
Review
Management and Prevention of Multidrug-Resistant Bacteria in War Casualties
by Diana Isabela Costescu Strachinaru, Céline Ragot, Anke Stoefs, Nicolas Donat, Pierre-Michel François, Peter Vanbrabant, Alexia Verroken, Frédéric Janvier and Patrick Soentjens
Trop. Med. Infect. Dis. 2025, 10(5), 128; https://doi.org/10.3390/tropicalmed10050128 - 8 May 2025
Cited by 3 | Viewed by 2696
Abstract
The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related [...] Read more.
The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related AMR, a comprehensive literature search was conducted in the PubMed database in April 2025, using defined search terms related to war casualties and antimicrobial resistance. We screened and included 117 relevant publications, comprising original research articles, reviews, case series, case reports, editorials, and commentaries, published in English or French, with no date restriction. This narrative review synthesizes current evidence on multidrug-resistant bacteria most commonly isolated from war casualties, their associated resistance mechanisms, and the microbiological diagnostic tools available at various levels of the military continuum of care (Roles 1–4). It also presents strategies for preventing cross-contamination and infection in resource-limited combat settings and provides practical, field-adapted recommendations for clinicians, from first responders to specialized care providers, aiming to improve infection management in armed conflict zones and mitigate the spread of AMR. Full article
(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)
14 pages, 1257 KB  
Review
Schistosomiasis in the Military—A Narrative Review
by Diana Isabela Costescu Strachinaru, Jemima Nyaboke Nyandwaro, Anke Stoefs, Eric Dooms, Peter Vanbrabant, Pierre-Michel François, Mihai Strachinaru, Marjan Van Esbroeck, Emmanuel Bottieau and Patrick Soentjens
Trop. Med. Infect. Dis. 2024, 9(9), 221; https://doi.org/10.3390/tropicalmed9090221 - 19 Sep 2024
Cited by 1 | Viewed by 3363
Abstract
Schistosomiasis is a parasitosis caused by trematodes of the genus Schistosoma. Humans are infected when coming into contact with freshwater containing the parasites’ infective stages, which are amplified through freshwater-dwelling snails acting as intermediate hosts. Schistosomiasis has posed significant problems for troops [...] Read more.
Schistosomiasis is a parasitosis caused by trematodes of the genus Schistosoma. Humans are infected when coming into contact with freshwater containing the parasites’ infective stages, which are amplified through freshwater-dwelling snails acting as intermediate hosts. Schistosomiasis has posed significant problems for troops exposed to freshwater in endemic regions ever since the Napoleonic wars. Schistosomiasis has substantial differences in clinical presentation, depending on the type of parasite, intensity of infection and reinfection, clinical form, and disease stage. It can remain undiagnosed for long periods of time, with well-known long-term morbidity and mortality risks. The diagnosis of schistosomiasis depends on its stage and relays on several tests, all with limitations in sensitivity and specificity. The diagnostic gold standard is the detection of eggs in urine, feces, or tissue biopsies, but this can raise problems in patients such as military personnel, in which the worm burden is usually low. Praziquantel is the drug of choice for schistosomiasis. Currently, there is no available commercial vaccine against any Schistosoma parasite. Avoiding freshwater exposure is the best prevention. Herein, we review the clinical presentation, diagnosis, treatment, and prevention of schistosomiasis in the military. This information may decrease the impact of schistosomiasis on this particular professional group. Full article
(This article belongs to the Special Issue Military Medicine: An Everlasting War against Tropical and Infectious Diseases)
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