KANDAHAR AIRFIELD, Afghanistan - At least 38 cases of malaria have been diagnosed in troops serving in Afghanistan since January 2010.
Malaria is a mosquito-borne, parasitic infection affecting more than 200 million people each year, according to 2008 estimates by the World Health Organization. While two common subtypes known to exist in Afghanistan are not likely to cause death, they may still result in a severe infection that would limit the effectiveness of troops on the battlefield.
Common symptoms of malaria include fever, muscle aches and pains, and nausea and vomiting.
"If a servicemember has fever plus other symptoms they should go to their local aid station and be evaluated for treatment," said U.S. Army Maj. Erica Johnson, officer in charge of the 1st Brigade Combat Team, 4th Infantry Division's aid station.
Troops are prescribed the anti-malarial medication doxycycline before deploying to Afghanistan, but healthcare providers say the medication is only effective if servicemembers remember to take it.
"I think malaria is one of those things that if you've never personally seen someone have malaria infection or never been personally exposed to infection, it may not seem very important to take anti-malarials," said Johnson, who has treated cases of malaria.
"A Soldier should start taking the pills one to two days before they leave the United States, and continue taking one pill every day while they're deployed," said Johnson. "And then after redeployment back to the states they continue to take it for four weeks, because they can still be at risk for malaria up to four weeks after leaving Afghanistan."
Malaria prophylaxis may not be 100 percent effective, but there are other precautions troops can take to avoid contact with mosquitoes.
"The other thing that should be done hand-in-hand with anti-malarials is taking personal protective measures," Johnson added. "That would include using an insect repellant on the skin regularly."
The military recommends servicemembers use repellants that contain 30 to 35 percent DEET to minimize bites from mosquitoes and to also treat uniforms, bedding and other textiles regularly with the chemical permethrin as a mosquito deterrent.
Malaria could also cause not only health issues for troops, but legal issues as well. With the protective measures the military puts in place to ensure servicemembers avoid contracting malaria, it is possible that failing to properly take prescribed medication and subsequently falling ill with the disease could result in action under the Uniformed Code of Military Justice.
"The decision to punish a servicemember in such circumstances would be up to individual unit commanders based on the circumstances of each case," said Lt. Col. Lawrence Austin, Staff Judge Advocate for Joint Sustainment Command - Afghanistan.
Malaria has historically changed the course of a number of wars, from battles in ancient Rome to the conflict in Vietnam. According to the World Health Organization, nearly 3.3 billion people, or approximately half of the world's population, is at risk of contracting malaria. Each year this leads to approximately 250 million cases and nearly one million deaths.
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