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Show March 29, 2001 J TrUa fee c3 qj n n D U j i Exposure can be common for military deploying to endemic locations Tuberculosis Case Rates, United States, 1993 by Douglas E. Pierson Preventive Medicine manager Exposure to tuberculosis can be quite common in military members who deploy to TB endemic locations around the world. VT II HH 1.2 CI J.J Tuberculosis is one of the oldest, MA RJ MO DE most common and easily spread diseases in the world. Globally, it is the leading cause of deaths resulting from a single infectious disease. It is an infectious disease caused by the microorganism Mycobacterium tuberculosis. It can affect several organs of the human body, but most commonly will affect the lungs. It is spread from person to droplets, expelled person by tiny from the lungs of a person with active TB by coughing, sneezing, laughing air-bo- MJ 4.1 1.4 U 4.1 1.9 1(0,111 Papulation OM 0 m PR or just talking. assessment questions and a negative can receive prevenchest tive TB therapy, which consists of the How can you tell if you've been exposed? The best method that is currently being X-ra- used is the Mantoux test, or IPPD, which military members regularly y antibiotic Isoniazid. The Isoniazid program is a 6- - to therapy of medication that is monitored by a doctor monthly and has been shown to dramatically reduce ones risk of acquiring active Tuberculosis later on in life. If you have a positive TB skin test, your close contacts, such as persons living in the same residence, should also be receive before deployment or annually depending on their occupational risk of exposure. The IPPD measures the body's memory response to a previous TB exposure, by injecting a small amount of fluid containing a protein derived from the microorganism under the skin. Depending on the induration or size tested. of the reaction, as well as risk assess- In healthy individuals with a healthy immune system, the body's natural defenses will resist the disease and most or all of the bacteria will be walled in by a fibrous capsule, not allowing the bacteria to spread, grow or pro ment questions administered by lic Health personnel, a positive or negative test will be concluded. A person who has been exposed to TB but has been determined not to confirmed by health have active TB Pub- 15 li i.t IS Vear 2008 target) I.I twtnnal average) 12 an overseas PCS assignment or moving from one overseas PCS assignment to another are tested after notification of PCS assignment. Personnel working in medical treatment facilities are tested annually. People in close contact with active tuberculosis patients, and occupational exposed personnel. Recently, the Air Force Medical Operations Agency directed all active duty personnel be tested every two years, but if you're on mobility at Hill AFB you'll be tested annually during your birth month as part of the Preventive Health Assessment. TB skin tests are available from the Immunization Clinic, Bldg. 570, on Monday, Tuesday or Wednesday from 0 a.m. or 4 p.m. An estimated 10 to 15 million Americans are infected with the TB bacteria, and have the potential to develop active TB disease in the future. About 10 percent of these infected individuals will develop TB disease at some point in their lives. According to Provisional data received for 1999, more that 17,000 cases of active TB were 7:30-11:3- duce symptoms consistent with active TB. However, when a person's immune system is compromised either by disease or from old age, the TB germ can multiply and rapidly destroy tissues of the lungs (or other affected organs). This destruction or "consumption" of lung tissues results in diminished respiratory capacity and may leave permanent disabling scar tissue. Who should be tested? Everyone who enters active duty for more than 30 days should be tested. This is usually done during reception processing at the recruit training center or at the first duty station. All military personnel, Department Air Force civilian employees, the of and their dependents returning from reported 1-- in the United States. This is the seventh consecutive year thatTB cases have declined; yet this national trend masks several areas of ongoing concern, including cases of TB and an increasing TB cases among resiproportion of dents born outside the United States. For more information about tuberculosis, visit www.cdc.gov or call the Preventive Medicine office at Ext. drug-resista- nt Sailor needing bone marrow showed no symptoms Myelogenous Leukemia or CML. by Steve Barbour DoD Marrow Donor Program Each week, another military service member or their dependent is diagnosed with a blood disease that requires a bone marrow transplant. Through the C.W. Bill Young Department of Defense Marrow Donor Center, over 200,000 volunteers have been recruited from the DoD community and are marrow standing by, ready to provide donations. The DoD Donor Center is just one of more than 90 donor centers that make up the National Marrow Donor Program. The center is holding a marrow donor registration drive April 5 from 9 a.m.-- 3 p.m. in the Officers' Club Daedalian Room and April 6 from 9 a.m.-- 3 p.m. in Bldg. 1221, Room 24. With each recruitment drive, additional volunteers bring hope to waiting military and civilian patients. life-savi- ng Marrow donation is simple process that provides recipients with a second chance at life. One such recipient of a marrow donation was former sailor, Tim Wheeler who joined the Navy in September 1988 with an attitude right off the recruitment poster. "I was thinking about making it a career, " he said, "wanting to get an education and see the world." After boot camp, Wheeler endured one of the longest nuclear the two-yewas course. He assigned training schools of any service reactor operator-traininto submarine duty and spent g ar 3 12 years aboard the USS Salt Lake City. into his Navy career, Wheeler got what he thought was a break. He was assigned to Ball-sto- n Spa Nuclear Prototype Training Unit, N.Y., where he was to serve as an instructor. A routine physical showed a high white blood cell count. DocSix-yea- rs tors at the Ballston clinic decided he needed further examinations and sent him to the Albany, VA Hospital where he was diagnosed with Chronic 1 COPY Chronic Myelogenous Leukemia (also called chronic myeloid or chronic myelocytic leukemia) is a relaabout 5,000 new cases tively common leukemia are diagnosed each year in the U.S. Most cases occur in adults, only 2 percent of all CML cases occur in children. CML is not an inherited disease, but has a genetic component. It's caused by a change in a chromosome called the Philadelphia chromosome in marrow cells that leads to overproduction of white blood cells. As the "chronic" in its name implies, CML usually g develops slowly although it can progress to a "accelerated phase." Chemotherapy can induce long periods of remission (periods when white blood cell counts and symptoms are reduced), but bone marrow or stem cell transplantation is at present the only known cure for CML. "They told me'that I needed a bone marrow transplant or I would die in three years," Wheeler said. "I had no symptoms. I was feeling fine. I really thought they were wrong. I was in a total state of denial. My only choice was a bone marrow transplant if I wanted to live." After diagnosis, Wheeler spent at the National Naval Medical Center, in Bethesda, Md. Doctors worked to get the CML in remission while Wheeler waited for a marrow donor. Amazingly, in a little more than 60 days doctors found a donor match and the transplant was scheduled. Unfortunately the donor had to back out when she became pregnant. A few months later a second donor was found and the transplant was conducted at Atlanta's Emory University Hospital in June 1996. Five years later Wheeler still has vivid memories of the 67 days he spent in the hospital following the fast-growin- six-mont- transplant. "I went into the hospital weighing 190 pounds and came out at 135 pounds. After I got out, during the first 100 days I lost another 10 pounds and suf fered from what they call Graft Versus Host Disease a condition where the body tries to reject new marrow. My skin was flaking off; I had no hair, no eyebrows and no eyelashes. When I was on the transplant floor at Emory there were five other patients. I'm the only one that survived." Wheeler is married, and studying civil engineering at the University of Central Florida where he's a senior. Wheeler said the experience put things in perspective, "I'm back in school. I'm a civil engineering student because... I want to leave a mark. I want to build bridges and buildings that will be here for years." r As Tim approaches the anniversary mark of his life saving bone marrow transplant, he expects the Navy will notify him that it's time once again to come in for his medical review and a discussion on whether to medically retire him or grant him severance pay. "My health is a little bit guarded. I get a cold and sinus infection every six months. I had to get all my childhood immunization shots again. I have to be careful and wash my hands eight times a day. I have the immune system of a kid." fifth-yea- Wheeler admits to moments when he misses friends, people, opportunities and possibilities of his Navy days. But with each new day he's optimistic and credits the whole experience with his renewed passion. Tim has not had the chance to meet his donor but would like to. "What do you say besides thanks?," he said. "I just want them to know how well I'm doing. How important it is to give." Military members, immediate dependents, DoD civilian employees, National Guard and drilling Reserve Personnel, ages 18 to 60, in good health are eligible to participate in the bone marrow drive. One small test tube of blood could be the beginning of a life saving journey for you and someone like Wheeler. |