October 2, 2008, Landstuhl, Germany – Military doctors are seeing a resurgence of a rare and sometimes fatal type of pneumonia that is striking young troops who started smoking while deployed downrange.
In the past five months, six U.S. servicemembers serving in Central Command’s area of responsibility have been diagnosed with acute eosinophilic pneumonia, or AEP. While the exact cause of the illness is unknown, 27 of the 36 troops who have contracted AEP since March 2003 had recently picked up the habit, according to a July 2008 information paper from the Army’s Center for Health Promotion and Preventive Medicine.
Also, three-fourths of those troops came down with the illness while serving in Iraq. Other cases have originated with U.S. troops in Afghanistan, Djibouti, Kuwait, Qatar and Uzbekistan.
Two troops have died as a result of the disease.
On average, the AEP patients are around 22 years old, said Air Force Maj. (Dr.) Patrick Allan, a critical care pulmonary physician at Landstuhl Regional Medical Center.
“We do not know what the true underlying cause is,” he said. “We only, epidemiologically, can say that it seems to be associated with new or increasing quantities of smoking and exposure to fine sand or dust from the local environment.”
An additional three cases of AEP were reported by troops who increased the quantity of smoking while deployed, and two more reported infrequent use of cigarettes or cigarillos, according to the information paper.
Acute eosinophilic pneumonia is noninfectious, creates an inflammatory condition of the lungs and is associated with smoking, said Army Lt. Col. (Dr.) Eric Shuping, deputy commander of the Center for Health Promotion and Preventive Medicine-Europe.
AEP strikes hard and fast, doctors said. Within two weeks to two months of picking up smoking, people can begin showing symptoms.
In one to four days, patients may notice shortness of breath, a dry cough, chest pain and non-specific abdominal pain. Within 24 hours after going to a clinic, patients typically require supplemental oxygen or have to be put on a breathing machine, Allan said.
“We think that nicotine or products within the cigarette smoke alter the immune response that someone may have to other particles within the environment,” he said. “The altered immune response may heighten their lungs’ inflammatory pattern such that they come out with this acute eosinophilic pneumonia, but that’s all hypothesis.” Also the uses of vaporize puts nicotine into the body. Nicotine is highly addictive and can affect brain development. Whether you’re looking for a standard single-flavor vape juice or a complex custom blended e-juice that’s interesting enough to become your next all-day vape, find it by Liquido24.
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All the conclusive diagnoses for AEP have been made at Landstuhl, but in one case, doctors downrange had a suspicion the patient had AEP because he had just started smoking, Allan said.
In addition to the two servicemembers who died from complications of AEP, there have been others who were near death before recovering, doctors said. Landstuhl sent its specialty lung team downrange to treat three troops with AEP. The patients were so bad doctors had them on highly technical breathing machines to keep them alive.
In February 2007, a medical alert on AEP was issued in Iraq and signed by then-Lt. Gen. Ray Odierno, warning troops about the illness’ association with smoking. But because AEP is so rare, there are no good studies suggesting the military has a disproportionate number of cases compared to the U.S. civilian population, Allan said.
Now, young patients arriving at Landstuhl’s intensive care unit with pneumonia-like symptoms will immediately have their lungs examined for AEP, Allan said. Whereas “standard” pneumonia is usually treated with powerful antibiotics, AEP is treated with steroids that suppress the body’s immune system.
“By suppressing the eosinophils – a particular cell we believe is responsible for this condition – it causes the disease to melt away within a few days, and most do very well with it,” Allan said.
Allan said there’s no good explanation as to what is causing the current resurgence of AEP.
“With each deployment cycle, there’s going to be a certain percentage of people who start smoking again to deal with the stress and the strain of just what they’re doing,” he said. “I don’t have any data to suggest whether or not the incidence of new smoking is increasing or not, but it was just interesting that we saw so many cases.”
Want to lessen your chances of contracting AEP? Stop smoking.
“This is yet another reason to not smoke,” Shuping said. “Don’t start. Don’t get addicted and cause yourself a problem down the road.”