Infectious disease challenges in military personnel returning from Iraq and Afghanistan

About 1 million US military personnel have been deployed to Iraq and Afghanistan in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). During deployment, healthy personnel undergo potential exposures to endemic infectious diseases they may not have previously encountered. Although most of these diseases will probably present and be managed during the deployment or immediately after the personnel return home, some diseases may require prolonged care or have long incubation periods, resulting in later diagnosis and management after return to the United States. Leishmaniasis, malaria, and drug-resistant bacterial infections (specifically, infection with Acinetobacter baumannii) are among the entities most likely to be seen in personnel who have returned home after supporting OIF/OEF and who present with diseases that have prolonged incubation periods or require prolonged therapy.