Troops, families fear Zika returning from Honduras
October 28, 2016
SOTO CANO AIR BASE, HONDURAS — The Marines brought bug spray, mosquito nets, and a vigilance to kill any bug within reach. But there was only one way to fully guard against the Zika virus during relief efforts in Haiti.
“You just try to be lucky,” said Sgt. William Hubbard, a Marine Corps reservist deployed to Soto Cano Air Base in central Honduras.
The Zika virus has been transmitted in virtually every nation in Latin America, including Honduras and Haiti. The 300 Marines and sailors, deployed here since May, have agonized with their families at the potential of the virus returning with them.
And further frustrating families: Marines and sailors here have received guidance that no one will receive testing before they return home in the next few weeks unless they show symptoms of the virus.
“Every Marine and sailor here is worried about this in some capacity,” Hubbard said.
Navy Lt. Pierre Cagniart, the top medical officer for the Marines and sailors based in Honduras, confirmed Tuesday there are no plans for widespread tests, which has prompted spouses of Marines to get Capitol Hill involved.
About 80 percent of Zika-infected people do not show symptoms, according to the national Centers for Disease Control and Prevention.
The statistic is well known to troops in Honduras, who worry about being unknown carriers.
Nearly 100 U.S. troops, including three pregnant women, have contracted the Zika virus. Dependents were also affected, with 32 contracting the virus, including one pregnant woman, according to a Pentagon count as of Oct. 19.
The virus can be transmitted through mosquito bites and unprotected sex, according to the CDC. Zika has produced microcephaly, a condition in which babies are born with misshapen heads and brain defects. It has also been linked to problems in infants, including eye defects, hearing loss and impaired growth, according to the CDC.
There have been more than 4,000 total cases reported in the continental United States, according to a CDC count as of Oct. 19.
Most were associated with travel outside the United States.
Zika was declared a global emergency in February by the World Health Organization.
The stakes are enormous for young troops, such as Hubbard, who are recently married and looking to start a family soon.
“It’s been a major source of contention” back home, said Hubbard, who is based in Quantico, Virginia. His wife constantly worries about him contracting the virus.
“It has definitely put additional strain on the deployment,” Hubbard said.
A mosquito paradise in HaitiThe Special Purpose Marine Air-Ground Task Force is a rapid-response unit based in Honduras to strengthen security in the region and respond to natural disasters. It’s essentially the same mission as the larger operation at Soto Cano, Joint Task Force Bravo, a group of approximately 500 troops.
That second mission of the SP-MAGTF was realized earlier this month, when Hurricane Matthew swept through the Caribbean and ravaged the western tip of Haiti, leaving between 546 and 1,600 dead, the vast majority occurring in that country.
The special task force was among the first U.S. troops on the ground in Haiti, using heavy-lift helicopters to deliver food, water and medical supplies in desolated areas where roads and bridges were washed away.
The Zika virus was already a concern for the troops in Honduras. But when Hurricane Matthew dumped several feet of rain in Haiti, it produced a perfect storm for concern of mosquito-borne viruses: consolidated people in search of shelter and supplies coupled with sprawling seas of trash and stagnant water right where the Marines were tasked to operate.
The Marines were headquartered in an unfinished airport terminal during the operation. Even indoor areas were infested with mosquitoes, Hubbard said. Clouds of them filled the terminal. The Marines slept in nets to keep the bugs out. But some of them still got through their defenses.
The Dominican Republic, which shares the same island as Haiti, has reported more than a thousand Zika cases in pregnant women, with only 22 as of September in Haiti, according to a National Public Radio report. That number is likely higher and underreported due to a lack of reliable testing, a recent doctor’s strike and chronic government mismanagement in Haiti, the report stated.
Sgt. Mark Wong, a Marine reservist based in Cleveland, Ohio, said the potential of Zika infection was a top concern among Marines when they were activated for the Honduras deployment. An officer at the pre-deployment family event at Camp Lejeune, North Carolina, said he had no guidance on testing or prevention of Zika at the time, which further worried families and troops, according to Wong.
“There were several times we killed a mosquito and it burst with blood,” Wong said of the Marines operating in Haiti during relief efforts. “So we know someone got bit. You just have to assume you have Zika at this point.”
Low risk of ZikaCagniart, the senior medical officer for the SP-MAGTF, downplayed the risk of Zika for the Marines and sailors operating in Honduras.
He said the danger of heat injuries and dengue fever, particularly at an austere outpost on the eastern Caribbean coast of Honduras, are his biggest concerns, with Zika near the bottom of the list.
The Marines here are predominately men, and symptoms of Zika are no more severe than a fever or flu, with a virtually zero mortality rate, he said. But Caginart acknowledged the heightened concern are for the Marines who could transmit Zika to wives or girlfriends who might become pregnant.
“They don’t want to bring something to their spouses back home,” the doctor said.
The Defense Department routes all Zika testing through the Naval Medical Research Center in Silver Spring, Maryland, said Dr. Timothy Whitman, an infectious disease clinician at nearby Walter Reed National Military Medical Center in Bethesda. Troops with symptoms submit blood or urine samples, or both if the nature of their symptoms and area of travel call for it, Whitman said. The process takes one to two weeks, he said Thursday.
Cagniart said he would be surprised if all or even some Marines and sailors of the task force were tested before they returned home. As of now, he said, only troops with symptoms, like a fever above 101 degrees, are screened for Zika. He has seen four or five tests -- all negative, he said.
One reason that Cagniart said a full test of deployed troops deployed to Honduras is impractical: an imperfect test coupled with symptom-free patients would lead to false positives, causing anxiety and treatment for some Marines who did not have the virus.
It’s an issue of statistical errors balanced with risk, and not as simple as just testing everyone who served in Central America, he said.
Cagniart likened the issue to pap smears, which were done annually in the past. More tests led to more false positives, and biopsies on women without cervical cancer damaged their ability to bear children, he said. Now they are done every three or four years to mitigate false diagnoses.
“Nothing is perfect. Testing for Zika is not perfect. And our determination for who to test will improve as we better understand the disease,” he said.
Cagniart said he receives guidance from the Defense Department, which aligns closely to recommendations from the CDC.
There are recommendations that men avoid unprotected sex for six months after leaving affected regions such as Central America. So even if a servicemember tests negative and feels confident they are virus-free, they should follow the CDC recommendation, he said.
“You have to determine where you are in life. If waiting six months reduces your risk, then you have to make that decision with the knowledge we have,” Cagniart said.
Marines here expressed concern they were not receiving guidance to alleviate their family’s concerns. Cagniart said he did not hear many direct concerns or complaints, and did not want to confuse anyone with constant changes and revisions to CDC policy. Whitman, the infectious disease clinician, also acknowledged a constant evolution of CDC guidance could be confusing for troops.
But he could have produced practical descriptions of testing drawbacks earlier to quell rumors and barracks gossip, he conceded. Cagniart planned to address the issue—at the end of the deployment in November, he said.
Congress now involvedWong, like Hubbard, has a wife and plans to start a family soon. He said the conversations with his wife often drift toward Zika worries and the additional pressure it puts on marriages already dealing with separation.
“It creates a lot of undue stress on family issues and family planning,” Wong said. He planned to start a family with his wife shortly after he returned, but Zika concerns have been a roadblock.
“It’s another layer of adjustment and uncertainty,” Wong said.
Those concerns have already reached Capitol Hill. Some wives of troops here have written their congressmen demanding answers, using a form letter to send to multiple members.
“We are a young couple looking to start a family, however the threat of Zika is obviously very real to us and concerning given my husband has now been in Honduras and Guatemala for months,” according to a copy of the letter obtained by Stars and Stripes.
“We have yet to be given a clear answer on what kinds of testing (if any) will be provided to servicemembers upon returning home. Could you please let me know what options with be afforded for Zika virus testing, and if none, why not?” the letter concluded.
The legislative office of Rep. Don Beyer, R-Va., which according to a deployed Marine is among at least five offices contacted, is tracking the issue and will pursue a positive outcome that alleviates the concerns of military families, an aide to the Congressman told Stars and Stripes on Tuesday.
Hubbard equated the issue to any visible injury or danger faced by troops on any other deployment.
“There is a reasonable expectation that the government will try its best to mitigate a problem like this,” he said. “There is an expectation it will be addressed. And in this respect, it’s not being addressed.”
Wong sees a contradiction in how the Marine Corps discusses safety as a top priority.
“They say: ‘Watch out for the Marine next to you’,” Wong said. “Then we have situations like this where they’re setting us up for failure.
Safety is a good talking point. But in this case, it’s not followed up with any action.”
email@example.com Twitter: @AlexHortonTX