Tuberculosis infection after humanitarian assistance, Guantanamo Bay, 1995

Upon redeployment to Fort Lewis, Washington, from Operation Sea Signal in G uantanamo Bay, Cuba, 5% of a military police unit was identified as positiv e for purified protein derivative (PPD). A case-control study was conducted to document the number of converters and to identify risk factors among th e soldiers for PPD conversion while in Cuba. Forty-six of the soldiers (3.7 % of the unit) met the criteria for PPD conversion as a result of deploymen t. Forty-four converters and 84 controls completed surveys. Logistic regres sion showed that statistically significant independent risk factors for PPD conversion included working around coughing migrants (odds ratio [OR] = 6. 73, 95% confidence interval [CI] = 2.2-20.4) and birthplace outside the Uni ted States (OR = 4.89, CI = 1.3-18.5). Contact in the psychiatric hospital (OR = 0.22, CI = 0.05-0.90) and contact with migrants with known tuberculos is (OR = 0.16, CI = 0.05-0.54) appeared to be protective factors, possibly because known tuberculosis patients and hospitalized patients most likely w ould be on treatment and rendered noninfectious. With the U.S. military's i nvolvement in humanitarian and refugee operations in countries highly endem ic for tuberculosis, service members are at increased risk of acquiring tub erculosis infection. Detection of tuberculosis infection and appropriate tr eatment should become a higher priority within the U.S. military.