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Sunday, October 03, 2004

Cost-Benefit Analysis 

Via our distinguished colleague Rorschach at No Capital: A potentially deadly respiratory disease afflicts one in ten recruits at boot camp. For two decades the army holds the virus in check by administering an effective, inexpensive oral vaccine. Then, when it turns out that a $5 million investment will be required to keep the vaccine in production, the Pentagon balks: too expensive. The treatment is discontinued. What happens?

At least six deaths and up to 2,500 infections a month, seriously hampering the military's ability to rapidly deploy troops overseas:
More than three decades ago, the Pentagon created two pills to ward off a lethal virus infecting boot-camp recruits. But defense officials abandoned the program in 1996 as too expensive. Now recruits are dying, thousands are falling ill, and the military is desperately racing to bring back a vaccine it once owned . . . .

Since the oral vaccinations stopped, the flulike germ, adenovirus, has been associated with the deaths of at least six recruits, four within the past year, according to military records and internal reports obtained by The Seattle Times . . . .

Adenovirus spreads by cough or touch, thrives in confined places such as overcrowded barracks, and targets those with weakened immune systems. Overstressed recruits, trying to get in shape and adapt to the military, turn out to be ideal incubators for the virus.

Military foot-dragging and high turnover of procurement officers have caused the replacement vaccine to fall behind schedule, making pills unavailable until at least 2007, possibly 2009, military health-care records show . . . .

The military began using the vaccine in 1971 after adenovirus blanketed military bases during the 1950s and '60s, killing an undisclosed number of troops. The vaccine essentially vanquished the germ, military studies show.

Later, doctors ruefully noted that a newer, younger cadre of Pentagon leaders failed to understand that the latent virus was controlled — not eliminated — and that it could escape once again if vaccine restraints were loosened.
Nor are military personnel the only victims. The virus has "leapfrogged" into the general population, killing children at several civilian facilities:
Military and public-health professionals are deeply concerned about one of the virus' most deadly strains: Ad7d2. This strain flared up in the civilian world in June 1996, just months after the military began limiting the vaccine pills in boot camps to the winter months. The outbreak killed seven children and infected six others at a pediatric chronic-care facility in Houma, La.

In November 1998, the Ad7d2 strain killed eight children and infected 23 others in a long-term pediatric care center in Chicago.

The Chicago center was just miles away from the Great Lakes naval base that had been hit the year before with an Ad7d2 outbreak that infected 396 recruits, CDC records show.

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