WASHINGTON, Aug. 28 (UPI) -- The U.S. military is worried press attention to a possible link between the recent spate of slayings and suicides at Fort Bragg, N.C., and Lariam, a widely prescribed anti-malarial drug, could prompt soldiers to resist taking it, Army officials tell United Press International.
The officials -- who asked not to be named -- fear the Army may end up with a rebellion on its hands like the one over the anthrax vaccine.
If that happens, they say, the Army will have a bigger health problem than any possible Lariam side effects: soldiers exposing themselves to the risk of contracting malaria.
The very public resistance to the anthrax vaccination program was largely fomented by information available on various Internet sites that allege a long list of health side effects for the vaccine.
But the concerns of some soldiers were also fed by the military's unfortunate history with medical research and treatment, especially during wartime.
The number of anthrax vaccine refuseniks is small -- around 200 since 1998 -- compared to the thousands who have received the injections. But they are a very vocal minority, putting the Pentagon on the defensive nearly continuously since the program began to vaccinate all military personnel. A quick search of the Internet revealed nearly 4,000 references to the 200 who declined the vaccine, many of whom have been discharged from the military.
The program has slowed considerably as supplies of the vaccine have been limited by production difficulties. The vaccine is now required only for troops deploying to high-threat areas in the Middle East.
It has been used by veterinarians, researchers and for Special Forces soldiers for nearly 30 years. Created to combat cutaneous anthrax, its effectiveness against the much deadlier inhaled form remains an open question.
Now the Army has a new medical and public relations headache: the side effects of Lariam, which United Press International has been investigating for six months.
The drug has been associated with reports of aggression, psychosis and suicide, according to its manufacturer, Hoffmann-La Roche. Soldiers are warned to call their healthcare provider if they "develop unexplained anxiety, mood changes, depression, restlessness, or confusion" while taking Lariam.
Several soldiers deployed to Afghanistan joked to UPI reporters that the night they take the once-a-week pill has been dubbed "Monday Night at the Movies" because of the vivid dreams it often causes.
Most soldiers who deploy to Afghanistan and other hot climates are required to take Lariam, the commercial name for mefloquine, as the Army considers malaria the number one health risk around the world, according to senior officials. The World Health Organization says malaria is the fifth most common cause of death among communicable diseases in the world -- killing between 1.1 million and 2.7 million people annually.
Seventy-five soldiers and Marines deployed to Somalia in 1993 contracted malaria, forcing their hospitalization. All eventually recovered.
Four soldiers at Fort Bragg -- three of whom were special operations troops who had served in Afghanistan -- allegedly killed their wives during a six-week period in June and July. On July 23, the wife of a Special Forces soldier apparently shot and killed him in his sleep in the fifth domestic slaying at Fort Bragg this summer.
All three of the soldiers who deployed to Afghanistan were given Lariam, sources close to the soldiers told UPI.
While it is one factor an investigative team at Fort Bragg is considering, the Army says it believes Lariam is not to blame for the flurry of violence.
"Fort Bragg's Serious Incident Review Board is continuing a rigorous, exhaustive investigation into each of the recent tragedies," said Garrison Commander Col. Tad Davis. "Nothing in that investigation so far suggests the FDA-approved anti-malarial drug Lariam is a factor."
Army officials tell UPI the press attention to Lariam, whose side effects are well known by doctors, could spur resistance among soldiers who have to take the pill orally. If they are nervous about the side effects, they may not take the medication and therefore expose themselves to what the Army regards as a far greater danger: contracting malaria.
Several officers on deployment in Afghanistan recently told one UPI reporter that they were not taking any anti-malarial drugs because of concerns about side effects.
Although there are alternative medications available, which can be given to soldiers who experience side effects, a number of factors make Lariam the Army's first choice.
Lariam is taken once a week, but the others all have to be taken daily, making it easier for soldiers to miss a dose, and expose themselves to the possibility of contracting malaria. Defenders of Lariam also say it is much more effective than the alternatives. Finally, at least one of the alternatives -- Malarone -- is much more expensive.
Military officials also regard reluctance -- even among small numbers of soldiers -- to take medication they are given as detrimental to good order and discipline.
However, the military has a well-known and checkered history with medical research and treatment, especially during wartime, which does little to inspire confidence and trust among the wary.
A 1994 U.S. Senate report detailed more than 50 years of questionable medical research and testing on human subjects, often military -- a pattern veterans and others point to whenever pharmaceutical issues arise.
"For at least 50 years, DOD has intentionally exposed military personnel to potentially dangerous substances, often in secret," states the report. "DOD has repeatedly failed to comply with required ethical standards when using human subjects in military research during war or threat of war," the report stated.
According to the report, the abuses range from experimentation with LSD on unknowing subjects, the intentional release of radioactive gas to test their effects on humans, and the release of chemical nerve agents and biological agents on farm animals and people.
The most recent examples occurred during the Persian Gulf War, when the Pentagon used two investigational treatments on soldiers. U.S. troops were intentionally exposed to an investigational vaccine -- botulinum toxoid -- that was intended to protect them against biological warfare. They were also given pyridostigmine bromide pills in an experimental protocol intended to protect them against chemical warfare.
"The goals of many of the military experiments and exposures were very appropriate. For example, some experiments were intended to provide important information about how to protect U.S. troops from nuclear, biological, and chemical weapons or other dangerous substances during wartime," the report stated.
However, the Committee on Veterans Affairs found in a survey of 150 Persian Gulf War veterans, 15 of 17 respondents who used botulinum toxoid reported being threatened with administrative punishments or court martial if they told anyone of the use of the vaccination. Likewise, 86 percent said they were ordered to take pyridostigmine bromide without being warned of the potential risks.
