An outbreak of malaria in a forward battalion on active service in East Timor

An outbreak of malaria first developed within Second Battalion Royal Australian Regiment, a forward (Australian) Battalion of the International Force in East Timor in October 1999. Before the Battalion redeployed to Australia, 17 cases had occurred and in the 12 months following return to Australia another 89 cases have occurred, including 18 single recurrences and 2 second recurrences. The overall attack rate for this deployment of 4 months, mostly including the wet season of Timor, has been 13.5%. The attack rate for the Battalion (5/7 Royal Austarlian Regimen) subsequently occupying this ground (for approximately 4 months and including the 12 months following redeployment) was 5.2%. Investigation of the initial outbreak and comparisons with the subsequent Battalion suggest major risk factors for contracting malaria were side effects from doxycycline, involvement in night operations, lack of preventive medicine support, and the location of platoon positions.