Fort Benning statement on infections of A Streptococcus from January 2019

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The following statement came from Fort Benning’s Ben Garrett, the Chief of Public Affairs regarding qeustions from News 3 about the Dez Del Barba necrotizing fasciitis infection and treatment

.“Our thoughts and concerns are with our Soldier, who is currently hospitalized, and his family during this trying time.  Our Soldiers are our most important asset and we will make every effort to ensure they receive the best medical care the U.S. Army provides. Fort Benning and U.S. Army Training and Doctrine Command are committed to providing a high-quality training environment for our new Soldiers as we prepare them for service in the Army.  A part of that commitment includes ensuring our Soldiers receive first-rate medical care during their initial entry training.  When concerns about the medical care provided in this environment are brought to the Command’s attention, the Command works with its partners in the Army’s medical community to ensure those concerns are being appropriately addressed.  Due to privacy concerns, we cannot speak about the medical status of our Soldier. U.S. Army Training and Doctrine Command and Fort Benning are working with the Regional Health Command- Atlantic to perform a clinical quality review, which is a routine practice for any unintended occurrence or condition associated with care or service of a patient.”

Question 1: Is there an ongoing medical investigation into Del Barba’s treatment while at Fort Benning?
Due to HIPAA and Privacy Laws, we are unable to provide details about the medical status of our Soldiers.

Question 2: If so, what is the progress? If not, what is the timeline to launch such an investigation?
Whenever there is an unintended occurrence or condition associated with care or service of a patient, it is Army policy to initiate a clinical quality review. Our risk manager at Benning Martin Community Hospital (BMACH) has initiated this review and has sent out an official tasker to those involved and those reviewing the care for this official review.  It is important to note that this review is statutorily restricted from being released.  Additionally, the trainees’ command is investigating into whether trainees were prevented from seeking medical care. Both are ongoing.

Question 3: Can you confirm how many people were diagnosed with A Streptococcus at Fort Benning, Ga. last month?
After consultation with the TRADOC Surgeon, the Consultant for Infectious Disease for the Army and the U.S. Army Public Health Center (APHC), Benning Martin Army Community Hospital (BMACH) initiated enhanced screening for Group A Beta-Hemolytic Streptococcus (GABHS) during February.  From the Initial Entry Training (IET) population, 61 patients were symptomatic and tested positive for Group A Streptococcus. In an effort to ensure the health and readiness of the force, Fort Benning, BMACH leadership and public health staff recognized the increased Group A Streptococcus activity and coordinated for all Soldiers and cadre in Basic Combat Training (BCT) and One Station Unit Training (OSUT) to receive antibiotic treatment.  This considerable logistical undertaking of providing antibiotics to a population of nearly 10,000 began less than one week after the invasive Group A Streptococcus was noticed.  These efforts quickly controlled the spread of Group A Streptococcus in this population, and there has not been another case of invasive Group A Streptococcal disease diagnosed since.

Question 4: Did any of those cases result in necrotizing fasciitis?
Due to HIPAA and Privacy Laws, we are unable to provide details about the medical status of our Soldiers.

Question 5: What is the condition of any soldiers who were treated for necrotizing fasciitis?
We are unable to provide specific details of any individual’s medical treatment or condition due to HIPAA and Privacy Laws.

Question 6: What is the status of the antibiotic program that the Army instituted after the A Streptococcus outbreak?
Trainees who screened positive were treated and returned to training. Additional preventive measure were taken to include administering the proper dose of azithromycin to nearly 10,000 Initial Entry Trainees and cadre who were already present at Fort Benning at time of the A Streptococcus cases within the IET environment. Out of an abundance of caution, as a preventive measure, the command directed, that all trainees arriving since that time receive a bicillin injection upon arrival at the reception station. The initial results of Fort Benning’s responsive preventive efforts have been positive, and all new trainees arriving to the installation are receiving preventive medicine to eradicate future Streptococcus cases.

Question 7: How many Soldiers had to seek treatment for A Streptococcus or necrotizing fasciitis off post?
From January 15 to February 15, 2019, a cluster of three invasive Group A Beta-Hemolytic Streptococcus (GABHS) infections was detected among two Fort Benning basic combat training (BCT) and One-Station Unit Training (OSUT) trainees. A fourth trainee was diagnosed on February 15 with a Peritonsillar abscess, but GABHS was ruled out based on culture results.

It is important to note, the vast majority of Group A Streptococcus infections are mild, noninvasive, and treated on post.  Rarely do Group A Streptococcus infections become invasive.  These invasive infections include for example, peritonsillar abscess, septicemia, toxic shock syndrome, and necrotizing fasciitis.

In an effort to ensure the health and readiness of the force, Fort Benning spared no expense in its aggressive response to address the Group A Streptococcus concern. By the end of February, treatment had been initiated for Fort Benning’s entire basic training population of nearly 10,000. The efforts thus far have vastly reduced any concern for future cases of A Streptococcus.

Question 8: Fort Benning released that a Soldier died during the timeframe of the A Streptococcus concerns? What is that soldier’s name? What day did he die? Was he under medical care at the time of his death? Was his death connected to the A Streptococcus situation? If so, how?
Tragically, Fort Benning suffered the untimely death of Pvt. Christopher Wellington Huss on January 22, 2019, and we grieve this loss of life together with his family and the Soldiers who knew him. The cause of this Soldier’s death is HIPAA-protected as protections continue after death and require release authorization from the Soldier’s personal representative.

Question 9: Regarding the treatment of basic trainee Dez Del Barba, you have said you can’t comment because HIPPA regulations. Is this accurate?
We take medical privacy very seriously and are unable to provide details of any individual’s medical treatment or condition due to HIPAA and Privacy Act considerations as well as for concern and respect for our Soldiers and their families.

The sections of HIPAA/Privacy Act that cover your questions are below:

DODM 6025.18:

4.5. SPECIAL RULES AND OTHER REQUIREMENTS RELATING TO USES AND DISCLOSURES OF PHI.

a. De-Identification of PHI.

(1) Standard: Uses and Disclosures of De-Identified PHI. A DoD covered entity may use PHI to create information that is not individually identifiable health information, or disclose PHI only to a business associate for such purpose, whether or not the de-identified information is to be used by the DoD covered entity. Health information that does not identify an individual and there is no reasonable basis to believe that the information can be used to identify an individual is not individually identifiable health information. (2) Implementation Specifications: Requirements for De-Identification of PHI. A DoD covered entity may determine that health information is not individually identifiable health information only if: (a) A person with appropriate knowledge of and experience with generally accepted statistical and scientific principles and methods for rendering information not individually identifiable, applying such principles and methods, determines that the risk is very small that the information could be used, alone or in combination with other reasonably available information, by an anticipated recipient to identify an individual who is a subject of the information, and documents the methods and results of the analysis that justify such determination. (b) The identifiers listed in Paragraph 4.5.a.(2)(c) of the individual or of relatives, employers, or household members of the individual, are removed and the DoD covered entity does not have actual knowledge that the information could be used alone or in combination with other information to identify an individual who is a subject of the information.

Para. 4.5h. Standard: Deceased Individuals. A DoD covered entity must comply with the requirements of this issuance regarding the PHI of a deceased individual for a period of 50 years following the death of the individual.

Attribution: Ben Garrett, Fort Benning spokesman

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