title: Diarrheal illness among deployed U.S. military personnel during Operation Bright Star 2001--Egypt.
abstract: In the fall of 2001, approximately 15,000 U.S. military personnel participated in a military exercise in the northwestern Egyptian desert. To assess the prevalence and impact of diarrhea and enteropathogen distribution, we conducted a post-deployment survey and a case series study. A departure convenience sampling (n = 3725) was used in the post-deployment survey. Overall, 9.3% reported diarrhea, 2.6% sought medical care, and 2.8% stopped or decreased their work for at least a day. Among those reporting diarrhea, 41.7% had symptoms for less than 2 days, 43.5% had symptoms from 2-5 days, and 14.8% had symptoms for more than 5 days. In the case series study, pathogens were identified in 53.6% of the 129 cases enrolled. Pathogens identified included enterotoxigenic E. coli (n = 53), enteroaggregative E. coli (n = 13), Cryptosporidium (n = 9), Campylobacter jejuni (n = 7), noroviruses (n = 7), Shigella flexneri (n = 2), rotavirus (n = 2), and Entamoeba histolytica (n = 2). Among those seeking care for diarrhea, two thirds reported a decreased ability or inability to perform their jobs for at least one day, but overall, diarrhea was much less prevalent than in past surveys in this region, with minimal impact on the mission.
authors.affiliation: Naval Medical Research Unit #3, Cairo, AE 09835, Egypt. sandersj@namru3.med.navy.mil
authors.forename: John W
authors.initials: JW
authors.lastname: Sanders
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Putnam
authors.forename: Philip
authors.initials: P
authors.lastname: Gould
authors.forename: John
authors.initials: J
authors.lastname: Kolisnyk
authors.forename: Norma
authors.initials: N
authors.lastname: Merced
authors.forename: Vincent
authors.initials: V
authors.lastname: Barthel
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Rozmajzl
authors.forename: Hind
authors.initials: H
authors.lastname: Shaheen
authors.forename: Salwa
authors.initials: S
authors.lastname: Fouad
authors.forename: Robert W
authors.initials: RW
authors.lastname: Frenck
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D011528:Protozoan Infections / Q000150:complications* / Q000453:epidemiology / Q000469:parasitology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014481:United States / Q000208:ethnology; D014777:Virus Diseases / Q000150:complications* / Q000453:epidemiology / Q000821:virology