Vaccine-preventable adenoviral respiratory illness in US military recruits, 1999-2004.
METHODS
The high burden of respiratory infections in military populations is well documented throughout history. The primary pathogen responsible for morbidity among US recruits in training was shown to be adenovirus. Highly efficacious oral vaccines were used for 25 years, but vaccine production ceased in 1996, and available stores were depleted by early 1999. Surveillance for acute febrile respiratory illness was performed at eight military recruit training sites throughout the United States from July 1999 through June 2004 to document rates after loss of the vaccines. Laboratory diagnoses complimented the surveillance efforts.


RESULTS
Over the 5 years, nearly 12 million person-weeks were followed and an estimated 110,172 febrile respiratory illness cases and 73,748 adenovirus cases were identified. Rates of illness were highest at the Navy and Air Force training centers, with average annual rates of 1.20 and 1.35 cases per 100 recruit-weeks, respectively. Adenoviral-associated illness rates peaked in weeks 3-5 of training, depending upon service.


CONCLUSIONS
The burden of adenoviral illness among US recruit populations has returned to high levels since loss of the vaccines. Restoration of an effective adenovirus vaccine effort within the military is anticipated by 2008, potentially reducing the adenovirus morbidity suffered in this vulnerable population. Efforts to determine the burden of adenovirus and potential benefits of vaccination in civilian populations are being renewed.
Department of Defense Center for Deployment Health Research, Naval Health Research Center, P.O. Box 85122, San Diego, CA 92186-5122, USA. russell@nhrc.navy.mil
Kevin L
KL
Russell
Anthony W
AW
Hawksworth
Margaret A K
MA
Ryan
Jennifer
J
Strickler
Marina
M
Irvine
Christian J
CJ
Hansen
Gregory C
GC
Gray
Joel C
JC
Gaydos
D000258:Adenovirus Infections, Human / Q000453:epidemiology* / Q000517:prevention & control; D000260:Adenoviruses, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008889:Military Personnel; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control; D013997:Time Factors; D014481:United States / Q000453:epidemiology