title: Acute gastrointestinal infection, respiratory illness, and noncombat injury among US military personnel during Operation Bright Star 2005, in Northern Egypt.
abstract: BACKGROUND
  In the fall 2005, approximately 7,500 US military personnel participated in an exercise in the Egyptian desert. The epidemiology of disease and noncombat injury among deployed troops is important in the context of assessing current mitigation strategies and the development of future ones.
  
  
  METHODS
  To assess the prevalence and impact of diarrhea and enteropathogen distribution, we conducted a case series study. To assess the relative impact of diarrhea compared to respiratory infection and injury, we conducted a post-deployment survey and compared these data to clinic-based syndromic surveillance data.
  
  
  RESULTS
  We enrolled 43 patients with acute diarrhea, 21 (49%) having one or more pathogens isolated. Enterotoxigenic Escherichia coli (n= 16), enteroaggregative E coli (n= 3), and Shigella spp. (n= 3) were the most common pathogens identified. Respiratory illness had the highest incidence (73 episodes/100 person-months) compared to diarrhea (35 episodes/100 person-months) and noncombat injury (17 episodes/100 person-months), though noncombat injury more frequently resulted in lost duty days and health-care utilization.
  
  
  CONCLUSIONS
  Noncombat injuries and illnesses have had a significant impact on military missions and continue to result in force health protection challenges today. Future studies are needed to test and evaluate countermeasures to mitigate these illnesses and injuries to increase the health of the individuals and optimize mission readiness.
authors.affiliation: Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD 20910, USA. markriddlemd@hotmail.com
authors.forename: Mark S
authors.initials: MS
authors.lastname: Riddle
authors.forename: Heather A
authors.initials: HA
authors.lastname: Halvorson
authors.forename: Danny
authors.initials: D
authors.lastname: Shiau
authors.forename: Juliann
authors.initials: J
authors.lastname: Althoff
authors.forename: Marshall R
authors.initials: MR
authors.lastname: Monteville
authors.forename: Hind
authors.initials: H
authors.lastname: Shaheen
authors.forename: Edward P
authors.initials: EP
authors.lastname: Horvath
authors.forename: Adam W
authors.initials: AW
authors.lastname: Armstrong
mesh_terms: D000208:Acute Disease; D000328:Adult; D000704:Analysis of Variance; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011159:Population Surveillance; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D014481:United States / Q000208:ethnology; D014947:Wounds and Injuries / Q000453:epidemiology*