title: Viral agents responsible for febrile respiratory illnesses among military recruits training in tropical Singapore.
abstract: BACKGROUND
  Military personnel are highly susceptible to febrile respiratory illnesses (FRI), likely due to crowding, stress and other risk factors present in the military environment.
  
  
  OBJECTIVE
  Our objective was to investigate the viral etiological agents responsible for FRI among military recruits training in a tropical climate in Singapore.
  
  
  METHODS
  From March 2006 through April 2007, a total of 1354 oropharyngeal (throat) swabs were collected from military recruits who reported sick with an oral temperature of > or =38 degrees C and a cough and/or sore throat. Real-time polymerase chain reaction (PCR) was used to assay for the presence of influenza A and B viruses and adenoviruses (H-AdV), and conventional PCR used for the remaining respiratory viruses in all specimens.
  
  
  RESULTS
  Influenza A virus was the dominant infection with a laboratory-confirmed incidence of 24% (326/1354) and a predominance of the H3N2 subtype. The temporal pattern for influenza A virus infections coincided with the nation-wide pattern in the civilian community. Detection rates of 12% (159/1354) and 2.7% (5/1354) were obtained for influenza B virus and other respiratory viruses, respectively.
  
  
  CONCLUSIONS
  The laboratory findings identified influenza A virus as the primary causative viral agent for FRI in the Singapore military, in strong contrast to findings from temperate countries and countries where recruits are often vaccinated for influenza. Our results suggest that influenza vaccination should be considered as a requirement to reduce the incidence of influenza infections. This is the first report describing respiratory infections in a tropical military setting, in a developed country in Asia.
authors.affiliation: Detection and Diagnostics Laboratory, DSO National Laboratories, Singapore.
authors.forename: Shirley Gek-Kheng
authors.initials: SG
authors.lastname: Seah
authors.forename: Elizabeth Ai-Sim
authors.initials: EA
authors.lastname: Lim
authors.forename: Seng
authors.initials: S
authors.lastname: Kok-Yong
authors.forename: Jasper Chin-Wen
authors.initials: JC
authors.lastname: Liaw
authors.forename: Vernon
authors.initials: V
authors.lastname: Lee
authors.forename: Peter
authors.initials: P
authors.lastname: Kammerer
authors.forename: David
authors.initials: D
authors.lastname: Metzgar
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Russell
authors.forename: Boon-Huan
authors.initials: BH
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008889:Military Personnel; D009960:Oropharynx / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000821:virology*; D012846:Singapore; D014777:Virus Diseases / Q000821:virology*; D014780:Viruses / Q000145:classification* / Q000302:isolation & purification*; D055815:Young Adult