title: Hotel clinic-based diarrheal and respiratory disease surveillance in U.S. service members participating in Operation Bright Star in Egypt, 2009.
abstract: We conducted clinic-based, influenza-like illness and diarrheal disease surveillance among U.S. service members participating in Operation Bright Star 2009. Epidemiologic data and samples were collected. Nasopharyngeal swab specimens were tested for viruses, and feces was tested for microbiologic, immunologic, and molecular diagnostics. A survey was used to collect self-reported data. From 1,529 surveys, 41% reported diarrheal disease and 25% reported respiratory illness (incidence rate = 62 of 100 versus 37 of 100 person-months; incidence rate ratio = 1.7, 95% confidence interval = 1.5-1.9). Enterotoxigenic Escherichia coli was identified in 74% (69 of 93) of fecal samples. In the influenza-like illness case series, 17% (9 of 52) were positive for influenza A; all were positive for pandemic (pH1N1) 2009 virus. Rates of decreased work performance reported by patients with diarrhea and influenza-like illness were similar (46% versus 48%; P = 0.8). Diarrheal diseases and respiratory illness remain common among deployed military personnel, with important operational impact. Despite an ongoing influenza pandemic, diarrheal disease incidence was higher than that of respiratory illness.
authors.affiliation: United States Naval Medical Research Unit Number 3, Cairo, Egypt. Peter.Sebeny@med.navy.mil
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Sebeny
authors.forename: Isabelle
authors.initials: I
authors.lastname: Nakhla
authors.forename: Manal
authors.initials: M
authors.lastname: Moustafa
authors.forename: Jody A
authors.initials: JA
authors.lastname: Bruton
authors.forename: Joanne
authors.initials: J
authors.lastname: Cline
authors.forename: Douglas
authors.initials: D
authors.lastname: Hawk
authors.forename: Hanan
authors.initials: H
authors.lastname: El-Mohammady
authors.forename: Rania A
authors.initials: RA
authors.lastname: Nada
authors.forename: Salwa F
authors.initials: SF
authors.lastname: Ahmed
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pimentel
authors.forename: Sylvia Y N
authors.initials: SY
authors.lastname: Young
mesh_terms: D000328:Adult; D003967:Diarrhea / Q000453:epidemiology*; D004196:Disease Outbreaks; D004534:Egypt / Q000453:epidemiology; D005243:Feces / Q000382:microbiology / Q000469:parasitology; D005260:Female; D006801:Humans; D015994:Incidence; D009980:Influenza A virus / Q000235:genetics; D008297:Male; D008889:Military Personnel; D016012:Poisson Distribution; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D014481:United States / Q000208:ethnology
chemical_list: D012367:RNA, Viral