title: Enteric disease on Operation HERRICK.
abstract: BACKGROUND
  It is increasingly recognised that diarrhoeal disease is an important contributor to disease non-battle injury (DNBI) rates on operations. Current data collection methods (J97/EPINATO) rely on self-presentation of patients to medical care, which is likely to under-record the true incidence of diarrhoea in theatre. Along with this, the data recording itself is less than adequate, with acknowledged issues in classification of diarrhoeal disease within J97/EPINATO categories.
  
  
  METHODS
  Two post-tour diarrhoeal disease questionnaire surveillance exercises were carried out at the end of Operation HERRICK 6 (H6) and 10 (H10), respectively.
  
  
  RESULTS
  Crude diarrhoeal disease attack rates were similar across the two surveillance periods with approximately 40% of troops questioned reporting at least one diarrhoeal illness episode. The severity of illness increased from H6 to H10 as measured by disease-related symptomatology and days ill and/or off work. Mission burden was substantial and increased in H10 compared with H6.
  
  
  CONCLUSIONS
  Diarrhoeal disease is a significant cause of DNBI on operations. Current data collection methodologies underestimate its incidence and true operational burden.
authors.affiliation: Military Enteric Disease Group, Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Connor
authors.forename: E
authors.initials: E
authors.lastname: Hutley
authors.forename: H E
authors.initials: HE
authors.lastname: Mulcahy
authors.forename: M S
authors.initials: MS
authors.lastname: Riddle
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D011159:Population Surveillance; D012307:Risk Factors; D012720:Severity of Illness Index; D018582:Sick Leave / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: EPIDEMIOLOGY; INFECTIOUS DISEASES; PUBLIC HEALTH