title: Respiratory Infections in the U.S. Military: Recent Experience and Control.
abstract: This comprehensive review outlines the impact of military-relevant respiratory infections, with special attention to recruit training environments, influenza pandemics in 1918 to 1919 and 2009 to 2010, and peacetime operations and conflicts in the past 25 years. Outbreaks and epidemiologic investigations of viral and bacterial infections among high-risk groups are presented, including (i) experience by recruits at training centers, (ii) impact on advanced trainees in special settings, (iii) morbidity sustained by shipboard personnel at sea, and (iv) experience of deployed personnel. Utilizing a pathogen-by-pathogen approach, we examine (i) epidemiology, (ii) impact in terms of morbidity and operational readiness, (iii) clinical presentation and outbreak potential, (iv) diagnostic modalities, (v) treatment approaches, and (vi) vaccine and other control measures. We also outline military-specific initiatives in (i) surveillance, (ii) vaccine development and policy, (iii) novel influenza and coronavirus diagnostic test development and surveillance methods, (iv) influenza virus transmission and severity prediction modeling efforts, and (v) evaluation and implementation of nonvaccine, nonpharmacologic interventions.
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA jose.l.sanchez76.ctr@mail.mil.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cooper
authors.affiliation: Naval Health Research Center, San Diego, California, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Myers
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Cummings
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA.
authors.forename: Kelly G
authors.initials: KG
authors.lastname: Vest
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Russell
authors.affiliation: Mayo Clinic, Division of General Internal Medicine, Rochester, Minnesota, USA.
authors.forename: Joyce L
authors.initials: JL
authors.lastname: Sanchez
authors.affiliation: Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA Oak Ridge Institute for Science and Education, Postgraduate Research Participation Program, U.S. Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland, USA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Hiser
authors.affiliation: International STD, Respiratory, and Biothreat Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D004196:Disease Outbreaks / Q000706:statistics & numerical data; D006801:Humans; D008889:Military Personnel; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D014481:United States; D014611:Vaccination / Q000592:standards