Search

This article reports on the occurrence of adenovirus type 4-associated acute respiratory disease epidemic at Fort Jackson army base in 1997. Data show that 66.1% of 1,000 hospitalized trainees had an adenovirus infection., In May 1997, a large, persistent epidemic of adenovirus type 4-associated acute respiratory disease began at Fort Jackson, South Carolina, the largest army basic training center. The epidemic lasted until [...]

Background: Leptospirosis diagnoses have increased in Sarawak, Malaysia in recent years. Methods: To better understand the burden of disease and associated risk factors, we evaluated 147 patients presenting with clinical leptospirosis to local hospitals in Sarawak, Malaysia for the presence of Leptospira and associated antibodies. Sera and urine specimens collected during the acute illness phase were assessed via a commercially available rapid diagnostic test (Leptorapide, Linnodee Ltd., Antrim, Northern Ireland), an ELISA IgM assay (Leptospira IgM ELISA, PanBio, Queensland, Australia) and a pan-Leptospira real-time PCR (qPCR) assay to estimate disease prevalence and diagnostic accuracy of each method. Microagglutination testing was performed on a subset of samples. Results: Overall, 45 out of 147 patients (30.6%) showed evidence of leptospires through qPCR in either one or both sera (20 patients) or urine (33 patients), and an additional ten (6.8%) were considered positive through serological testing, for an overall prevalence of 37.4% within the study population. However, each diagnostic method individually yielded disparate prevalence estimates: rapid test 42.2% for sera and 30.5% for urine, ELISA 15.0% for sera, qPCR 13.8% for sera and 23.4% for urine. Molecular characterization of a subset of positive samples by conventional PCR identified the bacterial species as Leptospira interrogans in 4 specimens. A multivariate risk factor analysis for the outcome of leptospirosis identified having completed primary school (OR = 2.5; 95 CI% 1.0-6.4) and weekly clothes-washing in local rivers (OR= 10.6; 95 CI% 1.4-214.8) with increased likelihood of leptospirosis when compared with those who had not. Conclusion: Overall, the data suggest a relatively high prevalence of leptospirosis in the study population. The low sensitivities of the rapid diagnostic test and ELISA assay against qPCR highlight a need for better screening tools. [ABSTRACT FROM AUTHOR]

Service in the Persian Gulf War does not appear to have caused any significant reproductive abnormalities or increased the risk of birth defects in children of veterans. This was the conclusion of a study which analyzed all live births at 135 military hospitals in the three years after the war. The rate of birth defects was no higher among the 33,998 babies born to Gulf War veterans than in the general population or in veterans not deployed in the Persian Gulf. There was also no increased risk of infertility among Persian Gulf veterans.

Hospitalization rates among US Persian Gulf War veterans during the two years after the war were not higher than in a group of veterans who did not serve in the Persian Gulf. This was demonstrated by researchers who studied hospital data on 547,076 Persian Gulf veterans and 618,335 other veterans. Hospitalization rates were essentially similar in both groups. The Persian Gulf veterans had a higher incidence of certain diagnoses such as benign tumors, anemia and mental disorders. However, postwar stress and a delay in receiving health care could account for this difference.

Cross-species infections with influenza A viruses readily occur between humans and pigs. Pigs often have been infected by human epidemic viruses (1), and swine workers and their family members are [...]

Objectives. To assess the risk of epidemic transmission and to guide immunization policy, the seroprevalence of antibody to measles, mumps, and varicella was determined in a group of young adults. Methods. A cross-sectional study of 1533 US Navy and Marine Corps recruits was conducted in June 1989. Antibody status was determined with commercially available enzyme-linked immunosorbent assays. Results. Direct sex and race adjustment to the 15- to 29-year-old US population resulted in seronegativity rates of 17.8% for measles, 12.3% for mumps, and 6.7% for varicella. Measles and mumps seronegativity rates were higher among Whites whereas varicella seronegativity was higher among non-Whites. Recruits enlisting from outside the 50 US states, especially those from island territories, were more likely to lack varicella antibody. The sensitivity of a positive history of vaccination or disease in predicting antibody status was less than 90% for all diseases. Conclusions. These results suggest a continued potential for epidemics, especially of measles, and the need for mandatory immunization policies. Immigrants to the United States, especially those from island territories, may be a high-risk group that could benefit from varicella vaccination. (Am J Public Health. 1993; 83:1717-1720), Young adults entering military service may have an increased risk of acquiring measles, mumps and chickenpox. A total of 1,533 US Navy and Marine Corps recruits completed questionnaires about their medical history and gave blood samples. The blood samples were analyzed using an enzyme-linked immunoabsorbent assay (ELISA) test. Information given by the recruits about disease history was about 90% accurate for all disease. About one-fifth of the recruits lacked antibodies to measles, 12% lacked mumps antibodies and 9% were seronegative to chickenpox. These results were comparable to an earlier study of 15- to 29-year-olds. These high rates of seronegativity indicate the potential of epidemic spread of the diseases. Effective immunization programs may help reduce the risk of transmission in both the military and civilian populations.

Infections with the bacteria Streptococcus pyogenes, responsible for "Strep throat" and other infections, are common among people living in close quarters. During World War II, there were over a million streptococcal infections in the US Navy, and over 21,000 cases of rheumatic fever, a serious complication which can follow these infections. It has now become common to use penicillin G benzathine injections as a preventive (prophylactic) measure for new recruits arriving at camp. Penicillin G benzathine dissolves very slowly, and so the preparation is suited for providing extended protection. However, recent reports within the military have suggested that the use of this prophylactic treatment was failing to prevent streptococcus infection in many recruits, and therefore a study was conducted to evaluate the transmission of infections among recruits and determine why the penicillin G benzathine prophylaxis was ineffective. A total of 736 Marine recruits were prospectively followed for three months. Routine throat swabs were taken every two weeks to monitor colonization with the bacteria and any infections for which the recruit did not seek medical attention. Despite the fact that 93 percent of the recruits had received penicillin G benzathine injections, 37 percent of the 265 sore throats reported by the recruits were due to S. pyogenes infection. Seven percent of the recruits were allergic to penicillin and did not receive injections. These recruits were more likely to be colonized with the bacteria than were their treated comrades. Furthermore, colonization and infection were found to be more likely in the platoons with a greater percentage of allergic recruits who did not receive the prophylactic treatment. After the study data were obtained, the allergic recruits were placed on oral erythromycin, an alternative antibiotic, and the rate of strep throat decreased. The results of the study indicate that a minority of unprotected individuals can provide a reservoir for infection which can then spread even to the people who have been prophylactically treated. For people living in close quarters, such as military recruits, individuals must not be exempted from prophylactic treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Streptococcus suis is one of the most important pathogens affecting the swine industry. The gram-positive, encapsulated bacterium causes a wide range of clinical disease syndromes in pigs and other domestic [...]

Varicella (chicken pox) is highly contagious. Although varicella virus causes a variety of conditions in children, death is rare. Unfortunately, adults tend to develop more severe disease, and mortality is 25-fold higher. Despite the fact that fewer than 10 percent of adults are thought to be susceptible to varicella, the incidence of the virus among new recruits in the US Army and Navy has recently jumped, resulting in many hospitalizations. The cost of care for varicella illnesses, prevention of transmission, and lost time is high. To plan effective public health measures, the epidemiology of varicella was evaluated by examining hospital records from the Army (1980 to 1988) and Navy (1975 to 1988). These records were compared with those of control subjects, randomly selected soldiers on active duty who did not have varicella. Rates of hospitalization for varicella increased significantly in both military services during the periods studied, and were four to eight times higher than comparable rates for the general population. About half of the patients had been in military service for less than one year. Among Army personnel, several independent factors predisposed a recruit to hospitalization due to varicella infection: young age; being black or Asian-American; being from Puerto Rico, the Caribbean, Guam, the District of Columbia, New York, or New Jersey. Among Navy personnel, risk factors associated with hospitalization for varicella were: young age; being Filipino, Puerto Rican, black, or non-white; being from the Philippines, Puerto Rico, New York, New Jersey, California, Florida, or another country. The reasons why particular races and particular places of origin are associated with increased susceptibility to varicella are unclear. The results suggests that the incidence of varicella is indeed increasing for unknown reasons related to increased susceptibility of young adults. The military services would likely benefit from preventively vaccinating new military personnel, once more is known about the effectiveness of varicella vaccine in adults. (Consumer Summary produced by Reliance Medical Information, Inc.)