1921
Volume 75, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

A health assessment survey was collected from US military personnel deployed to the Middle East taking part in the “Rest and Recuperation” program or on temporary assignment to Camp As Sayliyah Doha, Qatar, from January to December 2004. In addition, a concurrent clinic-based observational study was conducted to determine pathogen etiology and potential risk factors. From 28,322 health assessment surveys, overall self-reported incidence of diarrhea was 4.9 cases per 100 person-months. Disease incidence increased with rank and was higher in Iraq compared with Afghanistan. During this period, 109 US military personnel with acute diarrhea and 85 asymptomatic personnel were enrolled in the observational study. Enterotoxigenic (ETEC) was the predominant pathogen (32%), followed by enteroaggregative (12%) and spp. (6%). These data are consistent with previous reports implicating ETEC as the primary cause of acute diarrhea for military personnel deployed to this region.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2006.75.762
2006-10-01
2017-09-19
Loading full text...

Full text loading...

/deliver/fulltext/14761645/75/4/0750762.html?itemId=/content/journals/10.4269/ajtmh.2006.75.762&mimeType=html&fmt=ahah

References

  1. Connor P, Farthing MJ, 1999. Travellers’ diarrhea: a military problem? J R Army Med Corps 145 : 95–101.
  2. Hyams KC, Bourgeois AL, Merrell BR, Rozmajzl P, Escamilla J, Thornton SA, Wasserman GM, Burke A, Echeverria P, Green KY, et al., 1991. Diarrheal disease during Operation Desert Shield. N Engl J Med 325 : 1423–1428.
  3. Sanchez JL, Gelnett J, Petruccelli BP, Defraites RF, Taylor DN, 1998. Diarrheal disease incidence and morbidity among United States military personnel during short-term missions overseas. Am J Trop Med Hyg 58 : 299–304.
  4. Cook GC, 2001. Influence of diarrhoeal disease on military and naval campaigns. J R Soc Med 94 : 95–97.
  5. Sanders JW, Putnam SD, Riddle MS, Tribble DR, Jobanputra NK, Jones JJ, Scott DA, Frenck RW, 2004. The epidemiology of self-reported diarrhea in operations Iraqi freedom and enduring freedom. Diagn Microbiol Infect Dis 50 : 89–93.
  6. Putnam SD, Sanders JW, Frenck RW, Monteville M, Riddle MS, Rockabrand DM, Sharp TW, Frankart C, Tribble DR, 2006. Self-reported description of diarrhea among military populations in operations iraqi freedom and enduring freedom. J Travel Med 13 : 92–99.
  7. Sanders JW, Putnam SD, Riddle MS, Tribble DR, 2005. Military importance of diarrhea: Lessons from the Middle East. Curr Opin Gastroenterol 21 : 9–14.
  8. Sanders JW, Putnam SD, Frankart C, Frenck RW, Monteville MR, Riddle MS, Rockabrand DM, Sharp TW, Tribble DR, 2005. Impact of illness and non-combat injury during Operations Iraqi Freedom and Enduring Freedom (Afghanistan). Am J Trop Med Hyg 73 : 713–719.
  9. Thornton SA, Sherman SS, Farkas T, Zhong W, Torres P, Jiang X, 2005. Gastroenteritis in US Marines during Operation Iraqi Freedom. Clin Infect Dis 40 : 519–525.
  10. Sanders JW, Isenbarger DW, Walz SE, Pang LW, Scott DA, Tamminga C, Oyofo BA, Hewitson WC, Sanchez JL, Pitarangsi C, Echeverria P, Tribble DR, 2002. An observational clinic-based study of diarrheal illness in deployed United States military personnel in Thailand: presentation and outcome of Campylobacter infection. Am J Trop Med Hyg 67 : 533–538.
  11. Svennerholm AM, Wikstrom M, Lindblad M, Holmgren J, 1986. Monoclonal antibodies against Escherichia coli heat-stable toxin (STa) and their use in a diagnostic ST ganglioside GM1-enzyme-linked immunosorbent assay. J Clin Microbiol 24 : 585–590.
  12. Svennerholm AM, Wiklund G, 1983. Rapid GM1-enzyme-linked immunosorbent assay with visual reading for identification of Escherichia coli heat-labile enterotoxin. J Clin Microbiol 17 : 596–600.
  13. Silberschmidt G, Schick MT, Steffen R, Kilpatrick ME, Murphy JR, Oyofo BA, el-Etr S, Gyurech D, Mourad AS, Mathewson JT, DuPont HL, 1995. Treatment of travellers’ diarrhoea: zaldaride compared with loperamide and placebo. Eur J Gastroenterol Hepatol 7 : 871–875.
  14. Gunzburg ST, Tornieporth NG, Riley LW, 1995. Identification of enteropathogenic Escherichia coli by PCR-based detection of the bundle-forming pilus gene. J Clin Microbiol 33 : 1375–1377.
  15. Kolling GL, Matthews KR, 1999. Export of virulence genes and Shiga toxin by membrane vesicles of Escherichia coli O157:H7. Appl Environ Microbiol 65 : 1843–1848.
  16. Riddle MS, Tribble DR, Jobanputra NK, Jones JJ, Putnam SD, Frenck RW, Sanders JW, 2005. Knowledge, attitudes, and practices regarding epidemiology and management of travelers’ diarrhea: A survey of front-line providers in Iraq and Afghanistan. Mil Med 170 : 492–495.
  17. Riddle MS, Sanders JW, Putnam SD, Tribble DR, 2006. Incidence, etiology, and impact of diarrhea among long-term travelers (US military and similar populations): A systematic review. Am J Trop Med Hyg 74 : 891–900.
  18. Cohen D, Block CS, Ambar R, Shif I, Greenberg Z, Green MS, 1992. Pilot study of an extended range of potential etiologic agents of diarrhea in the Israel Defense Forces. Isr J Med Sci 28 : 49–51.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2006.75.762
Loading
/content/journals/10.4269/ajtmh.2006.75.762
Loading

Data & Media loading...

  • Received : 15 Mar 2006
  • Accepted : 30 Jun 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error