Medical Surveillance Monthly Report (MSMR). Volume 5, Number 4, May 1999
Abstract
Acute respiratory diseases (ARD) cause significant morbidity in military populations. Training centers have traditionally been the foci of respiratory disease epidemics due to the close living conditions, the physically and psychologically stressful activities, and the multitude of pathogens brought together by these troops. For more than five decades, mass antibiotic prophylaxis has been used with success to interrupt outbreaks, to prevent serious clinical sequelae of streptococcal and meningococcal infections, to reduce infection transmission and nasopharyngeal carriage, and to minimize acute febrile respiratory morbidity in general. Still, many military medical officers are reluctant to use mass antibiotic prophylaxis, mainly due to concerns regarding side effects (e.g., allergic reactions), unintended consequences (e.g., antibiotic resistance), and costs. While these concerns are important, they must be weighed against the medical and military operational costs associated with recurrent outbreaks. Of historical note, in March 1991, in the aftermath of outbreaks of pneumococcal pneumonia and streptococcal pharyngitis, Ranger students at Fort Benning began to receive two doses of benzathine penicillin (4 weeks apart) at the start of their training. In September 1997, the prophylaxis regimen was reduced to a single dose, and in March 1998, routine prophylaxis was discontinued altogether. Pneumonia quickly reemerged as a problem among Ranger students, first in the spring of 1998 and then in the winter of 1998-1999 (figure).
Document Details
- Document Type
- Technical Report
- Publication Date
- May 01, 1999
- Accession Number
- ADA497192
Entities
People
- John Brundage
- Kimmie F. Kohlhase
- Mark V Rubertone
- Robert F. DeFraites
Organizations
- Armed Forces Health Surveillance Center