Diarrhea Outbreak During U.S. Military Training In El Salvador

Abstract

Infectious diarrhea remains a major risk to deployed military units worldwide in addition to their impact on travelers and populations living in the developing world. This report describes an outbreak of diarrheal illness in the U.S. military's 130th Maneuver Enhancement Brigade deployed in San Vicente, El Salvador during a training and humanitarian assistance mission. An outbreak investigation team from U.S. Naval Medical Research Unit - Six conducted an epidemiologic survey and environmental assessment, patient interviews, and collected stool samples for analysis in an at risk population of 287 personnel from May 31st to June 3rd, 2011. Personnel (n = 241) completed an epidemiological survey (87% response rate)and 67 (27%) reported diarrhea and/or vomiting during the past two weeks. The median duration of illness was reported to be 3 days (IQR 2-4 days) and abdominal pain was reported among 30 (49%) individuals. Presentation to the medical aid station was sought by (62%) individuals and 9 (15%) had to stop or significantly reduce work for at least one day. Microscopy and PCR analysis of 14 stool samples collected from previously symptomatic patients, Shigella (7),Cryptosporidium (5), and Cyclospora (4) were the most prevalent pathogens detected. Consumption of food from onbase local vendors (RR = 4.01, 95% CI = 1.53-10.5, p-value ,0.001) and arriving on base within the past two weeks (RR = 2.79 95% confidence [CI] = 1.35-5.76, p-value = 0.001) were associated with increased risk of developing diarrheal disease. The risk of infectious diarrhea is great among reserve military personnel during two week training exercises. The consumption of local food, prepared without proper monitoring, is a risk factor for deployed personnel developing diarrheal illness. Additional information is needed to better understand disease risks to personnel conducting humanitarian assistance activities in the Latin America Region.

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Document Details

Document Type
Technical Report
Publication Date
Jul 01, 2012
Accession Number
ADA562600

Entities

People

  • AndrĂ©s G. Lescano
  • Brian J. Biese
  • Carmen Lucas
  • Duncan Gilles
  • Erik J. Reaves
  • Gary Stolovitz
  • Matthew R. Kasper

Organizations

  • Naval Medical Research Center

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Biomedical Research
  • Diseases And Disorders
  • Drinking Water
  • El Salvador
  • Environmental Assessment
  • Health Services
  • Hygiene
  • Latin America
  • Medical Personnel
  • Military Operations
  • Military Personnel
  • Military Training
  • Pain
  • Pcr Testing
  • Public Health
  • Surveys
  • Training

Fields of Study

  • Medicine

Readers

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