Retrospective Analysis of Demographic and Clinical Factors Associated with Etiology of Febrile Respiratory Illness Among US Military Basic Trainees
Abstract
Basic trainees are historically vulnerable to outbreaks of febrile respiratory illness (FRI). Adenovirus and influenza are common agents responsible for FRI, presenting with similar clinical symptoms. Identifying factors to differentiate between adenovirus and influenza will improve differential diagnosis and improve troop readiness. Methods: Specimens were collected from military trainees meeting FRI case definition (fever greater than or equal to 100.5 Degrees Farenheit with either cough or sore throat; or provider-diagnosed pneumonia) at eight training centers. PCR and/or cell culture testing for respiratory pathogens were performed. Polychotomous logistic regression was employed to assess the association between factors and FRI outcome. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for combinations of predictors. Among 21,570 FRI cases sampled between 2004 and 2009, 63.6% were confirmed adenovirus cases and 6.65% were confirmed influenza. The best multivariate predictors of adenovirus were sore throat (OR, 2.94; 95% CI, 2.66-3.25), cough (OR, 2.33; 95% CI, 2.11-2.57), and fever (OR, 2.07; 95% CI, 1.90-2.26), with a PPV of 77% (p less than or equal to .05). A combination of cough, fever, training week 0-2, and acute onset were most predictive of influenza (PPV = 38%; p less than or equal to .05). Specific demographic and clinical factors were associated with influenza and adenovirus among military trainees.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 05, 2014
- Accession Number
- ADA619166
Entities
People
- Anthony Hawksworth
- Damaris S. Padin
- Dennis J. Faix
- Hector Lemus
- Patrick Blair
- Shannon Putnam
- Stephanie Brodine
Organizations
- Naval Health Research Center