1035. Epidemiology and Co-recovery of Respiratory Pathogens in Military Trainees Presenting with Upper Respiratory Illness
Session: Poster Abstract Session: Diagnostic Procedures in Clinical Practice
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Upper respiratory illness (URI) is a well-described cause of morbidity, expense and lost training time among military trainees. We characterized the epidemiology and clinical presentation of respiratory pathogens among trainees presenting with URI.

Methods: The Advanced Diagnostics Laboratory evaluates epidemiology and rapid diagnostics of respiratory pathogens in trainees with URI. From 1/1/2008 to 4/30/2009, demographic, clinical and PCR data from throat and nasal specimens for respiratory pathogens were prospectively collected on trainees presenting with URI.

Results: 704 cases of URI (88% male) were enrolled with complaints of fever (96%), sore throat (86%), cough (85%), and sinus congestion (79%), and a mean temperature of 101.40F.  The most frequently amplified pathogens were adenovirus (79%) and Haemophilus influenzae (81%). Influenza and Streptococcus pneumoniae were less commonly found (7% and 2%, respectively). Others, including Streptococcus pyogenes, Mycoplasma pneumoniae, Legionella pneumoniae, Chlamydophila pneumoniae, human parainfluenza virus, enterovirus, bocavirus, coronavirus, human metapneumovirus and respiratory syncitial virus were routinely screened for, but rarely or never found. Most cases enrolled in the spring (108 cases in 4/2009), and fewest in the summer (3 in 9/2008).  Adenovirus was most frequently isolated in weeks 6-7 of training, influenza during week 1, and H. influenzae presented throughout. Adenovirus was most commonly found between March and May (88-92% of URI cases), whereas H. influenzae was isolated year round. 67% of cases involved more than 1 pathogen, and 12% more than 2. Adenovirus was present in 90% of coinfections, and the most commonly co-recovered pathogens were adenovirus and H. influenzae (68%), followed distantly by influenza and H. influenzae (3%).

Conclusion: Adenovirus is the predominant URI pathogen in military trainees presenting late in training, typically with co-recovery of other respiratory pathogens, including H. influenzae. Introduction of routine vaccination of adenovirus on arrival to basic training may significantly reduce the morbidity of adenovirus-related URI, as well as coinfection or URI associated with H. influenzae.


Subject Category: J. Clinical practice issues

Charla Tully, DO1, Clinton K. Murray, MD1, William H. Fugate, BS, MBA2, Francine F. Stotler, BS2, Thomas L. Cropper, DVM3, Lisa Lott, PhD2, J. Matthew McDonald, PhD2 and Heather Yun, MD1, (1)San Antonio Military Medical Center, Fort Sam Houston, TX, (2)Eagle Applied Sciences Advanced Diagnostics Laboratory, 59th Medical Wing, Lackland AFB, TX, (3)Trainee Health Surveillance, Lackland AFB, TX

Disclosures:

C. Tully, None

C. K. Murray, None

W. H. Fugate, None

F. F. Stotler, None

T. L. Cropper, None

L. Lott, None

J. M. McDonald, None

H. Yun, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.