Acute Respiratory Disease and the Reintroduction of Adenovirus Vaccine in US Army Trainees
Background: Adenoviruses are a cause of respiratory illness in civilian and military populations. The Army's Acute Respiratory Disease Surveillance Program (ARD-SP) was implemented in 1966 to monitor the occurrence of respiratory disease in Initial Entry Training (IET or recruit) centers where outbreaks associated with Adenovirus Types 4 (ADV 4) and 7 (ADV 7) were occurring. The ARD-SP later documented the effectiveness of live, oral ADV 4 and ADV7 vaccine introduced in 1971. Manufacture of ADV 4 and ADV 7 vaccine ended in 1994 and all vaccine stocks were depleted in 1999. Subsequently, ARD rates increased at IET installations. In March 2011, a new ADV 4 & 7 vaccine was licensed by the Food and Drug Administration for use in US Military Members. Administration of the new vaccine began in November 2011.
Methods: Weekly ARD-SP data from four Army IET sites collected by the US Army Public Health Command were evaluated to develop ARD rates per 100 trainee weeks for the total Army IET population and each IET installation for calendar years 2010, 2011 and 2012 using SPSS ver. 21.
Results: ARD rates dropped dramatically at the end of 2011 (see figure). The overall mean ARD rate was five times higher in 2010 than in 2012 (0.43/100 trainee weeks vs. 0.08/100 trainee weeks). ARD rates varied between sites. Site 2 saw the biggest decrease (88%), with ARD rates decreasing from an average of 0.59/100 trainee weeks in 2010 to 0.07/100 trainee weeks in 2012.
Conclusion: The reintroduction of the two tablet, oral Adenovirus vaccine has been associated with a dramatic and sustained decrease in ARD rates in US Army Initial Entry Training populations. This was expected since during the absence of the vaccine two-thirds of recruits with respiratory disease tested were positive for an adenovirus and 80% of those specimens were positive for ADV 4. Since adenovirus outbreaks have been reported in militaries of other countries and civilian settings such as residential facilities with close personal contact, other populations might benefit from the Adenovirus vaccine.
Z. Mccormic, None
J. Gaydos, None