523. Risk factors for febrile respiratory illness and mono-viral infections in a semi-closed 2 military environment: a case-control study
Session: Poster Abstract Session: Respiratory Infections: Viral (non Influenza)
Thursday, October 8, 2015
Room: Poster Hall
  • risk factors.pdf (797.3 kB)
  • Background:

    Febrile respiratory illness (FRI) results in substantial burden in semi-closed environments. Tackling risk factors may reduce transmission and infection. However, risk factors involved in one setting may not be generalizable in all settings due to differences in climate, residential environment, population genetic and cultural backgrounds. This study aims to identify risk factors of FRI and mono-viral infections in a tropical military environment. 


    From year 2009 to 2012, military personnel with temperature ≥37.5oC, cough and/or sore throat, and personnel with no fever or no respiratory symptoms were recruited as cases and controls, respectively. Subjects provided nasal wash specimens and answered a standardized questionnaire. Resplex assays were used to determine the viral etiologies. Descriptive, univariate and multivariate analyses of the variables were performed using appropriate descriptive tests and logistic regression modelling, respectively, with R program.


    A total of 7,743 FRI cases and 1,247 non-FRI study controls were recruited. Increasing age [adjusted odds ratio (AOR)=1.03; 95% confidence interval (CI)=1.01-1.05], recruit camp (AOR=4.67; 95%CI=3.99-5.46) and smoker (AOR=1.31; 95%CI=1.13-1.52) were independent risk factors of FRI. Malay ethnicity was positively associated with influenza A(H1N1)pdm09 (AOR=1.50; 95%CI=1.04-2.15) and coxsackie/echovirus (AOR=1.67; 95%CI=1.19-2.36) mono-infection. Significant contact risk factors were stay-out personnel with ill household member (AOR=4.96; 95%CI=3.39-7.24), and stay-in personnel with ill bunkmate and household member (AOR=3.55; 95%CI=2.57-4.91). Staying in camp with none ill in bunk and at home was a protective factor against FRI (AOR=0.80; 95%CI=0.64-0.99). These contact risk factors were similarly observed for the five most common viruses detected, namely adenovirus, rhinoviruses, influenza A and B, and coxsackie/echovirus.


    Increasing age, smoker, recruit-camp, stay-out personnel with ill household members and stay-in personnel with ill bunkmates were independent risk factors of FRI in a semi-closed military environment. Early identification and isolation of ill personnel from their bunk may be effective to prevent and reduce transmission and disease burden.

    Jun Xiong Pang, PhD1, Jing Jin, PhD1, Christine Gao, MPH2, Marc Ho, MBBS2, Xin Quan Tan, MBBS2, Vernon Lee, MBBS, PhD, MPH, MBA, FAMS2, Jin Phang Loh, PhD3, Boon Huan Tan, PhD3, Wee Hong, Victor Koh, BSC3, Sock Hoon Ng, PhD3, Alex Cook, PhD1, Li Yang Hsu, MBBS1 and Mark Chen, MBBS1, (1)Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, (2)Biodefence Centre, Ministry of Defence, Singapore, Singapore, (3)DSO National Laboratories, Singapore, Singapore


    J. X. Pang, None

    J. Jin, None

    C. Gao, None

    M. Ho, None

    X. Q. Tan, None

    V. Lee, None

    J. P. Loh, None

    B. H. Tan, None

    W. H. V. Koh, None

    S. H. Ng, None

    A. Cook, None

    L. Y. Hsu, None

    M. Chen, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.