Abstract. The safety and immunogenicity of Japanese encephalitis (JE) vaccine (Nakayama strain, monovalent / BIKEN) was studied in 538 U.S. soldiers in 1990. Three doses of vaccine from three consecutively manufactured lots were given on days 0, 7, and either 14 or 30. Serum for antibody determination was drawn at months 0, 2, and 6. Japanese encephalitis plaque reduction neutralization tests were performed by three laboratories on each specimen. Five hundred twenty-eight (98%) participants completed the immunization series. All recipients without antibody before immunization developed neutralizing antibody against JE virus. There were no differences in geometric mean titer among the three test lots at months 2 and 6. Soldiers who received the third dose on day 30 had higher titers at both time points. Antibody to yellow fever had no significant effect on immune response to vaccine. Conclusions drawn from analysis of serologic data from the three labs were nearly identical. Symptoms were generally limited to mild local effects and were reduced in frequency with each subsequent does in the series (21% to 11%; P Ͻ 0.0001). Generalized symptoms were rare (e.g., fever ϭ 5%) with no reported cases of anaphylaxis.
Most military physicians know that disease and non-battle injuries (DNBIs) have historically caused more death during war than battle injury. Most DNBIs are preventable, but many unit surgeons and physician assistants, especially at battalion/squadron and brigade/wing level, may not have had the benefit of preventive medicine training or experience. The authors present a logical and thorough framework that all unit surgeons can use to organize their preventive efforts.
The Department of Defense has conducted extensive HIV testing for over 5 years. We summarize the epidemiology of the HIV infection in the total Army. While screening of civilian applicants effectively ensures seronegativity of enlistees, there are approximately 220 new HIV infections each year among active duty soldiers. High-risk demographic groups in the Army include single soldiers, males, those age 25-35, blacks, and Hispanics (including black and Hispanic females). While preventive efforts in the Army should reflect the higher risk experienced by these groups, all soldiers should be made aware of their susceptibility as the epidemic evolves to include more women and heterosexual men.
For a variety of reasons, occupational health services at Army Material Command installations became severely strained during the 1980s. The Occupational Health Partnership Program, developed to improve this support, describes control, responsibility, and cost sharing between Army Materiel Command and Army Medical Command. This innovative approach is finding new solutions to challenging problems. The authors describe the history, principles, status, and possible future of the partnership program.
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