Diarrheal and Respiratory Disease Aboard the Hospital Ship, USNS Mercy T-AH 19, during Operation Desert Shield

Abstract

Diarrhea and respiratory disease were common problems among ground troops deployed to the Middle East during Operation Desert Shield. In order to determine the prevalence and impact of diarrheal and upper respiratory disease among shipboard personnel during this period, an epidemiologic survey was conducted on the hospital ship, USNS Mercy T-AH 19. An episode of acute diarrhea was reported by 46% of the surveyed population, and 79% reported upper respiratory symptoms. Six percent of personnel were temporarily unable to perform scheduled duties due to gastrointestinal symptoms and 7% due to respiratory symptoms. Officers were at increased risk of experiencing an episode of diarrhea, and female crew members more often reported respiratory complaints. Improved strategies to prevent diarrhea and respiratory disease among shipboard personnel are needed.

Self Reported Incidence and Morbidity of Acute Respiratory Illness among Deployed U.S. Military in Iraq and Afghanistan

“…Of concern is the apparent temporal increase in the percentage of deployed personnel that reported a decrease in job performance due to a respiratory infection in this study. Our results show 33.8% reported a decrease in job performance due to a respiratory infection compared to previous studies by Sanders, et al and Paparello, et al, which found 14.1% and 7.4%, respectively [4], [5]. A possible reason for this increase may be related to increased job demand on deployed troops; therefore, even minor illness may have a larger impact on performance.…”

“…This association remained significant in the multivariate analysis, even after adjusting for the other covariates. A previous study found that 78.7% of responding Navy personnel aboard the USNS Mercy during Operation Desert Shield reported at least one respiratory infection [5]. The rate of respiratory infection aboard ship was higher than that of ground troops stationed in Saudi Arabia during the same military operation [11].…”

“…Military personnel are at particularly high risk for respiratory infections because of close living conditions, stressful work environments and exposure to novel pathogens in disease-endemic areas during deployments [2], [3]. Non-battle injuries and illness have been responsible for more lost work-time and hospitalizations than combat injuries in U.S. military history [4], [5]. Respiratory illnesses in particular have had a significant impact on military missions [4]–[6].…”

Increased postwar symptoms and psychological morbidity among U.S. Navy Gulf War veterans.

“…44,[51][52][53][54] Some scientists have postulated that unusual respiratory-borne pathogens 16,55 or sand exposure 45,46 might explain Gulf War veteran postwar morbidity. Although chronic respiratory complaints have been reported among Gulf War veterans, 32,37 with 7.4% of the participants in the present study reporting shortness of breath for 30 or more days, surveyed Gulf War veterans showed no evidence of impaired pulmonary airway function.…”

No serologic evidence of an association found between Gulf War service and Mycoplasma fermentans infection.

“…[13][14][15][16] Aggressive preventive measures, 17,18 and the deployment of a sophisticated field laboratory 19 in the theater of operations provided substantial infectious disease morbidity data during the conflict, which essentially ended in 1991. 17,[19][20][21][22][23][24][25][26] These data reveal that U.S. forces experienced diarrheal, [21][22][23][24] respiratory, 24,27 and parasitic infections, 27 although the incidence was much lower than expected. 17 Additional medical data were collected after the war, when the Departments of Defense and Veterans Affairs conducted more than 100,000 comprehensive clinical evaluations of veterans and their families.…”