Gastroenteritis Outbreak in British Troops, Iraq

Bailey, M S; Boos, Christopher J.; Vautier, Guy; Green, Andrew D.; Appleton, Hazel; Gallimore, Christopher; Gray, Jim; Beeching, Nicholas

doi:10.3201/eid1110.050298

Cited by 34 publications

(20 citation statements)

References 14 publications

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“…Gastroenteritis has always been a scourge on military campaigns [1], but recent experience suggests that the usual bacterial causes are being overtaken by viruses [2][3][4]. Norovirus is now a major cause of gastroenteritis outbreaks in military populations [5] and other semi-closed communities such as hospitals, hotels, cruise ships, nurseries and nursing homes [6].…”

Section: Introductionmentioning

confidence: 99%

Viral Gastroenteritis Outbreaks in Deployed British Troops During 2002-7

Bailey

Gallimore²,

Lines

et al. 2008

J R Army Med Corps

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Section: Introductionmentioning

confidence: 99%

Viral Gastroenteritis Outbreaks in Deployed British Troops During 2002-7

Bailey

Gallimore²,

Lines

et al. 2008

J R Army Med Corps

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“…This may have been true for established military operations with good facilities in areas where exotic, emerging or re-emerging infections did not occur. However, during operations in Sierra Leone (1999–2002), there were outbreaks of malaria47 and intestinal helminths;48 in Iraq (2003–2009), there were outbreaks of viral gastroenteritis (Figure 6)49 50 and bacterial gastroenteritis (L Lines, personal communication); and in Afghanistan (2001 onwards) there were outbreaks of viral gastroenteritis,51 bacterial gastroenteritis (E Hutley, personal communication), cutaneous leishmaniasis52 and ‘Helmand Fever’ caused by sandfly fever, acute Q fever or rickettsial infections (including typhus) 43 53. In Iraq and Afghanistan, complex trauma-related wound infections with multi-drug resistance have also occurred and these create new challenges for surgeons, medical microbiologists, infectious disease physicians and infection control practitioners 54 55.…”

Section: British Military Experiences In the 21st Centurymentioning

confidence: 99%

“…Although infectious and tropical diseases now rarely cause deaths in British military personnel, they can still have a serious impact on operational effectiveness and military medical resources 49 51. Infections such as Q fever and bacterial gastroenteritis can also have serious long-term sequelae that are not recognised by current data collection methods.…”

Section: British Military Experiences In the 21st Centurymentioning

confidence: 99%

A brief history of British military experiences with infectious and tropical diseases

Bailey

2013

J R Army Med Corps

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Infectious and tropical diseases have been a problem for British expeditionary forces ever since the Crusades. Outbreaks were especially common on Navy ships from the 16th to 18th centuries due to poor living conditions and travel to the tropics. However, since these occurred in small, isolated and controlled environments it meant that naval medical practitioners were able to keep detailed records and develop empirical approaches for their prevention. The first Royal Naval Hospitals were established in response to these diseases and Royal Navy doctors made valuable early contributions towards understanding them. Even larger outbreaks of infectious and tropical diseases occurred in the Army during the Napoleonic, Crimean and Boer Wars and throughout the colonial era, which strongly influenced the formation of the Army Medical Services including provision for teaching and research. The establishment of germ theory led to a golden era of discovery regarding these diseases and British Army doctors made numerous important contributions. Subsequent improvements in prevention, diagnosis and treatment reduced the mortality from infectious and tropical diseases during the World Wars, but they remained a significant problem in the non-European campaigns and also the numerous ‘small wars’ that followed. Even in the 21st century some of these diseases still cause outbreaks with significant morbidity and impact on deployments, but the military clinical and academic resources to deal with them are now much reduced. Preventive measures such as hygiene, sanitation, infection control, vaccination and chemoprophylaxis are invaluable, but history shows that these can become neglected over time and disrupted or overwhelmed during the early or most intense stages of military operations. This is why military specialists in infectious diseases, tropical medicine, sexual health, medical microbiology and communicable diseases control are still required.

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“…9,10 In addition, there has been increasing attention paid to the impact of viral gastroenteritis, including norovirus, which has been shown to have an operational impact during outbreaks. 11 The short-term morbidity from diarrheal illness increases health care service use, loss of human-hours, and may cause transient critical shortages in the deployed force. Meanwhile, there have been important efforts to understand more intermediate and longterm effects of diarrheal disease in a traveler population, such as the risk of post-infectious irritable bowel syndrome and other long-term sequelae.…”

Section: Introductionmentioning

confidence: 99%

Hotel Clinic-Based Diarrheal and Respiratory Disease Surveillance in U.S. Service Members Participating in Operation Bright Star in Egypt, 2009

Sebeny

Nakhla²,

Moustafa³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. We conducted clinic-based, influenza-like illness and diarrheal disease surveillance among U.S. service members participating in Operation Bright Star 2009. Epidemiologic data and samples were collected. Nasopharyngeal swab specimens were tested for viruses, and feces was tested for microbiologic, immunologic, and molecular diagnostics. A survey was used to collect self-reported data. From 1,529 surveys, 41% reported diarrheal disease and 25% reported respiratory illness (incidence rate = 62 of 100 versus 37 of 100 person-months; incidence rate ratio = 1.7, 95% confidence interval = 1.5-1.9). Enterotoxigenic Escherichia coli was identified in 74% (69 of 93) of fecal samples. In the influenzalike illness case series, 17% (9 of 52) were positive for influenza A; all were positive for pandemic (pH1N1) 2009 virus. Rates of decreased work performance reported by patients with diarrhea and influenza-like illness were similar (46% versus 48%; P = 0.8). Diarrheal diseases and respiratory illness remain common among deployed military personnel, with important operational impact. Despite an ongoing influenza pandemic, diarrheal disease incidence was higher than that of respiratory illness.

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Gastroenteritis Outbreak in British Troops, Iraq

Cited by 34 publications

References 14 publications

Viral Gastroenteritis Outbreaks in Deployed British Troops During 2002-7

Viral Gastroenteritis Outbreaks in Deployed British Troops During 2002-7

A brief history of British military experiences with infectious and tropical diseases

Hotel Clinic-Based Diarrheal and Respiratory Disease Surveillance in U.S. Service Members Participating in Operation Bright Star in Egypt, 2009

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