Surveillance for Febrile Respiratory Infections during Cobra Gold 2003

Abstract

The Naval Health Research Center was charged with conducting laboratory-based surveillance for respiratory infections including severe acute respiratory syndrome (SARS), at the 2003 Cobra Gold Exercise in Thailand. SARS transmission was not known to be present in Thailand in early 2003, and there were concerns that exercise participants could bring SARS into the country. Respiratory illness surveillance was initiated, including geographic exposure history for elucidating a SARS "suspect" case. Although no suspect SARS cases were identified, 17 individuals met the case definition for febrile respiratory illness; diagnostic specimens were obtained from 16. Laboratory testing identified influenza A in 44%; selected sequence analysis demonstrated these were Fujian-like influenza strains, which was the predominant strain found globally in 2003/2004. Concern for SARS transmission was eased and knowledge of circulating respiratory pathogens was obtained as the logistics of implementing respiratory surveillance during a military training operation were overcome. 4

Review a brief history of coronaviruses in Thailand

“…Similarly, HCov-OC43 and HCoV-229E were detected in respiratory samples from suspected influenza cases ( Wertheim et al, 2015 ). HCov-OC43 was detected in US military personal with fever and respiratory symptoms or diagnosed with pneumonia who were stationed in Thailand for the 2003 Cobra Gold military exercise ( Fuller et al, 2006 ), and HCoV-229E has been detected in Thai military recruits with respiratory illness ( Levy et al, 2015 ). Uncharacterized human coronaviruses have been variously detected in children with community acquired pneumonia ( Pratheepamornkull et al, 2015 ) and in samples from patients with influenza-like illness ( Horthongkham et al, 2014 ).…”

Global Infectious Disease Surveillance at DoD Overseas Laboratories, 1999–2007

“…In addition, direct-support projects often took the form of providing epidemiologic support to major, multi-country military training exercises in Asia and North Africa. [10][11][12][13][14] The presidential directive adding EID surveillance and response to DoD's responsibilities named the overseas laboratories because of their strategic positioning and considerable expertise. During the 1980s and 1990s, the Military Infectious Diseases Research Program prioritized funding toward the development of specific drugs and vaccines at the overseas laboratories.…”

Applications of PCR (Real-Time and MassTag) and Enzyme-Linked Immunosorbent Assay in Diagnosis of Respiratory Infections and Diarrheal Illness Among Deployed U.S. Military Personnel During Exercise Balikatan 2009, Philippines

“…Diarrheal and acute respiratory illnesses are considered important health concerns among military personnel during deployments. [1][2][3] Infectious diarrhea is one of the more common medical problems associated with military operations, 4 with the disease documented to cause signifi cant loss in person-days and increase in health care utilization. [4][5][6] Acute respiratory infections and infl uenza can also have significant operational implications especially in the setting of local outbreaks.…”