Investigation of an Outbreak of Acute Febrile Respiratory Illness Among Recruits at Lackland Air Force Base, TX.

摘要

A large sustained outbreak of febrile respiratory illness (FRI) began in the Fall of 1999 among basic trainees at Lackland Air Force Base, Texas. Adenovirus was quickly identified as the predominant etiologic pathogen; every isolate typed was found to be type 4. Although the use of the oral adenovirus vaccine had been discontinued at Lackland AFB in 1989, this report documents the first outbreak among Air Force trainees since before the vaccine era. Historical records of respiratory illness occurrence among trainees indicated that this was clearly a new, large outbreak. Over a nine-month period, 1,371 trainees were hospitalized with FRI at a direct cost estimated at $898,O()O. The mean maximum oral temperature of hospitalized trainees was 102.4F and the mean length of stay was 2.7 days, showing that the morbidity was not trivial. An adenovirus carriage prevalence of 16.6% was found among 'well' trainees. Among seroconverters, 43% had no record of seeking medical care during basic training. Self-reported personal hygiene practices were found to be wanting. A number of potentially effective interventions were recommended, none of which were felt to be likely to significantly impact the occurrence of adenovirus-related FRI other than the resumption of administration of an effective vaccine.