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Sanchez JL, Cooper MJ, Myers CA, Cummings JF, Vest KG, Russell KL, Sanchez JL, Hiser MJ, Gaydos CA. Respiratory Infections in the U.S. Military: Recent Experience and Control. Clin Microbiol Rev 2015; 28:743-800. [PMID: 26085551 PMCID: PMC4475643 DOI: 10.1128/cmr.00039-14] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This comprehensive review outlines the impact of military-relevant respiratory infections, with special attention to recruit training environments, influenza pandemics in 1918 to 1919 and 2009 to 2010, and peacetime operations and conflicts in the past 25 years. Outbreaks and epidemiologic investigations of viral and bacterial infections among high-risk groups are presented, including (i) experience by recruits at training centers, (ii) impact on advanced trainees in special settings, (iii) morbidity sustained by shipboard personnel at sea, and (iv) experience of deployed personnel. Utilizing a pathogen-by-pathogen approach, we examine (i) epidemiology, (ii) impact in terms of morbidity and operational readiness, (iii) clinical presentation and outbreak potential, (iv) diagnostic modalities, (v) treatment approaches, and (vi) vaccine and other control measures. We also outline military-specific initiatives in (i) surveillance, (ii) vaccine development and policy, (iii) novel influenza and coronavirus diagnostic test development and surveillance methods, (iv) influenza virus transmission and severity prediction modeling efforts, and (v) evaluation and implementation of nonvaccine, nonpharmacologic interventions.
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Affiliation(s)
- Jose L Sanchez
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Michael J Cooper
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | | | - James F Cummings
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA
| | - Joyce L Sanchez
- Mayo Clinic, Division of General Internal Medicine, Rochester, Minnesota, USA
| | - Michelle J Hiser
- Armed Forces Health Surveillance Center, Silver Spring, Maryland, USA Oak Ridge Institute for Science and Education, Postgraduate Research Participation Program, U.S. Army Public Health Command, Aberdeen Proving Ground, Aberdeen, Maryland, USA
| | - Charlotte A Gaydos
- International STD, Respiratory, and Biothreat Research Laboratory, Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
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Vest KG, Clark LL. Serosurvey and observational study of US Army Veterinary Corps officers for Q fever antibodies from 1989 to 2008. Zoonoses Public Health 2013; 61:271-82. [PMID: 23859558 PMCID: PMC4171783 DOI: 10.1111/zph.12067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Indexed: 11/30/2022]
Abstract
Since World War II, the military has experienced outbreaks of Q fever among deploying units including recent case reports of Q fever in US military personnel returning from serving in the Middle East during Operation Iraqi Freedom and Operation Enduring Freedom. Occupational exposure and prevalence of Q fever among US Army Veterinary Corps officers have not been examined. A retrospective serosurvey and observational study of 500 military veterinarians were conducted using archived serum specimens from military veterinarians who entered and served between 1989 and 2008 and were tested for exposure to Coxiella burnetii. Corresponding longitudinal health-related, demographic, medical and deployment data were examined. A total of 69 (13.8%) individuals at military entry and 85 (17%) had late career positive titres. A total of 18 (3.6%) individuals showed seroconversion. Women were more likely to be seropositive after military service [prevalence ratio (PR) 1.96; 95% confidence interval (CI) 1.15–3.35] and were also more likely to seroconvert (incidence rate ratio 3.55; 95% CI 1.19–12.7). Women who deployed to Operation Iraqi Freedom were more likely to be seropositive (PR 3.17; 95% CI 1.03–9.71). Veterinarians with field service and pathology specialties had the highest incidence rates (7.0/1000 PY; 95% CI 4–12 and 3–19, respectively). This is the first report documenting US military veterinarians' exposure to C. burnetii. Military veterinarians are at risk prior to service, with moderate number of new cases developing during service and most maintaining titres for long periods of time. Women consistently demonstrated higher seroprevalence and incidence levels. As increasing numbers of women enter the veterinary profession and subsequently the US Army, this may warrant close monitoring. This study likely underestimates exposure and risk and does not address chronic health effects, which may be valuable to explore in future health studies.
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Affiliation(s)
- K G Vest
- Armed Forces Health Surveillance Center, Silver Spring, MD, USA
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Blazes DL, Bondarenko JL, Burke RL, Vest KG, Fukuda MM, Perdue CL, Tsai AY, Thomas AC, Chandrasekera RM, Cockrill JA, Von Thun AM, Baliga P, Meyers M, Quintana M, Wurapa EK, Mansour MM, Dueger E, Yasuda CY, Lanata CF, Gray GC, Saylors KE, Ndip LM, Lewis S, Blair PJ, Sloberg PA, Thomas SJ, Lesho EP, Grogl M, Myers T, Ellison D, Ellis KK, Brown ML, Schoepp RJ, Shanks GD, Macalino GE, Eick-Cost AA, Russell KL, Sanchez JL. Contributions of the Global Emerging Infections Surveillance and Response System Network to global health security in 2011. US Army Med Dep J 2013:7-18. [PMID: 23584903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In its 15th year, the Global Emerging Infections Surveillance and Response System (GEIS) continued to make significant contributions to global public health and emerging infectious disease surveillance worldwide. As a division of the US Department of Defense's Armed Forces Health Surveillance Center since 2008, GEIS coordinated a network of surveillance and response activities through collaborations with 33 partners in 76 countries. The GEIS was involved in 73 outbreak responses in fiscal year 2011. Significant laboratory capacity-building initiatives were undertaken with 53 foreign health, agriculture and/or defense ministries, as well as with other US government entities and international institutions, including support for numerous national influenza centers. Equally important, a variety of epidemiologic training endeavors reached over 4,500 individuals in 96 countries. Collectively, these activities enhanced the ability of partner countries and the US military to make decisions about biological threats and design programs to protect global public health as well as global health security.
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Affiliation(s)
- David L Blazes
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Sanchez JL, Johns MC, Burke RL, Vest KG, Fukuda MM, Yoon IK, Lon C, Quintana M, Schnabel DC, Pimentel G, Mansour M, Tobias S, Montgomery JM, Gray GC, Saylors K, Ndip LM, Lewis S, Blair PJ, Sjoberg PA, Kuschner RA, Russell KL, Blazes DL. Capacity-building efforts by the AFHSC-GEIS program. BMC Public Health 2011; 11 Suppl 2:S4. [PMID: 21388564 PMCID: PMC3092414 DOI: 10.1186/1471-2458-11-s2-s4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Capacity-building initiatives related to public health are defined as developing laboratory infrastructure, strengthening host-country disease surveillance initiatives, transferring technical expertise and training personnel. These initiatives represented a major piece of the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) contributions to worldwide emerging infectious disease (EID) surveillance and response. Capacity-building initiatives were undertaken with over 80 local and regional Ministries of Health, Agriculture and Defense, as well as other government entities and institutions worldwide. The efforts supported at least 52 national influenza centers and other country-specific influenza, regional and U.S.-based EID reference laboratories (44 civilian, eight military) in 46 countries worldwide. Equally important, reference testing, laboratory infrastructure and equipment support was provided to over 500 field sites in 74 countries worldwide from October 2008 to September 2009. These activities allowed countries to better meet the milestones of implementation of the 2005 International Health Regulations and complemented many initiatives undertaken by other U.S. government agencies, such as the U.S. Department of Health and Human Services, the U.S. Agency for International Development and the U.S. Department of State.
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Affiliation(s)
- Jose L Sanchez
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Matthew C Johns
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Ronald L Burke
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Mark M Fukuda
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
| | - In-Kyu Yoon
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
| | - Chanthap Lon
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
| | - Miguel Quintana
- U.S. Army Public Health Command Region-South, Building 2472, Schofield Road, Fort Sam Houston, TX 78234, USA
| | - David C Schnabel
- U.S. Army Medical Research Unit-Kenya, U.S. Embassy, Attn: MRU, United Nations Avenue, P.O. Box 606, Village Market 00621 Nairobi, Kenya
| | - Guillermo Pimentel
- Naval Medical Research Unit Number 3, Extension of Ramses Street, Adjacent to Abbassia Fever Hospital, Postal Code 11517, Cairo, Egypt
| | - Moustafa Mansour
- Naval Medical Research Unit Number 3, Extension of Ramses Street, Adjacent to Abbassia Fever Hospital, Postal Code 11517, Cairo, Egypt
| | - Steven Tobias
- Naval Medical Research Unit Number 2, Kompleks Pergudangan DEPKES R.I., JI. Percetakan Negara II No. 23, Jakarta, 10560, Indonesia
| | - Joel M Montgomery
- Naval Medical Research Center Detachment-Peru, Centro Medico Naval “CMST,” Av. Venezuela CDRA 36, Callao 2, Lima, Peru
| | - Gregory C Gray
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Post Office Box 100188, Gainesville, FL 32610, USA
| | - Karen Saylors
- Global Viral Forecasting Initiative, One Sutter Street, Suite 600, San Francisco, CA 94104, USA
| | - Lucy M Ndip
- University of Buea, Department of Biochemistry and Microbiology, Faculty of Science, Post Office Box 63, Buea, South Western Province, Cameroon
| | - Sheri Lewis
- Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, MP2-160, Laurel, MD 20723-6099, USA
| | - Patrick J Blair
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Paul A Sjoberg
- U.S. Air Force School of Aerospace Medicine, Public Health and Preventive Medicine Department, 2513 Kennedy Circle, Building 180, Brooks City-Base, TX 78235-5116, USA
| | - Robert A Kuschner
- Walter Reed Army Institute of Research, Building 503, 503 Robert Grant Avenue, Silver Spring, MD 20910-7500, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - David L Blazes
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - the AFHSC-GEIS Capacity Building Writing Group
- Walter Reed Army Institute of Research, Building 503, 503 Robert Grant Avenue, Silver Spring, MD 20910-7500, USA
- Kenyan Medical Research Institute, Mbagathi Post Office Box 54840, 00200, Nairobi, Kenya
- Landstuhl Regional Medical Center, CMR 402, Box 483, APO AE 09180, USA
- Makerere University Walter Reed Project, Plot 42, Nakasero Road, Post Office Box 16524, Kampala, Uganda
- Makerere University, Faculty of Veterinary Medicine & Medicine, Post Office Box 16524, Kampala, Uganda
- Navy Environmental and Preventive Medicine Unit Number 2, 1887 Powhatan Street, Norfolk, VA 23511-3394, USA
- PharmAccess Foundation, Skyway Building, Third Floor, Plot Number 149/32, Corner of Ohio Street/Sokoine Street, Post Office Box 635, Dar es Salaam, Tanzania
- Tanzania People’s Defence Forces, Defence Forces Headquarters Medical Services, Post Office Box 9203, Dar es Salaam, Tanzania
- U.S. Army Medical Department Activity & 65th Medical Brigade, Korea, Unit 15281, Box 769, APO AP 96205-5281
- U.S. Army Medical Research Institute of Infectious Diseases, Diagnostic Systems Division, 1425 Porter Street, Fort Detrick, MD 21702-5011, USA
- U.S. Army Public Health Command Region-Europe, Building 3810, CMR 402, Box 808, APO AE 09180
- U.S. Army Public Health Command Region-Pacific, Building 715, Camp Zama, Japan, Unit 45006, APO AP 96343-5006
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Burke RL, Vest KG, Eick AA, Sanchez JL, Johns MC, Pavlin JA, Jarman RG, Mothershead JL, Quintana M, Palys T, Cooper MJ, Guan J, Schnabel D, Waitumbi J, Wilma A, Daniels C, Brown ML, Tobias S, Kasper MR, Williams M, Tjaden JA, Oyofo B, Styles T, Blair PJ, Hawksworth A, Montgomery JM, Razuri H, Laguna-Torres A, Schoepp RJ, Norwood DA, MacIntosh VH, Gibbons T, Gray GC, Blazes DL, Russell KL. Department of Defense influenza and other respiratory disease surveillance during the 2009 pandemic. BMC Public Health 2011; 11 Suppl 2:S6. [PMID: 21388566 PMCID: PMC3092416 DOI: 10.1186/1471-2458-11-s2-s6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The Armed Forces Health Surveillance Center's Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) supports and oversees surveillance for emerging infectious diseases, including respiratory diseases, of importance to the U.S. Department of Defense (DoD). AFHSC-GEIS accomplishes this mission by providing funding and oversight to a global network of partners for respiratory disease surveillance. This report details the system's surveillance activities during 2009, with a focus on efforts in responding to the novel H1N1 Influenza A (A/H1N1) pandemic and contributions to global public health. Active surveillance networks established by AFHSC-GEIS partners resulted in the initial detection of novel A/H1N1 influenza in the U.S. and several other countries, and viruses isolated from these activities were used as seed strains for the 2009 pandemic influenza vaccine. Partners also provided diagnostic laboratory training and capacity building to host nations to assist with the novel A/H1N1 pandemic global response, adapted a Food and Drug Administration-approved assay for use on a ruggedized polymerase chain reaction platform for diagnosing novel A/H1N1 in remote settings, and provided estimates of seasonal vaccine effectiveness against novel A/H1N1 illness. Regular reporting of the system's worldwide surveillance findings to the global public health community enabled leaders to make informed decisions on disease mitigation measures and controls for the 2009 A/H1N1 influenza pandemic. AFHSC-GEIS's support of a global network contributes to DoD's force health protection, while supporting global public health.
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Affiliation(s)
- Ronald L Burke
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Kelly G Vest
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Angelia A Eick
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Jose L Sanchez
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Matthew C Johns
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Julie A Pavlin
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
| | - Richard G Jarman
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
| | - Jerry L Mothershead
- Center for Disaster and Humanitarian Assistance Medicine, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Miguel Quintana
- Public Health Region-South, Building 2472, Schofield Road, Fort Sam Houston, TX 78234, USA
| | - Thomas Palys
- Landstuhl Regional Medical Center, Department of Pathology and Area Laboratory Services, CMR 402, APO AE 09180, USA
| | | | - Jian Guan
- Public Health Region-Pacific, Unit 45006, APO AE 96343, USA
| | - David Schnabel
- U.S. Embassy, Attention: MRU, United Nations Avenue, Post Office Box 606, Village Market 00621 Nairobi, Kenya
| | - John Waitumbi
- U.S. Embassy, Attention: MRU, United Nations Avenue, Post Office Box 606, Village Market 00621 Nairobi, Kenya
| | - Alisa Wilma
- Department of Defense Veterinary Food Analysis & Diagnostic Laboratory, 2472 Schofield Road, Suite 2630, Fort Sam Houston, TX 78234, USA
| | - Candelaria Daniels
- Department of Defense Veterinary Food Analysis & Diagnostic Laboratory, 2472 Schofield Road, Suite 2630, Fort Sam Houston, TX 78234, USA
| | - Matthew L Brown
- USAMEDDAC-Korea, Microbiology Section, Unit 15244, Box 459, APO AP 96205, USA
| | - Steven Tobias
- Naval Medical Research Unit Number 2, Kompleks Pergudangan DEPKES R.I., JI. Percetakan Negara II No. 23, Jakarta 10560, Indonesia
| | - Matthew R Kasper
- Naval Medical Research Unit Number 2, Kompleks Pergudangan DEPKES R.I., JI. Percetakan Negara II No. 23, Jakarta 10560, Indonesia
| | - Maya Williams
- Naval Medical Research Unit Number 2, Kompleks Pergudangan DEPKES R.I., JI. Percetakan Negara II No. 23, Jakarta 10560, Indonesia
| | - Jeffrey A Tjaden
- Naval Medical Research Unit No. 3, Extension of Ramses Street, Adjacent to Abbassia Fever Hospital, Postal Code 11517, Cairo, Egypt
| | - Buhari Oyofo
- Naval Medical Research Unit No. 3, Extension of Ramses Street, Adjacent to Abbassia Fever Hospital, Postal Code 11517, Cairo, Egypt
| | - Timothy Styles
- U.S. Navy Environmental Preventive Medicine Unit No. 2, 1887 Powhatan Street, Norfolk, VA 23511, USA
| | - Patrick J Blair
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Anthony Hawksworth
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
| | - Joel M Montgomery
- Naval Medical Research Center Detachment, Centro Medico Naval “CMST,” Av. Venezuela CDRA 36, Callao 2, Lima, Peru
| | - Hugo Razuri
- Naval Medical Research Center Detachment, Centro Medico Naval “CMST,” Av. Venezuela CDRA 36, Callao 2, Lima, Peru
| | - Alberto Laguna-Torres
- Naval Medical Research Center Detachment, Centro Medico Naval “CMST,” Av. Venezuela CDRA 36, Callao 2, Lima, Peru
| | - Randal J Schoepp
- U.S. Army Medical Research Institute of Infectious Diseases, Diagnostic Systems Division, 1425 Porter Street, Fort Detrick, MD 21702, USA
| | - David A Norwood
- U.S. Army Medical Research Institute of Infectious Diseases, Diagnostic Systems Division, 1425 Porter Street, Fort Detrick, MD 21702, USA
| | - Victor H MacIntosh
- U.S. Air Force School of Aerospace Medicine, 2513 Kennedy Circle, Building 180, Brooks City Base, TX 78235, USA
| | - Thomas Gibbons
- U.S. Air Force School of Aerospace Medicine, 2513 Kennedy Circle, Building 180, Brooks City Base, TX 78235, USA
| | - Gregory C Gray
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Post Office Box 100188, Gainesville, FL 32610, USA
| | - David L Blazes
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - Kevin L Russell
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
| | - AFHSC-GEIS Influenza Surveillance Writing Group
- Armed Forces Health Surveillance Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
- Armed Forces Research Institute of Medical Sciences, 315/6 Rajavithi Road, Bangkok, Thailand 10400
- Center for Disaster and Humanitarian Assistance Medicine, Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
- Landstuhl Regional Medical Center, Department of Pathology and Area Laboratory Services, CMR 402, APO AE 09180, USA
- U.S. Embassy, Attention: MRU, United Nations Avenue, Post Office Box 606, Village Market 00621 Nairobi, Kenya
- Naval Medical Research Unit Number 2, Kompleks Pergudangan DEPKES R.I., JI. Percetakan Negara II No. 23, Jakarta 10560, Indonesia
- Naval Medical Research Unit No. 3, Extension of Ramses Street, Adjacent to Abbassia Fever Hospital, Postal Code 11517, Cairo, Egypt
- U.S. Navy Environmental Preventive Medicine Unit No. 2, 1887 Powhatan Street, Norfolk, VA 23511, USA
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA
- Naval Medical Research Center Detachment, Centro Medico Naval “CMST,” Av. Venezuela CDRA 36, Callao 2, Lima, Peru
- U.S. Air Force School of Aerospace Medicine, 2513 Kennedy Circle, Building 180, Brooks City Base, TX 78235, USA
- Walter Reed Army Institute of Research, Emerging Infectious Diseases Research Unit, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
- Australian Army Malaria Institute, Gallipoli Barracks, Enoggera, QLD 4051, Australia
- Johns Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD 20723, USA
- U.S. Navy and Marine Corps Public Health Center, 620 John Paul Jones Circle, Suite 1100, Portsmouth, VA 23708, USA
- Laboratory for Emerging Infectious Diseases, University of Buea, Post Office Box 63, Buea, Cameroon
- Global Viral Forecasting Initiative, 1 Sutter, Suite 600, San Francisco, CA 94104, USA
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Johns MC, Burke RL, Vest KG, Fukuda M, Pavlin JA, Shrestha SK, Schnabel DC, Tobias S, Tjaden JA, Montgomery JM, Faix DJ, Duffy MR, Cooper MJ, Sanchez JL, Blazes DL, Wangchuk S, Dorji T, Gibbons R, Iamsirithaworn S, Richardson J, Buathong R, Jarman R, Yoon IK, Shakya G, Ofula V, Coldren R, Bulimo W, Sang R, Omariba D, Obura B, Mwala D, Kasper M, Brice G, Williams M, Yasuda C, Barthel RV, Pimentel G, Meyers C, Kammerer P, Baynes DE, Metzgar D, Hawksworth A, Blair P, Ellorin M, Coon R, Macintosh V, Burwell K, Macias E, Palys T, Jerke K. A growing global network's role in outbreak response: AFHSC-GEIS 2008-2009. BMC Public Health 2011; 11 Suppl 2:S3. [PMID: 21388563 PMCID: PMC3092413 DOI: 10.1186/1471-2458-11-s2-s3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A cornerstone of effective disease surveillance programs comprises the early identification of infectious threats and the subsequent rapid response to prevent further spread. Effectively identifying, tracking and responding to these threats is often difficult and requires international cooperation due to the rapidity with which diseases cross national borders and spread throughout the global community as a result of travel and migration by humans and animals. From Oct.1, 2008 to Sept. 30, 2009, the United States Department of Defense's (DoD) Armed Forces Health Surveillance Center Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) identified 76 outbreaks in 53 countries. Emerging infectious disease outbreaks were identified by the global network and included a wide spectrum of support activities in collaboration with host country partners, several of which were in direct support of the World Health Organization's (WHO) International Health Regulations (IHR) (2005). The network also supported military forces around the world affected by the novel influenza A/H1N1 pandemic of 2009. With IHR (2005) as the guiding framework for action, the AFHSC-GEIS network of international partners and overseas research laboratories continues to develop into a far-reaching system for identifying, analyzing and responding to emerging disease threats.
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Affiliation(s)
- Matthew C Johns
- Armed Forces Health Surveillance Center, 11800 Tech Rd, Silver Spring, MD 20904, USA.
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Jeremy Sueker J, Blazes DL, Johns MC, Blair PJ, Sjoberg PA, Tjaden JA, Montgomery JM, Pavlin JA, Schnabel DC, Eick AA, Tobias S, Quintana M, Vest KG, Burke RL, Lindler LE, Mansfield JL, Erickson RL, Russell KL, Sanchez JL. Influenza and respiratory disease surveillance: the US military's global laboratory-based network. Influenza Other Respir Viruses 2010; 4:155-61. [PMID: 20409212 PMCID: PMC4941663 DOI: 10.1111/j.1750-2659.2010.00129.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Please cite this paper as: Jeremy Sueker et al. (2010) Influenza and respiratory disease surveillance: the US military’s global laboratory‐based network. Influenza and Other Respiratory Viruses 4(3), 155–161. The US Department of Defense influenza surveillance system now spans nearly 500 sites in 75 countries, including active duty US military and dependent populations as well as host‐country civilian and military personnel. This system represents a major part of the US Government’s contributions to the World Health Organization’s Global Influenza Surveillance Network and addresses Presidential Directive NSTC‐7 to expand global surveillance, training, research and response to emerging infectious disease threats. Since 2006, the system has expanded significantly in response to rising pandemic influenza concerns. The expanded system has played a critical role in the detection and monitoring of ongoing H5N1 outbreaks worldwide as well as in the initial detection of, and response to, the current (H1N1) 2009 influenza pandemic. This article describes the system, details its contributions and the critical gaps that it is filling, and discusses future plans.
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Affiliation(s)
- J Jeremy Sueker
- Armed Forces Health Surveillance Center, US Army Public Health Command (Provisional), Silver Spring, MD 20910, USA
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Johns MC, Eick AA, Blazes DL, Lee SE, Perdue CL, Lipnick R, Vest KG, Russell KL, DeFraites RF, Sanchez JL. Seasonal influenza vaccine and protection against pandemic (H1N1) 2009-associated illness among US military personnel. PLoS One 2010; 5:e10722. [PMID: 20502705 PMCID: PMC2873284 DOI: 10.1371/journal.pone.0010722] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Accepted: 04/08/2010] [Indexed: 11/18/2022] Open
Abstract
Introduction A novel A/H1N1 virus is the cause of the present influenza pandemic; vaccination is a key countermeasure, however, few data assessing prior seasonal vaccine effectiveness (VE) against the pandemic strain of H1N1 (pH1N1) virus are available. Materials and Methods Surveillance of influenza-related medical encounter data of active duty military service members stationed in the United States during the period of April–October 2009 with comparison of pH1N1-confirmed cases and location and date-matched controls. Crude odds ratios (OR) and VE estimates for immunized versus non-immunized were calculated as well as adjusted OR (AOR) controlling for sex, age group, and history of prior influenza vaccination. Separate stratified VE analyses by vaccine type (trivalent inactivated [TIV] or live attenuated [LAIV]), age groups and hospitalization status were also performed. For the period of April 20 to October 15, 2009, a total of 1,205 cases of pH1N1-confirmed cases were reported, 966 (80%) among males and over one-half (58%) under 25 years of age. Overall VE for service members was found to be 45% (95% CI, 33 to 55%). Immunization with prior season's TIV (VE = 44%, 95% CI, 32 to 54%) as well as LAIV (VE = 24%, 95% CI, 6 to 38%) were both found to be associated with protection. Of significance, VE against a severe disease outcome was higher (VE = 62%, 95% CI, 14 to 84%) than against milder outcomes (VE = 42%, 95% CI, 29 to 53%). Conclusion A moderate association with protection against clinically apparent, laboratory-confirmed Pandemic (H1N1) 2009-associated illness was found for immunization with either TIV or LAIV 2008–09 seasonal influenza vaccines. This association with protection was found to be especially apparent for severe disease as compared to milder outcome, as well as in the youngest and older populations. Prior vaccination with seasonal influenza vaccines in 2004–08 was also independently associated with protection.
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Affiliation(s)
- Matthew C Johns
- Division of GEIS Operations, Armed Forces Health Surveillance Center, Silver Spring, Maryland, United States of America.
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