Spread of adenovirus to geographically dispersed military installations, May-October 2007

Abstract

In mid-May 2007, a respiratory disease outbreak associated with adenovirus, serotype B14 (Ad14), was recognized at a large military basic training facility in Texas. The affected population was highly mobile; after the 6-week basic training course, trainees immediately dispersed to advanced training sites worldwide. Accordingly, enhanced surveillance and control efforts were instituted at sites receiving the most trainees. Specimens from patients with pneumonia or febrile respiratory illness were tested for respiratory pathogens by using cultures and reverse transcription-PCR. During May through October 2007, a total of 959 specimens were collected from 21 sites; 43.1% were adenovirus positive; the Ad14 serotype accounted for 95.3% of adenovirus isolates. Ad14 was identified at 8 sites in California, Florida, Mississippi, Texas, and South Korea. Ad14 spread readily to secondary sites after the initial outbreak. Military and civilian planners must consider how best to control the spread of infectious respiratory diseases in highly mobile populations traveling between diverse geographic locations.

Figure 1

Evolving adenovirus subtype B14 incidence rate per 100 US Air Force basic military trainees over 6.5 weeks of basic training, based on epidemiologic and laboratory surveillance data. Red circles, acutely ill; yellow circles, recovering/possibly infectious; blue circles, well.

Figure 2

Locations of military sites that received US Air Force basic military training graduates for secondary training in North America (A), the Pacific region (B), and Europe and the Middle East (C). Red indicates locations that submitted specimens as part of adenovirus surveillance. Star in panel A indicates Lackland Air Force Base, Texas, USA. Maps generated by using TerraMetrics (www.terrametrics.com).

Figure 3

Rates of confirmed adenovirus for secondary training students at Sheppard Air Force Base, Texas, USA (A); Goodfellow Air Force Base, Texas, USA (B); and Keesler Air Force Base, Mississippi, USA (C), compared with rates for basic military trainees at Lackland Air Force Base, Texas, USA, May 25–October 31, 2007.