RESUMEN
On February 10, 2014, the USS Ardent, a U.S. Navy minesweeper, was moored in San Diego, California, while conducting training. Over the course of 3 days, 25 of 102 crew members sought medical care because of influenza-like illness (ILI). Nasal swab specimens were collected from each patient, and initial rapid influenza testing indicated 16 cases of influenza A. Ultimately, polymerase chain reaction (PCR) testing conducted by the Naval Health Research Center determined that 20 specimens were influenza A, of which 18 were subtype H3N2. Two specimens could not be subtyped. The HA gene sequence of an outbreak isolate was 99% identical to strains circulating during the 2013-14 influenza season and antigenically similar to the H3N2 component of the 2013-14 influenza vaccine. At the time of the outbreak, 99% of the crew had received influenza vaccine. Through the duration of the outbreak, the minesweeper squadron medical officer collaborated with Navy Environmental and Preventive Medicine Unit Five, higher-level Navy authorities, and County of San Diego Public Health Services to implement the outbreak response, which included disseminating outbreak information to surrounding Navy units, disinfecting the ship, sending home infected crew members, identifying family members at high risk, and providing antiviral medications and guidance. No crew member had onset of symptoms >6 days after the first crew member became ill. This outbreak highlights the risk for an H3N2 influenza outbreak among vaccinated and otherwise healthy young persons.
Asunto(s)
Brotes de Enfermedades , Subtipo H3N2 del Virus de la Influenza A/aislamiento & purificación , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/epidemiología , Personal Militar , Adulto , California/epidemiología , Trazado de Contacto , Brotes de Enfermedades/prevención & control , Humanos , Gripe Humana/prevención & control , Gripe Humana/virología , Masculino , Personal Militar/estadística & datos numéricos , Navíos , Adulto JovenRESUMEN
Rashes are common complaints on ships. With limited diagnostic tests and no specialists readily available, treating serious skin conditions is difficult. The patient in this case report had a gradually worsening, severe rash, with multiple possible etiologies, in which incorrect treatment could have resulted in significant morbidity. Moreover, medical evacuations are costly and detrimental to accomplishing Navy mission objectives. This report highlights the medical workup of an unidentified, severe rash with only limited diagnostic tools and a varied medical history.