Tuberculosis outbreak investigation of a U.S. Navy amphibious ship crew and the Marine expeditionary unit aboard, 1998.

A Marine deployed aboard a U.S. Navy amphibious ship had smear-positive, cavitary pulmonary tuberculosis (TB). Contact investigation ultimately found 21 active cases of TB among sailors and Marines who were aboard the affected ship. Approximately 3 months lapsed between onset of the source patient's illness and appropriate diagnosis and treatment. During the contact investigation, 3,338 persons received tuberculin skin tests and 712 were identified as new latent tuberculosis infection cases. Four persons diagnosed with latent tuberculosis infection developed active TB because of poor compliance with treatment. After personnel disembarked from the ship, persistent efforts to identify persons with active disease and latent infections were successful in controlling further spread of tuberculosis in military units and local communities. The Mycobacterium tuberculosis bacteria isolated from the source patient and 16 of the other active cases were susceptible to all drugs commonly used to treat TB.

Neoplasms in the Navy, 1998-2000: a descriptive analysis of the Physical Evaluation Board database.

Records with diagnoses for neoplasms (International Classification of Diseases, Ninth Revision, Clinical Modification, codes 140-239) contained in the U.S. Navy Physical Evaluation Board database for 1998 to 2000 were identified (n = 427 cases, 342 malignant and 85 benign). The four most common sites of occurrence were other and unspecified sites (27%), lymphatic and hematopoietic tissues (22%), benign neoplasms (20%), and genitourinary organs (12%). Crude overall cancer rates were 37.7 cases per 100,000 male subjects and 55.4 cases per 100,000 female subjects. Overall, Hodgkin's disease was the most common diagnosis, with a rate of 3.3 cases per 100,000 population. It also had the highest rate among male subjects, with 3.5 cases per 100,000 male subjects of all ages and 4.2 cases per 100,000 men more than 40 years of age. For women, breast cancer had the highest rate of 8.5 cases per 100,000 subjects. These values are consistent with or lower than the published reports of U.S. Navy and national rates. Ongoing surveillance of malignancies among Navy personnel is an important part of force health protection.

Analysis of Navy Physical Evaluation Board diagnoses (1998-2000).

An analysis is provided from 19,265 Physical Evaluation Board diagnoses from 10,406 Navy personnel from 1998 to 2000. The leading diagnostic categories were musculoskeletal and mental disorders as well as for subgroups of women and officers. Musculoskeletal conditions were 41.6% of the diagnoses and decreased with advancing age (42.9% for <30 years; 41.1% for 30-40 years; 37.6% for >40 years; chi2 for trend [1 df] = 26.4; p = 0.000). Mental disorders were 11.8% of the diagnoses and also decreased with advancing age (14.1% for <30 years; 10.4% for 30-40 years; 8.8% for >40 years; chi2 for trend [1 df] = 84; p = 0.000). Diagnoses for injury and poisoning (8.9%), nervous system (7.6%), and ill-defined conditions (4.7%) completed the top five categories below age 40 years, whereas circulatory disorders were evident after age 40 years. These findings suggest priorities for reducing overall medical disability losses in our active duty Navy forces.

Community-acquired methicillin-resistant Staphylococcus aureus among military recruits.

We report an outbreak of 235 community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections among military recruits. In this unique environment, the close contact between recruits and the physical demands of training may have contributed to the spread of MRSA. Control measures included improved hygiene and aggressive clinical treatment.