Seroepidemiologic Investigation of a COVID-19 Outbreak Aboard a U.S. Navy Ship.

The crew of USS Kidd experienced a COVID-19 outbreak identified in April 2020. This is the earliest documented COVID-19 study with RT-PCR, serology, and pre-exposure test data on the entirety of the exposed population (n=333). Case definitions included 121 confirmed (36.3% of crewmembers) and 18 probable (5.4% of crewmembers) based on laboratory diagnostic test results. At the time of testing positive, 62 (44.6%) cases reported no symptoms. Hispanic ethnicity (AOR: 2.71, CI: 1.40-5.25) and non-smoker status (AOR: 2.28, CI: 1.26-4.12) were identified as statistically significant risk factors. This study highlights the value of rapid, onboard diagnostic testing to quickly identify an outbreak and enumerate cases, as well as the serological testing to flag potential cases missed with standard viral case identification methodologies.

Prevalence of glucose-6-phosphate dehydrogenase deficiency, U.S. Armed Forces, May 2004-September 2018.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited genetic disorder most commonly associated with hemolytic anemia. Among those with G6PD deficiency, hemolytic anemia may be triggered by bacterial or viral infections and by certain foods and drugs, including the 8-aminoquinoline (8-AQ) class of antimalarials. Because 8-AQ drugs remain the only drugs approved by the U.S. Food and Drug Administration for malaria relapse prevention, the Department of Defense (DoD) requires testing of all service members' G6PD status. To estimate prevalence of G6PD deficiency among DoD service members, Composite Health Care System-generated, Health Level 7-formatted laboratory records for all service members (n=2,311,223) dated between May 2004 and September 2018 were queried for G6PD testing. Corresponding demographic data were obtained from the Defense Enrollment Eligibility Reporting System. Overall prevalence of G6PD deficiency among this cohort was low, at 2.2%. Demographic trends mirrored U.S. statistics; the cohort prevalence among males (2.3%) was higher than among females (1.5%), and the prevalence among non-Hispanic blacks (9.5%) was higher than among those in any other race/ethnicity group.