Incidence of gastrointestinal infections among U.S. active component service members stationed in the U.S. compared to U.S. civilians, 2012-2014.

Gastrointestinal (GI) infections in the U.S. Armed Forces have consistently been among the most frequent disease and non-battle injury diagnoses. A retrospective analysis of surveillance data categorized as GI infections among active component service members during 2012-2014 was performed. During the study period, 99% of inpatient and outpatient GI encounters were reported as nonspecific GI infection (13,331 cases per 100,000 people), leaving only a small percentage of cases attributed to specific causes. The five most common organisms associated with GI infections were Campylobacter (10.30 per 100,000 people), nontyphoidal Salmonella (7.43), Giardia (3.15), Shigella (2.11), and norovirus (1.25). The civilian population incidence rates of foodborne diseases during the same time period are significantly greater than incidence rates within the U.S. active component for all select bacterial and parasitic pathogens, except Campylobacter. Nonspecific gastroenteritis incidence increased during winter months, which is similar to the seasonal pattern for viruses such as norovirus. The preponderance of nonspecific infections highlights the need for increased testing and a more in-depth review of the impact of GI infections on operational effectiveness within the U.S.

Zika virus infections in Military Health System beneficiaries since the introduction of the virus in the Western Hemisphere, 1 January 2016 through 30 November 2016.

The introduction and rapid spread of Zika virus (ZIKV) across the Western Hemisphere have posed a risk of infection to Military Health System (MHS) beneficiaries. The associated consequences of infection and the dynamics of transmission may place a unique burden on military personnel, their dependents, and the MHS. This article summarizes the impact of ZIKV transmission on MHS beneficiaries between 1 January and 30 November 2016. Cases were identified from a variety of sources, including direct reporting from the services, extraction of laboratory data, and data from the Defense Medical Surveillance System (DMSS) Reportable Medical Events database. There have been 156 confirmed cases of Zika in MHS beneficiaries, including five Zika cases in pregnant beneficiaries and 110 cases in service members. A majority of cases reported exposure in Puerto Rico (n=91, 58.3%). Although most ZIKV infections are asymptomatic or have a relatively mild illness, the gravity of pregnancy and neurologic issues linked to infection remains a significant impetus for the continued surveillance of ZIKV in the MHS population.