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

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.

Reproductive tract complications associated with Chlamydia trachomatis infection in US Air Force males within 4 years of testing.

BACKGROUND: Chlamydia trachomatis (CT) is a common sexually transmitted infection for which young, sexually active persons are at highest risk. Health consequences such as orchitis/epididymitis, prostatitis, infertility, and urethral stricture have been described among CT-infected males, although not all of these are indisputably linked to CT. Current literature lacks population-based studies needed to examine these associations on a larger scale, to evaluate the true risk of developing complications after a CT infection. The US Air Force contains a large population of young, sexually active males, making it suitable for conducting such a study. METHODS: We conducted a retrospective cohort study between 2001 and 2005 comparing the incidence of orchitis/epididymitis, prostatitis, infertility, and urethral stricture among male Air Force members with and without prior CT infections. Cumulative incidence rates were calculated and Cox proportional hazard models were generated to evaluate the risk of developing complications and to adjust for potential confounders. RESULTS: Among 17,764 men enrolled in the study, 913 (5.14%) experienced a reproductive tract outcome. Among CT-positive men, cumulative incidences of orchitis/epididymitis, prostatitis, infertility, and urethral stricture were 4.28%, 1.41%, 1.27%, and 0.13%, respectively. Orchitis/epididymitis [Hazard ratio (HR) = 1.38 (1.13-1.70)] and "any" outcome [HR = 1.37 (1.16-1.61)] were positively associated with CT; infertility was marginally associated [HR = 1.36 (0.93-2.00)]. CONCLUSIONS: Overall, the burden of reproductive health outcomes among Air Force males is small. Significant associations were observed between CT and both orchitis/epididymitis and any outcome; a larger cohort or longer follow-up may have detected a significant association between CT and infertility.

Completeness and timeliness of Chlamydia trachomatis and Neisseria gonorrhoeae genital infection reporting in the U.S. Air Force.

Genital Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are reportable diseases in the U.S. Air Force. Base-level personnel enter laboratory-confirmed cases into the Air Force Reportable Events Surveillance System (AFRESS). To examine completeness and timeliness of CT and GC reporting, we compared laboratory and AFRESS records collected between 2000 and 2005. We used joinpoint regression analysis to identify trends in reporting over time. Of 23,118 CT laboratory-confirmed cases, 74.0% were reported into AFRESS; of 1,897 GC cases, 57.5% were reported. CT reporting completeness increased through 2003, but declined afterward; completeness of GC reporting steadily declined throughout the study. The median time between collection and reporting dates was 12.0 days and 13.5 days for CT and GC, respectively. Timeliness of CT reporting improved until mid-2004, after which it sharply declined; GC reporting timeliness declined throughout the study. Monitoring data, training personnel, and adopting an electronic reporting system may improve data quality.