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Diarrhea outbreak during U.S. military training in El Salvador

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dc.contributor.author Kasper, M.R.
dc.contributor.author Lescano Guevara, Andres Guillermo
dc.contributor.author Lucas, C.
dc.contributor.author Gilles, D.
dc.contributor.author Biese, B.J.
dc.contributor.author Stolovitz, G.
dc.contributor.author Reaves, E.J.
dc.date.accessioned 2022-01-18T19:34:39Z
dc.date.available 2022-01-18T19:34:39Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11100
dc.description.abstract Infectious diarrhea remains a major risk to deployed military units worldwide in addition to their impact on travelers and populations living in the developing world. This report describes an outbreak of diarrheal illness in the U.S. military's 130th Maneuver Enhancement Brigade deployed in San Vicente, El Salvador during a training and humanitarian assistance mission. An outbreak investigation team from U.S. Naval Medical Research Unit - Six conducted an epidemiologic survey and environmental assessment, patient interviews, and collected stool samples for analysis in an at risk population of 287 personnel from May 31st to June 3rd, . Personnel (n = 241) completed an epidemiological survey (87% response rate) and 67 (27%) reported diarrhea and/or vomiting during the past two weeks. The median duration of illness was reported to be 3 days (IQR 2-4 days) and abdominal pain was reported among 30 (49%) individuals. Presentation to the medical aid station was sought by (62%) individuals and 9 (15%) had to stop or significantly reduce work for at least one day. Microscopy and PCR analysis of 14 stool samples collected from previously symptomatic patients, Shigella (7), Cryptosporidium (5), and Cyclospora (4) were the most prevalent pathogens detected. Consumption of food from on-base local vendors (RR = 4.01, 95% CI = 1.53-10.5, p-value <0.001) and arriving on base within the past two weeks (RR = 2.79, 95% confidence [CI] = 1.35-5.76, p-value = 0.001) were associated with increased risk of developing diarrheal disease. The risk of infectious diarrhea is great among reserve military personnel during two week training exercises. The consumption of local food, prepared without proper monitoring, is a risk factor for deployed personnel developing diarrheal illness. Additional information is needed to better understand disease risks to personnel conducting humanitarian assistance activities in the Latin America Region. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS ONE
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject risk factor en_US
dc.subject clinical evaluation en_US
dc.subject major clinical study en_US
dc.subject polymerase chain reaction en_US
dc.subject disease association en_US
dc.subject abdominal pain en_US
dc.subject diarrhea en_US
dc.subject fever en_US
dc.subject nausea en_US
dc.subject United States en_US
dc.subject interview en_US
dc.subject disease course en_US
dc.subject Military Personnel en_US
dc.subject soldier en_US
dc.subject Cryptosporidium en_US
dc.subject Diarrhea en_US
dc.subject high risk population en_US
dc.subject infection risk en_US
dc.subject microbiological examination en_US
dc.subject Sanitation en_US
dc.subject Disease Outbreaks en_US
dc.subject epidemic en_US
dc.subject food intake en_US
dc.subject feces analysis en_US
dc.subject Shigella en_US
dc.subject ciprofloxacin en_US
dc.subject microscopy en_US
dc.subject dehydration en_US
dc.subject vomiting en_US
dc.subject metronidazole en_US
dc.subject El Salvador en_US
dc.subject Clinical Laboratory Techniques en_US
dc.subject Norovirus en_US
dc.subject Cyclospora cayetanensis en_US
dc.subject epidemiological data en_US
dc.subject training en_US
dc.subject Entamoeba histolytica en_US
dc.subject Giardia lamblia en_US
dc.subject abdominal cramp en_US
dc.subject Entamoeba en_US
dc.subject asymptomatic disease en_US
dc.subject Beverages en_US
dc.subject Campylobacter jejuni en_US
dc.subject environmental aspects and related phenomena en_US
dc.subject Food Analysis en_US
dc.subject hematochezia en_US
dc.subject military service en_US
dc.subject Nipah virus en_US
dc.subject Water Quality en_US
dc.title Diarrhea outbreak during U.S. military training in El Salvador en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0040404
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.00
dc.relation.issn 1932-6203


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