Research article

Epidemic infectious gastrointestinal illness aboard U.S. Navy ships deployed to the Middle East during peacetime operations – 2000–2001

Mark S Riddle¹ , Bonnie L Smoak^{* 2} , Scott A Thornton^{* 3} , Joseph S Bresee^{* 4} , Dennis J Faix^{* 5} and Shannon D Putnam^{* 6}

¹Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

²Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, MD, USA

³Navy Environmental and Preventive Medicine Unit #6, Pearl Harbor, HI, USA

⁴National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, GA, USA

⁵Navy Environmental and Preventive Medicine Unit #5, San Diego, CA, USA

⁶U.S. Naval Medical Research Unit #2, Jakarta, Indonesia

author email corresponding author email* Contributed equally

BMC Gastroenterology 2006, 6:9doi:10.1186/1471-230X-6-9

Published:	25 February 2006

Abstract

Background

Infectious gastrointestinal illness (IGI) outbreaks have been reported in U.S. Navy ships and could potentially have an adverse mission impact. Studies to date have been anecdotal.

Methods

We conducted a retrospective analysis of weekly reported disease and non-battle injury health data collected in 2000 – 2001 from 44 U.S. Navy ships while sailing in the 5^th Fleet (Persian Gulf and nearby seas).

Results

During this period, 11 possible IGI outbreaks were identified. Overall, we found 3.3 outbreaks per 100 ship-weeks, a mean outbreak duration of 4.4 weeks, and a mean cumulative ship population attack rate of 3.6%. Morbidity, represented by days lost due to personnel being placed on sick-in-quarters status, was higher during outbreak weeks compared to non-outbreak weeks (p = 0.002). No clear seasonal distribution was identified.

Conclusion

Explosive outbreaks due to viruses and bacteria with the potential of incapacitating large proportions of the crew raise serious concerns of mission impact and military readiness.