Self Reported Incidence and Morbidity of Acute Respiratory Illness among Deployed U.S. Military in Iraq and Afghanistan

BACKGROUND: Historically, respiratory infections have had a significant impact on U.S. military missions. Deployed troops are particularly at high risk due to close living conditions, stressful work environments and increased exposure to pathogens. To date, there are limited data available on acute respiratory illness (ARI) among troops deployed in support of ongoing military operations, specifically Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). METHODS: Using self-report data from two sources collected from troops deployed to Iraq, Afghanistan and the surrounding region, we analyzed incidence and risk factors for ARI. Military personnel on mid-deployment Rest & Recuperation (R&R) or during redeployment were eligible to participate in the voluntary self-report survey. RESULTS: Overall, 39.5% reported having at least one ARI. Of these, 18.5% sought medical care and 33.8% reported having decreased job performance. The rate of self-reported ARI was 15 episodes per 100 person-months among those taking the voluntary survey, and 24.7 episodes per 100 person-months among those taking the clinic health questionnaire. Negative binomial regression analysis found female sex, Navy branch of service and lack of flush toilets to be independently associated with increased rates of ARI. Deployment to OIF, increasing age and higher rank were also positively associated with ARI risk. CONCLUSIONS: The overall percentage of deployed military personnel reporting at least one acute respiratory illness decreased since earlier parts of OIF/OEF. However, the reported effect on job performance increased tremendously. The most important factors associated with increased respiratory infection are female sex, Navy branch of service, lack of improved latrine facilities, deployment to OIF, increasing age and higher rank

Probability of respiratory illness among U.S military personnel deployed in support of OIF/OEF by country of operation.

<p>Probability of respiratory illness among U.S military personnel deployed in support of OIF/OEF by country of operation.</p

Demographic characteristics of 2,872 deployed U.S. military personnel who completed the voluntary respiratory infection questionnaire Jan 2005 to Jan 2006.

<p>Demographic characteristics of 2,872 deployed U.S. military personnel who completed the voluntary respiratory infection questionnaire Jan 2005 to Jan 2006.</p

Multivariate negative binomial regression of the association between rate of self-reported respiratory infection and covariates, voluntary respiratory questionnaire data Jan 2005 to Jan 2006.

<p>Multivariate negative binomial regression of the association between rate of self-reported respiratory infection and covariates, voluntary respiratory questionnaire data Jan 2005 to Jan 2006.</p

Multivariate negative binomial regression of the association between rate of self-reported respiratory infection and covariates, Qatar Clinic health screening questionnaire Feb 2005 to Feb 2006. (n = 14,361).

<p>Multivariate negative binomial regression of the association between rate of self-reported respiratory infection and covariates, Qatar Clinic health screening questionnaire Feb 2005 to Feb 2006. (n = 14,361).</p

Demographic characteristics of deployed U.S. military personnel who completed the Qatar Clinic health screening questionnaire Feb 2005 to Feb 2006, N = 15,463^*.

*<p>denominator for characteristic varies due to missing values.</p