Respiratory Illness and Diarrheal Disease Surveillance in U.S. Military Personnel Deployed to Southeast Asia for Military Exercises from 2023–2025
Year: 2025
Type: article
Study design: Observational Study
Abstract: The Indo-Pacific region hosts several annual military exercises that involve the deployment of thousands of U.S. and partner-nation military personnel. Respiratory and diarrheal diseases pose a significant health risk to exercise participants and represent a substantial portion of medical encounters and lost duty days. We conducted surveillance for respiratory and diarrheal illness at the Cobra Gold and Balikatan military exercises in Thailand and the Philippines from 2023–2025. Through coordination with health providers in the field, military personnel that reported acute symptoms were asked to provide a nasopharyngeal swab or stool sample. These samples were transported to a field lab and tested by PCR for common respiratory and diarrheal pathogens. Follow-up analyses included bacterial culture, antimicrobial susceptibility testing, and viral whole-genome sequencing. From 84 respiratory and 61 diarrheal samples analyzed, we found that respiratory illness was primarily attributed to rhinoviruses/enteroviruses (23%), common coronaviruses (21%), and SARS-CoV-2 (11%) while diarrheal disease was attributed to a high rate of diarrheagenic E. coli (73%) and norovirus (20%), followed by Salmonella spp. (18%) and Campylobacter spp. (13%). Our findings highlight the distinct etiologies of respiratory and diarrheal disease in military field settings and demonstrate the feasibility of conducting real-time infectious disease surveillance in operational environments.
Authors: Sidhartha Chaudhury, Paphavee Lertsethtakarn, Piyawan Chinnawirotpisan, Nattaya Ruamsap, Worachet Kuntawunginn, Chadin Thongpiam, Kingkan Pidtana, Kittijarankon Phontham, Saowaluk Wongarunkochakorn, Montri Arsanok, Kamonporn Poramathikul, Parat Boonyarangka, Paksathorn Kietsiri, Wilawan Oransathit, Siriphan Gonwong, Patcharawalai Wassanarungroj, Panida Nobthai, Nuanpan Khemnu, Thipwipha Phonpakobsin, Wudtichai Manasatienkij, Joonlasak Khajohn, Chonthicha Klungthong, Nillawan Buathong, Sabaithip Sriwichai, Siriporn Sornsakrin, Umaporn Suksawad, Susie Leonardia-Santiago, Maria Theresa Valderama, John Mark Velasco, Paula Corazon Diones, Matthew Pascual, Chris Mahabir, Kathryn A. McGuckin, Daniel M. Boudreaux
Institution: Armed Forces Research Institute of Medical Science
Language: English
Topic: Travel-related health issues
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,258
OpenAlex ID: W4417426901