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A tuberculosis event on a Navy assault ship
1Division of Neurology, Naval Medical Center Portsmouth, VA 23708, USA.
Military Medicine
|January 30, 2007
Summary
A U.S. Navy ship experienced a tuberculosis (TB) event in 2003, marked by a significant rise in purified protein derivative (PPD) positivity. Prompt screening identified numerous new reactors, highlighting challenges in maritime respiratory disease control.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Maritime Medicine
Background:
- Tuberculosis (TB) surveillance is critical in closed environments like naval ships.
- Understanding transmission dynamics is key to preventing outbreaks in military populations.
Observation:
- A U.S. Navy amphibious assault ship reported a sudden increase in purified protein derivative (PPD) positivity rates in September 2003.
- The new reactor rate surged from a baseline of 0-1% to 6.3%, necessitating immediate crew-wide screening.
Findings:
- Screening identified 31 Navy personnel and 17 Marines as new reactors (2.4% and 1.2% of respective groups).
- Infection risk was significantly higher in two male enlisted berthing areas.
- No active tuberculosis cases were identified despite the high number of new reactors.
Implications:
- This event underscores the importance of robust respiratory disease control protocols in maritime settings.
- Prompt identification and treatment of new reactors with isoniazid can effectively manage potential TB outbreaks at sea.
- The findings highlight specific risk factors, such as berthing arrangements, in TB transmission on ships.
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