Respiratory disease in Army recruits: surveillance program overview, 1995-2006

Since 1966, the U.S. Army has had in place a comprehensive surveillance system for acute respiratory disease (ARD) because of its continued high incidence in the recruit population. A retrospective review of the program from 1995 to 2006, a continuation of an earlier analysis from 1985-1994, was performed to describe the program and to summarize group A streptococcal (GAS) outbreaks identified through this program.

Weekly incidence data and daily sentinel case data collected as part of the ARD surveillance program were analyzed in 2007 to report rates of ARD and GAS outbreaks over this 12-year period (1995-2006) for five participating Army sites.

Average ARD rates were consistently higher from 2000 to 2006 than from 1995 to 1999. Rate ratios of winter rates to summer rates were greater than 1.0 prior to 2000, but from 2000 to 2006, ratios were consistently near 1.0. Rheumatogenic M types were available for three of five outbreaks.

Continuing high incidence of ARD in the military, re-emerging rheumatogenic M types, and a highly mobile military underscore the need for continued surveillance efforts. The continued employment of interventions with demonstrated effectiveness, such as chemoprophylaxis and basic preventive measures, is essential to reducing the burden of ARD.