Respiratory illnesses at the 2009 U.S. Army ROTC Advanced Camp

Area of Science:

• Public Health
• Epidemiology
• Military Medicine

Background:

• The novel H1N1 influenza pandemic emerged in 2009, posing a significant public health threat.
• The U.S. Army Reserve Officer Training Corps (ROTC) Leader Development Assessment Course (LDAC) involves close-quarters living for thousands of cadets annually.
• Understanding the impact of novel influenza strains in congregate settings is crucial for military readiness.

Purpose of the Study:

• To describe the incidence and impact of respiratory illnesses during the 2009 ROTC LDAC following the emergence of the novel H1N1 influenza pandemic.
• To compare respiratory illness rates between cadets and cadres during the 2009 LDAC.
• To evaluate the effectiveness of implemented infection prevention measures.

Main Methods:

• A retrospective cohort study was conducted involving 5,554 cadets and 1,616 cadres from the 2009 LDAC.
• Data from 5,180 cadets who attended the 2008 LDAC were used as a historical comparison.
• Respiratory clinic visits, hospitalizations, and isolation data were analyzed.

Main Results:

• Respiratory clinic visits were significantly higher for 2009 cadets (8.7 per 1000 person-days) compared to 2009 cadres (2.0) and 2008 cadets (4.2) (p < 0.001).
• Respiratory illness hospitalizations and isolations were also significantly higher among 2009 cadets compared to cadres (p = 0.020).
• Despite prevention efforts, a considerable impact of respiratory illnesses was observed.

Conclusions:

• The 2009 novel H1N1 influenza pandemic substantially impacted respiratory health among ROTC LDAC participants.
• Close-quarters military training environments are vulnerable to infectious disease outbreaks.
• Lessons learned from this experience are vital for future planning of LDAC and similar training scenarios.