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Updated: Dec 15, 2025
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Control of three gastrointestinal illness outbreaks in a British Role 1 facility in Afghanistan: a primary care
Seth Makin1, L Hudson2, R Robinson3
1RMAS, Army Medical Services, Camberley, Surrey, UK smakin@gmail.com.
Insights
Gastrointestinal illness outbreaks at Camp Qargha, Afghanistan, led to significant operational disruption. Norovirus was a primary cause, highlighting the need for early detection and robust hygiene protocols to prevent future outbreaks.
Area of Science:
- Military Medicine
- Infectious Disease Epidemiology
- Public Health
Background:
- Camp Qargha (QAA), a British-led multinational military camp in Kabul, experienced three major gastrointestinal illness (GI) outbreaks in 2019.
- These outbreaks represented the most significant GI events for the British Military since 2003.
Purpose of the Study:
- To analyze the incidence and impact of GI outbreaks at QAA.
- To evaluate the response of the British-led Role 1 (R1) medical facility.
- To identify causative factors and implement control measures.
Main Methods:
- Data collection included local GI questionnaires, FMed85 forms, and EpiNATO returns.
- Analysis focused on identifying trends, environmental health factors, and outbreak patterns.
- Stool samples were tested for causative pathogens.
Main Results:
- Norovirus was detected in 56% of positive stool samples.
- Outbreaks peaked within 3 days, with hardened multiperson rooms most affected.
- The outbreaks resulted in 206 patient presentations, 706 lost working days, and a 27-day camp quarantine.
Conclusions:
- Outbreaks placed significant strain on camp resources and medical facilities.
- Potential contributing factors include close interaction with the local population, high population density, and accommodation limitations.
- Early recognition, strong standard operating procedures, and good hygiene are crucial for norovirus prevention.
Introduction:
In 2019, Camp Qargha (QAA), a British-led multinational military camp in Kabul, had three of the largest outbreaks of gastrointestinal illness (GI) experienced by the British Military since 2003. This paper discusses the incidence, the response of the British-led Role 1 (R1) medical treatment facility, identifies potential causative and exacerbating factors, and explains the control measures initiated.
Method:
GI in QAA results in local and UK military-wide data collection including in the form of local GI questionnaires, FMed85 forms and EpiNATO returns. The data from these was used to identify trends during and after outbreaks and produce environmental health (EH) and local outbreak reports.
Results:
Overall, among the outbreaks 56% of stool samples tested positive for norovirus. In each outbreak incidence peaked within the first 3 days, and hardened multiperson rooms were worst affected. 206 patient presentations occurred during the three outbreaks, 706 working days were lost in isolation, with QAA shut down while in quarantine for 27 days.
Discussion:
Significant strain was placed on QAA and the R1. Causative factors may include close interaction with the local national (LN) population, a high population density and accommodation being limited by specific national infrastructure protocols in an operational environment.
Conclusion:
Early recognition of GI, positive standard operating procedures and good hygiene habits are essential to prevent the spread of GI such as norovirus. An early awareness of LN population illness patterns will allow the R1 and command to be better prepared for outbreaks in the future.
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