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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Diarrheal Disease during Operation Desert Shield
New England Journal of Medicine, Volume 325, No. 20, Year 1991
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Description
Under combat conditions infectious disease can become a major threat to military forces. During Operation Desert Shield, there were numerous outbreaks of diarrhea among the U.S. forces. To evaluate the causes of and risk factors for diarrheal disease, we collected clinical and epidemiologic data from U.S. troops stationed in northeastern Saudi Arabia. 432 military personnel who presented with diarrhea, cramps, vomiting, or hematochezia. In addition, a questionnaire was administered to 2022 soldiers in U.S. military units located in various regions of Saudi Arabia. A bacterial enteric pathogen was identified in 49.5 percent of the troops with gastroenteritis. Enterotoxigenic Escherichia coli and Shigella sonnei were the most common bacterial pathogens. Of 125 E. coli infections, 39 percent were resistant to trimethoprim–sulfamethoxazole, 63 percent to tetracycline, and 48 percent to ampicillin. Of 113 shigella infections, 85 percent were resistant to trimethoprim–sulfamethoxazole, 68 percent to tetracycline, and 21 percent to ampicillin. All bacterial isolates were sensitive to norfloxacin and ciprofloxacin. After an average of two months in Saudi Arabia, 57 percent of the surveyed troops had at least one episode of diarrhea, and 20 percent reported that they were temporarily unable to carry out their duties because of diarrheal symptoms. Vomiting was infrequently reported as a primary symptom, but of 11 military personnel in whom vomiting was a major symptom, 9 (82 percent) had serologic evidence of infection with the Norwalk virus. Gastroenteritis caused by enterotoxigenic E. coli and shigella resistant to a number of drugs was a major problem that frequently interfered with the duties of U.S. troops during Operation Desert Shield. (N Engl J Med 1991;325:1423–8.) © 1991, Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Hyams, Kenneth Craig
United States, Bethesda
Naval Medical Research Institute, Bethesda
Bourgeois, August Louis
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Merrell, Bruce R.
United States, Bethesda
Naval Medical Research Institute, Bethesda
Rozmajzl, Patrick J.
Italy, Naples
U.s. Navy Environmental and Preventive Medicine Unit No. 7
Escamilla, Joel
Peru, Lima
Naval Medical Research Unit No. 6
Thornton, Scott A.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Wasserman, Glenn M.
United States, Fort Bliss
William Beaumont Army Medical Center
Burke, Arlene
United States, San Antonio
Army Medical Department
Echeverria, Peter D.
Thailand, Bangkok
Armed Forces Research Institute of Medical Sciences, Thailand
Green, Kim Y.
United States, Bethesda
National Institutes of Health Nih
Kapikian, Albert Z.
United States, Bethesda
National Institutes of Health Nih
Woody, James N.
United States, Bethesda
Naval Medical Research and Development Command
Statistics
Citations: 256
Authors: 12
Affiliations: 9
Identifiers
Doi:
10.1056/NEJM199111143252006
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Infectious Diseases