Pneumococcal Pneumonia Ranger Training Brigade Fort Berning Georgia March-April 1999

An epidemiological consultation (EPIC ON) was requested to investigate a cluster of 7 pneumonia cases in the Ranger Training Brigade (RTB) which had developed during Phase I training. An EPICON team assembled to determine the magnitude of the outbreak, the amount of upper/lower respiratory disease in class 4-99 since the beginning of phase one of Ranger training, the most likely causative agent(s) of the outbreak and possible mode(s) and risk factor(s) for its(their) transmission, and provide recommendations for control of the current and future outbreaks. Out of the 239 students, a total of 30 pneumonia cases were detected, 18 of which were hospitalized. The attack rate for this time period was 12.6% (30 of 239). initial results of bacteriologic cultures performed on the 30 ill Rangers had sputum/blood/throat cultures of which 14 were positive for S. pneumoniae. Initial rapid control of this pneumonia outbreak appears to have been achieved by mass administration of low-dose azithiomycin prophylaxis (250 mg once a week for 2 weeks). Only one additional case of pneumonia, diagnosed as an outpatient during the swamp phase and treated with a 5-day azithromycin regimen, was documented during the second half of training. Recommendations were provided to preclude future outbreaks. Prepared in collabrate with Epidemiology and Disease Surveillance, Aberdeen Proving Ground, Md, Walter Reed Army Institute of Research, Washington, D.C. and Health Research Center, San Diego, Ca.