Noroviruses : A Challenge for Military Forces

Abstract

For military forces, the control of infectious acute gastroenteritis constitutes an old, constant and unsolved concern. Recent epidemiological studies suggest that the common bacterial causes are being overtaken by viruses. Norviruses are the most alarming group and norovirus outbreaks in military forces are regularly reported. Illness is generally mild and characterised by acute vomiting and diarrhoea, which lasts for a few days on average, but may be severe and potentially life-threatening in subjects who are already dehydrated due to daily activity. Moreover, outbreaks may diminish operational effectiveness. Prevention of norovirus infection currently relies on strict application of personal and collective hygiene rules including isolation of the cases, to the greatest possible extent. Although noroviruses are frequently mentioned as the cause of gastroenteritis outbreaks in troops deployed overseas, laboratory diagnosis is rarely done. So their real burden in military forces remains unclear and further epidemiological studies are required to determine the full impact of norovirus gastroenteritis on troops.

Detection of enteropathogens associated with travelers' diarrhea using a multiplex Luminex-based assay performed on stool samples smeared on Whatman FTA Elute cards

“…We also observed difficulty in detecting Campylobacter and an increase in norovirus GI/GII LoD with prolonged storage. Prior reports have documented successful storage and detection of Campylobacter for 7 months and norovirus for 11 weeks on the FTA Card (Delacour, Dubrous, & Koeck, 2010; Owens & Szalanski, 2005). Further testing is needed to evaluate the stability and detection of these pathogens with long-term storage.…”

Tropical and travel-associated norovirus

“…This outbreak highlighted the potential for norovirus to cause severe disease in otherwise healthy individuals under extreme environmental stress [86]. In another norovirus outbreak in Iraq, 975 of 1,340 affected British troops were admitted to a field hospital, where significant transmission to medical staff occurred, resulting in hospital closure [85,88,89]. …”

Multiple enteropathogenic viruses in a gastroenteritis outbreak in a military exercise of the Portuguese Army

“…Although generally considered mild and of short duration in healthy young adults (e.g. soldiers), Norovirus gastroenteritis can diminish operational effectiveness and impede force readiness, as demonstrated by an array of military units in Iraq [8,10,11].…”