By Cmdr. Dennis J. Faix, MC, USN; Anthony Hawksworth, Cmdr. Patrick J. Blair, MSC, USN
Military recruits are particularly vulnerable to respiratory infections like the cold or flu because of crowded living quarters and shared facilities. Adenoviruses, a large family of viruses, are the most common cause of respiratory infections and outbreaks in military recruits. “Boot camp flu” and “recruit hack” are familiar slang terms often used in the training environment.
Adenovirus infections decreased dramatically at basic training centers between 1971 and 1996 following immunization with a vaccine against two types of adenovirus. However, the disease reemerged when production of the vaccine ceased and vaccination was discontinued. Since 1996 the Naval Health Research Center (NHRC) in San Diego, has conducted surveillance studies at eight DoD training sites. This surveillance has allowed for an historical record of the prevalence of adenovirus infections and was the reason for re-establishing the vaccine in DoD in 2011.
In 2007, a multi-center study of a new vaccine was conducted by investigators from the Naval Health Research Center and Walter Reed Army Institute of Research located in Silver Spring, Md., to assess the new vaccine’s safety and efficacy. Recruits at two basic training sites were randomly assigned to receive either the new vaccine or a placebo. Vaccine efficacy was 99.3 percent. As a result of this safety trial, the new vaccine was FDA approved for use in the military in 2011. After October 2011, when recruits began to received the vaccine, adenovirus infections have almost disappeared from the training sites, likely attributable to the new vaccine.
Recent data from the Naval Health Research Center noted a remarkable reduction of almost 75 percent in the febrile respiratory illness rates beginning in mid-November 2011.
While rates will be monitored well into the future, we are encouraged. It is extremely gratifying to see the work of so many professionals culminate with such a clear demonstration of the effectiveness of this new vaccine – the people who worked on this project can be proud that their efforts in preventing recruit illness and saving lives.
The NHRC develops and delivers operational biomedical research solutions that enhance the health, safety, readiness, and performance of our military forces.
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The Naval Health Research Center’s role in the adenovirus surveillance and vaccine testing.
- Conducted Febrile Respiratory Illness surveillance to monitor adenovirus infection in recruits at Basic Training Centers
- Served as reference laboratory for 2004 phase II study of Ad4/Ad7 vaccine
- Co-led 2007 phase III vaccine trial, managing one of the two clinical sites
- Performed all of the virologic testing for the trial in compliance with established Good Laboratory Practices and FDA standards
- Continues the long term, ongoing Febrile Respiratory Illness surveillance to monitor effectiveness of the vaccine