Description of Bacterial Respiratory Infections among Department of Defense Beneficiaries, Utilizing Electronic Clinical Laboratory Data, October 2008-September 2013

Abstract

Abstract : Respiratory illness is a constant threat for military personnel due to crowded and stressful occupational conditions.1 Respiratory infections are among the leading causes of ambulatory visits and hospitalizations for active duty service members. It is also one of the leading causes of ambulatory clinic visits and absenteeism from work and school in the United States (US).2,3 This study used electronic clinical laboratory data to describe bacterial respiratory infections from October 2008 to September 2013, among all Department of Defense (DOD) beneficiaries seeking care within the Military Health System (MHS). Data were analyzed by fiscal year (FY), October 01 through September 30. Upper respiratory infections (URIs) displayed seasonal trends, occurring more frequently in fall and winter months. URIs occurred more frequently in the first two years of the study period (FY 2009 and FY 2010) than in the last three years of the study period. Lower respiratory infections (LRIs) declined since 2008 and lacked seasonal trends. Overall, URIs and LRIs declined by 36% and 23%, respectively, from FY 2009 to FY 2013. Additionally, there were significant changes in the demographic and clinical characteristics of URIs and LRIs. Beneficiaries 5-17 years of age were consistently most impacted by URIs, whereas those 45 years of age and older had the highest rates of LRIs. Periodic monitoring contributes to risk reduction by tracking trends and identifying populations that exceed baseline, which may help to mitigate increased risk of morbidity and mortality, given the occupational realities of DOD personnel.