America's North Shore Journal

The United States military continues to experience the same pandemic influenza that is widespread in the civilian population. The military brings together, year round, groups of young people which are the most at risk to catch this illness. Outbreaks or clusters have been noted at various recruit training centers. 132 cases of swine flu happened at the Air Force Academy.

Of note in the latest Department of Defense report on novel H1N1 or swine flu are these statements:

• Fort Bliss (Texas) and Fort Sam Houston (Texas) and Tripler Army Medical Center (Hawaii) continue to report increases in pH1N1cases
• Isolated cluster of hospital-acquired pH1N1 observed among healthcare workers at Landstuhl Regional Medical Center
• Marines and Navy personnel in Okinawa, Guam and Hawaii are seeing increases in clinically mild influenza activity in active duty service members returning from joint military exercises in the Southern Hemisphere.
• Febrile respiratory illness (FRI) rates in recruits at MCRD-SD and Parris Island are substantially elevated.
• States experiencing noticeably higher ILI visit counts include South Carolina (Fort Jackson, Parris Island), New Jersey (Cape May) and California (NMCSD, MCRD-SD, Camp Pendleton)

The Landstuhl report is significant because of the phrase hospital-acquired. It suggests that universal precautions are not being used effectively. We saw failures of similar nature in the SARS epidemic, and those in the Canadian healthcare system were especially deadly.

Hawaii has just opened its schools for the fall. As our only tropical state, the pandemic never reduced in severity as we saw it do in northern states. The potential for clusters in school settings is high and should be evident by August 14 or so. One concern is the nature of the infections arriving from the Southern Hemisphere. Any genetic variance could alter the expected virulence of the pandemic in the islands.