{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T01:40:07Z","timestamp":1723513207150},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The emergence of Zika virus disease (ZVD) in areas of military operations provided a new opportunity for force health protection. ZVD infection had an estimated 4:1 asymptomatic-to-symptomatic ratio and can cause neurologic sequelae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We provide a brief report of a field investigation utilizing laboratory-based surveillance and survey instruments to characterize ZVD risk among personnel deployed to the Dominican Republic in support of Operation NEW HORIZONS (NH). Additionally, we describe a cluster of 3 ZVD cases among 8 aircrew on a short mission to St. Croix (U.S. Virgin Islands).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following Operation NH, 6 of a total 189 deployed cohort members tested positive for ZVD by immunoglobulin M and confirmatory plaque reduction neutralization test (3.2%). Reverse transcription polymerase chain reaction testing in urine or serum was positive in 4 of those 6 cases. All 6 cases reported at least one symptom, with 5 reporting subjective fever and arthralgia and 4 reporting rash. Cases were less likely to have air-conditioned living quarters (odds ratio\u00a0=\u00a00.1; 95% confidence interval 0.02\u20130.77; P\u00a0&amp;lt;\u00a00.03), but were otherwise similar to non-cases. Likewise, in St. Croix, 3\/8 tested positive by immunoglobulin M and plaque reduction neutralization test for an attack rate of 38%. Similar to Operation NH, all three cases were symptomatic with subjective fever (67%), arthralgia (67%), and\/or rash (100%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This field investigation identified differing, mission location-dependent ZVD attack rates and a 0:9 asymptomatic-to-symptomatic case ratio. As this was unexpected based on a previous report of a 4:1 ratio, it emphasizes the need to be cautious before generalizing outbreak characteristics between populations while also offering additional practical experience for force health protection.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usaa188","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T00:03:15Z","timestamp":1599004995000},"page":"e1453-e1460","source":"Crossref","is-referenced-by-count":0,"title":["Public Health Response to Zika Virus Exposure of Air Force Members Deployed to Caribbean Islands, 2016"],"prefix":"10.1093","volume":"185","author":[{"given":"Jameson","family":"Voss","sequence":"first","affiliation":[{"name":"Air Force Medical Readiness Agency, 7700 Arlington Blvd, Falls Church, VA 22042"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danny","family":"Dacey","sequence":"additional","affiliation":[{"name":"52nd Medical Group, Unit 3690, Spangdahlem AB, APO AE 09126-3690"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefani","family":"Ruiz","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"},{"name":"Solutions Through Innovative Technologies, Inc., 3152 Presidential Dr, Beavercreek, OH 45324"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"99th Force Support Squadron, 5871 Fitzgerald Blvd, Nellis AFB, NV 89191"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain","family":"Pujolar","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Swope","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lehman","sequence":"additional","affiliation":[{"name":"Air Force Medical Readiness Agency, 7700 Arlington Blvd, Falls Church, VA 22042"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tammy","family":"Shaw","sequence":"additional","affiliation":[{"name":"55th Medical Group, 2501 Capehart Road. Offutt AFB, NE 68113"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Leon","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Erich","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Cowan","sequence":"additional","affiliation":[{"name":"USAF Reserve Command HQ, 549 Pine St, Robins AFB, GA 31098"},{"name":"United States Air Force, Biomedical Sciences Corps, Retired"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"West","sequence":"additional","affiliation":[{"name":"39th Medical Group, Unit 7095, Box 185, Bldg 865, APO, AE, Incirlik 09824"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Walters","sequence":"additional","affiliation":[{"name":"59th Medical Wing, 1100 Wilford Hall Loop, Bldg 4554. JBSA-Lackland, TX 78236-9854"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Macias","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline","family":"Lucas","sequence":"additional","affiliation":[{"name":"USAF School of Aerospace Medicine, 2510 5th Street, Bldg. 840, WPAFB, OH 45433"},{"name":"United States Air Force, Biomedical Sciences Corps, Retired"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,1]]},"reference":[{"key":"2020092112444436000_ref1","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.3201\/eid2112.151167","article-title":"Outbreak of exanthematous illness associated with Zika, chikungunya, and dengue viruses, Salvador, Brazil","volume":"21","author":"Cardoso","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"2020092112444436000_ref2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2016.21.28.30283","article-title":"The epidemiology and transmissibility of Zika virus in Girardot and San Andres island, Colombia, September 2015 to January 2016","volume":"21","author":"Rojas","year":"2016","journal-title":"Euro Surveill"},{"key":"2020092112444436000_ref3","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1056\/NEJMoa0805715","article-title":"Zika virus outbreak on Yap Island, Federated States of Micronesia","volume":"360","author":"Duffy","year":"2009","journal-title":"N Engl J Med"},{"volume-title":"Zika Virus","author":"Centers for Disease Control and Prevention","key":"2020092112444436000_ref4"},{"key":"2020092112444436000_ref5","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.antiviral.2016.03.010","article-title":"Zika virus: history, emergence, biology, and prospects for control","volume":"130","author":"Weaver","year":"2016","journal-title":"Antiviral Res"},{"key":"2020092112444436000_ref6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.5365\/wpsar.2013.4.2.003","article-title":"The threat of chikungunya in Oceania","volume":"4","author":"Horwood","year":"2013","journal-title":"Western Pac Surveill Response J"},{"volume-title":"Situation Report: Zika Virus Microcephaly, Guillain Barr\u00e9 Syndrome","author":"World Health Organization","key":"2020092112444436000_ref7"},{"volume-title":"Zika in the Americas: 16 Aug, 2017","author":"Armed Forces Health Surveillance Branch","key":"2020092112444436000_ref8"},{"key":"2020092112444436000_ref9","first-page":"525","article-title":"Possible roles of new mutations shared by Asian and American Zika viruses","volume":"34","author":"Yokoyama","year":"2017","journal-title":"Mol Biol Evol"},{"key":"2020092112444436000_ref10","first-page":"18","article-title":"Zika virus surveillance in active duty US military and dependents through the naval infectious diseases diagnostic laboratory","volume":"26","author":"Sugiharto","year":"2019","journal-title":"MSMR."},{"key":"2020092112444436000_ref11","doi-asserted-by":"crossref","first-page":"395","DOI":"10.15585\/mmwr.mm6515e1","article-title":"Patterns in Zika virus testing and infection, by report of symptoms and pregnancy status \u2014 United States, January 3\u2013March 5, 2016","volume":"65","author":"Dasgupta","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020092112444436000_ref12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0891-5520(03)00099-0","article-title":"Evolution of virulence","volume":"18","author":"Ewald","year":"2004","journal-title":"Infect Dis Clin North Am"},{"key":"2020092112444436000_ref13","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1073\/pnas.93.2.548","article-title":"Population dynamics of flaviviruses revealed by molecular phylogenies","volume":"93.2","author":"Zanotto","year":"1996","journal-title":"Proc Natl Acad Sci U.S.A."},{"key":"2020092112444436000_ref14","doi-asserted-by":"crossref","first-page":"669","DOI":"10.3201\/eid2304.161549","article-title":"Zika virus seroprevalence, French Polynesia, 2014-2015","volume":"23","author":"Aubry","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2020092112444436000_ref15","doi-asserted-by":"crossref","first-page":"903","DOI":"10.4269\/ajtmh.16-0635","article-title":"Mosquito exposure and chikungunya and dengue infection among travelers during the chikungunya outbreak in the Americas","volume":"96","author":"Lindholm","year":"2017","journal-title":"Am J Trop Med Hyg."},{"key":"2020092112444436000_ref16","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1001\/jama.293.2.212","article-title":"An outbreak of malaria in US Army rangers returning from Afghanistan","volume":"293","author":"Kotwal","year":"2005","journal-title":"JAMA."},{"volume-title":"CDCHAN-00402: Prolonged IgM Antibody Response in People Infected with Zika Virus: Implications for Interpreting Serologic Testing Results for Pregnant Women","author":"Centers for Disease Control and Prevention: Division of Emergency Operations","key":"2020092112444436000_ref17"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1453\/33765958\/usaa188.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1453\/33765958\/usaa188.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T00:48:33Z","timestamp":1723510113000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/9-10\/e1453\/5900200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,1]]},"references-count":17,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2020,9,1]]},"published-print":{"date-parts":[[2020,9,18]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaa188","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"type":"print","value":"0026-4075"},{"type":"electronic","value":"1930-613X"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,9,1]]}}}