{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:14:31Z","timestamp":1792005271557,"version":"4.4.0"},"reference-count":23,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Acute respiratory infections (ARI) are a significant challenge in military settings due to close communal living, which facilitates the rapid transmission of pathogens. A variety of respiratory pathogens contribute to ARI, each varying in prevalence, severity, and impact on organizational productivity. Understanding and mitigating the impact of ARI is critical for optimizing the health of military personnel and maintaining organizational productivity.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This retrospective study of surveillance data aims to identify pathogens causing ARI among servicemen and determine which pathogens contribute most to medical absenteeism, defined as the combined duration of the issued medical certificate and light duty.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n From September 2023 to August 2024, anonymous nasopharyngeal swabs (BioFire FilmArray Respiratory Panel) were collected from Singapore Armed Forces servicemen presenting with ARI symptoms after a doctor\u2019s consultation at a local military camp\u2019s medical centre. The presence of fever and duration of medical certificate and light duty were self-reported by Singapore Armed Forces servicemen.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 1095 nasopharyngeal swabs were collected, of which 608 (55.5%) tested positive. The most common respiratory pathogen was human rhinovirus\/enterovirus (HRV\/HEV) in 303 (27.7%) individuals. The highest proportions of fever were observed in servicemen with influenza (62.8%, 27\/43), SARS-CoV-2 (34.3%, 12\/35), and parainfluenza (31.6%, 12\/38). The odds of patients with influenza that have fever was 5.8 times higher than those of patients infected with HRV\/HEV (95% CI 2.95\u201011.40,\n P<\/jats:italic>\n <.001). The median duration of medical certificate, light duty, and medical absenteeism were 0 (IQR 0), 2 (IQR 2) and 2 (IQR 0) days, respectively. The odds of patients with influenza having a medical certificate with duration \u22651 day was 5.34 times higher than those in patients with HRV\/HEV (95% CI 2.63\u201010.88,\n P<\/jats:italic>\n <.001). No significant differences in the duration of medical absenteeism were found between HRV\/HEV and other pathogens.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Compared to HRV\/HEV, influenza infections were significantly associated with longer medical certificate duration. Nonetheless, there were no significant differences in the overall duration of medical absenteeism across pathogens, as servicemen infected with other pathogens were given light duty instead. These findings emphasize the need for pathogen-agnostic ARI measures. While influenza vaccinations are already mandatory for servicemen in local military camps, encouraging additional public health measures (eg, mask-wearing among symptomatic servicemen, COVID-19 vaccinations, therapeutics) can further reduce ARI incidence, minimize the duration of medical absenteeism, and mitigate the impact on organizational productivity.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/69113","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T17:31:01Z","timestamp":1744997461000},"page":"e69113-e69113","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Acute Respiratory Infections on Medical Absenteeism Among Military Personnel: Retrospective Cohort Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8790-0842","authenticated-orcid":false,"given":"Premikha","family":"M","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9327-9551","authenticated-orcid":false,"given":"Jit Khong","family":"Goh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1489-6158","authenticated-orcid":false,"given":"Jing Qiang","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2298-260X","authenticated-orcid":false,"given":"Adeliza","family":"Mutalib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2844-4175","authenticated-orcid":false,"given":"Huai Yang","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1128\/CMR.00039-14","article-title":"Respiratory infections in the U.S. military: recent experience and control","volume":"28","author":"Sanchez","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","DOI":"10.1186\/2054-9369-1-21","article-title":"Emerging and re-emerging infectious diseases: challenges and opportunities for militaries","volume":"1","author":"Ho","journal-title":"Mil Med Res"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S364845","article-title":"Risk factors for respiratory viral infections: a spotlight on climate change and air pollution","volume":"16","author":"Burbank","journal-title":"J Asthma Allergy"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1128\/CMR.00077-12","article-title":"Human rhinoviruses","volume":"26","author":"Jacobs","journal-title":"Clin Microbiol Rev"},{"issue":"5","key":"R5","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1183\/09031936.00186214","article-title":"Influenza virus-induced lung injury: pathogenesis and implications for treatment","volume":"45","author":"Herold","journal-title":"Eur Respir J"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1111\/irv.13040","article-title":"Population-based hospitalization burden estimates for respiratory viruses, 2015-2019","volume":"16","author":"Zimmerman","journal-title":"Influenza Other Respir Viruses"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1279159","article-title":"A cooperativity between virus and bacteria during respiratory infections","volume":"14","author":"Lalbiaktluangi","journal-title":"Front Microbiol"},{"issue":"9","key":"R8","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed7090233","article-title":"Epidemiology of community-acquired respiratory tract infections in patients admitted at the emergency departments","volume":"7","author":"Helou","journal-title":"Trop Med Infect Dis"},{"issue":"1","key":"R9","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-018-3040-x","article-title":"Epidemiologic analysis of respiratory viral infections among Singapore military servicemen in 2016","volume":"18","author":"Lau","journal-title":"BMC Infect Dis"},{"issue":"4","key":"R10","first-page":"285","volume":"6","author":"Kili\u00e7","journal-title":"Turk Silahli Kuvvetleri Koruyucu Hekim Bul"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2011.13307","article-title":"H1N1 outbreak in a Swiss military boot camp--observations and suggestions","volume":"141","author":"Jeger","journal-title":"Swiss Med Wkly"},{"issue":"6","key":"R12","first-page":"162","volume":"59","author":"Centers for Disease Control and Prevention (CDC)","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"R13","unstructured":"COVID-19 vaccination. 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