Sentinel Case of COVID-19 at Fort Stewart, GA in a National Guard Soldier Participating in Annual Training: A Case Report.

For healthcare providers, specifically military and federal public health personnel, prompt and accurate diagnosis and isolation of SARS-CoV-2 novel coronavirus patients provide a two-fold benefit: (1) directing appropriate treatment to the infected patient as early as possible in the progression of the disease to increase survival rates and minimize the devastating sequelae following recovery and remission of symptoms; (2) provide critical information requirements that enable commanders and public health officials to best synchronize policy, regulations, and troop movement restrictions while best allocating scarce resources in the delicate balance of risk mitigation versus mission readiness. Simple personal protective measures and robust testing and quarantine procedures, instituted and enforced aggressively by senior leaders, physicians, and healthcare professionals at all levels are an essential aspect of the battle against the COVID-19 pandemic that will determine the success or failure of the overall effort. As consideration, the authors respectfully submit this vignette of the first confirmed positive COVID-19 case presenting to the Emergency Department at Winn Army Community Hospital, Fort Stewart, Georgia.

Virus detections among patients with severe acute respiratory illness, Northern Vietnam.

Severe acute respiratory illness (SARI) is a major cause of death and morbidity in low- and middle-income countries, however, the etiologic agents are often undetermined due to the lack of molecular diagnostics in hospitals and clinics. To examine evidence for select viral infections among patients with SARI in northern Vietnam, we studied 348 nasopharyngeal samples from military and civilian patients admitted to 4 hospitals in the greater Hanoi area from 2017-2019. Initial screening for human respiratory viral pathogens was performed in Hanoi, Vietnam at the National Institute of Hygiene and Epidemiology (NIHE) or the Military Institute of Preventative Medicine (MIPM), and an aliquot was shipped to Duke-NUS Medical School in Singapore for validation. Patient demographics were recorded and used to epidemiologically describe the infections. Among military and civilian cases of SARI, 184 (52.9%) tested positive for one or more respiratory viruses. Influenza A virus was the most prevalent virus detected (64.7%), followed by influenza B virus (29.3%), enterovirus (3.8%), adenovirus (1.1%), and coronavirus (1.1%). Risk factor analyses demonstrated an increased risk of influenza A virus detection among military hospital patients (adjusted OR, 2.0; 95% CI, 1.2-3.2), and an increased risk of influenza B virus detection among patients enrolled in year 2017 (adjusted OR, 7.9; 95% CI, 2.7-22.9). As influenza A and B viruses were commonly associated with SARI and are treatable, SARI patients entering these hospitals would benefit if the hospitals were able to adapt onsite molecular diagnostics.