Congregate military training during a 6-week period was associated with a 40% incidence (473/1,187) of medically attended acute respiratory infections among incoming freshmen.
Observational (n=1,187)
No
What is the incidence, viral etiology, and impact of medically attended acute respiratory infections among midshipmen at the US Naval Academy during Plebe Summer?
High attack rates of medically attended acute respiratory infections, driven by diverse viruses including rhinovirus and SARS-CoV-2, cause substantial training days lost in congregate military settings.
Abstract Background Understanding the epidemiology of acute respiratory infections (ARIs) in congregate military settings is vital to force health protection. This analysis describes insights gleaned from the “Acute Respiratory Infections at the Academy” (ARIA) study regarding respiratory virus incidence and impact at the United States Naval Academy during ‘Plebe Summer’ 2023, an intense 6-week training for all incoming freshmen (plebes). Methods Residual nasal swabs collected as part of the standard-of-care work-up in midshipmen who presented to clinic with an ARI were sent for multiplex PCR testing and viral genomic sequencing. Corresponding patient demographics, symptoms, diagnoses, and outcomes were abstracted from medical records. Integrated epidemiological and viral genomic analyses were performed. Results During Plebe Summer 2023, 40% of incoming freshmen (473/1,187) sought healthcare for at least one ARI, as did 71 upperclassmen. Swabs were collected in 598 of 615 ARIs (97%), among which 324 (54%) tested positive for at least one virus; 2+ viruses were detected in 52/324 (16%). Rhinovirus/enterovirus was most frequently detected, followed by SARS-CoV-2; several SARS-CoV-2 variants, all Omicron sub-lineages, were identified. There was considerable symptom overlap among MAARIs in which different viruses were detected. Most (83%) midshipmen with a medically attended ARI (MAARI) spent at least one day sick-in-quarters (SIQ). SARS-CoV-2 detections were associated with the longest SIQ durations. Conclusions Plebe Summer 2023 was characterized by high MAARI attack rates, considerable viral diversity and viral co-detections, and substantial training days lost. ARIA highlights the importance of ongoing characterization of ARIs in congregate populations to help inform mitigation strategies.
Hone et al. (2026) conducted an observational in Acute respiratory infections (ARIs) (n=1,187). Congregate military training (Plebe Summer) was evaluated on Incidence of medically attended acute respiratory infections (MAARIs). Congregate military training during a 6-week period was associated with a 40% incidence (473/1,187) of medically attended acute respiratory infections among incoming freshmen.