Lessons Learnt from a Pneumonia Outbreak in a Naval Training Establishment
Introduction: In August 2014, an unusually large number of cases of pneumonia was reported amongst Naval Recruits in a Naval Training Establishment by the co-located Indian Naval Hospital Ship.
Material and Methods: The study was descriptive observational (retrospective), carried out at Indian Naval Training Establishment and Indian Naval Hospital Ship. The following information was collected: (a) Batch-wise comparison of data of recruits at the Indian Naval Training establishment (where two major batches undergo
training every year) was done for the occurrence year (2014) and the preceding 03 years i.e 2011, 2012 and 2013. Further, data on cases of pneumonia were collected from the Indian Naval Hospital Ship as recorded
by the hospital for last 03 years (2011, 2012 & 2013) and the year 2014, using an epidemiological format.
Results: (a) Overcrowding. (b) Confirmation of existence of Outbreak. (c) Distribution of cases as per symptomatology and X-ray findings. (d) Manmade overcrowding, physical and psychological stress of military
training exposes non-immune persons to several pathogens. The study confirms overcrowding with per capita standard for floor space and air space being 5 sqm and 18 m 3. The recommended distance between two adjacent beds is 1.8m 1 Infact, they were even below the standard of 4 sqm recommended by WHO 4. A positive Correlation is known to exist between overcrowding and incidence of pneumonia 5.
Conclusion: Batch-wise comparison of cases and incidence of LRTI/ Pneumonia confirmed the outbreak. Further, there were no cases of Pneumonia amongst training staff (officers & sailors) and other civilian in adjoining areas. Consequent to increase in induction pattern at Naval Training Establishment, coupled with absence of accompanying increase. Consequently, analysis of living conditions established that overcrowding
existed in dormitories, dining areas and all facilities related to training.
How to cite this article:
Bhandari S. Lessons Learnt from a Pneumonia Outbreak in a Naval Training Establishment. Epidem Int. 2022;7(2):1-5.
Environmental Health Sciences -Chapter 44, Public Health & Preventive Medicine for the Indian Armed
forces (Red Book), Armed Forces Medical College, Pune. 2008.
Levison EM. Disorders of respiratory system. Harrison’s principles of Internal Medicine, McGraw Hill Companies Vol II, 15th Ed, 2003, pp.1476-81.
Ekdahl K, Ahlinder I, Hansson HB, Melander E, Mölstad S, Söderström M, Persson K. Duration of nasopharyngeal carriage of penicillin resistant Streptococci pneumoniae. Clin Infect Dis. 1997 Nov;25(5):1113-7. [PubMed] [Google Scholar]
World Health Organization.Rapid Health Assessment Protocols for Emergencies, WHO, Geneva 1999. [Google
Nelson KE, Williams CM, Graham NMH, editors. Infectious Disease Epidemiology: Theory and Practice. Aspen Publishers, Inc., Maryland, 2001. pp.439-76.
Graham NMH, Douglas RM, Ryan P. Stress and acute respiratory infection. Am J Epidemiol. 1986 Sep;124(3):389-401. [PubMed] [Google Scholar]
Nelson KE, Williams CM, Graham NMH, editors. Infectious Disease Epidemiology: Theory and Practice.
Aspen Publishers, Inc., Maryland, 2001. pp.439-76.
Bartlett JG, Breiman RF, Mandell LA, File TM Jr.Community-acquired pneumonia in adults: guidelines
for management. Clin Infect Dis. 1998 Apr;26(4):811-38. [PubMed] [Google Scholar]
Reimer LG, Carolll KC. Role of the microbiology laboratory in the diagnosis of lower respiratory tract
infections. Clin Infect Dis. 1998 Mar;26:742-8. [PubMed] [Google Scholar]
Sanchez JL, Craig SC, Kolavic S, Hastings D, Alsip BJ, Gray GC, Hudspeth MK, Ryan MA.An outbreak of
pneumococcal pneumonia among Miliatry personnel at high risk: control by low doses post-exposure chemoprophylaxis. Mil Med. 2003 Jan;168(1):1-6. [PubMed] [Google Scholar]
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