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Infectious Diseases

Symptom Characterization and Outcomes of Sailors in Isolation After a COVID-19 Outbreak on a US Aircraft Carrier

Educational Objective
To understand the symptom characterization and outcomes of sailors in isolation after a COVID-19 outbreak on a US aircraft carrier

1 Credit CME

JAMA Network Open

Published Online: October 1, 2020

Research Letter

Article Information and Disclosures

Gadiel R. Alvarado, DO¹;

Benjamin C. Pierson, DO²;

Eric S. Teemer, BSN³;

Hector J. Gama⁴;

Ronald D. Cole, MPH⁴;

Samuel S. Jang, DO⁴

Author Affiliations

¹Infectious Disease Department, Brooke Army Medical Center, Fort Sam Houston, Texas
²US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
³Public Health Department, D. D. Eisenhower Army Medical Center, Fort Gordon, Georgia
⁴Army Public Health Center, Aberdeen Proving Ground, Maryland

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Reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks affecting nursing homes, homeless shelters, and cruise ships describe both asymptomatic and symptomatic cases among patients whose primary risk factor for acquisition was residence in a confined congregate environment.¹^- 3 However, the age distribution of patients with coronavirus disease 2019 (COVID-19) described is weighted heavily toward elderly individuals and those with preexisting conditions. The USS Theodore Roosevelt (TR) outbreak investigation by the US Navy and Centers for Disease Control and Prevention illuminated how the virus affects a young military population.⁴ In this study, the US Army Public Health COVID-19 Task Force describes the results of an independent investigation of the shore-based USS TR outbreak response and 736 USS TR sailors in isolation status.

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Article Information

Accepted for Publication: August 4, 2020.

Published: October 1, 2020. doi:10.1001/jamanetworkopen.2020.20981

Correction: This article was corrected on December 16, 2020, to fix the approval statement in the first sentence of the Methods section.

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Alvarado GR et al. JAMA Network Open.

Corresponding Author: Gadiel R. Alvarado, DO, Infectious Disease Department, Brooke Army Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 (gadiel.r.alvarado.mil@mail.mil).

Author Contributions: Dr Alvarado had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Alvarado, Pierson, Gama, Cole, Jang.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: Alvarado, Pierson, Gama, Jang.

Statistical analysis: Alvarado, Pierson, Gama, Cole, Jang.

Administrative, technical, or material support: Alvarado, Teemer, Gama, Cole, Jang.

Supervision: Alvarado, Jang.

Conflict of Interest Disclosures: None reported.

Disclaimer: The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, the Department of the Navy, or the Department of Defense or the US Government.

Additional Contributions: Matthew Dolan, MD (Infectious Disease Department, Brooke Army Medical Center, Fort Sam Houston), reviewed the manuscript. He was not compensated for his time.

References

Moriarty LF , Plucinski MM , Marston BJ , et al; CDC Cruise Ship Response Team; California Department of Public Health COVID-19 Team; Solano County COVID-19 Team. Public health responses to COVID-19 outbreaks on cruise ships—worldwide, February-March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):347-352. doi:10.15585/mmwr.mm6912e3 PubMed Google Scholar Crossref

McMichael TM , Currie DW , Clark S , et al; Public Health–Seattle and King County; EvergreenHealth; CDC COVID-19 Investigation Team. Epidemiology of COVID-19 in a long-term care facility in King County, Washington. N Engl J Med. 2020;382(21):2005-2011. doi:10.1056/NEJMoa2005412 PubMed Google Scholar Crossref

Mosites E , Parker EM , Clarke KEN , et al; COVID-19 Homelessness Team. Assessment of SARS-CoV-2 infection prevalence in homeless shelters—four U.S. cities, March 27-April 15, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(17):521-522. doi:10.15585/mmwr.mm6917e1 PubMed Google Scholar Crossref

Payne DC , Smith-Jeffcoat SE , Nowak G , et al. SARS-CoV-2 infections and serologic responses from a sample of U.S. Navy service members—USS Theodore Roosevelt, April 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):714-721. doi:10.15585/mmwr.mm6923e4 PubMed Google Scholar Crossref

Chow EJ , Schwartz NG , Tobolowsky FA , et al. Symptom screening at illness onset of health care personnel with SARS-CoV-2 infection in King County, Washington. JAMA. 2020;323(20):2087-2089. doi:10.1001/jama.2020.6637 PubMed Google Scholar Crossref

Lechien JR , Chiesa-Estomba CM , De Siati DR , et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251-2261. doi:10.1007/s00405-020-05965-1 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.