Case Study Investigation: Respiratory System Symptoms

In the April 2011, a basic military training camp in Maryland reported 7 recruits between the ages 18 and 22 years presenting with a fever and upper respiratory symptoms, including cough, sore throat, and rhinitis. Four developed bronchitis within two days of initial symptoms and were transported to a local hospital where their conditions rapidly deteriorated. Patient 1 experienced seizures and respiratory failure that required a ventilator. He died the same day that he was admitted. Patient 2 died 7 days after hospitalization of respiratory failure and pericarditis. Patient 3 developed complications during the first month of being hospitalized, including acute respiratory distress syndrome and renal failure, then died. Patient 4 also developed complications during the first month of hospitalizations, including acute respiratory distress syndrome, multiple bacterial and fungal infections, encephalomyelitis, and seizures, then died.

The remaining 3 recruits were given antibiotics during the early stages of infection, but their condition continued to deteriorate and they were hospitalized within a week of initial symptoms.

The training camp was located in a wooded area. It had barracks with 20 beds in each, provided cafeteria-style dining, and public showers and toilet facilities.

Part A. The Problem

Type your group member names:

Your team is charged with managing the response to this problem. Your team must ensure that 1) the etiological agent causing the signs and symptoms in the patient(s) is identified and 2) the transmission of the infectious agent to other people in the community is prevented.

1. At your team's first meeting, you discuss actions to care for the patient(s). What type of sample(s) would you collect from the patient(s) to send to the lab for testing? Explain your reasoning.

2. What type of lab test(s) would you run on your sample(s)? Explain your reasoning.

3. At your meeting, you also discuss your opinions for how the etiologic agent is being transmitted. Propose the most likely way(s) that the etiologic agent is transmitted in this situation. Explain your reasoning.