Gastrointestinal infections, active component, U.S. Armed Forces, 2002-2012.

Acute gastroenteritis and other infectious disorders of the gastrointestinal system are common in civilian and military populations. During the years 2002 through 2012, there were 286,305 cases of gastrointestinal infection (GI) diagnosed among members of the active component of the U.S. Armed Forces. The distribution of presumed causes of these illnesses (as reported in administrative medical records) was bacterial (29%), viral (68%), and parasitic (3%). Most recorded diagnoses did not specify an etiologic agent. In addition, there were 379,509 other healthcare encounters in which the recorded diagnosis was simply "diarrhea." During the period, rates of hospitalization for Clostridium difficile and "ill-defined intestinal infection" increased greatly. In the outpatient setting, rates of GI diagnoses remained stable or declined, but rates of non-specific "diarrhea" increased steadily. Among reportable infectious causes of GI, rates of both campylobacteriosis and norovirus diagnoses increased steadily since 2009. Among deployed service members with GI during the period 2005 through 2012, viral agents were most often recorded as the underlying etiology (60%). Salmonellosis was the most frequent specific bacterial etiology diagnosed among deployed service members. Countermeasures against GI among service member should be emphasized in military education programs at all levels, during field training exercises, and particularly in deployment settings.