DIARRHEAL DISEASE - A MILITARY PERSPECTIVE

Diarrhoeal disease has always been a major medical problem during mili tary operations. Lost personnel time has been significant, with over 5 0% of deployed forces being affected and unable to do their jobs for s everal days. During 'Operation Desert Shield' in Saudi Arabia in 1990, the US military took extensive precautions to prevent diarrhoeal dise ase. Surveys from 1% of the 200 000 US military personnel in Saudi Ara bia indicated that 97% experienced diarrhoea, 22% sought medical care, and 19% were not able to perform their duties while affected. Medical evaluation of 452 individuals with diarrhoea determined a bacterial a etiology in 50% and a clear relationship with consumption of local fru its and raw vegetables. Prophylactic antibiotic administration was not a reasonable proposal and treatment was effective only when susceptib ility patterns of local enteric agents were considered. Research effor ts must continue for diagnostic tests to indicate which individuals wi th diarrhoeal disease would benefit from early antibiotic therapy and for development of vaccines effective against the common agents of dia rrhoeal disease.