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David O. Matson, Norovirus Gastroenteritis in US Marines in Iraq, Clinical Infectious Diseases, Volume 40, Issue 4, 15 February 2005, Pages 526–527, https://doi.org/10.1086/427508
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In this issue of Clinical Infectious Diseases, Thornton et al. [1] report the findings of a cross-sectional laboratory study of gastroenteritis that affected a military unit operating during the first portion of the 2003 invasion in central Iraq. The new findings of this report are most evident for norovirus—also known as “Norwalk virus,” “Norwalk-like virus,” and “small, round-structured virus”—a virus for which the known impact among humans has markedly increased since 1990, when the viral genome was first characterized and new diagnostic reagents were designed [2]. Norovirus is and deserves to be listed by the National Institute of Allergy and Infectious Diseases as category B among pathogens of importance to biodefense.
The lead author of this study [1] is part of a group that has been investigating infectious diseases in the US military during recent deployments [3–8]. This report represents an important advancement in their investigations, because they established field testing for norovirus infections during combat, with attendant better catchment of the study population and more prompt pathogen recognition; they used better primers for RT-PCR detection of norovirus; and, consequently, they identified a broader spectrum of infecting strains. They also provided evidence that antimicrobial prophylaxis reduced the impact of bacterial gastroenteritis pathogens commonly observed in prior studies.
