1. Navy Environmental and Preventive Medicine Unit TWO, 1285 West D St, Bldg. U-238, Norfolk, VA 23511
2. Naval Hospital Jacksonville, Family Medicine Department, 2080 Child Street, Jacksonville, FL 32214.The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or U.S. Government