13 July 2012

Army Public Health Weekly Update

The Army Public Health Update is a collection of articles taken verbatim

from public sources to offer awareness of current health issues and the

media coverage given to them. The articles do not necessarily represent

US Army Medical Department opinions, views, policy, or guidance, and

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

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Contents

U.S. MILITARY

 Amputations of upper and lower extremities, active and reserve components, U.S. Armed 

Forces, 2000-2011

 Making commanders accountable for soldiers’ suicides

GLOBAL

 Laws that criminalise gays hurt HIV treatment

 Study finds high effectiveness for indoor spraying to prevent malaria

 Study maps zoonotic disease burden, hot spots

INFLUENZA

 Antiviral-resistant H1N1 virus in Australia didn't spread far

 Australia: Dangerous flu season upon us

 CDC: Weekly Influenza Surveillance Report

 China reports bird flu outbreak

 European Centre for Disease Prevention and Control: Weekly Influenza Surveillance Overview

 France: Pandemic vaccine uptake was poor in pregnant women

 Google.org: Flu Trends

 Hong Kong finds H5N1 in pet bird shop

 Indonesian girl dies from H5N1 infection

 Mexico: Bird flu strikes poultry farms

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 U.S.: H1N1 flu in pigs and people at Ohio county fair identical

 WHO: Flu season starts in Southern Hemisphere

VETERINARY/FOOD SAFETY

 Botulism outbreak in Oregon sickens three

 Ohio: E. coli outbreak rises to 55; 10 hospitalized

 Hendra virus detected in Australian horse
Adolescent Vaccine 

Poster

A new poster on the 

USAPHC Health 

Information eCatalog

encourages parents to 

make sure that their 

children are up-to date on 

vaccinations especially as 

they enter middle school. 

 Upstate New York Shigella outbreak expands to 45

WELLNESS

 Fake sweeteners might help keep pounds off

 Get up! Sitting less can add years to your life

 Really, cranberries do protect against urinary tract infections

USAFRICOM

 Nigeria aims for generation of HIV-free babies

 Tanzania: Gender violence fuels HIV/Aids infections in women

 Uganda: HIV prevention no longer just ABC

 West Africa: Cholera upsurge kills more children in the Sahel

USCENTCOM

 Pakistan: Birth control – roping in Pakistan’s men

 Plight of Afghanistan's mentally ill

 Study links polio rise in Afghanistan, Pakistan to ebbing vaccine coverage

USEUCOM

 Netherlands: Little change in Dutch euthanasia post-legality

USNORTHCOM

 Babesiosis surveillance — 18 States, 2011

 Babies addicted to prescription painkillers?

 Can a deadly form of hand, foot and mouth disease hit the US?

 HPV vaccine reducing infections, even among unvaccinated

 Newspaper says Florida health officials kept mum about TB outbreak

 Record year for whooping cough? Get the shots, health experts say

 West Nile virus disease and other arboviral diseases — United States, 2011

USPACOM

 Vaccine rolls out to boys

 Cambodia: Mix of pathogens caused mystery illness, doctors say

 Samoa: Ministry of health reports increase in typhoid cases

USSOUTHCOM

 Brazil to breed GM mosquitoes

 Cuba reports cholera outbreak, first in over a century

 Report - Little environmental damage from Chevron’s offshore Brazil oil spill
Pertussis Posters

Two new posters on the 

importance of getting a 

pertussis booster are now 

available on the USAPHC 

Health Information 

eCatalog. One focuses on 

the need to vaccinate

family members. The 

second poster is geared 

toward those who work 

with children (health care 

providers, teachers, 

daycare providers and 

babysitters.)

U.S. MILITARY

Amputations of upper and lower extremities, active and 

reserve components, U.S. Armed Forces, 2000-2011 

June - This report summarizes the numbers and types of traumatic amputations, and the 

demographic and military characteristics of affected active and reserve service members 

from 2000 to 2011. Both minor and major amputations are described and stratified by 

location of amputation. Furthermore, the trends and demographic and military 

characteristics of deployment-related cases are described. .The surveillance period was 1 

January 2000 through 31 December 2011. The surveillance population consisted of all 

individuals who served in an active and/or reserve component of the U.S. Armed Forces at 

any time during the surveillance period. During the surveillance period there were 6,144 

incident cases of traumatic amputation among 5,694 service members. The majority of the 

injuries reported were considered minor amputations (i.e., toes, fingers, thumbs, 

upper/lower unspecified) (n=3,849; 63%). There were 2,295 major amputations (i.e., hands, 

feet, arms, legs) among 2,037 individuals, and of these, 29 were bilateral upper extremity 

amputations and 360 were bilateral lower extremity amputations. Medical Surveillance 

Monthly Report

Making commanders accountable for soldiers’ suicides

26 June - Suicide remains an alarming and growing problem throughout the Army, with the 

annual number of suicides now greater than the number of deaths resulting from combat. A 

few years ago the Army took the aggressive position that suicide prevention should be 

taken away from its Medical Department and given to the “line” — the commanders of 

troops. This was accomplished by placing the deputy chief of staff of the Army at the time, 

General Peter W. Chiarelli, in charge of suicide prevention. This was a tremendous move in 

the right direction. However, it wasn’t enough and hasn’t solved the problem, as recent data 

show. New York Times

top of page...

GLOBAL

Laws that criminalise gays hurt HIV treatment

10 July - Laws that criminalise gay behaviour are among a host of legal tangles that waste 

resources and hinder an effective response to HIV/AIDS worldwide, an independent 

commission reported. The report by the Global Commission on HIV and the Law also 

pointed to laws that make sex work a crime, laws that prevent interventions with injecting 

drug workers, and legislation that denies the youth access to sex education. "Too many 

countries waste vital resources by enforcing archaic laws that ignore science and perpetuate 

stigma," said former president of Brazil Fernando Henrique Cardoso, who serves as chair of 

the commission. EIN News
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Study finds high effectiveness for indoor spraying to 

prevent malaria

4 July - Indoor insecticide spraying has reduced malaria infections in malaria-endemic 

communities by 62%, according to a meta-analysis published online Jul 3 in the American 

Journal of Tropical Medicine and Hygiene (AJTMH). The researchers examined 13 studies 

published between 2000 and 2010 on the effect of indoor residual spraying (IRS) on malaria 

transmission, primarily in Africa. Because the effectiveness of IRS in the studies varied 

considerably, as did study design and other factors, the authors performed a metaregression analysis using 45 observations and deduced the following: IRS is most effective 

in areas with a high initial prevalence of malarial disease, where both Plasmodium 

falciparum and Plasmodium vivax parasites are a threat, when several rounds of spraying 

are conducted, and where DDT rather than pyrethroids or other insecticides is used. The use 

of DDT is controversial and has been banned in many countries, the authors acknowledge, 

but it may be worth consideration in areas of intense malaria transmission. CIDRAP

Study maps zoonotic disease burden, hot spots

5 July - A review and mapping study to gauge the burden of zoonotic diseases found that 

Ethiopia, Nigeria, Tanzania, and India are four top hot spots and that a surging demand for 

livestock products will likely fuel the spread of several diseases. The report was designed to 

help global health officials target disease-fighting resources to best help the poor... Besides 

offering a detailed view of the interplay between poverty, farming practices, climate change, 

and zoonotic diseases, the report also provides a vivid snapshot of the overall global burden 

of animal-human diseases. The group estimated that 13 of 56 zoonoses they studied are 

responsible for 2.4 billion human illnesses and 2.2 million deaths each year, mainly in lowand middle-income countries. CIDRAP

top of page...

INFLUENZA

Antiviral-resistant H1N1 virus in Australia didn't spread 

far

5 July - An oseltamivir-resistant 2009 H1N1 virus that spread in one Australian community 

in 2011 apparently did not escape to a nearby large city, according to a report published in 

Eurosurveillance yesterday. Researchers previously reported the community spread of a 

resistant 2009 H1N1 virus in the Newcastle, Australia, area from June through August of 

2011, the report notes. The authors of the new study looked for signs of the resistant strain 

in Sydney, the nearest major city to Newcastle, 120 kilometers away. They ran genetic 

assessments of H1N1 viruses from 143 patients who had not received oseltamivir and from 

23 patients who had been treated with it. Only 2 (1.4%) of the 143 isolates from untreated 
patients carried the resistance mutation (H275Y in the neuraminidase), indicating a low 

prevalence of the resistant strain and "no convincing evidence" of its spread from the 

Newcastle area. CIDRAP

Australia: Dangerous flu season upon us

11 July - Doctors are warning people to protect themselves against potentially deadly flu 

strains that have already taken lives and sent dozens of people to hospital. Nationally, 8183 

cases of flu have been reported this year, with 1034 of them in Victoria. This is up from 698 

during the same period in Victoria last year and 226 in 2010. Seven deaths have been 

reported to the federal Department of Health. But the chairman of the Influenza Specialist 

Group, Dr Alan Hampson, said this was likely to be the tip of the iceberg. He said he feared 

Australia was in for a difficult year because most people were being diagnosed with the 

H3N2 and Type B flu virus strains. ''When we see high levels of H3N2, which is the 

predominant strain this season, there is significant impact, especially in high-risk groups. 

Typically, we can expect to see more deaths and hospital admissions,'' said Dr Hampson, 

whose group receives some funds from pharmaceutical companies. The World Health 

Organisation's Ian Barr said he also feared a worse flu season than the past two years. But 

he said this year's flu vaccine included protection against these strains because they were 

dominant in the northern hemisphere winter. The Sydney Morning Herald

CDC: Weekly Influenza Surveillance Report

During week 26, 6.6% of all deaths reported through the 122-Cities Mortality Reporting 

System were due to pneumonia and influenza. This percentage was below the epidemic 

threshold of 6.9% for week 26. FluView

China reports bird flu outbreak

2 July - Authorities in China's remote northwestern region of Xinjiang have culled more than 

150,000 chickens following an outbreak of bird flu, officials said. The outbreak of the H5N1 

strain of avian flu initially killed 1,600 chickens and sickened about 5,500, the agriculture 

ministry said late Monday. In an effort to contain the disease, agricultural authorities 

quarantined the area and culled 156,439 chickens, according to the ministry. The outbreak 

occurred on June 20 but was only confirmed as H5N1 bird flu on Monday, it said. The 

ministry and state press did not specify exactly where the outbreak occurred, but said it 

happened at a farm run by the Xinjiang Production and Construction Corps, described by 

state media as a semi-military government organisation of about 2.5 million people. AFP

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During weeks 25 and 26 (18 June – 1 July 2012), sixteen countries reporting experienced 

low-intensity influenza activity. Of 68 sentinel specimens, one was positive for influenza type 

B virus. Since week 40/2011, 89.3% of the detected influenza viruses have been type A and 

10.7% type B. The A(H3) subtype represented 98.5% of influenza A type viruses detected 

during the 2011–2012 season. Weekly Influenza Surveillance Overview
France: Pandemic vaccine uptake was poor in pregnant 

women

7 July - Despite an active campaign in France urging pregnant women to receive the 2009 

H1N1 pandemic vaccine, poor coverage ensued, with social disparities and no increase in 

protection for women at highest risk for complications, according to a study published 

online Jul 7 in Vaccine. Data from 13,453 French women who were in their second trimester 

during the campaign were analyzed. Coverage was 29.3% (95% confidence interval [CI], 

28.6%-30.1%). Among women not getting the vaccine, 91.2% gave as the reason that they 

did not want it. The vaccination rate was higher in pregnant women who were older, were 

employed, were born in France, had fewer than three children, and had positive health 

behaviors during pregnancy. Women who had received postgraduate education had an 

adjusted odds ratio for vaccination of 4.1 (95% CI, 3.5-4.8) compared with those having less 

than a high school education. CIDRAP

Google.org: Flu Trends

12 July – Estimates of flu activity based on flu-related Internet search queries indicate that 

the level of flu activity in the northern hemisphere is minimal and ranges from minimal to 

high in the southern hemisphere. High levels are indicated for Chile, Australia and New 

Zealand. Google.org Flu Trends

Hong Kong finds H5N1 in pet bird shop

5 July - Officials in Hong Kong have shuttered a pet bird shop after routine tests yielded the 

H5N1 avian flu virus, according to a statement today from Hong Kong's Agriculture, 

Fisheries, and Conservation Department (AFCD). The virus was found on a swab sample 

collected on Jun 25 from a cage holding an Oriental magpie robin. Authorities have 

transferred all of the shop's birds to an AFCD animal management center, where they will be 

destroyed. Authorities have also closed the Bird Garden, where the shop was located, for 21 

days as a precaution. CIDRAP

Indonesian girl dies from H5N1 infection

5 July - Indonesia's health ministry today announced the death of an 8-year-old girl from an 

H5N1 avian influenza infection, according to a report from the Jakarta Globe. The girl, from 

West Java province, got sick on Jun 18 during a trip to Singapore. Six days later her 

symptoms worsened and she was admitted to a Jakarta hospital with signs of pneumonia. 

She was transferred two more times and required treatment with a ventilator. A health 

ministry official told the Globe that she tested positive for the virus on Jun 29 and died on 

Jul 3. The official said she had often walked past a live-bird market on her way to school, 

and 6 days before she got sick she had helped carry freshly killed birds home from the 

market with her father. If the World Health Organization (WHO) confirms the girl's H5N1 

illness and death, she will be listed as Indonesia's 190th case-patient and its 158th fatality 

from the disease. CIDRAP
Mexico: Bird flu strikes poultry farms

10 July - An outbreak of avian flu in western Mexico has killed 

approximately 870,000 poultry birds since June. The state 

government of Jalisco has declared a national animal health 

emergency and is currently working to prevent the spread of 

the disease to other parts of the country. The strain of avian flu 

in this outbreak, H7N3, rarely infects humans. Jose Munoz, a member of the Jalisco state 

government, reassured people that there is no risk of infection for humans who consume 

the region’s poultry or eggs. The Disease Daily

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 7 July 2012:

Influenza: Laboratory-confirmed influenza cases among U.S. military basic trainees included 

19 cases of type A/H3, 16 cases of A/pH1N1, and 21 cases of type B influenza.

FRI surveillance at all U.S. military basic training centers indicated FRI rates were at or below 

expected values. NHRC Febrile Respiratory Illness Surveillance Update 

U.S.: H1N1 flu in pigs and people at Ohio county fair 

identical

9 July - The discovery of identical triple-reassortant H1N1 influenza in pigs and humans at a 

county fair in Ohio in August 2007 illustrated the importance of coordinating public health 

and animal health disease investigations, says a report released yesterday in Zoonoses and 

Public. Clinical signs of a flu-like illness were seen in most of more than 200 pigs within 80 

hours of their arrival at the fair; these included anorexia, fever, lethargy, and a "barking" 

cough. The pig barns were temporarily closed to the public and the animals were treated 

with antibiotics. Five days after the pigs' arrival at the fair, respiratory symptoms in several 

exhibitors were reported. CIDRAP

WHO: Flu season starts in Southern Hemisphere

9 July - The flu season has started in most of the temperate Southern Hemisphere countries 

that collect surveillance information, the World Health Organization (WHO) said Jul 6 in its 

latest global flu update. The H3N2 virus is dominant overall, but the virologic picture varies 

by country, with some, including Bolivia, reporting high levels of 2009 H1N1 infections and 

others seeing co-circulation of influenza B. In Chile, flu activity has almost reached the 

country's alert threshold, and the proportion of emergency visits for respiratory disease has 

reached 31%, surpassing the level reported for the same period in the last 2 years. Most 

virus detections there are H3N2. Brazil has reported a sustained rise in flu detections since 

the middle of May, with a notable increase in severe respiratory infections, 80% from the 

2009 H1N1 virus and the rest from H3N2. In Bolivia, more than 50% of samples tested were 

positive for flu, and the country has seen a recent rise in severe infections. In sub Saharan 
Africa, limited data suggests low or no flu activity in most countries, except for Ghana, Ivory 

Coast, and Madagascar. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

Botulism outbreak in Oregon sickens three 

8 July - Three Oregonians were hospitalized with botulism after 

eating at a private barbecue, according to state health officials.

The Clostridium botulinum bacteria that infected these 

individuals is thought to have come from home-canned foods 

served at the event, held in Deschutes County. All three victims 

were residents of the county, located in central Oregon. The Deschutes County Health 

Department says the incident was isolated and that all barbeque attendees had been 

notified. Food Safety News

Ohio: E. coli outbreak rises to 55; 10 hospitalized

12 July - The number of people sickened by E. coli bacteria in Germantown has risen to 55, 

according to Public Health — Dayton & Montgomery County officials. The health 

department is investigating the outbreak which appears to have stemmed from a customer 

appreciation picnic July 3 at Neff’s Lawn Care. Bill Wharton, a spokesman for the health 

department, said 19 additional cases were identified Wednesday with 10 hospitalizations 

since the event... The health department is not expecting the illness count to rise 

significantly, because the normal incubation period for this strain of E. coli is eight days, and 

Wednesday was the eighth day since the picnic. The number has grown over time because 

those who were feeling ill heard about illnesses from the picnic and contacted the health 

department, Wharton said. Dayton Daily News

Hendra virus detected in Australian horse

10 July - Another case of Hendra virus was detected last week in Queensland, Australia. 

Australian news agencies reported that a veterinarian treated a gravely ill horse in the 

northern part of the state. Lab results confirmed that the animal had Hendra virus (HeV), a 

severe virus of the Henipavirus genus that can cause fatal neurological and respiratory 

disease in horses and humans. Upon confirmation of infection, the horse was humanely 

euthanized. One person was exposed to the virus, but officials say that the risk of infection 

was low, as he had worn full protective equipment. The Disease Daily

Upstate New York Shigella outbreak expands to 45

12 July - Almost three weeks after health officials in Upstate New York announced they were 

investigating a Shigella outbreak affecting 25 people, the estimated victim count has grown 

to 45. The outbreak is affecting residents of Onondaga County, which includes the city of 
Syracuse and is located in the northern central part of the state. "There are currently 45 

cases of Shigella," reported the Onondaga County Health Department in a statement to 

Food Safety News. "This includes confirmed, probable, and what New York State 

Department of Health is considering suspect (cases). We continue to investigate each and 

every case for linkages but the source remains unknown." Food Safety News

top of page...

WELLNESS

Fake sweeteners might help keep pounds off

10 July - Can artificial sweeteners help people reach and maintain a healthy body weight? 

Maybe, according to two major medical societies. A scientific statement issued by the 

American Heart Association and the American Diabetes Association concluded that using 

non-nutritive sweeteners could cut down on added sugars and therefore lead to beneficial 

effects. But an extensive literature search found sketchy, limited, and often contradictory 

evidence, researchers concluded in Circulation: Journal of the American Heart Association 

and Diabetes Care. "Smart use of non-nutritive sweeteners could help you reduce added 

sugars in your diet, therefore lowering the number of calories you eat," said lead author 

Christopher Gardner of Stanford University in Palo Alto, Calif. That reduction "could help 

you attain and maintain a healthy body weight, and thereby lower your risk of heart disease 

and diabetes," Gardner said in a statement. But any beneficial effects, the researchers noted, 

could be undone if people "compensate" for the calorie cuts by eating more high-calorie 

foods. ABC News

Get up! Sitting less can add years to your life

10 July - Sitting for more than three hours a day can cut two 

years off a person’s life expectancy, even if he or she exercises 

regularly, a new study finds. Watching TV for more than two 

hours a day can shorten life expectancy even further, by 

another 1.4 years. The findings suggest that when it comes to 

gleaning health benefits from physical activity, it may not be enough just to get the 

recommended amount of daily exercise — the government advises about a half-hour of 

moderate activity a day for adults...Whether “you’re physically active and meet the exercise 

guidelines, or if you’re not active,” says Peter Katzmarzyk, professor of epidemiology at 

Pennington Biomedical Research Center and lead author of the new paper published in the 

online journal BMJ Open, “sitting is bad.” Healthland Time

Really, cranberries do protect against urinary tract 

infections

10 July - This folk remedy may be for real: A new study finds that cranberry products really 

do help prevent urinary tract infections. The benefit of cranberry juice and other cranberry 

products in staving off urinary tract infections (UTIs) has long been debated. In 2011, a 
study showed that among a group of college-age women, those consuming more cranberry 

products were 43% more likely to develop a UTI. Yet, other studies, including one 

conducted by the Cochrane Review in 2008, have hinted that cranberry products can help 

reduce the risk of these infections by as much as 34%. Those results were backed up by 

molecular analyses showing that compounds in cranberries could block the ability of the 

bacteria that cause UTIs to attach themselves to the membranes of the urinary and genital 

tracts. Despite the lack of consensus, however, many doctors have continued to advise their 

patients to try cranberry products for infection, since the alternative treatment — antibiotics 

— can lead to drug resistance, which makes bacterial infections harder to treat. Healthland 

Time

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USAFRICOM

Nigeria aims for generation of HIV-free babies

10 July - Health authorities say 70,000 children are born 

HIV-positive in Nigeria every year, and one-fourth of them 

don't live past their first birthday. While some officials say 

they want to make Nigeria one of Africa's first nations to 

give birth to a generation of HIV-free babies, activists say 

poverty, stigma and a lack of government support make that goal lofty, if not impossible... 

Edward Ogenyi is the national coordinator for the Network of People Living With HIV/AIDS 

in Nigeria. He says 2.9 million people are known to be living with HIV in Nigeria, but more 

than 80 percent of the population does not know their HIV status. And for many who do 

know, drugs are not available. More than half of the people known to be in need of antiretroviral drugs in Nigeria don't get them because there are not enough. "The culture of 

voluntary counseling and testing is not there. It is something that we are still struggling 

with," said Ogenyi. "It is only when we can take it up very seriously that we can be sure that 

we can prevent new HIV infections in this country." Voice of America

Tanzania: Gender violence fuels HIV/Aids infections in 

women

11 July – Any person who intentionally transmits HIV to another person commits an offence 

and on conviction the culprit shall be liable to life imprisonment. This amounts to gender 

violence and is partially what the HIV and AIDS Prevention Control Act (2007) seeks to curb. 

The law is also tailored to provide incisive prevention, care and control of HIV and AIDS and 

promotion of public health to persons living with HIV and AIDS. A national report on 

HIV/AIDS prevalence shows that by the end of 2004 it was estimated that 1.3 million 

Tanzanians were positive to HIV/AIDS with the infection rate standing at seven per cent 

among the sexually active age group... Today, however, two million Tanzanians live with the 
disease. Fortunately, the infection rate has been scaled down to five per cent at national 

level, thanks to sustained campaigns by the state, NGOs and other stakeholders in the 

welfare of Tanzanians. All Africa

Uganda: HIV prevention no longer just ABC

11 July - Uganda enjoyed tremendous success reducing its AIDS prevalence rate in the 

1990s through a campaign based on the ABCs: Abstain, Be Faithful or Use a Condom. Now 

new infections are on the rise again. As health workers struggle to keep HIV in check, the 

country is moving beyond its celebrated ABC message to new prevention strategies... [A] 

recently released AIDS Indicator Survey showed new infections are on the rise again in 

Uganda. Though the increase was less than one percent, the news alarmed health workers 

and activists... [Dr. Bernard Etukoit] says for Uganda, the most important of these strategies 

are preventing transmission of HIV from mothers to their children, and safe male medical 

circumcision, which can reduce the chance of HIV transmission by up to 60 percent. Over 

the last year, the country has strengthened plans for both strategies, though limited 

resources mean neither service is universally available. Voice of America

West Africa: Cholera upsurge kills more children in the 

Sahel

10 July - As the rainy season unfolds across the Sahel, a 

recent upsurge of cholera that has killed over 60 people 

and sickened about 2,800 this year is putting more and 

more people - especially malnourished children - at risk, 

UNICEF warned today. Last week, an outbreak in Northern 

Mali left two children dead and 34 other people sick, including a growing number of 

children, according to Mali's Ministry of Health. So far in 2012, cholera has killed nearly 700 

people in West and Central Africa and more than 29,000 cases were reported. Since midJune, the number of people affected by the deadly highly infectious water-borne disease 

has shot up in the Sahel, especially in Niger's regions bordering the Niger River, where the 

Ministry of Health reports nearly three times as many cholera patients over the first half of 

2012 compared to the same period last year. All Africa

top of page...

USCENTCOM

Pakistan: Birth control – roping in Pakistan’s men

11 July - “No scalpel, no stitch and no rest needed,” guarantees Dr. Ghulam Shabbir 

Sudhayao, referring to the surgical procedure called vasectomy – the least popular method 

of birth control around the world, including Pakistan. “People confuse vasectomy with 

castration (surgical removal of the testicles) and that scares them away,” Sudhayao, who 
works for the government’s population welfare department, tells IPS... But, Sudhayao is 

frustrated that the 2,000 social mobilisers working for the department are unable to meet 

their quotas. “We get no more that 80 to 90 clients in a month though the operation is free 

and the patient gets Pakistani rupees 500 (five dollars) for nutrition, and the introducer can 

collect 1.59 dollars as incentive money.” IPS

Plight of Afghanistan's mentally ill

10 July - Afghanistan is struggling to fight mental health problems that afflict its population 

after decades of violence. Slideshow. Reuters

Study links polio rise in Afghanistan, Pakistan to ebbing 

vaccine coverage

4 July - Decreases in polio vaccination coverage in parts of Pakistan and southern 

Afghanistan, two of the three remaining polio-endemic countries, have led to an increase in 

cases despite eradication efforts and more effective polio vaccines, says a study published 

online yesterday in The Lancet. The researchers, from Imperial College London and the 

World Health Organization (WHO), did a matched case-control analysis of data from 

national surveillance programs in Afghanistan and Pakistan to study the effect of 

immunization campaigns and the effectiveness of the three polio vaccines available. The 

database included 46,977 children 0 through 14 years old with acute flaccid paralysis from 

2001 through 2011. The team found that the serotype 1 monovalent vaccine and the 

serotype 1/3 bivalent vaccine had comparable effectiveness and were both superior to the 

trivalent vaccine. They report that the number of polio cases increased from 40 in Pakistan 

and 31 in Afghanistan in 2006 to 198 and 80 in 2011, respectively. The increase is occurring 

primarily in regions where vaccination coverage and population immunity are decreasing, 

including Balochistan and the Federally Administered Tribal Areas in Pakistan and parts of 

southern Afghanistan where security concerns continue. CIDRAP

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USEUCOM

Netherlands: Little change in Dutch euthanasia postlegality

11 July - The frequency of doctor-assisted euthanasia in the Netherlands has changed little 

since the longstanding practice was legalized in 2002, according to a new study. A summary 

published Wednesday on The Lancet magazine's website said that "in 2010, of all deaths in 

the Netherlands, 2.8 percent were the result of euthanasia. This is higher than the 1.7 

percent in 2005, but comparable with (levels seen) in 2001 and 1995." Under Dutch law, a 

person who asks to die may be administered a lethal mixture of sedatives and muscle 

relaxants if two doctors agree he or she is suffering "unbearable" pain with no prospect for 
recovery. Most cases involve cancer victims. The Lancet study used data from the country's 

death registry and sent confidential questionnaires to doctors, extrapolating results to 

represent a cross-section of deaths in different social, medical and geographical areas. 

Yahoo News

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USNORTHCOM

Babesiosis surveillance — 18 States, 2011

13 July - ...For the first year [2011] of babesiosis surveillance, health departments notified 

CDC of 1,124 confirmed and probable cases. Cases were reported by 15 of the 18 states 

where babesiosis was reportable; however, 1,092 cases (97%) were reported by seven states 

(Connecticut, Massachusetts, Minnesota, New Jersey, New York [including New York City], 

Rhode Island, and Wisconsin). Cases were identified in persons aged <1–98 years; 57% were 

in persons aged ≥60 years. Among patients for whom data were available, 82% (717 of 879) 

had symptom onset dates during June–August. Ongoing national surveillance using the 

standard case definition will provide a foundation for developing evidence-based 

prevention and control measures to reduce the burden of babesiosis. Morbidity and 

Mortality Weekly Report

Babies addicted to prescription painkillers?

9 July - ...The Journal of the American Medical Association recently published a study taking 

a closer look at the growing number of mothers taking painkillers and the babies born that 

are addicted to drugs. On average, a child is born every hour in the U.S., addicted to a class 

of painkillers called opiates. By 2009, there were more than 13,000 babies born with 

neonatal abstinence syndrome (NAS), a withdrawal syndrome that occurs in some babies 

after being exposed to opiates, while in utero, according to the study. Even more startling, 

that one-baby-per-hour figure marks about a three-fold increase in the number of babies 

born with NAS since 2000; and during the same time period, opiate use among expectant 

mothers was also jumping, increasing nearly five-fold. HLN

Can a deadly form of hand, foot and mouth disease hit 

the US?

10 July - Public health experts think they’ve solved the mystery behind the illness that’s 

linked to more than 50 deaths of children across Cambodia since April: a virus that causes a 

common illness in children called hand, foot and mouth disease. The particular strain of the 

virus -- Enterovirus Type 71 or EV-71 -- that destroyed the lungs and led to brain swelling in 

the children who died, has posed problems in other Asian countries, but it isn’t seen often in 

the US and tends to be less dangerous when it does infect children here. “We’re not sure 

why that is,” said Dr. Al DeMaria, state epidemiologist at the Massachusetts Department of 
Public Health. “It may be a slightly different strain that comes here or have something to do 

with a difference in hygiene practices or overall health of our population.” While parents 

shouldn’t panic that the deadly EV-71 might cause an outbreak at, say, summer camp, 

DeMaria said public health officials have it on their radar screen. “I think it is a concern. It’s 

one of the emerging infections we look out for,” he said. “We need to keep an eye on it 

since infections can travel quickly around the world.” The Boston Globe

HPV vaccine reducing infections, even among 

unvaccinated

9 July - Even among unvaccinated girls and young women, the 

human papillomavirus vaccine is reducing infections of certain 

strains of the virus known to cause genital warts and cervical 

cancer, new research finds. The study is among the first to show 

signs that the human papillomavirus (HPV) vaccine not only 

prevents infections, but it can also promote herd protection -- a decrease in infections 

among the unimmunized thanks to lower rates of infections among other people in their 

community who might otherwise be transmitting the disease... The study involved two 

groups of women aged 13 to 26 who had already had sexual contact and who were seen at 

two primary-care clinics in Cincinnati, one of which was a teen health center. One group was 

seen at the clinic in 2006 or 2007, before the HPV vaccine, which protects against four 

strains of HPV, was widely available. The second group was seen in 2009 or 2010, after the 

vaccines were widely available. U.S. News

Newspaper says Florida health officials kept mum about 

TB outbreak

9 July - Florida health officials withheld from key state decision makers a Centers for Disease 

Control and Prevention (CDC) report of a serious tuberculosis (TB) outbreak in Jacksonville, 

even as the state took steps to close a TB hospital, the Palm Beach Post reported yesterday. 

In the CDC report, Robert Luo, MD, MPH, warned Florida officials that the Jacksonville 

outbreak, with 13 deaths and 99 cases, was one of the worst hit group had investigated in 

20 years, the story said. Luo issued his report in April, shortly after Gov. Rick Scott signed a 

bill that trimmed the Department of Health and required closure of the A.G. Holley State 

Hospital in Lantana, where patients with difficult TB cases have been treated for 60 years, 

the newspaper said. CIDRAP

Record year for whooping cough? Get the shots, health 

experts say

10 July - The U.S. is on course for a record year for whooping cough, health officials said this 

week. And while vaccinating kids is clearly the most important defense, health experts say 

adults may not realize they’re supposed to be getting regular shots, too... So far this year, 

the United States has seen more than 16,000 validated cases of whooping cough, said 

Stacey Martin, an epidemiologist with the Centers for Disease Control and Prevention. That’s 

more than the 15,216 cases reported last year. The latest peak was 27,550 cases in 2010, 
when it killed 27 people, 25 of them babies... Pertussis has reached epidemic levels in the 

state of Washington, with more than 2,700 cases so far this year, and CDC is following 

outbreaks in 18 other states: Wisconsin, Minnesota, New York, New Jersey, Illinois, Idaho, 

Montana, Texas, Ohio, Iowa, Missouri, Florida, Arizona, Maine, New Mexico, Pennsylvania, 

Kansas, and Oregon. MSNBC

West Nile virus disease and other arboviral diseases —

United States, 2011

13 July - ... West Nile virus (WNV) is the leading cause of domestically acquired arboviral 

disease in the United States (1). However, several other arboviruses also cause seasonal 

outbreaks and sporadic cases (1). In 2011, CDC received reports of 871 cases of nationally 

notifiable arboviral diseases (excluding dengue); etiological agents included WNV (712 

cases), La Crosse virus (LACV) (130), Powassan virus (POWV) (16), St. Louis encephalitis virus 

(SLEV) (six), Eastern equine encephalitis virus (EEEV) (four), and Jamestown Canyon virus 

(JCV) (three). Of these, 624 (72%) were classified as neuroinvasive disease, for a national 

incidence of 0.20 per 100,000 population. WNV and other arboviruses continue to cause 

focal outbreaks and severe illness in substantial numbers of persons in the United States.

Morbidity and Mortality Weekly Report

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USPACOM

Vaccine rolls out to boys

13 July - The human papillomavirus vaccine - provided to 

girls to protect against cervical cancer - will be extended to 

boys from next year to protect against other cancers and 

bolster the vaccine's effectiveness in girls. Federal Health 

Minister Tanya Plibersek said the government would fund 

the vaccine for year 7 boys through schools and also for year 9 boys in a ''catch-up 

program'' over the next two years, in a $21 million program. The vaccine, developed in 

Australia, protects against four strains of the human papillomavirus (HPV) that can also 

cause head and neck cancer and genital warts. Ms Plibersek said about 80 per cent of 

Australians had some strain of HPV in their lifetime and several strains could cause cancer. 

''So if you are able to protect your sons and your daughters against being infected with 

HPV, you increase the likelihood of protecting them from cancer,'' she said. Cancer Council 

Victoria director of cancer prevention Craig Sinclair welcomed the extension of the vaccine 

after its ''terrific results'' in girls since 2007. ''The number of girls under 18 with high-grade 

abnormal pre-cancerous cells of the cervix has halved, so we know the vaccine is incredibly 

effective,'' he said. The Sydney Morning Herald
Cambodia: Mix of pathogens caused mystery illness, 

doctors say

10 July - The World Health Organization, in conjunction with the Cambodian Ministry of 

Health, will conclude that a combination of pathogens is to blame for the mysterious illness 

that has claimed the lives of more than 60 children in Cambodia, medical doctors familiar 

with the investigation told CNN on Wednesday. The pathogens include enterovirus 71, 

streptococcus suis and dengue, the medical sources said. Additionally, the inappropriate use 

of steroids, which can suppress the immune system, worsened the illness in a majority of the 

patients, they said. The sources did not want to be identified because the results of the 

health organization's investigation have not yet been made public. Dr. Beat Richner, head of 

Kantha Bopha Children's Hospitals -- which cared for 66 patients affected by the illness, 64 

of whom died -- said that no new patients had been seen there since last Saturday. CNN

Samoa: Ministry of health reports increase in typhoid 

cases

11 July - Typhoid fever cases in Samoa have increased dramatically since April with more 

than one hundred cases reported to the ministry. A health consultant Leausa Dr Take Naseri 

says the ministry suspects a lack of food hygiene is the major cause of the outbreak 

recently. Dr Naseri says the ministry is looking at preventative measures such as licensing all 

food handlers in the country from shops to village stores, restaurants, food stalls and also 

mobile food sellers in villages... Dr Naseri has also confirmed the outbreak of the disease in 

April at Tafaigata prison has been contained. But he also adds the ministry has advised the 

Police Commissioner to consider medical check-ups on people facing a 3 to 6 month 

sentence before they begin their jail terms. He says such a policy would prevent any more 

outbreaks of communicable and non communicable diseases in prisons. Radio New Zealand 

International

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USSOUTHCOM

Brazil to breed GM mosquitoes

10 July - Brazil said it will breed huge numbers of genetically modified 

mosquitoes to help stop the spread of dengue fever, an illness that has 

already struck nearly 500 000 people this year nationwide... The initiative in 

Brazil will produce large quantities of genetically modified male Aedes 

aegypti mosquitoes, which will be released into nature to mate with 

females, the health ministry said. "Their offspring will not reach adulthood, which should 

reduce the population," it said in a statement. The new mosquitoes will be produced in a 

factory inaugurated on Saturday in the north-eastern Brazilian state of Bahia. Four million 

insects will be churned out per week. The experiment has already been attempted in two 

mosquito-infested towns in Bahia, each with about 3 000 inhabitants. EIN News
Cuba reports cholera outbreak, first in over a century

10 July - Cholera has reportedly struck Cuba for the first time in 130 years, causing three 

deaths and at least 85 illnesses. The outbreak is centered in Manzanillo, a town of about 

130,000 people located in the Granma province in eastern Cuba. Suspected, but still 

unconfirmed, cases appear in Caimanera, a town next to the U.S. Guantanamo Bay camp. 

Officials have named contaminated wells as the source of the outbreak; the contaminated 

wells were subsequently closed and disinfected. Heavy rains and hot temperatures may also 

have been factors in the spread of the disease. According to the health ministry, the 

outbreak has been controlled and case counts are falling. The Disease Daily

Report - Little environmental damage from Chevron’s 

offshore Brazil oil spill

11 July - A federal police spokesman confirmed Wednesday that investigators have found 

that an offshore oil spill near a Chevron well last year caused no significant environmental 

damage... Chevron spokesman Kurt Glaubitz said in an emailed statement that “continuous 

monitoring of the incident area shows no discernible environmental impact to marine life or 

human health. No oil has reached Brazil’s coast.” Washington Post

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