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12 July 2013

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.

U.S. Army Public Health Command

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Contents

U.S. MILITARY

 Finding simple tests for brain disorders turns out to be complex

 Finds raise toxic chemical suspicions at ex-Kadena site

 IG report: Military burn pits may endanger health

 Johns Hopkins APL and AFHSC release open source electronic disease surveillance software

 Medical evacuations from Afghanistan during Operation Enduring Freedom, active and reserve 

components, U.S. Armed Forces

GLOBAL

 Concern at undetected cases as WHO holds coronavirus talks

 Gut bacteria we pick up as kids stick with us for decades

 Human head transplants are possible, says neuroscientist

 New tick-borne illness discovered

 Solving a viral mystery

 The paradox of disease prevention: Celebrated in principle, resisted in practice

 What it takes to cure drug-resistant tuberculosis

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 Variant influenza virus (H3N2v) infections

 PANDEMIC AND AVIAN INFLUENZA

 NIH scientists assess history, pandemic potential of H7 influenza viruses

VETERINARY/FOOD SAFETY

 Coke changed caramel color to avoid cancer warning; Pepsi in transition

 FDA bans some imports from Turkey as hepatitis count rises

 Smithfield CEO: China deal won't hurt food safety

 Tainted cheese linked to Listeria infections in 5 states

 Workers at livestock factories face increased MRSA risk
2

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TG 356 - Vibration 

Pocket Guide

A new technical guide 

provides:

A way to prioritize work 

areas needing further 

investigation relative to 

worker exposure to handarm vibration (HAV). 

A method for determining 

an approximate estimate of 

a worker’s HAV exposure. 

A reference document of 

methods to minimize HAV 

exposure. 

WELLNESS

 High-tech gadgets monitor seniors' safety at home

 Kids' pneumonia shots helping young and old

 Omega-3 supplements linked to prostate cancer

 Prescription painkiller overdoses

 Skin cancer on the rise in young women

 Therapists say African Americans are increasingly seeking help for mental illness

 WHO: Tobacco control measures avert millions of deaths

USAFRICOM

 Liberia: Boost for fistula treatment

 Nigeria: Polio - Kaduna govt goes hunting for missing kids

USCENTCOM

 Saudi Arabia: Hajj virus threat spurs WHO’s Chan to call emergency meeting

 Saudi Arabia: Middle East respiratory syndrome coronavirus (MERS-CoV) – WHO update

 Tajikistan: Rich with water but little to drink

USEUCOM

 Europe: Air pollution linked to higher risk of lung cancer and heart failure

 Europe: Carbapenemase-producing Enterobacteriaceae, February 2013

USNORTHCOM

 Mexico takes title of "most obese" from America

 Update: Recommendations for Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

 U.S.: As Arizona fires rage on, inquiry into firefighters’ death focuses on wind

 U.S.: Federal funds for disaster preparedness decline

 U.S.: Health officials blame heroin for spike in Maryland overdose deaths

 U.S. health outcomes far worse than other comparable nations, report finds

 U.S. lagging other countries on many health measures

 U.S./Mexico: Doctors working in fast-food restaurants

 U.S.: Surgical errors rise in Mass. despite new controls

 U.S.: Syphilis cases rising in Detroit, driven by young men in their 20s

USPACOM

 Bangladesh: Clothiers act to inspect factories

 China: Air pollution in Northern China blamed for drop in life span

 China floods death toll rises

 India’s food security plan met with skepticism

 India: Dengue-like disease hits Bangalore

USSOUTHCOM

 Brazil unveils plan to hire 10,000 doctors for poor areas

 Tropical Storm Chantal dissipates in Caribbean
3

Transport of 

Biomedical 

Materials Course -

July 15

This course details the 

provisions governing 

biomedical material 

transport and focuses on 

regulatory requirements. 

Students learn to identify 

and classify hazardous 

materials; prepare 

regulated medical waste, 

diagnostic specimens, 

biological products and 

infectious substances for 

transport; prepare and 

certify shipping papers for 

all classes of hazardous 

materials; package samples 

and specimens for 

transport; and certify 

shipments of biomedical 

material for transport.

U.S. MILITARY

Finding simple tests for brain disorders turns out to be 

complex

8 July - If you're having chest pain, your doctor can test you for a heart attack. If you're 

having hip pain, your doctor could test for osteoarthritis. But what if you're depressed? Or 

anxious? Currently there are no physical tests for most disorders that affect the mind... One 

multimillion-dollar effort, funded by private foundations and the U.S. military, is looking for 

biomarkers for PTSD and traumatic brain injury. The idea is to explore whether changes in 

certain brain chemicals like cortisol and norepinephrine, which have been associated with 

anxiety and fear, could be signals of PTSD, according to Dr. Charles Marmar, head of 

psychiatry at New York University Langone Medical Center, who is leading the project. 

"There is a biological footprint of learned fear," Marmar says. The question is, he adds, "are 

there downstream effects?" If there were, it would be easier to identify soldiers with PTSD 

and get them treatment. NPR

Finds raise toxic chemical suspicions at ex-Kadena site

3 July - The Okinawa Defense Bureau and the city of Okinawa uncovered seven more barrels 

Tuesday at a former U.S. military installation in the prefecture that may have been used to 

hold toxic chemicals during the Vietnam War, stoking concern among residents. Prior to 

Tuesday’s findings, the city had dug up 19 barrels from the same site in mid-June. The 

barrels found Tuesday had been buried about 1 meter deep in a soccer ground adjacent to 

the Kadena Air Base that had been part of the installation until 1987, the Defense Ministry 

said. The barrels had white stripes around their rims and bore “Dow Chemical” markings, a 

city official said. The Dow Chemical Co. was one of the main developers of Agent White and 

other herbicides. Some decayed barrels were also marked “30 gallons,” the official added.

Japan Times

IG report: Military burn pits may endanger health

11 July - A military camp in Afghanistan continues to use open-air burn pits to dispose of its 

solid wastes, potentially endangering the health of the nearly 13,500 people working there 

and violating the Pentagon's own regulations and guidance, federal investigators say. The 

Defense Department has said burn pits should only be used as a temporary last resort when 

no other alternative trash disposal method is feasible. Even then, at bases containing more 

than 100 personnel, burn pits are supposed to operate a maximum of 360 days. However, 

the burn pit at Camp Leatherneck in Afghanistan's Helmand province continues to operate 

some five years after the camp was started, says John F. Sopko, the special inspector general 

for Afghanistan reconstruction. The base could avoid using the burn pits altogether if the 

Pentagon were to make full use of four incinerators that cost $11.5 million to purchase and 

install, Sopko said. Yahoo! News
4

Zoonotic Disease 

Report

The first issue of the 

Zoonotic Disease Report

is now available on the 

USAPHC Periodic 

Publications and 

Surveillance Reports

page. The report compiles 

current human, animal, and 

entomological information 

that affects Military 

members on Army 

installations.

Johns Hopkins APL and AFHSC release open source 

electronic disease surveillance software

1 July - The Johns Hopkins University Applied Physics Laboratory (APL) and the Armed 

Forces Health Surveillance Center (AFHSC) have released the Suite for Automated Global 

Electronic bioSurveillance (SAGES), a collection of flexible, open-source software products 

developed for electronic disease surveillance in all settings. Public health officials around the 

world, especially those with limited capabilities or resources to meet World Health 

Organization International Health Regulations requirements for outbreak surveillance and 

reporting, can use a SAGES system that is both effective and secure 

(http://www.jhuapl.edu/sages/).Through this initial open source code release, users can 

download and customize the various software to fit their needs, as well as contribute to the 

continued development of SAGES. AFHSC

Medical evacuations from Afghanistan during Operation 

Enduring Freedom, active and reserve components, U.S. 

Armed Forces

June 2013 - From October 7, 2001 to 31 December 2012, over 

20,000 service members were medically evacuated from the 

Operation Enduring Freedom (OEF) theater of combat 

operations to a medical treatment facility outside of theater... 

During every month of the period, medical evacuations for 

disease and non-battle injuries exceeded those for battle-related injuries. The majority of 

evacuations (88.7%) occurred among males; however, the rate of medical evacuations was 

22 percent higher among females. The major causes of medical evacuations differed among 

male and female deployers; however, rates of battle injuries and mental health disorders 

increased in both sexes during the period... Most service members were discharged back to 

duty after medical evacuation. The findings enforce the need to tailor force health 

protection policies and practices to the characteristics of the deployed force and the nature 

of the military operation. Medical Surveillance Monthly Report

top of page...

GLOBAL

Concern at undetected cases as WHO holds coronavirus 

talks

9 July - International health experts began urgent talks on the 

Middle East coronavirus (MERS) on Tuesday amid concerns 

about larger numbers of milder infections possibly going 

undetected, the World Health Organization (WHO) said. The 
5

Surety Medicine 

VTC

Given the ocular hazards 

and special vision 

requirements associated 

with chemical, biological 

and nuclear surety 

programs, this videoteleconference will address 

the potential PRP reliability 

or suitability issues 

identified during vision 

screening or 

comprehensive vision 

examinations described in 

DA PAM 40-506

17 July 2013 at 1:00 pm ET

For VTC, dial-in audio, or 

Defense Connect Online

access contact the Surety 

Medicine Program.

United Nations agency announced last Friday that it was forming an emergency committee, 

to convene this week, to prepare for a possible worsening of the SARS-like virus. The 

committee is to assess whether the outbreak constitutes a "public health emergency of 

international concern", and can recommend measures to try to contain its spread, such as 

travel restrictions. Reuters

Gut bacteria we pick up as kids stick with us for decades

4 July - Most of the microbes in our guts appear to remain stable for years, perhaps even 

most of our lives, researchers reported Thursday. An analysis of the bacteria in the digestive 

systems of 37 healthy women over a period of about five years found, for the most part, 

little variation over time, says molecular biologist Jeffrey Gordon of the Washington 

University School of Medicine, who led the research. As decades-long internal companions, 

Gordon says, many microbes "are in a position to shape our lives, to promote our health or, 

in certain circumstances, contribute to risk for disease." NPR

Human head transplants are possible, says neuroscientist

1 July - Scientists have been carrying out head transplants on animals since the 1970s, when 

a monkey's head was moved to another monkey's body; the resulting creature survived, 

paralyzed, for a few days. But so far, no one has attempted to put a human head on a 

different human body. That's because, in part, they haven't had a way to properly connect 

the donor body's spinal cord up to the head, so the head-body hybrid would be similarly 

paralyzed below the transplant area. But a new paper by an Italian neuroscientist says the 

technology now exists "for such linkage," Quartz reports. Dr. Sergio Canavero believes the 

best method would be to sever both spinal cords with an ultra-sharp knife, then rapidly fuse 

the two together mechanically, using plastics like polyethylene glycol, which has been 

successfully used to fuse severed spines in dogs. USA Today

New tick-borne illness discovered

1 July - Researchers have discovered a new tick-borne illness whose symptoms are similar to 

those of Lyme disease and other tick-borne illnesses but that does not respond to 

conventional doxycycline in the same way... New England researchers identified two 

patients from the northeastern United States who were hospitalized for presumptive 

[human granulocytic anaplasmosis (HGA)] and treated with doxycycline -- but both patients 

failed to respond. A lack of response to doxycycline after more than 24 hours prompted 

further analysis. Borrelia miyamotoi infection was identified in these patients who previously 

would have been reported to the Department of Public Health as possible HGA cases.

Patients with the new illness, due to B. miyamotoi, presented much like the others, with 

patients complaining of acute febrile illness, with myalgia, headache, neutropenia, 

thrombocytopenia, and elevated hepatic aminotransferase levels. MedPage Today

Solving a viral mystery

1 July - ...The search for bats is part of an investigation into a deadly new viral disease that 

has drawn scientists from around the world to Saudi Arabia. The virus, first detected there 
6

Detecting and 

Reporting DoD 

Cases of Middle 

Eastern Respiratory 

Syndrome 

Coronavirus 

(MERS-CoV) 

Infection

Due to frequent 

deployments with 

geographic exposure 

potential and an unknown 

spectrum of illness 

presentation in DoD 

populations, AFHSC 

recommends more 

stringent screening criteria 

as follows*: 

• A person with acute 

respiratory infection, which 

may include fever (> 38° C, 

100.4° F), cough; AND 

• History of travel to the 

Arabian Peninsula or 

neighboring countries 

within 14 days before 

onset of illness; AND 

• Symptoms not already 

explained by any other 

infection or etiology, 

including clinically 

indicated tests for 

community-acquired 

pneumonia according to 

management guidelines. 

*Note that these criteria 

apply to all suspect cases, 

even without evidence of 

pneumonia or ARDS

Armed Forces Health 

Surveillance Center

last year, is known to have infected at least 77 people, killing 40 of them, in eight countries. 

The illness, called MERS, for Middle Eastern respiratory syndrome, is caused by a 

coronavirus... As the case count climbs, critical questions about MERS remain unanswered. 

Scientists do not know where it came from, where the virus exists in nature, why it has 

appeared now, how people are being exposed to it, or whether it is becoming more 

contagious and could erupt into a much larger outbreak, as SARS did. The disease almost 

certainly originated with one or more people contracting the virus from animals — probably 

bats — but scientists do not know how many times that kind of spillover to humans has 

occurred, or how likely it is to keep happening. 

New York Times

The paradox of disease prevention: Celebrated in 

principle, resisted in practice

3 July - Prevention of disease is often difficult to put into practice. Among the obstacles: the 

success of prevention is invisible, lacks drama, often requires persistent behavior change, 

and may be long delayed; statistical lives have little emotional effect, and benefits often do 

not accrue to the payer; avoidable harm is accepted as normal, preventive advice may be 

inconsistent, and bias against errors of commission may deter action; prevention is 

expected to produce a net financial return, whereas treatment is expected only to be worth 

its cost; and commercial interests as well as personal, religious, or cultural beliefs may 

conflict with disease prevention. Six strategies can help overcome these obstacles: (1) Pay 

for preventive services. (2) Make prevention financially rewarding for individuals and 

families. (3) Involve employers to promote health in the workplace and provide incentives to 

employees to maintain healthy practices. (4) Reengineer products and systems to make 

prevention simpler, lower in cost, and less dependent on individual action. (5) Use policy to 

reinforce choices that favor prevention. (6) Use multiple media channels to educate, elicit 

health-promoting behavior, and strengthen healthy habits. Prevention of disease will 

succeed over time insofar as it can be embedded in a culture of health. Journal of the 

American Medical Association

Two patients HIV-free after stem cell treatment 

3 July - Two HIV-positive men who got a stem cell transplant to treat blood cancers have 

now been off antiretroviral drugs for several weeks without evidence of the virus 

rebounding, a researcher said here. The apparent HIV remissions are exciting developments, 

but it is too early to say the men have been cured, according to Timothy Henrich, MD, of 

Brigham and Women's Hospital in Boston. "It is possible that the virus could come back 

next week," Henrich told reporters before his late-breaker presentation at the 7th 

International AIDS Society meeting on HIV pathogenesis, treatment, and prevention. But 

researchers have been unable to find evidence of HIV replication or of HIV DNA integrated 

into inactive immune cells, although the men have been off HIV therapy for 8 and 15 weeks, 

respectively, Henrich reported. If that state persists, he said, it might offer clues to a more 

widely applicable approach to inducing HIV remission, since stem cell transplant is "not a 

practical strategy" to cure the 34 million people with HIV worldwide. MedPage Today
7

Understanding the 

Public’s Response to 

a Possible Scenario 

Involving Inhalation 

Anthrax

CDC COCA Conference Call

Date: Tuesday, July 23, 

2013

Time: 2:00 - 3:00 pm ET

Dial In Number:

888-233-9077

Passcode: 8674163

More information

What it takes to cure drug-resistant tuberculosis

9 July - ...Regular TB takes about six to nine months to cure, with four antibiotics daily. 

Drug-resistant TB takes about two years to cure, and the treatment is much rougher. The 

drugs are more toxic, and only about 50 percent of people recover. That rate may be a little 

higher in the U.S. NPR

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 26, ending June 29, 2013, 6.2% 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 6.5% for week 26. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

Supplemental Report #1 – EUCOM: 30 September 2012 - 1 June 2013 

 Data from Landstuhl Regional Medical Center (LRMC), Germany. LRMC’s laboratory is 

the forward lab for military sites in Europe. This analysis does not include rapid antigen 

testing. 

 Testing has been completed on 1,147 specimens from 29 EUCOM locations, of which 

286 were positive for influenza A (123 A(H3N2), 106 A(H1N1)pdm09, 17 influenza A coinfections, and 40 A/not subtyped). 

 Seventy-nine specimens were positive for influenza B/Unknown. 

 There have been 278 other respiratory viruses isolated (16 adenovirus, 94 RSV, 18 

parainfluenza, 90 rhinovirus/enterovirus, 29 metapneumovirus, and 31 non-influenza 

co-infections). USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

Influenza activity has been low in Europe since week 21/2013. In weeks 25-26/2013: 

 All 18 reporting countries experienced low-intensity transmission. Stable trends were 

reported by almost all reporting countries

 Four countries tested five sentinel specimens, none of which was positive for influenza 

virus

 No hospitalised laboratory-confirmed influenza cases have been reported since week 

21/2013 European Centre for Disease Prevention and Control
8

Evaluation of 

PEPFAR

The U.S. government 

supports programs to 

combat global HIV/AIDS 

through an initiative that is 

known as the President's 

Emergency Plan for AIDS 

Relief (PEPFAR). 

Evaluation of PEPFAR 

makes recommendations 

for improving the U.S. 

government's bilateral 

programs as part of the 

U.S. response to global 

HIV/AIDS. 

Google.org: Flu Trends

11 July – Estimates of flu activity based on certain Internet search queries indicate that the 

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

to intense (Chile) in the southern hemisphere. Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For week 27, ending 6 July 2013:

 Influenza: No new cases of NHRC laboratory-confirmed influenza (A/H3) among US 

military basic trainees.

 FRI surveillance at all eight U.S. military basic training centers indicated FRI rates were at 

or below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

Variant influenza virus (H3N2v) infections

5 July - The first cases of influenza A (H3N2) variant1 (H3N2v) virus infection this year were 

reported in June 2013. These cases were associated with exposure to swine at an 

agricultural fair prior to illness onset. H3N2v viruses... were responsible for a multi-state 

outbreak in the summer of 2012... Clinical characteristics of the 2012 and 2013 H3N2v cases 

have been generally consistent with those of seasonal influenza... Rapid detection and 

characterization of novel influenza viruses remain important components of national efforts 

to prevent further cases and evaluate clinical illness associated with these viruses... CDC 

anticipates that state health departments will identify more H3N2v cases in 2013 as 

agricultural fair season continues. The number of cases may exceed those identified last 

year. CDC

PANDEMIC AND AVIAN INFLUENZA

NIH scientists assess history, pandemic potential of H7 

influenza viruses

9 July - The emergence of a novel H7N9 avian influenza virus in humans in China has raised 

questions about its pandemic potential as well as that of related influenza viruses... In recent 

decades, the scientists write, avian H7 viruses have caused numerous influenza outbreaks 

among poultry in Europe and North America. Since at least 1918, none of these poultryadapted viruses has evolved to widely infect humans or cause a pandemic. However, some 

of them have stably adapted to infect mammals such as horses, suggesting that these 

viruses might become adapted to and transmissible among other mammals, including 

humans. In particular, the novel H7N9 virus shares some genes with the H9N2 influenza 

virus subtype, which has also infected humans. This genetic relatedness may predispose it 
9

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to more easily adapt to humans than other H7 viruses. The possibility that H7N9 or another 

H7 virus may adapt to easily infect humans highlights a need for more research on how 

avian influenza strains adapt to mammals, especially humans, and better integration of 

influenza research between human and veterinary public health specialists, the study 

authors conclude. NIH

top of page...

VETERINARY/FOOD SAFETY

Coke changed caramel color to avoid cancer warning; 

Pepsi in transition

3 July - In 2011, the state of California created a problem for the soda 

industry. The caramel color that Coke and Pepsi used to give colas that 

distinctive brown hue contained a chemical, 4-methylimidazole — 4-MEI 

— that is listed as a carcinogen by the state... Now, it appears that both 

companies have managed to complete this transition [to sodas that do 

not contain 4MEI] sold in the state of California. But a new analysis by the 

Center for Environmental Health found that 10 of 10 samples of Pepsi products purchased 

nationwide during the month of June (in locations outside California) contained levels of 4-

MEI that were about four to eight times higher than the safety thresholds set by California... 

In contrast, nine of the 10 samples of Coke products purchased in locations outside 

California contained little or no trace of 4-MEI. NPR

FDA bans some imports from Turkey as hepatitis count 

rises

1 July - The US Food and Drug Administration (FDA) said this weekend it will detain 

shipments of pomegranate seeds from Goknur Foodstuffs of Turkey in connection with a 

hepatitis outbreak that has now grown to 127 cases. The step came after the Centers for 

Disease Control and Prevention (CDC) said on Jun 28 that the hepatitis A outbreak had 

grown to 127 cases and 55 hospitalizations, up from 122 cases and 54 hospitalizations just 2 

days earlier. The number of affected states remained at eight, and no deaths have been 

reported in the outbreak. CIDRAP

Smithfield CEO: China deal won't hurt food safety

10 July - Congressional lawmakers grilled the top executive at pork giant Smithfield Foods 

Wednesday about how the proposed $4.7 billion purchase of the company by China's 

largest meat producer might affect the U.S. food supply and agricultural producers. CEO 

Larry Pope told a packed Senate hearing his company remains committed to producing safe 

and plentiful food if the deal is approved. He underscored the benefits he said would come 
10

from the takeover by Shuanghui International Holdings, including jobs and higher pork 

exports... Lawmakers expressed concern the takeover would squeeze the U.S. pork supply 

by shipping more of the meat to China and leave the U.S. susceptible to food safety 

concerns that have plagued Chinese companies, including Shuanghui. USA Today

Tainted cheese linked to Listeria infections in 5 states

5 July - Federal and state officials are investigating a Listeria monocytogenes outbreak linked 

to a Wisconsin company's cheese that has so far sickened five people in four midwestern 

states, killing one and causing a miscarriage in another. News of the outbreak first came to 

light on Jul 2 when the Illinois Department of Public Health (IDPH) warned consumers about 

Les Freres cheese made by Crave Brothers Farmstead Classics Cheese, based in Waterloo, 

Wis., because it has been linked to a multistate Listeria outbreak. It said one of the state's 

residents got sick after eating the cheese in the middle of May. CIDRAP

Workers at livestock factories face increased MRSA risk

5 July - Biomarkers for livestock-associated Staphylococcus aureus were more prevalent in 

workers at industrial livestock operations than in those at antibiotic-free, free-range (AFFR) 

farms, researchers found. Nasal swab testing revealed that 36.6% of industrial livestock 

workers carried multidrug-resistant S. aureus (MDRSA) compared with 19.0% of AFFR 

workers, according to Christopher D. Heaney, PhD, of the Bloomberg School of Public 

Health at Johns Hopkins University, and colleagues. Complete resistance to tetracycline was 

found in 46.3% of S. aureus-positive workers in industrial operations compared with 2.4% of 

S. aureus-positive participants working with free-range livestock, the researchers reported 

online in PLOS ONE. MedPage Today

top of page...

WELLNESS

High-tech gadgets monitor seniors' safety at home

10 July - ...Research is growing with high-tech gadgets that promise new safety nets for 

seniors determined to live on their own for as long as possible... Common-sense 

interventions like grab bars in bathrooms and taping down rugs to prevent tripping can 

make homes safer as seniors deal with chronic illnesses. Technology is the next frontier, and 

a far cry from those emergency-call buttons seniors sometimes wear to summon help. 

Already, some companies are offering monitoring packages that place motion sensors on 

the front door, a favorite chair, even the refrigerator, and then send an alert to a family 

member if there's too little activity over a certain period of time. Other gadgets can make 

pill bottles buzz when it's time for a dose and text a caregiver if it's not taken, or promise to 

switch off a stove burner that's left on too long. Researchers at the University of Missouri 

aim to go further: Their experiments show that certain automatic monitoring can spot 
11

changes — such as restlessness in bed or a drop in daytime activity — that occur 10 days to 

two weeks before a fall or a trip to the doctor or hospital. Yahoo! News

Kids' pneumonia shots helping young and old

11 July - Vaccinating children against pneumococcal pneumonia cut hospitalizations for the 

infection over the past decade in nearly all age groups, particularly the youngest and oldest, 

a nationwide study showed. Annual hospitalizations for pneumonia fell by 10% overall -- an 

age-adjusted 55 per 100,000 people -- after addition of the 7-valent pneumococcal 

conjugate vaccine to the childhood immunization schedule in 2000, Marie R. Griffin, MD, 

MPH, of Vanderbilt University in Nashville, Tenn., and colleagues found. MedPage Today

Omega-3 supplements linked to prostate cancer

11 July - Taking health supplements with omega-3 fatty 

acids can increase the chances of contracting prostate 

cancer, according to new research. Omega-3 fatty acids, 

found naturally in oily fish and lauded for their antiinflammatory properties, were found to increase the risk of 

high-grade disease by 71 percent. Taking omega-3 was also associated with a 44 percent 

greater chance of developing low-grade prostate cancer. Overall, the fatty acids raised the 

risk of all prostate cancers by 43%. Fox News

Prescription painkiller overdoses

July 2013 - Nearly 48,000 women died of prescription painkiller* overdoses between 1999 

and 2010. Deaths from prescription painkiller overdoses among women have increased 

more than 400% since 1999, compared to 265% among men. For every woman who dies of 

a prescription painkiller overdose, 30 go to the emergency department for painkiller misuse 

or abuse. About 18 women die every day of a prescription painkiller overdose in the US, 

more than 6,600 deaths in 2010. Prescription painkiller overdoses are an under-recognized 

and growing problem for women. Although men are still more likely to die of prescription 

painkiller overdoses (more than 10,000 deaths in 2010), the gap between men and women 

is closing. Deaths from prescription painkiller overdose among women have risen more 

sharply than among men... This rise relates closely to increased prescribing of these drugs 

during the past decade. CDC

Skin cancer on the rise in young women

5 July - ...But as I learned more about skin cancer, I discovered that it is becoming 

increasingly common, especially among young women. A recent study by the Mayo Clinic

found that melanoma, the most serious type, had increased eightfold for women under 40 

since 1970. “There is this thought that, ‘It won’t happen to me because I’m young,’ but that’s 

not true anymore,” said Dr. Jerry Brewer, a dermatologist at the Mayo Clinic and an author 

of the study. New York Times
12

Therapists say African Americans are increasingly 

seeking help for mental illness

9 July - Many people, regardless of race, have a hard time talking about mental illness. But 

for many African Americans, the topic has carried particularly negative connotations — to 

the point where it’s easier to talk about drug or alcohol addiction than depression or 

anxiety. In 2008, whites received mental health treatment or counseling at nearly twice the 

rate of blacks, and whites received prescription medication for mental health-related issues 

at more than twice the rate of blacks, according to the 2010 National Healthcare Disparities 

Report. But African Americans’ acceptance of therapy has been rising in the past decade, 

providers say, particularly among the young and those with more education and in those 

urban areas with large black populations. There have been no large-scale studies about the 

recent shift, but providers interviewed said they have seen it in their work and in their 

communities. Washington Post

WHO: Tobacco control measures avert millions of deaths

10 July - The World Health Organization reports tobacco 

control measures can avert millions of deaths. A new WHO 

Report on the Global Tobacco Epidemic 2013 shows 

hundreds of millions of non-smokers are less likely to start 

smoking because of national anti-tobacco campaigns that 

are reaching three billion people worldwide. WHO estimates some three billion people 

globally now are covered by at least one life-saving measure to limit tobacco use. In 2008, 

WHO identified six tobacco control measures that are the most effective in reducing 

tobacco-use. VOA

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USAFRICOM

Liberia: Boost for fistula treatment

10 July - The fight against fistula is gaining ground in Liberia, where doctors and nurses at 

48 health clinics have been trained to treat the condition. Since the launch of the Liberia 

Fistula Program (LFP) in 2007, a government scheme supported by international network 

Zonta International and UNFPA, doctors have treated 1,026 fistula cases. All treatment is 

now free. While only six doctors in the country are able to perform the surgery, 65 

professional nurses have been trained to train colleagues in fistula management in rural 

health clinics. Some 300 trainees are currently enrolled. IRIN
13

Nigeria: Polio - Kaduna govt goes hunting for missing 

kids 

6 July - Kaduna State government is hunting, discovering and administering polio vaccine 

on children in the state, who skipped the last routine exercise in southern Kaduna, in an 

effort to eradicate the crippling virus. As the battle for the total eradication of Polio in 

Kaduna State becomes more serious, state government officials have launched and 

intensified manhunt for children who missed the last immunization. Weekly Trust gathered 

that the incidence of two missing children in Zangon-Kataf community recently compelled 

the Kaduna state deputy governor, Ambassador Nuhu Audu Bajoga to lead the search into 

some huts in southern Kaduna to find the children and have them immunized. Weekly Trust

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USCENTCOM

Saudi Arabia: Hajj virus threat spurs WHO’s Chan to call 

emergency meeting

10 July - Margaret Chan, the director-general of the World 

Health Organization, said she decided to convene the 

agency's emergency committee for just the second time to 

help protect travelers to the annual Hajj pilgrimage against 

the coronavirus that's killed 38 people in Saudi Arabia. The 

15-member committee, which includes Saudi Arabia's deputy health minister Ziad Memish 

and health officials from six other predominantly Muslim countries, met via teleconference 

today to decide whether Middle East respiratory syndrome coronavirus, or MERS-CoV, 

represents a public health emergency of international concern. Times of Oman

Saudi Arabia: Middle East respiratory syndrome 

coronavirus (MERS-CoV) – WHO update

7 July - The Ministry of Health (MoH) in Saudi Arabia has announced one additional 

laboratory-confirmed case and two deaths in previously confirmed cases of Middle East 

respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia. The new case is a 

56 year-old female from Hafr Al- Batin city, North-eastern region. She is a health care 

worker with contact of a previously reported laboratory confirmed MERS-CoV case who 

subsequently recovered and was discharged. In addition, the two deaths in previously 

confirmed cases are a 53 year-old citizen from the Eastern Region and a two year-old male 

from Jeddah. WHO
14

Tajikistan: Rich with water but little to drink

10 July - The Central Asian nation of Tajikistan has huge rivers. 

They begin atop some of the world's highest mountains and then 

flow west through the country's lush, green valleys. Yet for many 

Tajik families, getting enough water each day is still a struggle. A 

study by the United Nations last year found that most Tajiks lack 

access to safe, clean water. Many people rely on rivers and open ditches for drinking water, 

which are often fouled by animals, agricultural runoff and even human sewage. The 

situation has gotten steadily worse as infrastructure built by the Soviets has decayed and 

failed. NPR

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USEUCOM

Europe: Air pollution linked to higher risk of lung cancer 

and heart failure

9 July - Air pollution increases the risk of lung cancer even at levels lower than those 

recommended by the European Union, which are also standard in the UK, says a paper in 

the Lancet Oncology journal. Although smoking is a far bigger cause of lung cancer, a 

significant number of people will get the disease because of where they live. The study, 

codenamed Escape, combined data from 17 cohort studies in nine European countries 

covering a total of almost 313,000 people... It looked at the effect of long-term exposure to 

nitrogen oxides and particulate matter – PM2.5, which has a diameter of less than 2.5 

micrometres, and PM10, with a diameter less than 10 micrometres. Among the participants, 

2,095 developed lung cancer during an average 13 years of follow-up. The researchers, led 

by Ole Raaschou-Nielsen from the Danish Cancer Society Research Centre, found that for 

every increase of five micrograms per cubic metre of PM2.5 pollution, the risk of lung cancer 

rose by 18%, and for every increase of 10 micrograms per cubic metre in PM10 pollution the 

risk increased by 22%. They found no link between lung cancer and nitrogen oxides. 

Guardian

Europe: Carbapenemase-producing Enterobacteriaceae, 

February 2013 

11 July - The spread of carbapenemase-producing Enterobacteriaceae (CPE) is a threat to 

healthcare delivery, although its extent differs substantially from country to country. In 

February 2013, national experts from 39 European countries were invited to self-assess the 

current epidemiological situation of CPE in their country. Information about national 

management of CPE was also reported. The results highlight the urgent need for a 

coordinated European effort on early diagnosis, active surveillance, and guidance on 

infection control measures. Eurosurveillance

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15

USNORTHCOM

Mexico takes title of "most obese" from America

8 July - Modern Mexicans' urban lifestyle, rising incomes 

and myriad consumption vices have fed a seemingly 

endless struggle that's killing thousands more of them 

each year. Yep, we're talking the desperate Battle of the 

(body) Bulge. Even as nearly half its people are poor and 

as officials launch a national anti-hunger campaign, Mexico by some accounts recently has 

replaced the United States as the chubbiest of the globe's larger countries. CBS News

Update: Recommendations for Middle East Respiratory 

Syndrome Coronavirus (MERS-CoV)

12 July - On June 11, 2013, CDC issued interim infection prevention and control 

recommendations for hospitalized patients with known or suspected Middle East respiratory 

syndrome coronavirus (MERS-CoV) infection in U.S. hospitals (1). To date, no MERS-CoV 

cases have been reported in the United States; however, cases have been reported in eight 

other countries (2). Recent published reports (3,4) have described limited health-care 

transmission of MERS-CoV, including cases among health-care personnel in international 

settings. These published reports highlight the need for rapid detection of infectious 

patients and adherence to correct infection prevention measures to prevent transmission of 

the virus among patients, health-care personnel, and visitors. In coming months, the U.S. 

health-care system might be called upon to provide care to patients infected with MERSCoV. Front-line providers and health-care organizations should be prepared to care for 

MERS-CoV patients as part of routine operations. To aid providers and facilities, CDC has 

developed checklists that identify key actions that can be taken now to enhance 

preparedness for treating persons with MERS-CoV infection and compiled a list of 

preparedness resources. Morbidity and Mortality Weekly Report

U.S.: As Arizona fires rage on, inquiry into firefighters’ 

death focuses on wind

2 July - A swelling army of firefighters aided by bulldozers, air tankers and helicopters 

struggled on Tuesday to subdue the forest blaze that killed 19 elite firefighters on Sunday 

and continued carving a destructive path through two mountainside communities whose 

residents were forced to flee... The firefighters’ chief opponent has been the wind, which 

gusted at 20 miles per hour throughout the day from the south and southwest, only to twirl 

under thick storm clouds that have for days moved over the area in the late afternoons... 

Increasingly, the shifting winds — part of a meteorological phenomenon known as outflow 

— have become the main focus of investigators who arrived from several states on Tuesday 

to begin piecing together what happened to the 19 members of the Granite Mountain 

Hotshots, the elite firefighters killed Sunday. New York Times
16

U.S.: Federal funds for disaster preparedness decline

8 July - The US Department of Health and Human Services (HHS) has awarded a total of 

$916 million in emergency preparedness grants for states and territories for fiscal year 2013, 

a decrease of $55 million from the previous year. In a Jul 3 announcement, the HHS said the 

grants include $584 million for the Public Health Emergency Preparedness (PHEP) 

cooperative agreement and a $332 million award for the Hospital Preparedness Program 

(HPP) cooperative agreement. Last year for the first time the HHS aligned the two programs 

to boost efficiency and streamline collaboration between the public health and healthcare 

systems. CIDRAP

U.S.: Health officials blame heroin for spike in Maryland 

overdose deaths

10 July - Heroin overdose deaths soared last year in Baltimore, a city that has struggled with 

one of the highest rates of heroin addiction in the nation and with the violence that comes 

with illegal drug dealing. In 2012, 126 people died in the city from heroin overdoses, a jump 

of 66 percent from the previous year, when 76 died, reversing recent declines, according to 

a Maryland Department of Health and Mental Hygiene report released Wednesday. 

Baltimore Sun

U.S. health outcomes far worse than other comparable

nations, report finds

10 July - Compared to other major nations, the overall health 

outcomes of the United States have been found to be 

significantly lacking. In one of the most comprehensive 

studies of its kind, researchers from the Institute for Health 

Metrics and Evaluation (IHME) found that in nearly every 

major cause of premature death – from heart disease to interpersonal violence – the U.S. 

fares worse than its economic peers... While the United States has made strides in some 

major areas – such as preventing premature deaths from stroke and breast cancer – the 

country has fallen behind most nations in regards to deaths from many other conditions. 

Ischemic heart disease still remains the leading cause of premature death, measured in 

years of life lost. Fox News

U.S. lagging other countries on many health measures

10 July - Life expectancy has increased in the United States over the last two decades, but 

Americans are also spending more of their lives in poor health, a sweeping new study finds.

And despite being the biggest spender on health care in the world, the United States lags 

behind many other prosperous countries in the leading causes of premature death, 

including heart disease, violence, traffic accidents and diabetes. The main culprit behind the 

U.S. health problems appears to be eating habits, which are too low in fruits, vegetables, 

nuts and seeds, and too high in sodium, processed meats and trans fatty acids, according to 

the report. Medline Plus
17

U.S./Mexico: Doctors working in fast-food restaurants

4 July - ...In Southern California alone, there are an estimated 3,000 medically trained Latino 

immigrant doctors who aren't practicing medicine. "We had always wondered, where are 

the (immigrant) doctors from Latin America?" says Dr. Patrick Dowling, chairman of UCLA's 

Department of Family Medicine. "And we stumbled upon them working in menial jobs."

Instead of treating patients, Dowling says, many doctors spend years cleaning houses or 

working on construction sites and in fast-food chain restaurants... Latino immigrant doctors 

have a harder time than other immigrants transitioning into the U.S. health system, 

according to Dowling. "Often they work in their own country for 10 years and then come 

here and they aren't licensed, and then they see how hard the process is and they have to 

get an odd job to support themselves “...Dowling and his colleague, Dr. Michelle Bholat, 

have developed a program at UCLA that helps fast-track Latino immigrant doctors into the 

U.S. health care system, the International Medical Graduate program. CNN

U.S.: Surgical errors rise in Mass. despite new controls

7 July - Massachusetts hospitals are reporting more errors during surgery and invasive 

procedures, even after an intensive, decade-long campaign to reduce these mistakes —

called “never events” because they’re preventable and, with reasonable precautions, simply 

shouldn’t happen... Several of them said the reported number of such incidents is rising as 

more care shifts to outpatient clinics, procedure rooms, and physicians’ offices, where 

administrators and caregivers generally have been less vigilant about implementing safety 

protocols of the sort required in most hospital operating rooms. Hospital leaders said they 

are doing a better job recognizing and reporting these errors and training staff. Boston 

Globe

U.S.: Syphilis cases rising in Detroit, driven by young 

men in their 20s

7 July - Facing an alarming surge in syphilis cases, Detroit and state health authorities are 

launching a campaign alerting the public about the sexually transmitted disease that they 

say is making a comeback among a much younger crowd than in previous years. “One of 

the things we’re learning is that with adolescents and young adults — they’ve not seen it, 

not experienced it, and they’re not seeing the early signs and symptoms,” said Karen 

Krzanowski, manager of the sexually transmitted disease section of the Michigan 

Department of Community Health... On average, about 100 cases of primary- and 

secondary-stage syphilis are reported for Detroit each year, with the number of cases 

increasing. Last year, the city logged 123 cases. By May 31, 82 cases had been reported, 

Davis said. Detroit Free Press

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18

USPACOM

Bangladesh: Clothiers act to inspect factories

7 July - A mostly European consortium of 70 retailers and apparel brands has agreed to 

inspect within nine months all Bangladeshi garment factories that supply the companies. In 

a plan to be announced on Monday, the companies agreed that they would take 

responsibility and immediate action wherever serious safety problems are found. They 

pledged “to insure that sufficient funds are available to pay for renovations and other safety 

improvements.” The companies are announcing details of their ambitious, legally binding 

plan after negotiating with labor unions and nongovernment organizations since mid-May... 

Very few American companies have joined the effort. New York Times

China: Air pollution in Northern China blamed for drop 

in life span

9 July - Researchers studying the health impact of China’s 

air pollution say that people in the south of the country are 

living on average 5.5 years longer than their counterparts 

in the north. Using health and pollution data collected by 

official Chinese sources, scientists concluded that decades 

of burning coal have led to a rise in deaths from cardio-respiratory diseases for people 

living north of the Huai River - considered the dividing line between northern and southern

China. The academics from the United States, Israel and China concluded that government 

coal policies in force since China’s Mao era have resulted in higher levels of total suspended 

particulates north of the Huai River. VOA

China floods death toll rises

11 July - Floodwaters surging through Himalayan foothills in 

western China have swept away bridges, houses and hillsides, 

leaving at least 25 people dead and dozens missing. Flooding 

in Sichuan was the worst for 50 years in some areas of the 

province, with more than 100,000 people forced to evacuate

their homes. Nationwide at least 44 people have died, around 

66 are missing and at least 1.6 million have been otherwise affected since Sunday, according 

to figures from the civil affairs ministry and the official Xinhua news agency. Thousands of 

homes have been destroyed or damaged and transportation has been brought to a virtual 

standstill in hard-hit areas. Many of the casualties in Sichuan were from a massive landslide 

at a resort outside the city of Dujiangyan. Guardian

India’s food security plan met with skepticism

8 July - India's government is moving forward with a landmark measure that will provide 

highly subsidized food grains to more than two-thirds of the country's 1.2 billion 
19

population. With food inflation hitting 8.25 percent in May, New Delhi resident Geeta 

Kashyap bargains even harder at the market to keep costs down. As food prices rise, she is 

left to wonder how the poorest in India can survive. “Everything is so expensive now, diesel 

is expensive, gasoline is expensive, food is getting expensive - tomatoes that used to be 20 

rupees a kilo are now 70 rupees a kilo - how can someone eat?” asked Kashyap. It’s a 

question the Indian government wants to answer with the food security program - aimed at 

guaranteeing a majority of India’s population five kilograms of rice, wheat and coarse cereal 

a month at extremely cheap rates of one to three rupees or a few pennies per kilogram.

VOA

India: Dengue-like disease hits Bangalore

9 July - A mysterious, dengue-like disease is spreading in Bangalore. The still unidentified 

ailment is affecting many children, triggering a sharp fall in blood platelet count, multiple 

organ failure, and eventual death. At least five deaths have been reported from a prominent 

city hospital alone with more feared in other medical set-ups, both private and government. 

Based on the symptoms — high fever, vomiting and low platelet count—many doctors have 

dubbed it “dengue shock syndrome,” a serious form of dengue. But they are not so sure, 

and want the government laboratories to label the disease... Doctors are more worried 

because patients are mostly children and adolescents. Dr Preeti Galgali, a consultant 

paediatrician and central executive board member for the Indian Academy of Paediatricians, 

told Deccan Herald: “There are three types of dengue—the dengue fever, the haemorrhagic 

dengue and the dengue shock. The first one is the most common one and the latter two the 

serious forms.” Deccan Herald

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USSOUTHCOM

Brazil unveils plan to hire 10,000 doctors for poor areas

8 July - Brazil has unveiled plans to hire 10,000 doctors to work in poorly served areas as 

part of wider reforms. The shake-up will include employing foreign doctors for the first time 

from September, as well as changes to the university medicine curriculum. Students 

graduating from 2015 must serve two years in the public sector. The changes come about a 

month after millions took to the streets in mass demonstrations against poor public 

services, corruption and other issues. The health ministry said the "More Doctors" scheme 

was modelled on health services in countries such as Britain and Sweden. BBC

Tropical Storm Chantal dissipates in Caribbean

10 July - Tropical Storm Chantal dissipated into a tropical wave late Wednesday after 

skirting the southern coasts of the Dominican Republic and Haiti. The storm's remnants 

could bring heavy rain to areas where many people live in vulnerable homes of plywood 
20

and corrugated steel and where flooding is common. In both countries, people fortified 

houses with extra tarps and wood and gathered supplies, largely ignoring warnings to leave 

their neighborhoods... The storm passed overnight to the south of Puerto Rico. Authorities 

in the U.S. island territory said some 7,000 people are without power and more than 2,500 

people without water. More than 20 people also sought shelter at a school in the southern 

city of Ponce, but officials said they would return home soon. USA Today

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