21 September 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.

U.S. Army Public Health Command

U.S. Military | Global | Influenza | Veterinary/Food Safety | Wellness | Contact Us

USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM

Subscription or 

Comments

If you wish to be added to 

the APH Weekly Update 

mailing list, removed from 

the mailing list, or if you 

have comments or 

questions about the 

update, please contact us. 

We welcome your 

comments. Please feel free 

to share this update with 

others who may be 

interested.

Follow us!

Facebook

Twitter

Approved for public release, distribution unlimited.

Contents

U.S. MILITARY

 Sex assault victims need more privacy

 Substance use disorders in the U.S. Armed Forces

 Viral meningitis, active and reserve components, U.S. Armed Forces, 2002-2011

GLOBAL

 A tickling in the ear

 Cholera vaccine another element of battling disease

 Link between BPA and childhood obesity is unclear

 Researcher invents weapons of waste destruction

 Test of new dengue vaccine shows promise

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 China: Avian influenza, H5N1, poultry

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

VETERINARY/FOOD SAFETY

 Swaziland: Cattle die in the thousands

 U.S.: Antibiotic resistance, campylobacter, swine

 U.S.: FDA awards contract for tools to analyze food pathogen genomes

WELLNESS

 Cancers on the rise in pregnant women: study

 Mid-life men struggle with identity, have higher suicide risk

 Second-hand smoke tied to memory problems: study
Substance Use 

Disorders in the U.S. 

Armed Forces

Like many sectors of 

society, the U.S. military 

has a long history of 

alcohol and other drug 

misuse and abuse. In 

recent years, the face of 

the issue has been 

transformed by increasing 

rates of prescription drug 

abuse among service 

members. 

An Institute of Medicine 

analysis concludes that to 

deal with this public health 

crisis, the DoD will need to 

consistently implement 

evidence-based

prevention, screening, 

diagnosis, and treatment 

services and take 

leadership for ensuring 

that these services expand 

and improve.

 Surgery for extreme obesity produces long-term, dramatic weight loss and diabetes remission

USAFRICOM

 Democratic Republic of Congo: Ebola outbreak, WHO update

 Niger: Floods and cholera claim 162 lives

 Nigeria: Floods displace 12,000 people in Kano, Jigawa

 Sierra Leone: Cholera, WHO update

 Uganda's poorest communities tackling diseases

USCENTCOM

 Afghanistan: Grandmother, mom and kids addicted to opium

 China donates 100 ambulances to Afghanistan

 Egypt: Vaccine shortage hits children

USEUCOM

 Belgium: Usefulness of the European Epidemic Intelligence Information System in the 

management of an outbreak of listeriosis, 2011

 ECDC report profiles tickborne encephalitis patterns

 Greece: Malaria

 United Kingdom: Legionellosis

 West Nile virus kills 5 in Balkans, dozens in hospital

USNORTHCOM

 U.S.: Anthrax vaccine offer for first responders may begin in 2013

 U.S.: F as in fat - How obesity threatens America’s future 2012

 U.S.: More kids opting out of school-required vaccinations, study

 U.S., New York City: Evaluation of a neighborhood rat-management program - December 2007-

August 2009

 U.S.: Pace of West Nile virus activity slows

 U.S.: Schools not ready for next pandemic

USPACOM

 China to sell cigarettes for quake relief?

 Taiwan: Dengue fever epidemic increases by nearly a hundred cases a week

USSOUTHCOM

 Honduras: Hepatitis
Health, 

United States, 2011

Monitoring the health of 

the American people is an 

essential step in making 

sound health policy and 

setting research and 

program priorities. In a 

Chartbook and detailed 

tables, Health, United 

States provides an annual 

picture of the health of the 

entire Nation.

This report was compiled 

by the Centers for Disease 

Control and Prevention’s 

(CDC) National Center for 

Health Statistics (NCHS). 

Classified Version of 

the Weekly Update

An Army Public Health

Weekly Update is available 

with articles classified up to 

the SECRET level from the 

USAPHC SIPRNet site: 

http://phc.army.smil.mil

Look under Hot Topics & 

Current Issues.

To access this version, you 

will need a SECRET

clearance and a SIPRNet 

account.

U.S. MILITARY

Sex assault victims need more privacy

20 September - An interim policy promising more privacy to military sexual assault victims 

applying for security clearances is not enough to make victims comfortable about seeing 

mental health counseling, says an official with the Service Woman’s Action Network. Sexual 

assault victims won’t be truly comfortable seeking counseling until the questionnaire no 

longer asks about the counseling at all, said Greg Jacob, SWAN’s policy director and a 

Marine Corps veteran with service as an enlisted member and officer. Service members who 

receive mental health counseling for combat-related stress already are exempt from 

reporting their treatment, a move made in response to fears that having to report 

counseling would discourage people from seeking treatment. SWAN, a human rights 

organization founded in 2007, has been working with Congress, the Defense Department 

and Office of the Director of National Intelligence to make a similar change to the 

government’s security clearance application for victims of military sexual trauma. “I am 

confident the question is going to change,” Jacob said. “The end-state for this is to not have 

to say ‘yes’ when asked about receiving mental health counseling.” Army Times

Substance use disorders in the U.S. Armed Forces

17 September - Like many sectors of society, the U.S. military has a long history of alcohol 

and other drug misuse and abuse. In recent years, the face of the issue has been 

transformed by increasing rates of prescription drug abuse among service members. Heavy 

alcohol use and binge drinking continues to be a concern within the military. To better 

understand the current substance use problems within the U.S. military, the Department of 

Defense (DoD) asked the IOM to analyze policies and programs that pertain to prevention, 

screening, diagnosis, and treatment of substance use disorders for active duty service 

members in all branches, members of the National Guard and Reserve, and military families. 

The IOM concludes that to deal with this public health crisis, the DoD will need to 

consistently implement evidence-based prevention, screening, diagnosis, and treatment 

services and take leadership for ensuring that these services expand and improve. Institute 

of Medicine

Viral meningitis, active and reserve components, U.S. 

Armed Forces, 2002-2011

August 2012 - Viruses are the most common causes of meningitis, a condition characterized 

by inflammation of the protective membranes that surround the brain and spinal cord. 

During the 10-year surveillance period, there were 3,205 confirmed cases, 724 probable 

cases, and 2,495 suspected cases of viral meningitis among active and reserve component 

members. In all three categories of cases, the most common diagnoses were meningitis due 

to enteroviruses; however a majority of these were unspecified enteroviruses. Nearly twothirds (64.2%) of all cases due to enteroviral infection were hospitalized; on average, cases 

were hospitalized for 3.2 days. Numbers of cases peaked in late summer/early fall; and 

higher than average numbers of cases in 2003 reflected several outbreaks that occurred in 
Links

A-Z Index 

About USAPHC

Army Public Health and 

Health Information 

Weekly Update Archives

Medical Surveillance 

Monthly Report 

Medical Threat Briefings

(AKO)

Request USAPHC Services 

USAPHC Library

USAPHC Homepage 

USAPHC Training 

Contact USAPHC

civilian populations that year. Six states (Texas, California, Virginia, North Carolina, Florida, 

Georgia) reported the most cases in 2003 and overall during the period. Prevention of viral 

meningitis relies upon the interruption of viral transmission, e.g., thorough hand washing 

and disinfection of contaminated surfaces. Medical Surveillance Monthly Report

top of page...

GLOBAL

A tickling in the ear

20 September - A 63-year-old man presented with acute pruritus and 

bubbling tinnitus in his right ear, without hearing loss. Otoscopy 

revealed a tick anchored to the anterosuperior portion of the right 

tympanic membrane. The tick was removed by suction after a topical 

anesthetic agent was applied to the patient's ear. The tinnitus 

resolved immediately. Aside from mild hyperemia, no visible damage to the tympanic 

membrane was observed. The tick was identified as the nymph form of Ixodes ricinus, a 

species frequently found on cats throughout Europe. This tick can serve as a vector for 

Borrelia burgdorferi. In addition to being able to transmit disease, ticks and other insects 

can be found as foreign bodies in the outer ear canal. New England Journal of Medicine

Cholera vaccine another element of battling disease 

20 September - The cholera vaccine is emerging as a prominent tool in the fight against the 

disease that the World Health Organization says kills at least 100,000 people every year.

WHO is creating a cholera vaccine stockpile that countries can tap into during outbreaks. 

Health experts say the vaccine is not a panacea and must not detract from prevention 

basics, like safe water and proper sanitation, but given the extent of cholera’s global impact 

it is an important tool. VOA

Link between BPA and childhood obesity is unclear

18 September - BPA could be making kids fat. Or not. That's the unsatisfying takeaway from 

the latest study on bisphenol A — the plastic additive that environmental groups have 

blamed for everything from ADHD to prostate disease. Unfortunately, the science behind 

those allegations isn't so clear. And the new study on obesity in children and teens is no 

exception. Researchers from New York University looked at BPA levels in the urine of more 

than 2,800 people aged 6 through 19. The team wanted to know whether those with 

relatively high levels of BPA were more likely to be obese. But the results, published today in 

the Journal of the American Medical Association, didn't offer a simple answer to that 

question. Among white kids and teens, higher BPA levels were associated with more than 

twice the risk of obesity. With black and Hispanic youth, though, BPA levels didn't make a 

difference. NPR
Researcher invents weapons of waste destruction

3 September - Aleksandr Georgievich Semenov patented an efficiently disgusting weapon 

system. Using his method, soldiers inside an armoured tank, under battle conditions, can 

dispose of their biological waste products in an unwasteful way: encasing those materials, 

together with explosives, in artillery shells that they then fire at the enemy. Semenov, 

residing in St Petersburg, can and does brag of having Russian patent #2399858, granted in 

2009, officially titled Method of Biowaste Removal From Isolated Dwelling Compartment of 

Military Facility And Device or Its Implementation. Guardian

Test of new dengue vaccine shows promise 

14 September - A clinical trial of a new vaccine against 

dengue fever shows progress toward fighting the most 

common mosquito-borne disease. The drug is less 

successful than hoped, but seems to be effective at 

preventing three of the four related viruses that cause 

dengue. Dengue fever is endemic across the tropics, with more than 2.5 billion people in 

128 countries at risk. Symptoms can range from aches and fever to circulatory failure, coma 

and death. Some 21,000 people die of dengue each year, and the number of cases is 

increasing, including outbreaks in the southeastern United States. There is no vaccine 

available to prevent dengue fever. VOA

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 36, 6.0% of all deaths reported through the 122-Cities Mortality Reporting 

System were due to P&I. This percentage was below the epidemic threshold of 6.5% for 

week 36. FluView

China: Avian influenza, H5N1, poultry

18 September - The H5N1 avian flu virus has been detected in the city of Zhanjiang in south 

China's Guangdong province, experts confirmed on Tuesday [18 Sep 2012]. The virus has 

infected 14 050 ducks and killed 6300 of them since 11 Sept 2012, when symptoms were 1st 

reported, a Ministry of Agriculture official said. After the epidemic was confirmed, local 

authorities cordoned off an infected area in the city and killed all poultry in the area before 

starting to decontaminate it, the official said. China is particularly prone to bird flu 

epidemics, as it has the world's largest poultry population and many rural farmers live in 

close proximity to their poultry. ProMED-mail
European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During weeks 35-36 (27 August – 9 September 2012), influenza activity of low-intensity was 

notified by all 18 reporting countries. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

20 September – Estimates of flu activity based on flu-related Internet search queries indicate 

that the level of flu activity in the U.S. ranges from minimal to low. Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 15 September 2012:

Adenovirus 

 Vaccination against types 4 and 7 adenovirus was instituted at all basic training centers 

by mid-November 2011 (week 45). 

 FRI rates and the proportion of FRI cases positive for adenovirus have decreased 

markedly since vaccine was reintroduced. 

 Type 14 adenovirus is present at MCRD Parris Island.

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 

top of page...

VETERINARY/FOOD SAFETY

Swaziland: Cattle die in the thousands

20 September - Cold and wet weather, coupled with 

overgrazing and poor animal husbandry, has been blamed for 

the deaths of about 10,000 cattle in Swaziland in the past 

month - and has increased fears of health risks as people 

scavenge carcasses for food. “This is the highest number of 

cattle deaths in the country’s [modern] history,” Zolani Dlamini, the director of the 

government’s livestock and veterinary services, told local media. Since the rinderpest 

outbreak in the 1890s, which killed about 90 percent of all stock animals in Swaziland, 

farming practices have barely evolved in the landlocked country. Cattle are highly valued 

culturally and represent the only means of financial security for the two-thirds of the 

country’s 1.2 million people who reside on communal Swazi Nation Land (SNL). Prior to the 

mass deaths, Swaziland’s national herd was estimated at about 750,000 head of cattle, but 
the agricultural ministry estimates the optimum number of cattle for the country’s pastures 

- depending on the weather conditions - is between 400,000 and 600,000. While the mass 

deaths may be seen as mitigating some of the cattle overpopulation, the losses are difficult 

for impoverished farmers to manage. IRIN

U.S.: Antibiotic resistance, campylobacter, swine

19 September - Researchers from North Carolina State University have found identical 

strains of antibiotic-resistant _Campylobacter coli_ (_C. coli_) in both antibiotic-free (ABF) 

and conventionally raised pigs. This finding may indicate that these antibiotic-resistant 

pathogens can persist and thrive in the environment, regardless of antimicrobial usage by 

pork producers. Dr Siddhartha Thakur, assistant professor of population health and 

pathobiology, had previously found that antibiotic-resistant _C. coli_, a leading cause of 

foodborne illness in the US, was present in both ABF-certified and conventionally raised 

pigs. The pathogen was present in both groups in all facilities from breeding to processing. 

Thakur wanted to determine whether the _C. coli_ that he found in each group was 

genetically the same, in order to see if the presence or absence of antimicrobial usage had 

an effect on the pathogen's genetic makeup. The rise of antibiotic-resistant pathogens like 

_C. coli_ is a concern for the food animal industry. ProMED-mail

U.S.: FDA awards contract for tools to analyze food 

pathogen genomes

19 September - The US Food and Drug Administration (FDA) yesterday awarded a contract 

to Illumina Inc., of San Diego, for technology it hopes will speed pathogen identification on 

produce, the company said in a news release. The funding is for Illumina to provide the FDA 

with its MiSeq sequencing systems and reagents for conducting whole-genome analyses of 

Salmonella and Shiga-toxin–producing Escherichia coli isolates from produce and producerelated environmental samples. The contract is worth up to $17 million over 5 years. The 

FDA already deploys several MiSeq systems, but the new award is to enhance its ability to 

conduct whole-genome analysis and collect data crucial for tracking the sources of 

Salmonella in produce-related outbreaks. Using MiSeq, FDA and state laboratories will be 

able to generate whole-genome sequences from historical pathogen collections and from 

bacteria collected from produce, the release said. CIDRAP

top of page...

WELLNESS

Cancers on the rise in pregnant women: study

19 September - The number of pregnant women diagnosed with cancer has increased over 

the past couple of decades, a new study from Australia suggests. In 2007, the most recent 

year studied, researchers found 192 out of every 100,000 pregnant and postpartum women 
received a cancer diagnosis - up from 112 per 100,000 women in 1994. Researchers couldn't 

determine what was behind that increase in risk, but said it could be due in part to the older 

average age of expectant moms combined with better cancer detection. Another 

explanation could be "the increased interaction with health services during pregnancy," said 

Christine Roberts, an obstetrics researcher at the University of Sydney who worked on the 

study. Roberts said some doctors in her department had seen a few cases of expectant 

moms with cancer and wanted to know whether this was indicative of any increase in risk.

Medline Plus

Mid-life men struggle with identity, have higher suicide 

risk

20 September - Middle-aged men from disadvantaged backgrounds are 10 times more 

likely to commit suicide, often because they have lost a sense of identity and masculine 

pride, researchers said on Thursday. In a report commissioned by the British helpline charity 

the Samaritans, health experts explored why men in their 30s, 40s and 50s are at such a 

substantially higher risk of ending their own lives. The findings suggest suicide is not simply 

a mental health problem, the researchers said, but also one of men's place in societies and 

of societies' inability to adapt to men's needs when trying to deal with depression, anxiety 

and other problems. Reuters

Second-hand smoke tied to memory problems: study

20 September - Smokers and people who regularly breathe others' cigarette fumes are 

worse at remembering things on their to-do lists than are people with no tobacco exposure, 

a small study says. Problems with so-called prospective memory may not only lead to 

embarrassment if a person forgets to meet with their friends, British researchers write in the 

journal Addiction. It can also have more-serious consequences such as forgetting to take 

your medication. The study doesn't prove that smoke damages memory, but is nonetheless 

a cause for concern, the researchers say. Reuters

Surgery for extreme obesity produces long-term, 

dramatic weight loss and diabetes remission

18 September - More than 30 million of the Americans classified as obese or extremely 

obese might benefit from surgery that reconstructs the stomach to accommodate less food. 

A new study shows that gastric bypass surgery, which leads to weight loss and improvement 

of related health problems, may yield long-term health benefits. Earlier research had shown 

improvements but most patients were tracked for shorter intervals. A report published 

online September 18 in JAMA, Journal of the American Medical Association tracked hundreds 

of extremely obese patients for six years (body mass index (BMI) above 40 or greater than 

35 with health complications) and found that even after this lengthy period of time, those 

who received the surgery had significantly better health outcomes than those who did not. 

Preexisting type-2 diabetes went into remission more than half of the time (62 percent of 

cases)... [T]wo years later, the researchers found dramatic results. Those who had the 

surgery experienced a roughly 35 percent weight reduction—for many as much as 100 
pounds or more under their baseline weight—whereas the control groups remained 

extremely obese. Even after six years and without other interventions, the patients who had 

the surgery were still about 28 percent lighter on average than before and experienced 

improved quality of life scores compared to the control groups. Scientific American

top of page...

USAFRICOM

Democratic Republic of Congo: Ebola outbreak, WHO 

update

18 September - As of 15 September 2012, 46 cases (14 laboratory confirmed, 32 probable) 

with Ebola haemorrhagic fever (EHF) have been reported in the Democratic Republic of 

Congo (DRC). Of these 19 have been fatal (6 confirmed, 13 probable). The cases reported 

are from two health zones of Isiro and Viadana in Haut-Uélé district in Province Orientale. 

Additionally, 26 suspected cases have been reported and are being investigated. The MoH 

continues to work with partners to control the outbreak. Active epidemiological 

investigation is being done to identify all possible chains of transmission of the illness, and 

ensure that appropriate measures are immediately taken to interrupt the transmission, and 

stop the outbreak. WHO

Niger: Floods and cholera claim 162 lives

13 September - Floods in Niger have killed 81 people since July, the UN Office for 

Humanitarian Affairs announced Thursday, adding cholera outbreaks have killed a further 

81 people. "The last update of the toll of the floods dating from September 11 indicates 

that 527,471 people have been affected by the bad weather and 81 people have lost their 

lives," OCHA said in a statement in Niamey. The previous toll established by the authorities 

was 68 dead and 485,000 people affected in the Sahel nation in west Africa. Thousands of 

homes, schools, health centres and mosques have been destroyed, along with large 

quantities of food supplies, according to the authorities. The UN office also reported 

outbreaks of cholera, which have claimed 81 lives since the start of the year, mainly in the 

west of the country. Cholera is spreading fast in at least four places, making 3,854 people 

sick and notably affecting the Tillaberi regions lying by the Niger river and close to the 

border with Mali, OCHA said. AFP

Nigeria: Floods displace 12,000 people in Kano, Jigawa

17 September - About 12,000 people have been displaced by 

flood disaster that ravaged many communities in Kano and 

Jigawa states. This was disclosed by the National Emergency 

Management Agency (NEMA) north-west zone coordinator, 

Alhaji Musa Ilallah, who spoke to journalists shortly after 

delivering relief materials to some flood victims at Ringim LGA, Jigawa State. He said that in 
Ringim LGA alone over 2,000 flood victims were camped at Government Arabic Secondary 

School, Ringim. Alhaji Illalah explained that out of the said number (2,000) in the camp, 45 

were pregnant women and 30 were disabled. allAfrica

Sierra Leone: Cholera, WHO update

18 September - As of 16 September 2012, a cumulative total of 18,508 cases including 271 

deaths (with a case fatality ratio of 1.5%) has been reported in the ongoing cholera 

outbreak in Sierra Leone since the beginning of the year. The highest numbers of cases are 

reported from the Western area of the country where the capital city of Freetown is located. 

The Ministry of Health and Sanitation (MOHS) is closely working with partners at national 

and international levels to step up response to the cholera outbreak. The ongoing activities 

at the field level include case management; communication and social mobilization; water, 

sanitation and hygiene promotion; surveillance and data management. WHO

Uganda's poorest communities tackling diseases 

14 September - ...The Ugandan government is preparing to 

roll out a new master plan designed to tackle the most 

common of these NTDs - including elephantiasis, sleeping 

sickness, bilharzia and plague. According to Kurylo, 

Uganda is only the second country in Africa to draft such a 

plan. Gabriel Matwale of the Ministry of Health says the focus will be on both prevention 

and treatment of these diseases. "We are scaling up by covering endemic communities with 

mass drug administration, that is, giving them drugs," said Matwale. "We have a 

component of improved hygiene and sanitation." But with most NTDs occurring in hard-toreach rural communities, Matwale says, it is important to build networks of volunteers who 

can access even the most isolated villages. "We need to strengthen what we call village 

health teams, the lowest level where health care can be got," Matwale added. "So if we 

strengthen the village health team level, we would be able to reach the most marginalized 

communities." VOA

top of page...

USCENTCOM

Afghanistan: Grandmother, mom and kids addicted to 

opium

20 September – ...They may look like any normal Afghan family, but they're hiding a 

shameful secret: They're all addicted to opium, the main ingredient of heroin. It is a drug so 

prevalent that one million Afghans are addicted to it -- that's 8% of the population, 

according to the United Nations... "I feel shame," she tells me as her mother weeps in the 

background. "I always say to myself, why did I do this? Why didn't I think about my children, 
my future? People want nothing to do with us." That was until Laila Haidari found them. The 

local Afghan woman set up Mother Camp in the abandoned school about a year ago. It's a 

place for drug addicts to live, escape their destructive environment and hopefully get clean. 

She and her small team of volunteers offer counseling to help the addicts become "mentally 

strong." There is no government assistance to fund the program. Instead the profits from a 

restaurant she owns keep Mother Camp running... In another suburb, close to the slums of 

Kabul, is a methadone clinic operated by Medecins du Monde (Doctors of the World). It's 

the only clinic in Afghanistan that is allowed to dispense methadone --- a substitute for 

heroin. Some 71 addicts registered on the program arrive each day to receive the 

methadone -- a liquid poured into a small paper cup and drunk once a day. Program 

director Ernst Wisse says this is the best and most effective way to get drug addicts off 

heroin. It also eliminates the use of needles and dramatically reduces the risk of HIV 

spreading. CNN

China donates 100 ambulances to Afghanistan

20 September - The government of China donated 100 ambulances to Afghanistan's Public 

Health Ministry on Thursday, Public Health Ministry said in a statement released here, 

Xinhua reported. "The People Republic of China donated 100 new ambulances worth 4 

million U.S. dollars to the Ministry for Public Health and a technical team of China would 

also train Afghans on how to maintain and repair the ambulances," the statement added. 

Afghan minister for public health Dr. Saraya Dalil, while thanking China for the contribution, 

said the ambulances will be distributed to all the health centers in the provinces. Journal of 

Turkish Weekly

Egypt: Vaccine shortage hits children

14 September - Tens of thousands of children are at risk because 

of a vaccine shortage in Egypt, paediatricians warn. "The longer 

the government fails to immunize these children, the more 

vulnerable to disease they are," Eman Masoud, head of the 

Paediatrics Section at Abul Riesh University Hospital in Cairo, told 

IRIN. She said a delay of more than one or two months in obtaining vital vaccines like MMR, 

which protects against measles, mumps and rubella, can put children’s lives in peril. Over 

the last two weeks, parents have lined up at many of the government’s 5,000 health offices 

which vaccinate children for free, only to be told: “The vaccines are not available.” (Shots 

are, however, available for the equivalent of US$50 at private clinics.) IRIN

top of page...
USEUCOM

Belgium: Usefulness of the European Epidemic 

Intelligence Information System in the management of 

an outbreak of listeriosis, 2011 

20 September - A cluster of time-linked cases and the identification of a clonal strain 

suggest the occurrence of an outbreak of listeriosis in Belgium in 2011, presumably due to 

the consumption of hard cheese made with pasteurised milk and produced by a Belgium 

manufacturer. The outbreak clone was identified as Listeria monocytogenes serovar 1/2a, 

sensitive to arsenic and cadmium and of multilocus sequence typing MLST-type 37. Food 

investigation of this outbreak was facilitated by the European Epidemic Intelligence 

Information System and data exchanged between French and Belgium listeriosis 

surveillance systems. Eurosurveillance

ECDC report profiles tickborne encephalitis patterns

19 September - The European Centre for Disease Prevention and Control (ECDC) yesterday 

published its first major report on the prevalence of tickborne encephalitis (TBE) in Europe 

from 2000 to 2010, a move intended to build support for harmonizing TBE surveillance and 

increase prevention efforts. TBE is endemic across large parts of Europe and Asia, and the 

virus causes thousands of cases of neuroinvasive disease in Europe each year. The report 

includes data from 20 of 30 countries in the region and highlights key risk areas, seasonal 

peaks, and groups at risk, the ECDC said in a press release. The main risk areas are the 

Nordic and Baltic countries, eastern and central Europe, and southern Europe, including 

northern Italy and the Balkans. Men ages 40 to 60, particularly those who work outdoors, 

may be at increased risk for the disease, which peaks seasonally from June to October. In 16 

countries reporting TBE case data, the annual numbers were relatively stable over the 

decade, ranging from about 1,900 to 2,630, with notable increases in 2003, 2006, 2009, and 

2010. The new report follows a Sep 5 European Commission decision to add TBE to the list 

of notifiable diseases. ECDC Director Marc Sprenger, MD, PhD, said in the press release that 

TBE prevalence should be lower, considering that vaccines against the disease are safe and 

protective. CIDRAP

Greece: Malaria

14 September - As of August 5, 2012, 8 cases of malaria have been reported from the Attica 

and Laconia regions of Greece. Cases have occurred in the cities of Marathon, Markopoulo, 

and Evrotas. No cases have been reported in Athens. The Hellenic (Greek) CDC and the 

European CDC are improving surveillance for malaria cases. In affected areas, mosquito 

control has been intensified, healthcare providers have been educated, and the public has 

been informed. CDC
United Kingdom: Legionellosis

19 September - Public Health Wales and Carmarthenshire County Council's Environmental 

Health department are investigating an outbreak of Legionnaires' disease in Carmarthen. 

There are currently 3 cases, and all have links to Carmarthen. All were admitted to hospital 

as a result of their illness but have since been discharged. Legionnaires' disease is 

contracted by breathing in droplets from contaminated water sources. It cannot be caught 

from another person. Investigations into the possible source are ongoing. Information has 

been circulated to general practitioners (GPs) and hospitals in the area to advise them to be 

alert to the symptoms of Legionnaires' disease. Anyone who lives or works in the 

Carmarthen area and has symptoms suggestive of Legionnaires' disease is advised to 

contact their GP. Symptoms include breathlessness, chest pain and a dry cough, as well as 

fever, muscle aches, and sometimes vomiting and diarrhoea. Legionnaires' disease can lead 

to pneumonia and can be fatal and so it is important for anyone with symptoms to seek 

medical advice. ProMED-mail

West Nile virus kills 5 in Balkans, dozens in hospital

20 September - At least five people in the Balkans have died 

from West Nile virus and several dozen others have been 

hospitalized in the past four weeks, according to health 

authorities in Serbia, Kosovo, Macedonia and Croatia. West Nile 

virus is a mosquito-borne disease usually found in temperate 

and tropical regions. While many cases are mild and have no symptoms, severe disease 

symptoms can include headaches, high fever, neck stiffness, coma, tremors, convulsions, 

muscle weakness and paralysis. Kosovo confirmed its first fatality on Wednesday, saying the 

victim was a woman from central Kosovo who died on Sept 14. Macedonia's health officials 

said on Thursday one woman had died and two other people were infected with the virus.

Reuters

top of page...

USNORTHCOM

U.S.: Anthrax vaccine offer for first responders may 

begin in 2013

14 September – The US Department of Homeland Security (DHS) may launch a pilot plan to 

offer anthrax vaccination to first responders early in 2013, a DHS official said at a 

congressional hearing yesterday. In response to questions, Alexander Garza, MD, MPH, 

DHS's chief medical officer and assistant secretary for health affairs, was reluctant to discuss 

timing but said the trial program may be ready to debut "early next year." In April the 

Obama administration unveiled the proposal to offer unused federal supplies of the vaccine 

to emergency personnel because they would probably be first on the scene in an anthrax 

attack. State and local health officials could choose to accept the vaccine doses or not, 
officials said at the time. The vaccine is currently given to military personnel who serve in 

high-risk areas, such as the Middle East. CIDRAP

U.S.: F as in fat - How obesity threatens America’s future 

2012

18 September - F as in Fat: How Obesity Threatens America’s Future 2012 is the 9th edition 

of the annual report by RWJF and Trust for America’s Health. For the first time, the report 

forecasts adult obesity rates in each state by 2030 and the likely resulting rise in obesityrelated diseases and health care costs. Researchers used data from the Centers for Disease 

Control and Prevention’s Behavioral Risk Factor Surveillance System to model two scenarios:

if obesity rates continue to rise on their current trajectory and if states reduce residents’ 

average body mass index by five percent by 2030. The report also includes the most recent 

adult and childhood obesity rates for each state. In 2011, adult obesity rates exceeded 30 

percent in 12 states. The new projection shows that, if rates continue to increase at the 

current pace, adult obesity rates could exceed 60 percent in 13 states, and all states could 

have rates above 44 percent by 2030. Robert Wood Johnson Foundation

U.S.: More kids opting out of school-required 

vaccinations, study

19 September - The number of parents who opted out of schoolrequired vaccines for their children because of non-medical reasons, 

such as religious or philosophical beliefs, increased between 2005 

and 2011, according to U.S. researchers. During this period, the rates 

of non-medical exemptions were higher in the states with easy optout policies, such as California and Maryland, and in those states that allowed philosophical, 

instead of only religious, exemptions. "The more relaxed these requirements are, as we and 

others have shown, the easier it is to get an exemption, the higher the rates of exemptions," 

said Saad Omer, an infectious disease epidemiologist at Emory University in Atlanta, and 

lead study author. "It is common sense to me that it should not be easier to file for an 

exemption than it is to get your kid vaccinated," Omer said. Every state requires vaccines for 

school attendance that protect against diseases including measles, mumps and rubella 

(MMR), polio, chickenpox, and diphtheria, tetanus and pertussis (DTaP), according to the 

U.S. Centers for Disease Control and Prevention. Religious exemptions are permitted in 

every state except Mississippi and West Virginia, and 20 states also accept philosophical 

exemptions, the CDC notes. Medline Plus

U.S., New York City: Evaluation of a neighborhood ratmanagement program - December 2007-August 2009

21 September - ...Several areas of New York City have experienced persistent rat infestation 

despite a longstanding rat control program that employed property-level inspection and 

control measures triggered by individual citizen complaints, a common approach in urban 

areas (3). Recognizing the need to address conditions conducive to rat infestation at the 

community level, in 2007 the New York City Department of Health and Mental Hygiene 
launched a proactive "rat indexing" (active surveillance) program, using rapid inspections of 

properties in several Bronx neighborhoods with persistent rat infestation (5). The program 

included repeated, neighborhood-wide inspections; education and enforcement actions to 

promote rat control measures by property owners; and community outreach. Signs of rat 

infestation were noted and recorded electronically by inspectors, and records were analyzed 

to evaluate program effectiveness. After three rounds of indexing over a 21-month period, 

the percentage of properties with active rat signs (ARS) had declined 54%, and the 

percentage with severe rat infestation had declined 58%. The indexing approach to rat 

control subsequently was expanded to other parts of the city. Indexing can be an effective 

control strategy in urban neighborhoods with persistent rat infestation. Morbidity and 

Mortality Weekly Report

U.S.: Pace of West Nile virus activity slows

19 September – The number of new West Nile virus (WNV) infections dropped somewhat 

last week in comparison with the week before, but cases continued to pile up, especially in 

hard-hit states like Texas. The number of cases rose 19%, compared to 35% the previous 

week, when officials from the US Centers for Disease Control and Prevention (CDC) said they 

saw signs that disease activity might have peaked. In an update today, the CDC said it has 

received a total of 3,142 case reports so far, an increase of 506 from the week before. The 

number of neuroinvasive disease cases climbed to 1,630, which is 225 more than the 

previous week. Sixteen more WNV deaths were reported, pushing the nation's total so far to 

134. The number of cases reported so far is the highest the CDC has recorded through the 

third week of September since 2003. However, last week CDC officials said the number of 

neuroinvasive disease cases—considered the best indicator of the size of the epidemic—

was on track to be the highest since 1999, when WNV was first detected in the United 

States. CIDRAP

U.S.: Schools not ready for next pandemic

19 September - Many U.S. schools are not prepared for bioterrorism attacks, outbreaks of 

emerging, infectious diseases, or pandemics, despite the recent 2009 H1N1 influenza 

pandemic which resulted in more than 18,000 deaths worldwide, Saint Louis University 

researchers say. The study, led by Terri Rebmann, Ph.D., associate professor at SLU’s 

Institute for Biosecurity, surveyed about 2,000 nurses working in elementary, middle, and 

high schools across twenty-six states. A Saint Louis University release reports that the 

findings reveal that only 48 percent of schools address pandemic preparedness and only 40 

percent of schools have updated their plans since the 2009 H1N1 pandemic that spread 

illnesses in more than 214 countries. “There is a lot of research that shows influenza spreads 

quickly in schools because it’s a communicable disease and kids interact closely,” Rebmann 

said. “Schools need to have a written pandemic plan in order to be prepared to put 

interventions into place quickly when an event occurs.” ...[T]he study also found that 44 

percent of schools do not participate in community surveillance that tracks the presence of 

a disease based upon symptoms reported by area residents. Homeland Security News Wire

top of page...
USPACOM

China to sell cigarettes for quake relief? 

17 September - Authorities in south China's Yunnan province, where a recent earthquake 

claimed at least 81 lives, now plan to sell 400,000 cartons of cigarettes in order to raise tax 

revenue to spend on quake relief, a Chinese daily said. According to the state-run Global 

Times daily, China has become the world's largest tobacco producer and consumer, with 

more than 300 million smokers. It is estimated that deaths in China from smoking will 

exceed three million annually by 2050. The tobacco industry in the country remains the 

foremost source of revenue for certain local governments. "However, the idea of using 

increased tobacco production to raise relief funds is not only contrary to the national 

tobacco control commitment, but also comes at the expense of public health," the daily 

said. SME Times

Taiwan: Dengue fever epidemic increases by nearly a 

hundred cases a week

19 September – [A]ccording to the Central News Agency, dengue fever cases surge in 

southern Taiwan, "Department of Health, Centers for Disease Control announced yesterday, 

last week, 96 new cases of indigenous dengue fever epidemic in Annan District, Tainan.” 

CDC epidemic director of the Center for Zhuangren Xiang pointed out last week, added 96 

cases of local (including two cases [of] DHF) and eight cases of imported confirmed cases of 

dengue. Paper Wenweipo via Google Translate

top of page...

USSOUTHCOM

Honduras: Hepatitis

19 September - The lack of treated water for human consumption as well as inadequate 

family hygiene triggered a hepatitis outbreak in the Concepcion del Horno community. 

Health authorities identified 12 people with symptoms of the disease that were later 

confirmed. Rodolfo Miranda, municipal Coordinator of Environmental Health, said that an 

education session was carried out with the water boards and trusts. "We have instructed 

them to wash their hands before eating, after going to the bathroom, to wash fruit and 

vegetables, and have good home hygiene. We also taught them to purify water from the 4 

systems that serve the community." ProMED-mail

top of page...
U.S. Military | Global | Influenza | Veterinary/Food Safety | Wellness | Contact Us

USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical 

intelligence product. Medical intelligence is available from the National Center for Medical Intelligence.

External Links: The appearance of external hyperlinks does not constitute endorsement by the U.S. Army of this Web site or the information, products, 

or services contained therein. For other than authorized activities such as military exchanges and MWR sites, the U.S. Army does not exercise any 

editorial control over the information you may find at these locations. Such links are provided consistent with the stated purpose of this product.

Although Health Information Operations avoids links to sites that may be blocked, all sites may not be accessible from all locations. While we verify the 

links at the time of publication, we cannot guarantee that they will be active in the future.

Articles appearing in the Update 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.

The Army Public Health Weekly Update is published by the Health Information Operations Program, Deputy Chief of Staff for Communication, United 

States Army Public Health Command.