21 December 2012

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

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Contents

U.S. MILITARY

 Air Force studies effects of highly popular, super-caffeinated drinks

 Analysis: The militarization of hospital beds

 Army releases November suicide data

 Costs of war: Excess health care burdens during the wars in Afghanistan and Iraq

 FDA approves raxibacumab to treat inhalational anthrax

 Paper links nerve agents in ’91 Gulf War and ailments

GLOBAL

 Global malaria battle stalls as financing gets tight

 Obesity - the big picture

 Successful results against human leishmaniasis with a more efficient and economic vaccine

 Vaccine rule is said to hurt health efforts

 When the doctor is not needed

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 GlaxoSmithKline wins U.S. approval for new flu vaccine

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 Experts at NIH meeting say H5N1 research moratorium may end soon

 Influenza at the human-animal interface

 Pigs in southern China infected with avian flu

 With more surveillance, flu patterns in Africa begin to emerge

VETERINARY/FOOD SAFETY

 Under many aliases, mislabeled foods find their way to dinner tables

 USDA sets rules for tracking livestock across state lines
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WELLNESS

 Daylight savings tied to bump in heart attack rates

 Do health care workers practice what they preach?

 Patients who Google hemorrhoids may want to avoid doctor

 Regular marijuana use by teens continues to be a concern

 Scientists in Hong Kong map initial anti-aging formula

 Small changes in eating prompts weight loss

USAFRICOM

 Ethiopia introduces health-care phone service

 Guinea: New cholera strain poses prevention challenges

 Quick and affordable test is saving lives in areas still ravaged by “Black Death”

USCENTCOM

 Karzai admits lack of proper healthcare system in Afghanistan

 Pakistan: Gunmen kill women who were giving children polio vaccines

 Syria: IDPs brace for winter in rebel-controlled camps

USEUCOM

 Irish government to legalize life-saving abortion

 United Kingdom: Norovirus - vomiting bug cases are up by 80 per cent

USNORTHCOM

 After shootings, a flood of ideas and proposals for curbing gun violence

 DHS to re-examine possible health effects of backscatter X-ray

 HIV cases decline for black women, increase for gay men: CDC

 New air pollution standards restrict soot particles

 No clear link between cancer and 9/11 debris, study finds

 Senators call for return of assault weapon ban

 TB's global resurgence amplifies U.S. risk

 Use of selected contraception methods among women aged 15–44 years currently using 

contraception

USPACOM

 Australia: Whooping cough epidemic as state records highest numbers

 China: Donation of organs directed to the needy

 Philippines OKs divisive contraceptives bill

 Pollution from car emissions killing millions in China and India

USSOUTHCOM

 Cuba (Havana): Cholera, diarrhea and dysentery update 2012

U.S. MILITARY

Air Force studies effects of highly popular, supercaffeinated drinks

17 December - Amid growing concern about the effects of energy drink consumption, an 

Air Force researcher is conducting the service’s first comprehensive study of energy drink 
Developing and 

Strengthening the 

Global Supply Chain 

for Second-Line 

Drugs for 

Multidrug-Resistant 

Tuberculosis -

Workshop Summary

Patients diagnosed with 

multidrug-resistant 

tuberculosis face lengthy 

treatment regimens of two 

years or more with daily, 

directly observed 

treatment with second-line 

anti-TB drugs (SLDs) that 

are less potent, more toxic, 

and more expensive than 

those used to treat drugsusceptible TB. 

A strengthened global 

supply chain for SLDs 

could save lives by 

consistently delivering high 

quality medicines to more 

of the people who need 

them. Ensuring a reliable 

and affordable supply of 

high-quality SLDs is a 

complex public health 

intervention that, so far, 

has not been organized or 

implemented in a way that 

allows all providers and 

patients access to SLDs 

when they are needed. 

usage among the force’s active-duty and civilian personnel. “We just don’t know how much 

folks are consuming them — in quantities, duration and what’s driving it,” said Maj. Nicholas 

Milazzo, chief of pharmacy research for the 60th Medical Group’s clinical investigation 

facility at Travis Air Force Base, Calif. Launched in September, the online survey targets 12 

bases. Two are in Europe — Aviano and Lakenheath air bases — and the others in the 

States. Previous Air Force studies on energy drink usage have been limited to one base... 

Milazzo said there have been no reports of deaths attributed to energy drinks in the 

military, but the limited knowledge about the physical effects of energy drinks and how 

many Air Force personnel consume them is a potential health risk. Stars and Stripes

Analysis: The militarization of hospital beds

20 December - Delivering health aid to hotspots including Haiti 

and Afghanistan has brought together - and at times pitted 

against one another - humanitarians and militaries in an uneasy 

but increasingly necessary union. As the military’s role in health aid 

is likely to grow - since the 2004 Indian Ocean tsunami, the US 

military has deployed 40 times to natural disasters worldwide - delineating the rules and 

responsibilities of each side in the field has become all the more necessary. Even after some 

two decades of working more closely with militaries to deliver aid, researchers and 

humanitarians are still divided about such cooperation in health care... “To have any type of 

weapon near a health structure makes them the target in conflict. That is why a no-weapon 

strategy is the best way to guarantee patients’ security,” Michiel Hofman, a UK-based 

operations adviser for health NGO Médecins sans Frontières (MSF), told IRIN in early 2012.

IRIN

Army releases November suicide data

13 December - The Army released suicide data today for the month of November. During 

November, among active-duty soldiers, there were 12 potential suicides: one has been 

confirmed as a suicide and 11 remain under investigation. For October, the Army reported 

20 potential suicides among active-duty soldiers; since the release of that report, one case 

has been removed for a total of 19 cases: nine have been confirmed as suicides and 10 

remain under investigation. For 2012, there have been 177 potential active-duty suicides:

113 have been confirmed as suicides and 64 remain under investigation. Active-duty 

suicide number for 2011: 165 confirmed as suicides and no cases under investigation.

Defense.gov

Costs of war: Excess health care burdens during the wars 

in Afghanistan and Iraq

November - This report estimates the health care burden related to the wars in Iraq and 

Afghanistan by calculating the difference between the total health care delivered to U.S. 

military members during wartime (October 2001 to June 2012) and that which would have 

been delivered if pre-war (January 1998 to August 2001) rates of ambulatory visits, 

hospitalizations, and hospital bed days of active component members of the U.S. Armed 

Forces had persisted during the war. Overall, there were estimated excesses of 17,023,491 
Immunization 

Continuing 

Education

A new calendar is posted 

to the MILVAX website. 

The calendar shows 

immunization-specific 

training offered in-person 

and online. It highlights 

training to meet the 8-hour 

annual education 

requirement at little or no 

cost to the trainee.

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.

ambulatory visits, 66,768 hospitalizations, and 634,720 hospital bed days during the war 

period relative to that expected based on pre-war experience. Medical Surveillance Monthly 

Report

FDA approves raxibacumab to treat inhalational anthrax

14 December - The U.S. Food and Drug Administration today approved raxibacumab 

injection to treat inhalational anthrax, a form of the infectious disease caused by breathing 

in the spores of the bacterium Bacillus anthracis. Raxibacumab also is approved to prevent 

inhalational anthrax when alternative therapies are not available or not appropriate... “In 

addition to antibiotics, raxibacumab will be a useful treatment to have available should an 

anthrax bioterrorism event occur,” said Edward Cox, M.D., M.P.H, director of the Office of 

Antimicrobial Products in FDA’s Center for Drug Evaluation and Research. “Although 

antibiotics are approved to prevent and treat anthrax infection, raxibacumab is the first 

approved agent that acts by neutralizing the toxins produced by B. anthracis.” FDA

Paper links nerve agents in ’91 Gulf War and ailments

13 December - Reviving a 20-year debate over illnesses of veterans of the 1991 Persian Gulf 

war, a new scientific paper presents evidence that nerve agents released by the bombing of 

Iraqi chemical weapons depots just before the ground war began could have carried 

downwind and fallen on American troops staged in Saudi Arabia. The paper, published in 

the journal Neuroepidemiology, tries to rebut the longstanding Pentagon position, 

supported by many scientists, that neurotoxins, particularly sarin gas, could not have carried 

far enough to sicken American forces. The authors are James J. Tuite and Dr. Robert Haley, 

who has written several papers asserting links between chemical exposures and gulf war 

illnesses. They assembled data from meteorological and intelligence reports to support their 

thesis that American bombs were powerful enough to propel sarin from depots in 

Muthanna and Falluja high into the atmosphere, where winds whisked it hundreds of miles 

south to the Saudi border. New York Times

top of page...

GLOBAL

Global malaria battle stalls as financing gets tight

17 December - Global funding for the fight against malaria has stalled in the past two years, 

threatening to reverse what the World Health Organisation (WHO) says are "remarkable 

recent gains" in the battle to control one of the world's leading infectious killers. After rapid 

expansion between 2004 and 2009, funding for malaria prevention and control leveled off 

between 2010 and 2012 - meaning there were fewer life-saving steps taken in hard- hit 

malarial regions such as sub-Saharan Africa. "If we don't scale up vector control activities in 

2013 we can expect major resurgences of malaria," said Richard Cibulskis, lead author of the 

WHO's World Malaria Report, which was published on Monday. "Vector control" means 
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stopping transmission of the disease with tools such as treated mosquito nets. The report 

found that deliveries of such nets to endemic countries in sub-Saharan Africa dropped from 

145 million in 2010 to an estimated 66 million in 2012. Reuters

Obesity - the big picture

15 December - A huge new global health study, led by Christopher Murray of the University 

of Washington, shows that since 1990 obesity has grown faster than any other cause of 

disease. For women a high BMI is now the third-largest driver of illness. At the same time 

childhood mortality has dropped and the average age of the world’s population has risen 

rapidly. In combination these trends may mark a shift in public-health priorities. 

Increasingly, early death is less of a worry than decades spent alive and sick. Economist

Successful results against human leishmaniasis with a 

more efficient and economic vaccine 

19 December - A research coordinated by the UAB has succeeded in testing a vaccine 

against leishmaniasis. The vaccine was tested with the best animal model existing, the 

golden hamster, and can be produced at low costs by using insect larvae. The research, 

published in the latest edition of PLoS ONE, is an important step towards the fight against a 

disease which causes the death of 70,000 people each year in developing countries and of 

countless dogs, which also suffer from this disease and are its natural reservoir. EurekAlert

Vaccine rule is said to hurt health efforts

17 December - A group of prominent doctors and public health experts warns in articles to 

be published Monday in the journal Pediatrics that banning thimerosal, a mercury 

compound used as a preservative in vaccines, would devastate public health efforts in 

developing countries. Representatives from governments around the world will meet in 

Geneva next month in a session convened by the United Nations Environmental Program to 

prepare a global treaty to reduce health hazards by banning certain products and processes 

that release mercury into the environment. But a proposal that the ban include thimerosal, 

which has been used since the 1930s to prevent bacterial and fungal contamination in 

multidose vials of vaccines, has drawn strong criticism from pediatricians. They say that the 

ethyl-mercury compound is critical for vaccine use in the developing world, where 

multidose vials are a mainstay. New York Times

When the doctor is not needed

15 December - There is already a shortage of doctors in many parts of the United States. 

The expansion of health care coverage to millions of uninsured Americans under the 

Affordable Care Act will make that shortage even worse. Expanding medical schools and 

residency programs could help in the long run. But a sensible solution to this crisis —

particularly to address the short supply of primary care doctors — is to rely much more on 

nurse practitioners, physician assistants, pharmacists, community members and even the 

patients themselves to do many of the routine tasks traditionally reserved for doctors. There 

is plenty of evidence that well-trained health workers can provide routine service that is 
every bit as good or even better than what patients would receive from a doctor. And 

because they are paid less than the doctors, they can save the patient and the health care 

system money. New York Times

top of page...

INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

For the week ending 20 December 2012, 

 Throughout the MHS, Influenza-Like Illness (ILI) incidence rates decreased or remained 

the same compared to last week except for EUCOM unvaccinated with an increased 

rate; the percent of all outpatient visits due to Pneumonia and Influenza (P&I) remained 

stable from previous week. 

 Influenza activity is at moderate levels across the overseas DoD laboratory surveillance 

network, except in Europe where the activity remains low; sites reported variable cocirculation of influenza A/H1, A/H3, and B. 

 The influenza vaccination coverage for the DoD (Active Duty component only) is 93%. 

AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 49 (December 2-8, 2012), influenza activity increased in the U.S.

 Viral Surveillance: Of 7,663 specimens tested, 2,172 (28.3%) were positive for influenza. 

 Novel Influenza A Virus: One human infection with a novel influenza A virus was 

reported. 

 Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia 

and influenza (P&I) was below the epidemic threshold. 

 Influenza-Associated Pediatric Deaths: One influenza-associated pediatric death was 

reported and was associated with an influenza B virus. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During week 49 (2-8 December 2012), 79 specimens were collected and tested from 29 

locations. There was one influenza B at Walter Reed National Military Medical Center, 

Bethesda, MD and 32 influenza A/H3 viruses detected (see Table 1 below). Results are 

preliminary and may change as more results are received. 
 In Week 49, 41.8% of respiratory specimens collected and tested were positive for 

influenza. 

 To date, 619 specimens have been submitted and tested from 56 locations of which 118 

were positive for influenza A (two co-infections of A/H3 & B, 110 A/H3, and six 

A(H1N1pdm09) and seven were positive for influenza B. There have been 64 other 

respiratory viruses isolated (16 adenovirus, seven RSV, seven enterovirus, and 34 

parainfluenza). USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During week 49 (3-9 December 2012), all 24 countries reporting experienced low-intensity 

levels of influenza-like illness or acute respiratory infection. For the first time this season, the 

majority of the countries reported sporadic geographic spread and eight countries 

experienced increasing trends. 

 Of 573 sentinel specimens tested in 24 countries, 76 (13.3%) were positive for influenza 

virus. This is the second consecutive week with a notable increase in the proportion of 

influenza-positive samples since the start of the season. 

 Since week 40/2012, 53% of influenza virus detections in sentinel specimens have been 

type A and 47% type B viruses. Of the A viruses subtyped, 47% were A(H3) and 53% 

were A(H1). Weekly Influenza Surveillance Overview

GlaxoSmithKline wins U.S. approval for new flu vaccine

17 December - U.S. health regulators have approved a new four-strain seasonal influenza 

vaccine made by GlaxoSmithKline Plc (GSK.L), the company said on Monday. The U.S. Food 

and Drug Administration has approved Fluarix Quadrivalent to immunize children age 3 and 

older and adults against flu virus subtypes A and B contained in the vaccine. It is the first 

intramuscular vaccine to protect against four influenza strains. Three-strain flu vaccines 

currently administered help protect against the two most common A virus strains and the B 

strain expected to be predominant in a given year, the company said. Reuters

Google.org: Flu Trends

19 December - Estimates of flu activity based on Internet search queries indicate that the 

levels of flu activity in the northern hemisphere range from minimal in eastern Europe to 

high in the U.S. and Russia. Levels range from minimal to low in the southern hemisphere.

Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 15 December 2012:

Influenza

No new NHRC laboratory-confirmed influenza cases among US military basic trainees.
Adenovirus

Type 14 adenovirus cases continue at MCRD Parris Island, though FRI rates remain low.

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 

USAPHC: U.S. Army Influenza Activity Report

For the week ending 8 December 2012 (Week 49), influenza activity remains high for this 

time of year; 18 states report widespread activity. Vaccination efforts should continue. 

WRMC and NRMC saw the highest proportion of positive Influenza A specimens.

 ILI Activity: Army incident ILI outpatient visits in week 49 were 7% higher than the same 

week last year.

 Influenza cases: Three hospitalized influenza cases were reported in DRSi in week 49. A 

total of eight hospitalized cases have been reported during this influenza season.

 Acute Respiratory Disease at BCT sites: ARDS rates remain lower at all Army BCT sites 

compared to the same period last year. Despite high civilian rates in the southeast, no 

increased influenza activity has been noted in trainees.

 Viral specimens: During week 49, 237 of 784 (30%) clinical specimens tested were 

positive for respiratory pathogens. Influenza A accounted for 71% of positive 

specimens. USAPHC U.S. Army Influenza Activity Report

PANDEMIC AND AVIAN INFLUENZA

Experts at NIH meeting say H5N1 research moratorium 

may end soon

18 December – As a meeting to discuss issues related to federally funded H5N1 avian 

influenza research wrapped up today, experts anticipated that a voluntary moratorium on 

work with lab-modified strains that have increased transmissibility might end soon and said 

they sensed agreement about lab biosecurity levels... Lab biosafety is one of the issues that 

have stalled the lifting of the moratorium, which has been in place for nearly a year. CIDRAP

Influenza at the human-animal interface 

17 December - From 2003 through 17 December 2012, 610 laboratory-confirmed human 

cases with avian influenza A(H5N1) virus infection have been officially reported to WHO 

from 15 countries, of which 360 died. Since January 2012, 32 human cases of influenza 

A(H5N1) virus infection have been reported to WHO. Since the last update on 5 November 

2012, two new laboratory-confirmed human cases with influenza A(H5N1) virus infection 

were reported to WHO, one from Egypt and the other a fatal case from Indonesia. WHO
Pigs in southern China infected with avian flu

19 December - Researchers report for the first time the seroprevalence of three strains of 

avian influenza viruses in pigs in southern China, but not the H5N1 avian influenza virus ... In 

the study, from 2010-2012, Guihong Zhang and colleagues of the College of Veterinary 

Medicine, South China Agricultural University, Guangzhou, People's Republic of China, 

tested 1080 21-25 week old pigs for H3, H4, H5, and H6 subtypes of avian influenza virus, 

and H1 and H3 subtypes of swine influenza virus. Thirty-five percent of the serum samples 

were positive for H1N1, and 19.7 percent were positive for H3N2 swine flu virus, and 0.93 

percent, 1.6 percent, and 1.8 percent were positive, respectively, for the H3, H4, and H6 

subtypes of avian influenza A virus. However, no serum samples collected in 2001 were 

positive for any of these viruses, indicating that transmission into swine was recent. 

EurekAlert

With more surveillance, flu patterns in Africa begin to 

emerge

17 December – Increased surveillance in recent years has begun to fill in some of the huge 

information gaps regarding influenza in Africa, which should eventually make it possible to 

develop or improve public health interventions, according to a big collection of articles 

published recently in the Journal of Infectious Diseases (JID). One of the many reported 

findings is that several countries in West Africa didn't see their first case of pandemic 2009 

H1N1 (pH1N1) flu until 6 months after the virus emerged in North America. Another article 

discusses the belated distribution and administration of the pH1N1 vaccine in Africa. The 

collection consists of 27 reports involving close to 300 authors from more than 50 

institutions, most of them based in 16 African countries, the US Centers for Disease Control 

and Prevention (CDC) said in a press release. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

Under many aliases, mislabeled foods find their way to 

dinner tables

15 December - ... The subject of deceptive restaurant menus took on new life last week 

when Oceana, an international organization dedicated to ocean conservation, released a 

report with the headline “Widespread Seafood Fraud Found in New York City.” Using 

genetic testing, the group found tilapia and tilefish posing as red snapper. Farmed salmon 

was sold as wild. Escolar, which can also legally be called oil fish, was disguised as white 

tuna, which is an unofficial nickname for albacore tuna. Every one of 16 sushi bars 

investigated sold the researchers mislabeled fish. In all, 39 percent of the seafood from 81 

grocery stores and restaurants was not what the establishment claimed it was. New York 

Times
USDA sets rules for tracking livestock across state lines

20 December - The U.S. Department of Agriculture on Thursday announced final rules 

meant to improve the ability to trace livestock across state lines when there are disease 

outbreaks. The regulations, which were laid out as proposals in August 2011, had their 

genesis in the handful of cases of mad cow disease, or bovine spongiform encephalopathy, 

in the United States dating back to 2003. USDA's initial proposals were attacked by farmers 

and ranchers as burdensome and too expensive. Under the final rule, unless specifically 

exempted, livestock moved across state lines would have to be officially identified and 

accompanied by an interstate certificate of veterinary inspection or other documentation, 

such as owner-shipper statements or brand certificates. Reuters

top of page...

WELLNESS

Daylight savings tied to bump in heart attack rates

16 December - Setting the clock ahead for daylight savings time may set the scene for a 

small increase in heart attacks the next day, according to a U.S. study - which suggests that 

sleep deprivation may be to blame. Researchers at two hospitals in the U.S. state of 

Michigan, whose findings appeared in the American Journal of Cardiology, reviewed six 

years of records and found that they treated an average of 23 heart attacks on the Sunday 

when the United States switched to daylight savings time. That compared to 13 on a typical 

Sunday. Reuters

Do health care workers practice what they preach?

19 December - Health care workers may not always "practice what they preach" when it 

comes to keeping up to date with cancer screenings, maintaining a healthy weight and not 

smoking, a new study suggests. Researchers found people surveyed by phone who said 

their job involved direct patient care were just as likely to be overweight, avoid the dentist, 

get sunburned and not wear their seatbelt as those in other fields. Health care workers, 

however, were more likely to have had a recent check-up and to report exercising in the 

past month - findings that were "reassuring," researchers said. They were also less apt to 

drink heavily, according to results published this week in the Archives of Internal Medicine.

Reuters

Patients who Google hemorrhoids may want to avoid 

doctor

19 December - Google's annual roundup of the year's top search trends revealed that 

people took to the internet to learn more about Whitney Houston, Hurricane Sandy and Big 

Bird, but an unlikely pain in the butt joined the group, too: hemorrhoids. The top trending 
health issue in the United States this year was "hemorrhoids," according to Google's annual 

"zeitgeist" roundup of the world's hottest search trends, and doctors say it may be because 

patients would rather ask Google than their physicians. ABC News

Regular marijuana use by teens continues to be a concern

19 December - Continued high use of marijuana by the nation's eighth, 10th and 12th 

graders combined with a drop in perceptions of its potential harms was revealed in this 

year's Monitoring the Future survey, an annual survey of eighth, 10th, and 12th–graders 

conducted by researchers at the University of Michigan. The survey was carried out in 

classrooms around the country earlier this year, under a grant from the National Institute on 

Drug Abuse (NIDA), part of the National Institutes of Health. The 2012 survey shows that 6.5 

percent of high school seniors smoke marijuana daily, up from 5.1 percent five years ago. 

Nearly 23 percent say they smoked it in the month prior to the survey, and just over 36 

percent say they smoked within the previous year. National Institute on Drug Abuse

Scientists in Hong Kong map initial anti-aging formula

20 December - Scientists in Hong Kong appear to have mapped out a formula that can 

delay the aging process in mice, a discovery they hope to replicate in people. Their finding, 

published in the December issue of Cell Metabolism, builds on their work in 2005 which 

shed light on premature aging, or progeria, a rare genetic disease that affects one in 

four million babies. Reuters

Small changes in eating prompts weight loss

19 December - Making small easy changes to our eating habits on a consistent basis - 25 

days or more per month - can lead to sustainable weight loss, according to research by 

Professor Brian Wansink in Cornell University's Food and Brand Lab... To explore this issue, 

Cornell researchers launched the National Mindless Eating Challenge (NMEC), an online 

healthy eating and weight loss program that focused on simple eating behavior changes, 

instead of dieting. NMEC participants... were sent three customized tips to follow for a 

month. All tips were founded on research and based on Wansink's book "Mindless Eating: 

Why We Eat More than We Think" (Bantam, 2006)... Of the 504 participants who completed 

at least one follow-up survey, more than two thirds (42 percent) either lost weight or 

maintained their weight (27 percent). Weight loss was highest among people who made 

changes consistently. Those whose adherence was 25 or more days per month reported an 

average monthly weight loss of 2 pounds. EurekAlert

top of page...
USAFRICOM

Ethiopia introduces health-care phone service 

14 December - Ethiopia is launching medical services over the phone. A young Ethiopian 

doctor is starting the service in an attempt to improve access to health care across the 

country. "HelloDoctor" is Ethiopia’s first general medical hotline, in which a small fee is 

taken from a person’s mobile phone credit to receive medical advice or request home-care 

service. Dr. Yohans Wodaje is the young Ethiopian doctor who founded HelloDoctor. He 

said that healthcare services for the average Ethiopian will improve through the new service, 

as there are not enough doctors and clinics for the whole population.... "And you have a 

very few number of highly skilled, highly specialized professionals, then you definitely need 

to link technology with those professionals to multiply the effect that they would have.” 

Voice of America

Guinea: New cholera strain poses prevention challenges

18 December - The cholera that struck more than 7,000 people in Guinea this year was 

caused by a new generation of cholera strains - atypical variants of vibrio cholerae O1 El 

Tor, epidemiologists have confirmed. The new strains secrete a toxin severer than usual 

strains, creating a more virulent illness - with harsher symptoms and a higher infection rate, 

according to cholera experts in the region. The same types of strain are believed to be in 

Sierra Leone, where cholera affected 22,345 people this year: the bacteria are thought to 

have come to Guinea from Sierra Leone. For now, genetic sequencing has been done only 

on samples from Guinea; analysis of Sierra Leone samples is under way. IRIN

Quick and affordable test is saving lives in areas still 

ravaged by “Black Death”

7 December - CDC scientists are developing better ways of 

detecting the world’s most deadly diseases. In this guest blog 

post, Dr. Paul Mead, a medical epidemiologist with the Division 

of Vector-Borne Diseases (DVBD) at CDC, explains how he and 

a team of scientists are using a quick and affordable handheld 

test to detect plague in patients in a matter of minutes – critical for such a rapidly fatal 

disease. This tool – developed by Dr. Marty Schriefer and his team at DVBD – is being used 

in collaboration with the Ministry of Health and village leaders to save lives in rural Uganda, 

where laboratories for diagnosing diseases like plague are rare. In addition to improving the 

diagnosis and treatment of plague in communities still ravaged by the disease, DVBD is 

evaluating ways to prevent human plague altogether by reducing exposure to rats and their 

disease-causing fleas. CDC

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USCENTCOM

Karzai admits lack of proper healthcare system 

in Afghanistan

17 December - Afghan president Hamid Karzai on Sunday admitted that daily issues of 

Afghans regarding a proper health system in the country. It has become common among 

the Afghans who are saying that the healthcare has been turned into a major business in 

Afghanistan... There have been growing complaints regarding the activities of the private 

hospitals despite Afghan public health ministry has said they have increased monitoring the 

operations of the hospitals. Dozens of private hospitals have started operations in capital 

Kabul and other provinces of Afghanistan however people are continuously complaining 

regarding the activities, lack of profession of the doctors and high charges. In the meantime 

the private hospitals are paying more privilege and wages to the doctors and nurses which 

have limited the service of the government hospitals. Khaama Press

Pakistan: Gunmen kill women who were giving children 

polio vaccines

18 December - Gunmen shot dead five female health workers who were immunizing 

children against polio on Tuesday, causing the Pakistani government to suspend 

vaccinations in two cities and dealing a fresh setback to an eradication campaign dogged 

by Taliban resistance in a country that is one of the disease’s last global strongholds... No 

group claimed responsibility for the attacks, but most suspicion focused on the Pakistani 

Taliban, which has previously blocked polio vaccinators and complained that the United 

States is using the program as a cover for espionage. New York Times

Syria: IDPs brace for winter in rebel-controlled camps

19 December - ... They are among 4,000 people marooned in more than 500 tents at Qah 

camp for displaced people close to the Turkish border, set up three months ago. More 

families arrive every day, many from Hass. Another 10,000 people live nearby in the only 

other known camp in the north, called Atma. Across the country, at least 2.5 million people 

are internally displaced within Syria, according to the Syrian Arab Red Crescent. Cold and 

afraid, many here say they want desperately to leave Syria’s nearly two-year conflict behind 

and cross into Turkey. But for the moment, their northern neighbour has refused to accept 

them, citing overcrowding. Fourteen Turkish camps, hosting 141,000 people, are already 

well over capacity, with thousands of people sleeping in communal tents or in neighbouring 

villages for lack of space. IRIN

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USEUCOM

Irish government to legalize life-saving abortion

18 December - Ireland's government pledged Tuesday to pass a law soon that will allow 

women to receive abortions if continued pregnancy threatens their lives — including from 

their own threats to commit suicide if denied one. The announcement comes after decades

of inaction on abortion in Ireland, and just weeks after the predominantly Catholic country 

faced international criticism over the death of an Indian woman hospitalized in Ireland with 

an imminent miscarriage... This would mark the first time that Irish lawmakers have ever 

voted on abortion, arguably the most divisive issue in a country whose constitution bans the 

practice. ABC News

United Kingdom: Norovirus - vomiting bug cases are up 

by 80 per cent 

19 December - ... The number of laboratory-confirmed cases of norovirus is 83 per cent 

higher than the same time last year, the Health Protection Agency said. The bug has swept 

the country, leading to the closure of dozens of hospital wards. It has also affected 

holidaymakers on two cruise ships. So far there have been 3,046 confirmed cases in England 

and Wales, compared with 1,669 cases last winter, but for every reported case there are 

likely to be a further 288 unreported sufferers. During the fortnight ending 16 December, 

there were 61 outbreaks in hospitals in England. Independent

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USNORTHCOM

After shootings, a flood of ideas and proposals for 

curbing gun violence

19 December - The flurry of proposals for responding to the massacre in Newtown, Conn., 

have come from all quarters: the White House, members of Congress, advocacy 

organizations, religious leaders, governors and state and county legislators. Specifics are 

hard to come by in some cases. But taken together, the suggestions for legislative and 

executive action foreshadow a broad political debate about assault weapons, ammunition, 

violent video games, shoot-em-up movies, gun shows, mental health services, and permits 

for concealed firearms. Much of the national discussion this week has focused on a 

comprehensive approach, rather than just new gun controls. New York Times
DHS to re-examine possible health effects of backscatter 

X-ray

17 December - The Homeland Security Department is asking the National Academy of 

Sciences to find an independent group to study whether airport backscatter X-ray security 

scanners pose any health risk. In a notice published Dec. 13 on FedBizOpps, DHS asks the 

academy to convene a committee to report on whether exposure to ionizing radiation from 

the machines complies with health and safety standards, and whether adequate procedures 

are in place to prevent overexposure to travelers and operators. The committee will review 

earlier studies as well as examine what DHS and equipment manufacturers have done to 

estimate radiation exposure. Fierce Homeland Security

HIV cases decline for black women, increase for gay men: 

CDC

19 December - Fewer black women in the United States are being infected with HIV, but the 

number of young gay and bisexual men infected is rising, the Centers for Disease Control 

and Prevention said on Wednesday. Between 2008 and 2010, the number of newly infected 

black women dropped 21 percent, according to the CDC report. Yet despite the decline, 

they still accounted for 70 percent of all new HIV cases among women, the federal health 

agency said. The rate of new infections for black women was 20 times higher than the rate 

for white women, the CDC said. The number of new infections among young gay and 

bisexual men increased by 22 percent during that same two-year period, the CDC said. The 

number of new HIV infections diagnosed annually in the overall U.S. population remained 

unchanged between 2008 and 2010 at about 47,500, according to health officials. Reuters

New air pollution standards restrict soot particles

14 December - The Obama administration announced a new air pollution standard Friday 

that would bring about a 20% reduction in microscopic particles of soot emitted by coalfired power plants and diesel vehicles that contribute to haze and respiratory ailments... 

Right now, 99% of U.S. counties are in compliance with the new standard, the EPA said. Of 

the remaining, many of them will be in California, the EPA said. Los Angeles Times

No clear link between cancer and 9/11 debris, study finds

18 December - Six months after the federal government added cancer to the list of 

sicknesses covered by the $4.3 billion World Trade Center fund, a New York City health 

department study has found no clear link between cancer and the dust, debris and fumes 

released by the burning wreckage of the twin towers. The study was by far the largest to 

date. It examined 55,700 people, including rescue and recovery workers who were present 

at the World Trade Center site, on barges or at the Staten Island landfill where debris was 

taken in the nine months after Sept. 11, 2001, as well as residents of Lower Manhattan, 

students, workers and passers-by exposed on the day of the terrorist attacks. Over all, there 

was no increase in the cancer rate of those studied compared with the rate of the general 

population, researchers concluded after looking at 23 cancers from 2003 to 2008. New York 

Times
Senators call for return of assault weapon ban

17 December - In light of the school shooting in Newtown, Conn., Robert Siegel speaks with 

Dr. Daniel Webster of John Hopkins University about the legislative history and debate 

about the assault weapons ban... Professor Daniel Webster studies firearm policy and gun 

violence prevention. His field is public health, and he's at Johns Hopkins University...

WEBSTER: ... What's really most relevant to public safety has to do with the capacity to fire 

dozens of bullets, perhaps in some instances, in a matter of seconds. So it would make more 

sense to sort of focus on the functionality and the thing that's most relevant.

SIEGEL: The University of Pennsylvania study - that I think you were alluding to - wrote that 

the ban exempted assault weapons and large-capacity magazines manufactured before 

September 13, 1994. At that time, there were upwards of 1.5 million privately held assault 

weapons in the U.S. and nearly 25 million guns equipped with large-capacity magazines. So, 

certainly, a great many weapons escape the impact of the ban.

WEBSTER: That's right. My understanding is that Senator Feinstein's new legislation would 

try to go beyond what the prior legislation focused on and actually go for a broad ban even 

for so-called grandfathered weapons. I think that'll be harder to do politically. But if it does 

go through, I think it has a far better chance for impact. NPR

TB's global resurgence amplifies U.S. risk 

18 December - ... Multidrug-resistant TB is at epidemic proportions in some parts of the 

world—a growing problem the U.S. is surprisingly unprepared for. The U.S. beat back 

multidrug-resistant tuberculosis in the 1990s. Today, however, a new threat is emerging as 

drug resistance worsens abroad and far more dangerous strains develop and spread, 

including some that are all but untreatable with standard drugs. In the U.S., rates of 

multidrug-resistant tuberculosis remain low, but are starting to inch back up, as hundreds of 

millions of American citizens and foreigners alike travel to the U.S. from abroad every year. 

At the same time, funding and expertise are in decline. Wall Street Journal

Use of selected contraception methods among women 

aged 15–44 years currently using contraception

21 December - Little change occurred from 1995 to 2006–2010 in the percentage of women 

aged 15–44 years currently using contraception who were using female or male sterilization 

or the pill as their most effective method. A decrease occurred in the percentage of women 

relying on condoms, and increases occurred in the percentages of women using other 

hormonal methods and the IUD. The pill (28%) and female sterilization (27%) remained the 

most common contraceptive methods used. Morbidity and Mortality Weekly Report

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USPACOM

Australia: Whooping cough epidemic as state records 

highest numbers

18 December - A whooping cough epidemic has led NSW to record its highest number of 

new cases of the disease. More than 13,000 people were infected in 2011, and one baby 

died, surveillance figures published in the CSIRO's NSW Public Health Bulletin show... 

Overall, vaccine-preventable diseases increased in 2011, with rates of measles more than 

tripling from 26 cases in 2010 to 90 in 2011. Vaccination rates are currently greater than 90 

per cent for one and two-year-old children, according to separate research published in the 

same journal. Study leader Brynley Hull, an epidemiologist from the National Centre for 

Immunisation Research and Surveillance, said a high-profile increase in so-called 

"conscientious objectors" across Australia had not affected vaccination rates. Sydney 

Morning Herald

China: Donation of organs directed to the needy

15 December - China is set to expand a computerized system to ensure transparent and fair 

allocation of donor organs, said Vice-Minister of Health Huang Jiefu. The system is expected 

to expand nationwide early next year for transplants around the mainland. Once that 

happens, donated organs from different procurement organizations will be shared by all 

transplant centers to improve efficiency and ensure the most medically needy patients 

benefit, according to Wang Haibo, director of the China Organ Transplant Response System 

Research Center at the University of Hong Kong. China Daily

Philippines OKs divisive contraceptives bill

17 December - Philippine legislators passed a landmark bill Monday that would provide 

government funding for contraceptives and sexuality classes in schools despite strong 

opposition by the dominant Roman Catholic Church and its followers, some of whom 

threatened to ask the Supreme Court to block the legislation. The Senate and the House of 

Representatives passed different versions of the bill, which languished in Congress for more 

than a decade as legislators avoided colliding with the influential church. The two versions 

will have to be reconciled before President Benigno Aquino III has an opportunity to sign 

the legislation. Yahoo! News

Pollution from car emissions killing millions in China 

and India

17 December - An explosion of car use has made fastgrowing Asian cities the epicentre of global air pollution and 

become, along with obesity, the world's fastest growing 

cause of death according to a major study of global diseases. 

In 2010, more than 2.1m people in Asia died prematurely 

from air pollution, mostly from the minute particles of diesel soot and gasses emitted from 
cars and lorries. Other causes of air pollution include construction and industry. Of these 

deaths, says the study published in The Lancet, 1.2 million were in east Asia and China, and 

712,000 in south Asia, including India. Worldwide, a record 3.2m people a year died from air 

pollution in 2010, compared with 800,000 in 2000. It now ranks for the first time in the 

world's top 10 list of killer diseases, says the Global Burden of Disease (GBD) study. 

Guardian

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USSOUTHCOM

Cuba (Havana): Cholera, diarrhea and dysentery update 

2012

19 December - A reporter for the independent news agency reported in Cuba dozens of 

new cases of cholera in Havana while authorities of the island made urgent appeals to the 

population to prevent further increased number of patients. Information was provided by 

Mario Echevarria, Let's Talk Press, based in Havana. Echevarria said that Public Health 

Ministry officials have declared a "state of alert" in certain areas of Old Havana. The order 

was established recently after house to house inspection, he said. "A doctor, who preferred 

to remain anonymous said that they have 47 cases detected in the town Habana Vieja, 17 

are natural capital and 33 come from the eastern provinces," said the journalist. He also said 

that the authorities have activated emergency stations. In August 2012, the Cuban 

government said the cholera crisis was over after 3 deaths and 417 confirmed cases. 

ProMED-MAIL

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