11 May 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

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Contents

U.S. MILITARY

 Court dismisses vets' suit on mental health care

 Heat injuries, active component, U.S. Armed Forces 2011

 New DoD-wide program aimed at enhancing coordination of psychological health resources

 Pentagon to limit antipsychotic drugs for PTSD

GLOBAL

 Firm wins NIAID funds for vaccine against Nipah and Hendra viruses

 Leishmaniasis vaccine trial underway

 MSU plan would control deadly tsetse fly

 'One in six cancers worldwide are caused by infection'

 Range of brain diseases could be treated by single drug

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

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

 H1N1 discovery paves way for universal flu vaccine

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 H5N1 strikes Indian poultry farm

VETERINARY/FOOD SAFETY

 Pakistan: Newcastle disease, vaccine failure

WELLNESS

 Ask women about partner violence, panel says

 Completion of HPV vaccination series lagging in U.S.
Food Safety 

Products

Although eating local food 

while deployed may be 

good for relationship 

building, it increases the 

risk of foodborne illnesses. 

New food safety products -

a food safety poster, two 

brochures, one for leaders 

and one for soldiers, an 

eCard, and a sticker give 

tips on safer types of local 

food to eat. They are now 

available in the Health 

Information Products 

eCatalog.

 Fat future: 42% of Americans may be obese by 2030

 Persistent cough 'could be lung cancer warning'

 Probiotics may help prevent diarrhea, report finds

 Warfarin and aspirin give roughly similar anticoagulation outcomes in heart failure

USAFRICOM

 Kenya: 2,500 children vaccinated against measles in Kwale

 Madagascar: Peer pressure to stop teen pregnancy

USCENTCOM

 Afghanistan: Nursing and Midwifery Institute opens in Kandahar

 Kuwait: MEW confirms news report on 'contaminated' water samples

 Pakistan: Red Cross suspends work after staffer's killing

USEUCOM

 Belgium: Four multifaceted countrywide campaigns to promote hand hygiene in Belgian 

hospitals, 2005 - 2011

 Measles activity off to a slower start in Europe

 Sweden: Pneumococcal disease, more cases but fewer deaths

 United Kingdom: Prostate cases rise to more than 40,000

USNORTHCOM

 Ardent Sentry 2012

 U.S.: Fear fans flames for chemical makers

 U.S.: FEMA's first national preparedness report cites progress, gaps

 U.S., North Carolina: Hand, foot and mouth disease

 U.S.: Obesity fight must shift from personal blame, panel

 U.S.: Popular weed killer stirs health, environmental concerns

 U.S.: Sunburn and sun protective behaviors among adults aged 18–29 Years, 2000–2010

 U.S.: Vaccination rates -- herd at risk

USPACOM

 Asia: Massive rise in Asian eye damage

 Burma suffering from huge shortfall in HIV and Aids drugs, warn doctors

 Chinese-made infant flesh capsules seized in S. Korea

 Solomon Islands: Rubella, travel alert

USSOUTHCOM

 Argentine law aims to provide 'dignified deaths'

 Cuba: A regime’s tight grip on AIDS

 Paraguay: More than 10,000 cases of dengue, 30 deaths

 Peru warns against beaches due to bird deaths
Minimalist Running 

Shoes

A poster and a brochure on 

minimalist running shoes 

and how to transition to 

running in them are now 

available in the Health 

Information Products 

eCatalog.

U.S. MILITARY

Court dismisses vets' suit on mental health care

8 May - Claims of systematic delays and neglect in mental health care for the nation's 

military veterans are beyond the power of courts to address, a federal appeals court in San 

Francisco ruled Monday in ordering dismissal of a 5-year-old suit by veterans groups. At a 

trial in 2008, Department of Veterans Affairs documents showed that the system took an 

average of 4.4 years to review veterans' health care claims, that more than 1,400 veterans 

who had been denied coverage died in one six-month period while their appeals were 

pending, and that 18 veterans per day were committing suicide, much higher than the rate 

among the general population. Declaring that "the VA's unchecked incompetence has gone 

on long enough," a panel of the Ninth U.S. Circuit Court of Appeals ruled 2-1 a year ago 

that vets groups could ask a federal judge to order changes in the system. But at the 

Obama administration's request, the full appeals court granted a new hearing before a 

larger panel, which ruled Monday that courts lack authority to order system-wide changes 

in veterans' health care. San Francisco Chronicle

Heat injuries, active component, U.S. Armed Forces 2011

March 2012 - In 2011, the number of service members treated for heat stroke (n=362) was 

higher than the number in 2010, but lower than the numbers in 2007-2009. Incidence rates 

of heat stroke were highest among males, service members in combat-specific occupations, 

in the Marine Corps and Army, and among those younger than 20 years of age. The number 

of service members treated for “other heat injury” was higher in 2011 (n=2,652) than in any 

of the four prior years; however, there were fewer hospitalizations for “other heat injuries” in 

2011 than in recent prior years. In contrast to heat stroke, the incidence rate of “other heat 

injuries” was higher among females than males and the rate among enlisted members was 

more than twice that of officers. Medical Surveillance Monthly Report

New DoD-wide program aimed at enhancing 

coordination of psychological health resources

2 May - The Department of Defense is undertaking a new initiative to enhance leadership 

and advocacy for the psychological health of Service members and their families across all 

of its military installations. According to a new department policy issued Feb. 27, the military 

Services will ensure that each installation has a designated individual to serve as its principal 

consultant and advocate for psychological health. These designated ‘Directors of 

Psychological Health’ will coordinate clinical mental health services provided on base in 

military medical treatment facilities and specialty clinics, and ensure they are integrated with 

other available counseling and supportive services from military and civilian organizations in 

the local community. The directors will further provide consultation to operational 

leadership toward integrating the military Services with DoD-wide psychological health 

initiatives. Force Health Protection & Readiness
Ranking Vaccines: 

A Prioritization 

Framework

As a number of diseases 

emerge or reemerge, thus 

stimulating new vaccine 

development opportunities 

to help prevent those 

diseases, it can be 

especially difficult for 

decision makers to know 

where to invest their 

limited resources.

In this first phase report, 

the IOM offers a 

framework and proof of 

concept to account for 

various factors influencing 

vaccine prioritization—

demographic, economic, 

health, scientific, business, 

programmatic, social, 

policy factors and public 

concerns.

Pentagon to limit antipsychotic drugs for PTSD

3 May - The Pentagon is moving to limit off-label use of powerful anti-psychotic drugs for 

post-traumatic stress disorder — a practice some say may contribute to accidental drug 

overdoses among troops. Assistant Secretary of Defense for Health Affairs Dr. Jonathan 

Woodson sent a letter to the services in February asking military treatment facilities to 

monitor prescriptions of atypical antipsychotics like risperidone and quetiapine, marketed 

under the brand name Seroquel. The drugs, used to treat severe mental illnesses like 

schizophrenia and bipolar disorder, are sometimes prescribed to troops in lower doses to 

alleviate symptoms associated with PTSD and anxiety, including nightmares and irritability.

But when mixed with other prescriptions, they can be dangerous and sometimes fatal. Army 

Times

top of page...

GLOBAL

Firm wins NIAID funds for vaccine against Nipah and 

Hendra viruses

9 May - Profectus BioSciences Inc. announced today that it has received a $5.6 million grant 

from the US National Institute of Allergy and Infectious Diseases (NIAID) to develop a 

vaccine against the Nipah and Hendra viruses. The vaccine, called Hendra virus soluble G, is 

intended for use against either virus, the Baltimore company said in a press release. Nipah 

and Hendra are closely related Paramyxoviruses that cause often-fatal respiratory disease 

and encephalitis in humans and animals, the company noted. Fruit bats known as flying 

foxes, found in Australia, Southeast Asia, and Oceania, are the natural reservoir for the 

viruses, and humans can contract infections through exposure to infected horses, pigs, and 

bats or contaminated food. The vaccine targets the Hendra virus G glycoprotein, which 

mediates invasion of host cells, the company said. The vaccine was created in the lab of 

Christopher C. Broder at the Uniformed Services University of the Health Sciences in 

Bethesda, Md. Broder and his colleagues have tested the vaccine successfully in animals in 

Australia and the United States, according to the announcement. CIDRAP News Scan

Leishmaniasis vaccine trial underway

9 May - A vaccine against one of the most neglected yet fatal tropical diseases is being 

tested for the first time in a clinical trial in India and the US. After malaria, leishmaniasis is 

the second largest parasitic killer, and the visceral form is the most deadly. “Visceral 

leishmaniasis (VL) kills 50,000 persons per year, 70 percent of them children. It can be 

treated but the costs are too high... at hundreds of US dollars per person,” said Dr Franco 

Piazza at the Infectious Disease Research Institute (IDRI), a Seattle-based NGO that 

developed the vaccine with funding from the Bill and Melinda Gates Foundation. VL, also 
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called kala-azar or black fever, infects an estimated half million persons or more annually. It 

is found most commonly in India, Nepal, Bangladesh, Brazil and Sudan. IRIN

MSU plan would control deadly tsetse fly

7 May - For the first time, scientists have created a satellite-guided plan to effectively 

control the tsetse fly – an African killer that spreads “sleeping sickness” disease among 

humans and animals and wipes out $4.5 billion in livestock every year. Michigan State 

University (MSU) researchers developed the plan using a decade’s worth of NASA satellite 

images of Kenyan landscape and by monitoring tsetse movement. With unprecedented 

precision, the plan can tell where and when to direct eradication efforts. Current control 

efforts in Kenya are ineffective and waste money by targeting tsetse-free areas, said Joseph

Messina, associate professor of geography. Messina is lead researcher on the project, 

funded by the National Institutes of Health, to attack the tsetse fly. “Our model dramatically 

reduces the cost of controlling the tsetse, and it’s more effective,” Messina says. If applied, 

the plan would be effective in all of East Africa and other areas of the continent consisting 

of savannah, Messina said. The tsetse, which feeds on the blood of vertebrate animals, lives 

in 37 sub-Saharan countries and infects thousands of people and millions of cattle every 

year, affecting primarily the rural poor. Infection Control Today

'One in six cancers worldwide are caused by infection'

8 May – One in six cancers - two million a year globally -

are caused by largely treatable or preventable infections, 

new estimates suggest. The Lancet Oncology review, which 

looked at incidence rates for 27 cancers in 184 countries, 

found four main infections are responsible. These four -

human papillomaviruses, Helicobacter pylori and hepatitis B and C viruses - account for 

1.9m cases of cervical, gut and liver cancers. Most cases are in the developing world. BBC 

News

Range of brain diseases could be treated by single drug

6 May - The tantalising prospect of treating a range of brain diseases, such as Alzheimer's 

and Parkinson's, all with the same drug, has been raised by UK researchers. In a study, 

published in Nature, they prevented brain cells dying in mice with prion disease. It is hoped 

the same method for preventing brain cell death could apply in other diseases... Many 

neuro-degenerative diseases result in the build-up of proteins which are not put together 

correctly - known as misfolded proteins. This happens in Alzheimer's, Parkinson's and 

Huntington's as well as in prion diseases, such as the human form of mad cow disease. BBC 

News

top of page...
INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

10 May - This is the final issue of the DoD Influenza Surveillance Summary for the 2011-

2012 season.

The overall influenza activity remains low to moderate with predominantly influenza 

A/H3 & B in overseas DoD laboratory surveillance networks, except in Southeast Asia & 

Central Africa where no influenza activity is detected. 

The influenza activity level within the MHS continues to decrease from previous weeks.

AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 17 (22-28 April 2012), influenza activity declined nationally and in most 

regions, but remained elevated in some areas of the United States. FluView

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

11 May - During week 18 (30 April – 6 May 2012):

All countries but Slovakia reported low-intensity influenza activity.

Of 154 sentinel specimens tested, 23 (14.9%) were positive for influenza virus. This 

proportion has been continuously decreasing over the past 10 weeks

The A(H3N2) influenza viruses examined at the WHO Collaborating Centre in London 

show increasing evidence of an imperfect match between the circulating viruses and the 

A(H3N2) vaccine antigen used in 2011. There has also been a significant rise in the 

proportion of B/Yamagata viruses among the B viruses detected this season. This 

supports the WHO and EMA recommendation to modify two components in the 

trivalent vaccines for the 2012/2013 Northern Hemisphere season.

One SARI case, unrelated to influenza, was reported by Romania.

Weekly Influenza Surveillance Overview

H1N1 discovery paves way for universal flu vaccine

8 May - University of British Columbia researchers have found a potential way to develop 

universal flu vaccines and eliminate the need for seasonal flu vaccinations. Each year, 

seasonal influenza causes serious illnesses in 3 million to 5 million people and 200,000 to 

500,000 deaths. The 2009 H1N1 pandemic killed more than 14,000 people worldwide. 

Meanwhile, public health and bioterrorism concerns are heightened by new mutations of 

the H5N1 "bird flu" virus, published last week by the journal Nature, that could facilitate 

infection among mammals and humans. Led by professor John Schrader, Canada Research 

Chair in Immunology and director of UBC's Biomedical Research Centre, the research team 
found that the 2009 H1N1 "swine flu" vaccine triggers antibodies that protect against many 

influenza viruses, including the lethal avian H5N1 "bird flu" strain. Details are published 

today in the journal Frontiers in Immunology. "The flu virus has a protein called 

hemagglutinin, or HA for short. This protein is like a flower with a head and a stem," says 

Schrader, a professor of medicine and pathology and laboratory medicine. "The flu virus 

binds to human cells via the head of the HA, much like a socket and plug. Infection Control 

Today

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update

For the week ending 5 May 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. 

A MSMR paper on the initial impact of adenovirus vaccine resumption was recently 

published. 

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 

PANDEMIC AND AVIAN INFLUENZA

H5N1 strikes Indian poultry farm

9 May - Animal health officials in India reported an H5N1 avian influenza outbreak at a 

district poultry farm in Tripura state, according to a May 7 report to the World Organization 

for Animal Health (OIE). The outbreak began on Apr 18, killing 3,168 of 4,668 susceptible 

birds. All domestic poultry in a 3-km radius around the outbreak site are being culled, and 

an intensive surveillance campaign, poultry market closure, and poultry movement ban are 

underway in a 10-km radius around the zone. Earlier this year, H5N1 outbreaks struck two 

other farms in Tripura state, which is located in northeast India and shares a border on three 

sides with Bangladesh. CIDRAP News Scan

top of page...
VETERINARY/FOOD SAFETY

Pakistan: Newcastle disease, vaccine failure

9 May - During the last 3 to 5 months most of the poultry farmers in Pakistan and in 

Afghanistan saw acute outbreaks of Newcastle disease in commercial poultry and domestic 

birds. The prevailing scenario indicates 2 major factors: 1. Vaccination failure due to one or 

another reason, or 2. Change in genetics of field viruses of Newcastle disease. The latter one 

is in need of laboratory and molecular investigation but the 1st one is very clear. Currently, 

[9] well known companies are dealing in biologics/poultry vaccines in Pakistan, all showing 

very poor immunological response in the field. ProMED-mail

top of page...

WELLNESS

Ask women about partner violence, panel says

7 May - Doctors should screen all of their female patients for signs of partner violence, 

whether face-to-face or through a waiting room questionnaire, a new report suggests. The 

review of the current evidence on screening for partner abuse, from researchers at Oregon 

Health & Science University in Portland, is the first step toward new recommendations on 

screening from the government-sponsored United States Preventive Services Task Force.

According to the Centers for Disease Control and Prevention, close to three in 10 U.S. 

women have experienced rape, stalking or physical violence by a partner. Other studies 

suggest as many as half of women will experience psychological aggression from an 

intimate partner at some point in their lives. Reuters

Completion of HPV vaccination series lagging in U.S.

7 May - Although many women and girls have started the human papillomavirus 

vaccination series, the proportion completing all three shots with the quadrivalent vaccine 

dropped from about 50% in 2006 to roughly 20% in 2009. (Men and boys were only 

recommended to receive the vaccine as of last year.) Reporting in Cancer, U.S. researchers 

used a national insurance database to track the number of people who initiated the series 

and went on to complete it within 1 year (as recommended by the Advisory Committee on 

Immunization Practices). They found steep declines from 2006 to 2009 in every age group 

— from preadolescents to young women — with the sole exception of those aged 27 and 

older. The researchers also found that patients who began the series with family 

practitioners were less likely to receive all shots than those starting with pediatricians. 

Obstetrician/gynecologists were the most likely to have their patients complete the series. 

Physician’s First Watch
Fat future: 42% of Americans may be obese by 2030

7 May - By 2030, 42% of Americans will be obese and 11% of Americans will be severely 

obese, Duke University and CDC researchers predict. These shocking numbers actually are 

conservative, note study researchers Eric A. Finkelstein, PhD, and colleagues... The study 

suggests that adult obesity in the U.S. is leveling off, albeit at an unacceptably high level. 

Previous estimates had suggested that 51% of Americans would be obese in 2030. But 

consideration of other factors suggests that figure is too full. Whatever comfort that good 

news may bring is more than made up for by the finding that severe obesity -- BMI of 40 or 

more -- is skyrocketing. Severely obese people are at the highest risk of diabetes, heart 

disease, and other obesity-related conditions. WebMD

Persistent cough 'could be lung cancer warning'

6 May - The public should be vigilant about persistent coughs as they could be a sign of 

lung cancer, a new government advertising drive is warning. The campaign, which is being 

run in TV, radio, print and online media, recommends people with coughs lasting three 

weeks visit their GP. Research has shown the public are much more aware that lumps and 

bleeding are warning signs of cancer than a cough. But the ads make clear persistent 

coughs should also raise alarm bells. BBC News

Probiotics may help prevent diarrhea, report finds

9 May - Taking probiotics on top of a course of antibiotics may help ward off the diarrhea 

that often comes along with antibiotic treatment, a new review of past studies suggests. 

When researchers combined trials of all types of the gut-healthy microbes, they found that 

patients with a range of conditions -- from ear infections to sepsis -- were 42 percent less 

likely to get diarrhea from their antibiotic drugs if they were also taking a probiotic. Onequarter to one-third of people treated with an antibiotic typically get diarrhea as a result, 

researchers said. It's often not more than an unpleasant side effect, but can be serious 

enough to send some patients to the hospital. "Antibiotics in doing their work actually kill 

off a lot of the normal flora that are supposed to exist in our gut, so things kind of go 

haywire," said Sydne Newberry from the RAND Corporation in Santa Monica, California, who 

worked on the study. Probiotics are strains of "good" bacteria that research suggests can 

help replace some of the flora that antibiotics -- especially so-called broad-spectrum 

antibiotics -- wipe out. FOX News

Warfarin and aspirin give roughly similar 

anticoagulation outcomes in heart failure 

3 May - Aspirin and warfarin are roughly equivalent in addressing the coagulation-related 

complications of heart failure, according to an international double-blind study in the New 

England Journal of Medicine... Investigators randomized 2300 patients with heart failure 

(ejection fraction of 35% or less) and normal sinus rhythm either to warfarin (target INR, 

2.75) or to aspirin (325 mg daily). The primary outcome was time to first occurrence of a 

composite of ischemic stroke, intracerebral hemorrhage, or all-cause mortality. After 3.5 

years' mean follow-up, the rates of the primary outcome were not significantly different —
7.47 events per 100 patient-years with warfarin versus 7.93 with aspirin. Warfarin showed 

better protection against ischemic stroke, but aspirin was more protective against major 

hemorrhage. Physician’s First Watch

top of page...

USAFRICOM

Kenya: 2,500 children vaccinated against measles in 

Kwale

9 May – The measles outbreak in Kwale county has been contained, Kwale district disease 

surveillance coordinator Hannah Kache has said. The outbreak had been reported at 

Mbuguni, Mwalubamba and Mkongani areas which later spread to Kombani in Waa 

location. Speaking to the Star, Kache said the health department took immediate action to 

ensure the disease does not spread further. 'We had three cases of measles and we 

observed 18 children who came with the same symptoms before declaring an outbreak. We 

then immediately took the initiative to launch a vaccination campaign which mothers and 

their children cooperated well," Kache said. She said the vaccination outreach programme 

initiated to control the disease has so far reached more than 2,500 children of six years and 

below who were in danger of being affected. All Africa

Madagascar: Peer pressure to stop teen pregnancy

4 May - ...At the Good Hope Hospital, a relative haven in the midst 

of a neglected and inadequate health sector, Yolande Zafindraivo 

is the only gynaecologist in this region of over 1 million 

inhabitants. "There are no doctors or trained midwives in the 

villages, so people deliver with the help of the village matron, the

elder woman of the village who has knowledge of traditional medicine," she told IRIN. "It's 

dangerous - the matrons give the girls traditional herbs to induce the baby, [but] these are 

very strong and can cause a shock reaction in the body." Zafindraivo concentrates on saving 

the mothers, and says she succeeds most of the time. Nonetheless, figures from the UN 

Population Fund (UNFPA) reveal that the Sofia region has one of the highest maternal death 

rates in the country, with 1 in every 10 mothers dying during childbirth. Nationwide, 3,750 

mothers and 16,500 babies die each year during or soon after delivery. Another 75,000 

women experience medical problems as a result of childbirth, and an estimated 40 percent 

of these women receive insufficient care. IRIN

top of page...
USCENTCOM

Afghanistan: Nursing and Midwifery Institute opens in 

Kandahar

10 May - The May 9 ribbon cutting ceremony for the Kandahar Nursing and Midwifery 

Institute marked a big step in the improvement of medical facilities in Afghanistan... The 

Nursing and Midwifery facility is one of only eight similar facilities in the country and will be 

able to train up to 800 students, both male and female, per year. The facility will teach 

students nursing, midwifery, pharmacy, lab, and dental services, with an emphasis on 

improving maternal and infant mortality rates in Kandahar as well as surrounding provinces. 

The compound consists of male and female dormitories, a dining hall, schoolhouse, 

mosque, recreation field and administrative buildings. Blackanthem Military News

Kuwait: MEW confirms news report on 'contaminated' 

water samples 

4 May - The Ministry of Water and Electricity has confirmed the news published by AlWatan Arabic Daily regarding the contaminated drinking water samples taken from 

government buildings in Farwaniya, reports Al-Watan Arabic daily. Wasmiyah Al-Khatlaan, 

the Head of Bacteriology Division at the Center of Water Resources Development in the 

Ministry of Water and Electricity confirmed that the news about contaminated drinking 

water is true. However, he stressed that the Ministry bears no responsibility because the 

contamination did not occur from the water network. He explained that the contamination

was found in building's water storage tanks, adding that the Ministry's responsibility for 

clean water ends just before the water enters the storage tanks. He emphasized that the 

water produced by the Ministry in the five main hydro stations is suitable for human 

consumption, and no biological or chemical contamination was found in them. Zawya

Pakistan: Red Cross suspends work after staffer's killing

10 May - The International Committee of the Red Cross said Thursday it was suspending its 

work in Pakistan pending a review of its presence in the South Asian country. The decision 

comes after the killing of Khalil Rasjed Dale, a 60-year old health program manager who 

was abducted four months ago in Balochistan. His body was found last month. The 900 

national staff members of the Red Cross have been placed on paid leave, and 80 foreign 

staffers have been flown to Islamabad, said spokesman Christian Cardon... The organization 

has halted all its activities and said it was painfully aware of the consequences on the 

wounded, sick and other vulnerable people. CNN

top of page...
USEUCOM

Belgium: Four multifaceted countrywide campaigns to 

promote hand hygiene in Belgian hospitals, 2005 - 2011

3 May - Four consecutive one-month campaigns were organised to promote hand hygiene 

in Belgian hospitals between 2005 and 2011. The campaigns included a combination of 

reminders in wards, educational sessions for healthcare workers, promotion of alcoholbased hand rub use, increasing patient awareness, and audits with performance feedback. 

Prior and after each one month intervention period, the infection control teams measured 

hand hygiene compliance of healthcare workers by direct observation using a standardised 

observation roster. A total of 738,367 opportunities for hand hygiene were observed over 

the four campaigns. Compliance with hand hygiene significantly increased from 49.6% 

before to 68.6% after the intervention period for the first, from 53.2% to 69.5% for the 

second, from 58.0% to 69.1% for the third, and from 62.3% to 72.9% for the fourth 

campaign. The highest compliance rates were consistently observed in paediatric units. 

Compliance rates were always markedly lower among physicians than nurses. After patient 

contact and body fluid exposure risk, compliance rates were noticeably higher than before 

patient contact and performing aseptic procedures. We conclude that repeated countrywide 

campaigns to promote hand hygiene result in positive long-term outcomes. However, lower 

compliance rates among physicians compared with nurses, before patient contact, and 

before performing aseptic procedures remain challenges for future campaigns.

Eurosurveillance

Measles activity off to a slower start in Europe

8 May - Measles activity in European countries is lower so far this year compared this point 

in the 2010 and 2011 seasons, the European Centre for Disease Prevention and Control 

(ECDC) said today in its latest update, which covers the first 2 months of the year. Through 

the end of February, countries reported 1,447 cases, compared with 5,731 during the first 2 

months of 2011 and 5,752 during the same period of 2010. Fewer outbreaks have been 

reported in most countries, except for the United Kingdom, Romania, and Spain. Among 

several ongoing UK outbreaks, one in Merseyside is the largest in northwestern England 

since the measles, mumps, and rubella vaccine was introduced in 1988. Another hot spot is 

the Ukraine, which has reported 8,082 cases in six districts as of Apr 24. The ECDC said 

Romania was the only country to exceed 1 case per 100,000 population during the 

reporting period. Twelve countries reported no measles cases in January and February. Of 

1,315 patients with known vaccination status, 83% were unvaccinated, and 75% of the 

vaccinated group had received only one dose of the measles vaccine. CIDRAP News Scan

Sweden: Pneumococcal disease, more cases but fewer 

deaths

7 May - The vaccine given to children to immunize against serious pneumococcal disease 

does not offer full protection, reveals research from the Sahlgrenska Academy at the 
University of Gothenburg, Sweden, finding that the number of cases diagnosed has tripled 

over the past 50 years. Each year an estimated 1 million children worldwide die as a result of 

pneumococcal disease. Worst affected are those in poor countries, but pneumococcal 

bacteria cause disease and suffering in all age groups and in all countries, including Sweden. 

There are currently two types of active vaccine: polysaccharide vaccines, which protect 

against more types of pneumococcal bacteria but cannot be given to children under the 

age of two, and conjugated vaccines, which can be given to infants but protect against 

fewer types. In his thesis, Erik Backhaus, infection specialist at Skövde Hospital and doctoral 

student at the University of Gothenburg's Sahlgrenska Academy, looks at all cases of serious 

pneumococcal disease in children and adults in the Västra Götaland region of Sweden 

between 1998 and 2001. Infection Control Today

United Kingdom: Prostate cases rise to more than 

40,000

4 May - The number of men in the UK being diagnosed with prostate cancer has risen to 

more than 40,000 a year as a result of greater rates of testing for the disease, figures out 

today have revealed. Cancer Research UK says the rise in cases – up from 14,000 in 1989 – is 

linked to greater use of PSA (prostate specific antigen) testing, which measures a chemical 

produced by the prostate that may be raised when a man has prostate cancer. PSA testing 

first started in the UK in about 1989 and since then prostate cancer incidence rates have 

more than doubled in Britain from 47.4 to 102.9 per 100,000 men. However, PSA testing is 

not used as part of a national cancer screening programme because high PSA levels do not 

necessarily mean that a man has prostate cancer. Research suggests that up to two thirds of 

men with high PSA levels do not have the disease. In addition, the test and additional 

investigations cannot reliably distinguish between aggressive prostate cancers that need 

treating or slow-growing cancers that may not. This can then lead to unnecessary treatment.

Professor Malcolm Mason, Cancer Research UK’s prostate cancer expert, said: “Accurately 

diagnosing and predicting the need for treatment of prostate cancer is fraught with 

difficulties and there is no escaping the fact that we need a better tool than PSA to help 

detect prostate cancers that actually need treating. Englemed

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USNORTHCOM

Ardent Sentry 2012

4 May - Ardent Sentry is a U.S. Northern Command (NORTHCOM) annual exercise designed 

to stress several Global Combatant Command (GCC) contingency plans. The exercise is 

conducted annually in May and normally lasts 8 to 10 days. The venues for Ardent Sentry 

2012 (AS12) spread across the GCC area of operations from the Arctic Circle to Brownsville, 

Texas, from Salem, Oregon, to Minot, North Dakota. Stand-To!
U.S.: Fear fans flames for chemical makers

6 May - Manufacturers of fire retardants rely on questionable testimony, front groups to 

push standards that boost demand for their toxic -- and ineffective – products... a decadeslong campaign of deception that has loaded the furniture and electronics in American 

homes with pounds of toxic chemicals linked to cancer, neurological deficits, developmental 

problems and impaired fertility. The tactics started with Big Tobacco, which wanted to shift 

focus away from cigarettes as the cause of fire deaths, and continued as chemical 

companies worked to preserve a lucrative market for their products, according to a Tribune 

review of thousands of government, scientific and internal industry documents. These 

powerful industries distorted science in ways that overstated the benefits of the chemicals, 

created a phony consumer watchdog group that stoked the public's fear of fire and helped 

organize and steer an association of top fire officials that spent more than a decade 

campaigning for their cause. Chicago Tribune

U.S.: FEMA's first national preparedness report cites 

progress, gaps

8 May - The Federal Emergency Management Agency (FEMA) issued a report last week on 

the nation's progress in emergency preparedness, highlighting successes in all-hazards 

planning and gaps in cybersecurity efforts and disaster recovery. The report is the first in a 

series of annual reports designed to gauge key capabilities and help national officials set 

priorities and fill gaps. Dated Mar 30 but posted on the FEMA Web site on May 3, the 75-

page report includes input from FEMA's federal agency partners, data from state 

preparedness reports, and its own assessments of data for 31 core capacities. It contains 70 

key findings, including eight that address broad national trends. CIDRAP News

U.S., North Carolina: Hand, foot and mouth disease

8 May - Fever, sores and blisters in your mouth, on your hands and feet, these are painful 

symptoms of a disease that some pediatricians say is on a rise here in the Triad. It's called 

hand, foot, and mouth Disease (HFMD). No one knows the extent of the [disease] because 

doctors don't have to report it to the Health Department or even the CDC [Centers for 

Disease Control and Prevention]. But health experts say in rare cases, people may have to be 

hospitalized and the virus could be deadly. Within hours of asking News 2 Facebookers if 

they've seen any sign of the disease, more than 40 people responded, some with pictures of 

family members recovering. One Kernersville mom also told us her child's daycare had an 

outbreak last week. "From what I understand there were not many children there on Friday 

and today," she said. Her daughter hasn't been feeling well since she picked her up from the 

center last Thursday [3 May 2012]. "You could just tell she wasn't feeling good. We got 

home, 102-degree fever that night. She developed blisters all over her legs, her behind, and 

her back and her arms." And as her daughter's pediatrician found out, the blisters also made 

it to her oesophagus. "From a parent who's never seen it before, it's very scary," said her 

mother. ProMED-mail
U.S.: Obesity fight must shift from personal blame, panel

8 May - America's obesity epidemic is so deeply rooted that it 

will take dramatic and systemic measures - from overhauling 

farm policies and zoning laws to, possibly, introducing a soda 

tax - to fix it, the influential Institute of Medicine said on 

Tuesday. In an ambitious 478-page report, the IOM refutes the 

idea that obesity is largely the result of a lack of willpower on the part of individuals. 

Instead, it embraces policy proposals that have met with stiff resistance from the food 

industry and lawmakers, arguing that multiple strategies will be needed to make the U.S. 

environment less "obesogenic." Reuters

U.S.: Popular weed killer stirs health, environmental 

concerns

7 May - Atrazine is the most widely-used weed-killer in the United States. It is also one of 

the most controversial. Studies have linked atrazine to environmental damage and adverse 

health effects, including cancer. While the European Union banned its use nearly ten years 

ago, it is still approved for use in U.S. corn, sugarcane and sorghum fields. Jamie Jamison 

produces corn, wheat and soybeans on his 500-hectare farm. To boost production, he uses 

genetically modified seeds. To control weeds, he uses Atrazine. “It gives us good longseason control and allows us to have a good crop," Jamison said. Jamison takes precautions 

when he sprays atrazine on his fields. He knows the wind could take the pesticide to 

unintended areas and kill other crops, or pollute waterways. But he's convinced its benefits 

outweigh the risks. But opposition to Atrazine is growing. “I think the most convincing 

evidence of effects on humans is actually the ones on birth defects data, and also reports on 

effects on male reproductive fitness, poor sperm quality and low sperm mobility," said 

Jennifer Sass, a senior scientist at the Natural Resources Defense Council in Washington, a 

private environmental group. VOA News

U.S.: Sunburn and sun protective behaviors among 

adults aged 18–29 Years, 2000–2010

11 May - Skin cancer is an important public health concern. Nonmelanoma skin cancers, 

comprised mainly of basal cell carcinoma and squamous cell carcinoma, are the most 

common malignancies in the United States (1). Melanoma, although less common, is the 

deadliest form of skin cancer (2). Both melanoma and nonmelanoma skin cancers can be 

disfiguring, negatively affect quality of life, and create economic burden (2,3). Furthermore, 

age-adjusted incidence rates of both have increased in recent years (1,4). Morbidity and 

Mortality Weekly Report

U.S.: Vaccination rates -- herd at risk

5 May – [L]ocal concentrations of unvaccinated children pose a growing risk to public 

health. For the most common shots, vaccination rates for America overall, and even 

California, are still above 90%, at or near the levels considered necessary to provide “herd 
immunity” for a population. But in places the rates have been falling for almost a decade. In 

many counties, towns and nursery schools—within Washington state, Oregon, Vermont and 

California, especially—vaccination rates are now far below the herd-immunity level. This 

trend, predictably, is leading to the resurgence of diseases considered vanquished long ago. 

In 2010, for example, California had an outbreak of whooping cough, which at its height put 

455 babies in hospital and killed ten of them. Elsewhere there have been outbreaks of 

measles. The Economist

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USPACOM

Asia: Massive rise in Asian eye damage

3 May - Up to 90% of school leavers in major Asian cities are suffering from myopia - shortsightedness - a study suggests. Researchers say the "extraordinary rise" in the problem is 

being caused by students working very hard in school and missing out on outdoor light.

The scientists told the Lancet that up to one in five of these students could experience 

severe visual impairment and even blindness. BBC News

Burma suffering from huge shortfall in HIV and Aids 

drugs, warn doctors

9 May - Doctors in Burma are calling for the "devastating gap" between people's need and 

access to treatment for HIV and Aids to be bridged. There are approximately 240,000 

people with HIV in Burma, half of whom are in urgent need of life-saving antiretroviral 

treatment (ART), say doctors. According to national estimates in 2010, less than 30,000 of 

them were receiving it. The Guardian

Chinese-made infant flesh capsules seized in S. Korea

7 May - The dried flesh of dead infants appears to be the 

not-so-secret ingredient in a health supplement that is 

reportedly being smuggled out of China. The performanceenhancement pills, touted for increasing vitality and sex 

drive, have been found in the luggage of tourists and in 

international mail, according to South Korean authorities. They said they had confiscated 

nearly 17,500 of the human flesh capsules since last August, according to a report in the 

Wall Street Journal. South Korean authorities warned that the pills could be dangerous to 

human health. "This is gross, as well as creepy," said Dr. William Schaffner, chairman of 

preventive medicine at Vanderbilt University Medical Center, who consults regularly with the 

Centers for Disease Control. "We have no idea how this material is processed and under 

what circumstances," he said. "If it's not done in a hygienic fashion to make assurances 

infections are excluded, it could contain viruses as well as bacteria." ABC News
Solomon Islands: Rubella, travel alert

9 May - Foreigners planning to attend the Festival of Pacific Arts in Solomon Islands in July 

2012 are being urged to vaccinate against rubella, also known as German measles. The 

health authorities have issued the warning after a 1st case was recorded on Tue 8 May 2012 

and 5 more a day later. Officials say due to the airborne nature of the virus, containment is 

no longer an option. The Undersecretary for Health Improvement, Dr Cedric Alependava, 

says a nationwide vaccination program is being organised to start next month [June 2012].

ProMED-mail

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USSOUTHCOM

Argentine law aims to provide 'dignified deaths'

9 May - Terminally ill patients and their families would have more power to decide how they 

die in Argentina under a "dignified death" law being debated Wednesday in the Senate. If 

the measure is passed as expected, families will no longer have to struggle to find judges to 

order doctors to end life-support for people who are dying or in a permanent vegetative 

state. Getting such approval can be very difficult in many countries, particularly in Latin 

America, where opposition from the Roman Catholic church still runs strong. USA Today

Cuba: A regime’s tight grip on AIDS

7 May - ...Whatever debate may linger about the government’s harsh early tactics — until 

1993, everyone who tested positive for H.I.V. was forced into quarantine — there is no 

question that they succeeded. Cuba now has one of the world’s smallest epidemics, a mere 

14,038 cases. Its infection rate is 0.1 percent, on par with Finland, Singapore and Kazakhstan. 

That is one-sixth the rate of the United States, one-twentieth of nearby Haiti. The 

population of Cuba is only slightly larger than that of New York City. In the three decades of 

the global AIDS epidemic, 78,763 New Yorkers have died of AIDS. Only 2,364 Cubans have. 

Other elements have contributed to Cuba’s success: It has free universal basic health care; it 

has stunningly high rates of H.I.V. testing; it saturates its population with free condoms, 

concentrating on high-risk groups like prostitutes; it gives its teenagers graphic safe-sex 

education; it rigorously traces the sexual contacts of each person who tests positive. New 

York Times

Paraguay: More than 10,000 cases of dengue, 30 deaths

7 May - Paraguayan Ministry of Health confirmed that, to date, there are 10,827 cases and 

30 deaths in the country because of dengue. Ivan Allende, director of the Health 

Surveillance of the entity, noted the level reached by the disease nationwide, although he 

accepted that, at week 18, the epidemic is beginning to show a gradual decline. He pointed 

out that, of the 30 confirmed deaths, a total of 12 correspond to people over 60 years... As 
is the case since the beginning of the epidemic, the largest number of cases occurs in the 

capital of the nation and the central department. Prensa Latina

Peru warns against beaches due to bird deaths

6 May - Peru is urging people to stay away from Pacific beaches because of continuing 

discoveries of dead pelicans and dolphins. The South American nation's Ministry of Health 

has issued the warning and it says it is trying to find the cause of deaths. Since February, 

some 877 dolphins and 1,200 pelicans have washed up on Peruvian beaches for 

unexplained reasons. Local fishermen and restaurant owners say Saturday's warning hasn't 

had much effect on their businesses. It's the low-season for Peruvian beach-goers in any 

case. Official Wire

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