19 October 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

 As military suicides rise, focus is on private weapons

 Military study: Can dietary supplements prevent soldier suicides?

 Report: Soldier killed herself in Afghanistan

 Severely wounded soldiers’ survival rates may be improved by better battlefield triage, transport

 Task force aims to reduce urinary tract infections among deployed women

 West Nile virus vectors and prevention

GLOBAL

 A high price to pay: The impact of rising and volatile food prices on children’s nutrition and food security

 Airborne dispersion of superbugs around hospital wards

 Millions of healthy years of life lost to cancer worldwide

 Mobile phones used to track malaria transmission patterns

 New Ebola antibody treatment protects monkeys from lethal disease

 New TB vaccine on the horizon

 World TB cases fall, but drug-resistance a worry, WHO

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

VETERINARY/FOOD SAFETY

 Canada: More illnesses in Canada linked to recalled beef

 Netherlands: Over 500 salmonella cases tied to smoked salmon in Netherlands
New Entomology 

Fact Sheets

Two new entomology fact 

sheets are available in the 

USAPHC Library. The Army 

Combat Uniform with 

Permethrin fact sheet 

discusses the uniform as a

key component of the DoD 

Insect Repellent System.

The Mosquito Control 

Around the Home fact 

sheet addresses ways to 

control and protect 

yourself against 

mosquitoes.

WELLNESS

 Alcoholism shortens life more than smoking: study

 By forgoing vaccines, adults leave themselves vulnerable to diseases and viral infections

 Daily multivitamin shown to help ward off cancer in men

 HPV vaccine doesn’t alter sexual behavior, study finds

 Instant pain relief for burns provided by new dissolvable oral strip

 Too little sleep plays havoc with fat cells

 Wearing bicycle helmets saves lives

 Weight loss surgery boosts risk for substance abuse

 When adults smoke in cars, child passengers suffer: study

USAFRICOM

 Democratic Republic of Congo: Ebola virus disease

 Mali: New hope in fight against malaria

 Nigeria: Gold feeds – and poisons – children

 Nigeria: Worst flooding in decades

 South Sudan: Sudanese refugees embrace Global Handwashing Day for disease control

USCENTCOM

 Pakistan: How the Taliban is thwarting the war on polio

 Syria and the regional food chain

USEUCOM

 Portugal: Outbreak of dengue fever hits island of Madeira

 United Kingdom: Free ARVs for all in England

USNORTHCOM

 U.S.: CDC says another 19 people diagnosed with meningitis in U.S. outbreak

 U.S.: CDC West Nile virus update

 U.S.: Health hazards associated with laundry detergent pods, May–June 2012

USPACOM

 Japan ex Malaysia: Malaria, Plasmodium knowlesi

 Myanmar: Closing the HIV/AIDS “treatment gap”

 Sri Lanka: Drought hits northern rice farmers

USSOUTHCOM

 Chile: Meningococcal meningitis

 Colombia: Flooding/windstorm in Putumayo department, situation report no. 1

 Guatemala: Food security outlook update September 2012
Evaluation of the 

Lovell Federal 

Health Care Center 

Merger

The 2010 opening of the 

Captain James A. Lovell 

Federal Health Care Center 

(FHCC) created a joint 

entity between the 

Department of Defense 

(DoD) and the Department 

of Veterans Affairs (VA) 

that replaced two separate 

centers in North Chicago. 

This report finds that initial 

implementation of the 

Lovell FHCC has provided 

important lessons about 

how to integrate VA and 

DoD health care services 

and has identified 

remaining obstacles that 

the departments could 

overcome to make such 

mergers more effective and 

less costly to implement. 

U.S. MILITARY

As military suicides rise, focus is on private weapons

7 October - With nearly half of all suicides in the military having been committed with 

privately owned firearms, the Pentagon and Congress are moving to establish policies 

intended to separate at-risk service members from their personal weapons. The issue is a 

thorny one for the Pentagon. Gun rights advocates and many service members fiercely 

oppose any policies that could be construed as limiting the private ownership of firearms. 

But as suicides continue to rise this year, senior Defense Department officials are developing 

a suicide prevention campaign that will encourage friends and families of potentially 

suicidal service members to safely store or voluntarily remove personal firearms from their 

homes... Dr. Woodson, who declined to provide details, said the campaign would also 

include measures to encourage service members, their friends and their relatives to remove 

possibly dangerous prescription drugs from the homes of potentially suicidal troops. New 

York Times

Military study: Can dietary supplements prevent soldier 

suicides?

9 October - The military wants to find out if this idyllic scenario can be transformed into a 

reality, and one that could curb the growing number of suicides among soldiers and 

veterans. Earlier this week, they announced a three-year, $10 million study on whether 

omega-3 supplements can work as preventive medicine for at-risk personnel... There’s no 

question that omega-3 fatty acids are beneficial, and that most of us could use more of 

them. Unfortunately, much of the breathless enthusiasm surrounding omega-3s is based on 

insufficient evidence bolstered by breathless media hype. A major analysis in the Journal of 

the American Medical Association, published earlier this year, put a major dent in the claim 

that omega-3s can improve cardiovascular health. And as Forbes contributor David DiSalvo

noted recently, a plethora of studies on omega-3s and mental health have found benefits —

but definitive links between omega-3s and brain health have yet to be established. Forbes

S. Ward Casscells III dies at 60

S. Ward Casscells III was in his early 50s and in the throes of prostate cancer when he told his wife that 

he had decided to join the Army Reserve... Dr. Casscells, who died Oct. 14 at his home in Washington, 

became Col. Casscells. He joined the Army Reserve in the summer of 2005 and volunteered the 

following year for duty in Iraq. There he served as medical liaison to Gen. George W. Casey Jr., the top 

U.S. military commander in the country, and Zalmay Khalilzad, the U.S. ambassador. Dr. Casscells also 

worked with Iraqi doctors to help rebuild the local medical community. During his four-month tour of 

duty, Dr. Casscells survived a shelling and an ambush by insurgents. Widely admired, both for his 

military service and his medical work in Houston, he returned home and assumed a civilian post as 

assistant secretary of defense for health affairs — effectively the Pentagon official in charge of the 

sprawling bureaucracy of military medical policies and programs. Washington Post
Future Uses of the 

Department of 

Defense Joint 

Pathology Center 

Biorepository

The IOM proposes a series 

of protocols, standards, 

safeguards, and guidelines 

that could help to ensure 

that this national treasure 

continues to be available 

to researchers in the years 

to come, while protecting 

the privacy of the people 

who provided the materials 

and maintaining the 

security of their personal 

information.

Report: Soldier killed herself in Afghanistan

15 October - A 20-year-old soldier from Longview killed herself in Afghanistan last 

December as she served alone in a guard tower, where she was stationed despite a long 

history of mental-health issues that was not communicated to her supervisors, according to 

a new report. An Army investigation determined that Spc. Mikayla Bragg’s commanding 

officers were never told she had made an apparent previous suicide attempt while serving 

stateside in Fort Knox, even though officials at the Kentucky base knew of it, The Daily News

of Longview reported... Among the findings were that her superiors weren’t told she had 

spent 45 days in an Army hospital at Fort Knox for mental-health treatment just months 

before she deployed. She had been hospitalized after telling doctors she wanted to crash a 

car and injure herself. Army Times

Severely wounded soldiers’ survival rates may be 

improved by better battlefield triage, transport

8 October – Wounded soldiers who sustained chest injuries in Operation Enduring Freedom 

(Afghanistan) and Operation Iraqi Freedom (Iraq) had higher mortality rates than soldiers in 

Korea and Vietnam, according to a military trauma study presented at the 2012 American 

College of Surgeons Annual Clinical Congress. However, better battlefield triage and 

transport may have meant that severely wounded soldiers whom would have been 

considered killed in action in previous conflicts are more likely to get sent to trauma centers 

in the United States sooner in their course of care, study authors explained. Medical News 

Today

Task force aims to reduce urinary tract infections among 

deployed women

14 October - ...Nearly half of 850 women surveyed in 2000 for a study of women’s 

perceptions of their health care while deployed said they’d had symptoms of UTIs or 

vaginitis while deployed, according to an Army report released by a new task force on 

women’s health earlier this year. Many of them declined to seek medical treatment, risking 

complications like kidney disease and pelvic infections... The Army Women’s Health Task 

Force, formed last year, has recommended changes and initiatives based on the report. 

Some of those recommendations are about to be implemented, officials said. Devices that 

allow women to urinate discreetly will be made widely available before or while they’re 

deployed. Self-diagnosis kits to let women test themselves for urinary and vaginal infections 

are planned by next year. Stars and Stripes

West Nile virus vectors and prevention

September 2012 - The United States is experiencing one of the worst outbreaks of West 

Nile virus (WNV) since its introduction into the U.S. in 1999.1As of 11 September 2012, 

2,636 cases of West Nile virus disease in humans – and 118 deaths – have been reported to 

the Centers for Disease Control and Prevention (CDC).2The number of human cases 

reported to the CDC thus far in 2012 is higher than the number reported at a comparable 
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time of any year since 2003. Also, by 11 September 2012, WNV infections had been 

documented in humans, birds, or mosquitoes in 48 states. Of note, however, two thirds of 

human cases were reported from just six states (Texas, Louisiana, South Dakota, Mississippi, 

Michigan, and Oklahoma) and approximately 40 percent of human cases were reported 

from Texas.2The Department of Defense (DoD) and its public health hubs have also been 

closely monitoring the outbreak; the U.S. Army Public Health Command Vector-borne 

Disease report of 11 September 2012 reported seven WNV cases in U.S. Army service 

members and beneficiaries.3 Medical Surveillance Monthly Report

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GLOBAL

A high price to pay: The impact of rising and volatile food 

prices on children’s nutrition and food security

16 October – Millions of children in the world’s poorest countries are at risk from rising 

global food prices which are teetering dangerously close to their highest level in history.

[Save the Children’s] new report, A High Price to Pay, released today on World Food Day, 

finds factors like climate change, population growth, and land being given over to biofuel 

production, are contributing to sharply rising and volatile prices. The results are that 

nutritious food is being put beyond the reach of poor families and children who are already 

not getting enough of the right food. Our research shows 36 countries, home to more than 

90% of the world’s malnourished children, are being hit hardest by the effects of the food 

price rises. Reliefweb/Save the Children

Airborne dispersion of superbugs around hospital wards

15 October – Hospital superbugs can float on air currents and contaminate surfaces far 

from infected patients' beds, according to University of Leeds researchers. The results of the 

study, which was funded by the Engineering and Physical Sciences Research Council 

(EPSRC), may explain why, despite strict cleaning regimes and hygiene controls, some 

hospitals still struggle to prevent bacteria moving from patient to patient. It is already 

recognised that hospital superbugs, such as MRSA and C-difficile, can be spread through 

contact. ...But the University of Leeds research showed that coughing, sneezing or simply 

shaking the bedclothes can send superbugs into flight, allowing them to contaminate 

recently-cleaned surfaces. ..."The level of contamination immediately around the patient's 

bed was high but you would expect that," said Dr Cath Noakes, from the University's School 

of Civil Engineering, who supervised the work. "However, we also captured significant 

quantities of bacteria right across the room, up to 3.5 metres away and especially along the 

route of the airflows in the room." Medical New Today
Millions of healthy years of life lost to cancer worldwide

16 October - Nearly 170 million years of healthy life were lost worldwide due to cancer in 

2008, according to a new study. Researchers analyzed cancer registries from around the 

world and used a measure called disability-adjusted life-years (DALYs) to assess not only the 

impact of fatal cancer, but also the effects of disabilities among cancer survivors, such as 

breast loss due to breast cancer or infertility due to cervical cancer. Along with finding that 

169.3 million years of healthy life were lost due to cancer in 2008, the researchers also 

determined that men in eastern Europe had the largest cancer burden worldwide (3,146 

age-adjusted DALYs lost per 100,000 men). Among women, the highest burden was in subSaharan Africa (2,749 age-adjusted DALYs lost per 100,000 women). Medline Plus

Mobile phones used to track malaria transmission 

patterns 

11 October - Scientists are studying the use of mobile phones to track patterns of malaria 

transmission in endemic nations. The research is part of an effort by many countries to 

control or eliminate the mosquito-borne disease. On their own, malaria-carrying 

mosquitoes can’t travel very far. But the insects that are responsible for nearly one million 

deaths around the world each year can, and do, hitch rides in the belongings of people who 

travel. Malaria can also be transmitted to healthy individuals by asymptomatic people who 

venture from an area where many people are sick with the disease, to a location, such as a 

city, where residents are seldom exposed to malarial mosquitoes. VOA

New Ebola antibody treatment protects monkeys from 

lethal disease

16 October – A new Ebola virus study resulting from a widespread scientific collaboration 

has shown promising preliminary results, preventing disease in infected nonhuman primates 

using monoclonal antibodies; the research team describes a proof-of-concept for using a 

“cocktail” of monoclonal antibodies, or mAbs, to prevent lethal disease in rhesus macaques; 

when administered one hour after infection, all animals survived; two-thirds of the animals 

were protected even when the treatment, known as MB-003, was administered forty-eight 

hours after infection. Homeland Security News Wire

New TB vaccine on the horizon

16 October 2012 – A research team at Oxford University in the UK is very close to 

determining the efficacy of their new tuberculosis (TB) vaccine. If current clinical trials are 

successful, it will be the first new TB vaccine in almost a century. The urgent need for a new 

vaccine is emphasised by research showing that extensively drug-resistant (XDR) forms of 

the disease are rapidly spreading. Today, most babies in the world are immunized with the 

old Bacille Calmette-Guerin (BCG) vaccine, first used in 1921. The leader of the Oxford 

research team, Helen McShane, says it saves children's lives, but beyond infancy its effects 

are limited. ...Oxford’s vaccine, known as MVA85A, is designed to boost the effects of BCG. 

“It's that efficacy against severe disease which is the rationale behind keeping BCG and 

making it better,” McShane said. IRIN PlusNews
World TB cases fall, but drug-resistance a worry, WHO

17 October - New tuberculosis infections dropped 2.2 percent worldwide last year, but with 

nearly 9 million new infections, the World Health Organization said TB remains a massive 

problem that could worsen if countries shortchange funding to fight it. In its annual 

assessment released Wednesday, WHO also said only one in five people with drug-resistant 

strains of TB is being diagnosed each year, leaving hundreds of thousands of people who 

are potentially infecting others with this particularly deadly form of the disease. Overall, the 

report found that 8.7 million people fell ill with tuberculosis in 2011 and 1.4 million died, 

including nearly 430,000 people who were also infected with HIV, the virus that causes AIDS. 

Reuters

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INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

For the week ending 6 October 2012: 

 This is the first issue of the DoD Influenza Surveillance Summary for the 2012-2013 

season. 

 Overall, influenza activity remains low to moderate throughout the overseas DoD 

laboratory surveillance network; circulating subtypes include influenza A/H1, A/H3 and 

influenza B. AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 40 (September 30-October 6, 2012), influenza activity was low in the United 

States.

Viral Surveillance: Of 2,870 specimens tested and reported by U.S. World Health 

Organization (WHO) and National Respiratory and Enteric Virus Surveillance System 

(NREVSS) collaborating laboratories during week 40, 75 (2.6%) were positive for influenza.

Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below 

the epidemic threshold.

Influenza-associated Pediatric Deaths: No influenza-associated pediatric deaths were 

reported

Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like illness 

(ILI) was 1.2%, which is below the national baseline of 2.2%. All 10 regions reported ILI 

below region-specific baseline levels. Forty-seven states and New York City experienced 

minimal ILI activity and the District of Columbia and three states had insufficient data.
Geographic Spread of Influenza: The geographic spread of influenza in one state was 

reported as local (Wyoming); the District of Columbia and 29 states reported sporadic 

activity; Guam and 18 states reported no influenza activity, and Puerto Rico, the U.S. Virgin 

Islands, and two states did not report. FluView

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During week 4 (1-7 October 2012), the first week of the 2012–2013 influenza season, there 

was no evidence of significant influenza activity in Europe.

 Of 25 reporting countries, 24 countries experienced low intensity of clinical influenza 

activity, 22 countries no geographic spread and 19 countries stable or decreasing trends 

(all at the lowest categories) 

 No sentinel specimen was tested positive for influenza. From non-sentinel sources, 11 

influenza A viruses and four influenza B viruses were detected. 

 No severe hospitalised laboratory-confirmed influenza case was reported. Weekly 

Influenza Surveillance Overview

Google.org: Flu Trends

17 October – Estimates of flu activity based on flu-related Internet search queries indicate 

that the level of flu activity ranges from minimal to moderate in the northern hemisphere 

with moderate levels in Russia and ranges 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 13 October 2012:

Influenza: The cluster of influenza A/H1N1(09) cases at MCRD Parris Island is continuing into 

early October.

Adenovirus: Type 14 adenovirus is present at MCRD Parris Island. 

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

below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

USAPHC: U.S. Army Influenza Activity Report

6 October – Current influenza and influenza-like illness activity is low in US Army and civilian 

populations. All beneficiaries aged 6 months and older should receive this year's influenza 

vaccine, unless medically exempted.

ILI Activity: Army beneficiary outpatient visits for incident influenza-like illness are lower this 

year than at same time in the last two seasons

Viral specimens: During week forty (2012) 24 of 414 (6%) specimens submitted for testing 

were positive for respiratory disease. Influenza A was identified in 4 (6%) of these positive 

samples.
Influenza cases: No hospitalized influenza cases have been reported in DRSi through week 

forty of the 2012-2013 season.

Army MEDCEN & reporting trend: RSV was the most commonly identified respiratory 

pathogen during week 40 (2012) accounting for 50% of positive specimens. USAPHC U.S. 

Army Influenza Activity Report

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VETERINARY/FOOD SAFETY

Canada: More illnesses in Canada linked to recalled beef

12 October – The number of E. coli O157:H7 infections linked to beef from XL Foods in 

Canada has risen from 12 to 15, according to a notice issued by Canadian health officials 

Friday. The 15 cases have occurred in Alberta (7), Newfoundland and Labrador (1), Quebec 

(4) and British Columbia (3). One of the BC victims was a visitor to Canada, notes the 

Canadian Food Inspection Agency, which issued Friday’s outbreak update. ...The XL Foods 

recall – the largest in Canadian history – has been expanded 16 times since it was first 

issued September 16 after testing by the U.S. Department of Agriculture revealed the 

presence of E. coli in the company’s ground beef product at the Canadian border 

September 3. Food Safety News

Netherlands: Over 500 salmonella cases tied to smoked 

salmon in Netherlands

13 October – More than 500 people in the Netherlands have now contracted Salmonella 

infections linked to smoked salmon, and at least one of these patients has died, reported 

Dutch health officials Saturday. According to The National Institute for Public Health and the 

Environment of the Netherlands, two fatalities have been connected to the outbreak. One 

has been confirmed to be a result of the patient’s Salmonella infection and the other is 

under investigation. ...The Dutch health agency says approximately 550 people have are 

now thought to be affected by the outbreak, which has been tied to smoked salmon 

produced by Netherlands-based Foppen but manufactured in a facility in Greece. Food 

Safety News

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WELLNESS

Alcoholism shortens life more than smoking: study

16 October - New research suggests that people who are alcohol-dependent, particularly 

women, may be cutting their lives even shorter than smokers. In the study, German 

researchers found death rates were 4.6-fold higher among alcohol-dependent women and 

1.9-fold higher among alcohol-dependent men, compared with the general population. 

"This paper confirms the well-known association between alcoholism and premature death," 

said Dr. James Garbutt, professor of psychiatry at the University of North Carolina, who was 

not involved in the study. "It also supports the evidence that women are more likely to have 

more severe health problems from alcohol than men -- 'sicker quicker.'" The report was 

published online Oct. 16 in the journal Alcoholism: Clinical & Experimental Research. 

Medline Plus

By forgoing vaccines, adults leave themselves vulnerable 

to diseases and viral infections

17 October - As children, our parents take us to the doctor every year, like clockwork. As we 

get older, regular checkups often fall by the wayside. But they shouldn't. For adults, 

checkups, preventative screenings and vaccinations are vital to living healthy, happy lives. 

According to Dr. Carolyn Bridges, associate director for adult immunization at the Centers 

for Disease Control in Atlanta, numerous screening procedures and vaccines are available to 

adults, but they are often underused. "National vaccination rates are low," she says, "even 

for vaccines that have been recommended for many years." Chicago Tribune

Daily multivitamin shown to help ward off cancer in men

17 October - Swallowing a daily multivitamin can reduce the risk of cancer by at least eight 

percent in middle-aged and older men and appears to have no dangerous side-effects, 

according to the first large-scale, randomized study on the subject. The protective effect of 

the daily pill was described as "modest" by the trial investigators who emphasized that the 

primary use of vitamins was to prevent nutritional deficiencies. The findings were published 

in the Journal of the American Medical Association and presented on Wednesday at a 

meeting of the American Association for Cancer Research in Anaheim, California. "This is 

indeed a landmark study," said Cory Abate-Shen, a professor of urological oncology at 

Columbia University Medical Center who was not involved in the trial. "It suggests that a 

balanced multivitamin approach is probably more beneficial than increasing to high levels 

any one vitamin." Reuters
HPV vaccine doesn’t alter sexual behavior, study finds

15 October - ...Since public health officials began 

recommending in 2006 that young women be routinely 

vaccinated against HPV, many parents have hesitated over 

fears that doing so might give their children license to have 

sex. But research published on Monday in the journal 

Pediatrics may help ease those fears. Looking at a sample of nearly 1,400 girls, the 

researchers found no evidence that those who were vaccinated beginning around age 11 

went on to engage in more sexual activity than girls who were not vaccinated. “We’re 

hopeful that once physicians see this, it will give them evidence that they can give to 

parents,” said Robert A. Bednarczyk, the lead author of the report and a clinical investigator 

with the Kaiser Permanente Center for Health Research Southeast, in Atlanta. “Hopefully 

when parents see this, it’ll be reassuring to them and we can start to overcome this barrier.” 

New York Times

Instant pain relief for burns provided by new dissolvable 

oral strip

16 October – A dissolvable oral strip has been developed to immediately relieve pain from 

burns caused by ingestion of hot foods and liquids, such as coffee, pizza, and soup. ...Lead 

researcher Jason McConville, Ph.D., and colleagues from University of Texas at Austin, 

designed the strip for controlled delivery of a local anesthetic, benzocaine, and a 

therapeutic polymer. Benzocaine, commonly used as a topical pain reliever in dental 

products and throat lozenges, was chosen as for its non-irritating properties. The strip is 

applied directly to the burned part of the tongue, cheek or roof of the mouth. It sticks to the 

affected area and won't interfere with normal day-to-day activities, as it quickly dissolves for 

instant pain relief and promotes healing. Medical News Today

Too little sleep plays havoc with fat cells

15 October - Here's another reason to get a good night's sleep: Too little shut-eye plays 

havoc with your fat cells, which could lead to weight gain and type 2 diabetes, researchers 

reported Monday. Scientists have known for years that sleep deprivation makes you tired 

and cranky and less able to think clearly. It also can make you fat because it increases levels 

of a hunger hormone and decreases levels of a fullness hormone, which could lead to 

overeating and weight gain. The latest study indicates that not getting enough sleep 

reduces your fat cells' ability to respond properly to the hormone insulin, which is crucial for 

regulating energy storage and use. Over time the disruption could lead to weight gain, type 

2 diabetes and other health problems, the researchers say. USA Today

Wearing bicycle helmets saves lives

16 October – Cyclists who died of a head injury were three times as likely to not be wearing 

a helmet compared with those who died of other injuries, according to a study in CMAJ 

(Canadian Medical Association Journal). "We saw an association between dying as a result 
of sustaining head injury and not wearing a helmet," states Dr. Navindra Persaud, Keenan 

Research Centre and the Department of Family and Community Medicine, St. Michael's 

Hospital, Toronto, with coauthors. "These results are consistent with a protective effect of 

helmets on cycling deaths." There is scant evidence on the relationship between helmet use 

and fatal head injuries. Researchers looked at data from the Office of the Chief Coroner for 

Ontario on all 129 accidental cycling deaths between January 2006 and December 2010 in 

the province. Cyclist ages ranged from 10 to 83 years and 86% were boys or men. More 

than three quarters of the deaths (77%) involved a motor vehicle. The results are consistent 

with an approximate 3-fold increase in the risk of death from head injuries for people who 

do not wear helmets compared with those who do. Medical News Today

Weight loss surgery boosts risk for substance abuse

16 October – Patients who have had bariatric weight loss surgery could be at an elevated 

risk of substance use (alcohol, cigarette smoking, drug use) following surgery, especially 

those who underwent laparoscopic Roux-en-Y gastric bypass surgery, who seemed to be at 

a higher risk for alcohol use after surgery. This report, published in Archives of Surgery, 

describes previous studies that relate bariatric weight loss surgery candidates to individuals 

addicted to other substances such as nicotine and alcohol. These candidates suffer from 

binge-eating disorder and display addictive personalities, therefore after their weight loss 

surgery (WLS), they may replace overeating with a different substance. Medical News Today

When adults smoke in cars, child passengers suffer: 

study

16 October - Smoking in cars produces levels of harmful particulate pollutants that are far 

above World Health Organization indoor air standards and likely pose a threat to children's 

health, a new study reveals. Dangerous levels of particulate air pollution occur even when 

the windows are open or the air conditioning is on, according to the findings released Oct. 

15 in the journal Tobacco Control. Medline Plus

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USAFRICOM

Democratic Republic of Congo: Ebola virus disease

17 October - The Ebola [virus disease] epidemic that has killed more than 30 people in 

eastern Democratic Republic of Congo (DRC) is not yet over and is still killing according to 

local religious sources to the missionary news agency (MISNA). "I would like to tell you that 

the Ebola epidemic is over, but we still do not see an end," said a missionary in Orientale 

province in a report received by MISNA. Last week [week of 8 Oct 2012], only one case was 

detected but "since then a young woman with all the symptoms of Ebola hemorrhagic fever 

died near Isiro," the correspondent added. The latest report of the World Health 
Organization (WHO), in mid-September [2012], recorded 31 deaths. Since then there have 

been 3 others, according MISNA. "The group most affected are nurses and health workers, 

at least until appropriate protective measures were implemented" by the Ministry of Health, 

WHO, and the humanitarian organisation Medecins sans Frontieres (MSF), said the 

missionary. ProMED-mail

Mali: New hope in fight against malaria

16 October - A pioneering malaria prevention method trialled in Mali is dramatically 

reducing seasonal malaria among children, according to a mass pilot launched by NGO 

Médecins Sans Frontières (MSF) in August 2012. In Koutiala District in the southeast, 

170,000 children were given a three-day course of anti-parasite medicine amodiaquine and 

sulfadoxine/ pyrimethamine (branded as Fansidar) on a monthly basis during the high 

transmission period of the disease between July and October. MSF teams witnessed a 75 

percent decline of uncomplicated malaria cases and a more than 60 percent decline in 

disease-related hospitalizations in the week following the distribution of the medication. 

IRIN

Nigeria: Gold feeds – and poisons – children

16 October - ...Activists say hundreds of children have been killed in this region over the 

past few years, and thousands have been crippled by the lead from the mining and 

processing of gold here in Zamfara State in northern Nigeria. Many villages in the region 

already have been cleaned up and survivors have been treated. Some of those villages lost 

more than 40 percent of their children before the outbreak subsided. VOA

Nigeria: Worst flooding in decades

10 October 2012 – Some 1.3 million Nigerians have been displaced and 431 have died in 

what the authorities say is the worst flooding in over 40 years, with 30 of the country’s 36 

states affected since July, according to the National Emergency Management Agency 

(NEMA). Heavy rain has submerged much of Delta and Bayelsa states in the southwest, 

affecting some 350 communities and making 120,000 people homeless, according to the 

state authorities and the Nigerian Red Cross (NRC). ...Thousands of houses, some 20 health 

clinics and five hospitals, as well as dozens of schools, churches and government buildings 

have been destroyed or damaged in Delta State. IRIN

South Sudan: Sudanese refugees embrace Global 

Handwashing Day for disease control

15 October – UNHCR staff and health workers in camps across Africa, including Sudanese 

nurse Dafala Baruk, will today be stressing the vital importance of cleanliness for refugees in 

harsh environments. Monday is Global Handwashing Day, launched in 2008 to stress the 

importance of cleaning before eating or after going to the lavatory as a key approach to 

disease prevention. The health message has ...been embraced by refugees, including 

children, who will on Monday perform catchy songs with the core message. "On Global 

Handwashing Day, the message to wash one's hands will be reinforced in camps around 
Maban County," said UNHCR Public Health Officer Pillar Moreno. "We hope that in a short 

period of time, handwashing will become second nature before the preparation of food or 

after using latrines. Reliefweb

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USCENTCOM

Pakistan: How the Taliban is thwarting the war on polio

17 October - Pakistan is one of the remaining corners of the world where polio still lingers. 

Last year, the government declared a national emergency, and with the help of international 

institutions, embarked on an aggressive vaccination campaign. So far, the results have been 

promising. The number of new polio cases is about a third of last year's total of 198. But the 

new campaign, like previous efforts, hasn't been able to overcome one critical problem: 

getting into parts of Pakistan's lawless tribal regions along the border with Afghanistan to 

vaccinate the children there. About 75 percent of Pakistan's polio cases can be traced back 

to certain areas there, primarily FATA, the Federally Administered Tribal Areas, and 

neighboring Khyber Pakhtunkhwa. Quetta, in Baluchistan, is also difficult to enter, says 

Pakistan's point person for polio, Shahnaz Wazir Ali. The Taliban, al-Qaida and other Islamist 

groups are based throughout the region, and it's volatile and dangerous. NPR

Syria and the regional food chain

18 October - The Syrian crisis has disrupted food imports and 

exports in the region, raising food prices in Jordan, Iraq and 

Turkey, but governments have so far been able to contain the 

impact on consumers by finding new trade routes and 

absorbing some of the increased cost, according to food 

vendors, truck drivers and analysts. Arab countries import at least half of the food they 

consume, according to the World Bank, with trade moving from agricultural breadbaskets 

such as Turkey, Lebanon and Syria to more arid countries such as Jordan, Iraq and the Gulf 

countries. Before the crisis, Syrian farmers were suppliers of vegetables, fruit and other food 

products – exporting nearly 2 million tons of vegetable products and 212,000 tons of animal 

products in 2010, according to the Syrian Central Bureau of Statistics. Up to one fifth of that 

went to Turkey and Iraq alone, according to Ayesha Sabavala, a Syria analyst with the 

Economist Intelligence Unit. But as the conflict drags on, exports are slowing, with violence 

reducing agricultural production, shutting down businesses, and disrupting trade routes. 

IRIN

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USEUCOM

Portugal: Outbreak of dengue fever hits island of Madeira

12 October – Eighteen people are confirmed to be suffering from dengue fever in the 

Portuguese archipelago of Madeira and another 191 probably have the mosquito-borne 

disease. The European Centre for Disease Prevention and Control (ECDC) which monitors 

disease in the European Union, said the outbreak was "significant but not entirely 

unexpected" given that the most efficient carriers of the disease, mosquitoes known as 

Aedes aegypti, have an established presence in Madeira. "Portuguese public health 

authorities are implementing control measures to reduce the risk of sustained transmission 

locally, the export of infected vectors from the island, and to minimize the impact on the 

affected population," it said. Reuters

United Kingdom: Free ARVs for all in England

8 October 2012 – On the first day of October, a law change enabled everyone in England, 

regardless of their immigration status, to obtain free treatment for HIV and AIDS. ... Every 

resident in Britain contributes to the National Health Service (NHS) through their taxes, and 

gets free treatment. People without residency have to pay for treatment, with two 

exceptions: Cases of accidents or emergencies, where everyone receives free treatment from 

hospitals, and cases where serious infectious disease could be passed on to members of the 

public. But while treatment for STIs like syphilis and gonorrhoea fell under this latter 

category, treatment for HIV and AIDs did not. This has changed, and HIV is now eligible for 

free treatment. IRIN PlusNews

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USNORTHCOM

U.S.: CDC says another 19 people diagnosed with 

meningitis in U.S. outbreak

16 October - Another 19 people have been diagnosed with fungal meningitis linked to 

possibly tainted vials of a steroid medication, the U.S. Centers for Disease Control and 

Prevention said on Tuesday, bringing the total number of cases to 231. The CDC said there 

were two additional cases of infection in joints after a steroid injection but these were not 

confirmed as meningitis, bringing the total of infections nationwide to 233. The death toll 

from the unprecedented outbreak was unchanged at 15, the CDC said. The new cases were 

in Tennessee (6), Florida (2), Indiana (2), Maryland (1), Michigan (1), New Hampshire (2), New 

Jersey (2), Ohio (2), and Virginia (1). Reuters
U.S.: CDC West Nile virus update

16 October - As of October 16, 2012, 48 states have reported West Nile virus infections in 

people, birds, or mosquitoes. A total of 4,531 cases of West Nile virus disease in people, 

including 183 deaths, have been reported to CDC. Of these, 2,293 (51%) were classified as 

neuroinvasive disease (such as meningitis or encephalitis) and 2,238 (49%) were classified as 

non-neuroinvasive disease. The 4,531 cases reported thus far in 2012 is the highest number 

of West Nile virus disease cases reported to CDC through the third week in October since 

2003. Almost 70 percent of the cases have been reported from eight states (Texas, 

California, Louisiana, Mississippi, Illinois, South Dakota, Michigan, and Oklahoma) and over a 

third of all cases have been reported from Texas. CDC

U.S.: Health hazards associated with laundry detergent 

pods, May–June 2012

19 October - During May and early June 2012, the Carolinas Poison Center and the Poison 

Control Center at the Children's Hospital of Philadelphia received four reports of children 

with vomiting, mental status changes, and respiratory distress after ingesting the contents 

of laundry detergent pods. Laundry detergent pods are single-load capsules that contain 

concentrated liquid detergent within a water-soluble membrane that dissolves when in 

contact with moisture (1). Laundry detergent pods were introduced in the U.S. market in 

2010, and multiple manufacturers now sell laundry detergent packaged in pods (2–4). On 

May 17, 2012, CDC and the American Association of Poison Control Centers (AAPCC) began 

tracking and characterizing reported exposures to laundry detergent from pods. Morbidity 

and Mortality Weekly Report

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USPACOM

Japan ex Malaysia: Malaria, Plasmodium knowlesi

17 October - We have recently confirmed _Plasmodium knowlesi_ infection in a traveler 

returning from Malaysia to Japan. In September 2012, a previously healthy Japanese man in 

his 30's presented to the travel clinic of the National Center for Global Health and Medicine 

(NCGM) hospital in Tokyo with a 2-day history of fever, headache, and arthralgia. He had 

visited Temenggor, Johor, and Kuala Lumpur in Malaysia during 2 months for field 

investigations of entomology and zoology, without malaria chemoprophylaxis. His 

symptoms started 10 days after returning from Malaysia to Japan. On admission, his body 

temperature was 37.0 deg C [98.6 deg F], other vital signs were normal. Physical 

examination showed left upper abdominal pain and mild splenomegaly. Laboratory 

investigations showed thrombocytopenia and slightly elevated liver enzymes. The thin 

blood smear with Giemsa stein showed malaria parasites including band forms similar to _P. 

malariae_, and heavily pigmented schizonts inside non-enlarged erythrocytes. He was 
diagnosed with non-falciparum malaria and was treated with mefloquine (1500 mg base). 

He recovered in 3 days after treatments. He was discharged from our hospital on the 7th 

day of admission without any complications. We finally diagnosed human _P. knowlesi_ 

infection based on nested multiplex PCR analysis. This is the 1st reported case of imported 

human _P. knowlesi_ infection in Japan. ProMED-mail

Myanmar: Closing the HIV/AIDS “treatment gap”

12 October - Health workers in Myanmar are confident that efforts to narrow the country’s 

huge gap between access to, and need for, life-saving medicines to treat HIV/AIDS are back 

on track after the Global Fund to Fight AIDS, Tuberculosis and Malaria invited the country to 

apply for additional funding. “I would not have dreamt that this was possible last 

November,” said Peter Paul de Groote, head of mission for Médecins Sans Frontières (MSF) 

in Myanmar, referring to the Global Fund’s cancellation of funding that health workers in 

Myanmar were relying on to expand access to antiretrovirals (ARVs). Instead, MSF has been 

forced to turn away people in need of ARVs. “It’s a trauma for patients sent away and for 

our staff,” said de Groote. The Joint UN Programme on HIV/AIDS (UNAIDS) estimates 18,000 

people die of AIDs-related illnesses annually in Myanmar. IRIN

Sri Lanka: Drought hits northern rice farmers

18 October - Officials in northern Sri Lanka’s Vavuniya District say 

60 percent of the rice harvest could be lost if the dry weather 

continues. “In Mannar District [in the north] we have records 

indicating that between 5,000 to 6,000 paddy hectares of the 

cultivated 10,000 are lost,” Ravi Vinanithambi, an environment 

officer for the North East Reawakening Programme (NERP - part of the Ministry of Economic 

Development), told IRIN. Residents report no significant rain in the region for over eight 

months. In some villages like Visvamadhu in Kilinochchi District, they say the last rains of 

any substance were in September-November 2011. “This year has been a big problem 

because most of the people in the region depend on agriculture heavily,” Vinanithambi said, 

noting despite some rains earlier this week, they needed several weeks to fill dried-up wells 

and reservoirs. IRIN

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USSOUTHCOM

Chile: Meningococcal meningitis

17 October - Chile is currently facing an increase of meningococcal disease and also a shift 

of serotypes compared to the year 2011. The surveillance system of the Chilean Ministry of 

Health has reported the following numbers, which reflect the epidemiological situation of 

meningococcal disease for 2012 from week 1 to 40 [1 Jan-6 Oct 2012]: There are a total of 
83 accumulated cases compared with 52 for the total of 2011 (median number of cases 

2007-2011: 76). The increase is mainly observed in 2 Chilean regions: the Metropolitan 

Region (RM), which includes Santiago, with 58 percent of cases and the region of Valparaiso 

with 21 percent of cases. The RM is divided into several health administrative regions; of 

those, 3 were mostly affected. ProMED-mail

Colombia: Flooding/windstorm in Putumayo 

department, situation report no. 1

15 October – On 16 August a strong windstorm affected more than 52,000 people in 

western, central and eastern Putumayo department (southern border with Ecuador). Some 

of the people affected had been hit by massive flooding at the end of July, with the floods 

affecting more than 95,000 people. Despite an overall strong response to the floods by the 

National Unit for Disaster Management and Response (UNGRD), critical gaps remain 

regarding access to secure water, livelihoods, health and nutrition, particularly in conflictaffected rural areas to which authorities have limited access. ...Humanitarian partners are in 

the process of submitting proposals to the Central Emergency Response Fund (CERF) to 

request urgently needed kick-start funding for amplifying interventions in WASH, health, 

nutrition and crop rehabilitation. Reliefweb

Guatemala: Food security outlook update September 

2012

16 October – The Government of Guatemala (GoG) is implementing a response plan to 

provide food assistance to households at greatest risk of food and nutritional insecurity, 

particularly those affected by this year’s prolonged canícula [midsummer heat] in the 

eastern and central regions of the country, as well as several other localized areas. The GoG 

is calling for the distribution of 1,950 MT of food assistance during the month of 

September, which should help to offset the food deficit until the beginning of the high 

season for unskilled labor. In light of the above factors, the poorest households in the 

affected areas are expected to maintain their food insecurity classification at Stressed (IPC 

Phase 2) through the end of the year. Reliefweb

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