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26 July 2013

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

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Contents

U.S. MILITARY

 Army releases May 2013 suicide information

 Fighting military suicide: Can technology help?

 Incident diagnoses of common symptoms (“sequelae”) following traumatic brain injury, active 

component, U.S. Armed Forces, 2000-2012

 Initial testing at Fort Bliss bunker indicates 'safe' levels of radiation

 'Prolonged exposure' therapy may help vets with PTSD

 US survivors of military sexual assaults seek better treatment

 VA health care facilities named to 2013 “Most Wired” hospitals list

GLOBAL

 NIH study uncovers a starring role for supporting cells in the inner ear

 Pertussis vaccine only 'moderately effective' during outbreak

 Poll finds public a bit wary about taking anthrax pills

 Potential for the international spread of Middle East Respiratory Syndrome in association with 

mass gatherings in Saudi Arabia

 Social media spots a strep outbreak

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 Study: H7N9 highly transmissible by airborne route

VETERINARY/FOOD SAFETY

 FDA offers guidance on eggs from free-range hens

 Health risks from arsenic in rice exposed
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Biggs Bunker 

Complex Radiation

In this video, Fort Bliss PAO 

MAJ Joe Buccino and Army 

Public Health Command 

Physicist COL John Cuellar 

address the radiation in the 

Biggs Bunker Complex.

 New bat virus called closest known relative of MERS-CoV

 Stomach virus linked to produce sickens 285 people in 11 U.S. states

WELLNESS

 Decongestants in pregnancy linked to birth defects

 HPV virus 'linked to third of throat cancer cases'

 Mosquito-repelling bands and clip-on devices: Which work best

 Neighborhood planning increases impact of Community Transformation Grants

 Plain cigarette packs 'encourage smokers to quit'

 Risky supplements Jack3d and OxyElite voluntarily destroyed, following FDA crackdown on 

DMAA products

 Skipping breakfast may increase coronary heart disease risk

USAFRICOM

 Report finds gradual fall in female genital cutting in Africa

 Somalia: Polio eradication suffers a setback as Somali outbreak worsens

 Sudan: Measles kills four children in El Salam Camp, South Darfur

USCENTCOM

 Middle East respiratory syndrome coronavirus (MERS-CoV) – update

 Pakistan battles polio, and its people’s mistrust

 Risk from MERS virus "very low" for haj pilgrims: WHO

USEUCOM

 Spain: Re-emergence of leishmaniasis: community outbreak in Madrid, 2009 to 2012

 The Netherlands: Measles outbreak widens, reaches 600 cases

USNORTHCOM

 Canada: Big railways review safety rules after train disaster

 U.S.: Brooklyn measles outbreak shows risks

 U.S.: FDA eyes menthol in cigarettes

 U.S.: Federal judge halts new North Dakota abortion law, for now

 U.S.: Mental health parity rules coming soon

 U.S.: Milwaukee County reports 27 cases of Legionnaire's disease

 U.S.: Researchers trace novel Heartland virus to Missouri ticks

 U.S.: State-specific healthy life expectancy at age 65 years — United States, 2007–2009

USPACOM

 Australians are getting fatter

 China: Bribery serves as life-support for Chinese hospitals

 China: Drug research falls under a cloud

 China: Strong earthquake in western China kills at least 89

 India: Contaminated school meal kills 25 Indian children

USSOUTHCOM

 Colombia: Malaria - P. vivax, urban outbreak

 Honduras: Health Ministry confirms 15 deaths from dengue in Honduras
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July 28th is World 

Hepatitis Day: New 

Hepatitis Brochures

Brochures on Hepatitis B 

and Hepatitis C are 

available for download on 

the Health Information 

Products eCatalog.

U.S. MILITARY

Army releases May 2013 suicide information

18 July - The Army released suicide data today for the month of May 2013. During May, 

among active-duty soldiers, there were 12 potential suicides. None have been confirmed as 

suicides and 12 remain under investigation. For April 2013, the Army reported 11 potential 

suicides among active-duty soldiers: five have been confirmed as suicides and six are under 

investigation. For calendar year 2013, there have been 64 potential active-duty suicides: 31 

have been confirmed as suicides and 33 remain under investigation. Defense.gov

Fighting military suicide: Can technology help?

15 July - ...Last week, an initiative called The Durkheim Project

announced the availability of an opt-in veteran’s database that 

will analyze veterans’ social-media posts to identify suicide risk 

factors. The project is named in honor of Emile Durkheim, 

whose book, Suicide – published in 1897 — consisted of surveys 

and suicide statistical analysis that classified victims into categories, and found links 

between their daily actions and the likelihood of committing suicide. Phase One of The 

Durkheim Project, conducted with The Geisel School of Medicine at Dartmouth and the U.S. 

Department of Veterans Affairs, and completed in 2013, the predictive analytics and textmining technology methods used to power the database were statistically significant in 

predicting suicide-risk factors with 65% accuracy. Time

Incident diagnoses of common symptoms (“sequelae”) 

following traumatic brain injury, active component, U.S. 

Armed Forces, 2000-2012

June – 2013 - ...Given that the majority of traumatic brain injuries sustained by service 

members were not war-related (most service members in this analysis had no history of

deployment at the time of their injury), it seems unlikely that the observed increases in the 

proportion of individuals with diagnosed symptoms in the three time periods can be 

attributed to changes in combat operations. The sharp increase in the percentage of injured 

service members with post-TBI symptoms undoubtedly reflects increased awareness, more 

complete ascertainment, and broader reporting of current and past TBI cases. Medical 

Surveillance Monthly Report

Initial testing at Fort Bliss bunker indicates 'safe' levels of 

radiation

19 July - Test results of possible low-level radiation contamination of a weapons storage 

bunker at Fort Bliss, Texas, were normal, said an installation spokesman. No harmful levels 

of radiation were found inside the bunker, with the exception of low levels of alpha and 
4

Public Health 

Linkages with 

Sustainability -

Workshop Summary

The IOM hosted a 

workshop to consider the 

linkages between 

sustainability and health. 

Presentations emphasized 

the intersections between 

sustainability and 

toxicology, 

noncommunicable 

diseases, energy options 

and air quality, food and 

water resources, 

occupational and 

childhood health, and the 

role of climate change and 

urbanization across these 

topic areas. 

beta particles which are safely contained within the paint used in the bunker's interior, said 

Maj. Joe Buccino, Fort Bliss public affairs officer, during a press conference on the 

installation, July 19. The epoxy used in the paint effectively sealed the particles, preventing 

their release, he explained. No gamma particles, a more dangerous form of radiation, were 

detected in the paint or elsewhere, he added. Army Times

'Prolonged exposure' therapy may help vets with PTSD

17 July - Therapy that involves repeatedly processing painful memories and approaching 

anxiety-provoking situations in a safe way may ease symptoms of posttraumatic stress 

disorder (PTSD) among veterans, a new study suggests... One Veterans Affairs report 

showed that of about 830,000 veterans who were treated at VA medical centers over the 

last decade, 29 percent had a diagnosis of PTSD and 22 percent were depressed. In 2007, 

the VA launched a national initiative to train psychologists and social workers in prolonged 

exposure therapy. Every VA facility is now required to provide evidence-based treatments 

for PTSD, including prolonged exposure. Reuters

US survivors of military sexual assaults seek better 

treatment 

19 July - Four U.S. military veterans who are survivors of military sexual assaults testified 

Friday before a House of Representatives Veterans' Affairs subcommittee. They asked for 

better care and treatment for their trauma from the U.S. Veterans Administration. The U.S. 

Defense Department released a study in May estimating that as many as 26,000 military 

members were victims of sexual assault in the military last year. The Republican Chairman of 

the House Subcommittee on Health, Dan Benishek, broke that number down. "Last fiscal 

year there were roughly 71 incidents of sexual assault every single day among those who 

wear our uniform," said Benishek. Four veterans who were victims of sexual assault traveled 

to Washington, D.C., to tell lawmakers their story and to ask for changes in the way 

survivors are treated. VOA

VA health care facilities named to 2013 “Most Wired” 

hospitals list

22 July - The Department of Veterans Affairs, representing 152 VA medical centers, was 

recently named to the 2013 “Most Wired” hospitals list. The list, which is released by 

Hospitals & Health Networks, in partnership with McKesson, the College of Healthcare 

Information Management Executives (CHIME) and the American Hospital Association (AHA), 

is the result of a national survey aimed at ranking hospitals that are leveraging health 

information technology (HIT) in new and innovative ways.... Over the past year, VA has 

provided Veterans and VA health care teams with 21st century health care through the use 

of new and innovative technology. Some examples are: telehealth being used in Veterans 

homes as an adjunct to traditional face-to-face care; recent VA Blue Button enhancements

that allow improved access to critical patient medical information; deployment of asset 

tracking devices; the use of technology to better link specialty care providers to primary 

care physicians in rural areas. Department of Veterans Affairs

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GLOBAL

NIH study uncovers a starring role for supporting cells in 

the inner ear 

25 July - Researchers have found in mice that supporting cells in the inner ear, once thought 

to serve only a structural role, can actively help repair damaged sensory hair cells, the 

functional cells that turn vibrations into the electrical signals that the brain recognizes as 

sound. The study... reveals the rescuing act that supporting cells and a chemical they 

produce called heat shock protein 70 (HSP70) appear to play in protecting damaged hair 

cells from death. Finding a way to jumpstart this process in supporting cells offers a 

potential pathway to prevent hearing loss caused by certain drugs, and possibly by 

exposure to excess noise. NIH

Pertussis vaccine only 'moderately effective' during 

outbreak

19 July - Tetanus toxoid, reduced diphtheria toxoid, and reduced acellular pertussis (Tdap) 

vaccines are only moderately effective against pertussis in adolescents and adults, according 

to a BMJ case-control study that includes data from the large California outbreak of 2010...

The authors calculated a vaccine effectiveness of 53% using the PCR-negative controls, and 

64% using the population controls. Previous estimates of the vaccine's effectiveness were 

higher, but based on smaller sample sizes. The authors suggest that giving the Tdap 

booster to those who received only acellular vaccines as children would be one strategy to 

decrease the incidence of pertussis. Their findings, they say, "draw attention to the need for 

more effective vaccines." NEJM Journal Watch

Poll finds public a bit wary about taking anthrax pills

23 July - Federal officials have beefed up the nation's Strategic National Stockpile (SNS) with 

antibiotics to protect Americans in future anthrax attacks and public health plans are set for 

their distribution, but the public may not be willing to take the drugs, a new poll found... In 

an anthrax attack, federal response plans call for treating those at risk of Bacillus anthracis

spore exposure with a 60-day course of antibiotics, and also offering three doses of anthrax 

vaccine for longer-term protection against late-germinating spores... [H] health 

departments face a tall task in getting the medication to the public within the 

recommended 48-hour time frame, including the step of getting the public to come to the 

PODs... An overarching question about how likely the public would be to follow 

recommendations to pick up the pills from dispensing sites showed that 69% would be very 

likely and 21% would be somewhat likely. "Those are pretty good numbers," she said. 

CIDRAP
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Potential for the international spread of Middle East 

Respiratory Syndrome in association with mass 

gatherings in Saudi Arabia

17 July - Background: A novel coronavirus (MERS-CoV) causing severe, life-threatening 

respiratory disease has emerged in the Middle East at a time when two international mass 

gatherings in Saudi Arabia are imminent. While MERS-CoV has already spread to and within 

other countries, these mass gatherings could further amplify and/or accelerate its 

international dissemination, especially since the origins and geographic source of the virus 

remain poorly understood... Results: 16.8 million travelers flew on commercial flights out of 

Saudi Arabia, Jordan, Qatar, and the United Arab Emirates between June and November 

2012, of which 51.6% were destined for India (16.3%), Egypt (10.4%), Pakistan (7.8%), the 

United Kingdom (4.3%), Kuwait (3.6%), Bangladesh (3.1%), Iran (3.1%) and Bahrain (2.9%). 

Among the 1.74 million foreign pilgrims who performed the Hajj last year, an estimated 

65.1% originated from low and lower-middle income countries. Conclusion: 

...Understanding global population movements out of the Middle East through the end of 

this year’s Hajj could help direct anticipatory MERS-CoV surveillance and public health 

preparedness to mitigate its potential global health and economic impacts. PLOS

Social media spots a strep outbreak

18 July - An alert parent who noticed postings about multiple cases of severe sore throat on 

Facebook helped the Minnesota public health authorities identify a foodborne outbreak of 

group A Streptococcus pharyngitis, according to a new report. Within days of a banquet 

given for an all-female high school dance team attended by 63 people, a parent notified the 

public health department of a cluster of cases of strep throat described on the team's 

Facebook page, Sarah K. Kemble, MD, of the Minnesota Department of Health, and 

colleagues reported. A total of 18 primary cases ultimately were confirmed, for an attack 

rate of 29%, the researchers reported online in Clinical Infectious Diseases. MedPage Today

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 28, 5.3% of all deaths reported through the 122-Cities Mortality Reporting 

System were due to pneumonia and influenza. This percentage was below the epidemic 

threshold of 6.4% for week 28. FluView
7

DoD Global Laboratory-Based Influenza Surveillance 

Program

Respiratory Highlights for 1-30 June 2013 (Surveillance Weeks 23-26)

 During the month of June, 42 specimens were received from 23 locations. Results were 

finalized for 40 specimens from 22 locations. There was one A(H3N2), one influenza B, 

two adenoviruses, one enterovirus, and two parainfluenzas detected (see Table 1). 

 To date this influenza season, 3,832 specimens have completed testing from 82 

locations, of which 1,077 were positive for influenza A (957 A(H3N2), 110 

A(H1N1)pdm09, five co-infections, and five A/not subtyped). 

 To date this influenza season, 378 specimens were positive for influenza B. Of these, 

there were 71 B/Yamagata, 19 B/Victoria, and two B & enterovirus co-infections. The 

lineage is pending or unknown for 286 specimens. 

 There have been 268 other respiratory viruses isolated (69 adenovirus, 91 RSV, 96 

parainfluenza, and 12 enterovirus) cumulatively this season. USAF School of Aerospace 

Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

For weeks 27-28/2013:

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

reported by almost all reporting countries. 

 Four countries tested 16 sentinel specimens, none of which were positive for influenza 

virus. 

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

21/2013.

Influenza activity has been low in Europe since week 21/2013. Weekly Influenza Surveillance 

Overview

Google.org: Flu Trends

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

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

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

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 20 July 2013:

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

basic trainees.
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 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

Study: H7N9 highly transmissible by airborne route

18 July - Chinese researchers who did extensive work on H7N9 viruses from birds and 

humans found that one of the human strains was highly transmissible by aerosol droplets in 

ferrets, fueling more concerns that the new virus could spread between people. The 

potential for aerosol spread is one of the key factors health officials use in gauging a new 

virus's pandemic potential, and the new study follows closely on the heels of two others 

that also found evidence of respiratory droplet transmission in ferrets. CIDRAP

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VETERINARY/FOOD SAFETY

FDA offers guidance on eggs from free-range hens

23 July - Proposed guidance released by the US Food and Drugs Administration (FDA) today 

suggests the use of measures such as high walls and netting to limit Salmonella Enteritidis 

(SE) contamination of eggs from hens that have access to the outdoors. The FDA said the 

guidance outlines "practical and reasonable safety controls" to help egg producers comply 

with the agency's 4-year-old Egg Safety Rule. In an e-mailed statement, the FDA said that to 

help develop the guidance, officials visited a number of farms to observe a range of laying 

operations with various poultry house designs and field conditions. CIDRAP

Health risks from arsenic in rice exposed

22 July - High levels of arsenic in rice have been shown to be associated with elevated 

genetic damage in humans, a new study has found. Over the last few years, researchers 

have reported high concentrations of arsenic in several rice-growing regions around the 

world. Now, University of Manchester scientists, working in collaboration with scientists at 

CSIR-Indian Institute of Chemical Biology in Kolkata, have proven a link between rice 

containing high levels of arsenic and chromosomal damage, as measured by micronuclei in 

urothelial cells, in humans consuming rice as a staple... Increased frequency of these 

micronuclei has been shown by other groups to be linked to the development of cancers. 

EurekAlert
9

New bat virus called closest known relative of MERS-CoV

24 July - The view that MERS-CoV (Middle East respiratory 

syndrome coronavirus) originated in bats gathered steam today 

with the report that a new coronavirus (CoV) found in the feces of a 

South African bat is more closely related to MERS-CoV than any 

other known virus. The study, published as a letter in Emerging 

Infectious Diseases, doesn't solve the mystery of what animal is passing MERS-CoV to 

humans. But the authors, from the University of Bonn, Germany, and several South African 

institutions, say the findings suggest that ancestors of the human virus evolved in African 

bats. CIDRAP

Stomach virus linked to produce sickens 285 people in 11 

U.S. states

25 July - At least 285 people in 11 states have been sickened by a parasitic infection 

commonly linked to fresh produce, and the exact cause of the outbreak has yet to be 

pinpointed, the U.S. Centers for Disease Control and Prevention said on Thursday. Most of 

the cyclospora infections have been clustered in the Midwest, with 138 cases reported in 

Iowa and 70 in neighboring Nebraska. The remainder have been identified in Texas, 

Georgia, Wisconsin, Connecticut, Illinois, Kansas, Minnesota, New Jersey and Ohio. The 

cause of the illness has not yet been identified, but the parasite is most commonly found in 

fresh produce, including fruits, vegetables and herbs, grown in tropical and subtropical 

regions, according to Dr. Barbara Herwaldt, a medical epidemiologist at the CDC. Reuters

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WELLNESS

Decongestants in pregnancy linked to birth defects

22 July - A woman's use of decongestant medications in the first trimester of pregnancy 

may raise her child's risk of certain rare birth defects, according to a small study. Some types 

of over-the-counter decongestants, including the popular phenylephrine and 

pseudoephedrine, were individually linked to rare, specific birth defects of the digestive 

tract, ear and heart. Reuters

HPV virus 'linked to third of throat cancer cases'

20 July - One third of people diagnosed with throat cancer are infected with a form of the 

HPV virus, a study suggests. HPV (human papillomavirus) is the major cause of cervical 

cancer, and the virus is known to spread through genital or oral contact... There are two 

HPV strains which are most likely to cause cancer - HPV-16 and HPV-18. HPV-16 is thought 
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to be responsible for around 60% of cervical cancers, 80% of cancers in the anus and 60% of 

oral cancers. BBC News

Mosquito-repelling bands and clip-on devices: Which 

work best

22 July - The Ache: The most effective way to avoid bug bites is wearing 

mosquito repellent with Deet, entomologists say. But many people want 

to avoid applying chemical repellents directly to their skin. And 

mosquito repellent has to be reapplied after swimming or sweating a 

lot. The Claim: Wristbands and devices that clip to a belt or beach chair 

can repel mosquitoes by diffusing natural or chemical repellents in the 

air. The Verdict: Several studies—including a recently published eightperson study of several products—show that the best of the wearable 

devices can significantly reduce the number of mosquitoes that land on the skin or bite. 

Wall Street Journal

Neighborhood planning increases impact of Community

Transformation Grants

23 July - ...[T]he Community Transformation Grant program, or CTGs, [is] a series of 

community-based grants implemented to improve the health of more than four of 10 U.S. 

citizens... Through a recent neighborhood plan, the city of Fort Worth assigned separate 

task forces to improve education, public transit, employment, urban development, health 

and wellness, arts and homelessness rates. Its plan has defined goals, such as a 50 percent 

increase in city bikeways by 2016 and a restaurant health inspection passing rate of 95 

percent. Before and after pictures of Crockett Street in Fort Worth show the impact of the 

city’s neighborhood planning: dormant only five years ago, the street is now booming with 

thriving businesses and busy sidewalks. Public Health Newswire

Plain cigarette packs 'encourage smokers to quit'

22 July - Selling cigarettes in unbranded packs seems to make tobacco less appealing and 

encourages smokers to quit, suggests a study. The work comes from Australia - the first 

country to introduce plain packaging. The BMJ Open research looked at the impact of the 

policy on 536 smokers in the state of Victoria... Researchers polled a sample of smokers 

during November 2012 when plain packs were already available in the run up to the 

country-wide introduction of the legislation. Almost three out of four (72.3%) were smoking 

cigarettes from plain packs while the remainder (27.7%) were still using branded packs with 

smaller health warnings. Compared with branded pack smokers, smokers using plain packs 

were 66% more likely to think their cigarettes were poorer quality than a year ago and they 

were 70% more likely to say they found them less satisfying. BBC News
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Risky supplements Jack3d and OxyElite voluntarily 

destroyed, following FDA crackdown on DMAA products

17 July - Two popular sport supplements, Jack3d and OxyElite, have been voluntarily 

destroyed by their manufacturer following the Food and Drug Administration's (FDA) 

increasing pressure to remove the stimulant dimethylamylamine (DMAA) from the products' 

ingredients. The stimulant DMAA is not a proper amphetamine, but the FDA warns people 

of the extreme health risks associated with its consumption. Manufacturers claim the 

stimulant is all-natural, likening it to caffeine; however, the FDA claims it can "elevate blood 

pressure and lead to cardiovascular problems ranging from shortness of breath and 

tightening in the chest to heart attack," according to a recent statement. Medical Daily

Skipping breakfast may increase coronary heart disease 

risk

22 July - Here's more evidence why breakfast may be the most important meal of the day: ... 

Men who reported they skipped breakfast had a 27 percent higher risk of heart attack or 

death from coronary heart disease than those who reported they didn't. The men who 

reported not eating breakfast were younger than those who did, and were more likely to be 

smokers, employed full time, unmarried, less physically active and drank more alcohol. 

EurekAlert

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USAFRICOM

Report finds gradual fall in female genital cutting in 

Africa

22 July - A comprehensive new assessment of the ancient practice of female genital cutting 

by the United Nations Children’s Fund has found that it is gradually declining in many 

countries, even some where it remains deeply entrenched. The authors of the report, 

released Monday, describe the practice as “remarkably tenacious, despite attempts 

spanning nearly a century to eliminate it.” But they also say teenage girls are now less likely 

to have been cut than older women in more than half of the 29 countries in Africa and the 

Middle East where it is concentrated. In Egypt, where more women have been cut than in 

any other nation, 81 percent of 15- to 19-year-olds have undergone the practice, compared 

with 96 percent of women in their late 40s. New York Times
12

Somalia: Polio eradication suffers a setback as Somali

outbreak worsens

20 July - Somalia hadn't had a case of polio for nearly six 

years. But in the past few months, the virus has come back. 

Now the East African country has the worst polio outbreak 

anywhere in the world. Twenty new cases of polio were 

reported this week in Somalia by the Global Polio 

Eradication Initiative. That brings the total number of cases in the Horn of Africa to 73. The 

rest of the world combined has tallied only 59 cases so far this year. Health workers are 

worried that the virus could gain a foothold in the Horn of Africa and jeopardize the 

multibillion-dollar effort to wipe out the virus worldwide... Part of the problem, he says, is 

that the majority of children in Somalia have never been immunized against polio. "We have 

an outbreak in a population that has been quite vulnerable for quite some time," Yusuf says.

NPR

Sudan: Measles kills four children in El Salam Camp, 

South Darfur

22 July - Four children have died of measles in El Salam camp for the displaced near Nyala, 

capital of South Darfur, and there are threats the camp "might have to be dismantled". 

Speaking to Radio Dabanga on Friday, Sheikh Mahjoub Adam Tabaldiya attributed the 

children's deaths a lack of medicine, health care and a food shortage at the camp. Sheikh 

Tabaldiya reiterated that "the displaced are going through very difficult humanitarian and 

heath circumstances, especially children, women and the elderly". He warned that "the camp 

might be dismantled from lack of food, medicine and due to organisations' stoppage of 

food provision to displaced people," the sheikh said, appealing to the authorities and 

humanitarian NGOs to urgently provide food for the displaced. allAfrica

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USCENTCOM

Middle East respiratory syndrome coronavirus (MERSCoV) – update

21 July - WHO has been informed of two additional laboratory-confirmed cases of Middle 

East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia. Both the cases 

are currently critically ill and hospitalized in ICUs. The first case is a 41-year-old Saudi male 

in Riyadh who presented to the hospital with symptoms on 15 July. The second patient is a 

59-year-old Saudi female in the Al-Ahsa governorate. She presented with symptoms on 11 

July. Both patients have underlying medical conditions, but neither patient has had contact 
13

with known MERS-CoV confirmed cases or animals... Globally, from September 2012 to 

date, WHO has been informed of a total of 90 laboratory-confirmed cases of infection with 

MERS-CoV, including 45 deaths. WHO

Pakistan battles polio, and its people’s mistrust

21 July - ...Anger ...over American foreign policy has led to a disastrous setback for the 

global effort against polio. In December, nine vaccinators were shot dead here, and two 

Taliban commanders banned vaccination in their areas, saying the vaccinations could 

resume only if drone strikes ended. In January, 10 vaccinators were killed in Nigeria’s 

Muslim-dominated north. Since then, there have been isolated killings — of an activist, a 

police officer and vaccinators — each of which has temporarily halted the campaign. The 

war on polio, which costs $1 billion a year and is expected to take at least five more years, 

hangs in the balance... But the real urgency to finish the job began earlier, for a very 

different reason. Two years ago, India, Pakistan’s rival in everything from nuclear weapons 

to cricket, eliminated polio. “Nothing wounded our pride as much as that,” said Dr. Zulfiqar 

A. Bhutta, a vaccine expert at Aga Khan University’s medical school. New York Times

Risk from MERS virus "very low" for haj pilgrims: WHO

25 July - The risk from a new Middle East respiratory virus for millions of Muslims planning 

to go to the annual haj pilgrimage in Saudi Arabia is very low and there is no need for 

pilgrims to be screened, the World Health Organisation said on Thursday. While it 

encouraged countries to raise awareness about the virus to help reduce the risk of the virus 

spreading among pilgrims, the U.N. health agency said it would not be recommending any 

travel or trade restrictions. Reuters

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USEUCOM

Spain: Re-emergence of leishmaniasis: community 

outbreak in Madrid, 2009 to 2012

25 July - Since July 2009, there has been a community outbreak of leishmaniasis in the 

south-west area of the Madrid autonomous community, Spain, affecting residents from four 

towns that are geographically close together and share extensive park areas. As of 

December 2012, 446 cases were reported (6 in 2009, 97 in 2010, 196 in 2011 and 147 in 

2012), a mean incidence rate of 22.2 per 100,000 inhabitants during July 2009 and 

December 2012. The mean age was 44 years (range: 2 months to 95 years); 61.0% were 

male. A total of 68 (15.2%) had immunosuppressive conditions; 160 (35.9%) had visceral 

leishmaniasis and 286 (64.1%) cutaneous. A total of 421 (94.4%) cases were confirmed. 

Leishmania infantum was identified as the agent. Monitoring revealed high densities of the 

vector Phlebotomus perniciosus. The surveillance system for canine leishmaniasis did not 

detect any increase in prevalence during the period. Eurosurveillance
14

The Netherlands: Measles outbreak widens, reaches 600 

cases

25 July - A further 147 cases of measles were reported last week, bringing the total to 613, 

the public health institute RIVM said on Thursday. The outbreak, which began in May, has 

also spread to four new local authority health services, including Utrecht and The Hague. 

Among the new cases are two healthcare workers who probably contracted the disease 

during their work. Several hospitals in the affected regions and with low take-up of 

vaccination are now taking preventative measures. DutchNews.nl

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USNORTHCOM

Canada: Big railways review safety rules after train 

disaster

18 July - Canada's two big railroads are set to strengthen their safety measures following 

the deadly train crash on July 6 that killed some 50 people and destroyed the center of a 

small Quebec town. Canadian Pacific Railway Ltd, Canada's No. 2 operator, said on Thursday 

it has already made some changes to its operating rules. These include a ban on parking 

unattended trains that contain hazardous materials on main lines and tougher rules on 

setting the brakes that hold a stationary train in place. The runaway crude-oil train that 

smashed into Lac-Megantic, Quebec, had been parked on a main line after the engineer, its 

only crew member, finished his shift. The train, operated by the small Montreal Maine & 

Atlantic Railway, rolled down the track, derailed in the center of the lakeside town, and 

exploded. Reuters

U.S.: Brooklyn measles outbreak shows risks

19 July - A measles outbreak in Brooklyn, N.Y., this year shows how easily one of the most 

contagious diseases leaps hemispheres. In March, New York City health authorities saw a 

sudden rise in measles cases in several densely populated Orthodox Jewish communities. 

The disease quickly spread. Among the 58 measles cases reported thus far, a child 

contracted pneumonia and two pregnant women were hospitalized, according to the New 

York City Department of Health and Mental Hygiene. One of the women had a miscarriage. 

The department traced the outbreak to a person who it concluded brought the virus from a 

trip to London, says Jay Varma, the department's deputy commissioner for disease control. 

Overall, vaccination rates are high in the communities, he says, but the outbreak then 

started in a small group of families with members who refused vaccines, he says. Wall Street 

Journal
15

U.S.: FDA eyes menthol in cigarettes

24 July - The FDA has taken an initial step toward regulating -- and possibly banning -- the 

use of menthol in cigarettes... Accompanying the announcement was an FDA-authored, 

preliminary evaluation of the scientific evidence on the effects of menthol in cigarettes. The 

bulk of the evidence did not support an increase in toxicity or disease with the addition of 

menthol, although menthol was associated with increased initiation and greater progression 

to regular smoking, increased dependence, and reduced success in quitting, particularly 

among black smokers. MedPage Today

U.S.: Federal judge halts new North Dakota abortion law, 

for now

22 July - A federal judge on Monday temporarily blocked North Dakota's new abortion law, 

the most restrictive in the country because it prohibits ending a pregnancy once a fetal 

heartbeat can be detected, which can be as early as six weeks after conception. Banning 

abortions as early as six weeks, or before fetal viability between 24 and 26 weeks of 

gestation, would bar nearly 90 percent of the abortions performed at the Red River 

Women's Clinic, the state's only abortion clinic, said its director, Tammi Kromenaker. U.S. 

District Court Judge Daniel Hovland, in granting a preliminary injunction in response to a 

lawsuit filed by the clinic, wrote that the new law "is clearly an invalid and unconstitutional 

law based on the United States Supreme Court precedent in Roe v. Wade from 1973."

Reuters

U.S.: Mental health parity rules coming soon

24 July - The Obama administration will release in a few months final rules implementing 

the 2008 mental health parity law, a former Congressman said Wednesday. The law -- the 

Mental Health Parity and Addiction Equity Act -- states that health plans must cover the 

treatment of mental illness or drug or alcohol abuse at the same level as they cover other 

healthcare treatment. But full scale-up of the law has been delayed because rules haven't 

been issued outlining treatment limits for some nonquantitative services -- rules that would 

define exactly how mental health services are comparable to physical medical care.

MedPage Today

U.S.: Milwaukee County reports 27 cases of Legionnaire's 

disease

25 July - A late start to summer weather in the Upper Midwest may be linked to an outbreak 

of 27 cases of Legionnaire's disease in Milwaukee County since June 1 of this year, a health 

official said on Thursday. The outbreak includes 19 cases of the illness, a severe form of 

pneumonia, among Milwaukee residents, according to the city's health department. Two 

other county cases are suspected. Reuters
16

U.S.: Researchers trace novel Heartland virus to Missouri 

ticks

22 July - Researchers have solved part of a medical mystery about a new virus that infected 

two Missouri men in 2009, confirming the pathogen in lone star ticks near where the 

patients were infected, then hospitalized, after they were bitten by ticks, according to a 

study today... Henry Savage, PhD, lead author of the study and research entomologist at the 

CDC division of vector-borne diseases in Fort Collins, Colo., said in an ASTMH press release 

that 10 tick samples were positive for Heartland virus, 9 from the property of one of the 

patients and 1 from nearby conservation lands... The new tick disease stands apart from 

others such as Lyme, ehrlichiosis, and Rocky Mountain spotted fever because it is caused by 

a virus rather than bacterium and does not respond to antibiotics. CIDRAP

U.S.: State-specific healthy life expectancy at age 65 years

— United States, 2007–2009

19 July - Healthy life expectancy (HLE) is a population health measure that combines 

mortality data with morbidity or health status data to estimate expected years of life in 

good health for persons at a given age... during 2007–2009, females had a greater HLE than 

males at age 65 years in every state and DC. HLE was greater for whites than for blacks in all 

states from which sufficient data were available and DC, except in Nevada and New Mexico.

These results can be used as a baseline for states to monitor changes in the HLE of persons 

aged 65 years as they age and identify health disparities among subpopulations. Morbidity 

and Mortality Weekly Report

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USPACOM

Australians are getting fatter

25 July - Around the world, Australia may be known for its 

rugged outdoor lifestyles. But recent statistics suggest a 

different reality. Australia and its equally outdoorsy neighbor, 

New Zealand, are now two of the fattest countries in the 

developed world. Obesity rates in the two countries have 

tripled in the last three decades, mirroring the sharp rise that occurred in the United States 

during roughly the same period. In Australia, at least 60 percent of adults and roughly a 

quarter of children are overweight or obese. A United Nations report this month showed 

that Mexico and the United States, in that order, lead the developed world in obesity. But 

Australia and New Zealand were only slightly behind. New York Times
17

China: Bribery serves as life-support for Chinese 

hospitals

23 July - Bribery is the lubricant that helps keep China's public hospitals running, and the 

health system would struggle to function without illegal payments to poorly paid doctors 

and administrators, say medical practitioners and industry experts. They say government 

policies are partly to blame for a system in which doctors and other staff expect to be paid 

extra fees to perform operations and take kickbacks from pharmaceutical firms and 

medical-equipment suppliers. The profession's ugly underbelly was exposed last week when 

police accused British drugmaker GlaxoSmithKline of bribing officials and doctors for six 

years to boost sales and the price of its medicines. GSK has called the developments 

"shameful" and on Monday said some of its Chinese executives appeared to have broken 

the law. Reuters

China: Drug research falls under a cloud

22 July - Executives at the British drug maker GlaxoSmithKline were warned nearly two years 

ago about critical problems with the way the company conducted research at its drug 

development center in China, exposing it to potential financial risk and regulatory action, an 

internal audit found. The confidential document from November 2011, obtained by The 

New York Times, suggests that Glaxo’s problems may go beyond the sales practices that are 

currently at the center of a bribery and corruption scandal in China. They may extend to its 

Shanghai research and development center, which develops neurology drugs for Glaxo. The 

failings, some experts said, underscore the problems that can arise when major drug

companies export their scientific development to emerging markets like China. New York 

Times

China: Strong earthquake in western China kills at least 

89

23 July - An earthquake rocked a rural, semi-arid area of 

northwestern China's Gansu province on Monday, killing at least 

89 people and injuring hundreds more. Another five people were 

listed as missing and 628 injured in the quake near the city of 

Dingxi in Gansu province. About 123,000 people were affected by 

the quake, with 31,600 people moved to temporary shelters, the provincial earthquake 

administration said on its website. The first and strongest of a series of tremors struck at 

7:45 a.m. Beijing time south of Dingxi, about 770 miles west of Beijing, toppling farmers' 

one-story homes and severing power lines. Nearly 2,000 homes were destroyed and about 

22,500 damaged, the provincial government said. USA Today

India: Contaminated school meal kills 25 Indian children

17 July - At least 25 Indian children died and dozens needed hospital treatment after 

apparently being poisoned by a school meal, sparking violent protests and angry 
18

allegations of blame. The children aged four to 12 fell ill on Tuesday after consuming a 

lunch of rice, soybean and lentils in the impoverished eastern state of Bihar. The school, at 

Mashrakh village in the district of Chapra, provided free meals under the Mid-Day Meal 

Scheme, the world's largest school feeding program involving 120 million children. Medical 

teams treating the children said they suspected the food had been contaminated with 

insecticide. Reuters

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USSOUTHCOM

Colombia: Malaria - P. vivax, urban outbreak

24 July -...The latest report of the Department of Health... confirmed the increase to 5, of the 

malaria cases detected [in Colombiatón] this week. Thanks to early detection tests 

performed by officials in the district since Saturday, said Jorge coordinator of the direction 

of Environment and Health two people were diagnosed within the parasite incubation 

period. ProMED-mail

Honduras: Health Ministry confirms 15 deaths from 

dengue in Honduras

23 July - ...The Minister of Health, Salvador Pineda, said Tuesday during the Council of 

Ministers dengue deaths totaled certified 15, two more since the last official report... Pineda 

explained that "there are currently 11,000 reported cases of dengue fever... Moreover, to 

date there have been 1,838 reported cases of severe dengue or hemorrhagic throughout 

Honduras. According to official data, 152 of the 298 municipalities have a high incidence of 

dengue cases, with special focus on 37 communities where the situation is serious, as it has 

nearly double the average case of the last five or six years. El Heraldo (translation from

Google Translate)

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19

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