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22 March 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

 After the battle - how caregivers cope

 Chlamydia trachomatis screening initiative among U.S. Army soldiers assigned to Korea

 Combat soldiers more likely to commit violent crimes: study

 Eye doctors teach combat trauma management

 Gulf War Illness linked to physical changes in brain fibers that process pain

 Military mental health’s wins and losses since the Iraq invasion

 Nevada military depot blast kills seven Marines, hurts seven more

GLOBAL

 Agencies warn of global TB "powder keg", funding gap

 Device keeps liver "alive" outside body in medical first

 Early HIV drugs 'functionally cure about one in 10'

 Measles contagious on planes, study reports

 Test of anthrax vaccine in children gets tentative OK

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 Drug-resistant pandemic swine flu 'community risk'

 Most infected on Navy ship during 2009 H1N1 outbreak had no symptoms

VETERINARY/FOOD SAFETY

 Genetically modified seafood: Whole Foods, Trader Joe's and others vow not to sell GMO fish
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U.S. Health in 

International 

Perspective 

Shorter Lives, 

Poorer Health

The report examines the 

nature and strength of the 

research evidence on life 

expectancy and health in 

the United States, 

comparing U.S. data with 

statistics from 16 “peer” 

countries—other highincome democracies in 

western Europe, as well as 

Canada, Australia, and 

Japan. 

For many years, Americans 

have been dying at 

younger ages than people 

in almost all other highincome countries. This 

disadvantage has been 

getting worse for three 

decades, especially among 

women. 

 New spray product takes aim at Salmonella on poultry

 U.K.: Cryptosporidium outbreak sickened 300 last year

 USDA set to ban slaughter of sick downer veal calves, Humane Society says

WELLNESS

 Biennial mammograms best after 50, even for women with dense breasts

 Doctors urge F.D.A. to restrict caffeine in energy drinks

 Government changes course on graphic cigarette warnings

 How a healthy heart can lower risk of cancer

 Mississippi forbids local laws on nutrition, super-size drinks

 Sugary drinks may explain 180,000 deaths worldwide each year

 Vitamin D may lower blood pressure in blacks

USAFRICOM

 Cholera outbreak in Congo

 South Africa: 61 Cape children stung by bees

USCENTCOM

 Afghans help locals with medical treatment

 Surgeons struggle in Iran as sanctions squeeze drug supplies

USEUCOM

 U.K.: 97 percent of UK doctors have given placebos to patients at least once

 UK air pollution: why are we only now waking up to this public health crisis?

USNORTHCOM

 U.S.: Autism estimates climb to one in 50 school-age children

 U.S.: Deaths from Alzheimer's growing, data shows

 U.S.: Food stamps put Rhode Island town on monthly boom-and-bust cycle

 U.S.: Hundreds checked for rabies after transplant death

 U.S: With meth-contaminated homes, it's buyer beware

 U.S.: Trends in tuberculosis — United States, 2012

USPACOM

 Bali: Tourists warned of Bali health risk as dengue fever infections increase

 India: Measles claims life of 20 children in Sindh

 Japan: Record radiation level found in fish near Japan nuclear plant

 Philippines’ reproductive health law here - now what?

 Thailand: Dengue count stands at 13,200 cases

USSOUTHCOM

 Colombia: Hepatitis A

 Paraguay has the highest rate of fatality from dengue in South America
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Focus on the 

Treatment of STDs 

in Military 

Populations 2010 

STD Treatment 

Guidelines Webinar 

This live webinar is for 

clinicians who provide care 

for military populations. 

The webinar will begin with 

an overview of the 

epidemiology of STDs 

followed by a discussion of 

the critical diagnostic and 

management challenges 

for specific STDs of 

concern for this 

population. 

March 27, 2013

12 pm – 1:30 pm ET

Register for webinar

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the Weekly Update

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Weekly Update is available 

with articles classified up to 

the SECRET level from the 

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http://phc.army.smil.mil

Look under Hot Topics & 

Current Issues.

To access this version, you 

will need a SECRET

clearance and a SIPRNet 

account.

U.S. MILITARY

After the battle - how caregivers cope

16 March - ...The stress of taking care of a wounded service member can impact caregivers' 

own health, said Elissa Epel, an associate professor of psychiatry at UCSF. She has studied 

parents with sick children and adults caring for ailing parents or spouses, and said that 

about half of the caregivers showed depressive symptoms. The stress has also been found 

to trigger early cellular aging, Epel said, and studies have shown that caregivers even heal 

more slowly from injury. "There's a personal price for families, and women of course take on 

this burden more," she said. Physical exercise can buffer some of the stress-induced aging, 

Epel said, and social support can protect caregivers from some of the negative effects of 

their assumed role. San Francisco Chronicle

Chlamydia trachomatis screening initiative among U.S. 

Army soldiers assigned to Korea

February 2013 - During November 2007 to January 2010, 17,735 soldiers were screened for 

CT infections; 17,546 had evaluable test results and 742 (4.2%) tested positive. The majority 

(71.0%) of testing was performed in 2009 when screening was conducted among both 

males and females. During 2009, 478 (3.8%) of 12,588 tests were positive. Relative to their 

respective counterparts, CT infection prevalences were higher among women (5.8%), 

soldiers under 20 years of age (5.7%), black, non-Hispanic soldiers (7.0%), and enlisted 

members (4.2%). Prevalences among women less than 20 years of age and women 20-24 

years old were 12.6 percent and 7.2 percent, respectively; prevalences among men in the 

comparable age groups were 3.9 percent and 4.7 percent. Medical Surveillance Monthly 

Report

Combat soldiers more likely to commit violent crimes: 

study

15 March - British soldiers who have served in Iraq and Afghanistan - particularly young 

men and those who have seen active combat - are more likely to commit violent crimes 

than their civilian counterparts, according to research published on Friday. The study of 

almost 14,000 British soldiers deployed to Iraq and Afghanistan is the first to examine the 

link between military service and violent crime by using official criminal records. Researchers 

said the findings could help military officials improve their risk assessment of violence 

among serving and ex-military personnel. Reuters
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Eye doctors teach combat trauma management

18 March - ...Ocular trauma accounted for less than 1 percent of 

total battle injuries in the Civil War, and increased incrementally 

through World Wars I and II. The rate of combat ocular trauma 

more than doubled by the Korean War, and rose steadily to reach 

13 percent by Operation Desert Storm. "In recent conflicts, 

combat ocular trauma stabilized in the 10 to 15 percent range. A lot of that may be due to 

eye protection which has been widely implemented.” Army.mil

Gulf War Illness linked to physical changes in brain 

fibers that process pain

20 March - Researchers at Georgetown University Medical Center (GUMC) have found what 

they say is evidence that veterans who suffer from "Gulf War Illness" have physical changes 

in their brains not seen in unaffected individuals. Brain scans of 31 veterans with the illness, 

compared to 20 control subjects, revealed anomalies in the bundles of nerve fibers that 

connect brain areas involved in the processing and perception of pain and fatigue. The 

discovery, published online March 20 in PLOS ONE, could provide insight into the 

mysterious medical symptoms reported by more than one-fourth of the 697,000 veterans 

deployed to the 1990-1991 Persian Gulf War, the researchers say. These symptoms, termed 

Gulf War Illness, range from mild to debilitating and can include widespread pain, fatigue, 

and headache, as well as cognitive and gastrointestinal dysfunctions. Science Daily

Military mental health’s wins and losses since the Iraq 

invasion

19 March - Looking back, 10 years after we pushed into Iraq, how have we done? Let us 

start out by reviewing some of the improvements:

– Better screening for Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), 

including screening on the Post Deployment Health Re-Assessment (PDHRA, fielded in 

2005) and the Periodic Health Assessment (PHA, fielded in 2009).

– More education and screening about PTSD, TBI and suicide, with numerous efforts really 

beginning in 2007; there is a plethora of products available for service members, families 

and clinicians. Time

Nevada military depot blast kills seven Marines, hurts 

seven more

19 March - A mortar explosion at a U.S. Army munitions depot in Nevada killed seven 

Marines from Camp Lejeune, North Carolina, and injured seven other service members 

during a live-fire training exercise, military officials said on Tuesday. A Marine Corps official 

said a 60mm mortar round exploded prematurely Monday night during training at the 

Hawthorne Army Depot in western Nevada. The cause was under investigation. Reuters

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GLOBAL

Agencies warn of global TB "powder keg", funding gap

18 March - Deadly strains of tuberculosis that are resistant to multiple drugs are spreading 

around the world, and authorities urgently need another $1.6 billion a year to tackle them, 

global health officials said on Monday. Donors should step up with "significant funding" to 

help experts track down all existing cases and treat the most serious ones, the World Health 

Organization (WHO) and the Global Fund to Fight AIDS, TB and Malaria said in joint 

statement. Margaret Chan, WHO director general, said nearly 4 percent of people newly 

infected with TB worldwide were resistant to multiple drugs from the start - signaling that 

resistant forms of the disease were being transmitted directly from person to person. 

Reuters

Device keeps liver "alive" outside body in medical first

15 March - A donated human liver has been kept alive, warm and functioning outside a 

human being on a newly-developed machine and then successfully transplanted into 

patients in a medical world first. A British team of doctors, engineers and surgeons 

announcing the achievement on Friday said it could be common practice in hospitals across 

the developed world within a few years, up to doubling the number of livers available for 

transplant. So far the procedure has been performed on two patients on Britain's liver 

transplant waiting list and both are making excellent recoveries, the medical team told a 

news conference. Reuters

Early HIV drugs 'functionally cure about one in 10'

15 March - Rapid treatment after HIV infection may be 

enough to "functionally cure" about a 10th of those 

diagnosed early, say researchers in France. They have been 

analysing 14 people who stopped therapy, but have since 

shown no signs of the virus resurging. It follows reports of a 

baby girl being effectively cured after very early treatment in the US. However, most people 

infected with HIV do not find out until the virus has fully infiltrated the body. The group of 

patients, known as the Visconti cohort, all started treatment within 10 weeks of being 

infected. The patients were caught early as they turned up in hospital with other conditions 

and HIV was found in their blood. They stuck to a course of antiretroviral drugs for three 

years, on average, but then stopped. BBC

Measles contagious on planes, study reports

20 March - Measles can be spread on planes in rows far beyond infected passengers, a 

Australian study showed Wednesday, raising questions over control guidelines for the 

disease. Australian policy, which is similar to that of the United States and Europe, calls for 

travellers seated in the same row, and in two rows in front of and two rows behind the 
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patient, to be contacted. But new research... shows that this approach may be missing half 

of the cases transmitted on flights... [I]n those cases where an infection was transmitted, it 

took an average of eight days before the patient was diagnosed... By this time, the window 

in which to administer a vaccine or other preventative medical help had been lost, Dowse 

said... "And despite the policy, more than half the secondary cases that are going to occur 

are seated outside the two rows." Medical Xpress

Test of anthrax vaccine in children gets tentative OK

19 March - A presidential ethics panel has opened the door to testing an anthrax vaccine on 

children as young as infants, bringing an angry response from critics who say the children 

would be guinea pigs in a study that would never help them and might harm them. The 

report, however, released on Tuesday by the Presidential Commission for the Study of 

Bioethical Issues, said researchers would have to overcome numerous hurdles before 

launching an anthrax-vaccine trial in children. It now goes to Secretary of Health and 

Human Services Kathleen Sebelius, who will decide whether to take the steps the 

commission recommended. Reuters

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INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

 In Week 10 (through 09 March 2013), ILI and Pneumonia and Influenza (P&I) incidence 

rates continued to decrease or remain the same in all regions this week. Percents of 

outpatient visits due to ILI continued to be above previous season percents for all 

populations except US Service members and PACOM other beneficiaries. 

 Across the overseas DoD laboratory surveillance network, influenza activity varied from 

low to moderate levels except in Europe, where high levels of influenza activity were 

detected with co-circulation of influenza A/H1, A/H3, and B. 

 Current vaccine coverage in the active component of the U.S. Armed Forces is 97%. 

AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

 During week 10 (March 3 – 9, 2013), influenza activity remained elevated in the United 

States, but decreased in most areas. 

 Viral Surveillance: Of 5,747 specimens tested and reported by collaborating 

laboratories, 821 (14.3%) were positive for influenza.

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

and influenza (P&I) was above the epidemic threshold. 
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 Geographic Spread of Influenza: Eight states reported widespread influenza activity; 

Puerto Rico and 19 states reported regional influenza activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 10, 53 specimens were tested from 26 locations. There were nine influenza 

A viruses (seven A(H3N2) and two A(H1N1)pdm09); and 10 influenza B viruses detected.

 To date this influenza season, 3,120 specimens have been tested from 80 locations of 

which 1,004 were positive for influenza A (898 A(H3N2), 95 A(H1N1)pdm09, five coinfections, and six A/not subtyped). 

 To date this influenza season, 241 were positive for influenza B. The onset of influenza B 

cases compared to influenza A has been somewhat later in the season. 

 There have been 206 other respiratory viruses isolated (47 adenovirus, 81 RSV, 69 

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

Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

 In week 10/2013, the geographic pattern of influenza activity was reported as 

widespread by 18 countries, 16 of which also reported high/medium intensity. 

 Although the proportion of influenza virus-positive sentinel specimens has continued to 

decrease since the peak observed in week 5/2013 (61%), it remained high in week 

10/2013 (54%), indicating substantial influenza activity. 

 Since week 40/2012, 48% of sentinel specimens positive for influenza virus have been of 

type A and 52% of type B. The proportion of A(H1)pdm09 has remained at about 60% 

of subtyped type A viruses since week 7/2013. 

Influenza activity remained substantial across Europe, but an increasing number of countries 

reported indications of declining transmission. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

20 March – Estimates of flu activity based on certain Internet search queries indicate that 

the level of flu activity in the northern hemisphere ranges from low in some European 

countries to high in Russia and in the southern hemisphere ranges from minimal to low.

Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For Week 10 (ending 9 March 2013):

 Influenza: Three cases of NHRC laboratory-confirmed influenza(A/H3) and one 

influenza(B) among US military basic trainees.
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 Adenovirus: Type 14 adenovirus cases continue at MCRD Parris Island, though FRI rates 

remain low

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

or below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

USAPHC: U.S. Army Influenza Activity Report

For the week ending 9 March 2013 (Week 10), Army influenza-like illness (ILI) activity was 

slightly higher than the same time last season. Influenza B activity has exceeded influenza A 

activity among typed specimens in both the Army and the civilian populations for the 

second week in a row.

 ILI Activity: Army incident ILI outpatient visits in week 10 were 2% higher than the same 

week last year.

 Influenza cases: Two hospitalized influenza cases were reported to USAPHC in week 10. 

86 hospitalized cases have been reported during this influenza season, 76 in 

dependents and 10 in Active Duty.

 Acute Respiratory Disease at BCT sites: ARD rates remain low; rates did not increase at 

any sites during week 10.

 Viral specimens: During week 10, 309 of 1190 (26%) laboratory specimens tested were 

positive for respiratory pathogens. Influenza B accounted for 41% of positive specimens. 

Most of the influenza positive specimens were from ERMC (37%); 27% were from PRMC, 

and 18% from WRMC. USAPHC U.S. Army Influenza Activity Report

PANDEMIC AND AVIAN INFLUENZA

Drug-resistant pandemic swine flu 'community risk'

18 March - Australian experts are concerned about the 

threat of a new type of drug-resistant pandemic flu that is 

circulating in the population at large. The swine flu strain 

has learned how to dodge the antiviral Tamiflu and, though 

rare, is emerging outside of hospitals. The team who have 

studied it say the virus is "fitter" than other drug-resistant strains and the world should be 

on alert for outbreaks. UK experts say they have seen a handful of similar cases... The new 

strain that they have been examining is emerging among people who have never been 

treated with Tamiflu, suggesting it is very good at spreading from person to person. BBC
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Most infected on Navy ship during 2009 H1N1 outbreak 

had no symptoms

18 March - Although a third of tested crew members aboard a US Navy ship became 

infected with the pandemic 2009 H1N1 (pH1N1) virus during a summer 2009 outbreak, 53% 

did not recall respiratory symptoms, just 35% met criteria for respiratory illness, and only 

11% met criteria for influenza-like illness (ILI), according to a serologic study published 

yesterday. Writing in Influenza and Other Respiratory Viruses, researchers from the US 

Centers for Disease Control and Prevention (CDC) and the Navy reported results from 489 

of a 2,000-member crew for whom pre- and post-outbreak serum samples were available.

Of the 489, 142 (32%) were shown to be pH1N1-infected by polymerase chain reaction 

testing; 78% had been vaccinated against flu the year before. The attack rate in the 57 

women in the study was higher, 41%, compared with 31% in men. Marines had a higher 

attack rate compared with Navy personnel, 37% versus 25%. Of those infected, 74 (53%) 

were asymptomatic, 51 (35%) had acute respiratory symptoms, and 17 (11%) had ILI 

symptoms. CIDRAP News Scan

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VETERINARY/FOOD SAFETY

Genetically modified seafood: Whole Foods, Trader Joe's 

and others vow not to sell GMO fish 

20 March (Reuters) - Whole Foods Market Inc, Trader Joe's and other 

food retailers representing more than 2,000 U.S. stores have vowed 

not to sell genetically engineered seafood if it is approved in the 

United States, a new advocacy group said on Wednesday. The 

announcement from the Campaign for Genetically Engineered-Free 

Seafood comes as the U.S. Food and Drug Administration appears close to approving 

genetically engineered salmon from Massachusetts-based AquaBounty Technologies.

Reuters

New spray product takes aim at Salmonella on poultry

20 March - ...According to a company press release, SalmoFresh is specifically designed for 

foods that are at a high risk for Salmonella contamination. Red meat and poultry in 

particular can be treated before grinding for significant reductions in Salmonella 

contamination. In the case of poultry, SalmoFresh can be sprayed on the cut-up parts as 

they go through the line — before they’re ground up. In the latest news from Intralytix, the 

company announced that the U.S. Food and Drug Administration had granted SalmoFresh 

the status of GRAS (Generally Recognized as Safe). Food Safety News
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U.K.: Cryptosporidium outbreak sickened 300 last year 

21 March - Approximately 300 people in England and 

Scotland were sickened in an outbreak of Cryptosporidium in 

May of 2012, announced public health authorities this week.

The parasite that caused the outbreak is thought to have 

originated in ready-to-eat bagged salad mixes, said England’s 

Health Protection Agency in a report published Tuesday. “The 

strongest association with infection was found to be with consumption of ready to eat precut mixed salad leaves from a major supermarket chain,” said HPA in its outbreak report... 

Illnesses ranged from mild to moderate, and no deaths were reported in connection to the 

outbreak. Food Safety News

USDA set to ban slaughter of sick downer veal calves, 

Humane Society says

19 March - The Humane Society of the United States announced today that the Agriculture 

Department has granted its 2009 legal petition requesting the agency halt the "inhumane 

practice" of slaughtering downer veal calves too sick, weak or tired to even stand up. The 

petition asked the USDA to close a loophole in federal regulations that "allows downer 

calves to be kept alive indefinitely, leaves calves prone to cruel dragging, and incentivizes 

other abuses at slaughter facilities." The organization said the USDA has not announced 

when it would issue a proposed rule to implement the decision. Agri-Pulse

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WELLNESS

Biennial mammograms best after 50, even for women 

with dense breasts

18 March - Screening for breast cancer every two years appears just as beneficial as yearly 

mammograms for women ages 50 to 74, with significantly fewer “false positives” – even for 

women whose breasts are dense or who use hormone therapy for menopause. That is the 

finding of a new national study involving more than 900,000 women that was published 

Monday in JAMA Internal Medicine. UCSF

Doctors urge F.D.A. to restrict caffeine in energy drinks

19 March - A group of 18 doctors, researchers and public health experts jointly urged the 

Food and Drug Administration on Tuesday to take action on energy drinks to protect 

adolescents and children from the possible risks of consuming high amounts of caffeine. 

“There is evidence in the published scientific literature that the caffeine levels in energy 
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drinks pose serious potential health risks,” the doctors and researchers wrote. In their letter 

to Dr. Margaret A. Hamburg, the F.D.A. commissioner, the group argued that energy-drink 

makers had failed to meet the regulatory burden placed on them to show that the 

ingredients used in their beverages were safe, specifically where children, adolescents and 

young adults are concerned. As a result, the group urged the F.D.A. to restrict caffeine 

content in the products and to require manufacturers to include caffeine content on 

product labels. New York Times

Government changes course on graphic cigarette 

warnings

19 March - The government has dropped its push for cigarette labels to carry images of 

diseased lungs and other graphic health warnings, and will craft new anti-smoking ads that 

do not run afoul of free speech rights. In a letter to Republican House Speaker John 

Boehner last Friday, Attorney General Eric Holder said that the Food and Drug 

Administration would go back to the drawing board to develop the ads, as required by 

legislation passed by Congress in 2009. Half the space on the front and back of each 

cigarette pack must be taken up by anti-smoking warnings and a large share of other 

printed ads should have similar discouraging messages, according to the legislation. 

Cigarette manufacturers, however, sued to prevent the ads from appearing on the 

packaging for their products, saying such a move would curtail free speech rights. Reuters

How a healthy heart can lower risk of cancer

19 March - Hearts and tumors may actually share more in common than we think. Following 

heart-healthy recommendations can also protect you from cancer, according to the latest 

study from the American Heart Association (AHA). Eating a healthy diet, exercising and 

maintaining your weight have long been ways to fend off heart disease, but researchers at 

Northwestern University Feinberg School of Medicine in Chicago report in the journal 

Circulation that following the AHA’s Life’s Simple 7 steps to reduce heart disease can also 

cut cancer risk. Time

Mississippi forbids local laws on nutrition, super-size 

drinks

19 March - Mississippi, the state with the highest rate of 

obesity, has banned its cities and counties from trying to stop 

restaurants from selling super-sized soft drinks or requiring 

them to post nutritional information about meals. The move 

came a week after a judge blocked an effort by New York City 

Mayor Michael Bloomberg to prohibit vending machines, movie theaters and retailers from 

selling single-serving sugary drinks larger than 16 ounces (473 ml), an effort that was 

intended to tackle the public health problems caused by rising rates of obesity. Reuters
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Sugary drinks may explain 180,000 deaths worldwide 

each year

20 March- A large, international epidemiologic study reports that slurping back large 

amounts of sugary beverages was associated with an increased body-mass index (BMI), 

which in turn was linked with BMI-related deaths from diabetes, cardiovascular disease

(CVD), and cancer. Specifically, the researchers found that in 2010, 132,000 deaths from 

diabetes, 44,000 deaths from CVD, and 6000 deaths from cancer in the world could be 

attributed to drinking sugar-sweetened soft drinks, fruit juice, or sports beverages... The 

study reinforces the need for clinicians to encourage patients to drink fewer sugary 

beverages, Dr. Singh said. In addition, even though "it's certainly an uphill battle [to change 

public policy] — it's one that...physicians, cardiologists, public-health scientists, [and] policy 

makers...really need to advocate for and show support for," she noted. Medscape

Vitamin D may lower blood pressure in blacks

18 March - African-Americans have significantly higher rates of hypertension, and lower 

blood levels of vitamin D, than the rest of the population. Now a randomized trial suggests 

that vitamin D supplements may help lower blood pressure. In the three-month study, 

researchers randomly assigned 250 black men and women to one of four groups: one 

received a placebo, and the others received 1,000, 2,000, or 4,000 international units of 

vitamin D daily... The effect was modest. New York Times

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USAFRICOM

Cholera outbreak in Congo

15 March - An influx of migrants from the countryside into the Republic of Congo's second 

largest city, Pointe-Noire, is exacerbating a cholera outbreak that began in November 2012. 

The outbreak infected at least 389 and killed 10, according to the health ministry and local 

authorities... People build and settle in prohibited areas, including [around] sewers, blocking 

the free flow of wastewater, which explains the repeated outbreaks of cholera,” he told IRIN. 

IRIN

South Africa: 61 Cape children stung by bees

20 March - Sixty-one children and three teachers were stung by bees at a school in Bellville, 

Cape Town, on Wednesday morning, paramedics said. "Reports indicate that the children 

were at a school for special needs when the swarm of bees went on a rampage, stinging 

everything in their way," Netcare 911 spokesman Chris Botha said. The children were aged 

between five and 10. By the time paramedics got to the school four children in a critical 

condition had been taken to hospital in private transport. "Thirty-five people were treated 
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on scene by nursing staff while 26 children were treated by paramedics before they were 

transported to nearby hospitals," he said. "The exact cause for the bees becoming 

aggressive is still unknown at this stage." allAfrica

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USCENTCOM

Afghans help locals with medical treatment

20 March - The 2nd Brigade, 1st Kandak, 205th Medical Corps of 

the Afghan National Army held a Medical Civic Action Program 

by offering medical treatment to the local community around 

Mushan, March 14, in Kandahar Province, Afghanistan. During 

the Medical Civic Action Program, or MEDCAP, Afghan soldiers 

handed out a variety of items such as tea, hand-crank radios, candy and medical kits that 

contained bandages, pain relievers, antibiotic ointments, antacids and a variety of other 

items. "It's a community outreach program," said Capt. Johnny Anderson, team leader for 

Civil Affairs Team 8112. Army Times

Surgeons struggle in Iran as sanctions squeeze drug 

supplies

18 March - Operating theatres in Iran are running out of anaesthetics due to a shortage of 

medicine caused by the unintended consequences of international sanctions. Iranian 

doctors and pharmacists have warned that hospitals across the country are facing 

difficulties finding the drugs used during life-saving surgery. "Drugs such as Atracurium, 

Isoflurane and Sevoflurane are either not available in the market or are very scarce," said 

Kheirollah Gholami, a leading pharmacist from Tehran University of Medical Sciences. "If 

these drugs are not supplied, our operating theatres will have to close," he said, according 

to quotes carried by the semi-official Ilna news agency. "You can't just use a hammer to 

make patients become unconscious... If you don't have anaesthetics, patients in need of 

operations may simply die." Guardian

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USEUCOM

U.K.: 97 percent of UK doctors have given placebos to 

patients at least once

21 March - A survey of UK doctors found that 97% have prescribed placebo treatments to 

patients at least once in their career. Researchers at the Universities of Oxford and 

Southampton in the UK discovered that 97% of doctors have used 'impure' placebo 

treatments, while 12% have used 'pure' placebos. 'Impure' placebos are treatments that are 
14

unproven, such as antibiotics for suspected viral infections, or more commonly nonessential physical examinations and blood tests performed to reassure patients. 'Pure' 

placebos are treatments such as sugar pills or saline injections which contain no active 

ingredients. e! Science News

UK air pollution: why are we only now waking up to this 

public health crisis?

19 March - ... Most of last week, London's air was heavily polluted, with many of the capital's 

pollution monitors recording "high" nitrogen dioxide (NO2) levels as an acute 

photochemical smog of fumes and microscopic particles (PM) of acids, chemicals, metals 

and dust drifted in from the continent, mixed with London diesel exhaust and then became 

trapped in the still, dry air... After years of focusing on climate change, government and 

environment groups are only now slowly waking up to the public health crisis. In 2011, the 

House of Commons Environmental Audit Committee calculated that living in an air pollution 

hot spot could shave nine years off the lives of the most vulnerable people. It concluded 

that it cost Britain £6-19bn a year, or up to 17% of the total NHS budget, and that 15-20% 

more people died prematurely from it in cities with high levels of pollution than those in 

relatively cleaner ones. Guardian

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USNORTHCOM

U.S.: Autism estimates climb to one in 50 school-age 

children

20 March - As many as one in 50 U.S. school-age children have a diagnosis of autism, up 

from one in 86 in 2007, with much of the increase involving milder cases, suggesting the 

rise is linked to growing awareness and better testing methods, government researchers 

said on Wednesday. In line with previous estimates, boys in the study were four times more 

likely to be diagnosed with autism than girls, according to the study, which is based on 

American parent reports of autism diagnoses in 2011-12 compared with 2007. Reuters

U.S.: Deaths from Alzheimer's growing, data shows

19 March - Deaths and the risk of dying from Alzheimer's disease have risen significantly in 

the United States during the last decade, according to two reports released on Tuesday. The 

trend comes as scientists and drugmakers are increasingly focused on patients with few or 

no symptoms of the memory-robbing disease after efforts to halt progression in those who 

already have symptoms failed over the past few years. Data from the U.S. Centers for 

Disease Control and Prevention showed the risk of death from the degenerative brain 

disease rose 39 percent between 2000 and 2010 even as mortality rates for other conditions 

such as cancer, heart disease and stroke fell significantly. Reuters
15

U.S.: Food stamps put Rhode Island town on monthly 

boom-and-bust cycle

16 March - ...At precisely one second after midnight, on March 1, Woonsocket would 

experience its monthly financial windfall — nearly $2 million from the Supplemental 

Nutrition Assistance Program (SNAP), formerly known as food stamps. Federal money would 

be electronically transferred to the broke residents of a nearly bankrupt town, where it 

would flow first into grocery stores and then on to food companies, employees and banks, 

beginning the monthly cycle that has helped Woonsocket survive. Three years into an 

economic recovery, this is the lasting scar of collapse: a federal program that began as a last 

resort for a few million hungry people has grown into an economic lifeline for entire towns. 

Spending on SNAP has doubled in the past four years and tripled in the past decade, 

surpassing $78 billion last year. A record 47 million Americans receive the benefit. 

Washington Post

U.S.: Hundreds checked for rabies after transplant death

18 March - Public health agencies in five states are assessing the rabies risk for hundreds of 

people who may have had close contact with an infected organ donor and four transplant 

recipients, one of whom died, officials said Saturday. About 200 medical workers, relatives 

and others were assessed for potential exposure in Maryland, where the man who received 

an infected kidney died, state veterinarian Katherine Feldman said. She said fewer than two 

dozen were urged to get the rabies vaccine as a preventive measure... Health officials in 

Georgia and North Carolina are also involved in the epidemiological investigation prompted 

by the Maryland man's death from rabies in late February, nearly 18 months after he got the 

kidney from a donor in Pensacola, Fla. AP

U.S: With meth-contaminated homes, it's buyer beware

20 March - ...[S]tate and industry officials say, as more testing is done, they are discovering 

more meth-contaminated properties, particularly among foreclosed or rental homes that 

are coming back on the market amid a housing recovery. Not all of these homes are meth 

labs where the drug was cooked. Homes can be left toxic if someone has simply smoked 

methamphetamine a few times. The drug can leave behind toxins that cause respiratory and 

other illnesses. "Meth can be detected in homes after a small number of uses, and the 

residues persist in homes for many years, meaning that if anyone ever smoked meth there 

in the past, it may show up in a test. So, while most people do not use meth, many houses 

are still affected," Dennison said. Denver Post

U.S.: Trends in tuberculosis — United States, 2012

22 March - In 2012, a total of 9,951 new tuberculosis (TB) cases were reported in the United 

States, an incidence of 3.2 cases per 100,000 population. This represents a decrease of 6.1% 

from the incidence reported in 2011 and is the 20th consecutive year of declining rates. Of 

the 3,143 counties in the United States, 1,388 (44.2%) did not report a new TB case during 

2010–2012... The TB rate in foreign-born persons in the United States was 11.5 times as high 

as in U.S.-born persons. Morbidity and Mortality Weekly Report

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USPACOM

Bali: Tourists warned of Bali health risk as dengue fever 

infections increase

20 March – There has been a dramatic increase in the number of infectious diseases caught 

by West Australians when they visit Bali. A study shows that increased travel to the 

Indonesian island has resulted in a rising number of serious diseases, such as dengue fever 

and salmonella gastroenteritis. West Australia Health Department researchers say their 

findings highlight the need for better education of travellers about risks and preventative 

measures. Their research found the number of flights from WA to Indonesia increased more 

than five-fold from 2006 to 2012. Of all travellers to Indonesia in 2011, 90 per cent visited 

Bali. In 2012, a total of 2605 notifiable infectious diseases were acquired overseas by West 

Australians. Of these, 41 per cent were caught in Indonesia, mostly in Bali. From 2006 to 

2012, the number of cases originating in Indonesia increased six-fold, from 178 to 1078. 

News.com.au

India: Measles claims life of 20 children in Sindh

20 March - Measles has so far claimed the life of 20 children in different cities of Sindh this 

month. The Vigilance Cell of the Health Department disclosed that 302 children were 

suffering from the disease across the province. News International

Japan: Record radiation level found in fish near Japan 

nuclear plant 

16 March – A record level of radioactive material was detected in a fish captured near a 

damaged Japanese nuclear power plant in Fukushima, news reports said Saturday. Tokyo 

Electric Power Co, which runs the Fukushima Daiichi Nuclear Power Station, found a record 

740 000 becquerels per kilogramme of radioactive caesium in the greenling in waters near 

the plant, the Kyodo News agency reported. That is equivalent to 7 400 times the country's 

limit considered safe for human consumption. The operator has installed a net on the sea 

floor of the port exit in Fukushima prefecture to prevent fish near the sediments of 

contaminated soil from going anywhere, Kyodo said. Times Live

Philippines’ reproductive health law here - now what?

20 March - After a publicly contentious 14-year battle, legislators quietly signed the 

Philippines’ first reproductive health law in late December. It was expected to take effect by 

the end of March, but on 21 March the Supreme Court halted its implementation, issuing a 

120-day status quo ante to review court challenges... In Manila, the country’s largest city 

with nearly two million residents, a local ordinance banning condoms, birth control pills and 

other forms of contraception was passed in 2000. Since then public health clinics have 

promoted only what is known as “natural” family planning, which calls for abstinence during 

a woman’s peak days of fertility, and for avoiding any drugs or sterilization to prevent 
17

pregnancy... The promise of the hard-fought law is free access to reproductive health 

services - including contraception - for all, but the reality, Custodio and other activists fear, 

is that honouring that pledge will take more time than women - and their families - can 

afford. IRIN

Thailand: Dengue count stands at 13,200 cases

17 March - In an update from a report from the end of February, Thailand health officials 

say more than 13,000 people have been infected with the mosquito borne viral disease, 

dengue fever, as of last week, according to a Nation Multimedia report Sunday. The Thai 

Public Health Ministry report that 13,200 Thais have fallen ill with dengue, including 16 

deaths, from across the Kingdom. Officials said that the number of cases and the number of 

fatalities are both 4 times higher than the same period last year. In an earlier report, Thai 

health officials warned that 2013 could see more than 100,000 cases. Global Dispatch

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USSOUTHCOM

Colombia: Hepatitis A

18 March - The Health Agency of the municipality of La Plata have declared an alert 

following an outbreak of hepatitis A affecting both urban and rural areas of the 

municipality. According to Zulkerine Ramirez, Coordinator of Public Health for La Plata, in 

total, 42 cases have been detected, most of them children but also some adults. Ten of 

these cases have been confirmed positive for hepatitis A virus infection, a worrying figure 

given that the affected individuals belonged to communities in relatively well separated 

neighbourhoods. "Those affected include 2 people of the same family as well as others 

scattered through different districts of the city and in some adjacent villages," said the 

Public Health Coordinator. ProMED-mail

Paraguay has the highest rate of fatality from dengue in 

South America 

20 March - Paraguay has the dengue fatality rate highest in South America, after adding 35 

fatalities in the last three months, said today in Asuncion Director of Health Surveillance, 

Celia Martinez. In a statement released by the state agency Paraguay IP, the official said that 

82 percent of reported dengue correspond Central department, like most of the fatal cases... 

"Paraguay is going through a period of outbreak of the disease, which so far this year and 

affected more than 65,000 people, including suspected cases with symptoms," concluded 

the official. Diario Rotativo

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