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3 May 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

 Absolute and relative morbidity burdens attributable to various illnesses and injuries, U.S. 

Armed Forces, 2012

 Career-long mental health assessments proposed

 Service members surpass most federal health goals

GLOBAL

 First confirmed Japanese tsunami debris in California

 Parasite 'resistant to malaria drug artemisinin'

 Protein in breast milk fights antibiotic resistance

 Ratting out TB: Scientists train rodents to diagnose disease

 WHO report: Global guidance on dual-use research needed

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

 Chickens pegged as source of H7N9 Flu

 China: Human infection with avian influenza A(H7N9) virus – WHO update

VETERINARY/FOOD SAFETY

 Papua New Guinea: Newcastle disease, poultry

 U.S.: Caffeinated chewing gum catches FDA's eye

 U.S.: Multistate outbreak of Salmonella Saintpaul infections linked to imported cucumbers
2

Mental Health 

Month 

This year the Army's theme 

for Mental Health Month is 

"Breaking the Silence." The 

Army is determined to 

decrease the stigma and 

get help to those who 

need it, by promoting 

dialogue between leaders, 

Soldiers, families, civilians 

and the community.

Army Medicine recognizes 

that behavioral health 

encompasses 

psychological, physical and 

spiritual resilience, and can 

impact each of these 

aspects regardless of age, 

race, religion, or income. 

During the years of 2000 

through 2011, 936,283 

active component service 

members were diagnosed 

with at least one mental 

disorder. 

The Army database 

indicates that eight percent 

of the Soldiers deployed 

between 2001 and 2011 

received a diagnosis of 

post traumatic stress 

disorder.

STAND-TO!

WELLNESS

 Adults consume 13% of calories from added sugars

 Diabetes warning over soft drinks

 Implants may delay breast cancer detection, raise death risk

 Justice Dept. to appeal judge's order on Plan B pill

 Most people aren't meeting exercise guidelines

 Smoking 'poses bigger risk to women'

 To motivate patients to change, doctors stop scolding

 Two doses of HPV vaccine may be just as effective as three, study shows

USAFRICOM

 Madagascar: Food insecurity opens door to TB

 Nigeria: Polio eradication - what progress so far?

 Somalia: Building health systems from scratch

 Somalia famine 'killed 260,000 people'

USCENTCOM

 Arab cities aim to build resilience to natural disasters

 Egypt: Female genital mutilation still widespread

 Saudi Arabia says five dead from new SARS-like virus

 Syria: Mass measles vaccination campaign for Syrian children underway

USEUCOM

 European Immunization Week 2013 and new ECDC tools to support routine vaccination 

programmes

 Russia: Psychiatric institution fire kills at least 38

 Turkey: Crimean-Congo hemorrhagic fever

 United Kingdom: 'Heart-healing virus' trial starts

USNORTHCOM

 U.S.-born kids have more allergies, asthma

 U.S.: California may have to move 3,000 inmates at risk for Valley fever

 U.S.: HIV vaccine study cancelled

 U.S.: Over-diagnosis and over-treatment of depression is common

 U.S.: Suicide among adults aged 35–64 years, 1999–2010

 U.S.: Task force calls for routine HIV testing for all adults

USPACOM

 Can disaster risk reduction lessons be learned from China?

 India: Hospital roof collapses, injuring 8

 New Caledonia: Chikungunya

 Singapore: Dengue cases continue to rise

 Sri Lanka: Malaria, imported

USSOUTHCOM

 Argentina: In therapy? In Argentina, it’s the norm

 Latin America threatened by mounting cancer epidemic
3

Nominate a

Colleague for the 

Lienhard Award and 

Sarnat Prize

The Institute of Medicine is 

accepting nominations for 

The Gustav O. Lienhard 

Award and The Rhoda 

and Bernard Sarnat 

International Prize in 

Mental Health through 

Monday, May 6.

The Lienhard Award 

recognizes individuals for 

outstanding achievement 

in improving health care 

services in the United 

States.

The Sarnat Prize recognizes 

individuals, groups, or 

organizations for 

outstanding achievement 

in improving mental health.

Classified Version of 

the Weekly Update

An Army Public Health

Weekly Update is available 

with articles classified up to 

the SECRET level from the 

USAPHC SIPRNet site: 

http://phc.army.smil.mil

Look under Hot Topics & 

Current Issues.

To access this version, you 

will need a SECRET

clearance and a SIPRNet 

account.

U.S. MILITARY

Absolute and relative morbidity burdens attributable to 

various illnesses and injuries, U.S. Armed Forces, 2012

April 2013 - In 2012, more service members (n=600,006) received medical care for injuries 

and poisonings than any other morbidity-related category. In addition, injuries and 

poisonings accounted for more medical encounters (n=2,203,706) than any other morbidity 

category and one-fifth (20.8%) of all medical encounters overall. Mental disorders 

accounted for more hospital bed days (n=270,078) than any other morbidity category and 

nearly half (49.6%) of all hospital bed days overall. Together, injuries and poisonings, and 

mental disorders accounted for nearly two-thirds (62.2%) of all hospital bed days and twofifths (40.2%) of all medical encounters. Mental disorders also accounted for the most lost 

work time (n=349,464 lost duty days; 26.0% of the total). Medical Surveillance Monthly 

Report

Career-long mental health assessments proposed

30 April - An Indiana lawmaker wants to expand military suicide prevention programs to 

include an annual mental health assessment for active and reserve members, with reports 

from supervisors about any relationship or financial issues that might trigger stress or 

suicidal tendencies. Sen. Joe Donnelly, a Democrat and member of the Senate Armed 

Services Committee, is calling his proposal the Jacob Sexton Military Suicide Prevention Act, 

named for an Indiana National Guard specialist who took his own life in 2009 while on leave 

from a deployment to Afghanistan. The bill, S 810, is the first piece of legislation introduced 

by the newly elected Donnelly. Army Times

Service members surpass most federal health goals

26 April - A wide-ranging Defense Department survey released this week finds that active 

duty service members are healthier in most categories than their civilian counterparts and 

exceed most federal health objectives. Results of the 2011 Department of Defense Health 

Related Behaviors Survey of Active Duty Military Personnel found that soldiers, sailors, 

airmen, Marines and Coast Guardsmen beat federal goals for weight management and 

exercise and in the use of seat belts and motorcycle helmets. The results indicate that the 

military is a national leader in healthy living habits, Dr. Warren Lockette, chief medical officer 

of TRICARE and deputy assistant secretary of defense for Clinical and Program Policy, said at 

an April 22 media roundtable discussion. MHS

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GLOBAL

First confirmed Japanese tsunami debris in California

26 April - Federal officials say a fishing boat that washed ashore in Northern California is the 

first debris to reach the state that's been confirmed as having come from the Japanese 

tsunami. The Del Norte Triplicate reports (http://bit.ly/15MeRTl) that the 20-foot vessel 

belongs to the marine sciences program at Takata High School in the town of Rikuzentakata 

in the Iwate prefecture. It washed ashore in Crescent City on April 7... NOAA spokeswoman 

Keeley Belva says the skiff is the first confirmed debris from the 2011 tsunami in California. 

In total, 27 items from among more than 1,600 reports of debris have been firmly traced 

back to the tsunami. ABC News

Parasite 'resistant to malaria drug artemisinin'

28 April - New drug-resistant strains of the parasite that 

causes malaria have been identified by scientists. 

Researchers found parasites in western Cambodia that are 

genetically different from other strains around the world. 

These organisms are able to withstand treatment by 

artemisinin - a frontline drug in the fight against malaria. Reports of drug resistance in the 

area first emerged in 2008. The problem has since spread to other parts of South East Asia.

BBC

Protein in breast milk fights antibiotic resistance 

1 May - A protein discovered in human breast milk, which goes by the Shakespeareansounding acronym, HAMLET, reportedly fights drug-resistant bacteria when added to 

antibiotics. The researchers say HAMLET could be used to boost the effectiveness of 

medications against the rising number of drug-resistant and dangerous bacteria. VOA

Ratting out TB: Scientists train rodents to diagnose 

disease

1 May - Rats are notorious for spreading nasty diseases. 

Think the plague, lassa fever and even salmonella. But could 

some jumbo-size African rodents help health workers 

diagnose diseases more quickly? They just might. A group in 

Tanzania is training rats to detect tuberculosis in people. 

The critters in question are African giant pouched rats... The critters have very poor vision, 

which they make up for with a keen sense of smell... The team trains the critters with a 

Pavlovian click-and-reward approach... A trained rat can correctly pick out a TB sample 

about two-thirds of the time, Beyene says. The rate increases to about 80 percent when two 

or three animals are put on the task. NPR
5

WHO report: Global guidance on dual-use research 

needed

1 May - Participants in a World Health Organization (WHO) meeting held in February 

agreed that a binding global agreement to govern potentially dangerous life-sciences 

research is unlikely, but global guidance on the thorny issue could help nations figure out 

their own policies, according to a WHO report of the meeting. The conference, held Feb 26 

to 28, focused on "dual-use research of concern" (DURC)—studies whose results could be 

used for good or harm. The term gained currency in the wake of the controversy that 

erupted late in 2011 over experiments in which two teams of scientists developed labmodified H5N1 viruses capable of airborne transmission in ferrets. The detailed reports of 

those two studies were published in 2012, but debate and concern have continued over 

how to govern research that renders pathogens more dangerous or poses similar kinds of 

risks. CIDRAP

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INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 16 (April 14-20, 2013), influenza activity decreased in the United States. 

 Viral Surveillance: Of 3,384 specimens tested and reported by collaborating laboratories, 

250 (7.4%) were positive for influenza.

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

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

 Influenza-Associated Pediatric Deaths: Five pediatric deaths were reported. 

 Geographic Spread of Influenza: Three states reported widespread influenza activity and 

three states reported regional influenza activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 17, 59 specimens were tested from 19 locations. 26 specimens were 

tested from 18 locations. There was one influenza A(H1N1)pdm09 and three influenza B 

viruses detected.

 To date this influenza season, 3,648 specimens have been tested from 81 locations of 

which 1,065 were positive for influenza A (947 A(H3N2), 107 A(H1N1)pdm09, five coinfections, and six A/not subtyped).

 To date this influenza season, 356 specimens were positive for influenza B. Of these, 

there were 14 B/Yamagata, two B/Victoria, and two B & enterovirus co-infections. The 

lineage is pending or unknown for 338 specimens.
6

 There have been 244 other respiratory viruses isolated (58 adenovirus, 91 RSV, 86 

parainfluenza, and nine enterovirus) cumulatively this season.

 To date, a total of 126 laboratory-confirmed cases of human infection with avian 

influenza A(H7N9) virus including 24 deaths have been reported to WHO. Contacts of 

the confirmed cases are being closely monitored. USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

In week 16/2013 (15–21 April 2013): 

 Twenty-four countries reported low-intensity transmission while three countries (Latvia, 

the Netherlands and Sweden) still reported medium intensity. Decreasing or stable 

trends were reported by almost all reporting countries. 

 The proportion of influenza-positive sentinel specimens (26%) has continued to 

decrease since the peak observed in week 5/2013 (61%).

 Since week 40/2012, 47% of sentinel surveillance specimens testing positive for 

influenza virus have been type A and 53% type B. Of the influenza A viruses subtyped, 

the proportion of A(H1)pdm09 viruses was 62%. 

With influenza activity continuing to decline or having already returned to baseline levels in 

all reporting countries after more than three months of active transmission, the 2012–13 

influenza season appears to be coming to an end. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

2 May – Estimates of flu activity based on certain Internet search queries indicate that the 

level of flu activity in the northern hemisphere ranges from minimal and low in most areas 

to moderate in Russia. In the southern hemisphere the range is from minimal to low.

Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 27 April 2013:

 Influenza: There were no new cases of NHRC laboratory-confirmed influenza among US 

military basic trainees. NHRC has capability to test for the novel H7N9 influenza virus 

 Adenovirus: Sporadic adenovirus cases at basic training centers in 2013. 

 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 
7

PANDEMIC AND AVIAN INFLUENZA

Chickens pegged as source of H7N9 Flu

25 April - Evidence from a single patient infected with the novel 

avian influenza virus H7N9 points to transmission from live 

poultry, Chinese researchers reported. The virus isolated from a 

64-year-old man who died from the infection was "almost 

identical" to that isolated from a chicken taken from a wet market 

with epidemiological ties to the patient, Lanjuan Li, MD, of Zhejiang University in Hangzhou, 

China, and colleagues reported online in The Lancet. The finding suggests that live poultry 

could be the source of the H7N9 outbreak, which has sickened 108 people in eastern China 

and killed 22 according to the latest official update from the World Health Organization. 

Investigations into the source are ongoing. MedPage Today

China: Human infection with avian influenza A(H7N9) 

virus – WHO update

2 May - As of 2 May 2013 (16:00 CET), the National Health and Family Planning Commission, 

China notified WHO of an additional two laboratory-confirmed cases of human infection 

with avian influenza A(H7N9) virus. The first patient is a 58-year-old man from Fujian 

province who became ill on 21 April 2013 and the second patient is a 69-year-old man from 

Hunan province who became ill on 23 April 2013. Additionally, two patients earlier reported 

have died. To date, a total of 128 laboratory-confirmed cases of human infection with avian 

influenza A(H7N9) virus including 26 deaths have been reported to WHO. Contacts of the 

confirmed cases are being closely monitored. WHO

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VETERINARY/FOOD SAFETY

Papua New Guinea: Newcastle disease, poultry

2 May - The Papua New Guinea [PNG] Government has declared Sandaun or West Sepik 

province "a disease area" following the detection of the contagious Newcastle bird disease 

in the PNG-Indonesia border villages of Wutung and Musu and the provincial capital 

Vanimo. This means that the movement of poultry and poultry products out of Sandaun 

province is banned until further notice. However, commercially produced chicken meat and 

eggs entering the province from other PNG suppliers are exempted from the prohibition. 

Agriculture and livestock minister Tommy Tomscoll announced the declaration and 

prohibition in a full page advertisement published in the country's daily newspapers.

ProMED-mail
8

U.S.: Caffeinated chewing gum catches FDA's eye

30 April - Wrigley's new caffeinated gum has caught the attention of the Food and Drug 

Administration, which says it will investigate the effects of added caffeine on children and 

teens. Alert Energy Caffeine Gum was introduced this week by Mars Inc.'s Wrigley division. 

One piece contains 40 milligrams of caffeine, the same amount you'd get in a half a cup of 

coffee. The gum comes in two flavors: mint and fruit. When it's chewed, the caffeine is 

released into your saliva. Some gets swallowed as if you were drinking coffee or a soda; 

some is absorbed directly into the bloodstream through the cheeks and under the tongue. 

The only time the FDA has approved added caffeine in a food was in the 1950s for cola 

drinks, says Michael Taylor, the agency's deputy commissioner for foods and veterinary 

medicine, in a statement Monday. The caffeinated gum is the latest to add caffeine, he says. 

CNN

U.S.: Multistate outbreak of Salmonella Saintpaul 

infections linked to imported cucumbers

25 April - A total of 73 persons infected with the outbreak strain of Salmonella Saintpaul 

have been reported from 18 states. 27% of ill persons have been hospitalized, and no 

deaths have been reported. State public health officials are interviewing ill persons to obtain 

information regarding foods they might have eaten and other exposures in the week before 

illness. Preliminary information indicates that consumption of imported cucumbers is the 

likely source of infection for the ill persons. On April 24, 2013, the U.S. Food and Drug 

Administration placed Daniel Cardenas Izabal and Miracle Greenhouse of Culiacán, Mexico 

on Import Alert... Currently, there is no evidence that contaminated cucumbers supplied by 

Daniel Cardenas Izabal and Miracle Greenhouse are still on the market. CDC

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WELLNESS

Adults consume 13% of calories from added sugars

1 May - The intake has declined over the past decade, but it's still higher than American 

Heart Association recommendations. The trends are moving in the right direction: People 

are downing less added sugar in their diets, but health experts say Americans still consume 

too much. About 13% of adults' daily calories come from added sugars in things like cake 

and regular soda, according to government statistics, out today. Men consume about 335 

calories a day from added sugars; women, 239 calories. These are sugars added to 

processed and prepared foods but not sugar added at the table. About two-thirds (67%) of 

added sugars come from food; the other third (33%) from beverages. USA Today
9

Diabetes warning over soft drinks

24 April - Drinking one or more cans of sugary soft drinks a 

day is linked to an increased risk of diabetes in later life, a 

study suggests. A can a day raises the relative risk of Type2 diabetes by about a fifth, compared with one can a 

month or under, say European scientists. The report in the 

journal Diabetologia mirrors previous US findings. A diabetes charity recommends limiting 

sugary foods and drinks as they are calorific and can cause weight gain. The latest research 

was carried out in the UK, Germany, Denmark, Italy, Spain, Sweden, France and the 

Netherlands. BBC

Implants may delay breast cancer detection, raise death 

risk

1 May - Women with breast implants could run the risk of having breast cancer diagnosed 

at later stages, when survival might be worse, according to Canadian researchers. Breast 

implants can make it more difficult to diagnose breast cancer early because they block 

some areas of the breast on mammograms, experts say. "Women who currently have breast 

implants and those considering breast augmentation should be aware of the possible longterm health effects of cosmetic breast implants," said lead author Eric Lavigne, a Ph.D. 

graduate in epidemiology with the faculty of medicine at University Laval, in Quebec City.

"They should also be reassured that physicians and other health professionals will continue 

to offer the best medical practices to these women," he added. Medline Plus

Justice Dept. to appeal judge's order on Plan B pill

1 May - Obama administration seeks to block decision that would end all age restrictions on 

May 5. Action comes day after FDA allowed emergency contraception to be sold to girls 15 

years old without prescription. The Justice Department said late Wednesday that it is 

appealing a U.S. judge's order that lifted all age limits on buying the Plan B "morning-after" 

birth control pill without a prescription. The appeal, along with a request for an injunction, 

would not affect the Food and Drug Administration's decision Tuesday to allow the 

emergency contraceptive to be sold without a prescription to women and girls at least 15 

years old. USA Today

Most people aren't meeting exercise guidelines

2 May - Most adults in the USA aren't meeting the federal physical activity 

recommendations for both aerobic exercise and muscle-strengthening activity, according to 

government statistics out today. About 79% of adults don't meet the physical activity 

guidelines that advise getting at least 21⁄2 hours a week of moderate-intensity aerobic 

activity such as brisk walking, or one hour and 15 minutes a week of vigorous-intensity 

aerobic activity, such as jogging. Plus, the guidelines recommend that adults do musclestrengthening activities, such as push-ups, sit-ups or exercise using resistance bands or 

weights. These activities should involve all major muscle groups and be done on two or 

more days a week, the guidelines say. USA Today
10

Smoking 'poses bigger risk to women'

30 April - Smoking may pose a bigger health threat to women than 

men, say researchers. Women who smoke have a higher risk of cancer 

than men, Norwegian investigators found. They looked at the medical 

records of 600,000 patients and discovered the bowel cancer risk linked 

to smoking was twice as high in women than men. Female smokers had 

a 19% increased risk of the disease while male smokers had a 9% increased risk, Cancer 

Epidemiology, Biomarkers & Prevention reports. BBC

To motivate patients to change, doctors stop scolding

29 April - Instead of telling patients what to do and scolding them when they don't do it, 

clinicians ask the individual what changes he or she is willing and able to make, and then 

promote patients' desire, confidence and commitment to following through. Doctors who 

lecture or give scary warnings can cause patients to become defensive and disengage, says 

Stephen Rollnick, a professor of health-care communication at Cardiff University, in Wales, 

and a founder of the nonprofit Motivational Interviewing Network of Trainers, whose 

members provide training, coaching and consultation in 35 countries. Wall Street Journal

Two doses of HPV vaccine may be just as effective as 

three, study shows

30 April - The human papilloma virus (HPV) vaccine is widely viewed as an effective way to 

protect women from both cervical cancer and genital warts. But doctors suspect the high 

cost and inconvenience associated with the vaccine, which consist of three shots given over 

the course of six months, may be preventing women and young girls from receiving it. “It is 

one of the most expensive routinely used childhood vaccines,” Dr. Simon R.M. Dobson, of 

the of the University of British Columbia, Vancouver, told FoxNews.com This dilemma 

spurred Dobson and his colleagues to examine whether the vaccine could still be effective if 

doctors skipped the second shot, administering only the first and third doses. Fox News

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USAFRICOM

Madagascar: Food insecurity opens door to TB

1 May - Health experts fear the interruption of food assistance in Madagascar is increasing 

incidence of tuberculosis (TB) in Toliara, the capital city of Madagascar’s southern AtsimoAndrefana region. Malnutrition and TB are intimately linked: Malnutrition weakens the 

immune system, increasing susceptibility to the disease, while TB reduces appetite, worsens 

the absorption of micronutrients and alters patients’ metabolism. IRIN
11

Nigeria: Polio eradication - what progress so far?

30 April - The 3rd African Vaccination Week (AVW), organized by the African Region of 

World Health Organization (WHO) April 22 to 28, 2013, came under the theme, 'Save Lives. 

Prevent disabilities. Vaccinate', and accomplished heightened continent-wide awareness of 

the place of routine immunization against vaccine-preventable diseases. All 46 memberstates of WHO in the African region participated in efforts to strengthen immunization 

programmes around the continent against diphtheria, haemophilus influenzae serotype b 

infection, hepatitis B, influenza, measles, meningitis, mumps, pertussis, pneumococcal 

pneumonia, poliomyelitis (polio), rubella, tetanus, tuberculosis, and yellow fever. The 

ceremonies drew attention to the importance of immunization for children and why it is 

necessary to protect them against all vaccine-preventable diseases. All Africa

Somalia: Building health systems from scratch

26 April - ...While the conflict is not over, insecurity has 

diminished since the withdrawal of insurgent group Al-Shabab 

in 2011. This relative security is allowing Mohamed to focus on 

preventative healthcare, a luxury she did not have two years 

ago. In March 2013, she admitted 26 cases with measles, 19 

with tuberculosis, 14 with tetanus and nine with meningitis. She is frustrated because all of

these diseases are immunizable. Six of the children admitted that month died. Mohamed 

hopes this year to immunize 1,000 children per month in the hospital's tiny but brightly 

painted vaccination room. Two volunteers sit at a desk, another monitors those coming in 

and out. They say they became volunteers when donors pulled out and staff were let go. By 

1pm that day, they had vaccinated 28 children. "A huge improvement in a short time - if 

peace holds," Mohamed said. IRIN

Somalia famine 'killed 260,000 people'

2 May - Nearly 260,000 people died during the famine that 

hit Somalia from 2010 to 2012, a study shows. Half of them 

were children under the age of five, says the report by the 

UN and the US-funded Famine Early Warning Systems 

Network (Fews Net). The UN Food and Agriculture 

Organisation (FAO) said humanitarian aid needed to be provided more quickly. The crisis 

was caused by a severe drought, worsened by conflict between rival groups fighting for 

power. The number of deaths was higher than the estimated 220,000 people who died 

during the 1992 famine. BBC

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12

USCENTCOM

Arab cities aim to build resilience to natural disasters

29 April - Prevention may be better than a cure, but for the 

authorities in Arab cities and towns, natural disasters up to now 

have been largely about coping with them after they have 

taken place. “We react to disasters without any planning; we 

just go for the response, and you know that without any 

planning you can’t do the proper things,” Abdulmalek Al-Jolahy, first deputy minister at 

Yemen’s Ministry of Public Works and Highways, told IRIN. But disaster prevention experts 

say the region took a step in the right direction this month, with the official finalization of 

the Aqaba Declaration on Disaster Risk Reduction in Cities. IRIN

Egypt: Female genital mutilation still widespread

30 April - Egyptian activists are concerned that the rise of Islamist politicians could 

undermine years of work to discourage female genital mutilation. The practice, and the 

movement against it, however, have far deeper roots in the country. To its supporters, it is a 

sign of purity, community and religious devotion. To its opponents, it marks the physical 

manifestation of a woman's degradation. VOA

Saudi Arabia says five dead from new SARS-like virus

2 May - Saudi Arabia said five more people have died of a deadly new virus from the same 

family as SARS, and two other people were in intensive care. The seven cases were 

discovered in al-Ahsa governorate in the Eastern Province, the Saudi news agency SPA 

quoted the Saudi Health Ministry as saying in a statement late on Wednesday. A Saudi man 

died in March from the virus. Reuters

Syria: Mass measles vaccination campaign for Syrian 

children underway

30 April - U.N. and international aid agencies are stepping up a vaccination campaign in 

Syria and neighboring countries to contain measles outbreaks in the region. The U.N. 

Children's Fund says many Syrian children are at risk of killer diseases because they are not 

receiving routine immunizations. The U.N. Children’s Fund reports hundreds of cases of 

measles have broken out among children in Syria, Jordan, Lebanon, Iraq and Turkey over 

the past year. In the case of Turkey, UNICEF says some 3,000 to 4,000 measles cases have 

been reported across the country, including 300 among Syrian refugees. UNICEF 

spokeswoman Marixie Mercado said so far, no child has died from measles, but that could 

change at any time. VOA

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13

USEUCOM

European Immunization Week 2013 and new ECDC tools 

to support routine vaccination programmes

25 April - The eighth European Immunization Week (EIW) takes place between 22 and 27 

April 2013 [1]. EIW promotes the core message that the immunisation of every child is vital 

to prevent diseases and protect life. This initiative is led and coordinated by the World 

Health Organization Regional Office for Europe (WHO/Europe) and implemented by the 

countries of the European Region. For one week in April, countries across the Region unite 

under the EIW slogan – Prevent. Protect. Immunize. – and carry out activities to inform and 

engage target audiences and to address challenges regarding immunisation. These activities 

include training sessions for healthcare workers, dissemination of informational materials, 

workshops, press conferences, among other things. Eurosurveillance

Russia: Psychiatric institution fire kills at least 38

26 April - At least 38 people are dead after a fire quickly 

spread through a one-story, wooden psychiatric facility 

north of Moscow. Russian investigators believe that the 

blaze may have been caused by a short circuit... Officials 

say many of the patients, ages 20-76, were heavily sedated 

due to severe mental issues. Those who were able to wake up tried to escape the flames 

through the windows, but many of them had bars on them. Russia’s Emergency Ministry 

says that some of the windows had bars due to safety rules, but it is not known why other

windows were blocked... Russia is no stranger to disasters. In 2011, more than 10 thousand 

people died in fires across the former Soviet Union. In the first nine months of 2012, more 

than 75,000 people died. VOA

Turkey: Crimean-Congo hemorrhagic fever

1 May - A man died as a result of Crimean-Congo hemorrhagic fever (CCHF), a sometimes 

fatal viral disease contracted from a tick bite, in the Black Sea province of Tokat on Sat 27 

Apr 2013. He had been bitten by a tick while taking care of his animals in the fields on 17 

Apr 2013. He extracted the tick by himself and did not immediately seek professional 

attention. He was taken to Tokat State Hospital and later transferred to the Gaziosmanpasa 

University Research and Treatment Hospital when his condition deteriorated. Doctors at the 

Gaziosmanpasa hospital stated that the man is the 1st person to die due to CCHF this year 

[2013] in Turkey; however, some patients are currently receiving treatment for the disease in 

other hospitals. According to data released by the Ministry of Health, 174 people died as a 

result of CCHF in Turkey between 2002 and 2012. ProMED-mail
14

United Kingdom: 'Heart-healing virus' trial starts

30 April - Patients in the UK have been enrolled into a trial to see if an engineered virus can 

be used to heal their damaged and struggling hearts. The trial will use a virus to introduce 

genetic material into heart muscle to reverse the organ's decline. The British Heart 

Foundation said the idea had "great potential" but needed to be proven in clinical trials.

BBC

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USNORTHCOM

U.S.-born kids have more allergies, asthma

29 April - Kids and teens who are born abroad and immigrate to the United States are 

about half as likely to have asthma and allergies as those who are born in the U.S., 

according to a new study. Researchers surveyed the parents of 80,000 children in one of six 

languages and found that association held even after they took into account where families 

lived and how often they moved, as well as their race and income. "This is definitely 

something we see clinically and we're trying to better understand, what is it in our 

environment that's increasing the risk of allergic disease?" said Dr. Ruchi Gupta, who studies 

allergies at the Northwestern University Feinberg School of Medicine in Chicago but wasn't 

involved in the new research. Reuters

U.S.: California may have to move 3,000 inmates at risk 

for Valley fever

1 May - As many as 3,000 prison inmates in central California deemed to be at risk from a 

potentially lethal lung disease may need to be moved to other regions under an order from 

a court-appointed federal overseer. The directive, issued on Monday, marks the latest effort 

to stem cases of valley fever, or coccidioidomycosis, at two prisons where the disease was 

found to have contributed to the deaths of nearly three dozen inmates from 2006 to 2011.

Reuters

U.S.: HIV vaccine study cancelled 

26 April - The U.S. National Institutes of Health has 

cancelled a study testing an experimental HIV vaccine 

because scientists concluded it did not prevent infection or 

reduce the amount of HIV in the blood. HIV is the virus that 

causes AIDS. The so-called HVTN 505 study began in 2009 

and is one of several such studies underway to find an effective AIDS vaccine. The study 

involved over 2,500 volunteers, specifically men who have sex with men and transgender 

people who have sex with men. VOA
15

U.S.: Over-diagnosis and over-treatment of depression is 

common

30 April - Americans are over-diagnosed and over-treated for depression, according to a 

new study conducted at the Johns Hopkins Bloomberg School of Public Health. The study 

examines adults with clinician-identified depression and individuals who experienced major 

depressive episodes within a 12-month period. It found that when assessed for major 

depressive episodes using a structured interview, only 38.4 percent of adults with clinicianidentified depression met the 12-month criteria for depression, despite the majority of 

participants being prescribed and using psychiatric medications. Johns Hopkins Bloomberg 

School of Public Health News

U.S.: Suicide among adults aged 35–64 years, 1999–2010

3 May - ...To investigate trends in suicide rates among adults aged 35–64 years over the last 

decade, CDC analyzed National Vital Statistics System (NVSS) mortality data from 1999–

2010. Trends in suicide rates were examined by sex, age group, race/ethnicity, state and 

region of residence, and mechanism of suicide. The results of this analysis indicated that the 

annual, age-adjusted suicide rate among persons aged 35–64 years increased 28.4%, from 

13.7 per 100,000 population in 1999 to 17.6 in 2010. Among racial/ethnic populations, the 

greatest increases were observed among American Indian/Alaska Natives (AI/ANs) (65.2%, 

from 11.2 to 18.5) and whites (40.4%, from 15.9 to 22.3). By mechanism, the greatest 

increase was observed for use of suffocation (81.3%, from 2.3 to 4.1), followed by poisoning 

(24.4%, from 3.0 to 3.8) and firearms (14.4%, from 7.2 to 8.3). The findings underscore the 

need for suicide preventive measures directed toward middle-aged populations. Morbidity 

and Mortality Weekly Report

U.S.: Task force calls for routine HIV testing for all adults

29 April - An influential U.S. panel is calling for HIV screening for all Americans aged 15 to 

65, regardless of whether they are considered to be at high risk, a change that may help lift 

some of the stigma associated with HIV testing. The new guidelines from the U.S. Preventive 

Services Task Force (USPSTF), a government-backed panel of doctors and scientists, now 

align with longstanding recommendations by the U.S. Centers for Disease Control and 

Prevention for testing of all adults aged 15 to 65, regardless of their risk. Guidelines issued 

by the USPSTF in 2005 had recommended HIV screening for high-risk individuals. Reuters

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16

USPACOM

Can disaster risk reduction lessons be learned from 

China?

29 April - China, which annually faces almost every disaster possible - including 

earthquakes, floods, cyclones and landslides - is doing something right in the field of 

disaster risk reduction (DRR), experts say. "China has learned from the experience of many 

years of heavy human and economic losses how important it is to put a cap on annual 

acceptable losses if it is to succeed in protecting its economic and social development. It is 

now aiming to keep disaster losses at no more than 1.5 percent loss of GDP,” UN Special 

Representative of the Secretary-General for DRR Margareta Wahlström told IRIN on 29 

April. “They are the first government in the world to publicly announce such a move and we 

hope others will follow this example.” IRIN

India: Hospital roof collapses, injuring 8

26 April - Part of a hospital building collapsed in central India on Friday after its roof came 

crashing down, injuring at least eight people, an official said. More than a dozen people 

were rescued after being trapped in the rubble of the Kasturba Gandhi Hospital in Bhopal, 

the capital of Madhya Pradesh state, state minister Babu Lal Gaur said. None of the injuries 

were serious. Police officer Upendra Jain said about two dozen people were believed to be 

on the first floor of the women's medical ward when its roof crashed down. The cause of the 

collapse was not immediately known. The hospital is operated by state-run Bharat Heavy 

Electricals Ltd., Gaur said. Bhopal is about 750 kilometers (465 miles) south of New Delhi.

USA Today

New Caledonia: Chikungunya

30 April - The authorities in New Caledonia have confirmed that 3 people have been 

infected with chikungunya [virus]. A woman with chikungunya [virus infection] was identified 

in Poindimie in the far north. She had come from the Noumea area where authorities 

believe she was infected with the mosquitoborne disease, which has spread from Indonesia 

to Papua New Guinea. This comes as health services are stretched by a dengue outbreak, 

which this season has affected more than 8000 people and killed 3. The head of public 

health, Dr Jean Paul Grangeon, has appealed to the public to be very vigilant and to take 

measures to eliminate breeding grounds for the mosquitoes. He says chikungunya 

symptoms, such as fever and pains, are more severe than dengue, with possible relapses for 

several years. ProMED-mail
17

Singapore: Dengue cases continue to rise

29 April - The number of dengue cases continues to rise, 

reaching almost 539 for the week ending April 27th. This is 

the highest weekly number recorded, since the last major 

outbreak in 2005. The total number of dengue cases so far 

this year has now hit more than 5,385, compared to last 

year's total of more than 4,632. The National Environment Agency provided these figures on 

Monday, a day after a national campaign was launched as part of concerted efforts to curb 

the epidemic. Channel News Asia

Sri Lanka: Malaria, imported

30 April - Health officials have warned that although malaria is on the brink of being 

eliminated in Sri Lanka, there could be a re-emergence of the disease due to a rise in the 

number of "imported" cases. "We had 70 "imported" cases of malaria as against 23 

indigenous cases last year [2012]. The imported cases included a large number of refugees 

who arrived from Benin in West Africa; they were tested at the airport and 50 were found to 

be positive. The rest were from India and Pakistan," Anti Malaria Campaign (AMC) sources 

told the Sunday Observer. They said due to sustained awareness programs by the AMC to 

eradicate the disease, the parasite reservoir in the island was now absent. "The risk is that 

the malaria vector is still abundant during long drought periods, especially in the North 

Central Province in areas such as Hambantota, Anuradhapura, Polonnaruwa, Mullaitivu, and 

Mannar. If someone brings the parasite with them after visiting a malaria-prone country

such as African countries and India, there is a chance for another outbreak of the disease," 

they warned. ProMED-mail

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USSOUTHCOM

Argentina: In therapy? In Argentina, it’s the norm

28 April - ...It's not just psychoanalysis that's popular in Argentina. The country has the 

distinction of being home to more psychologists per capita than anywhere else in the world. 

Almost half the country's psychologists are concentrated in the capital city of Buenos Aires. 

Portenos -- that's what residents of Buenos Aires call themselves -- say they don't have the 

same stigma about seeking mental health treatment as Americans. Whereas mental health 

treatment in the United States might be seen as something to keep secret, it's common in 

Buenos Aires to talk about emotional problems or what's going on in therapy. CNN

Latin America threatened by mounting cancer epidemic

26 April - Latin America's growing prosperity is fueling a cancer epidemic that threatens to 

overwhelm the region unless governments take urgent preventive action, a study published 

on Friday warned. A multinational team of researchers found the current state of cancer 
18

care and prevention in Latin America is incompatible with the socioeconomic changes 

taking place in the region, where an increasingly urban populace faces mounting lifestylerelated cancer risks. VOA

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