17 August 2012

Army Public Health Weekly Update

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

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

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

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

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Contents

U.S. MILITARY

 Acute pelvic inflammatory disease, active component, U.S. Armed Forces, 2002- 2011

 Aiming to knock out mosquito-borne illnesses with one shot

 Army working on blood test to detect TBI

 DoD, VA pursue joint immunization system for iEHR

 War wounds

 West Nile Virus detected on post; experts offer preventive tips

GLOBAL

 Johnson & Johnson removing harsh chemicals from adult toiletries and cosmetic products by 2015

 Some children risk death with codeine, U.S. warns

 While Olympians peak, lack of activity remains a leading global cause of death

INFLUENZA

 Avian influenza – situation in Indonesia – update

 CDC: Weekly Influenza Surveillance Report

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 Study: Children, middle-aged most vulnerable to variant H3N2

 Study says pregnant women should get flu shot

 Study finds flu in healthy-looking pigs at state fairs

VETERINARY/FOOD SAFETY

 Europe: Schmallenberg virus

 Fatal foodborne Clostridium perfringens illness at a state psychiatric hospital — Louisiana, 2010

 FDA issues annual food safety report to Congress

WELLNESS

 A few hours of weekly exercise may help women's bones

 A host of ills when iron’s out of balance

 Egg yolks almost as bad for arteries as smoking: study
Issues for Fair 

Organizers to 

Consider When 

Planning Fairs

Thousands of fairs take 

place across the United 

States each year, providing 

a fun venue for people to 

interact and show off their 

livestock, horticulture or 

agriculture projects. 

As you organize your local 

or state fair, you need to 

be aware of important 

information to help protect 

visitors and livestock. This 

fair season, CDC is 

monitoring the occurrence 

of influenza caused by a 

specific H3N2 influenza 

virus that has been found 

in both people and pigs in 

a number of states. Some 

simple precautions are 

effective in reducing the 

spread of the virus.

 Screening for domestic violence doesn't always help

 Your blood type may boost your heart risk, study finds

USAFRICOM

 Africa: Nonsurgical circumcision device will be tested to help curb AIDS

 Exxon unit investigates oil spill near Nigeria facility

 Uganda: Ebola update, WHO

USCENTCOM

 Iran: Epidemic outbreak feared in Iran

USEUCOM

 EU considering cigarette logo ban to deter smoking

 Germany: Commuting and after-hour work a health hazard

 Germany to help Georgia with healthcare management

USNORTHCOM

 U.S.: Federal report details health, economic status of older Americans

 U.S: Hepatitis C case could bring federal law

 U.S.: Interim guidance for clinicians considering the use of preexposure prophylaxis for the prevention of 

HIV infection in heterosexually active adults

 U.S.: Mississippi fattest, Colorado thinnest in new federal obesity statistics

 U.S., Texas: Dallas mayor declares emergency over West Nile virus

 U.S.: Why whooping cough is back

USPACOM

 Australia: Landmark bill hailed

 Australia: Measles outbreak sparks vaccination warning

 Japan's nuclear leaks sparked butterfly mutations

 Philippines: Over 51,000 dengue cases reported since January

USSOUTHCOM

 Brazil: Women rebel against cesarean births

 Haiti: Years after quake, safe housing is a dream for many

U.S. MILITARY

Acute pelvic inflammatory disease, active component, 

U.S. Armed Forces, 2002- 2011 

July 2012 - This report documents stable rates of acute PID among active component 

servicewomen during 2002-2011, at approximately 8 per 1,000 p-yrs overall and 11 per 

1,000 p-yrs among known high-risk sub-populations (i.e., 17-24 years old, in the Army, 

black, non-Hispanic race/ethnicity). These rates and risk correlates are comparable to those 

previously reported in military and civilian populations. The proportion of servicewomen 

diagnosed with infertility subsequent to an incident diagnosis of acute PID increased during 
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the period for reasons which are unclear. Rates of PID are higher in the Army than the other 

Services. This may reflect that most servicewomen receive chlamydia screening, treatment 

and education immediately upon accession, while women entering the Army may wait up to 

12 months for such services. Medical Surveillance Monthly Report

Aiming to knock out mosquito-borne illnesses with one 

shot

13 August - Military medical researchers are making significant headway in developing 

dengue and malaria vaccinations designed to boost military readiness and save millions of 

civilian lives. One of the chief ways in which the Department of Defense supports the 

military readiness of service members is by protecting them against infectious diseases --

particularly when our nation’s warriors are deployed to regions of the world in which there 

are epidemics. Military medical researchers play a critical role in developing and testing 

vaccines that prevent troops from falling ill and spreading disease. Presently, DoD 

researchers are working hard to combat the global scourge of dengue and malaria. MHS

Army working on blood test to detect TBI

15 August - The Army is expected to have an FDA-approved battlefield blood test for 

traumatic brain injuries in two years, according to an official spearheading the service's 

efforts. The Army’s trials of the blood test among troops in Afghanistan have proved 

promising, Col. Dallas Hack, a doctor and director of Combat Casualty Care at Medical 

Research and Materiel Command, Fort Detrick, Md., told reporters. “Individuals that are 

diagnosed with a concussion and go to our recovery centers in Afghanistan, the vast 

majority are showing up positive in our biomarker tests,” said Hack, speaking by phone 

Wednesday from the Military Health System Research Symposium in Fort Lauderdale. Army 

Times

DoD, VA pursue joint immunization system for iEHR

7 August - The Tricare Management Authority wants details about how industry can build a 

joint immunization function for the integrated electronic health record (iEHR), which is 

being developed by the Defense and Veterans Affairs departments. TMA manages the 

military healthcare program... The functionality includes the ability to order immunizations; 

manage immunization schedules, patient lists and immunization history; document 

administered immunizations, immunity status and adverse reactions. The system will also be 

able to track the inventory of vaccine stock from manufacturer to dispensing to the patient. 

Government Health IT

War wounds

10 August – ... Military suicides are the starkest gauge of our nation’s 

failure to care adequately for those who served in uniform. With 

America’s wars winding down, the United States is now losing more 

soldiers to suicide than to the enemy. Include veterans, and the tragedy 

is even more sweeping. For every soldier killed in war this year, about 25 
Agency for 

Healthcare Research 

and Quality (AHRQ) 

Annual Conference

Moving Ahead: Leveraging 

Knowledge and Action to 

Improve Heath Care 

Quality is this year’s 

conference theme. More 

than 30 sessions offering 

continuing education 

credits this year to include 

two dynamic plenary 

sessions: Carolyn Clancy 

Unplugged: A Conversation 

About the Research and 

Implementation, 

Engagement, and Use: 

Making Health Care More 

Patient-Centered, Reliable, 

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Date: September 9-11

Location: Bethesda, MD

veterans now take their own lives. President Obama said recently that it was an “outrage” 

that some service members and veterans sought help but couldn’t get it: “We’ve got to do 

better. This has to be all hands on deck.” Admirable words, but so far they’ve neither made 

much impact nor offered consolation to those who call the suicide prevention hot line and 

end up on hold... An astonishing 45 percent of those who served in Iraq or Afghanistan are 

now seeking compensation for injuries, in many cases psychological ones. It’s unclear how 

many are exaggerated or even fraudulent, but what is clear is this: the financial cost of these 

disabilities will be huge, yet it is dwarfed by the human cost. New York Times

West Nile Virus detected on post; experts offer 

preventive tips

10 August - The West Nile Virus has been detected on Joint Base San Antonio-Fort Sam 

Houston; however, a few simple preventive measures can help to abate the issue, post 

officials said. “Three sample pools of mosquitoes collected July 18 tested positive for West 

Nile Virus by Public Health Command South,” said Capt. Lyndsay Knoblock-Fast, Brooke 

Army medical Center preventive medicine entomologist. “They’ve since confirmed one 

human case, one suspected case and no confirmed animal cases of the virus.” Larviciding, 

which is mosquito population control, will be performed in specific locations as deemed 

necessary, officials said. DVIDS

top of page...

GLOBAL

Johnson & Johnson removing harsh chemicals from 

adult toiletries and cosmetic products by 2015

15 August - Johnson & Johnson plans to remove trace amounts of potentially cancercausing and other dangerous chemicals from nearly all its adult toiletries and cosmetic 

products worldwide within 3 1/2 years. The health care giant late last year pledged to 

remove “chemicals of concern” from its baby products sold around the world. That change 

came after a large coalition of health and environmental groups began pressing J&J more 

than three years ago to make its personal care products safer. The company told The 

Associated Press in an exclusive interview Tuesday that it remains on track to have baby 

products, including its Johnson’s No More Tears baby shampoo, reformulated with safer 

ingredients by the end of 2013. Adult products will be reformulated by the end of 2015.

Washington Post

Some children risk death with codeine, U.S. warns

15 August - Three children died and one suffered life-threatening hyperventilation after 

taking codeine that was broken down in their bodies very quickly, likely causing a morphine 

overdose, U.S. health officials warned on Wednesday. The children, all between the ages of 
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2 and 5, received a normal dose of the opioid codeine after surgery to remove their tonsils 

or adenoids, the U.S. Food and Drug Administration said. The surgery was to treat sleep 

apnea, a condition in which the upper airways become blocked during sleep. Codeine, an 

ingredient in many prescription pain relievers and some over-the-counter cough syrups, 

normally turns into morphine in the body. But these children likely had a genetic condition 

that caused codeine to turn into morphine more quickly and completely than usual, causing 

a fatal overdose, the FDA said. Reuters

While Olympians peak, lack of activity remains a leading 

global cause of death 

10 August – Physical inactivity is the fourth leading cause 

of death worldwide. Seeking to raise awareness about the 

problem, the British journal, The Lancet, is highlighting the 

problem during the Olympic Games, when attention is 

focused on athletes at the top of their game. Lack of 

exercise also contributes to up to 10 percent of deaths worldwide from diseases like heart 

disease, diabetes, and colon and breast cancer, according to the special issue of the Lancet.

VOA News

top of page...

INFLUENZA

Avian influenza – situation in Indonesia – update

10 August - The Ministry of Health of Indonesia has notified WHO of a new case of human 

infection with avian influenza A(H5N1) virus. The case is a 37 year old male from Yogyakarta 

province. He developed fever on 24 July 2012, was hospitalized on 27 July and died on 30 

July. Epidemiological investigation on the case found that the case had four pet caged birds 

in his home, which is about 50 metres from a poultry slaughter house and near a farm. To 

date, the total number of human influenza A(H5N1) cases in Indonesia is 191 with 159 

fatalities, 8 (all fatal) of which occurred in 2012. WHO

CDC: Weekly Influenza Surveillance Report

During week 31, (ending 4 August), 5.8% 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 6.5% for week 31. FluView

Google.org: Flu Trends

16 August – Estimates of flu activity based on flu-related Internet search queries indicate 

that the level of flu activity in the northern hemisphere is minimal to low and ranges from 
minimal to high in the southern hemisphere. High levels are found in South Africa, Australia,

and New Zealand. Google.org Flu Trends

Study: Children, middle-aged most vulnerable to variant 

H3N2

10 August – A serologic study from Canada suggests that children and middle-aged adults 

have little or no immunity to the swine-origin variant H3N2 influenza virus (H3N2v), but 

about half of adolescents and young adults have some degree of immunity as measured by 

antibody levels. The researchers also found that seasonal flu vaccines used in the past two 

seasons did not improve participants' ability to mount an immune response to H3N2v... 

Given the results, "A specific vaccine would be needed in the event A(H3N2)v establishes 

epidemic spread," says the study, which was led by Danuta M. Sowronski, MD, of the British 

Columbia Centre for Disease Control as first author. CIDRAP

Study finds flu in healthy-looking pigs at state fairs

15 August – Testing of a sampling of pigs shown at the Minnesota State Fair during the 

2009 H1N1 influenza pandemic revealed that 19% of them were infected with flu viruses, 

even though they looked healthy, according to a new study. The findings highlight the 

challenges of preventing pigs and humans from passing flu viruses back and forth at fairs 

and swine shows, especially this summer when several states are tracking human illnesses 

from a novel H3N2 virus that has been detected in both pigs and people... [Researchers] 

recruited people ages 7 and older who were showing pigs at the Minnesota State Fair in 

2008 and 2009 and the South Dakota State Fair in 2009. Participants filled out a 

questionnaire and allowed the researchers to collect nasal swab samples from their pigs... 

Because most of the animals were sampled within 24 hours after arriving at the fair, the 

researchers concluded that the infected pigs were probably infected before they arrived. 

Absence of apparent illness in the pigs that tested positive suggests exposure to apparently 

healthy pigs at shows as a potential source of influenza A transmission, the team concluded. 

CIDRAP

Study says pregnant women should get flu shot

9 August - The Centers for Disease Control and Prevention is watching a strain of flu that 

contains a gene from the 2009 H1N1 pandemic flu virus. That 2009 virus infected millions of 

people around the world. Pregnant women were especially vulnerable and were urged to 

be vaccinated. But is the vaccination safe for unborn babies? A new Danish study is 

looking into that question. During the 2009 H1N1 influenza pandemic, pregnant women 

faced a greater risk of life-threatening complications and many were hospitalized. VOA 

News

top of page...
VETERINARY/FOOD SAFETY

Europe: Schmallenberg virus

16 August - Livestock producers should consider changing their breeding programme to 

help mitigate the risk of contracting the Schmallenberg virus [SBV], scientists have advised. 

They said the disease had survived the winter and there was now a "real risk" of it spreading 

further north and across the border into Wales this coming breeding season. ProMED-mail

Fatal foodborne Clostridium perfringens illness at a state 

psychiatric hospital — Louisiana, 2010

17 August - Clostridium perfringens, the third most common cause of foodborne illness in 

the United States (1), most often causes a self-limited, diarrheal disease lasting 12–24 hours. 

Fatalities are very rare, occurring in <0.03% of cases (1). Death usually is caused by 

dehydration and occurs among the very young, the very old, and persons debilitated by 

illness (2). On May 7, 2010, 42 residents and 12 staff members at a Louisiana state 

psychiatric hospital experienced vomiting, abdominal cramps, and diarrhea. Within 24 

hours, three patients had died. The three fatalities occurred among patients aged 41–61 

years who were receiving medications that had anti–intestinal motility side effects. For two 

of three decedents, the cause of death found on postmortem examination was necrotizing 

colitis. Morbidity and Mortality Weekly Report

FDA issues annual food safety report 

to Congress

16 August - The U.S. Food and Drug Administration's annual 

report to Congress, released this week, offers an overview of 

what the agency has been up to over the past year. In FDA's 

latest report, which is required by the 2011 Food Safety 

Modernization Act, one thing is immediately clear: FDA has an enormous food safety 

mandate... Out of 167,033 registered domestic facilities, FDA and states under contract 

inspected 19,073. Out of 254,088 registered foreign facilities, FDA and states under contract 

inspected 995. Of the 22,325 domestic food companies FDA has deemed "high-risk," the 

agency inspected 11,007, or nearly half of them... The agency has also "devoted significant 

time and resources" to building a more integrated national food safety system. FDA said in 

the last year they established several working groups to help state, local and tribal 

stakeholders work to help with the integration. Food Safety News

top of page...
WELLNESS

A few hours of weekly exercise may help women's bones

15 August - Engaging in more than two hours of physical activity per week 

appears to help pre-menopausal women maintain healthy bones, new 

research suggests. The finding is based on the impact that even small 

amounts of exercise seem to have on curtailing the production of a protein 

that impedes bone growth, while at the same time increasing the activity of 

another protein that promotes bone formation. The study will appear in the October issue 

of the Journal of Clinical Endocrinology and Metabolism. Medline Plus

A host of ills when iron’s out of balance

13 August - ... In examining more than 1,000 white Americans ages 67 to 96 participating in 

the Framingham Heart Study, researchers found that only about 3 percent had deficient 

levels of iron in their blood or stored in their bodies, but 13 percent had levels considered 

too high. The authors concluded that “the likely liability in iron nutriture in free-living, 

elderly white Americans eating a Western diet is high iron stores, not iron deficiency.”... The 

problem with too much stored iron is that, short of bleeding, the body can’t easily get rid of 

it. Menstruating women are unlikely to have a problem, but for others with high stores the 

recommended treatments include phlebotomy and frequent blood donation. Without these 

measures, excess iron gets deposited in the liver, heart and pancreas, where it can cause 

cirrhosis, liver cancer, cardiac arrhythmias and diabetes. New York Times

Egg yolks almost as bad for arteries as smoking: study

15 August - Whether boiled, scrambled or sunny-side up, 

cholesterol-rich egg yolks can stiffen your arteries almost as 

much as smoking, a new study suggests. "People at risk of 

vascular disease should not eat egg yolks," contends study lead 

author Dr. David Spence, professor of neurology at Western 

University in London, Ontario, Canada. The cholesterol found in an egg's yellow center can 

even clog the carotid artery leading to the brain, upping risks for stroke, he pointed out. 

Medline Plus

Screening for domestic violence doesn't always help

14 August – Asking women about domestic violence through a computerized questionnaire 

and giving them a list of local abuse resources had no effect on their health or quality of 

life, a new study from Chicago-area health centers found. Researchers agree that 

psychological and physical abuse in relationships is both common and a significant public 

health problem. But the question of how best to identify victims of violence and get them 

the help they need is unresolved. "Although the findings are maybe disappointing to some, 

I don't think they should be used to conclude that screening for intimate partner violence in 
clinical settings shouldn't be done or doesn't work," said Andrea Gielen, head of the Johns 

Hopkins Center for Injury Research and Policy in Baltimore. Medline Plus

Your blood type may boost your heart risk, study finds

14 August – Your blood type may influence your heart health, with types A, B and AB 

slightly increasing the odds of heart disease, a new study suggests. You can, however, 

counter this genetic predisposition by living a healthy lifestyle that includes a balanced diet, 

exercise and well-controlled blood pressure, cholesterol and weight, experts say. "Our data 

suggests the importance of knowing blood type as one factor in susceptibility to 

cardiovascular disease," said lead researcher Dr. Lu Qi, an assistant professor in the 

department of nutrition at the Harvard School of Public Health in Boston. Medline Plus

top of page...

USAFRICOM

Africa: Nonsurgical circumcision device will be tested to 

help curb AIDS

13 August - PrePex, a bloodless circumcision device for adults, will be tested in at least nine 

African countries in the next year, according to the backers of the tests. The device, above, 

was approved by the Food and Drug Administration in January, and World Health 

Organization approval is expected soon. No surgeon is needed for the procedure; a twonurse team slides a grooved ring inside the foreskin and guides a rubber band to compress 

the foreskin in the groove. After a week, the dead foreskin falls off like the stump of a baby’s 

umbilical cord or can be painlessly clipped off, said Tzameret Fuerst, chief executive of 

PrePex... A larger study has already established that PrePex is safer than conventional 

surgery. The new studies, Dr. Reed said, will be done to see whether men in each country 

will accept it and whether there are any regulatory hurdles. New York Times

Exxon unit investigates oil spill near Nigeria facility

15 August - ExxonMobil's Nigeria unit said it was investigating an oil spill near its facility off 

the country's southeast coast, which local fishermen said had covered the waters where they 

fish with a toxic film. Mobil Producing Nigeria, a joint venture between ExxonMobil and the 

state oil firm, said on Wednesday that relevant government agencies had been notified of 

the spill. "Mobil Producing Nigeria ... confirms that oiling from an unknown source has been 

sighted along the shoreline near Ibeno, Akwa Ibom State," spokesman Nigel Cookey-Gam 

said. "An emergency response team was immediately dispatched to the shoreline, and 

samples of the substance were collected for fingerprinting to determine its source, which 

remains unknown." Reuters
Uganda: Ebola update, WHO

14 August - The Ministry of Health of Uganda (MoH) continues to work with partners 

including WHO, CDC, Red Cross, MSF, World Vision, PREDICT, among others to control the 

outbreak of Ebola haemorrhagic fever in Kibaale district. The national and district task forces 

continue to meet daily to coordinate the response to the outbreak. To date, 24 probable

and confirmed cases including 16 deaths have been reported. 10 cases have been 

laboratory confirmed by the Uganda Virus Research Institute (UVRI) in Entebbe. The most 

recent confirmed case was admitted in Kagadi isolation facility on 4 August 2012. WHO

top of page...

USCENTCOM

Iran: Epidemic outbreak feared in Iran

16 August – Twin earthquakes that devastated rural villages in northwest Iran on the 

weekend killed 306 people, most of them women and children, and have sparked fears of 

disease outbreak, officials said Monday. Another 3,037 people were injured, of whom 2,011 

were given first aid at the scene and the rest were taken to hospital, where 700 surgeries 

were performed, Health Minister Marzieh Vahid told lawmakers in a report published on the 

parliament’s website. “We are continuing the search for bodies,” she said. Authorities called 

off rescue operations on Sunday after saying all possible survivors had been recovered... 

The head of Iran’s emergency services, Gholamreza Masoumi, meanwhile warned of a 

possible outbreak of infectious diseases as homeless survivors huddled in unsanitary 

conditions, lacking water and portable washrooms, the Fars news agency reported. “Another 

important issue is a large number of animal corpses scattered in the area and inside water 

resources,” he said. Saudi Gazette

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USEUCOM

EU considering cigarette logo ban to deter smoking

16 August - The European Union is considering banning logos on cigarette packs as part of 

an upcoming review of its law to deter smoking, a spokesman said on Thursday, a day after 

Australia's highest court upheld a similar ban. The Australian court dismissed a legal 

challenge to the government's ban, in a case filed by British American Tobacco, Britain's 

Imperial Tobacco, Philip Morris and Japan Tobacco. The ruling means that starting in 

December, all cigarette packs sold in Australia will brandish plain olive packaging. Reuters
Germany: Commuting and after-hour work a health 

hazard

16 August - Long commutes and doing job-related work at home after hours are having an 

increasing impact on many Germans' mental health, a study says. The authors claim being 

flexible more often than not means becoming sick. Germans whose work life balance is out 

of kilter are twice as likely to report in sick before long, a study by the country's Wido think 

tank of health insurers indicated on Thursday. The research group claimed long daily 

commuting distances and taking work home at night, as two elements of modern working 

life, were having an increasingly negative effect on people's well-being and psychological 

health... Wido said that since relevant data became first available in 1994, psychological 

malaise-related sick leaves had risen by 120 percent across the country. The think tank 

added that such leaves lasted for 22.5 days on average, twice longer than those taken 

because of other ailments. Deutsche Welle

Germany to help Georgia with healthcare management

16 August - German Secretary of State Thomas Ilka, along with a delegation from the 

Federal Ministry of Health recently visited Georgia. Meetings with the deputy minister at the 

Ministry of Health, Labour and Social Affairs of Georgia Irakli Nadareishvili, as well as 

representatives of insurance companies, hospitals and NGO leaders were held during the 

visit, the German Embassy in Georgia told Trend. The purpose of the meetings was to 

familiarise the group with the health system in Georgia. Issues of deepening bilateral 

cooperation and management in health care were discussed during the visit. Germany has 

already provided assistance to Georgia in the fight against tuberculosis with the training of 

medical staff, as well as humanitarian aid in the past. Trend

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USNORTHCOM

U.S.: Federal report details health, economic status of 

older Americans

16 August - Today's older Americans enjoy longer lives and better physical function than 

did previous generations, although, for some, an increased burden in housing costs and 

rising obesity may compromise these gains, according to a comprehensive federal look at 

aging. The report, Older Americans 2012: Key Indicators of Well-Being, tracks trends at 

regular intervals to see how older people are faring as the U.S. population grows older. NIH

U.S: Hepatitis C case could bring federal law

15 August - The case of a medical technologist suspected of infecting patients with hepatitis 

C could boost momentum for federal legislation requiring medical-imaging and radiation-
therapy workers to meet standards before their employers receive Medicare

reimbursements. David Kwiatkowski is accused of stealing drugs and contaminating 

syringes used on patients at Exeter Hospital in New Hampshire, where 32 people have been 

diagnosed with the same strain of hepatitis C he carries. He previously worked at 18 

hospitals in seven other states, moving from hospital to hospital despite having been fired 

twice over allegations of drug use and theft. San Francisco Chronicle

U.S.: Interim guidance for clinicians considering the use 

of preexposure prophylaxis for the prevention of HIV 

infection in heterosexually active adults

10 August - ... When PrEP is used by heterosexually active adults, it is important to ensure 

that 1) PrEP is targeted to persons at very high risk for HIV acquisition (11), especially 

uninfected persons whose regular sexual partners are known to have HIV infection; 2) the 

importance of adherence to daily medication and its influence on efficacy is clearly 

discussed; 3) couples understand that although no adverse effects have been found among 

infants exposed to TDF/FTC during pregnancy and breastfeeding, these data are incomplete 

for women in HIV-discordant couples using TDF/FTC to prevent acquisition of HIV; 4) PrEP is 

delivered as part of a comprehensive set of prevention services, including risk-reduction, 

PrEP medication adherence counseling, and ready access to condoms; 5) sexually 

transmitted infection treatment is provided when indicated by laboratory screening tests 

conducted at least every 6 months, and 6) PrEP is accompanied by monitoring of HIV status, 

pregnancy status, side effects, adherence, and risk behaviors at each quarterly follow-up 

visit. Morbidity and Mortality Weekly Report

U.S.: Mississippi fattest, Colorado thinnest in new federal 

obesity statistics

13 August -... The federal government released its “obesity map” on Monday, outlining the 

rates of obesity and how rates in the states compare. Colorado gets the svelte bragging 

rights, with 20.7% of its adults obese. At the other end of the scale is Mississippi, with a rate 

of 34.9%. The South had the highest prevalence of obesity – with several states among the 

12 that are in the over-30% category: Alabama, Arkansas, Indiana, Kentucky, Louisiana, 

Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Texas and West Virginia. Overall, 

the rate for the South was 29.5%, followed by the Midwest at 29%, the Northeast at 25.3% 

and the West at 24.3%. Los Angeles Times

U.S., Texas: Dallas mayor declares emergency over West 

Nile virus

15 August - The mayor of Dallas declared a state of emergency 

in the ninth largest U.S. city on Wednesday to combat the 

spread of West Nile virus infections, which have been more 

prevalent than usual in Texas and other states this year. There 

have been more cases of West Nile virus reported so far this year 
than any year since the disease was first detected in the United States in 1999, the Centers 

for Disease Control said on its website. Nearly half of the 693 human cases of the mosquitoborne West Nile virus infections reported this year to the CDC have been in Texas, along 

with 14 of the 26 deaths confirmed by the federal agency as of Tuesday. Reuters

U.S.: Why whooping cough is back

16 August - The number of whooping cough cases in the 

U.S. this year is on track to be the highest in 50 years, 

although one researcher says the main reason behind the 

disease's apparent resurgence is a heightened awareness of 

it. Besides improved reporting of cases of whooping cough 

(which is also called pertussis), factors in the disease's resurgence include the fact that 

vaccines don't completely protect against it, and that the current vaccine provides even less 

protection than previous ones did, according to Dr. James Cherry, a professor of pediatric 

infectious diseases at the David Geffen School of Medicine, University of California at Los 

Angeles. "It is time to recognize the successes of the past, and to implement new studies 

and direction for the control of pertussis in the future," Cherry writes in an editorial 

published Thursday (Aug. 16) in the New England Journal of Medicine. Fox News

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USPACOM

Australia: Landmark bill hailed

16 August – Global public health authorities have hailed the High Court decision - and with 

1 billion people expected to die from tobacco-related illnesses this century, the stakes have 

never been higher. The World Health Organisation hopes the decision will embolden poorer 

countries to enact laws without the fear of heavy legal bills. Susan Mercado, from the 

Tobacco Free Initiative in the organisation's western Pacific regional office, said the 

judgment would douse the tobacco industry with cold water. "I don't think the industry is 

going to let up ... but this is a victory and they need to start to retreat," she said. "It's 

important not only for the region. There are many other countries in the world who are 

facing intimidation and legal action." The president of the US-based global organisation 

Campaign for Tobacco-Free Kids, Matthew Myers, said the decision would be seen as an 

historic landmark. "Countries around the world have been waiting for this decision to move 

forward themselves on plain paper packaging," he said. Sydney Morning Herald
Australia: Measles outbreak sparks vaccination warning

15 August - Doctors are urging parents to ensure their children 

are fully immunised against measles because of an outbreak in 

Sydney's south-west. There have been 40 reported cases in the 

area, with 10 sufferers being taken to hospital. Dr Stephen 

Conaty from the South Western Sydney Public Health Unit says 

in all cases those infected were not fully immunised. "So all the cases we're seeing are either 

in unimmunised infants because they may be too young to be immunised because you get 

immunised at 12 months of age, or in teenagers, so young adults who for one reason or 

another they've missed out on either one or both of their MMR immunisations," he said. 

ABC News

Japan's nuclear leaks sparked butterfly mutations

16 August — Radiation that leaked from the Fukushima nuclear plant following last year's 

tsunami caused mutations in some butterflies — including dented eyes and stunted wings 

— though humans seem relatively unaffected, researchers say. The mutations are the first 

evidence that the radiation has caused genetic changes in living organisms. They are likely 

to add to concerns about potential health risks among humans though there is no evidence 

of it yet. Scientists say more study is needed to link human health with the Fukushima 

disaster. AP

Philippines: Over 51,000 dengue cases reported since 

January

17 August - Dengue has afflicted 51,597 individuals from Jan. 1 to July 14 and the number 

continues to rise, the Department of Health (DOH) said yesterday. In a report, the DOH said 

the figure is 16.43 percent higher than the 44,315 cases recorded during the same period 

last year. Most of the cases were from the National Capital Region (22.24 percent), 

Calabarzon (14.08 percent) and Central Luzon (13.65 percent), according to the report... Of 

the 51,597 cases, 324 have died, representing a case fatality rate of 0.63 percent. Philippine 

Star

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USSOUTHCOM

Brazil: Women rebel against cesarean births

12 August - In Brazil, where natural childbirth fell out of favor years ago, more than half of 

all babies are born via cesarean section, a figure that rises to 82 percent for women with 

private health insurance. But that trend may be turning around in a country with one of the 

highest cesarean rates in the world. More women are pushing for more of a say in childbirth 
— whether by C-section or naturally, at home or in a hospital, with a midwife or a medical 

doctor. As patients in doctors' offices and street protesters reject the pressure to have 

surgical births, the federal government is investing billions of dollars into a natural 

childbirth campaign, including the building of hospitals devoted to maternal care. Yahoo! 

News

Haiti: Years after quake, safe housing is a dream for 

many

15 August - Two and a half years after the earthquake, despite 

billions of dollars in reconstruction aid, the most obvious, 

pressing need — safe, stable housing for all displaced people 

— remains unmet. In what international officials term a 

protracted humanitarian crisis, hundreds of thousands remain 

in increasingly wretched tent camps. Tens of thousands inhabit dangerously damaged 

buildings. And countless others, evicted from camps and yards, have simply disappeared 

with their raggedy tarps and rusty sheet metal into the hills. New York Times

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