12 October 2012

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

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Contents

U.S. MILITARY

 6 promising advances to save soldiers' brains

 Health care encounters for injuries associated with a gun mechanism or component, U.S. 

Armed Forces

 New criteria prompt resubmission of PTSD claims

 Soldiers’ mental health: an emergency

GLOBAL

 Fears over risk of air transmission of superbugs

 GSK and Aeras to test TB vaccine in Africa, India

 Many millions suffer from depression

 Novel coronavirus infection – WHO update

 One in eight of world population going hungry, U.N.

 Trader turned neuroscientist explores risky highs

 Typhoid vaccine failure warning

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 Debate heats up about contentious bird flu research

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

 Google.org: Flu Trends

 More evidence flu shot is safe for the egg-allergic

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

VETERINARY/FOOD SAFETY

 Canada, U.S.: FSIS nearly triples beef covered by E. coli warning

 Germany: Frozen strawberries suspected in big gastroenteritis outbreak

WELLNESS

 2C-I or 'Smiles': The new killer drug every parent should know about

 Are we throwing away 'expired' medications too soon?

 Are you likely to respond to exercise?

 Breast Cancer Awareness Month: Study looks at how confidence and exercise plays a role
Operation 

Supplement Safety

OPSS is a joint initiative 

between the Human 

Performance Resource 

Center and the DoD to 

educate service members 

and retirees, their family 

members, leaders, 

healthcare providers, and 

DoD civilians about dietary 

supplements and how to 

choose supplements 

wisely.

New OPSS campaign 

products are now available 

in the Health Information 

Products eCatalog.

 'Like this page' to prevent sexually transmitted infections

 Mercury exposure in womb linked to ADHD symptoms

 New vending machines will display soda calorie counts

 Redefining medicine with apps and iPads

 Walking for heart health? Speed it up, study suggests

USAFRICOM

 Africa: Gavi partners help protect 50 million young people from seasonal meningitis

 Africa: Study - HIV, food insecurity closely linked

 Democratic Republic of Congo: Ebola outbreak, WHO update

 Sierra Leone: Cholera, WHO update

 Zimbabwe HIV activists push for government accountability

USCENTCOM

 Afghanistan and Pakistan: Progress toward Poliomyelitis eradication, January 2011-August 2012

 Egypt: Mumps

 Iraq's endless humanitarian crisis

 Pakistan introduces Glaxo pneumonia vaccine

 Pakistan, Karachi: Brain-eating amoeba kills 10

USEUCOM

 England offering free HIV treatment for visitors

 Gaza: British journal warns of ‘urgent’ Palestinian health crisis

 Portugal: Two dengue cases appear locally acquired

 The U.K. public health response to an imported laboratory confirmed case of a novel 

coronavirus, September 2012

USNORTHCOM

 Puerto Rico declares dengue epidemic

 U.S.: Calls for oversight grow as meningitis scare widens

 U.S. deaths reach record high as population grows, ages

 U.S.: Geographic differences in HIV infection among Hispanics or Latinos - 46 states and Puerto 

Rico, 2010

 U.S.: HIV deaths declining for most, but not all, Americans

 U.S.: Strokes in young people 'rising', study finds

USPACOM

 India: Dengue grips Bangalore, eight people dead, 700 cases reported

 Papua New Guinea: Chikungunya

USSOUTHCOM

 Haiti, Dominican Republic aim to oust cholera by 2022

U.S. MILITARY

6 promising advances to save soldiers' brains

4 October - ...Here are six promising TBI-related technologies they might consider, under 

development by U.S. Army Medical Research and Materiel Command (USAMRMC).
Multistate 

Meningitis Outbreak 

Investigation

CDC is aware that New 

England Compounding 

Center (NECC) has 

voluntarily expanded its 

recall to include all 

products currently in 

circulation that were

compounded at and 

distributed from its facility 

in Framingham, 

Massachusetts.

CDC's guidance to patients

has not changed as a result 

of this voluntary recall. 

Patients who feel ill and are 

concerned about whether 

they received a medication 

from NECC at one of the 

affected facilities should 

contact their physicians.

Clinicians should actively 

contact patients who have 

received medicines 

associated with three lots 

of preservative-free 

methylprednisolone 

acetate (80mg/ml) recalled 

on September 26. The 

potentially contaminated 

injections were given 

starting May 21, 2012.

Click to view case count 

map.

Head gear in a pill?...A fighter could swallow such a pill before the risk of head trauma 

even crops up. The drug would protect the neurological tissue in the event of a blow to the 

head...

A cocktail for safety... The goal of USAMRMC’s Neuroprotective Drug Combination 

Therapy Strategy Program is to identify possible drug combinations that work together to 

improve TBI treatment and results...

Rapid bio-marker testing A blood tester for the field could instantly ID neurological 

trauma.

Automated eye exams – via binoculars...An easy to use Automated Binocular Vision Tester 

that will spare warfighters the visit to the optometrist -- and ensures they are checked. 

A blast exposure-meter... A “blast dosimeter”... will objectively measure whether serious or 

even life-threatening exposure has occurred.

BrainScope... A smartphone-like device that records brain electrical activity without 

emitting radiation. It then uses advanced algorithms to quantify and characterize electrical 

activity in the brain. It is intended to assist in making vital triage decisions and help identify 

concussions. Fox News

Health care encounters for injuries associated with a gun 

mechanism or component, U.S. Armed Forces

September 2012 - ...During January 2010 through July 2012, 400 active component U.S. 

service members were treated for injuries during 419 medical encounters for which the code 

E928.7 was recorded. Approximately 6 percent of such encounters (n=26) were 

hospitalizations. Most encounters involved members of the Army (60.1%), and the Army and 

Marine Corps had much higher overall rates of injuries than the other service branches. The 

annual average number of encounters per month increased 49 percent from 2010 

(10.7/month) to 2011 (15.9/month) but declined slightly during the first seven months of 

2012 (14.3/month). The vast majority (91%) of medical encounters for injuries due to gun 

mechanisms were reported by military medical facilities in the United States; 7 percent of 

encounters occurred in Europe; Japan and Korea accounted for <2 percent each. Medical 

Surveillance Monthly Report

New criteria prompt resubmission of PTSD claims

10 October - Retirees who have been denied claims related to post-traumatic stress 

disorder are being encouraged to submit their claims again because the Army is using new, 

and more refined, criteria to assess those claims... Army Times Prime

Soldiers’ mental health: an emergency

Anyone who believes that our country’s methods are adequate for 

helping veterans re-adapt to society as the wars in Iraq and 

Afghanistan wind down need look no further than at the following 

data: In the year 2012, 211 members of the United States Armed 
Future Uses of the 

Department of 

Defense Joint 

Pathology Center 

Biorepository

In 2005, the federal Base 

Realignment and Closure 

Commission recommended 

that the AFIP be closed, 

and its biorepository was 

transferred to the newly 

created Joint Pathology 

Center. During the 

transition, the Department 

of Defense asked the IOM 

to provide advice on 

operating the 

biorepository, managing its 

collection, and determining 

appropriate future use of 

specimens for consultation, 

education, and research. 

In this report, the IOM 

proposes a series of 

protocols, standards, 

safeguards, and guidelines 

that could help to ensure 

that this national treasure 

continues to be available 

to researchers in the years 

to come, while protecting 

the privacy of the people 

who provided the materials 

and maintaining the 

security of their personal 

information.

Forces took their own lives. At least 53 of them committed suicide in July and August. That 

is more than the total number of battlefield deaths in those months. This is a crisis that has 

gone largely unaddressed in this political cycle, and it’s unacceptable. The numbers are a 

devastating wake-up call to a healthcare emergency that demands leadership and a new 

approach. Military brass, medical experts and elected officials are well aware of one cause of 

this epidemic: severe mental illnesses caused by Post-Traumatic Stress, often stemming 

from the unseen wound of this war, Traumatic Brain Injuries. New York Daily News

top of page...

GLOBAL

Fears over risk of air transmission of superbugs

10 October - The extent to which hospital superbugs are 

being transmitted via the air needs to be investigated, 

experts say. It comes after a Leeds University study has 

added to a growing body of evidence about the ability of 

bacteria to float on air currents. Researchers carried out lab 

tests on a bacteria associated with MRSA and found it could travel up to 3.5m (11ft). And 

they said the findings could have implications for the design and organization of hospitals. 

The news is not surprising - it is already well established that bacteria can be transmitted 

this way - but the focus on MRSA bacteria has prompted calls for further work to establish 

how significant this could be in the fight against hospital infections. BBC News

GSK and Aeras to test TB vaccine in Africa, India

10 October - GlaxoSmithKline and the non-profit biotech group Aeras are to assess an 

experimental tuberculosis vaccine in "proof of concept" tests in Africa and India, marking a 

step forward in the hunt for new ways to prevent the killer disease. The partners plan to 

launch a mid-stage Phase IIb clinical study in Kenya, South Africa and India next year, 

following successful initial tests with the GSK product, Aeras said on Wednesday.

Reuters

Many millions suffer from depression

9 October - Wednesday (October 10th) is World Mental 

Health Day. The World Health Organization is using the 

occasion to call for an end to stigma against those who 

suffer from depression and other mental disorders. Dr. 

Shekhar Saxena said more than 350 million people around 

the world suffer from depression. “When we say depression, we are talking about the 

mental disorder, which is very specific and is much beyond the usual feelings of sadness 

that everybody gets once in a while.” VOA
Permethrin-Treated 

Army Combat 

Uniforms

To better protect Soldiers 

from biting insects, the 

Army will begin fielding 

Army Combat Uniforms 

(ACUs) that have been 

factory treated with the 

Environmental Protection 

Agency (EPA) -approved 

insect repellent /insecticide 

permethrin. 

Permethrin has been used 

to treat uniforms since 

1991, but this new process 

will provide better 

protection for Soldiers. 

Factory treatment with 

permethrin has been 

available in civilian clothes 

for some time, and was 

adopted by the Marine 

Corps in 2007. And it has 

been used in the Iraq and 

Afghanistan operations 

since 2010. STAND-TO!

Novel coronavirus infection – WHO update

10 October - No new cases of infection with the novel coronavirus have been reported since 

22 September 2012. So far, after careful follow-up of close contacts of the two confirmed 

cases, and a heightened state of global surveillance, there is no evidence of human-tohuman transmission of the virus. The governments of Saudi Arabia, Qatar and the United 

Kingdom, are continuing their work to gain a better understanding of the disease and the 

likely source of infection. WHO is supporting the national authorities in their ongoing 

investigation, and has deployed experts to Saudi Arabia and Qatar as part of an 

international team. These and future epidemiological and scientific studies will lead to a 

better understanding of the novel coronavirus. WHO continues to work with the ministries 

of health and other international partners to coordinate actions for timely detection, rapid 

diagnosis and case management of infection caused by the novel coronavirus, should the 

need arise. WHO

One in eight of world population going hungry, U.N.

9 October - One out of every eight people in the world is 

chronically undernourished, the United Nations' food agencies 

said on Tuesday, and aid groups warned that rising food prices 

could reverse gains in the fight against hunger. In a report on 

food insecurity, the UN agencies said 868 million people were 

hungry in 2010-2012, or about 12.5 percent of the world's population, down more sharply 

than previously estimated from about 1 billion, or 18.6 percent in 1990-92. The new figures, 

based on a revised calculation method and more up-to-date data, are lower than the last 

estimates for recent years that pegged the number of hungry people at 925 million in 2010 

and 1.02 billion in 2009. Reuters

Trader turned neuroscientist explores risky highs

10 October - When John Coates was on a winning streak during his days as a trader at 

Deutsche Bank and Goldman Sachs, the narcotic-like "high" he experienced was so powerful 

he was determined to find out more. So after 13 years on trading floors on Wall Street he 

moved to the neuroscience labs of Rockefeller University in New York and of Britain's 

Cambridge University... What he's come up with, after several years reading up on animal 

studies and some interesting experiments with spit, is that risk taking is driven by a "winner 

effect" - a hormonal mechanism in which each competitive victory leads to more wins... 

"You become euphoric, delusional, you have less need for sleep, you have racing thoughts, 

an expanded appetite for risk, and less stringent requirements in the risk and reward tradeoff," said Coates. "Basically, you become a rogue trader." Since publishing some initial 

scientific studies exploring these traits in traders, Coates says he has been contacted by 

researchers analyzing politicians, soldiers, and even sports people who believe his work can 

shed light on theirs. Reuters
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Typhoid vaccine failure warning

8 October - More than 700,000 people recently immunised against typhoid may not have 

full protection because of a dud vaccine that has now been recalled, say experts. 

Manufacturer Sanofi Pasteur MSD has recalled 88% of its stock - 16 batches - of Typhim Vi 

vaccine because tests found some samples were too weak. Anyone immunised with the 

vaccine since January 2011 could be affected. Officials stress that the vaccine was safe and 

posed no health threat. But it could mean as many as 729,606 people who potentially 

received the affected vaccine are not fully immunised against typhoid, according to the 

body that regulates drugs in the UK, the Medicines and Healthcare products Regulatory 

Agency (MHRA). Experts say people should not get revaccinated but should take 

precautions against typhoid when abroad. BBC News

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During the week ending September 29, 6.3% of all deaths reported through the 122-Cities 

Mortality Reporting System were due to pneumonia and influenza This percentage was at 

the epidemic threshold of 6.8% for week 26. From July 12 through October 4, 2012, a total 

of 306 infections with influenza A (H3N2) variant (H3N2v) viruses have been reported from 

ten states. No new cases been reported since last week’s update. FluView

Debate heats up about contentious bird flu research

9 October - What was supposed to be a 60-day 

moratorium on certain experiments involving lab-altered 

bird flu has now lasted more than eight months. And 

there's no clear end in sight. Researchers still disagree on 

how to best manage the risks posed by mutant forms of 

highly pathogenic H5N1 bird flu. The altered viruses are contagious between ferrets, which 

are the lab stand-in for humans. The fear is that these germs could potentially cause a 

deadly flu pandemic in people if they ever escaped the lab. The journal mBio has now 

published six commentaries from key players in the debate. NPR

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During week 39 ( 24–30 September 2012):

• Low influenza activity and absence of geographic spread (the lowest categories) reported 

by all reporting countries. 
• No influenza virus was detected in sentinel samples from 17 countries reporting virological 

data. 

• As in previous weeks, no hospitalized severe influenza cases were reported. 

Although the 2012–2013 influenza season is approaching, there is no evidence as yet that 

transmission has started in Europe. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

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

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

with the highest level in Russia. The level of flu activity in the southern hemisphere ranges 

from minimal to low. Google.org Flu Trends

More evidence flu shot is safe for the egg-allergic

9 October - With flu season approaching, a new study offers 

more reassurance that kids with egg allergies can be safely 

vaccinated against the virus. "I think parents of children with 

egg allergy should be reassured about the safety of the 

influenza vaccine for their child, and understand that the 

benefits are likely to outweigh any risks," Dr. Lynda Schneider, director of the allergy 

program at Boston Children's Hospital, told Reuters Health by email. Because the flu vaccine 

is grown in chicken eggs, there have traditionally been concerns about the safety of flu 

shots for people with egg allergies, most of whom are young children. But today's vaccine 

has only tiny traces of egg protein, and studies have been showing that kids with egg 

allergies can be vaccinated without any serious reaction. Reuters

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 6 October 2012:

Influenza: There was a cluster of influenza A/H1N1(09) cases at MCRD Parris Island in midSeptember 

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

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

below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

top of page...
VETERINARY/FOOD SAFETY

Canada, U.S.: FSIS nearly triples beef covered by E. coli 

warning

4 October - The US Department of Agriculture (USDA) recently nearly tripled the amount of 

Canadian beef covered by an earlier public health warning about possible Escherichia coli 

O157:H7 contamination, according to an Oct 5 update from the agency's Food Safety and 

Inspection Service (FSIS). The amount of beef recalled by Canada-based XL Foods has 

expanded several times since early September when the Canadian Food Inspection Agency 

(CFIA) launched its probe of the tainted beef. The recall now covers all raw meat produced 

on Aug 24, 27, 28, 29, and Sep 5. The FSIS said it previously reported that US firms received 

about 890,000 pounds of recalled boneless beef trim from XL Foods, but after conducting 

recall effectiveness checks, it estimates that US companies received 1.1 million pounds of 

trim and 1.4 million points of primal and subprimal cuts from the Canadian company. 

CIDRAP

Germany: Frozen strawberries suspected in big 

gastroenteritis outbreak

4 October - German health officials suspect that a single batch of frozen strawberries is the 

source of a gastroenteritis outbreak in Germany that has sickened more than 11,000 

children at schools and daycare centers, according to an Oct 6 Associated Press (AP) story. 

Officials from the Robert Koch Institute, the country's national disease control agency, said 

on Oct 5 that epidemiologic studies show a strong connection between consuming foods 

prepared with the strawberries and illnesses involving vomiting and diarrhea. Authorities 

added that they have more evidence that norovirus is the cause, though they haven't 

completely ruled out other pathogens, the AP reported. A spokesman for the German 

agriculture ministry said the strawberries came from outside the European Union. CIDRAP

top of page...

WELLNESS

2C-I or 'Smiles': The new killer drug every parent should 

know about

20 September - ... 2C-I--known by its eerie street name "Smiles"--has become a serious 

problem in the Grand Forks area, according to local police. Overdoses of the drug have also 

be reported in Indiana and Minnesota. But if the internet is any indication, Smiles is on the

rise all over the country. "At the moment I am completely and fully submerged, if you can't 

tell by my eyes, in a psychedelic world known as 2C-I," one young man with a scruffy chin 
beard and dilated pupils effuses on a video posted in October of 2011. He's one of dozens 

of users providing YouTube "reports" of their experiences on the synthetic drug. Smile's 

effects have been called a combination of MDMA and LSD, only far more potent. Users have 

reported a speedy charge along with intense visual and aural hallucinations that can last 

anywhere from hours to days. Shine from Yahoo

Are we throwing away 'expired' medications too soon?

8 October - Have you ever reached into your medicine 

cabinet and pulled out a bottle with a faded label, only to 

discover that the aspirin or prescription drugs inside were 

past their date? Did you play it safe and toss the bottle into 

the trash? If so, you might have been overly cautious. A 

new laboratory analysis of eight prescription drugs that expired between 28 and 40 years 

ago has found that most have remained just as potent as they were on the day they were 

made .Overall, the eight drugs included 14 different active ingredients, including aspirin, 

codeine and hydrocodone. In 86% of cases, the study found, the amount of active 

ingredient present in the drugs was at least 90% of the amount indicated on the label. That 

falls within the range deemed acceptable by the Food and Drug Administration. The agency 

allows "reasonable variation" in the strength of any given batch of prescription drugs, 

generally requiring that drugs contain between 90% and 110% of the stated active 

ingredient. CNN

Are you likely to respond to exercise?

10 October - Research has confirmed that people’s physiological responses to exercise vary 

wildly. Now a new genetic test promises to tell you whether you are likely to benefit 

aerobically from exercise. The science behind the test is promising, but is this information 

any of us really needs to know? The new test, which is being sold by a British company 

called XRGenomics, is available to anyone through the company’s Web site and involves 

rubbing inside your cheek with a supplied swab and returning the tissue sample to the 

company. Results are then available within a few weeks. It is based on a body of research 

led by James Timmons, a professor of systems biology at Loughborough University in 

England, and colleagues at the Pennington Biomedical Research Center in Louisiana and 

other institutions. New York Times

Breast Cancer Awareness Month: Study looks at how 

confidence and exercise plays a role

9 October - As Breast Cancer Awareness Month is underway, a 

new study sheds light on a unique issue for older breast cancer 

survivors - staying motivated to exercise. According to scientists 

from Oregon State University, more than 40 percent of older 

breast cancer survivors don't get enough exercise after leaving 

their treatment program. Since regular exercise can reduce the risk of the disease's 

recurrence, experts say it is crucial for women to get moving after treatment. New York 

Daily News
'Like this page' to prevent sexually transmitted infections

9 October– Sexually transmitted infection (STI) prevention messages delivered by Facebook 

can be effective in promoting condom use among young adults in the short term, a new 

study has found. Few students and young adults receive comprehensive sexuality education 

or guidance on HIV and other STI risks. Social media may provide a viable alternative to 

promote safe sex using online networks of friends, the study published in the November 

issue of the American Journal of Preventive Medicine reports. EurekAlert

Mercury exposure in womb linked to ADHD symptoms

8 October - Attention deficit hyperactivity disorder (ADHD) appears to be on the rise in the 

United States, and in the search for explanations researchers have begun to scrutinize fetal 

exposure to a wide range of toxins, including lead, tobacco, pesticides, and chemicals such 

as PCBs. Mercury, a metal that affects the nervous system, is among the latest suspects to 

be investigated. And in a new study, researchers report that children who are exposed to 

higher levels of mercury in the womb are more likely to exhibit attention problems,

hyperactivity, and other ADHD symptoms when they're 8 years old. The study included 

roughly 600 mothers and children from New Bedford, Massachusetts. The researchers 

measured prenatal mercury exposure by analyzing samples of the mothers' hair shortly after 

birth, and found that a child's risk of ADHD symptoms increased by 40% to 70% past a 

certain exposure threshold (1 microgram per gram). The association was seen primarily in 

boys, which wasn't unexpected, since previous research has shown that boys seem to 

respond differently than girls to chemicals that disrupt the endocrine system. CNN

New vending machines will display soda calorie counts

10 October - Posting calorie counts on vending machines is an idea I like much better than 

New York City’s ban on large-sized sodas to help curb the overconsumption of sugary 

beverages. Starting in 2013, major soda and sugary beverage producers like Coca-Cola, 

PepsiCo and Dr. Pepper Snapple Group will display the calorie counts of each beverage on

the vending machine so consumers are aware of the number of calories in each container, 

according to Time magazine. This is an effort to get consumers to chose lower-calorie 

beverages and perhaps make a dent in the obesity epidemic. MNN

Redefining medicine with apps and iPads

8 October - ... The history of medicine is defined by advances born of bioscience. 

But never before has it been driven to this degree by digital technology. The 

proliferation of gadgets, apps and Web-based information has given clinicians 

— especially young ones like Dr. Rajkomar, who is 28 — a black bag of new 

tools: new ways to diagnose symptoms and treat patients, to obtain and share 

information, to think about what it means to be both a doctor and a patient. And it has 

created something of a generational divide. Older doctors admire, even envy, their young 

colleagues’ ease with new technology. But they worry that the human connections that lie at 

the core of medical practice are at risk of being lost. New York Times
Walking for heart health? Speed it up, study suggests

8 October - Fast walking and jogging every day can cut your risk of heart disease and stroke 

by as much as 50 percent, but an hour's walk every day does not make a difference, 

according to a new Danish study. The researchers said their findings suggest that exercise 

intensity rather than duration is what matters in protecting against metabolic syndrome, 

which refers to a combination of factors -- such as high blood pressure, elevated blood 

sugar levels, abnormal blood fat levels and abdominal obesity -- that increase the risk of 

heart disease, diabetes and stroke. The study was published Oct. 8 in the online journal BMJ 

Open. Medline Plus

top of page...

USAFRICOM

Africa: Gavi partners help protect 50 million young 

people from seasonal meningitis

4 October - Efforts to eliminate meningitis in 26 at-risk countries will take a major step 

forward over the next three months as 50 million people receive crucial vaccinations in 

seven African countries. Thanks to concerted efforts by members of the GAVI Alliance 

including the Serum Institute of India, the World Health Organization (WHO), UNICEF, and 

the Meningitis Vaccine Project, the seven countries will be able to launch large-scale 

campaigns to ensure babies, children and young adults receive the meningitis A vaccine by 

the end of December. "Meningitis takes a terrible toll on the people living in vulnerable 

parts of Africa every year. It is a painful disease which can kill quickly and often leaves 

victims with disabilities that will blight their lives," said Dr Seth Berkley, CEO of the GAVI 

Alliance. "GAVI support for meningitis vaccination campaigns across Africa is protecting the 

lives of millions of young people at risk from the illness." All Africa

Africa: Study - HIV, food insecurity closely linked 

5 October - A new study says Africa suffers from a coepidemic of HIV/AIDS and food insecurity. Researchers say 

treatment and better nutrition go hand-in-hand in 

controlling the epidemic. Dr. Sheri Weiser said when 

people fall ill due to HIV, accessing food becomes 

“progressively more difficult.” “Food insecurity and HIV are interacting like a vicious cycle to 

worsen the severity as well as enhancing vulnerability to the other condition,” she said. VOA
Democratic Republic of Congo: Ebola outbreak, WHO 

update

8 October - As of 7 October 2012, 49 cases (31 laboratory confirmed, 18 probable) with 

Ebola haemorrhagic fever (EHF) have been reported in the Democratic Republic of Congo 

(DRC). Of these, 24 have been fatal (10 confirmed, 14 probable). The cases reported are 

from Isiro and Viadana health zones in Haut-Uélé district in Province Orientale. The Ministry 

of Health (MoH) continues to work with partners, under the National Task Force to identify 

all possible chains of transmission of the illness and ensure that appropriate measures are 

taken to interrupt transmission and stop the outbreak. The task force includes Médecins 

Sans Frontières (MSF); the International Federation of Red Cross and Red Crescent Societies 

(IFRC); US Agency for International Development (USAID); US Centers for Disease Control 

and Prevention (CDC); and the United Nations Children’s Fund (UNICEF) and WHO. WHO

Sierra Leone: Cholera, WHO update

8 October - The Ministry of Health and Sanitation (MOHS) continues to work closely with 

partners at the national and international levels to step up response to the ongoing cholera 

outbreak. Twelve of the 13 districts in Sierra Leone have been affected since the beginning 

of the year. In the last 2 months, remarkable progress has been made in controlling the 

outbreak. A steady decline in daily reported cases continues to be observed. As of the 2 

October 2012 the national cumulative number for all twelve districts is 20 736 cases, 

including 280 deaths (case fatality rate or CFR=1.35%). The cumulative CFR declined from an 

average of 3.2% in July 2012 to below 0.5% in September 2012. Two (2) deaths have been 

reported in the last 8 days (since 23 September 2012). The western area of the country 

where the capital city of Freetown is located has been the most affected location with more 

than 50% of total cases. WHO

Zimbabwe HIV activists push for government 

accountability 

10 October - AIDS activists in Zimbabwe are demanding the government account for 

millions of dollars it is raising through an AIDS-related tax. The activists defied police orders 

and marched to a government agency they accuse of corruption. Hundreds of activists 

dressed in T-shirts with the words “HIV Positive” marched to the Harare offices of 

Zimbabwe’s National AIDS Council, a government body managing the three-percent AIDS 

levy collected from all workers. An HIV-positive man in his 40s, Douglas Muzanenhamo, said 

he joined the march to protest a lack of anti-retroviral drugs, crucial for prolonging the life 

of HIV carriers. VOA

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USCENTCOM

Afghanistan and Pakistan: Progress toward Poliomyelitis 

eradication, January 2011-August 2012

5 October - In 1988, the World Health Assembly resolved to eradicate polio, which led to 

the establishment of the Global Polio Eradication Initiative (GPEI). In 2012, however, the 

transmission of indigenous wild poliovirus (WPV) continued uninterrupted in Afghanistan, 

Pakistan, and Nigeria (1,2), leading the World Health Assembly to declare completion of 

polio eradication a programmatic emergency for global public health (3). This report 

updates previous reports (1,4,5) and describes polio eradication activities and progress in 

Afghanistan and Pakistan during January 2011–August 2012, as of September 9, 2012.

Morbidity and Mortality Weekly Report

Egypt: Mumps

9 October - An outbreak of the viral infection, mumps, has spread through schools 

nationwide in Egypt, according to an Egypt Independent report on Mon 8 Oct 2012. The 

number of cases reported as of Monday [8 Oct 2012] is 583; this is up from 157 cases 

reported just one week earlier. Despite the surge in mumps cases, a spokesman for the 

Education Ministry said that no schools have been closed due to the outbreak. According to 

the report, Giza Governorate has so far reported the most number of cases, with 240. Minya 

has reported 95, Beni Suef 48, and Fayoum 38, with Cairo reporting only 12. Last week, 

Health Ministry undersecretary Amr Qandil projected rising numbers of mumps cases this 

winter season, but assured it would not be a public health emergency. ProMED-mail

Iraq's endless humanitarian crisis

9 October - ...The ranks of Iraqi professionals are attenuated also by targeted assassinations. 

More than two thousand doctors and nurses and over four hundred Iraqi academics were 

murdered between 2003 and 2012. Thousands more have fled due to death threats and 

retaliatory acts of revenge, often carried out because of their actual or alleged ties to the 

former Baath regime. According to the International Committee of the Red Cross, more than 

half of the thirty-four thousand doctors registered in Iraq in 1990 had left the country by 

2008. Because of the rise in assassinations of Iraqi journalists, the country slid from the 

130th to the 152nd among the nations categorized in the 2011–2012 World Press Freedom 

Index. The National Interest

Pakistan introduces Glaxo pneumonia vaccine

9 October – Pakistan has become the first country in South Asia to introduce a vaccine 

against the deadly pneumococcal disease in children, with GlaxoSmithKline's Synflorix 

selected for the programme. Worldwide more than 1.3 million children under the age of five 

are killed each year by pneumonia and in Pakistan it accounts for almost 20 percent of child 

deaths, according to the Global Alliance for Vaccines and Immunization (GAVI). The move 

comes at a time when healthcare experts are still struggling to get polio vaccination 

accepted in parts of Pakistan, one of the few countries where it is still endemic. Reuters
Pakistan, Karachi: Brain-eating amoeba kills 10

9 October - A rare brain-eating amoeba is responsible for 

at least 10 deaths in the Pakistani city of Karachi in recent 

months, health officials believe. The source of the parasite 

is not yet known, but it is thought victims may have been 

exposed to it when using water to rinse their nasal 

passages. The amoeba, Naegleria Fowleri, lives in warm water and kills its victims by 

destroying brain tissue. Officials are now increasing the amount of chlorine in the public 

water supply. The deaths are in various locations across Karachi, Pakistan's biggest city. BBC 

News

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USEUCOM

England offering free HIV treatment for visitors

9 October - We're just catching up with our U.K. reading 

list, so we're a bit late with this one. But it's worth noting 

that as of Oct. 1, England's National Health Service is 

providing treatment for HIV free of charge to visitors from 

overseas. NHS guidelines cover short-term visitors as well 

as people living in England "without lawful permission." This latter group is seen as 

"presenting most risk in terms of having untreated HIV infection since they risk transmitting 

HIV to an uninfected person." New information that we've been reporting all year shows the 

spread of HIV can be radically reduced by giving everyone with HIV treatment. But if you're 

HIV-positive and in need of help paying for your drugs, think twice before you click on over 

to Travelocity and become undocumented in England. Section 4.6 of the guidance states, 

"There are no provisions under the Immigration Rules for a person to travel to the UK in 

order to access the NHS." NPR

Gaza: British journal warns of ‘urgent’ Palestinian health 

crisis

8 October - Palestinian refugees and those living in the West Bank and Gaza are a facing an 

urgent health emergency, according to the British public health journal, the Lancet. The 

Lancet has published 32 reports highlighting a range of health concerns for Palestinian 

refugees living across the Middle East and Palestinian territories. The journal says Palestinian 

refugees are dealing with a “hidden crisis” of high levels of chronic and acute illnesses. VOA
Portugal: Two dengue cases appear locally acquired

9 October - Two people in Madeira, a Portuguese resort island in the Atlantic, have dengue 

virus infections that appear to be locally acquired, which would be the first such cases in 

Europe since 2010, the European Centre for Disease Prevention and Control (ECDC) 

announced today. The Public Health Authority of Portugal reported the two cases on Oct 3, 

saying the patients had no recent history of travel abroad, the ECDC said. Investigations are 

ongoing to determine whether the cases are indeed indigenous. Also, some additional cases 

have been reported by the news media and are under investigation, the ECDC reported. 

"This is the first known occurrence of locally transmitted dengue infection in Madeira, and 

consequently a new geographical area reporting autochthonous cases in the EU," the 

agency said. "There have been no reports of confirmed autochthonous dengue infections in 

the rest of Europe since the 2010 cases in France and Croatia." CIDRAP

The U.K. public health response to an imported 

laboratory confirmed case of a novel coronavirus,

September 2012 

4 October - On 22 September 2012, a novel coronavirus, very closely related to that from a 

fatal case in Saudi Arabia three months previously, was detected in a previously well adult 

transferred to intensive care in London from Qatar with severe respiratory illness. Strict 

respiratory isolation was instituted. Ten days after last exposure, none of 64 close contacts 

had developed severe disease, with 13 of 64 reporting mild respiratory symptoms. The 

novel coronavirus was not detected in 10 of 10 symptomatic contacts tested. 

Eurosurveillance

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USNORTHCOM

Puerto Rico declares dengue epidemic

9 October - Puerto Rico's health department has declared a dengue epidemic. Health 

Secretary Lorenzo Gonzalez says at least six people have died, including two children 

younger than 10. A total of 4,816 cases have been reported, including 21 cases of the 

potentially fatal hemorrhagic dengue. The U.S. Centers for Disease Control and Prevention 

says 342 new cases were reported in one week last month, twice the number of cases 

during the same period last year. AP

U.S.: Calls for oversight grow as meningitis scare widens

10 October - Pressure mounted for greater regulation of a little known corner of the 

pharmaceuticals industry in response to a meningitis scare that widened to 11 states on 

Wednesday with the first case confirmed in Idaho. Since the September 25 recall of three 
lots of a steroid produced by a Massachusetts company, 138 people have contracted 

meningitis and 12 have died, according to the latest tally from the Centers of Disease 

Control and Idaho on Wednesday. The Idaho case was the first discovered in the western 

United States. The hardest hit state is Tennessee with 44 people sickened with the rare 

disease. Reuters

U.S. deaths reach record high as population grows, ages

10 October - U.S. deaths surpassed 2.5 million for the first time last year, reflecting the 

nation's growing and aging population. The increase of about 45,000 more deaths than in 

2010 was not surprising. The annual number of deaths has been generally rising for decades 

as the population has swelled. "If you have an older population, of course you have more 

deaths," said Qian Cai, a University of Virginia demographer who studies population trends. 

"That doesn't mean the population is less healthy or less vital." Before last year, the largest 

number of deaths was 2.47 million in 2008. The number of deaths can jump up or down 

from year to year, depending on whether there was a bad flu season or other factors. ABC 

News

U.S.: Geographic differences in HIV infection among 

Hispanics or Latinos - 46 states and Puerto Rico, 2010

12 October - In the United States, Hispanics or Latinos are disproportionately affected by 

infection with human immunodeficiency virus (HIV). In 2010, new diagnoses of HIV infection 

among Hispanics or Latinos occurred at an annual rate that was 2.8 times that of nonHispanic whites (20.4 versus 7.3 per 100,000 persons) (1). To further assess HIV infection 

among Hispanics or Latinos in the United States, CDC analyzed the geographic distribution 

of new diagnoses in 2010 in 46 states and Puerto Rico and the characteristics of those 

diagnosed. The results of this analysis determined that a lower percentage of infections 

were attributed to male-to-male sexual contact in Puerto Rico than in the 46 states (36.1% 

versus 66.5%) and a higher percentage were attributed to heterosexual contact (40.7% 

versus 22.0%) or injection-drug use (IDU) (20.4% versus 8.6%). Morbidity and Mortality 

Weekly Report

U.S.: HIV deaths declining for most, but not all, 

Americans

8 October - HIV death rates in the United States declined for most groups of people 

between 1993 and 2007, according to a large new study. Researchers analyzed data on 

more than 91,000 HIV-related deaths that occurred among people aged 25 to 64 in 26 

states. They looked for trends in deaths by sex, race and ethnicity, and education level, 

which was used to estimate socioeconomic status. There were significant declines in deaths 

related to HIV -- the virus that causes AIDS -- for all groups except poor, black women. 

Declines were greater for people with higher levels of education and for whites, said Edgar 

Simard, of the American Cancer Society, and colleagues. Medline Plus
U.S.: Strokes in young people 'rising', study finds

10 October - Strokes are becoming more common at a younger 

age, with about one in five victims now below the age of 55, 

research in the American Academy of Neurology Journal suggests. 

The study followed 1.3 million people in a US region and found 

19% of those experiencing a stroke in 2005 were in this age group, 

up from 13% in 1993. This is despite a trend of overall falling rates of the condition. The 

Stroke Association said the findings were alarming. Report author Dr Brett Kissela said: "The 

reasons for this trend could be a rise in risk factors such as diabetes, obesity and high 

cholesterol." BBC News

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USPACOM

India: Dengue grips Bangalore, eight people dead, 700

cases reported

9 October - Eight people have died in Bangalore due to dengue and the number of people 

affected has doubled since July 2012. Bangalore is in the grip of the dengue fever. But what 

is especially alarming now is the rate at which it is spreading across the city. In October, 700 

cases have been confirmed, up from the 373 in July. IBN Live

Papua New Guinea: Chikungunya

10 October - More than 600 people have been infected by a new disease called 

chikungunya. Chikungunya is a mosquitoborne viral disease that was 1st discovered in parts 

of Africa, Asia, and Europe. The disease was also detected in New Caledonia and just 

recently, in Vanimo's urban area, in the West Sepik Province. The disease was 1st reported in 

June this year [2012]. Between June and September, more clinic presentations were 

discovered with symptoms similar to those of malaria. "There is no need to panic as no 

deaths have been reported yet. Deaths due to chikungunya [virus] infection are usually 

rare," secretary for health Pasco Kase stated in a media release yesterday [9 Oct 2012]. Early 

this month, the Institute of Medical Research (IMR) confirmed that 14 out of 52 samples 

sent for testing were positive for chikungunya. Further investigations into the outbreak are 

currently undertaken by the National Department of Health (NDOH) and the IMR. The 

World Health Organization (WHO) is providing technical assistance. Since June to this 

month, a total of 633 patients suspected of having symptoms of chikungunya have been 

reported from Vanimo hospital. The outbreak is localised to the town vicinity and its satellite 

communities. ProMED-mail

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USSOUTHCOM

Haiti, Dominican Republic aim to oust cholera by 2022

9 October - The governments of Haiti and the Dominican Republic are working on a plan to 

eliminate cholera from their shared island of Hispaniola by 2022, the Associated Press (AP) 

reported yesterday. Dominican Deputy Minister of Public Health Rafael Schiffino said the 

plan will include substantial spending on clean water and sanitation. A bilateral meeting to 

work on the plan started yesterday in the Dominican Republic. Since cholera surfaced in 

Haiti in October 2010, it has struck about 560,000 people and killed about 7,300, according 

to previous reports. The Dominican Republic has had 22,000 cases and 350 deaths since 

then, the AP story said. The disease was probably introduced in Haiti by United Nations 

peacekeepers. CIDRAP

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