25 January 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

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Contents

U.S. MILITARY

 Appendicitis and appendectomies, active and reserve components, U.S. Armed Forces, 2002-

2011

 New research on military traumatic brain injury

GLOBAL

 Breathing program may help save newborns' lives

 Dengue getting worse, but progress being made on other tropical diseases, reports WHO

 DNA donors' identities easy to find online

 Harmful effects of bisphenol A demonstrated experimentally

 Melamine from soup bowls found in urine

 More than 140 nations adopt treaty to cut mercury

 Stopping smoking reduces risk of bacterial pneumonia in people with HIV

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 Flu sending many elderly to hospitals, CDC says

 Google.org: Flu Trends

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 Flu-conomics: The next pandemic could trigger global recession

 H5N1 strikes four more Nepal poultry farms

 Human infection with avian influenza A(H5N1) viruses and associated animal health events

 Scientists put an end to moratorium on bird flu research

 Study reveals reduced efficacy of H5N1 vaccines in Egypt

VETERINARY/FOOD SAFETY

 Poultry vaccinations credited for UK’s big drop in Salmonella

 Surveillance for foodborne disease outbreaks — United States, 2009–2010
Gulf War and Health 

Volume 9: 

Treatment for Chronic 

Multisymptom Illness

About one-third of 

veterans of the 1991 Gulf 

War suffer from an array of 

long-term medically 

unexplained symptoms 

known as chronic 

multisymptom illness 

(CMI), a serious health 

condition that imposes a 

tremendous burden of 

suffering. CMI does not 

have a defined set of 

symptoms and can vary 

from person to person. 

This report reviews and 

evaluates treatments for 

CMI to determine how to 

best manage care for 

veterans. In changing how 

it treats CMI, the VA can 

make a significant 

difference in the lives of 

veterans who have the 

condition.

 Tesco withdraws some beef products as horse DNA found

WELLNESS

 Alcohol-fuelled sleep 'less satisfying'

 Daily aspirin may increase risk for age-related blindness

 Is there one right way to run?

 Limited impact on child abuse from visits, intervention: study

 Obese drivers at higher risk of death

 Smoke-free laws linked to drop in child asthma attacks

 Smoking deaths now equal in women and men

 Snowboarding linked to injury rate rise on slopes: study

USAFRICOM

 Mali: Food insecurity the next crisis for northern Mali

 Namibia: Anthrax vaccinations start in Oshikoto

 Republic of the Congo: Maternal mortality down sharply

 Widespread flooding hits Southern Africa

USCENTCOM

 Importation of wild poliovirus detected in environmental (sewage) samples in Egypt

 Pakistan: 100 children die of measles

USEUCOM

 Insight: Evidence grows for narcolepsy link to GSK swine flu shot

 Meningitis vaccine gets Europe nod

 United Kingdom: Suicide rate rises 'significantly' in 2011

USNORTHCOM

 U.S.: Four deaths blamed on cold snap

 U.S.: Nearly half of US children receive vaccinations late or remain unvaccinated

 U.S., Philadelphia: Type 1 diabetes in urban children skyrockets

 U.S.: Select-agent safety reports find little public health risk

USPACOM

 Australia: HIV and sexual disease rates in young climbing, specialist says

 China: Beijing chokes on smog amid annual legislative sessions

 Japan: Tsunami stress may have brought on seizures

 Thailand: Forced labour in Thai factory

USSOUTHCOM

 Brazil: Campo Grande fights dengue fever outbreak

 Latin America takes action to decriminalize abortion
Evaluating and 

Responding to 

Chemical 

Emergencies: 

The Role of Poison 

Control Centers and 

Public Health Labs

During this COCA call, 

subject matter experts will 

discuss biomedical testing 

for chemical agents, state 

level poison control center 

practices, and clinical 

resources for chemical 

emergencies.

Date: January 31, 2013

Time: 2:00 - 3:00 pm ET

Call Number: 

888-790-6180

Passcode: 1281914

Webinar Link

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Weekly Update is available 

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U.S. MILITARY

Appendicitis and appendectomies, active and reserve 

components, U.S. Armed Forces, 2002-2011

December - Appendicitis is common among young, healthy populations; appendectomy is 

one of the most common surgical procedures performed in the United States. Among active 

and reserve component members, there were 31,610 cases of appendicitis and 30,183 

appendectomies during 2002 to 2011. The overall incidence rate of appendicitis in the 

active component was 18.4 per 10,000 person-years (p-yrs). During the period the incidence 

rates of appendicitis in the active component and counts in the reserve component

increased. Active component males reported greater rates of perforated appendicitis (2.6 

per 10,000 p-yrs). Active component females had higher rates of incidental appendectomies 

(2.6 per 10,000 p-yrs). During the period there was a four-fold increase in outpatient 

appendectomies, a decrease in nonincidental appendectomies without a diagnosis of 

appendicitis (“negative appendectomies”), and a decrease in inpatient bed days. Medical 

Surveillance Monthly Report

New research on military traumatic brain injury

22 January - Researchers are making new strides in understanding the health consequences 

and treatment and rehabilitation needs of combat veterans and other service members 

affected by traumatic brain injury (TBI). The January-February issue of The Journal of Head 

Trauma Rehabilitation... is a special issue devoted to new research in military TBI... It has 

been estimated that 19 percent of military personnel will sustain a TBI during combat 

deployment. Although most of these injuries are mild, some of those service members who 

incur a mild TBI will go on to develop a "post-concussive" syndrome, consisting of chronic 

cognitive, behavioral, and psychological problems... Highlighted topics include: Research... 

linking PTSD to structural brain damage seen on diffusion tensor imaging—even in service 

members with no reported history of mild TBI; a study... reporting that service members 

with previous TBIs had more symptoms in the first three months after a subsequent injury, 

compared to those with their first TBI... [and a] study... which found that service members 

with mild TBI were more likely to report health symptoms, such as headache, back pain, 

ringing in the ears, dizziness and memory problems. Those with dizziness and memory 

problems were at particularly high risk of declining health after mild TBI. EurekAlert

top of page...

GLOBAL

Breathing program may help save newborns' lives

21 January - Training midwives and other birth attendants to help babies start breathing 

immediately after birth may prevent stillbirths and newborn deaths in the developing world, 

two new studies suggest. So-called birth asphyxia - when babies are born not breathing - is 
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one of the major causes of newborn death in regions with limited resources, researchers 

said. The Helping Babies Breathe program, launched by the American Academy of Pediatrics 

(AAP), trains birth attendants to immediately dry and warm babies - and to start breathing 

for babies with a bag and mask if they don't breathe on their own within one minute... The 

researchers found newborn deaths dropped from 13 per 1,000 babies to seven per 1,000 

once Helping Babies Breathe was implemented. The rate of stillbirth fell from 19 per 1,000 

babies before to just over 14 per 1,000 after. Reuters

Dengue getting worse, but progress being made on other 

tropical diseases, reports WHO

18 January - The World Health Organization trumpeted its recent success in fighting 17 

neglected tropical diseases in a new report —but warned that dengue fever has reached 

"pandemic" levels, infecting an estimate 50 million around the world. The January 2013 

reports states that the WHO has achieved success in using preventative medicine to fight 

against four of the targeted diseases (lymphatic filariasis, onchocerciasis, schistosomiasis 

and soil-transmitted helminthiases), managing to treat 711 million in 2010 alone. The WHO 

is hoping to get treatment for schistosomiasis, a dangerous parasitic disease, to a whopping 

253 million people in the next five years, and the long-hoped for eradication of the deeply 

unpleasant guinea worm is in sight. The international health organization also reports 

progress against almost-always fatal (but easily preventable) rabies and Buruli ulcers, a 

painful skin condition. However, the news wasn't all rosy: the WHO reports that dengue 

fever, a intensely painful virus spread by mosquitoes, appears to be getting worse — and 

2.5 billion people are now thought to be at risk of contracting it. Global Post

DNA donors' identities easy to find online

18 January - In databases where genetic information is stored anonymously, that anonymity 

does not necessarily stay that way, stirring up concern about how much privacy research 

project participants can anticipate in this Internet age. A strained relationship has always 

existed between the need to share data to increase medical discoveries and the fact that 

many people do not want to make their health information public. The rising use of genetic 

sequencing makes this even more difficult, because genetic data give information about the 

individual as well as his or her family. New research conducted by a team from Whitehead 

Institute and published in the journal Science, has identified 50 people who had given 

genetic material as participants in genomic studies, by using just the Internet and publicly 

available online resources. Medical News Today

Harmful effects of bisphenol A demonstrated 

experimentally

22 January - Weak concentrations of bisphenol A are sufficient to produce a negative 

reaction on the human testicle... In this new study, researchers observed that exposure of 

human fetal testicles to bisphenol A reduces the production of testosterone, and of another 

testicular hormone that is necessary for the testicles to descend into the sacs in the course 

of fetal development. A concentration equal to 2 micrograms per litre of bisphenol A in the 
culture medium was sufficient to produce these effects. This concentration is equal to the 

average concentration generally found in the blood, urine and amniotic fluid of the 

population. Science Daily

Melamine from soup bowls found in urine

22 January - Melamine, a common plastic previously linked to urolithiasis in children and 

adults, was detected in urine after ingestion of hot noodle soup served in melamine 

tableware, a small trial found. Twelve young adults in a randomized, crossover trial showed 

significantly more melamine in urine after eating soup from melamine bowls than when 

they ate from ceramic bowls... "Although the clinical significance of levels of urinary 

melamine concentration has not yet been established, the consequences of long-term 

melamine exposure still should be of concern," Wu and colleagues wrote. MedPage Today

More than 140 nations adopt treaty to cut mercury

19 January - A new and legally binding international treaty to reduce harmful emissions of 

mercury was adopted Saturday by more than 140 nations, capping four years of difficult 

negotiations but stopping short of some of the tougher measures that proponents had 

envisioned. The new accord aims to cut mercury pollution from mining, utility plants and a 

host of products and industrial processes, by setting enforceable limits and encouraging 

shifts to alternatives in which mercury is not used, released or emitted. Yahoo News

Stopping smoking reduces risk of bacterial pneumonia in 

people with HIV

22 January - Bacterial pneumonia is one of the commonest and most serious infections 

occurring in people infected with HIV. A metanalysis of cohort and case control studies 

published in BioMed Central’s open access journal BMC Medicine finds that current smokers 

with HIV were at double the risk of bacterial pneumonia than non-smoking counterparts, 

but that when people stopped smoking their risk was reduced. The metanalysis reanalysed 

the data of several thousand participants with HIV, from 14 studies based in USA, Europe 

and South Africa. Overall it appeared that current smoking was associated with a 70-100% 

increase in risk of bacterial pneumonia, compared to non-smokers, but that stopping 

smoking decreased this by about a third. Science Daily

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 2 (January 6-12), influenza activity remained elevated in the United States, but 

decreased in some areas. 

 Viral Surveillance: Of 12,360 specimens tested and reported by collaborating 

laboratories, 3,638 (29.4%) were positive for influenza. 
 Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia 

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

 Influenza-Associated Pediatric Deaths: Nine influenza-associated pediatric deaths were 

reported. 

 Geographic Spread of Influenza: Forty-eight states reported widespread geographic 

influenza activity; 2 states reported regional activity; the District of Columbia reported 

local activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

Seasonal flu activity began earlier this surveillance year than in recent years. Influenza 

A(H3N2) has been the predominate strain in CONUS with recently increasing Influenza 

A(H1N1)pdm09 and Influenza B. Viruses circulating so far this season are well matched to 

this season’s vaccine components.

 During Week 2 (6 - 12 January 2013), 170 specimens were tested from 33 locations. 

There were 71 influenza A viruses (61 influenza A(H3N2) and 10 A(H1N1)pdm09) and 

nine influenza B viruses detected. 

 To date, 1,537 specimens have been tested from 63 locations of which 499 were 

positive for influenza A (471 A(H3N2), 24 A(H1N1)pdm09, two co-infections of A(H3N2) 

& B, and two A/not subtyped); and 69 were positive for influenza B (14 B/Yamagata, two 

B/Victoria, and 53 B/lineage undetermined). 

 There have been 105 other respiratory viruses isolated (45 Parainfluenza, 32 Adenovirus, 

20 RSV, and eight Enterovirus). USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

In week 2/2013 (7–13 January 2013), influenza activity continued to increase across Europe, 

with reports of severe cases from a number of countries. The patterns of virus co-circulation 

being identified in the EU/EEA are different from that being reported by North America 

where A(H3) viruses are dominant.: 

 Of 26 countries reporting clinical data in week 2/2013, 14 reported medium- or highintensity transmission and 19 reported increasing trends. At present, indications of 

higher transmission levels are mostly coming from the north west of Europe. 

 Of 1 238 sentinel specimens tested across 20 countries in week 2/2013, 521 (42%) were 

positive for influenza virus – a high percentage and similar to that seen in the two 

previous weeks. 

 Of the 2 102 influenza virus detections in sentinel specimens since week 40/2012, 991 

(47%) were type A, and 1 111 (53%) were type B viruses. Among the A viruses subtyped 

the proportions of A(H1) pdm09 (52%) and A(H3) (48%) were very similar. Weekly 

Influenza Surveillance Overview
Flu sending many elderly to hospitals, CDC says

18 January - This year's edition of influenza is hitting the elderly hard, putting many in 

hospitals, even as overall flu activity is showing signs of slowing down, the Centers for 

Disease Control and Prevention (CDC) said today. "We're in the middle of flu season, about 

halfway through, and it's shaping up to be worse than average and a bad season 

particularly for the elderly," CDC Director Thomas Frieden, MD, MPH, said at a noontime 

media briefing. "Last week hospitalization rates increased sharply in people 65 and over, 

and this week they increased sharply again, going up to 82 per 100,000, which is quite a 

high rate," he said, referring to numbers in the CDC's weekly flu activity update. The 

cumulative all-ages hospitalization rate is 18.8 per 100,000. CIDRAP

Google.org: Flu Trends

23 January – Estimates of flu activity based on certain Internet search queries indicate that 

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

intense in the United States and Japan; and in the southern hemisphere ranges from 

minimal to low. Google.org Flu Trends

USAPHC: U.S. Army Influenza Activity Report

For the week ending 12 January 2013 (Week 2)

During week 2, influenza-like illness activity increased in Army MTFs. Dependent 

populations were most affected, although the proportion of Active Duty visits increased 

from previous weeks. Although elevated, overall ILI activity decreased in US civilian 

populations while severity indicators began to increase.

 ILI Activity: Army incident ILI outpatient visits in week 2 were 27% higher than the same 

week last year.

 Influenza cases: 15 hospitalized influenza cases were reported to USAPHC in week 2. 54 

hospitalized cases have been reported during this influenza season, 51 in dependents 

and 3 in Active Duty Service Members.

 Acute Respiratory Disease at BCT sites: While ARD rates remain low at all Army BCT 

sites, increasing trends were noted at Fort Jackson and Fort Leonard Wood.

 Viral specimens: During week 2, 546 of 1828 (30%) laboratory specimens tested were 

positive for respiratory pathogens. Most of the influenza positive specimens were from 

SRMC (42%), although NRMC and WRMC accounted for larger proportions of positive 

Influenza A tests, 32% and 20% respectively. USAPHC U.S. Army Influenza Activity 

Report
PANDEMIC AND AVIAN INFLUENZA

Flu-conomics: The next pandemic could trigger global 

recession

21 January - A high body count is not the only meaningful number attached to a pandemic. 

The potential cost of a global outbreak of the flu or some other highly contagious disease, 

however ghoulish to calculate, is essential for government officials and business leaders to 

know. Only by putting a price tag on such an occurrence can they hope to establish what 

containing it is worth. The financial damage by itself can be devastating. The expense of 

major epidemics is evident every time a health agency totes up the cost of treating infected 

people — the outlays for drugs, doctors' visits, and hospitalizations. But that spending is 

only the most obvious economic impact of an outbreak... The majority of the economic 

losses would come not from sickness or death but from what the World Bank calls "efforts 

to avoid infection: reducing air travel ... avoiding travel to infected destinations, and 

reducing consumption of services such as restaurant dining, tourism, mass transport, and 

nonessential retail shopping." Reuters

H5N1 strikes four more Nepal poultry farms

22 January - Animal health authorities in Nepal yesterday reported H5N1 avian flu 

outbreaks at four commercial broiler poultry farms, all located in the same district of the 

country's Gandaki zone, according to a report to the World Organization for Animal Health 

(OIE). The farms are in Kaski district, which is located in the west central part of the country. 

The outbreaks began during the first week of January and have killed 1,112 of 3,160 

chickens. The remaining 2,048 birds were destroyed to control the spread of the virus. 

CIDRAP

Human infection with avian influenza A(H5N1) viruses 

and associated animal health events

16 January - From 2003 through 16 January 2013, 610 laboratory-confirmed human cases 

with avian influenza A(H5N1) virus infection have been officially reported to WHO from 15 

countries, of which 360 died. Since the last update on 17 December 2012, no new 

laboratory-confirmed human cases with influenza A(H5N1) virus infection were reported to 

WHO. Recent poultry outbreaks in Indonesia have been attributed to influenza virus 

A(H5N1) clade 2.3.2.1... [T]he public health risk from the H5N1 virus of the 2.3.2.1 clade (e.g. 

pathogenicity, transmissibility in humans) does not seem to be different from the public 

health risk associated with other H5N1 virus clades... The public health risk remains 

unchanged. World Health Organization

Scientists put an end to moratorium on bird flu research

23 January - Controversial experiments on bird flu could resume within weeks because 

leading influenza researchers around the world have finally called a halt to an unusual 

moratorium that has lasted more than a year. The voluntary pause in the research started 
back in January 2012. Scientists had genetically altered the bird flu virus H5N1, changing it 

in ways that allowed it to spread through the coughs and sneezes of ferrets — the lab 

stand-in for people. But the experiments caused a public outcry. Critics charged that if the 

man-made viruses ever got out of the lab, they could be contagious in humans and start a 

deadly pandemic. Virologist Ron Fouchier of Erasmus Medical Center in the Netherlands, 

whose lab did some of these experiments, says weighing the risks and benefits of this 

research isn't easy. "But it's clear that all of the 40 people who announced the moratorium 

in January 2012 have now signed to restart the work," he says. "That means that 40 of the 

world's leading experts in influenza research seem to think that the benefits outweigh the 

risks." NPR

Study reveals reduced efficacy of H5N1 vaccines in Egypt

23 January - Researchers are calling for a review of the prevention and control strategy for 

the H5N1 highly pathogenic avian influenza (HPAI) virus in Egypt... In a paper published in 

Poultry Science, they explain that, after emerging in Egypt in 2006, HPAI H5N1 viruses 

continued to cause outbreaks in Egyptian poultry and sporadic human infections... The 

group studied the cross-reactivity of six commercially available H5 poultry vaccines against 

recent H5N1 Egyptian isolates in a field setting in Egypt. Only one vaccine based on an 

Egyptian H5N1 virus induced high cross-reactive antibody titres. The scientists suggest their 

results may be explained by the fact that the seed viruses in these vaccines are genetically 

distinct from H5N1 viruses currently circulating in Egypt. The Poultry Site

top of page...

VETERINARY/FOOD SAFETY

Poultry vaccinations credited for UK’s big drop in 

Salmonella

23 January - The United Kingdom’s mass poultry vaccinations introduced to combat 

Salmonella infections have led to a dramatic fall in the number of cases since the late 1990s, 

according to a researcher at the University of Liverpool... Between 1981 and 1991, the 

number of salmonella infections rose by 170 percent in the UK, driven primarily by an 

epidemic of Salmonella Enteritidis which peaked in 1993. A raft of control measures were 

introduced into the poultry industry, including movement restrictions, compulsory slaughter 

and disinfection procedures and a voluntary industry-led vaccination scheme that began in 

breeding flocks in 1994 and in laying flocks in 1998. Food Safety News

Surveillance for foodborne disease outbreaks — United 

States, 2009–2010

25 January - ...During 2009–2010, a total of 1,527 foodborne disease outbreaks (675 in 2009 

and 852 in 2010) were reported, resulting in 29,444 cases of illness, 1,184 hospitalizations, 

and 23 deaths. Among the 790 outbreaks with a single laboratory-confirmed etiologic 
agent, norovirus was the most commonly reported, accounting for 42% of outbreaks. 

Salmonella was second, accounting for 30% of outbreaks. Among the 299 outbreaks 

attributed to a food composed of ingredients from one of 17 predefined, mutually exclusive 

food commodities, those most often implicated were beef (13%), dairy (12%), fish (12%), 

and poultry (11%). The commodities in the 299 outbreaks associated with the most illnesses 

were eggs (27% of illnesses), beef (11%), and poultry (10%). Morbidity and Mortality Weekly 

Report

Tesco withdraws some beef products as horse DNA found

16 January - Tesco Plc (TSCO), the U.K.’s largest grocer, said it withdrew some beef products 

after tests by the Food Safety Authority of Ireland found some contained horse DNA. Two 

frozen beef burger products sold by Tesco in both the U.K. and Ireland had horse DNA, the 

company said in a Jan. 15 statement on its web site... Irish food safety authorities on Jan. 15 

said about 37 percent of the beef burger products it examined in a broad survey tested 

positive for horse DNA, while 85 percent showed pig DNA... Alan Reilly, chief executive of 

the Irish agency, said the beef doesn’t pose any public health concerns. Bloomberg

top of page...

WELLNESS

Alcohol-fuelled sleep 'less satisfying'

22 January - A tipple before bedtime may get you off to sleep faster but it can disrupt your 

night's slumber, say researchers who have reviewed the evidence. The London Sleep Centre 

team says studies show alcohol upsets our normal sleep cycles. While it cuts the time it 

takes to first nod off and sends us into a deep sleep, it also robs us of one of our most 

satisfying types of sleep, where dreams occur. Used too often, it can cause insomnia. 

BBC News

Daily aspirin may increase risk for age-related blindness

22 January - Many people take aspirin to prevent heart attacks, but new research suggests 

the added benefits may be coming at the expense of pill-takers' eyesight. A 15-year-study 

published Jan. 22 in JAMA Internal Medicine showed that people taking regular aspirin 

faced a higher risk for age-related macular degeneration (AMD), one of the leading causes 

of blindness in older adults. The research also suggests the risk may worsen over time. 

CBS News

Is there one right way to run?

23 January- In recent years, many barefoot running enthusiasts have been saying that to 

reduce impact forces and injury risk, runners should land near the balls of their feet, not on 

their heels, a running style that has been thought to mimic that of our barefoot forebears 
and therefore represent the most natural way to run. But a new study of barefoot 

tribespeople in Kenya upends those ideas and, together with several other new runningrelated experiments, raises tantalizing questions about just how humans really are meant to 

move. New York Times

Limited impact on child abuse from visits, intervention: 

study

22 January - Home visits and doctor's office interventions to prevent child abuse appear to 

have only limited success, with evidence mixed on whether they help at all, according to a 

U.S. analysis based on ten international studies. As a result, the government-backed U.S. 

Preventive Services Task Force (USPSTF) said this week that current evidence is "insufficient" 

to recommend such programs for dealing with the hundreds of thousands of children 

reported to be abused each year. Reuters

Obese drivers at higher risk of death

22 January - A new US study finds that obese drivers are much more likely to die in road 

accidents than drivers of normal weight. The authors say car designers need to make their 

vehicles safer for obese drivers, especially given that around one in three American adults is 

obese. Transport safety researchers... suggest the most obese drivers are 80% more likely to 

die in a car crash than their normal weight counterparts, with obese women at much higher 

risk than obese men. Medical News Today

Smoke-free laws linked to drop in child asthma attacks

21 January - Introducing laws banning smoking in enclosed public places can lead to swift 

and dramatic falls in the number of children admitted to hospital suffering asthma attacks, 

according to a study in England published on Monday. Researchers at Imperial College 

London found there was a 12.3 percent fall in hospital admissions for childhood asthma in 

the first year after laws against smoking in enclosed public places and workplaces came into 

effect in July 2007. Reuters

Smoking deaths now equal in women and men

23 January - Smoking continues to kill Americans at a staggering rate, with women now as 

likely to die from tobacco-related disease as men, two large surveys found. In one national 

survey, the rate of all-cause mortality was three times higher for smokers than for 

nonsmokers... In a second study, the relative risk of death from any cause among a 

contemporary cohort of smokers was 2.80 (95% CI 2.72 to 2.88) for men and 2.76 (95% CI 

2.69 to 2.84) for women, reported Michael J. Thun, MD, of the American Cancer Society in 

Atlanta, and colleagues. MedPage Today

Snowboarding linked to injury rate rise on slopes: study

20 January - Allowing snowboarders to hit the slopes at one U.S. ski resort led to a small rise 

in the number of overall injuries, a trend in line with findings at ski areas elsewhere, 

according to a U.S. report. Injuries rose by 13 percent in the two years after snowboarders 
were permitted at the Taos Ski Valley in New Mexico, compared to the two years before, 

according to the report in The American Journal of Sports Medicine... The rise was due 

mostly to an increase in the kind of upper body injuries that are most common among 

snowboarders, such as wrist sprains and fractures. Reuters

top of page...

USAFRICOM

Mali: Food insecurity the next crisis for northern Mali

23 January - Many more northern Malians are likely to face severe food shortages in the 

coming days and weeks if markets remain blocked by border and road closures, and 

humanitarian access remains limited, warn food security agencies. The border with Algeria is 

officially closed as a result of the conflict that broke out on 11 January between Malian and 

French forces and Islamist groups that were occupying the north. As a result, the amount of 

food coming through has halved, according to the UN World Food Programme’s (WFP) 

Vulnerability and Analysis Mapping Unit. Algeria supplies almost all markets in Kidal Region 

in northeastern Mali with rice, couscous, oil and milk - the staple diet of northern Malians. 

IRIN

Namibia: Anthrax vaccinations start in Oshikoto

23 January - Health authorities in the Oshikoto Region yesterday cordoned off the 

Omadhiya village and started to vaccinate all livestock in the village. [Oshikoto Regional 

Health Director, Peter Kefas Angala] is appealing to residents of communities in the 

Oshikoto Region to remain calm and not to panic, because all efforts were made to contain 

the outbreak. He further called on anyone with anthrax symptoms to report to the nearest 

state health facility, be it a clinic or hospital, because they are all stocked with anthrax 

medication... Earlier this week, Angala told New Era that at least 3 000 people were at risk of 

anthrax infection, having consumed the meat of affected animals... Meanwhile, Ondangwabased Dr Sarah Luvala said veterinarians were doing everything in their power to contain 

the anthrax outbreak, while awaiting results from the Central Veterinary Laboratory (CVL)... 

“Based on the information that we got from the villagers, some animals died a few days 

after they showed symptoms, but anthrax is an acute disease, it kills within 24 hours," said 

Luvala. AllAfrica

Republic of the Congo: Maternal mortality down sharply 

21 January - Improved maternal healthcare and better family 

planning programmes have led to a sharp decrease in the 

Republic of Congo’s maternal mortality rate over the past decade. 

The rate declined from 781 maternal deaths per 100,000 live 

births in 2005 to 426 deaths per 100,000 live births at the end of 

2012, according to a demographic and health survey conducted with the support of the UN 
Population Fund (UNFPA)... The Ministry of Health, meanwhile, says several factors explain 

the downward trend in the rate of maternal mortality... free Caesarean sections; the 

strengthening of family planning, which has helped reduce maternal mortality by nearly 30 

percent; the fight against obstetric fistula; and the establishment of a national panel called 

the Observatory on Maternal and Newborn Mortality. IRIN

Widespread flooding hits Southern Africa

22 January - Several Southern African countries are dealing with the effects of flooding 

following heavy rains over much of the region in the past week. In South Africa’s northern 

Limpopo Province, floodwaters claimed 10 lives and left hundreds stranded after the 

Limpopo River burst its banks. By 22 January, the rain had subsided, but rescue operations 

were still underway in Musina, near South Africa’s border with Zimbabwe, said Tseng Diale, 

spokesperson for the province’s Disaster Management Centre. Across the border, in 

Zimbabwe’s Beitbridge District, the rains damaged roads and left some areas impassable, 

according to state-owned newspaper The Herald, which reported that since the onset of the 

rainy season, floods and lightning strikes had claimed 124 lives. IRIN

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USCENTCOM

Importation of wild poliovirus detected in environmental 

(sewage) samples in Egypt

18 January - Wild poliovirus has been found in samples taken from sewage in Al Haggana 

(Nasr City) and Al Salam district in Cairo. The wild poliovirus is related to the wild poliovirus 

type 1, from north Sindh, Pakistan, which was reported in September 2012. This is the first 

documented importation of wild poliovirus from Pakistan, after Egypt was declared polio 

free, with its last case in May 2004. At this stage, there are no cases (children) of paralysis 

associated with this importation. These poliovirus strains have been detected through 

ongoing environmental surveillance in Egypt, which involves regular testing of sewage water 

from multiple sites (total in the country 34, in Cairo 5). World Health Organization

Pakistan: 100 children die of measles 

24 January - More than a hundred children have died of measles in Pakistan during the first 

three weeks of the year, according to health officials who say they are fighting a losing 

battle against the disease. Three consecutive years of flooding and a decade of insecurity in 

Pakistan mean millions of children have gone unvaccinated and are so badly malnourished 

they are unable to resist infections. At the same time, the population has become suspicious 

of vaccination teams. Maryam Yunus, of the World Health Organisation (WHO), said 103 

children had died from complications of measles, such as pneumonia or diarrhoea, between 

January 1 and 19. The worst hit province was Sindh, she said, which recorded 63 deaths and 

which was very badly affected by floods in 2010, 2011 and 2012. Telegraph

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USEUCOM

Insight: Evidence grows for narcolepsy link to GSK swine 

flu shot

22 January - ... Emelie is one of around 800 children in Sweden and elsewhere in Europe 

who developed narcolepsy, an incurable sleep disorder, after being immunized with the 

Pandemrix H1N1 swine flu vaccine made by British drugmaker GlaxoSmithKline in 2009. 

Finland, Norway, Ireland and France have seen spikes in narcolepsy cases, too, and people 

familiar with the results of a soon-to-be-published study in Britain have told Reuters it will 

show a similar pattern in children there... In total, the GSK shot was given to more than 30 

million people in 47 countries during the 2009-2010 H1N1 swine flu pandemic. Because it 

contains an adjuvant, or booster, it was not used in the United States because drug 

regulators there are wary of adjuvanted vaccines. Reuters

Meningitis vaccine gets Europe nod

22 January - Families who have lost children to meningitis B are among campaigners 

pressing the government to introduce a new vaccine against the disease, following its 

approval by the European Medicines Agency... The bacterial disease is particularly 

frightening for families because the onset is so rapid and unpredictable. It can kill within 

hours or cause brain damage or loss of a limb... The new vaccine from Novartis, called 

Bexsero, does not protect against all strains of meningitis B – only about 73%. But, say 

charities, it should save lives. The decision on whether to include the vaccine in routine 

immunisation programmes for babies will be taken by the government's advisory body, the 

joint committee on vaccines and immunisation, which will look at the need, the efficacy of 

the vaccine, whether it interacts with other vaccines and the cost. Guardian

United Kingdom: Suicide rate rises 'significantly' in 2011

22 January - The number of people taking their own life in the UK rose "significantly" in 

2011, latest figures from the Office for National Statistics have shown. Some 6,045 people 

killed themselves in 2011, an increase of 437 since 2010. The highest suicide rate was 

among men aged between 30 and 44. About 23 men per 100,000 took their own lives. On 

average, across both sexes, 11.8 people per 100,000 population killed themselves in 2011, 

up from 11.1 people the previous year. The ONS data revealed there were 4,552 suicides by 

men in 2011, more than three times the number by women and the highest rate since 2002. 

BBC News

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USNORTHCOM

U.S.: Four deaths blamed on cold snap

23 January - The Upper Midwest remains locked in the deep 

freeze, with bitter temperatures stretching into a fourth day 

across several states. The cold snap arrived Saturday night as 

waves of Arctic air swept south from Canada, pushing 

temperatures to dangerous lows and leaving a section of the 

country well-versed in winter's pains reeling. Authorities suspect exposure has played a role 

in at least four deaths so far. WJLA 

U.S.: Nearly half of US children receive vaccinations late 

or remain unvaccinated

22 January - Every year, parents are required to make sure their children are up-to-date on 

all of the necessary vaccinations – and some children are not allowed back to school unless 

they have not been properly immunized. However, a new trend on the rise has many 

parents deviating from the recommend vaccine schedule – or simply disregarding it 

altogether. According to a new study from the Kaiser Permanente Colorado Institute for 

Health Research, 49 percent of children between the ages of 2 and 24 do not receive all of 

the recommended vaccinations or do not get vaccinated at all. FOX News

U.S., Philadelphia: Type 1 diabetes in urban children 

skyrockets

22 January - Over the past two decades, the incidence of type 1 diabetes in very young 

children under age 5 has increased by 70 percent in the city of Philadelphia, according to 

research from a University of Pennsylvania School of Nursing researcher who currently 

maintains the only US registry of diabetes in children that has collected data continuously 

since 1985... “The most rapid increase in type 1diabetes -- in children diagnosed before age 

5-- requires immediate attention,” reports Dr. Lipman. “These young children are at the 

highest risk for death because of often-delayed diagnosis. The rapidly rising risk of diabetes 

in black children ages 0-4 years is of particular concern given the marked racial disparities 

that have been identified in diabetes outcomes and treatment in this population.” Science in 

Action

U.S.: Select-agent safety reports find little public health 

risk

22 January - The risks in working with potentially dangerous pathogens in US labs are low 

to the scientists involved as well as to the general public, according to two recent reports on 

safety incidents. One of the reports details theft, loss, and release (TLR) of select agents and 

toxins that occurred at US labs from 2004 through 2010. It says that 11 lab-acquired 

infections were linked to select-agent releases that were reported to the Centers for Disease 
Control and Prevention (CDC), but none were fatal or spread to others. The report is the first 

accounting of TLR events since Congress passed laws in 2002—in the wake of the 2001 

anthrax attacks—requiring the government to regulate the possession, use, and transfer of 

the potential bioterror agents. CIDRAP

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USPACOM

Australia: HIV and sexual disease rates in young 

climbing, specialist says

20 January - Sexually transmitted infection rates for diseases such as chlamydia and 

gonorrhea continue to rise across Queensland, says Andrew Redmond, a staff specialist in 

infectious diseases at the Royal Brisbane and Women's Hospital. Dr Redmond said doctors 

had seen a ''sustained increase'' in infections, ''particularly in young people''. HIV rates also 

continued to rise, and people were taking dangerous risks... ''Some of these diseases can be 

asymptomatic, so it is also important for us as doctors and other healthcare professionals to 

think about screening patients for sexually transmissible infections because, if you have an 

asymptomatic infection, it can be damaging, but you could also be passing it on to others 

because you don't know you have it.'' Sydney Morning Herald

China: Beijing chokes on smog amid annual legislative 

sessions

23 January - Air quality in Beijing hit dangerous levels again on Wednesday, with smog 

blanketing the city. At 3 p.m., air quality indices at most monitoring stations in the city 

proper ranged from 311 to 400, a serious level, according to statistics from the Beijing 

Municipal Environmental Monitoring Center. A high concentration of pollutants was 

detected moving from the southeast at 3 p.m. Tuesday before shrouding the entire city, said 

an official from the center. Readings for PM2.5, or airborne particles measuring 2.5 microns 

or less in diameter that can deeply penetrate the lungs, reached 200 to 300 micrograms per 

cubic meter, indicating heavy pollution, he said. Xinhua

Japan: Tsunami stress may have brought on seizures

20 January - The number of seizure patients in a northern 

Japanese fishing community devastated by the March 11, 2011 

tsunami spiked in the weeks following the disaster, according 

to a Japanese study. The study, published in the journal 

Epilepsia, looked at 440 patient records from Kesennuma City 

Hospital, in a city that was devastated by the massive tsunami touched off by the 9.0 

magnitude earthquake. Thirteen patients were admitted with seizures in the eight weeks 
after the disaster, but only one had been admitted in the two months before March 11. 

Previous research has linked stressful life-threatening disasters with an increased risk of 

seizures, but most case reports lacked clinical data with multiple patients. "We suggest that 

stress associated with life-threatening situations may enhance seizure generation," wrote 

lead author Ichiyo Shibahara, a staff neurosurgeon at Sendai Medical Center in northern 

Japan. Reuters

Thailand: Forced labour in Thai factory

22 January - Up to 700 Burmese migrant workers in a pineapple factory in Thailand’s 

southern Prachuap Khiri Khan Province are victims of forced labour, according to a recently 

released report by Helsinki-based corporate watchdog Finnwatch. “It's a completely 

unlawful and abusive situation where they are afraid to leave because their documents have 

been confiscated by the factory owners,” said Andy Hall, a researcher for the Mahidol 

Migration Centre in Bangkok. The workers, including as many as 50 children under the age 

of 18 and a pregnant woman, are forced to process pineapples for up to 80 hours weekly, in 

contravention of Thai law. IRIN

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USSOUTHCOM

Brazil: Campo Grande fights dengue fever outbreak

20 January - Health authorities in the Brazilian city of Campo Grande, in the southern state 

of Mato Grosso do Sul, are fighting a dengue fever epidemic. About 600 residents a day 

have reported suffering from the symptoms of the fever since the beginning of the year. 

Heavy rains have increased the risk of reproduction of the mosquito which transmits the 

disease... The federal authorities said that nationwide two people had died from dengue 

fever. Apart from Campo Grande, the city of Vitoria in Espiritu Santo state has also seen a 

steep rise in the incidence of dengue cases with more than 1,500 cases reported this month. 

BBC News

Latin America takes action to decriminalize abortion

20 January - ... [Latin America] has some of the most restrictive laws against abortion in the 

world. Abortion is not permitted for any reason in seven of Latin America's 34 countries and 

territories, and it is allowed only to save the woman’s life in eight others. Only six countries 

and territories permit abortion without restriction, accounting for less than 5 percent of 

women aged 15 to 44 years old... According to the World Health Organization, 95 percent 

of abortions in Latin America are unsafe and one in eight maternal deaths in the region 

result from unsafe abortions. Nearly half of sexually active young women in Latin America 

and the Caribbean have an unmet need for contraception that would enable them to 

prevent unintended pregnancy. Women who are poor and live in rural areas are 

disproportionately affected. Global Post

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