1

21 June 2013

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

U.S. Army Public Health Command

U.S. Military | Global | Influenza | Veterinary/Food Safety | Wellness | Contact Us

USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM

Subscription or 

Comments

If you wish to be added to 

the APH Weekly Update 

mailing list, removed from 

the mailing list, or if you 

have comments or 

questions about the 

update, please contact us. 

We welcome your 

comments. Please feel free 

to share this update with 

others who may be 

interested.

Follow us!

Facebook

Twitter

 YouTube

Approved for public release, distribution unlimited.

Contents

U.S. MILITARY

 Are there 2 types of Gulf War illness?

 Military has schedule for women to move into combat jobs, including SEALs, other commandos

 Using the tuberculosis cohort review to evaluate and improve the U.S. Army's tuberculosis 

control program

GLOBAL

 Beyond NYC: Other places adapting to climate, too

 Dangerous strains of E. coli may linger longer in water

 Eye-tracking software may reveal autism and other brain disorders

 Investigation follows trail of a virus in hospitals

 Maternal and paediatric tuberculosis still overlooked

 Researchers find anthrax reduces key blood vessel protein

 Scientists go medieval to solve ancient leprosy puzzle

 WHO urges tougher food marketing rules to curb childhood obesity

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 CDC steps down emergency operations for H7N9

 WHO puts H5N1 at 'alert' in pandemic phase system

VETERINARY/FOOD SAFETY

 China: Salmonella sickens hundreds of Chinese schoolchildren

 Low-income children face higher risk of foodborne illness, study says

 U.S.: Illness count rises to 118 in frozen berry hepatitis A outbreak

WELLNESS

 AMA declares obesity a disease

 A wearable alert to head injuries in sports

 Big drop in HPV, vaccine gets credit
2

Posters in Dari

Two posters have been 

translated into Dari, one on 

mosquito-borne disease 

and the other on rabies. 

The posters are available 

from the Health 

Information Products 

eCatalog.

 Blood tests could detect sexually-transmitted oral cancers

 Bullying by siblings just as damaging, research finds

 Cheating ourselves of sleep

 The 4-minute workout

 What to drink while expecting: Study says moderate booze OK

 Whooping cough can be deadly for infants, but 61 percent of adults don't know their vaccine 

status

USAFRICOM

 Angola: Ongoing dengue epidemic

 Democratic Republic of Congo: Yellow fever

 South Sudan: Lack of access, rains hinder aid to Jonglei IDPs

 Tanzania: Tanzanian high-risk groups denied HIV services

USCENTCOM

 Jordan: CDC expert reports some anomalies in Jordan MERS cases

 Libya’s “growing” drugs/HIV problem

 Pakistan: Mourning in Pakistan for murdered polio workers

 Saudi Arabia: Middle East respiratory syndrome coronavirus (MERS-CoV) – WHO update

 Syria: Measles epidemic signals growing humanitarian needs

 Syria's wounded generation

USEUCOM

 Israel: Health Ministry to combat spread of polio with vaccination campaign

 Ukraine kids at risk from low vaccination rates

 United Kingdom: Breast cancer risk has risen for South Asian women

 United Kingdom: ‘Quiet epidemic’ of male cancer in UK

USNORTHCOM

 U.S.: Bioterror detection program comes under scrutiny

 U.S., Colorado: Black Forest fire 65% contained but 483 homes destroyed

 U.S.: Homemade chemical bomb incidents — 15 states, 2003–2011

 U.S.: Kids born in polluted areas more likely to have autism

 U.S.: National parks raise guard against virus

USPACOM

 Bangladesh: Piped water for Dhaka slums

 Cambodia reports 13,700 malaria cases in 5 months, killing 4 people

 India: H.I.V. tests urged for 800 million

 Japan: Rubella epidemic traced to past female-only vaccination efforts

 New Zealand: Law permits ‘low risk’ designer drugs

 Singapore fumes as air pollution hits 16-year high

USSOUTHCOM

 Brazil: Q fever

 Haiti moves a step closer toward eradicating elephantiasis
3

Classified Version of 

the Weekly Update

An Army Public Health

Weekly Update is available 

with articles classified up to 

the SECRET level from the 

USAPHC SIPRNet site: 

http://phc.army.smil.mil

Look under Hot Topics & 

Current Issues.

To access this version, you 

will need a SECRET

clearance and a SIPRNet 

account.

Links

A-Z Index 

About USAPHC

Army Public Health and 

Health Information 

Weekly Update Archives

Medical Surveillance 

Monthly Report 

Medical Threat Briefings

(AKO)

Request USAPHC Services 

USAPHC Library

USAPHC Homepage 

USAPHC Training 

Contact USAPHC

U.S. MILITARY

Are there 2 types of Gulf War illness?

14 June - U.S. veterans with Gulf War illness complain of different types 

of symptoms, and researchers now think they know why: There may be 

two distinct forms of the illness, depending on which areas of the brain 

have atrophied. "Our findings help explain and validate what these 

veterans have long said about their illness," said study lead author Rakib 

Rayhan, a Georgetown University Medical Center researcher. For the study, published online 

June 14 in the journal PLoS One, the research team conducted brain scans of 28 veterans 

with Gulf War illness before and after they underwent exercise stress tests. For 18 veterans, 

pain levels increased after exercise stress, and the scans showed a loss of brain matter in 

regions associated with pain regulation. Medline Plus

Military has schedule for women to move into combat 

jobs, including SEALs, other commandos

18 June - ...Under details the military laid out Tuesday, women could start training as Army 

Rangers by mid-2015 and as Navy SEALs a year later. U.S. Special Operations Command is 

coordinating the studies of what commando jobs could be opened to women, what 

exceptions might be requested and when the transition would take place. The proposals 

could mean that women are still excluded from some jobs if research and testing find that 

women could not be successful. But the services would have to defend such decisions to 

top Pentagon leaders... The military services have mapped out a schedule that includes 

reviewing and possibly changing the physical and mental requirements for certain infantry, 

armor, commando and other front-line positions across the Army, Navy, Air Force and 

Marines. Under the plans there would be one common requirement for men and women for 

each post, and it would be based on specific tasks troops need to do in order to perform 

those jobs. Washington Post

Using the tuberculosis cohort review to evaluate and 

improve the U.S. Army's tuberculosis control program

May 2013 - This is the first TB cohort review of experience of the U.S. military. The review

demonstrates that TB treatment and control measures in the low-incidence setting of the

U.S. Army compare well overall to national indicators and U.S. national averages. Delays in 

TB diagnosis can be addressed in multiple ways. Epidemiologic clues can be important in 

identifying patients at risk for TB, and the risk factors identified in this report should be 

shared with medical and public health providers. Chronic cough was the most common 

presenting symptom in this population... The most important component is developing 

administrative policies and procedures to ensure that the diagnosis of TB is considered in all 

appropriate settings. Medical Surveillance Monthly Report

top of page...
4

GLOBAL

Beyond NYC: Other places adapting to climate, too

16 June - From Bangkok to Miami, cities and coastal areas across the globe are already 

building or planning defenses to protect millions of people and key infrastructure from 

more powerful storm surges and other effects of global warming. Some are planning cities 

that will simply adapt to more water. But climate-proofing a city or coastline is expensive, as 

shown by New York Mayor Michael Bloomberg's $20 billion plan to build floodwalls, levees 

and other defenses against rising seas. The most vulnerable places are those with the fewest 

resources to build such defenses, secure their water supplies or move people to higher 

ground. How to pay for such measures is a burning issue in U.N. climate talks, which just 

wrapped up a session in the German city of Bonn. Yahoo! News

Dangerous strains of E. coli may linger longer in water

14 June - ...A toxin dangerous to humans may help E. coli fend off aquatic predators, 

enabling strains of E. coli that produce the toxin to survive longer in lake water than benign 

counterparts, a new study finds. Researchers from the University at Buffalo and Mercyhurst 

University reported these results online 7 June in the journal Applied and Environmental 

Microbiology. “The take-home lesson is that E. coli that produce Shiga toxin persisted longer 

in recreational water than E. coli that don’t produce this toxin,” said UB Professor of 

Biological Sciences Gerald Koudelka, Ph.D., who led the study. “This is because the toxin 

appears to help E. coli resist predation by bacterial grazers.” Homeland Security News Wire

Eye-tracking software may reveal autism and other brain 

disorders

18 June - The eyes of people with neurological conditions, including ADHD and Parkinson’s, 

have a distinctive motion that could form the basis of clinical diagnosis... Years of research 

have found that our tiny, rapid eye movements called saccades serve as a window into the 

brain for psychologists... In a small, proof-of-concept study [researchers] found that their 

algorithm could classify mental disorders through eye-movement patterns: They identified 

elderly Parkinson’s patients with nearly 90 percent accuracy as well as children with 

attention deficit hyperactivity disorder (ADHD) or fetal alcohol spectrum disorder with 77 

percent accuracy. Scientific American

Investigation follows trail of a virus in hospitals

19 June - ...A detailed investigation of the viral illness first detected last year in Saudi Arabia 

has revealed the chilling ease with which the virus can spread to ill patients in the hospital 

— and its ability to infect some close contacts like hospital staff and family members who 

were in good health. A report on the investigation published Wednesday in The New 

England Journal of Medicine pinpointed the time it takes for a person to get sick after being 

exposed to the virus, a median of 5.2 days. The disease has now infected 64 people and 
5

killed 38 in eight countries. Saudi Arabia has had the most cases. The United States has had 

none... [Dr. Alimuddin I. Zumla, an author of the study] said health experts would be 

increasingly concerned as the time nears for the annual pilgrimage of Muslims to Mecca. 

“Four million pilgrims from 182 countries are coming to Saudi Arabia in two months’ time,” 

Dr. Zumla said. “I am worried, as a physician.” New York Times

Maternal and paediatric tuberculosis still overlooked

18 June - The global target of a 50 percent reduction in tuberculosis (TB) by 2015 may 

already have been achieved, but TB remains a neglected disease among women and young 

children, say health experts. ...TB in expectant women increases the risk of birthing 

complications, including maternal death. According to WHO, maternal TB causes a two-fold 

increase in vaginal bleeding, eclampsia (pregnancy-induced hypertension), pre-eclampsia, 

and a 10-fold increase of miscarriage. Among newborns, maternal TB causes a two-fold 

increase in low birth weight and premature births (both risk factors for childhood death) 

and a six-fold increase of perinatal death (within the first 28 days of life). While the exact 

extent of the problem is still unknown, recent studies from sub-Saharan Africa and India 

have shown that TB was a direct cause of an estimated 6-15 percent of all maternal deaths 

and an indirect cause of 15-34 percent. IRIN

Researchers find anthrax reduces key blood vessel 

protein

17 June - Researchers at the U.S. Food and Drug Administration released findings on Friday 

that show the anthrax toxin reduces a key protein known for keeping the lining of blood 

vessels intact. ...A protein, called anthrax lethal toxin or LT, contributes to the symptoms of 

anthrax when the spores are inhaled. LT reduces the production of claudin-5, which is a 

molecule that keeps cells making tightly connected blood vessels. Without this connection, 

there is leakage of fluid from the blood. The researchers also found that this weakening of 

the blood vessels did not cause cell death. The data the researchers found could be used in 

the future to help make vaccines, drugs and diagnostics for anthrax and even other CBRN 

threats. BioPrep Watch

Scientists go medieval to solve ancient leprosy puzzle

14 June - ...Leprosy was so common in Europe during the Middle Ages that it's estimated 1 

in 30 people was infected with the bacteria. But by the turn of the 16th century, after the 

crusades had swept across Europe, the disease mysteriously disappeared. And it never 

returned. This left scientists puzzled. Did the bacteria mutate to become less harmful, or did 

Europeans become resistant to the germs? To answer this question, a team of biologists 

and archaeologists probed the mass grave of a 600-year-old leper colony for traces of 

ancient leprosy DNA. They found leprosy didn't change, we did... Indeed, scientists believe

that a certain gene makes some people highly resistant to leprosy. This particular gene, Cole 

says, is prevalent in Europeans. To stop a disease, Cole says, it's helpful to understand its 

origins. "Having information about the specific genes and proteins in the disease can help 

to determine preventative and therapeutic strategies, as well as possible drug resistances." 

NPR
6

WHO urges tougher food marketing rules to curb 

childhood obesity

18 June - The marketing of unhealthy foods to children has 

proven "disastrously effective", driving obesity by using cheap 

social media channels to promote fat-, salt- and sugar-laden 

foods, the World Health Organisation's Europe office said on 

Tuesday. The United Nations health agency called for tighter 

controls on such marketing, saying tougher regulations were crucial to winning the fight 

against childhood obesity. Reuters

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 23 ending June 8, 2013, 5.8% of all deaths reported through the 122-Cities 

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

below the epidemic threshold of 6.8%. FluView

Google.org: Flu Trends

19 June – Estimates of flu activity based on certain Internet search queries indicate that the 

level of flu activity in the northern hemisphere ranges from minimal to low. In the southern 

hemisphere levels in Argentina are moderate and in Chile and South Africa, levels are high.

Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 15 June 2013:

 Influenza: One case of NHRC laboratory-confirmed influenza (B) among US military 

basic trainees.

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

or below expected values.

 NHRC has the capability to test for the novel H7N9 influenza virus. NHRC Febrile 

Respiratory Illness Surveillance Update 
7

PANDEMIC AND AVIAN INFLUENZA

CDC steps down emergency operations for H7N9

18 June - The US Centers for Disease Control and Prevention (CDC) on Jun 14 deactivated 

its Emergency Operations Center (EOC) response to the novel H7N9 flu outbreak in China, 

the agency said today in a Twitter post. However, the CDC said it would continue to watch 

the H7N9 virus closely, given that flu is known for its constant changes and evolution. The 

number of new H7N9 cases in China has tailed off since early May, and flu experts suspect 

that the warmer weather and poultry market closures may have played a role. CIDRAP

WHO puts H5N1 at 'alert' in pandemic phase system

18 June - Following the recent release of a new pandemic alert system, the World Health 

Organization (WHO) today posted a notice that said the current phase for H5N1 avian 

influenza is "alert," the second notch on its four-tiered system. The "alert" phase signifies 

that a new influenza subtype has been identified and increased vigilance and risk 

assessment are warranted. The WHO unveiled the new alert system, which is designed to 

focus more on disease risk than geographic spread, on Jun 10. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

China: Salmonella sickens hundreds of Chinese 

schoolchildren

18 June - At least 386 children in a Chinese province were hospitalized last week with 

suspected Salmonella infections, health officials announced Sunday. The students, who 

reside in the Meishan City area of Sichuan province, fell ill at the end of last week with 

symptoms of nausea, vomiting, fatigue and dizziness. Chinese health authorities eventually 

determined that their illnesses were caused by Salmonella. Over two-thirds of those 

sickened remained hospitalized as of Sunday, reported CNTV. Food Safety News

Low-income children face higher risk of foodborne 

illness, study says

19 June - Poorer nutrition and less access to healthcare leads 

to a greater likelihood of bacterial and viral infections —

including foodborne illness — among low-income children, 

according to a report published Tuesday by the Consumer 

Federation of America. More than 2 out of every 5 children in 

the U.S. (44 percent) live in a low-income household, the report said, and studies show that 
8

economic status is a greater predictor of risk than race or ethnicity when it comes to 

unintentional injuries. Food Safety News

U.S.: Illness count rises to 118 in frozen berry hepatitis A 

outbreak

18 June - At least 118 people in 8 western states are now known to be victims of a hepatitis 

A outbreak traced to a frozen berry mix sold at Costco. This count comes as the latest in an 

almost daily rise in the number of illnesses, which yesterday was at 106. According to the 

Centers for Disease Control and Prevention, 47 of the victims have been hospitalized as a 

result of their infections. ...Of the 112 patients interviewed, 80 (71 percent) report eating 

“Townsend Farms Organic Anti-Oxidant Blend,” a mix of frozen berries and pomegranate 

seeds sold at Costco stores, prior to falling ill. Food Safety News

top of page...

WELLNESS

AMA declares obesity a disease

18 June - The American Medical Assn. voted Tuesday to declare obesity a disease, a move 

that effectively defines 78 million American adults and 12 million children as having a 

medical condition requiring treatment. The nation's leading physicians organization took 

the vote after debating whether the action would do more to help affected patients get 

useful treatment or would further stigmatize a condition with many causes and few easy 

fixes... Tuesday's vote is certain to step up pressure on health insurance companies to 

reimburse physicians for the time-consuming task of discussing obesity's health risks with 

patients whose body mass index exceeds 30. It should also encourage doctors to direct 

these patients to weight-loss programs and to monitor their often-fitful progress. Los 

Angeles Times

A wearable alert to head injuries in sports

15 June - ...A crop of new lightweight devices that athletes can wear on the field may help 

people on sidelines keep better track of hits to players’ heads during games and practice 

sessions. The devices, packed with sensors and microprocessors, register a blow to a 

player’s skull and immediately signal the news by blinking brightly, or by sending a wireless 

alert. Athletes can wear the devices pressed tightly to their heads, held in place by a

headband within a beanie, for example, or even by an adhesive patch and Velcro. Many of 

the systems are in research and development, but a few products are coming to the market 

this summer. New York Times
9

Big drop in HPV, vaccine gets credit

19 June - The prevalence of human papillomavirus (HPV) infection in young women has 

declined by more than half since the introduction of the HPV vaccine, despite low vaccine 

uptake, according to a study by the CDC. Compared with the 4 years prior to the vaccine's 

introduction, infection with the HPV strains covered by the vaccine decreased by 56% in 14-

to 19-year-old girls in the first 4 years after the vaccine became available. The decline in 

HPV infection rate occurred despite the fact that only a third of eligible patients received 

the vaccine. HPV prevalence in other age groups did not differ significantly between the two 

time periods. Medpage

Blood tests could detect sexually-transmitted oral 

cancers

17 June - Antibodies to a high-risk type of a virus that causes mouth and throat cancers 

when transmitted via oral sex can be detected in blood tests many years before onset of the 

disease, according to a World Health Organisation-led team of researchers. In a study in the 

Journal of Clinical Oncology, the researchers said their findings may in future lead to people 

being screened for human papillomavirus (HPV) antibodies, giving doctors a chance to find 

those at high risk of oral cancers. Reuters

Bullying by siblings just as damaging, research finds

17 June - Bullying and aggressive behavior by a sibling can be as damaging as bullying by a 

classmate, neighbor or other peer, finds a new study that links it to increased depression, 

anxiety and anger among victimized kids and teens. And that association holds true for the 

various types of aggressive behavior studied, both mild and severe, from physical and 

psychological aggression to property victimization, researchers say. USA Today

Cheating ourselves of sleep

17 June - ...Research shows that most people require seven or eight hours of sleep to 

function optimally. Failing to get enough sleep night after night can compromise your 

health and may even shorten your life. From infancy to old age, the effects of inadequate 

sleep can profoundly affect memory, learning, creativity, productivity and emotional 

stability, as well as your physical health... Poor sleep is also a risk factor for depression and 

substance abuse, especially among people with post-traumatic stress disorder, according to 

Anne Germain, associate professor of psychiatry at the University of Pittsburgh. People with 

PTSD tend to relive their trauma when they try to sleep, which keeps their brains in a 

heightened state of alertness. Dr. Germain is studying what happens in the brains of 

sleeping veterans with PTSD in hopes of developing more effective treatments for them and 

for people with lesser degrees of stress that interfere with a good night’s sleep. New York 

Times
10

The 4-minute workout

19 June - ...[Researchers] gathered 26 overweight and sedentary 

but otherwise healthy middle-aged men, determined their 

baseline endurance and cardiovascular and metabolic health, and 

randomly assigned them to one of two groups. Half began a 

supervised exercise program that reiterated the Norwegian 

researchers’ former routine. After briefly warming up, these volunteers ran on a treadmill at 

90 percent of their maximal heart rate... for four four-minute intervals, with three minutes of 

slow walking between, followed by a brief cool-down. The entire session was repeated three 

times a week for 10 weeks. The second group, however, completed only one four-minute 

strenuous run. They, too, exercised three times a week for 10 weeks. At the end of the 

program, the men had increased their maximal oxygen uptake, or endurance capacity, by an 

average of 10 percent or more, with no significant differences in the gains between the two 

groups. New York Times

What to drink while expecting: Study says moderate 

booze OK

19 June - ...According to a British study, children born to mothers who drank moderately 

while pregnant did not show signs of balance problems when they were 10; trouble with 

balance is a good indicator of problems with brain development in utero, the authors say... 

[Ten-year-olds] whose mothers reported drinking three to seven alcoholic beverages a week 

during their 18th week of pregnancy were more likely to fall into the top 25% of performers 

on the balance exercises compared to those whose moms abstained... [T]he current results 

don’t necessarily mean that it’s time to rethink the advice that pregnant women shouldn’t 

drink. Research has shown that drinking can cause physical deformities as well as behavioral 

and cognitive symptoms in babies, including fetal alcohol syndrome. TIME

Whooping cough can be deadly for infants, but 61 

percent of adults don't know their vaccine status

17 June – Cases of pertussis, also known as whooping cough, are on the rise in the U.S., 

recently reaching their highest level in 50 years. The disease can be serious or even fatal to 

newborns who have not yet received vaccinations. Effective vaccines against pertussis have 

been available for many decades, but that vaccine protection can wear off over time. A new 

University of Michigan poll shows that 61 percent of adults say they don't know when they 

were last vaccinated against pertussis, which could mean they might be unwittingly 

exposing vulnerable babies to the disease. Only 20 percent of adults reported that they 

received the pertussis vaccine less than 10 years ago (the recommended time frame) and 19 

percent said they were vaccinated more than 10 years ago. EurekAlert

top of page...
11

USAFRICOM

Angola: Ongoing dengue epidemic

17 June - On April 1, 2013, the Public Health Directorate of Angola announced that six cases 

of dengue had been reported to the Ministry of Health of Angola (MHA). As of May 31, a 

total of 517 suspected dengue cases had been reported and tested for dengue with a rapid 

diagnostic test (RDT). A total of 313 (60.5%) specimens tested positive for dengue, including 

one from a patient who died. All suspected cases were reported from Luanda Province, 

except for two from Malanje Province. ...At least 91 laboratory-confirmed dengue cases 

have been reported recently in seven countries (Canada, France, Germany, Israel, Portugal, 

South Africa, and the United States) among persons who had recently traveled to Luanda. 

Morbidity and Mortality Weekly Report

Democratic Republic of Congo: Yellow fever

14 June - The Ministry of Health of the Democratic Republic of Congo (DRC) is launching an 

emergency mass vaccination campaign against yellow fever from 20 June 2013, following 

laboratory confirmation of six cases in the country on 6 June 2013. WHO

South Sudan: Lack of access, rains hinder aid to Jonglei 

IDPs

17 June - Tens of thousands of people have been cut off from water, food and medical care 

in South Sudan's Jonglei State, after fleeing violence between rebels and the government in 

Pibor County. They now face escalated risks as the rainy season starts, but aid agencies say 

the government has denied humanitarian access to these populations. According to the 

NGO Médecins Sans Frontières (MSF), an estimated 120,000 people have fled Pibor to areas 

that "will shortly be under a meter or more of flood water". "The rainy season has already 

started, and we know from MSF's years of experience in Jonglei that without medical care, 

mortality rates will rise rapidly, with people dying of pneumonia and other respiratory 

diseases, malaria and diarrhoea," Bart Janssens, MSF director of operations, said in a 

statement on 14 June. "Furthermore, starting in June, the communities start to run out of 

food before the next harvest arrives. IRIN

Tanzania: Tanzanian high-risk groups denied HIV 

services

18 June - Sexual minorities, sex workers and people who use drugs who are at a higher risk 

of HIV than the general population, but in Tanzania, they face widespread police abuse and 

discrimination in health facilities, according to the new report by Human Rights Watch 

(HRW) and the Wake Up and Step Forward Coalition (WASO), a local rights group. ...Abuses 

include denial of health services, violations of confidentiality and denial of freedom of 

association, as well as verbal harassment, arbitrary arrest, extortion, assault, torture, rape 

and murder. IRIN

top of page...
12

USCENTCOM

Jordan: CDC expert reports some anomalies in Jordan 

MERS cases

19 June – Eight Jordanians who had MERS-CoV (Middle East respiratory syndrome 

coronavirus) infections in a hospital outbreak more than a year ago, as determined by 

recent blood tests, didn't quite match the profile of more recent cases, according to a CDC 

expert. Most of the eight people did not have preexisting diseases, and one of them had no 

symptoms, said Mark Pallansch, PhD, director of the CDC's Division of Viral Diseases. The 

majority of MERS-CoV cases reported in recent months involved patients who had 

preexisting health problems such as diabetes or heart disease. And the asymptomatic case 

appears to be the first one reported. The eight cases were associated with a hospital 

outbreak in Zarqa, Jordan, in April 2012. CIDRAP

Libya’s “growing” drugs/HIV problem

17 June - Doctors in Libya say they are seeing a “growing” 

number of patients with drug problems and a corresponding 

risk of HIV infection, in a post-Gaddafi era marked by limited 

law enforcement and government capacity. “Every month more 

people come to us needing help,” said Abdullah Fannir, deputy 

director of Gargaresh psychiatric hospital in Tripoli. “It’s part of the fallout from the 

revolution. Border control is weak, making it easy for drug-traffickers, and there’s more 

demand as well. Hundreds of thousands of Libyans were displaced, wounded or bereaved 

during the uprising.” IRIN

Pakistan: Mourning in Pakistan for murdered polio 

workers

17 June - Relatives are mourning two polio workers shot dead by suspected militants on 

Sunday in Pakistan's north-western Swabi district. Gunmen killed the two male health 

workers as they were providing vaccinations in Swabi's Kandar village. No group said it 

carried out the attack, but militants have accused polio workers of spying for the US. At 

least 17 polio workers and four security officials have died in attacks on polio health teams 

in recent months. BBC News

Saudi Arabia: Middle East respiratory syndrome 

coronavirus (MERS-CoV) – WHO update

17 June 2013 - The Ministry of Health in Saudi Arabia has announced an additional three 

laboratory-confirmed cases with Middle East respiratory syndrome coronavirus (MERS-CoV). 

The first patient is a 42-year-old man with an underlying medical condition from the Eastern 

region, the second patient is a 63-year-old woman with underlying medical conditions from 
13

Riyadh region and the third patient is a two-year-old child with an underlying medical 

condition from Jeddah. Additionally, four previously laboratory-confirmed cases have died. 

Globally, from September 2012 to date, WHO has been informed of a total of 64 laboratoryconfirmed cases of infection with MERS-CoV, including 38 deaths. WHO

Syria: Measles epidemic signals growing humanitarian 

needs

18 June - A measles epidemic is sweeping through districts of northern Syria, with up to 

7,000 known cases, an indication that humanitarian needs are increasing and the country’s 

healthcare system is in a state of collapse after more than two years of civil war. Teams from 

the international medical organisation Médecins Sans Frontières/Doctors Without Borders 

(MSF) have vaccinated more than 75,000 children in the provinces of Aleppo, Ar-Raqqah 

and Idlib in an effort to stem the epidemic amongst a population previously unused to 

outbreaks of this kind. ReliefWeb

Syria's wounded generation

14 June - At an after-care center near Turkey's border with Syria, civilians and combatants 

recover from life-altering injuries. The Times's Mac William Bishop speaks to casualties of 

Syria's brutal civil war. New York Times

top of page...

USEUCOM

Israel: Health Ministry to combat spread of polio with 

vaccination campaign 

18 June - The Health Ministry plans to launch a public awareness campaign focusing on the 

importance of hygiene after traces of the polio virus were detected in the sewage systems 

of a number of locations in southern Israel. The ministry has also decided to seek out all 

children who have not been vaccinated against polio, urging their parents to bring them to 

well-baby clinics across the country. Haaretz

Ukraine kids at risk from low vaccination rates

18 June - A combination of suspicion, funding problems, alleged corruption and inefficiency 

leave Ukraine with the lowest vaccination rate of the 15 former republics of the Soviet 

Union, even though it is one of the best developed — and the rate has fallen sharply in 

recent years. International health officials warn that the problems leave Ukraine vulnerable 

to an outbreak of polio, a disease that Europe has largely stamped out. Only about half of 

Ukraine's children are fully immunized against polio, measles, rubella and other diseases 

that vaccines can prevent, despite a government policy calling for free universal vaccination, 

according to UNICEF, the United Nations children's agency. That compares with a rate of 

some 90 percent or higher in most Western European countries. Yahoo! News
14

United Kingdom: Breast cancer risk has risen for South 

Asian women

13 June - The breast cancer risk for British Asian women 

has increased, a study carried out in Leicester suggests. 

Historically women from this ethnic group have had a 

lower risk of the disease than white British women, the 

University of Sheffield team said. But they found breast 

cancer incidence had risen in recent years for South Asian women. Experts said lifestyle 

factors such as obesity, or more coming forward for screening could explain the change.

BBC

United Kingdom: ‘Quiet epidemic’ of male cancer in UK

17 June - Action is needed to fight a "quiet epidemic" of oesophageal cancer, which is on 

the rise in the UK, particularly among men, cancer experts say. Men are almost three times 

more likely than women to get the cancer - one of the biggest gender divides in cancer

rates, according to new figures. Early diagnosis is the key to saving lives, says a Cancer 

Research UK team. Scientists are working on ways to detect symptoms earlier and to 

decipher the genetic code of the cancer. Oesophageal cancer - cancer of the gullet or food 

pipe - is the ninth most common cancer in the UK. It is one of the most difficult cancers to 

detect and treat, with only about one in 10 patients surviving for 10 years or more. Latest 

figures show 5,600 UK men (almost 15 out of every 100,000) developed the disease in 2010, 

compared with 2,800 UK women (about five out of every 100,000). BBC

top of page...

USNORTHCOM

U.S.: Bioterror detection program comes under scrutiny

17 June - ...BioWatch, an alert system designed to be an early detection system for airborne 

threats such as anthrax and smallpox, was unveiled in 2003 by Pres. George W. Bush. In his 

State of the Union address, he talked about the system, saying he was, “deploying the 

nation's first early warning network of sensors to detect biological attack.” Since then the 

system has cost $1 billion and been met with mixed reviews. A committee convened by the 

Institute of Medicine (IOM) and the National Research Council (NRC) said in a 2011 report 

no expansion of the program should be made without better collaboration with the existing 

public health system. The panel also called for further analysis of the program and how it 

could be used to reduce mortality and morbidity. Scientific American
15

U.S., Colorado: Black Forest fire 65% contained but 483 

homes destroyed

16 June - Firefighters in Colorado had the Black Forest fire 65 percent contained Sunday, 

and authorities said all residents of the area were accounted for. Authorities said the 

wildfire, which started Tuesday, had taken two lives while consuming 485 homes and 

blackening 14,198 acres, The Denver Post reported. About 1,175 personnel were working to 

control the blaze... The Post said investigators had yet to determine the cause of the fire, 

though the sheriff said it likely was human-caused... The Black Forest fire is the most 

destructive in Colorado history, surpassing 2012's Waldo Canyon fire that wiped out 346 

homes, the Post said. UPI

U.S.: Homemade chemical bomb incidents — 15 states, 

2003–2011

21 June - Homemade chemical bombs (HCBs) are made from commonly found chemicals. 

The volume of news reports of HCB explosions suggests they are not uncommon. To 

determine the number of events involving HCBs in the United States and describe the 

factors associated with them, the Agency for Toxic Substances and Disease Registry (ATSDR) 

analyzed data from its surveillance system that tracks spills and leaks of hazardous 

substances. This report describes the results of that analysis, which indicated that, during 

2003–2011, a total of 134 events involving HCBs were reported from 15 states. Among 

those events, 21 (16%) resulted in adverse health effects (i.e., respiratory symptoms, burns, 

and skin irritation) for 53 persons. Morbidity and Mortality Weekly Report

U.S.: Kids born in polluted areas more likely to have 

autism

18 June - Babies born in areas with high airborne levels of mercury, 

diesel exhaust, lead, manganese, nickel and methylene chloride were 

more likely to have autism than those in areas with lower pollution. 

Women who live in areas with polluted air are up to twice as likely to 

have an autistic child than those living in communities with cleaner 

air, according to a new study published today. Building on two 

smaller, regional studies, the Harvard University research is the first to link air pollution 

nationwide with autism. It also is the first to suggest that baby boys may be more at risk for 

autism disorders when their mothers breathe polluted air during pregnancy. Scientific 

American

U.S.: National parks raise guard against virus

20 June - ...Near the peak of the summertime tourist season, Yellowstone and Grand Teton

National Parks are fighting an outbreak of norovirus, the highly contagious gastrointestinal 

scourge of cruise ships. Park officials said that the virus had so far sickened 150 employees 

and 50 guests. Employees at the parks’ lodges and restaurants have been scrubbing rooms 
16

and sanitizing every surface to try to stop the spread of the virus. Sick employees, and some 

who might have been exposed, have been quarantined. On Wednesday, the National Park 

Service issued a statement warning visitors to the two parks to wash their hands to avoid 

the virus, which sickens about 21 million people every year in the United States. New York 

Times

top of page...

USPACOM

Bangladesh: Piped water for Dhaka slums

13 June - The Bangladesh government has started work on delivering piped water to more 

than three million Dhaka slum dwellers by the end of 2014, say officials. “By 2015, all slum 

dwellers will have access to piped water,” Taqsem A Khan, the managing director of the 

Dhaka Water Supply & Sewerage Authority (WASA), told IRIN, citing the issue of waterborne diseases and their prevalence in slums. Under the current law, WASA is not allowed to 

provide water to homes without a holding number. However, that law will be amended 

making it no longer mandatory. The government has already started work in Korail, the 

country’s biggest slum, home to 40,000 people. IRIN

Cambodia reports 13,700 malaria cases in 5 months, 

killing 4 people

17 June - Cambodia reported 13,700 malaria cases in the first five months of this year, down 

60 percent from 31,100 cases in the same period last year, the National Center for Malaria 

reported Monday. From January to May this year, the disease killed 4 people, a sharp 

decrease compared with 27 deaths in the same period last year, the report said. Dr. Char 

Meng Chuor, head of the center, said the remarkable decline was thanks to mosquito net 

distribution and awareness campaign. Last year, more than a million of mosquito nets were 

given free-of-charge to the vulnerable groups of people throughout the country. He said 

the country is committed to eliminating the disease by 2025. Xinhua

India: H.I.V. tests urged for 800 million

17 June - Despite India’s enormous population, it would be cost-effective to fight its 

growing AIDS epidemic by testing all 800 million sexually active adults in the country every 

five years and treating all those infected, a new statistical study has concluded. The study, 

published online in May by PLoS One, notes that testing there costs only $3.33, and that 

first-line antiretroviral therapy is about $100 a year. The World Health Organization measure 

for a medical intervention’s cost-effectiveness is whether it saves one year of life for less 

than three times the per capita gross domestic product. In India’s case, that is $3,900 per 

year-of-life saved. New York Times
17

Japan: Rubella epidemic traced to past female-only 

vaccination efforts

14 June - Japan had 5,442 rubella cases in the first 4 months of this year, largely because 

past rubella vaccination programs did not target males, according to an article in today's 

Morbidity and Mortality Weekly Report. The main aim of rubella vaccination is to prevent 

congenital rubella syndrome (CRS), which involves various birth defects in infants infected 

by their mothers, the article notes. Japan and several other countries that in the past 

targeted only girls and women for rubella vaccination have had large outbreaks among 

adolescent boys and young men. Rubella cases in Japan increased sharply in 2012, reaching 

2,392. The increase has continued this year, with men between the ages of 20 and 39, who 

were not included in the initial rubella vaccination program, accounting for 68% of cases. 

Vaccination efforts targeting both boys and girls were strengthened starting in 2006, with 

the result that children under age 15 account for only 5.6% of the cases this year. CIDRAP

New Zealand: Law permits ‘low risk’ designer drugs

14 June - ...[New Zealand] looks set to adopt new laws permitting the limited sale of some 

designer drugs for recreational purposes. The legislation is the first in the world to regulate 

new recreational drugs based on scientific evidence of their risk of harm. Under the 

proposed laws, which were recommended to be passed with amendments by a 

parliamentary committee yesterday, manufacturers will be able to sell any currently 

unregulated psychoactive substance if they can demonstrate it has a "low risk of harm". But 

they also allow for any psychoactive substance not already regulated to be prohibited from 

sale until approved by a new regulator. NewScientist

Singapore fumes as air pollution hits 16-year high

18 June - Singaporeans rolled back military training, kept 

cough-stricken children indoors and considered wearing 

protective masks to work after a smoky haze triggered by 

forest fires in neighboring Indonesia caused air pollution to 

briefly hit its worst level in nearly 16 years... The readings on 

the Pollutant Standards Index were mostly between 104 and 123 on Tuesday, within the 

"unhealthy" range between 101 and 200. A peak reading of 155 on Monday night was the 

highest since late 1997, when officials reported a 226 reading. Smoke haze is a nearly 

annual problem for Singapore and its northern neighbor Malaysia, often beginning in 

midyear when farmers in Indonesia seek to clear land cheaply by starting fires. Yahoo! News

top of page...
18

USSOUTHCOM

Brazil: Q fever

17 June - An outbreak of Q fever, a rare illness in Brazil, is being investigated by the [Minas 

Gerais] State Secretariat of Health. Between June 2010 and February 2013, 81 suspected 

cases were notified in the Metropolitan Region of Belo Horizonte and in April 2013, 6 

patients were seropositive for the illness. Q fever is a zoonosis that is more common in 

countries such as the USA, France, Portugal, and the Netherlands. The Netherlands, in recent 

years, had thousands of human cases confirmed. Human infection is caused by direct 

contact, inhalation of aerosolized secretions of the infected animal, or by the consumption 

of raw milk. Tania Martial, coordinator of the Minas Gerais Center for Strategic Information 

in Health Surveillance (CIEVS), however, affirms that the majority of patients with suspected 

[Q fever] did not have contact with the animal reservoirs of the illness. "As a precaution we 

are continuing with the inquiry", she said. ProMED-mail

Haiti moves a step closer toward eradicating 

elephantiasis

13 June - Haiti has finally carried out a nationwide 

campaign to get rid of the parasitic worms that cause 

elephantiasis. Haiti has waged other campaigns against the 

condition, characterized by severe disfiguration of the legs 

and arms. But until now, it has never managed to 

adequately reach residents of the chaotic capital Port-au-Prince. The latest effort by the 

Haitian Ministry of Health now puts the country on track to wipe out elephantiasis within 

the next four years, says a study published in the Morbidity and Mortality Weekly Report. 

NPR

top of page...
19

U.S. Military | Global | Influenza | Veterinary/Food Safety | Wellness | Contact Us

USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical 

intelligence product. Medical intelligence is available from the National Center for Medical Intelligence.

External Links: The appearance of external hyperlinks does not constitute endorsement by the U.S. Army of this Web site or the information, products, 

or services contained therein. For other than authorized activities such as military exchanges and MWR sites, the U.S. Army does not exercise any 

editorial control over the information you may find at these locations. Such links are provided consistent with the stated purpose of this product.

Although Health Information Operations avoids links to sites that may be blocked, all sites may not be accessible from all locations. While we verify the 

links at the time of publication, we cannot guarantee that they will be active in the future.

Articles appearing in the Update 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.

The Army Public Health Weekly Update is published by the Health Information Operations Program, Deputy Chief of Staff for Communication, United 

States Army Public Health Command.