4 May 2012

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

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Contents

U.S. MILITARY

 FDA orders halt to sale of products containing DMAA

 Imported human rabies in a U.S. Army Soldier — New York, 2011

 Mental health diagnoses during the year prior to schizophrenia, U.S. Armed Forces, 2001-2010

GLOBAL

 Analysis finds clinical trials often small, of poor quality

 As preterm births soar globally, U.S. ranks 130 of 184

 Plasma flashlight kills bacteria

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

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

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 Indonesia: Avian influenza situation, WHO update

VETERINARY/FOOD SAFETY

 Europe, Netherlands: Schmallenberg virus, no human infection

 New foot and mouth strain spreads to Gaza Strip

 Synthetic stool a prospective treatment for C. difficile

WELLNESS

 Anxiety, depression often go hand-in-hand with arthritis

 Can blood test predict breast cancer risk?

 Garlic compound fights source of foodborne illness better than antibiotics

 Healthy weight loss may also cut your cancer risk
Warrior Games

Retired Army veteran 

Melissa Stockwell and 

Royal Marine Capt. Simon 

Maxwell from Croydon, 

England, carry the torch 

after lighting the cauldron 

to kick off the 2012 Warrior 

Games in Colorado 

Springs, Colo., April 30, 

2012. DOD photo by D. 

Myles Cullen

 Here are the women who need mammograms in their 40s

 U.S. sees sharp rise in newborns with opiate withdrawal

USAFRICOM

 Africa: HIV funding boosts general health services - study

 Democratic Republic of Congo: Poor sanitation systems hinder fight against cholera

 Gambia: 61,000 locals would be infected with diabetes by 2030

 Somalia: UNICEF, thousands of children at risk

USCENTCOM

 Pakistan: Leishmaniasis, cutaneous

USEUCOM

 United Kingdom trial for portable brain-cooling device

USNORTHCOM

 U.S.: FDA approves new antibacterial treatment for plague

 U.S. health centers for poor, uninsured see ranks swell

 U.S.: New rules set for school immunizations

USPACOM

 Asia: Containing anti-malarial drug resistance in Mekong

 India: Malaria

 India: Scores dead in ferry sinking; hope for survivors dwindles

USSOUTHCOM

 Brazil: Encephalitis outbreak

U.S. MILITARY

FDA orders halt to sale of products containing DMAA

30 April - The U.S. Food and Drug Administration has ordered 

fitness supplement companies to immediately stop selling 

popular bodybuilding and weight-loss products containing 

DMAA, because of the substance’s potentially fatal side effects. 

The agency has determined DMAA — which is sold as 1,3-

dimethylamylamine, methylhexanamine, or geranium extract — is a synthetic substance that 

could cause heart attacks by elevating blood pressure in users. There have been 42 public 

complaints about products containing DMAA, indicating it might be linked to other serious 

health effects including nervous system and psychiatric disorders as well as death, the 

agency said Friday in a news release. Products containing DMAA were pulled from military 
FDA challenges 

marketing of DMAA 

products

The U.S. Food and Drug 

Administration issued 

warning letters to ten 

manufacturers and 

distributors of dietary 

supplements containing 

dimethylamylamine, more 

popularly known as DMAA, 

for marketing products for 

which evidence of the 

safety of the product had 

not been submitted to 

FDA.

New Website for 

MILVAX

MILVAX has redesigned

their Immunization 

Information and Training 

Web Portal. The new 

design brings important 

content closer to the front, 

emphasizes immunization 

training opportunities, and 

makes the site more 

modular for easier viewing. 

exchange store shelves in December. The substance has fallen under increasing scrutiny 

since Stars and Stripes reported that DMAA was found during toxicology tests of two 

soldiers who suffered heart attacks and died during physical training at a base in the 

Southwest U.S. In light of those deaths and other complaints, the Army Public Health 

Command initiated a case control study on the effects of DMAA to determine if there is a 

link between the use of the substance and reports of dangerous health conditions. Stars and

Stripes

Imported human rabies in a U.S. Army Soldier — New 

York, 2011

4 May - On August 19, 2011, a male U.S. Army soldier with progressive right arm and 

shoulder pain, nausea, vomiting, ataxia, anxiety, and dysphagia was admitted to an 

emergency department (ED) in New York for suspected rabies. Rabies virus antigens were 

detected in a nuchal skin biopsy, rabies virus antibodies in serum and cerebrospinal fluid 

(CSF), and rabies viral RNA in saliva and CSF specimens by state and CDC rabies 

laboratories. An Afghanistan canine rabies virus variant was identified. The patient 

underwent an experimental treatment protocol (1) but died on August 31. The patient had 

described a dog bite while in Afghanistan. However, he had not received effective rabies 

postexposure prophylaxis (PEP). In total, 29 close contacts and health-care personnel (HCP) 

received PEP after contact with the patient. This case highlights the continued risks for 

rabies virus exposure during travel or deployment to rabies-enzootic countries, the need for 

global canine rabies elimination through vaccination, and the importance of following 

effective PEP protocols and ensuring global PEP availability. Morbidity and Mortality Weekly 

Report

Mental health diagnoses during the year prior to 

schizophrenia, U.S. Armed Forces, 2001-2010

March 2012 - Identification of military members in the prodromal phase of schizophrenia 

may lead to earlier treatment and allow non-urgent transition away from military duties. 

This report documents the incidence of schizophrenia in the U.S. military and summarizes 

mental health diagnoses during the year prior to initial clinical diagnoses schizophrenia. 

During 2001-2010, 3,000 service members met the case definition of schizophrenia 

(incidence rate: 21 per 100,000 person years). Rates declined with increasing age. Of those 

diagnosed with schizophrenia, 71% had at least one mental health-related medical 

encounter during the preceding 12 months; 51% received at least one antecedent diagnosis 

of paranoia. The findings may inform a model to predict the likelihood and timing of clinical 

manifestations of schizophrenia among U.S. military members. Medical Surveillance 

Monthly Report

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Drug-Resistant 

Tuberculosis: 

Challenges and 

Potential Solutions 

in India

Although antibiotics to 

treat TB were developed in 

the 1950s and are effective 

against a majority of TB 

cases, resistance to these 

antibiotics has emerged 

over the years, resulting in 

the growing spread of 

multidrug-resistant (MDR) 

TB. 

Due to challenges in timely 

and accurate diagnosis of 

drug-resistant TB, length 

and tolerability of 

treatment regimens, and 

expense of second-line 

anti-TB drugs, effectively 

controlling the disease 

requires complex public 

health interventions. 

The aim of the IOM 

workshop was to highlight 

key challenges to 

controlling the spread of 

drug-resistant strains of TB 

in India and to discuss 

strategies for advancing 

and integrating local and 

international efforts to 

prevent and treat drugresistant TB. This document 

summarizes the workshop. 

GLOBAL

Analysis finds clinical trials often small, of poor quality

1 May - A new analysis of registered U.S. clinical trials -- the research that seeks to 

determine if medical treatments and prevention strategies work -- finds that many are small 

and of poor quality. Studies of cancer treatments, in particular, often fail to follow the 

highest standards of medical research, the analysis found. Meanwhile, a full 7 percent of the 

studies didn't bother to mention their purpose, while others failed to provide other 

important details. "We think expert groups need to start scrutinizing the database more and 

really examine the quality of the trials one by one," said report author Dr. Robert Califf, vice 

chancellor for clinical and translational research at Duke University. "For the first time, we 

have a chance to look at the entire universe [of clinical research] and we can see that we can 

do better." Califf and his colleagues examined the Clinicaltrials.gov database, which includes 

medical research studies that enroll people. By law in the United States, many kinds of 

studies must be registered in this database. Medline Plus

As preterm births soar globally, U.S. ranks 130 of 184

2 May - The world's developed countries have seen their average rate of premature births 

double to 6 percent since 1995, despite efforts to reduce the phenomenon, according to a 

report released on Wednesday. Worldwide, 15 million of the 135 million babies born in 

2010 were premature and 1.1 million died, according to the "Born Too Soon" report, which 

was compiled as part of the United Nations' "Every Woman Every Child" initiative. The 

report, three years in the making and written by experts from 11 countries, is intended to 

draw attention to the problem and attract donations from governments and charities to 

solve it. The study analyzes preterm births (before 37 weeks of the full 40-week gestation) in 

184 nations, more than ever previously studied. Of the 65 developed countries that have 

kept reliable data over the years, only Croatia, Ecuador and Estonia have cut their rate of 

preterm births since the 1990s. In the other 62, despite programs to, for instance, improve 

pre-natal care and reduce the number of Cesarean sections, premature births increased 

from an average of about 3 percent to 6 percent. Reuters

Plasma flashlight kills bacteria

26 April - A plasma flashlight – a torch that emits a plasma jet that kills bacteria on the skin 

in an instant -- is being developed by a group of Chinese and Australian scientists, including 

from the Commonwealth Scientific and Industrial Research Organization (CSIRO), and is 

designed to be completely mobile, light, efficient and works at room temperature. Due to its 

mobility it could be used in ambulance emergency calls, natural disaster sites, military 

combat operations and many other instances where treatment is required in remote 

locations. Infection Control Today

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INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

3 May 2012:

No influenza cases among shipboard populations were detected last week. 

The overall influenza activity remains low to moderate in overseas DoD laboratory 

surveillance networks and the activity level continues to decrease within the MHS from 

previous weeks. AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 16 (15-21 April 2012), influenza activity was elevated in some areas of the 

United States, but declined nationally and in most regions. FluView

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

4 May - Apart from Slovakia which reported medium intensity, all reporting countries 

experienced low-intensity influenza activity. Weekly Influenza Surveillance Overview

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 28 April 2012:

Adenovirus 

Vaccination against types 4 and 7 adenovirus was instituted at all basic training centers 

by mid-November 2011 (week 45). 

FRI rates and the proportion of FRI cases positive for adenovirus have decreased 

markedly since vaccine was reintroduced. 

Type 14 adenovirus is present at MCRD Parris Island. 

A MSMR paper on the initial impact of adenovirus vaccine resumption was recently 

published.

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

below expected values. NHRC Febrile Respiratory Illness Surveillance Update 
PANDEMIC AND AVIAN INFLUENZA

Indonesia: Avian influenza situation, WHO update

2 May – The Indonesian IHR National Focal Point of the Ministry of Health has notified WHO 

of a new case of human infection with avian influenza A(H5N1) virus. The case is a 2 yearold male from Riau Province. He developed fever on 17 April 2012 and was hospitalized on 

21 April 2012 but he died on 27 April 2012. Epidemiological investigation is ongoing. 

Preliminary findings indicate that the case’s parents are quail egg vendors. The case was 

confirmed by the National Institute of Health Research and Development (NIHRD), Ministry 

of Health. To date, of the 189 cases reported in Indonesia since 2005, 157 have been fatal.

WHO

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VETERINARY/FOOD SAFETY

Europe, Netherlands: Schmallenberg virus, no human 

infection

1 May - In total, 301 persons were tested for antibodies to SBV by virus neutralization test. 

All sera tested negative, whereas high levels of antibody were found in serum from an 

infected animal that was used as a control. The study population consisted of 234 persons 

working or living on SBV-infected farms, and 67 veterinarians -- all with known exposure to 

SBV-infected herds. Of these, 229 persons had direct exposure to newborn calves, lambs, 

and/or birthing materials from SBV-infected herds, and 150 persons reported exposure to 

biting insects. We conclude that there is no evidence for zoonotic infection. ProMED-mail

New foot and mouth strain spreads to Gaza Strip

2 May - A new strain of foot and mouth disease (FMD) has reached the Gaza Strip and 

threatens to spread further after first being detected in Egypt and Libya in February, the 

United Nations' Food and Agriculture Organization (FAO) said on Wednesday. FAO said sick 

animals had been detected on April 19 in Rafah, a town that lies on the border between the 

coastal Palestinian territory and Egypt. Reuters

Synthetic stool a prospective treatment for C. difficile

30 April - A synthetic mixture of intestinal bacteria could one day replace stool transplants 

as a treatment for Clostridium difficile (C. difficile). C. difficile is a toxin-producing bacteria 

that can overpopulate the colon when antibiotics eradicate other, naturally protective 

bacteria living there. "A synthetic stool transplant has a lot of potential because we can 

control what goes in and we can alter, change, or modify it as necessary," says Elaine Petrof, 

an assistant professor in the Department of Medicine at Queen's University and in the 
Gastrointestinal Disease Research Unit (GIDRU) at Kingston General Hospital. Petrof and her 

collaborator at the University of Guelph, Emma Allen-Vercoe, believe that a stool compound 

made from synthetic or "purified" bacteria could significantly improve on regular stool 

transplants. It could eliminate the chance of transmitting an infectious disease through fecal 

bacteria; physicians could tailor the mixture so as to increase patient acceptance; it would 

be easily reproducible; and, it may appeal to both doctors and patients as a 'cleaner' 

therapy. Infection Control Today

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WELLNESS

Anxiety, depression often go hand-in-hand with arthritis

30 April - Depression or anxiety affect one-third of Americans with arthritis who are aged 45 

or older, a new study shows. Researchers from the U.S. Centers for Disease Control and 

Prevention also found that even though anxiety is nearly twice as common as depression 

among people with arthritis, doctors tend to focus more on depression in these patients. 

The study included nearly 1,800 people with arthritis or other rheumatic conditions who 

took part in the CDC's Arthritis Conditions and Health Effects Survey. Among the study 

participants, 31 percent reported anxiety and 18 percent reported depression. One-third of 

the patients reported at least one of the two conditions and 84 percent of those with 

depression also had anxiety. Only half of those with anxiety or depression sought mental 

health treatment in the previous year, according to the study, which was published in the 

April 30 issue of the journal Arthritis Care & Research. Health Day

Can blood test predict breast cancer risk?

1 May - A blood test that spots changes in a specific gene could reveal a 

woman's risk for breast cancer years before the disease has a chance to 

develop, researchers report. British scientists analyzed blood samples from 

640 breast cancer patients and 741 women without breast cancer. The 

samples from the breast cancer patients were collected an average of three 

years before they were diagnosed with the disease. The objective was to find out if the 

alteration of single genes by a process called methylation could predict a woman's breast 

cancer risk. Medline Plus

Garlic compound fights source of foodborne illness better 

than antibiotics

1 May - Researchers at Washington State University have found that a compound in garlic is 

100 times more effective than two popular antibiotics at fighting the Campylobacter 

bacterium, one of the most common causes of intestinal illness. Their work was recently 

published in the Journal of Antimicrobial Chemotherapy. The discovery opens the door to 

new treatments for raw and processed meats and food preparation surfaces. "This work is 
very exciting to me because it shows that this compound has the potential to reduce 

disease-causing bacteria in the environment and in our food supply," says Dr. Xiaonan Lu, a 

postdoctoral researcher and lead author of the paper. "This is the first step in developing or 

thinking about new intervention strategies," says Michael Konkel, a co-author who has been 

researching Campylobacter jejuni for 25 years. "Campylobacter," says Konkel, "is simply the 

most common bacterial cause of food-borne illness in the United States and probably the 

world." Some 2.4 million Americans are affected every year, according to the Centers for 

Disease Control and Prevention, with symptoms including diarrhea, cramping, abdominal 

pain and fever. The bacteria are also responsible for triggering nearly one-third of the cases 

of a rare paralyzing disorder known as Guillain-Barré syndrome. Infection Control Today

Healthy weight loss may also cut your cancer risk

1 May - Moderate weight loss reduces levels of inflammation that have been tied to certain 

cancers, at least in postmenopausal women, a new study suggests. According to the 

findings, older women who lost at least 5 percent of their body weight through diet alone 

or diet plus exercise showed significant reductions in key inflammatory blood markers such 

as C-reactive protein and interleukin-6. In addition to risk for heart disease, elevated levels 

of these markers have also been associated with increased risk for several cancers, including 

breast, colon, lung and endometrial cancer. The findings appear May 1 in the journal Cancer 

Research. Medline Plus

Here are the women who need mammograms in their 

40s

30 April - A new analysis that may help women in their 40s interpret 

mammogram guidelines says those with a family history of breast cancer 

or extremely dense breast tissue should start getting regular screenings. 

The benefits of getting a mammogram every two years outweigh the 

risks for these particular women, who are at increased risk for developing 

breast cancer, according to the U.S. National Cancer Institute-funded study. "Among a 

group of women who have twice the average level of risk, screening every other year 

starting at age 40 has the same balance of benefit and harms as starting at age 50," said 

researcher Dr. Jeanne Mandelblatt, associate director for population sciences at 

Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C. HealthDay

U.S. sees sharp rise in newborns with opiate withdrawal

30 April - The number of babies born in the US showing symptoms of opiate withdrawal 

increased threefold in the 10 years up to 2009, a medical study has found. The research, 

published in the Journal of the American Medical Association, said one in every 1,000 

newborns was affected in 2009. The number of pregnant women testing positive for illegal 

or legal opiates increased fivefold in the same period. The report says abuse of prescription 

painkillers is partly to blame. The study, the first of its kind in the US, was based on records 

from more than 4,000 hospitals across the country. BBC News

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USAFRICOM

Africa: HIV funding boosts general health services -

study

3 May - The debate within the global health community about the impact of dedicated 

HIV/Aids funding on general public health services has been taken a step further with a 

study showing that funding dedicated to HIV/Aids does not undermine health funding for 

other diseases. A six-year long study in Rwanda published in the May 2012 issue of the 

American Journal of Tropical Medicine and Hygiene, found that when rural health clinics 

expanded Aids services, these efforts had no adverse effects on other types of health care. 

The study's lead author, Donald S. Shepard - a professor at Brandeis University's Schneider 

Institute for Health Policy - added that there was "even evidence that clinics that have 

received funding for HIV/Aids services provide better care for all patients, including superior 

prevention services, than do clinics without Aids programmes." All Africa

Democratic Republic of Congo: Poor sanitation systems 

hinder fight against cholera

30 April - More than 7,500 cholera cases have been identified in 

the Democratic Republic of Congo (DRC) since the beginning of 

the year as an epidemic that began in June 2011 continues to 

affect parts if the capital, Kinshasa, as well as four other 

provinces. In total, more than 30,000 cholera cases have been 

identified around the country since the epidemic started, while 230 people have succumbed 

to the disease since the beginning of the year, and more than 700 since June 2011. In 

addition to Kinshasa, the provinces of Orientale, North Kivu, Equateur and Bas Congo are 

currently experiencing outbreaks. According to Nona Zicherman, chief of emergency 

operations in DRC for the UN Children's Fund (UNICEF), the epidemic has continued largely 

because of "poor hygiene, lack of awareness of the population about transmission 

mechanisms, very limited access to protected and monitored water sources and lack of 

sanitation infrastructure." IRIN

Gambia: 61,000 locals would be infected with diabetes by 

2030

24 April - 'In 2010, the World Health Organisation (WHO) estimated that 61, 000 people in 

the Gambia would have diabetes by 2030, which is about 4% of the current population 

which is not too far from the global estimates'. This revelation is contained in a statement 

read on behalf of the minister of Health and Social Welfare, Fatim Badjie, by Dr Ahmed 

Secka, chief medical director of RVTH during The Gambia Medical and Dental Association's 

annual scientific meeting held recently at the Kairaba Beach Hotel. The meeting was 

organised in collaboration with Urolink, a medical organisation, based in Europe. The 

meeting centred on recent advances in the management of Diabetes with special references 

to developing countries, a theme described by the Health minister as timely to the current 
prevailing challenges being experienced locally and globally within the health sector.

According to her, man has come a long way through his survival and non sedentary 

networks; commenting that man doesn't necessarily need to move further than his 

surroundings now basically he can continuously consume fatty, salty and sugary foods, and 

such attitude is consistently creeping into our society at an alarming rate in the light of 

globalisation, as televisions and internet have in one way or the other with the rapid 

changing information technology increased vulnerability due to poverty. All Africa

Somalia: UNICEF, thousands of children at risk

1 May – The United Nations Children's Fund warned that 

thousands of acutely malnourished children in Somalia are at 

risk of death because little money is available to help them. 

UNICEF said it has received only 12 percent of its $289 million 

emergency appeal for humanitarian operations this year. The 

famine declared in southern Somalia last year is over. But, that does not mean that the crisis 

is finished. Somalia remains the world’s most complex humanitarian situation. The U.N. 

Children’s Fund reported that almost one-third of Somalis are unable to meet their essential 

food and non-food needs. About 70 percent of these people live in south and central 

Somalia, areas that have been wracked by conflict for years and recurrent drought. VOA 

News

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USCENTCOM

Pakistan: Leishmaniasis, cutaneous

29 April - The Khyber Pakhtunkhwa (KP) Health Department has sought help from the World 

Health Organization (WHO) to contain an outbreak of cutaneous leishmaniasis (CL), an 

official said. WHO is to spend USD 9.6m to help residents of KP, FATA KP to set up 700 

community health centres. "During the last three months, about 889 cases of CL have been 

recorded from 14 districts," Dr Muhammad Iqbal of the Health Department told Central Asia 

Online on 25 April. "We have requested the WHO to intervene." Nowshera District had the 

most cases, 214, he said. KP is requesting injectable medicines and help with insecticide 

spraying, he said, adding that patients cannot afford the 3500 Pak rupees (USD 39) cost of 

CL treatment. CL is a skin infection, transmitted by sand flies. ProMED-mail

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USEUCOM

United Kingdom trial for portable brain-cooling device

2 May - A trial has begun of a portable brain-cooling device which 

could enhance the survival prospects of cardiac patients. Groundbased cars in the service of the charity London's Air Ambulance are 

the first in the UK to carry the Rhinochill machine. Larger braincooling devices are already used in UK hospitals on cardiac and 

stroke patients to aid recovery. But cooling the body earlier in the field, during resuscitation,

could save more lives, early research suggests. "We know quite well that if you're cooled 

after your heart attack, it can not only mean that your chances of surviving are greatly 

increased, but your chances of surviving without brain damage are too," Dr Richard Lyon, a 

registrar with London's Air Ambulance, told BBC News. "For the last 10 years or so, the big 

thrust has been to cool you as quickly as possible, but usually after you get delivered to 

hospital, after your heart has been restarted. What we're doing is bringing everything much 

further forward - starting this brain-cooling process while CPR is still being carried out in the 

field." BBC News

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USNORTHCOM

U.S.: FDA approves new antibacterial treatment for 

plague

30 April - The Food and Drug Administration (FDA) today approved Levaquin (levofloxacin) 

to treat patients with plague, a rare and potentially deadly bacterial infection. The agency 

also approved the drug to reduce the risk of getting plague after exposure to Yersinia 

pestis, the bacterium that causes the disease. Plague is extremely rare in most parts of the 

world, including the United States, with 1,000 to 2,000 cases worldwide each year. The three 

most common forms of plague are bubonic plague (infection of the lymph nodes), 

pneumonic plague (infection of the lungs), and septicemic plague (infection of the blood). 

Primarily an animal disease, plague can be spread to humans through bites from infected

fleas, contact with infected animals or humans, or laboratory exposure. Yersinia pestis also is 

considered a biological threat agent, which could potentially be used as a bioterrorism 

agent. The FDA approved Levaquin for plague under the agency’s Animal Efficacy Rule, 

which allows efficacy findings from adequate and well-controlled animal studies to be used 

in cases where it is not feasible or ethical to conduct trials in humans. Because plague is 

such a rare disease, it would not be possible to conduct adequate efficacy trials in humans. 

Infection Control Today
U.S. health centers for poor, uninsured see ranks swell

1 May - U.S. community health centers that cater to the poor and uninsured saw their 

patients' ranks swell by nearly 18 percent from 2008 to 2011 as job loss left more Americans 

without health insurance, the Obama administration said on Tuesday. A report released by 

the White House said 20 million Americans now receive healthcare services through 8,500 

community health centers, up from 17 million four years ago. "Those numbers really took a 

big jump," Mary Wakefield, who heads the U.S. Health Resources and Services 

Administration, told reporters. "A lot of those folks were people who, when they lost their 

jobs early on, lost their coverage." Reuters

U.S.: New rules set for school immunizations

30 April - Health officials are using National Infant Immunization Week to highlight the 

importance of vaccinations by urging parents to make sure their children are up-to-date on 

their immunizations for school. For the first time, all Illinois students entering sixth and ninth 

grades during the 2012-2013 school year will be required to have a school physical and 

show proof of receiving the Tdap vaccine, which protects pre-teens, adolescents and adults 

against tetanus, diphtheria and pertussis, or whooping cough. As the law stands, students 

either must comply or otherwise have an appointment scheduled or an approved medical 

or religious exemption on file to be allowed to attend school. "Although we are 

approaching the end of the school year for many students, now is the time for parents to 

start scheduling appointments for next year's school immunization requirements," the 

acting director of the Illinois Department of Public Health, Dr. Arthur F. Kohrman, said in a 

news release. "While the department has recommended for several years that children 

entering the sixth grade receive the Tdap vaccine during their physical exam, it will be 

required this year for students entering both the sixth and ninth grades," he said. 

"Immunization is one of the best ways parents can protect their children against serious 

diseases, so start scheduling appointments now." The Telegraph

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USPACOM

Asia: Containing anti-malarial drug resistance in Mekong

26 April - Resistance to an anti-malaria drug, artemisinin, is 

suspected along the Thailand-Myanmar border and in southern 

Vietnam, but scientists are hoping that it can be contained. 

Artemisinin resistance emerged on the Thailand-Cambodia border 

around eight years ago. Resistance - the ability of the malaria 

parasite to survive drugs intended to kill it quickly - to chloroquine, an antimalarial 

previously widely used, forced treatment to change in the early 1970s and also originated in 

what is known as the Greater Mekong sub-region, which includes Cambodia, the southern 
provinces of China, Lao, Myanmar, Thailand and Viet Nam. Chloroquine resistance spread to 

India and then to sub-Saharan Africa, which has the world’s highest burden of the disease. 

Decades later, faced with another bout of resistance, officials are cautiously optimistic about 

preventing the spread of resistance to artemisinin. IRIN

India: Malaria

2 May - Despite the monsoon rains not arriving in [Bantwal] taluk [administrative division], 

28 cases of malaria have been detected already. This was revealed during the taluk quarterly 

KDP [Karnataka Development Programme] meeting held at SGSY auditorium, BC Road, on 

[Mon 30 Apr 2012]. Taluk health officer Dr Deepa Prabhu revealed this at the KDP meeting 

chaired by MLA [Member of Legislative Assembly] Ramanath Rai [in Bantwal] on Mon 30 

Apr 2012. "Out of the 28 cases of malaria detected in the taluk, 7 were reported from 

Kurnad primary health centre, and 21 from different primary health centers across the 

taluk," added Dr Prabhu. ProMED-mail

India: Scores dead in ferry sinking; hope for survivors 

dwindles

1 May - Rescue workers searched Tuesday for the remains of 

about 160 people who were still missing, 24 hours after an 

overcrowded ferry broke apart and sank in the Brahmaputra river 

during a severe storm in eastern India. The bodies of more than 

100 of the 350 people who were aboard the double-decker ferry 

when it capsized Monday have already been recovered. With every passing hour, rescuers 

said, hopes of finding live passengers dwindled... The ferry sank late Monday in the Dhubri 

district of the eastern state of Assam, near where the river flows into Bangladesh. Many 

passengers jumped from the rocking boat in panic, one official said. Passengers on the 

upper deck fared better than those who were trapped in the lower portion of the boat. 

Washington Post

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USSOUTHCOM

Brazil: Encephalitis outbreak

28 April - Teams from the Agency of Health Surveillance, Central Laboratory of Public Health 

- LACEN, the Center for Research in Tropical Diseases - Cepem, and the Secretariat of Health 

of Porto Velho joined throughout the day on Monday 23 [April / 2012], the staff of the 

Secretariat of Health Spiker West to study, discuss and investigate the facts that caused an 

outbreak of encephalitis and meningoencephalitis in some cases at least 7 children students 

of Monteiro Lobato. The Medical Cepem, Mauro said the team works with the hypothesis of 

transmission of the disease have occurred by the bite of an insect, since the forest 
surrounding the outbreak of the disease is inhabited by primates (monkeys) and vectors. In 

the research team found pockets of _Aedes aegipty_, but the technicians are also 

investigating the possibility of disease being transmitted by porvinha [gender _Culicoides_ -

Mod RNA] - a species of mosquito that transmits very kid a number of diseases. ProMEDmail via Google Translate

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