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17 May 2013

Army Public Health Weekly Update

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

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Contents

U.S. MILITARY

 Agent Orange: Still taking a toll on vets

 Ambulatory visits among members of the active component, U.S. Armed Forces, 2012

 Hagel orders retraining of sex-assault prevention officers; Army sergeant investigated

 Pentagon grapples with sex crimes by military recruiters

 Social media increasingly important for military families

GLOBAL

 An iPhone jury-rigged as a microscope

 Bacterial infection in mosquitoes renders them immune to malaria parasites

 Clusters of new coronavirus add to concern

 How austerity kills

 Inoculating against vaccine fears?

 New rotavirus vaccine developed in India billed as effective, cheap

 Scientists clone human embryos to make stem cells

 The latest buzz - eating insects can help tackle food insecurity, says FAO

 UN: Billions still will lack sanitation by 2015

 Victorian man brought back from the dead by Australian-first resuscitation technique

 WHO data shows narrowing health gap

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 H5N1 bird flu could be controlled by disinfection

 Death toll rises to 36 in H7N9 outbreak

VETERINARY/FOOD SAFETY

 FDA releases food defense planning software tool

 Illnesses in U.S. on the rise as a result of decline in foreign food inspections

 Kazakhstan: OIE - new FMD outbreak results in quarantine measures

 Study finds an increase in arsenic levels in chicken
2

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Afterdeployment.org

 U.S. report quantifies risk of listeria in deli foods

WELLNESS

 Actress's move shines light on preventive mastectomy

 Bed rest no help for women at risk of early delivery

 Biological clue to why women live longer than men

 Kidney problems linked to traffic fumes

 Number of abused U.S. children unchanged since 2008

 Teen drivers: TXTing tops risky behaviors

 Ultra-low salt intake may not boost health: U.S. panel

USAFRICOM

 Niger offers cash reward to help eradicate Guinea worm

 Slim in Sudan: Female fleshiness loses its allure

 Somalia: Wild poliovirus

 South Africa: Over 20 boys die in circumcision rituals

 Uganda grapples with paediatric vaccine shortages

USCENTCOM

 Afghanistan: Taliban pledge support for polio campaign

 Jordan: Recording about 151 TB infection among Syrian refugees in the camp of Zaatari

 Saudi Arabia: Novel coronavirus infection – WHO update

USEUCOM

 Hospital probes East German ‘human guinea pig’ drug tests

 Northern Greece: Re-emergence of animal rabies and subsequent human exposure, October 

2012 – March 2013

USNORTHCOM

 U.S.: At least 6 confirmed dead in Texas tornado outbreak

 U.S.: Chemical depots fall under a patchwork of rules

 U.S.: FDA approves labels with lower doses for sleep drugs like Ambien

 U.S.: Final 2012 West Nile virus update:

 U.S.: Judge denies FDA bid to stay 'morning-after' pill ruling

 U.S.: Ovarian cancer fall sped up as hormone use dropped

 U.S.: Tick-borne disease threat is growing

 U.S.: Spinal and paraspinal infections associated with contaminated methylprednisolone acetate 

injections — Michigan, 2012–2013

USPACOM

 Bangladesh: Non-communicable diseases account for half of all adult female mortality

 China’s prostitutes routinely extorted, abused by police, report says

USSOUTHCOM

 Chile: PDI investigates alleged medical negligence death of hantavirus infected woman

 Cuba: Cholera and dengue totaling 800 cases on the island
3

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U.S. MILITARY

Agent Orange: Still taking a toll on vets

13 May - U.S. veterans exposed to the powerful herbicide Agent Orange had a significantly 

increased risk of high-grade prostate cancer, researchers found. In a cohort of men who 

served in Vietnam, Agent Orange exposure was associated with high-grade disease... 

compared with low-grade disease... The authors also found an adjusted 52% overall 

increased risk for prostate cancer detection... Prior research has shown exposure to the 

defoliant has been associated with soft tissue sarcoma, Hodgkin disease, and non-Hodgkin 

lymphoma. Other, but limited, research has also found ties between exposure and 

respiratory cancers, prostate cancer, and multiple myeloma, Garzotto and co-authors wrote. 

MedPage Today

Ambulatory visits among members of the active 

component, U.S. Armed Forces, 2012

April 2013 - ...In 2012, there were 11,108,119 documented ambulatory visits for illnesses and

injuries (ICD-9-CM: 001-999 (including relevant pregnancy V-codes). The crude annual rate 

of illness- and injury-related visits was 7.7 visits per person per year (p-yr). The rate of 

ambulatory visits for illnesses and injuries in 2012 was 8.8 percent higher than in 2010 and 

24.5 percent higher than in 2008. In 2012, three major diagnostic categories accounted for 

the majority (56.8%) of all illness- and injury-related ambulatory visits among active 

component service members: musculoskeletal system/connective tissue disorders (27.8%), 

mental disorders (18.9%), and “signs, symptoms and ill-defined conditions” (10.2%)... The 

largest percentage increases from 2008 to 2012 were for mental disorders (change in 

ambulatory visits, 2008-12: +872,772; +71.2%), and musculoskeletal system/connective 

tissue disorders (change in ambulatory visits, 2008-12: +972,307; +46.0%). Medical 

Surveillance Monthly Report

Hagel orders retraining of sex-assault prevention 

officers; Army sergeant investigated

15 May - Defense Secretary Chuck Hagel on Tuesday evening ordered the armed services to 

immediately “re-train, re-credential and re-screen” tens of thousands of military recruiters 

and sexual-assault prevention officers as the revelation of another sex-crime scandal rocked 

the Pentagon. Hagel’s order came in response to the Army’s disclosure Tuesday that a 

sergeant first class responsible for handling sexual-assault cases at Fort Hood, Tex., had 

been placed under criminal investigation over allegations of abusive sexual contact and 

other related matters. Washington Post

Pentagon grapples with sex crimes by military recruiters

13 May - Military recruiters across the country have been caught in a string of sex-crime 

scandals over the past year, exposing another long-standing problem for the Defense 
4

Department as it grapples with a crisis of sexual assault in the ranks... The extent of the 

problem is hard to ascertain because the Defense Department does not keep figures on 

recruiters accused of sex crimes. The Army, Navy, Air Force and Marine Corps track incidents 

separately, but there is no uniform standard, which makes statistical comparisons difficult. 

Stars and Stripes

Social media increasingly important for military families

12 May - ...Social media networks and fast Internet connections across the world are 

revolutionizing what it means to be deployed to a war zone or other post. Online support 

communities such as blogs, video chat rooms, specialized Facebook pages and the Twitter 

hashtag for military significant others – #MilSO – are on the rise... With smartphones 

becoming a more popular medium to access the Internet, researchers are only beginning to 

realize the effects on the military and the home front. Although some see the access to 

family as a positive, there is some concern that it can also be a distraction... Karney said the 

Pentagon, for program and policy purposes, wants to know whether such a connection 

strengthens family bonds and eases the post-deployment transition, or whether it might 

distract service members from their mission and expose fractures in their personal 

relationships. The truth might be a little of both, he said. Stars and Stripes

top of page...

GLOBAL

An iPhone jury-rigged as a microscope

13 May - By sticking a little $8 lens to an iPhone with a piece of double-sided tape, a 

Canadian doctor has produced a microscope that works reasonably well at diagnosing 

intestinal worms in children... A three-millimeter ball lens was taped over the camera lens of 

an iPhone 4. The camera’s zoom was increased to maximum, and microscope slides were 

pressed right up to the lens, with another bit of tape atop the samples to keep the lens 

clean. A pen flashlight shone light through the slide. This inexpensive arrangement did not 

match the accuracy of a scan of the same slides with a conventional microscope, but it did 

about 70 percent as well... To be useful for field surveys — to decide whether to treat a 

whole village with deworming medicine, for example — the device would have to be about 

80 percent accurate, Dr. Bogoch said. But since smartphone cameras are improving rapidly, 

that may soon be feasible. New York Times

Bacterial infection in mosquitoes renders them immune 

to malaria parasites

9 May – Scientists... have established an inheritable bacterial infection in malariatransmitting Anopheles mosquitoes that renders them immune to malaria parasites. 

Specifically, the scientists infected the mosquitoes with Wolbachia, a bacterium common 

among insects that previously has been shown to prevent malaria-inducing Plasmodium 
5

parasites from developing in Anopheles mosquitoes. Before now, researchers had been 

unable to create mosquitoes with a stable Wolbachia infection that passed consistently 

from mother to offspring... A stable Wolbachia infection was maintained for 34 generations 

of mosquitoes, at which time the study ended. EurekAlert!

Clusters of new coronavirus add to concern

13 May - Close contact can spread the novel coronavirus hCoV-EMC, but there's still no 

evidence of sustained human-to-human transmission, the World Health Organization says. 

The agency said Sunday that the French health ministry has confirmed its second case of 

the infection, which has caused 34 laboratory confirmed infections and 18 since September 

2012. France's second case was a 50-year-old man who had shared a hospital room in 

northern France with a 65-year-old who fell ill after returning from Dubai. They shared the 

room for 3 days in late April, before the first patient's infection was confirmed on May 7. 

French investigators traced 120 contacts of the first patient and tested five for the virus, the 

WHO reported, and only the 50-year-old was infected. MedPage Today

How austerity kills

12 May - ...The correlation between unemployment and suicide has been observed since the 

19th century. People looking for work are about twice as likely to end their lives as those 

who have jobs. In the United States, the suicide rate, which had slowly risen since 2000, 

jumped during and after the 2007-9 recession...

[P]eople do not inevitably get sick or die because the economy has faltered... At one 

extreme is Greece, which is in the middle of a public health disaster. The national health 

budget has been cut by 40 percent since 2008... Some 35,000 doctors, nurses and other 

health workers have lost their jobs. Hospital admissions have soared after Greeks avoided 

getting routine and preventive treatment because of long wait times and rising drug costs. 

Infant mortality rose by 40 percent. New H.I.V. infections more than doubled... malaria cases 

were reported in significant numbers for the first time since the early 1970s. 

In contrast, Iceland avoided a public health disaster even though it experienced, in 2008, the 

largest banking crisis in history, relative to the size of its economy. [I]nstead of bailing out 

the banks and slashing budgets, as the I.M.F. demanded... Icelanders voted overwhelmingly 

to pay off foreign creditors gradually, rather than all at once through austerity. Iceland’s 

economy has largely recovered, while Greece’s teeters on collapse. No one lost health care 

coverage or access to medication, even as the price of imported drugs rose. There was no 

significant increase in suicide. New York Times

Inoculating against vaccine fears?

12 May - A new surveillance tool might help immunize communities against vaccine scares, 

researchers reported. An international pilot project has demonstrated that it's possible to 

trawl through the Internet and quickly identify places where public fear about vaccines is on 

the rise, according to Heidi Larson, PhD, of the London School of Hygiene and Tropical 

Medicine in England, and colleagues. Larson and colleagues adapted the HealthMap 

automated data collection system -- usually used to track disease outbreaks -- so that it 

could monitor online reports about vaccines... Over a year, from May 1, 2011, to April 30, 
6

2012, the system found 10,380 such reports from 144 countries. Of those, 31% were 

negative -- fears of adverse events, for instance, or distrust of the vaccine industry's motives 

-- and the rest were either positive or neutral. Of the 3,209 negative reports, 24% were 

associated with impacts on vaccine programs and disease outbreaks, 21% concerned 

beliefs, awareness, and perceptions, 16% discussed vaccine safety, and 16% were associated 

with vaccine delivery programs. MedPage Today

New rotavirus vaccine developed in India billed as 

effective, cheap

14 May - A new rotavirus vaccine that was developed in India with US support has been 

proved safe and effective in clinical trials and promises to offer a cheaper option for 

developing countries trying to protect children from the virus, according to press reports 

and US officials. The Indian government announced today that in a phase 3 trial, the 

vaccine, called Rotavac, reduced severe cases of diarrhea by 56% in the first year of life. 

CIDRAP News Scan

Scientists clone human embryos to make stem cells

15 May - Scientists say they have, for the first time, cloned human embryos capable of 

producing embryonic stem cells. The accomplishment is a long-sought step toward 

harnessing the potential power of embryonic stem cells to treat many human diseases. But 

the work also raises a host of ethical concerns... The controversy arises from several factors. 

The experiments involve creating and then destroying human embryos for research 

purposes, which some find morally repugnant. The scientists also used cloning techniques, 

which raise concerns that the research could lead to the cloning of people. NPR

The latest buzz - eating insects can help tackle food 

insecurity, says FAO

13 May - While insects can be slimy, cringe-inducing creatures, often squashed on sight by 

humans, a new book released today by the Food and Agricultural Organization (FAO) says 

beetles, wasps and caterpillars are also an unexplored nutrition source that can help address 

global food insecurity... While the idea of eating a worm, grasshopper or cicada at every 

meal may seem strange, FAO says this has many health benefits. Insects are high in protein, 

fat and mineral contents. They can be eaten whole or ground into a powder or paste, and 

incorporated into other foods. UN News Centre

UN: Billions still will lack sanitation by 2015

13 May - By 2015, almost one-third of the global 

population will remain without access to improved 

sanitation - which is U.N.-speak for hygienic toilet facilities. 

That would fall well short of a key global Millennium 

Development Goal [MDG], which is detailed in a new report

published jointly by the World Health Organization and the U.N. Children’s Fund. Bruce 
7

Gordon, the acting coordinator for water, sanitation and health at the World Health 

Organization, said Monday’s report was published as a wake-up call. “Now, with the period 

of the MDGs coming to a close - I think it is in about 1,000 days or so - we are seeing very 

clearly that unless we do something very differently, the sanitation goal is going to be 

missed.” VOA

Victorian man brought back from the dead by Australianfirst resuscitation technique

12 May - A Victorian man who was clinically dead for 40 minutes has been brought back to 

life by an Australian-first resuscitation technique. Dandenong's Colin Fiedler, 39, was one of 

three cardiac arrest patients brought back to life after being dead for between 40 and 60

minutes at The Alfred hospital, using two new techniques in the emergency department. 

The Alfred is trialling a mechanical CPR machine, which performs constant chest 

compressions, and a portable heart-lung machine - normally used in theatre - to keep 

oxygen and blood flowing to the patient's brain and vital organs... It allows doctors to 

diagnose the cause of the cardiac arrest and treat it, but keep blood and oxygen flowing to 

the vital organs and brain, which reduces the risk of permanent disability. News.com.au

WHO data shows narrowing health gap

15 May - The World Health Organization's annual statistics show progress is being made 

around the world in cutting child mortality - but it will miss its target of a two-thirds 

reduction by 2015. The number of under-fives dying fell from 12 million in 1990 to less than 

seven million in 2011, the data shows... The WHO says the health gap between countries is 

narrowing, but there are continuing inequalities in health care. Many people in low- and 

middle-income countries have insufficient access to medicines in the public sector, meaning 

they rely on the private sector, where prices can be up to 16 times higher, says the WHO... 

The World Health Statistics 2013 report compares progress made by countries with the best 

health status and the worst status over two decades, from 1990. BBC News

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 18 (April 28-May 4, 2013), influenza activity remained low in the United States. 

 Viral Surveillance: Of 3,048 specimens tested and reported by collaborating laboratories, 

125 (4.1%) were positive for influenza.

 Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia 

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

 Influenza-Associated Pediatric Deaths: One pediatric death was reported. 
8

 Influenza-Associated Hospitalizations: A cumulative rate for the season of 44.2 

laboratory-confirmed influenza-associated hospitalizations per 100,000 population was 

reported. Of reported hospitalizations, 50% were among adults 65 years and older. 

 Geographic Spread of Influenza: 5 states reported regional influenza activity; 3 states 

reported local influenza activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 18, 19 specimens were tested from 13 locations. There were three 

influenza A(H1N1)pdm09 and four influenza B viruses detected. 

 To date this influenza season, 3,680 specimens have been tested from 81 locations of 

which 1,069 were positive for influenza A (947 A(H3N2), 111 A(H1N1)pdm09, five coinfections, and six A/not subtyped). 

 To date this influenza season, 360 specimens were positive for influenza B. Of these, 

there were 14 B/Yamagata, two B/Victoria, and two B & enterovirus co-infections. The 

lineage is pending or unknown for 342 specimens. 

 There have been 246 other respiratory viruses isolated (60 adenovirus, 91 RSV, 86 

parainfluenza, and nine enterovirus) cumulatively this season. USAF School of 

Aerospace Medicine

Google.org: Flu Trends

16 May – Estimates of flu activity based on certain Internet search queries indicate that the 

level of flu activity ranges from minimal to low throughout the world with the exception of 

South Africa where activity is moderate. Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For week 19 ending 11 May 2013:

 Influenza: there were no new cases of NHRC laboratory-confirmed influenza (A/H3) 

among US military basic trainees. Influenza activity at most basic training centers 

decreased in March-April 

 Adenovirus: Sporadic adenovirus cases at basic training centers in 2013. 

 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 
9

PANDEMIC AND AVIAN INFLUENZA

H5N1 bird flu could be controlled by disinfection

09 May - The implementation of thorough, daily disinfection of the market environment as 

well as of traders’ vehicles and equipment in only a small number of hubs can disconnect 

the network dramatically, preventing the spread of influenza A(H5N1), according to a new 

study. This would allow live bird markets to re-open without risking viral spread. Poultry Site

Death toll rises to 36 in H7N9 outbreak

15 May – The first patient in China's Hunan province with confirmed H7N9 influenza has 

died, lifting the outbreak's fatality count to 36, according to official and media reports 

today. The patient is a 64-year-old woman who died yesterday morning at a hospital in 

Shaoyang, about 20 days after her illness was detected, according to a report from Xinhua, 

China's state news agency... The number of new H7N9 infections has tailed off in recent 

week, with the latest one reported May 7, which edged the number of cases to 131. 

However, the death toll continues to rise, because many of the previously confirmed 

patients are still hospitalized, battling the often serious complications of the disease, which 

can include acute respiratory distress syndrome and organ failure. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

FDA releases food defense planning software tool

13 May - The US Food and Drug Administration (FDA) yesterday released a computer 

software program to help food companies and retailers with risk assessment and planning 

for protecting their products from intentional contamination. Called the Food Defense Plan 

Builder, the program walks owners and operators through crafting a customized plan that 

reflects the FDA's guidance documents and incorporates the agency's other related 

planning resources. Food defense plans are voluntary, and the FDA recommends them as a 

way to help protect the nation's food supply against biological, chemical, and radiological 

attacks. CIDRAP News Scan

Illnesses in U.S. on the rise as a result of decline in 

foreign food inspections

9 May - More Americans get sick every year as a result of food-borne pathogens. The 

reason: inspections at foreign food factories shipping food and food ingredients to the 

United States have declined in recent years, and border inspections of food coming into the 

country could be next to be reduced. Experts say this decline in inspections is especially 

worrisome since Americans consume more imported food – or food made with imported 
10

ingredients – every year, and foreign food production and processing facilities often do not 

meet U.S. sanitation and hygiene standards. Homeland Security News Wire

Kazakhstan: OIE - new FMD outbreak results in 

quarantine measures

15 May - Quarantine measures have been imposed in the east of the country following the 

confirmation of a foot and mouth disease outbreak in the village of Akshoka. Notification 

was received from Dr Taitubayev, Chairman of the Veterinary Control and Supervision who 

confirmed a new outbreak of foot and mouth disease in the Akshokinsky region in 

Urdzarsky. The outbreak, on farms with cattle, sheep and goats, has resulted in 40 cases of 

FMD in cows which were destroyed. Pig Site

Study finds an increase in arsenic levels in chicken

11 May - Researchers at Johns Hopkins University said they found levels of arsenic in 

chicken that exceeded amounts that occur naturally, and warned that they could lead to a 

small increase in the risk of cancer for consumers over a lifetime. The levels were well below 

danger levels set in federal safety standards, though the researchers pointed out that those 

were first established in the 1940s. And the chicken samples tested were from 2010 and 

2011, before sales of the drug that researchers say was a major driver of the elevated 

arsenic levels, roxarsone, were suspended. A spokeswoman for the chicken industry said the 

levels found by researchers were low, but the researchers contend that the elevated levels 

are important because the Food and Drug Administration has not banned the drug, and it is 

still being sold abroad. New York Times

U.S. report quantifies risk of listeria in deli foods

10 May - Some simple safety techniques for food handling and preparation could help 

delicatessens and other food stores cut the risk of customers developing the potentially 

deadly foodborne illness of listeriosis, according to a U.S. government report released on 

Friday. The report by the Department of Agriculture and the Food and Drug Administration, 

recommended strict control of temperature during refrigeration, better cleaning and 

sanitizing of food contact surfaces and wearing gloves while serving customers. Reuters

top of page...

WELLNESS

Actress's move shines light on preventive mastectomy

14 May - Cancer experts said Angelina Jolie's decision to have a preventive double 

mastectomy because of a heightened genetic risk for breast cancer should encourage 

women to look into their family history for the disease. But they cautioned against the need 

for all women to routinely order a genetic test for breast cancer and noted that there are 
11

less-aggressive options to consider for those who do test positive for a genetic mutation 

tied to breast cancer. Wall Street Journal

Bed rest no help for women at risk of early delivery

14 May - Having a short cervix increases a pregnant woman's chance of delivering 

prematurely, and a new study suggests going on bed rest does nothing to allay that risk.

Researchers found that women were more than twice as likely to give birth before 37 weeks 

when doctors told them to restrict some combination of their work, non-work and sexual 

activities... Although the findings don't support bed rest for women with a short cervix, it's 

unclear why restricting activity would increase the chance of premature birth, researchers 

said. Reuters

Biological clue to why women live longer than men

15 May - Women live longer than men partly because their immune systems age more 

slowly, a study suggests. As the body's defences weaken over time, men's increased 

susceptibility to disease shortens their lifespans, say Japanese scientists. Tests of immune 

function could give an indication of true biological age, they report in Immunity & Ageing

journal. The immune system protects the body from infection and cancer, but causes 

disease when not properly regulated. BBC News

Kidney problems linked to traffic fumes

14 May - Living close to a busy road may increase your risk 

of developing kidney problems, research suggests. The US 

investigators who discovered a link in 1,100 patients believe 

traffic pollution could harm the arteries that supply the 

kidneys. Experts already know that long-term exposure to 

exhaust fumes increases the risk of vascular diseases such as heart attacks and stroke. BBC 

News

Number of abused U.S. children unchanged since 2008

The number of U.S. children who were exposed to violence, crime and abuse in 2011 was 

essentially unchanged from 2008, according to a new government survey. Researchers who 

interviewed 4,503 children and teenagers in 2011 found that two in five children reported 

being physically assaulted in the previous year, and one in every 10 kids was injured by that 

abuse. Reuters

Teen drivers: TXTing tops risky behaviors

13 May - In a national survey of high school students nearly half of the teen responders said 

they text while driving, a practice that appears to increase the likelihood of other risky 

behaviors, including drinking and driving. In a national survey of teens 16 or older almost 

half of the responders (44.5%) said they had texted while driving at least once in the 

previous month, according to Emily O'Malley Olsen, MSPH, of the Centers for Disease 
12

Control and Prevention in Atlanta, and colleagues reported in Pediatrics. Compared with 

teens who did not text while behind the wheel, texting teen drivers were more likely to drink 

and drive (prevalence ratio: 5.33, 95% CI 4.32-6.59), accept a ride from a drinking driver (PR: 

1.74, 95% CI 1.57-1.93), and fail to use seat belts (PR: 1.16, 95% CI 1.07-1.26). MedPage 

Today

Ultra-low salt intake may not boost health: U.S. panel

14 May - Americans at high risk for heart problems who have been told for years to sharply 

cut salt from their diet may not actually benefit from ultra-low sodium diets and could even 

face some harm, an independent panel of health experts said on Tuesday. The influential 

Institute of Medicine, in a report to U.S. health officials, reviewed the latest data on the link 

between salt intake and health. While blacks, diabetics and others more likely to have heart 

problems are urged to slash their salt intake, the IOM review showed there was limited 

evidence such a diet helped, and that too little salt might increase the risk of heart trouble.

Reuters

'Weight loss gut bacterium' found

14 May – Bacteria that live in the gut have been used to reverse obesity and Type-2 

diabetes in animal studies. Research, published in Proceedings of the National Academy of 

Sciences, showed that a broth containing a single species of bacteria could dramatically 

alter the health of obese mice. It is thought to change the gut lining and the way food is 

absorbed. Similar tests now need to take place in people to see if the same bacteria can be 

used to shed the pounds. BBC News

top of page...

USAFRICOM

Niger offers cash reward to help eradicate Guinea worm

14 May - Niger is offering cash rewards to anyone reporting a case of Guinea worm as part 

of efforts to permanently eradicate the parasitic disease in the impoverished West African 

nation, the health ministry said. Though it once afflicted around 3.5 million people annually 

across Asia and Africa, according to the U.S.-based Carter Center, Guinea worm disease is 

now on the verge of being eradicated worldwide. Niger had been due to join the list of 

countries free from the disease last year before an influx of some 60,000 refugees fleeing 

fighting in neighboring Mali where the parasite is present. Anyone reporting a case of 

Guinea worm, confirmed as such by health authorities, would be offered a reward of 20,000 

CFA francs ($39.58). Reuters

Slim in Sudan: Female fleshiness loses its allure

13 May - For centuries, female fleshiness has been prized in Sudan, with women 

encouraged to be plump. But many Sudanese women now aspire to being slim - and gyms 

are taking off in a big way... Obesity is a big - and growing - problem in Sudan, and health 

concerns are one motivation for women to work out. BBC News
13

Somalia: Wild poliovirus

11 May - An investigation has been launched into a preliminary report of the detection of a 

wild poliovirus type 1 (WPV1) in the Banadir region of Somalia. This is the first WPV to be 

reported from Somalia since 25 March 2007. The virus was isolated from specimens 

collected on 21 April 2013 from a 32-month-old girl, who became ill due to acute flaccid 

paralysis on 18 April 2013, and from specimens collected from 3 of her close contacts. An 

investigation team is on site; genetic sequencing of the virus is on-going to determine its 

origin. The preliminary results of these investigations will be reported as soon as possible. 

Given that substantial areas of central and southern Somalia have not conducted 

vaccination activities since 2009, the confirmation of WPV circulation would constitute a 

serious national and international risk to public health. WHO

South Africa: Over 20 boys die in circumcision rituals

16 May - More than 20 South African boys have died over the past week during coming of 

age rituals, police said on Thursday, and they blamed botched circumcisions as the likely 

cause of death. Northern Mpumalanga province's police department has opened 22 murder 

cases but no arrests have been made so far, spokesman Colonel Leonard Hlathi said. Every 

year in South Africa, boys aged 10 to 15 years from several of the country's tribal groups are 

circumcised in traditional "initiation rituals." Reuters

Uganda grapples with paediatric vaccine shortages

14 May - Ugandan children are going unimmunized as the country grapples with persistent 

and widespread vaccine shortages, the result of insufficient funds and inefficient 

procurement and supply systems, officials say... Most of the health centres across the 

country are facing critical shortages of vaccines to protect against tuberculosis, polio, 

tetanus, diphtheria, rotavirus and pneumonia, putting children at risk of largely preventable 

diseases. IRIN

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USCENTCOM

Afghanistan: Taliban pledge support for polio campaign

15 May - The Taliban in Afghanistan say they will now support programs aimed at 

eradicating polio in the country. In a statement released earlier this week in Afghanistan, the 

Taliban said they asked members “not to create any kind of trouble” for health workers, but 

would not tolerate foreigners participating in the eradication program. CBC News
14

Jordan: Recording about 151 TB infection among Syrian 

refugees in the camp of Zaatari

15 May – The director of the national program to combat 

tuberculosis in Jordan, Khaled Abu Rumman, a higher incidence of 

tuberculosis in Syria, where the 40 injured per 100 thousand people, 

which is high when compared to the rate of infection in Jordan, 

amounting to about 5 cases per 100 thousand people. Revealing 

that the number of Syrian refugees suffering from tuberculosis in 

the Zaatari camp, amounted to about 151 injured until the first Monday. Economic Forum

Saudi Arabia: Novel coronavirus infection – WHO 

update

15 May - The Ministry of Health in Saudi Arabia has informed WHO of an additional two 

laboratory-confirmed cases with infection of the novel coronavirus (nCoV). The two patients 

are health care workers who were exposed to patients with confirmed nCoV. The first 

patient is a 45-year-old man who became ill on 2 May 2013 and is currently in a critical 

condition. The second patient is a 43-year-old woman with a coexisting health condition, 

who became ill on 8 May 2013 and is in a stable condition. Although health care associated 

transmission has been observed before with nCoV (in Jordan in April 2012), this is the first 

time health care workers have been diagnosed with nCoV infection after exposure to 

patients. Health care facilities that provide care for patients with suspected nCoV infection 

should take appropriate measures to decrease the risk of transmission of the virus to other 

patients and health care workers. Health care facilities are reminded of the importance of 

systematic implementation of infection prevention and control (IPC). Since the beginning of 

May 2013 to date, a total of 21 patients, including nine deaths, have been reported from the 

outbreak primarily linked to a health care facility in the Eastern part of Saudi Arabia. The 

government is conducting ongoing investigation into the outbreak. WHO

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USEUCOM

Hospital probes East German ‘human guinea pig’ drug 

tests

14 May - A top Berlin hospital plans to investigate the 

conduct of drug trials in the former East Germany amid 

allegations that some patients were used as human guinea 

pigs. Communist officials allowed Western firms to test 

new drugs on about 50,000 people, often without their 

knowledge, the news magazine Der Spiegel says. Now the Charite hospital says it will stop 
15

shredding old patient records and investigate what happened. The tests took place in the 

1980s. BBC

Northern Greece: Re-emergence of animal rabies and 

subsequent human exposure, October 2012 – March 

2013

2 May - Greece has been rabies-free since 1987 with no human cases since 1970. During 

2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By 

end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd 

dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis 

according to the World Health Organization criteria. Human exposures occurred within 50 

km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray 

dogs were involved. Eurosurveillance

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USNORTHCOM

U.S.: At least 6 confirmed dead in Texas tornado 

outbreak

16 May – A rash of tornados whirled through small communities in North Texas overnight, 

leaving at least six people dead, dozens more injured and hundreds homeless. The violent 

spring storm threw trailers onto cars, blew windows from houses and scattered bodies far 

from their homes. Duluth News Tribune

U.S.: Chemical depots fall under a patchwork of rules

9 May - ...Buckley Powder had as much as 90,000 pounds of ammonium nitrate in bins at 

this Central Texas plant — stored, according to Howard Wichter, Buckley’s chief financial 

officer, under conditions in which “nothing can happen to it”... The facility is one of more 

than 110 across the state that report storing 10,000 pounds of ammonium nitrate or more 

at a time. Some companies hold it in powder form, like the depot in West, which in 2012 

reported storing 540,000 pounds of the chemical. Others store it in a liquid solution, which 

is a much less volatile form, said Charles C. Mitchell, a professor of soil sciences at Auburn 

University. The responsibility for overseeing these facilities varies. Some, like Buckley, which 

supplies materials used for blasting at rock quarries and construction sites, are inspected by 

the federal Bureau of Alcohol, Tobacco, Firearms and Explosives. Others, like Adair Grain, 

which owned the West storage site, are subject to inconsistent scrutiny by a long list of 

state and federal agencies. New York Times
16

U.S.: FDA approves labels with lower doses for sleep 

drugs like Ambien

14 May - The Food and Drug Administration approved label changes incorporating lower 

dosages for sleep medications containing zolpidem, a drug that can continue to affect 

patients' mental alertness even a day after its use... The agency said patients who take 

zolpidem extended-release drugs, such as Ambien CR, should not drive or take part in 

activities that require complete mental alertness the next day. The FDA in January asked 

zolpidem manufacturers... to reduce recommended dosages on the drugs' labels. The 

regulator also said that women were more susceptible to the risk as they eliminated the 

drug from the blood more slowly than men. Fox News

U.S.: Final 2012 West Nile virus update:

15 May - Last year ranked as the second worst outbreak of neuroinvasive, non–

neuroinvasive, and total West Nile virus (WNV) disease cases reported since WNV was first 

detected in the United States in 1999. The largest number of WNV cases was reported 

during 2003. In 2012, all 48 contiguous states, the District of Columbia, and Puerto Rico 

reported WNV infections in people, birds, or mosquitoes. A total of 5,674 cases of WNV 

disease in people, including 286 deaths, were reported to CDC. Of these, 2,873 (51%) were 

classified as neuroinvasive disease (such as meningitis or encephalitis) and 2,801 (49%) were

classified as non-neuroinvasive disease. CDC

U.S.: Judge denies FDA bid to stay 'morning-after' pill 

ruling

10 May - A federal judge in New York on Friday declined to temporarily halt a court order 

directing the U.S. Food and Drug Administration to make emergency contraception 

available over the counter to girls of all ages. Reuters

U.S.: Ovarian cancer fall sped up as hormone use 

dropped

15 May - Ovarian cancer rates in the U.S. began to decline faster in 2002 around the time 

many older women went off hormone replacement therapy, according to a new study. That 

year, the Women's Health Initiative (WHI) found that estrogen or estrogen plus progestin 

hormone therapy, prescribed for the symptoms of menopause, was linked to an increased 

risk of breast cancer, stroke and heart attack. Reuters

U.S.: Tick-borne disease threat is growing

15 May - ... According to veterinary parasitologist Dr. Michael Dryden, the tick population in 

America has exploded in recent years... Is there truly more tick-related disease today than, 

say, a decade ago, or have veterinarians simply become better at discovery and diagnosis? 

"Now, there's a good question," says Dryden. "There's no doubt that the new testing for tick 

disease is helpful. But ticks are flourishing." So, why are there so many? "Look at this year's 
17

weather," says Dryden. "Throughout most of the nation, it was wet. Much of the country 

experienced record rain. Now, it's warming up, and all after a relatively mild winter. We'll see 

ticks from about now to well into the fall and even into early winter." Weather isn't the only 

factor. Wildlife numbers are rising. Animals like deer and fox carry ticks from more wooded 

places right into our backyards. Chicago Tribune

U.S.: Spinal and paraspinal infections associated with 

contaminated methylprednisolone acetate injections —

Michigan, 2012–2013 

17 May - As of May 6, 2013, Michigan had reported 167 (52%) of the 320 paraspinal or 

spinal infections without meningitis associated with the 2012–2013 fungal meningitis 

outbreak nationally... Early experience with patients who received diagnoses of localized 

spinal or paraspinal infections despite minimal or no new symptoms and no prior diagnosis 

of meningitis prompted clinicians at St. Joseph Mercy Hospital to use an expanded 

diagnostic approach, offering spinal MRIs to patients who had received injections but had 

no symptoms of infection. Repeat MRIs were offered every 2–3 weeks to all persons who 

had received injections whether or not they had previously undergone care. Thus, increased 

case finding might partly explain the increased spinal or paraspinal infections in Michigan. 

Another possible explanation for the higher number of spinal or paraspinal infections could 

be that the vials of MPA shipped to Michigan had higher levels of contamination with 

fungus, predisposing patients to localized infection or tissue reaction. Morbidity and 

Mortality Weekly Report

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USPACOM

Bangladesh: Non-communicable diseases account for 

half of all adult female mortality 

14 May - While global attention has for decades been focused on reducing maternal 

mortality, population-based data on other causes of death among women of reproductive 

age has been virtually non-existent. A study conducted by researchers at the Johns Hopkins 

Bloomberg School of Public Health found that non-communicable diseases accounted for 

48 percent of 1,107 investigated female deaths in rural Bangladesh between 2002 and 2007. 

The findings lend urgency to review global health priorities to address neglected and 

potentially fatal non-communicable diseases affecting rural women in South Asia. Johns 

Hopkins Bloomberg School of Public Health News
18

China’s prostitutes routinely extorted, abused by police, 

report says

13 May - Police raids on brothels in China have a pattern, sex 

workers say, often occurring a few days ahead of politically 

sensitive events or whenever someone in government orders an 

anti-pornography campaign to please the leadership. It’s during 

these times, the workers say, that their already miserable jobs 

grow more perilous with some police officers demanding steep bribes or sex, beating them, 

or locking them up for as long as two years without trial. This is the life of prostitutes in 

modern China — a result of the Communist Party’s long discomfort with sex, widespread 

corruption among authorities and rigid policies that put an already fragile population at 

even greater risk, according to a report slated to be released Tuesday by Human Rights 

Watch... The report contends that the government’s practices have worsened the danger 

and health risks prostitutes face, and that it has done little to reduce the growing sex trade 

— allegations echoed by experts and sex workers in recent interviews. Washington Post

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USSOUTHCOM

Chile: PDI investigates alleged medical negligence death 

of hantavirus infected woman

15 May - A 38 year old woman, identified as Maria Reyes Pinto, died of hantavirus in Linares 

Hospital, becoming the second case which ended fatally in the Maule region, as confirmed 

by the ISP. On this, the Homicide Linares PDI investigates a complaint of alleged medical 

negligence related to his death, which occurred by acute respiratory failure after 

consultation in the emergency room four times and where she was diagnosed different 

pathologies. Cooperativa.cl

Cuba: Cholera and dengue totaling 800 cases on the 

island 

14 May - At least twenty people suffering from cholera in Cuba. Cases were reported from 

all provinces, except the Isle of Youth and Sancti Spiritus, said a doctor from the island, on 

condition of anonymity... At weekly meetings, [Public Health Minister] Morales Ojeda insists 

on calling these cases "digestive transmitted diseases", even though the doctors know that 

this is merely a euphemism for the spread of cholera and dengue, said the doctor, who also 

warned the occurrence of hepatitis. Independent journalist Ivan Garcia reported contact 

Marti News of the existence of more than 300 cases of hepatitis throughout the island, 

especially type B, according to reports from its sources in Public Health. Marti Noticias

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