30 November 2012

Army Public Health Weekly Update

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

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

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Contents

U.S. MILITARY

 Battle ready?

 Big disappointment in brain injury treatment study

 Reported vectorborne and zoonotic diseases, U.S. Army and U.S. Navy, 2000-2011

 Study provides more clues to Gulf War illness - and hope

 Tomodachi registry aids Japan's DOD population

GLOBAL

 J&J says it won't enforce AIDS drug patent in Africa

 Latest coronavirus cases prompt WHO call for vigilance

 Measles vaccine using a microneedle patch could boost immunization programs

 Novel coronavirus infection, WHO update

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 FDA approves first seasonal influenza vaccine manufactured using cell culture technology

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

VETERINARY/FOOD SAFETY

 Consumer Reports finds most pork contaminated with Yersinia

 India: Monkey fever outbreak suspected at Bandipur reserve

 Military's dogs of war also suffer post-traumatic stress disorder

WELLNESS

 'Bounce house' injuries skyrocketing

 Drugged driving bigger problem than drunk driving
New Redeployment 

Health Card

A new Redeployment 

Health Card is now 

available in print from the

USAPHC Health 

Information Products 

eCatalog. The pamphlet 

covers medical and 

environmental concerns as 

well as deployment-related 

stress.

 F.D.A. may tap experts on energy drinks

 Long-distance runners lap up miles for the love of it

 Mammograms are not effective in lowering breast cancer death rates

 Prescribe morning-after pills in advance, say pediatricians

 Study: ADHD medicines help curb criminal behavior

 Traffic pollution tied to autism risk: study

 Updating the message to get Americans moving

USAFRICOM

 Sudan: Yellow fever

 Uganda: Ebola

 Uganda: Marburg hemorrhagic fever, WHO update

USCENTCOM

 Afghan activist wins Mother Teresa Award

 Pakistan: Toxic cough syrup kills 16: officials

 Relentless Afghan conflict leaves traumatized generation

 Syria begins vaccination campaign against polio and measles

USEUCOM

 Portugal: Large dengue fever outbreak in Madeira spreads cases in Europe

 United Kingdom: CPS to crack down on female genital mutilation

USNORTHCOM

 U.S.: Deadly 'superbugs' invade U.S. health care facilities

 U.S.: F.D.A. may tap experts on energy drinks

 U.S.: HIV infection, testing, and risk behaviors among youths — United States

 U.S.: Lawmakers pledge action after meningitis outbreak

 U.S.: Less support for hepatitis C testing for baby boomers

 U.S.: Storm victims, in cleanup, face rise in injuries and illness

USPACOM

 Bangladesh: Fire kills 112 workers at garment-maker

 China: Alarm bells ring on diabetes

 China says HIV/AIDS cases up, premier-in-waiting promises help

USSOUTHCOM

 Dengue keeps advancing in Latam despite efforts to contain the disease

 Dominican Republic: CDC offers health advice for travelers

U.S. MILITARY

Battle ready?

17 November - About 17% of American troops returning from Iraq and 11% of those 

coming back from Afghanistan suffer from [post-traumatic stress disorder]. The most 

common treatment is known as exposure-based therapy. This asks those afflicted to 
Sexual Assault 

Posters

Two new sexual assault 

posters are now available 

in print from the USAPHC 

Health Information 

Products eCatalog. The 

posters give contact 

information for the DoD 

Safe Helpline.

World AIDS Day

The 2012 theme for World 

AIDS Day is "Working 

Together for an AIDS-Free 

Generation."

The National HIV/AIDS 

Strategy, aims to reduce 

new infections, increase 

access to care, reduce 

health disparities, and 

achieve a more 

coordinated national 

response to HIV/AIDS here 

in the United States.

imagine the sights and sounds that traumatised them, and helps them confront those 

memories. It often works. But not always. And it would undoubtedly be better if troops did 

not develop the condition in the first place. With this in mind, a team of engineers, 

computer scientists and psychologists led by Skip Rizzo at the University of Southern 

California propose a form of psychological vaccination. By presenting soldiers with the 

horrors of war before they set off to fight, Dr Rizzo hopes to inure squaddies to anything 

they might witness on the field of battle. Economist

Big disappointment in brain injury treatment study

20 November - The hunt for brain injury treatments has suffered a big disappointment in a 

major study that found zero benefits from a supplement that the U.S. military had hoped 

would help wounded troops. The supplement is marketed as a memory booster online and 

in over-the-counter powders and drinks. It is also widely used by doctors in dozens of 

countries to treat traumatic brain injuries and strokes, although evidence on whether it 

works has been mixed. U.S. scientists had high hopes that in large doses it would help 

speed recovery in patients with brain injuries from car crashes, falls, sports accidents and 

other causes. But in the most rigorous test yet, citicoline (see-tee-KOH'-leen) worked no 

better than dummy treatments at reducing forgetfulness, attention problems, difficulty 

concentrating and other symptoms. Boston.com

Reported vectorborne and zoonotic diseases, U.S. Army 

and U.S. Navy, 2000-2011

October 2012 - During the 12-year surveillance period, 4,534 cases of vectorborne and 

zoonotic disease were reported among beneficiaries receiving care at Army and Navy 

medical treatment facilities. A majority of cases occurred in males (80.9%), military members 

(70.5%), and the Army (53.1%). Over one-half (54.9%) of cases occurred in individuals aged 

18-34; nearly one-quarter (23.1%) occurred in individuals aged <1 to 17. Lyme disease 

accounted for 39 percent (n=1,762 cases) of all reported vectorborne or zoonotic diseases 

during the period. Malaria and leishmaniasis each accounted for nearly a quarter of all cases 

(malaria: 25%; n=1,119; leishmaniasis: 23%, n=1,061). Unlike Lyme disease, cases of malaria 

and leishmaniasis were far more likely to be reported in military members than other 

beneficiaries (86.1% and 97.3%, respectively). Medical Surveillance Monthly Report

Study provides more clues to Gulf War illness - and hope

26 November - Gulf War illness, the series of symptoms ranging 

from headaches to memory loss to chronic fatigue that plagues 

one of four veterans of the 1991 Persian Gulf war, is due to 

damage to the autonomic nervous system, a study released 

Monday shows. "This is the linchpin," said the study's lead author, 

Robert Haley, chief of epidemiology at the University of Texas Southwestern Medical Center 

in Dallas. "The disease itself is so difficult to express and to understand," Haley said, 

explaining that veterans described simply that they "don't feel well" or "can't function," 

without being able to further explain a disease that affects the automatic functions of their 

bodies, such as heat regulation, sleep or even their heartbeats... Veterans of suffering from 
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Gulf War illness tend to fall in three categories: Syndrome 1, or cognitive and depression 

problems, Syndrome 2, or confusion ataxia, which is similar to early Alzheimer's disease, 

Syndrome 3, or severe chronic body pain. USA Today

Tomodachi registry aids Japan's DOD population

29 November - The U.S. Army Public Health Command played a significant public health 

role in the aftermath of the March 11, 2011, Japanese earthquake and tsunami. USAPHC 

responders monitored radiation levels from the damaged Fukushima Daiichi nuclear power 

plant, checked the safety of water and food, and assessed search-and-rescue dogs coming 

into the country to assist in finding the missing. A year-and-a-half later, it looks as though 

USAPHC will have a decades-long role to play through the creation and maintenance of the 

Operation Tomodachi Registry. The registry's purpose is to provide general information 

about the incident; location-based, estimated radiation doses for the DOD-affiliated 

population; and a way for registry users to contact the registry staff. Army.mil

top of page...

GLOBAL

J&J says it won't enforce AIDS drug patent in Africa

29 November - Generic manufacturers are to be given a free rein to make cheap copies of 

Johnson & Johnson's HIV/AIDS drug Prezista for sale in Africa and other poor countries. U.S. 

healthcare group J&J said on Thursday it would not enforce patents, provided generic firms 

made high-quality versions of the drug - known generically as darunavir - for sub-Saharan 

Africa and Least Developed Countries. Prezista is a relatively new drug used when patients 

develop resistance to older antiretrovirals. The need for it was expected to grow rapidly as 

more patients in Africa stop responding to existing therapies. Pharmaceuticals head Paul 

Stoffels said he expected Indian drugmakers, in particular, to take advantage of the patent 

move, adding that competition among different companies should drive prices down 

further. Reuters

Latest coronavirus cases prompt WHO call for vigilance

26 November – The reporting of four more novel coronavirus infections in recent weeks, 

raising the total to six, has prompted the World Health Organization (WHO) to suggest that 

governments consider a major escalation of testing for the virus, a potentially burdensome 

undertaking... The global case count since the virus emerged in June has reached six, of 

which two were fatal. The latest cases noted by the WHO apparently include two that were 

reported earlier by Saudi health officials and the news media. Until more is known, the WHO 

statement said, "It is prudent to consider that the virus is likely more widely distributed than 

just the two countries which have identified cases. Member States should consider testing 

of patients with unexplained pneumonias for the new coronavirus even in the absence of 

travel or other associations with the two affected countries." CIDRAP
Measles vaccine using a microneedle patch could boost 

immunization programs

27 November - Measles vaccine given with painless and easy-to-administer microneedle 

patches can immunize against measles at least as well as vaccine given with conventional 

hypodermic needles, according to research done by the Georgia Institute of Technology 

and the Centers for Disease Control and Prevention (CDC). In the study, the researchers 

developed a technique to dry and stabilize the measles vaccine – which depends on a live 

attenuated virus – and showed that it remained effective for at least 30 days after being 

placed onto the microneedles. They also demonstrated that the dried vaccine was quickly 

released in the skin and able to prompt a potent immune response in an animal model. 

RedOrbit

Novel coronavirus infection, WHO update

23 November - WHO has been notified of four additional cases, including one death, due to 

infection with the novel coronavirus. The additional cases have been identified as part of the 

enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case). This 

brings the total of laboratory confirmed cases to 6. Investigations are ongoing in areas of 

epidemiology, clinical management, and virology, to look into the likely source of infection, 

the route of exposure, and the possibility of human-to-human transmission of the virus. 

Close contacts of the recently confirmed cases are being identified and followed-up. WHO

top of page...

INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

21 November 2012 -

 Overall, Influenza-Like Illness (ILI) incidence rates continued to decrease in the MHS for 

most regions. 

 Influenza activity is at moderate levels across the overseas DoD laboratory surveillance 

network except in Europe where the activity is low; influenza A/H3 is the predominate 

circulating subtype this week. 

 The influenza vaccination coverage for the DoD (Active Duty component only) is 88%. 

AFHSC DoD Influenza Surveillance Summary
CDC: Weekly Influenza Surveillance Report

During week 46 (November 11-17, 2012), influenza activity increased in the U.S.

 Viral Surveillance: Of 3,742 specimens tested and reported by U.S. World Health 

Organization (WHO) and National Respiratory and Enteric Virus Surveillance System 

(NREVSS) collaborating laboratories during week 46, 494 (13.2%) 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 influenza-associated pediatric death was 

reported and was associated with an influenza A (H3) virus. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During week 46 (11 - 17 November 2012), 24 specimens were collected and tested from 

17 locations. There were three influenza A/H3 viruses detected at three Air Force bases 

(MacDill AFB FL, Tinker AFB OK, and Luke AFB AZ), and one influenza B (Ellsworth AFB 

SD). 

 To date, 333 specimens have been submitted from 46 locations of which 22 were 

positive for influenza A (one co-infection A/H3 & B, 17 A/H3 and four A(H1N1pdm09) 

and four were positive for Influenza B. There have been 20 parainfluenza, five RSV, two 

enterovirus, and 10 adenovirus isolated. 

 Since 30 September 2012, ILI activity across the DoD has been low compared to the 

2011-2012 influenza season. USAF School of Aerospace Medicine (restricted access)

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During week 46 (12-18 November 2012), all 27 countries reporting experienced low 

intensity of clinical activity with influenza-like illness. 

 Of 416 sentinel specimens tested across 21 countries, 13 (3%) were positive for 

influenza virus. 

 No hospitalised laboratory-confirmed influenza cases were reported. 

Although the proportion of positive sentinel specimens has increased slightly since week 42, 

there is currently little evidence of sustained influenza virus transmission in EU/EEA 

countries. Much of the clinical activity with influenza-like illness will be due to other 

respiratory pathogens. Weekly Influenza Surveillance Overview
FDA approves first seasonal influenza vaccine 

manufactured using cell culture technology

20 November - The U.S. Food and Drug Administration announced today the approval of 

Flucelvax, the first seasonal influenza vaccine licensed in the United States produced using 

cultured animal cells, instead of fertilized chicken eggs. Flucelvax is approved to prevent 

seasonal influenza in people ages 18 years and older. The manufacturing process for 

Flucelvax is similar to the egg-based production method, but a significant difference is that 

the virus strains included in the vaccine are grown in animal cells of mammalian origin 

instead of in eggs. Cell culture technology has already been in use for several decades to 

produce other U.S. licensed vaccines... Advantages of cell culture technology include the 

ability to maintain an adequate supply of readily available, previously tested and 

characterized cells for use in vaccine production and the potential for a faster start-up of the 

vaccine manufacturing process in the event of a pandemic. FDA

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 24 November 2012:

Adenovirus: Type 14 adenovirus cases seen at MCRD Parris Island in November.

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 

USAPHC: U.S. Army Influenza Activity Report

For the week ending 10 November (Week 45), influenza activity has remained relatively 

stable during the past three weeks; overall influenza and influenzalike illness (ILI) activity 

remains low in US Army and civilian populations.

 ILI Activity: Army outpatient visits for incident ILI are 19% lower than the same time last 

year.

 Influenza cases: Eight hospitalized influenza cases have been reported in DRSi this 

influenza season.

 Acute Respiratory Disease at BCT sites: ARDS rates remain lower at all Army BCT sites 

compared to the same period last year.

 Viral specimens: During week 45, 102 of 489 (21%) clinical specimens tested were 

positive for respiratory pathogens. Influenza A was identified in 51 (50%) of these 

positive samples. Most of the Army influenza positive specimens were reported by 

SRMC (42%), primarily Ft. Gordon (53%) and Ft. Campbell (23%). USAPHC U.S. Army 

Influenza Activity Report

top of page...
VETERINARY/FOOD SAFETY

Consumer Reports finds most pork contaminated with 

Yersinia

27 November - In a new study of raw pork chops and ground pork, Consumer Reports 

found 69 percent of samples were contaminated with Yersinia enterocolitica, according to a 

report published by the group today. A lesser-known foodborne pathogen, Yersinia 

enterocolitica can cause fever, abdominal pain and diarrhea, lasting one to three weeks, 

according to the Centers for Disease Control and Prevention. There is approximately one 

confirmed infection per 100,000 people reported each year, but since these cases are 

severely under-reported, CDC estimates there are actually around 100,000 infections in the 

United States annually. Consumer Reports tested 198 samples and found that while the vast 

majority were positive for Yersinia, only 3 to 7 percent were positive for the more common 

foodborne pathogens Salmonella, Staphylococcus aureus or Listeria monocytogenes. Food 

Safety News

India: Monkey fever outbreak suspected at Bandipur 

reserve

28 November - Veterinary experts are suspecting an outbreak of the Kysasanur Forest 

Disease (KFD), popularly known as monkey fever, in Maddur range of the Bandipur Tiger 

Reserve bordering Mysore district. It is also reported to have affected humans. The tiger 

reserve authorities have reported deaths of eight bonnet macaques and two common 

langurs; and it has been transmitted to five workers of the forest department’s antipoaching camp. The workers are undergoing treatment at Gundlupet government hospital 

and the condition of one of them is serious. Daily News & Analysis

Military's dogs of war also suffer post-traumatic stress 

disorder

26 November – ..."Dogs experience combat just like humans," said 

Marine Staff Sgt. Thomas Gehring, a dog handler assigned to the 

canine training facility at Lackland Air Force Base, who works with 

Cora daily. Veterinarians and senior dog handlers at Lackland have 

concluded that dogs, like humans, can require treatment for PTSD, 

including conditioning, retraining and possibly medication such as the anti-anxiety drug 

Xanax. Some dogs, like 5-year-old Cora, just need to be treated as honored combat 

veterans and allowed to lead less-stressful lives. Walter Burghardt Jr., chief of behavioral 

medicine and military working-dog studies at Lackland, estimates that at least 10% of the 

hundreds of dogs sent to Iraq and Afghanistan to protect U.S. troops have developed 

canine PTSD. Los Angeles Times

top of page...
WELLNESS

'Bounce house' injuries skyrocketing

26 November - If you're not a parent, you may not be 

aware of the popularity of inflatable bounce houses, but 

they are popping up more and more -- at church picnics, 

county and mall fairs, birthday and "bounce house" 

parties, and indoor playgrounds... According to [National 

Electronic Injury Surveillance System] data, the number of 

inflatable bouncer-related injuries rose 1,500% between 1995 and 2010. In the last two 

years of the study, from 2008 to 2010, the rate of injuries more than doubled, according to 

the study published Monday in the journal Pediatrics... Arm and leg injuries were the most 

common injuries. The youngest children, those under 5, were more likely to have fractures, 

and teenagers were more likely to sustain sprains and strains. CNN

Drugged driving bigger problem than drunk driving

20 November - A statewide survey shows there are more drugged drivers than drunken 

drivers on California roads during the weekend. The California Office of Traffic Safety said 

Monday that 14 percent of drivers surveyed tested positive for driving under the influence 

of illegal or prescription drugs. A little more than 7 percent of drivers were driving with 

alcohol in their system. The Los Angeles Times says the federally funded impaired driving 

survey involved more than 1,300 drivers who voluntarily provided breath and-or saliva 

samples at roadside locations in nine California cities on Friday and Saturday nights.

Samples were tested for alcohol, marijuana and illegal drugs as well as prescription and 

over-the-counter medications. Marijuana was most prevalent with 7.4 percent of drivers 

having it in their system. SF Gate

F.D.A. may tap experts on energy drinks

27 November - The Food and Drug Administration said in a letter released on Tuesday that 

it was likely to seek advice from outside experts to help determine whether energy drinks 

posed particular risks to teenagers or people with underlying health problems. The letter 

appears to signal a change in the agency’s approach to the drinks, which contain high levels 

of caffeine. Previously, F.D.A. officials have said that they were investigating possible risks 

posed by popular products like 5-Hour Energy, Monster Energy and Red Bull. But an agency 

spokeswoman, Shelly Burgess, said the new letter was the first time that the F.D.A. had said 

it might turn to outside experts. The F.D.A. letter, which was released Tuesday by Senator 

Richard J. Durbin of Illinois and Senator Richard Blumenthal of Connecticut, follows 

disclosures that the agency received reports of 18 deaths and over 150 injuries that 

mentioned the possible involvement of energy drinks. New York Times
Long-distance runners lap up miles for the love of it

26 November - Although many people begin running as a practical path to weight loss or 

fitness, for many it becomes a love affair as the miles increase. Tom Holland, running coach 

and author of "The Marathon Method," tells his clients that running for 3 miles was horrible 

for him too, but farther down the road things changed. "It happens for different people at 

different times and different distances: that runner's high," he said in an interview. Holland 

calls it a cardiovascular turning point where the run becomes exponentially easier. "There's a 

point where the run becomes enjoyable," he said. "Whether this happens at 8 or 10 or 12 

miles down the road, it will happen," he said. Reuters

Mammograms are not effective in lowering breast cancer 

death rates

24 November - During the last 30 years, millions of women have been diagnosed with 

breast cancer. Although screenings with mammograms are often used, the prevalence of 

metastatic breast cancer has not changed and there has been no reduction in the rate of 

cancer being diagnosed in late stages, according to a recent study published in the New 

England Journal of Medicine... [C]lose to one third of all women who are newly diagnosed 

with breast cancer are over-diagnosed and that screening is not having a great impact on 

the death rates seen in breast cancer cases. Although fewer women are dying from the 

disease, the experts say this is not from screenings; it is due to the development of better 

medications and treatment therapies... The researchers said: "And although no one can say 

with certainty which women are overdiagnosed, there is certainty about what happens to 

them: they undergo surgery, radiation therapy, hormonal therapy for five years or more, 

chemotherapy, or (usually) a combination of these treatments for abnormalities that otherwise 

would not have caused illness." Medical News Today

Prescribe morning-after pills in advance, say 

pediatricians

26 November - Wading into the incendiary subject of birth control for young teenagers, the 

American Academy of Pediatrics (AAP) on Monday called on the nation's pediatricians to 

counsel all of their adolescent patients about emergency contraception and make advance 

prescriptions for it available to girls under 17. Because current federal policy bans over-thecounter sales of the pills to girls under 17, having a prescription on hand could help 

younger teens obtain emergency contraception more quickly than if they have to contact a 

physician only after they need it. Reuters

Study: ADHD medicines help curb criminal behavior

21 November - Older teens and adults with attention deficit disorder are much less likely to 

commit a crime while on ADHD medication, a provocative study from Sweden found. It also 

showed in dramatic fashion how much more prone people with ADHD are to break the law 

— four to seven times more likely than others. The findings suggest that Ritalin, Adderall 

and other drugs that curb hyperactivity and boost attention remain important beyond the 
school-age years and that wider use of these medications in older patients might help curb 

crime. USA Today

Traffic pollution tied to autism risk: study

26 November - Babies who are exposed to lots of traffic-related air pollution in the womb 

and during their first year of life are more likely to become autistic, suggests a new study. 

The findings support previous research linking how close children live to freeways with their 

risk of autism, according to the study's lead author. "We're not saying traffic pollution 

causes autism, but it may be a risk factor for it," said Heather Volk, an assistant professor at 

the Keck School of Medicine of the University of Southern California in Los Angeles. Reuters

Updating the message to get Americans moving

19 November - ...The public health message about exercise is 

that any amount is good and that walking is just fine. Everyone 

has been told, repeatedly, that regular exercise improves health 

and makes people feel better, happier, more energetic. Nearly 

all Americans say they have heard those messages. They know 

that exercise is good for them and that they should do it. Yet they do not... Now, with more 

recent studies using accelerometers that measure actual movement rather than relying on 

self-reports, the data are even more dismal. Only 3.5 percent of Americans between the 

ages of 18 and 59 do the minimum amount of physical activity recommended by the 

Department of Health and Human Services: 150 minutes a week of moderate activity. 

Among those over age 60, the percentage is even lower: 2.5 percent. New York Times

top of page...

USAFRICOM

Sudan: Yellow fever

22 November - The Federal Ministry of Health (FMOH) in Sudan began a 10-day mass 

vaccination campaign against yellow fever in Darfur on 20 November 2012, in response to 

the outbreak. As of 17 November 2012, the outbreak is reported to have affected 26 

localities, with a total of 459 suspected cases including 116 deaths. Two cases were 

confirmed by IgM ELISA test and RT-PCR by the WHO regional reference laboratory for 

yellow fever, the Institut Pasteur in Dakar, Senegal. An outbreak investigation team led by 

the Ministry of Health, with support from WHO are in the field to assess the extent of the 

outbreak and prioritize areas for the mass vaccination campaign. WHO

Uganda: Ebola

23 November - As of 23 November 2012, the Ministry of Health (MoH) of Uganda has 

reported 10 cases (6 confirmed and 4 probable,), including 5 deaths in Luweero and 

Kampala. The last confirmed case was hospitalised on 17 November 2012. Close contacts of 
the Ebola cases are being identified and followed up for a period of 21 days. All the cases 

alerted to the field teams are being investigated. WHO

Uganda: Marburg hemorrhagic fever, WHO update

23 November - As of 23 November 2012, a total of 20 (probable or confirmed) cases, 

including 9 deaths have been reported from4 districts in Uganda (Kabale, Ibanda, Mbarara, 

and Kampala). The last confirmed case was hospitalised on 31 October 2012. The Ministry of 

Health continues to conduct active surveillance and investigation on all cases alerted in the 

4 districts. Close contacts of the Marburg cases are being followed-up for a period of 21 

days. WHO

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USCENTCOM

Afghan activist wins Mother Teresa Award

29 November - “Women can wear the burka if they wish to do so but it shouldn’t be forced 

on them. It affects their health as it covers the entire body and doesn’t allow sunrays to go 

into the body. This leads to deficiency of vitamin D and results in poor bone health, ” said Dr 

Sima Samar, chief of Afghanistan Independent Human Rights Commission, who was in the 

city on Wednesday to receive the Mother Teresa Award instituted by the Harmony 

Foundation. Samar has continuously fought for human rights of girls and women in Taliban 

ruled Afghanistan. A medical doctor by training, Samar fled to Pakistan in 1984 when her 

husband was arrested by Afghanistan’s communist regime. Daily News & Analysis

Pakistan: Toxic cough syrup kills 16: officials

26 November - At least 16 people have died after drinking a toxic cough syrup in the 

Pakistani city of Lahore, forcing authorities to close three pharmacies and a medicine 

factory, officials said Monday. The deaths occurred in the low-income Shahdra Town 

neighbourhood between Friday and Sunday with the victims mostly drug addicts who took 

the syrup to get high, said local police station chief Atif Zulfiqar. The scandal comes after 

around 100 heart patients died in January in Lahore, Pakistan's second largest city, after 

taking faulty medicine made locally. Hurriyet Daily News

Relentless Afghan conflict leaves traumatized generation

16 November - ... The concept of mental illness is alien to many in Afghanistan, where the 

public health system, like much of the country's infrastructure, has been wrecked by 

decades of war. Frequently, people suffering psychological disorders are thought by their 

families to be under the influence of malign spirits, or showing symptoms of a physical 

ailment. The Kabul hospital, which has 60 beds for in-patients and another 40 in a separate 

facility for drug addicts, is run by the government in partnership with U.S.-based nonprofit 
group the International Medical Corps... Psychologists working there say children who have 

known nothing but fighting since the U.S.-led overthrow of the Taliban government more 

than a decade ago are especially vulnerable. Reuters

Syria begins vaccination campaign against polio and 

measles

26 November - Syria launched a national campaign today to vaccinate against polio and 

measles, something which should benefit some 2.5 million children. All the necessary 

conditions are being created in the 1,816 hospitals and mobile clinics throughout the 

country, said a source from the Ministry of Health. Doctor Ahmad al-Abboud, Director of 

the Health Ministry, asked families to come with their children to the health center or the 

nearest mobile clinic, bringing their vaccination cards. The campaign, which will run for two 

weeks, is part of the ministry ́s efforts to promote the health of children and protect them 

from diseases, especially from those which spread fastest and are life-threatening, he 

added. Prensa Latina

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USEUCOM

Portugal: Large dengue fever outbreak in Madeira 

spreads cases in Europe

21 November - Europe is experiencing its first sustained transmission of dengue fever since 

the 1920s with more than 1,300 people infected with the mosquito-borne disease in the 

Portuguese archipelago of Madeira. In a rapid risk assessment, the European Centre for 

Disease Prevention and Control (ECDC) said that 25 cases of the disease - which is also 

called "breakbone fever" because of the severe pain it can cause - have been found 

elsewhere in Europe in travellers returning from Madeira. Such cases have so far been 

picked up in Portugal, Britain, Germany, Sweden and France, it said. "Given the dramatic 

expansion of endemic dengue transmission globally over the last 20 to 30 years and the 

high number of visitors to Madeira, the outbreak is large and constitutes a significant public 

health event," the ECDC said in an assessment issued late on Tuesday. Reuters

United Kingdom: CPS to crack down on female genital 

mutilation

23 November - The Crown Prosecution Service has announced plans to crack down on 

those who compel young girls to undergo female genital mutilation – a criminal offence for 

nearly 30 years for which there has never been a prosecution. There has been growing 

concern that the practice continues to take place in the UK and that young girls are taken 

abroad by their families to undergo it. The very few attempts to bring a prosecution have all 
ended in failure. Keir Starmer, director of public prosecutions, has now published an action 

plan in an attempt to turn the tide. Guardian

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USNORTHCOM

U.S.: Deadly 'superbugs' invade U.S. health care facilities

29 November – ... The [drug resistant] bacteria, known as Carbapenem-Resistant 

Enterobacteriaceae, or CRE, are named for their ability to fight off carbapenem antibiotics --

the last line of defense in the medical toolbox. And so far, they've emerged almost 

exclusively in health care facilities, picking off the weakest of patients. The bacteria made 

headlines this summer after a CRE strain of Klebsiella pneumoniae battered the National 

Institutes of Health Clinical Center outside Washington, D.C. Seven died, including a 16-

year-old boy... The bacteria's ability to defeat even the most potent antibiotics has conjured 

fears of illnesses that can't be stopped. Death rates among patients with CRE infections can 

be about 40%, far worse than other, better-known health care infections such as MRSA or 

C-Diff, which have plagued hospitals and nursing homes for decades. And there are 

growing concerns that CRE could make its way beyond health facilities and into the general 

community. Detroit Free Press

U.S.: F.D.A. may tap experts on energy drinks

27 November - The Food and Drug Administration said in a letter released on Tuesday that 

it was likely to seek advice from outside experts to help determine whether energy drinks 

posed particular risks to teenagers or people with underlying health problems. The letter 

appears to signal a change in the agency’s approach to the drinks, which contain high levels 

of caffeine. Previously, F.D.A. officials have said that they were investigating possible risks 

posed by popular products like 5-Hour Energy, Monster Energy and Red Bull... The F.D.A. 

letter... follows disclosures that the agency received reports of 18 deaths and over 150 

injuries that mentioned the possible involvement of energy drinks. New York Times

U.S.: HIV infection, testing, and risk behaviors among 

youths — United States

30 November - ... Based on the most recent data available from 2009 and 2010, youths 

represent 6.7% of persons living with HIV in the United States and account for 25.7% of new 

HIV infections. Of new HIV infections among youths, 45.9% were among black/African 

American males, the majority of which were attributed to male-to-male sexual contact. 

Nationwide, the percentage of youths who had ever been tested for HIV was low compared 

with other age groups: 12.9% among high school students (22.2% among those who ever 

had sexual intercourse) and 34.5% among persons aged 18–24 years. Morbidity and 

Mortality Weekly Report
U.S.: Lawmakers pledge action after meningitis outbreak

15 November - Democratic and Republican lawmakers said on Thursday they would alter 

the regulation of drug compounding pharmacies in hopes of preventing more crises like the 

rare fungal meningitis outbreak that has now cost 32 lives. The outbreak of 461 cases in 19 

states has been linked to tainted steroid injections from a Massachusetts pharmacy and led 

to public condemnation of the U.S. Food and Drug Administration and state pharmacy 

regulators for failing to act against known problems over the course of a decade. A 

Thursday hearing before the Senate Health, Education, Welfare and Pensions Committee 

brought the strongest signs so far of bipartisan willingness to approve legislation that could 

break down the current separation of powers between the FDA and individual state 

regulators charged with overseeing drug compounding. Reuters

U.S.: Less support for hepatitis C testing for baby 

boomers

26 November - An influential advisory committee has given only 

lukewarm support to a government recommendation that all baby 

boomers be tested for hepatitis C. In a draft opinion Monday, the 

United States Preventive Services Task Force said that clinicians may 

“consider offering” hepatitis C screening to adults born between 1945 

and 1965. That falls short of the recommendation made in August by 

the Centers for Disease Control and Prevention that all adults in that 

age group should get a one-time test to see if they are infected. New York Times

U.S.: Storm victims, in cleanup, face rise in injuries and 

illness

19 November - Day and night, victims of Hurricane Sandy have been streaming into ad hoc

emergency rooms and relief centers, like the MASH-type medical unit on an athletic field in 

Long Beach, and the warming tent in the Rockaways the size of a small high school gym. 

They complain of rashes, asthma and coughing. They need tetanus shots because — houseproud and armed with survivalist instincts — they have been ripping out waterlogged 

boards and getting poked by rusty nails. Those with back pain from sifting through debris 

receive muscle relaxants; those with chest pain from overexertion are hooked up to cardiac 

monitors... It is impossible to say how many people have been sickened by what Hurricane 

Sandy left behind: mold from damp drywall; spills from oil tanks; sewage from floodwater 

and unflushable toilets; tons upon tons of debris and dust. But interviews with hurricane 

victims, recovery workers, health officials and medical experts over the last week reveal that 

some of the illnesses that they feared would occur, based on the toxic substances unleashed 

by the storm and the experience of other disasters, notably Hurricane Katrina, have begun 

to manifest themselves. New York Times

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USPACOM

Bangladesh: Fire kills 112 workers at garment-maker

26 November - Fire raced up the floors of a Bangladeshi garment factory with no 

emergency exits, killing at least 112 people, some of whom jumped from the eight-story 

building where they made clothes for major global retailers. The factory outside the capital, 

Dhaka, is owned by Tazreen Fashions Ltd., a subsidiary of the Tuba Group, which makes 

products for Wal-Mart and other companies in the U.S. and Europe. Firefighters recovered 

at least 100 bodies from the factory and 12 more people died at hospitals after jumping 

from the building to escape, Maj. Mohammad Mahbub, fire department operations director, 

told The Associated Press on Sunday. "Had there been at least one emergency exit through 

outside the factory, the casualties would have been much lower," Mahbub said. Local media 

reported that up to 124 people were killed. The cause of the blaze that began late Saturday 

was not immediately clear, and authorities ordered an investigation. Associated Press

China: Alarm bells ring on diabetes

24 November - About 6.8% of China's population has the disease, world's highest 

proportion. China has a huge diabetes problem but its hospital-centered medical care 

system undermines effective intervention in the rapidly rising chronic disease, a top 

specialist said... On Nov 16, members of the World Health Organization agreed for the first 

time to set global targets for the discovery and treatment of non-communicable diseases 

like diabetes. According to the Ministry of Health, the Chinese mainland is estimated to 

have more than 92 million diabetics, or 6.8 percent of the population, the highest 

proportion in the world. Sixty percent of Chinese diabetics remain undiagnosed, owing to 

low public awareness and limited medical resources, especially at grassroots level. Without 

efficient intervention, the mainland will have 40 million more patients by 2030, according to 

the International Diabetes Federation. China Daily

China says HIV/AIDS cases up, premier-in-waiting 

promises help

28 November - The number of new HIV/AIDS cases in China jumped in the first 10 months 

of the year, as premier-in-waiting Li Keqiang promised to let non-governmental groups play 

a bigger role in fighting an epidemic spreading fast in vulnerable groups. The number of 

new AIDS cases rose almost 13 percent in the January to October period, compared with the 

same period the previous year, while the number of people infected with HIV aged 50 and 

above leapt more than 20 percent, the official Xinhua news agency said. A total of 492,191 

people were living with HIV/AIDS as of the end of October, including 68,802 new cases this 

year, the news agency said, citing the Health Ministry. Reuters

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USSOUTHCOM

Dengue keeps advancing in Latam despite efforts to 

contain the disease

28 November - Dengue continues to claim lives in Latin America with over 400 deaths and 

nearly 161.000 infection cases according to this year’s reports from the different countries. 

The disease which is endemic in parts of tropical Latinamerica is caused by a virus 

transmitted by the mosquito Aedes Aegypti and its symptoms are high fever, headache, 

vomiting and skin rashes. A more dangerous manifestation is the hemorrhagic strain which 

has a high mortality rate. In 2010 the mosquito transmitted disease infected 1.5 million 

people and caused 1.020 deaths in Latam according to official reports. So far this year 

dengue has killed 69 people in Paraguay out of 29.277 confirmed cases, with a mortality 

rate of 0.21%, but according to Health Minister Antonio Arbo the real contagion may range 

between 150.000 and 200.000 cases. MercoPress

Dominican Republic: CDC offers health advice for 

travelers

28 November - The Dominican Republic has been battling a cholera outbreak for two years 

this month. In 2012 alone, Dominican health officials have reported more than 6,600 cholera 

cases, including 47 fatalities. Because of these large numbers, the Centers for Disease 

Control and Prevention (CDC) issued an outbreak notice for travelers to this part of 

Hispaniola on Nov. 28. Neighboring Haiti has seen well over a half million cases since the 

outbreak began in Oct. 2010. Examiner.com

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