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5 April 2013

Army Public Health Weekly Update

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

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

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

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

should not be construed or interpreted as being

endorsed by the US Army Medical Department.

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Contents

U.S. MILITARY

 Army researches small device to reduce female UTIs

 Drinking, drugs more common for kids of deployed

 External causes of traumatic brain injury, 2000-2011

 Fact sheet: BRAIN initiative

 How deployment stress affects families

 New survey reveals troops' drinking, drug use

 Veterans seeking mental health care for sexual assault face unacceptable hurdles

GLOBAL

 Body's anti-HIV 'training manual' offers vaccine hopes

 Cystic fibrosis bug 'can spread between patients'

 On Twitter, anti-vaccination sentiments spread more easily than pro-vaccination sentiments

 Polio to be eradicated by 2018

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 China: Human infection with influenza A(H7N9) virus in China - update

 H5N1 cases dropped in 2012, but fatality rate rose

 Scientists race to gauge pandemic risk of new bird flu
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CME credits for 

MSMR

Read the Medical 

Surveillance Monthly 

Report and earn free CME 

credits through Medscape: 

Article: Health of women 

after wartime 

deployments

Cognitive 

Rehabilitation 

Therapy for 

Traumatic Brain 

Injury: Model Study 

Protocols and 

Frameworks to 

Advance the State 

of the Science

As the signature wound of 

the American military 

conflicts in Iraq and 

Afghanistan, TBI has 

increasingly gained 

attention over the past 15 

years. As one form of 

treatment for TBI, CRT is a 

systematic, goal-oriented 

approach to helping 

patients overcome 

cognitive impairments. 

The 2011 IOM report’s 

conclusions revolved 

around the fact that there 

is little continuity among 

research studies of the 

effectiveness of different 

types of CRT, and there 

exist only small amounts of 

evidence demonstrating 

VETERINARY/FOOD SAFETY

 Canada: Botulism, gefilte fish

 U.S.: E. coli outbreak sickens 24, CDC

WELLNESS

 As world meat consumption grows, US appetite wanes

 Blood test might spot pancreatic cancer early, study finds

 Eat fish, live longer?

 Male baldness 'indicates heart risk'

 Sleep on it: How snoozing strengthens memories

 When a smoker lights-up may increase risk

 You are what you eat -- even the littlest bites

USAFRICOM

 Democratic Republic of Congo: Boost for healthcare

 Nigeria: Lassa fever, fatality

 Swaziland’s dental dilemma

USCENTCOM

 Pakistan: Fighting in Pakistan’s Tirah Valley displaces 40,000 people

 Pakistan: Measles - 59 cases reported in the past three months

USEUCOM

 Anthrax among heroin users in Europe possibly caused by same Bacillus anthracis strain since 

2000

 United Kingdom: Male bowel cancer on the increase, says Cancer Research UK

USNORTHCOM

 Mexico: Staying HIV-free for $288

 U.S.: About one in five teen births a repeat pregnancy

 U.S.: A.D.H.D. seen in 11% of children as diagnoses rise

 U.S.: As OSHA emphasizes safety, long-term health risks fester

 U.S.: CDC releases its first guidelines on managing Q fever

 U.S.: FDA gives nod to longer use of nicotine patch, gum

 U.S.: NBSB unveils situational awareness, SNS recommendations

 U.S.: Self-reported hypertension and use of antihypertensive medication among adults

 U.S.: Tulsa dentist may have put 7,000 patients at HIV risk

USPACOM

 Bangladesh reports 5 more Nipah virus cases, 4 fatal

 China's air pollution linked to millions of early deaths

USSOUTHCOM

 Brazil: 108 people die from dengue

 Honduras: Dengue rises by 40 percent
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the effectiveness of using 

CRT to treat TBI, though 

the small amount of 

evidence generally 

indicates that CRT 

interventions have some 

effectiveness. 

In October 2012, the IOM 

held a workshop to discuss 

the barriers for evaluating 

the effectiveness of CRT 

care and for identifying 

suggested taxonomy, 

terminology, timing, and 

ways forward for CRT 

research. This document 

summarizes the workshop. 

Classified Version of 

the Weekly Update

An Army Public Health

Weekly Update is available 

with articles classified up to 

the SECRET level from the 

USAPHC SIPRNet site: 

http://phc.army.smil.mil

Look under Hot Topics & 

Current Issues.

To access this version, you 

will need a SECRET

clearance and a SIPRNet 

account.

U.S. MILITARY

Army researches small device to reduce female UTIs

3 April - ...The most common health risk for deployed military women is urinary tract 

infection, or UTI, according to [Lt. Col. Nancy] Steele and other military researchers. UTI is 

often a result of reduced hydration and voluntarily holding urine for a prolonged time, 

counter measures some women have taken in order avoid exposure to potential dangers or 

difficult situations. But Female Urinary Diversion Devices, known as FUDDs, are changing 

that habit by allowing for both "privacy and protection," said Capt. Kelly Hasselman, the 

female engagement team, or FET, commander for 1st Brigade, 1st Armored Division, in 

Kandahar, Afghanistan... [The] push to get the devices into the inventory for her female 

Soldiers seems to be welcome.... The Soldiers of the FET presented some suggestions for 

improving the device, including a mesh carrying case, and offering options on how other 

gear might be redesigned to better accommodate for its use. Army.mil

Drinking, drugs more common for kids of deployed

3 April - Teens and preteens with a parent deployed in the military may be more likely to 

binge drink or misuse prescription drugs, according to a new study... Arndt and his 

colleagues analyzed statewide survey data from Iowa students in 2010, when 1.2 million 

American children had a parent in the active duty military. They compared data from 1,700 

kids of deployed parents and 57,000 kids from non-military families, including sixth, eighth 

and 11th graders. Twelve percent of sixth graders with a deployed parent had tried alcohol 

and seven percent had consumed five or more drinks in one sitting, compared to four and 

two percent of children of non-military parents, respectively. Among eleventh graders, 29 

percent of military children had binge drank in the past month and 15 percent had smoked 

pot, compared to 22 percent and 10 percent of non-military kids. Fifteen percent of all kids 

and teens in the deployed-parent group compared to seven percent of other youth had 

misused prescription drugs in the past month, the researchers reported in the journal 

Addiction. Reuters

External causes of traumatic brain injury, 2000-2011

March 2013 - This report summarizes frequencies, distributions, and trends of external 

causes of traumatic brain injuries (TBIs) that are recorded on standardized records of

medical encounters of U.S. military members. Causes of TBI were reported for 100 percent 

of cases hospitalized in military facilities, but were relatively infrequently reported in other 

treatment settings (i.e., military outpatient facilities, combat theater and civilian medical 

facilities). During 2008-2011 in all clinical settings combined, 24,115 service members had 

TBI case-defining medical encounters with recorded injury causes. Accidents represented 74 

percent of recorded causes; the most frequently reported specific causes were motor 

vehicle traffic accidents (20%), falls (20%), and being struck by or struck against an object 

(15%). Similar proportions of TBIs were reportedly due to intentional “assaults” unrelated to 

war (11%) and “battle injuries” (11%). Medical Surveillance Monthly Report
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Fact sheet: BRAIN initiative

2 April - ... [T]he President unveiled a bold new research initiative designed to revolutionize 

our understanding of the human brain. Launched with approximately $100 million in the 

President’s Fiscal Year 2014 Budget, the BRAIN (Brain Research through Advancing 

Innovative Neurotechnologies) Initiative ultimately aims to help researchers find new ways 

to treat, cure, and even prevent brain disorders, such as Alzheimer’s disease, epilepsy, and 

traumatic brain injury. The BRAIN Initiative will accelerate the development and application 

of new technologies that will enable researchers to produce dynamic pictures of the brain 

that show how individual brain cells and complex neural circuits interact at the speed of 

thought... DARPA is interested in applications—such as a new generation of information 

processing systems and restoration mechanisms—that dramatically improve the way we 

diagnose and treat warfighters suffering from post-traumatic stress, brain injury, and 

memory loss. The White House

How deployment stress affects families

2013 - Even when we are not at war, military families often deal with stresses such as 

frequent moves or the absence of a parent. Deployment to war creates additional issues for 

a family to handle. Families face a number of challenges before, during, and after 

deployment. This emotional cycle of deployment begins when news of deployment is 

released to the family. It starts with a short period of strong emotions, such as fear and 

anger. As departure grows closer, a period of detachment and withdrawal may occur. This 

can happen to prepare for the person being physically gone. Military.com

New survey reveals troops' drinking, drug use

1 April - A new worldwide survey of active-duty troops shows that they are engaging in 

harmful behaviors less than they did in 2008, with incidents of binge drinking, smoking, 

illegal drug use and suicide attempts on the decline. Army Times

Veterans seeking mental health care for sexual assault 

face unacceptable hurdles

4 April - A report released last week by the Institute of Medicine that assessed the health 

needs of Iraq and Afghanistan war veterans made national headlines by revisiting the high 

rate of sexual assault in the U.S. armed forces. While the Pentagon estimates that as many 

as one in three women experience sexual assault while serving in the military and 86 

percent of these crimes go unreported, one particularly chilling study cited in the report 

showed that servicewomen who experience sexual assault in the military are nine times 

more likely to develop post-traumatic stress disorder, or PTSD, compared to other female 

veterans. What the report failed to mention is that when female veterans seek mental health 

services through the Department of Veterans Affairs, or VA, for PTSD related to sexual 

assault, they face long wait times, and their claims are more likely than other PTSD claims to 

be dismissed because of a lack of documentation. Center for American Progress

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GLOBAL

Body's anti-HIV 'training manual' offers vaccine hopes

3 April - The body's own "training manual" for attacking HIV has been recorded by US 

scientists and it is hoped it can be used to design vaccines. HIV mutates in order to survive 

the onslaught of a patient's immune system. However, some patients develop highly 

effective antibodies that can neutralise huge swathes of HIV mutants... When someone is 

infected with HIV, their body produces antibodies to attack it. But the virus mutates and 

evades the offensive, so the body produces new antibodies that the virus then evades and 

the war goes on. However, after about four years of this struggle some patients hit on to a 

winner by targeting something the virus finds harder to change - an Achilles heel... some 

researchers believe that vaccines that encourage the body to produce these "broadly 

neutralising antibodies" may give people immunity to the virus. BBC News

Cystic fibrosis bug 'can spread between patients'

30 March - A dangerous infection which is becoming more common in 

people with cystic fibrosis can spread between patients, UK researchers 

say in The Lancet. Doctors previously thought the Mycobacterium 

abscessus bacteria could only be caught from water and soil. But 

hospitals around the world may now have to change the way patients 

are treated, the study says. Around 3-10% of cystic fibrosis patients in Europe and the US 

are infected with the hard-to-treat bug. There are around 9,000 people with cystic fibrosis in 

the UK although around one-in-25 people carries the faulty gene which causes the 

condition. BBC

On Twitter, anti-vaccination sentiments spread more

easily than pro-vaccination sentiments

4 April - On Twitter, a popular microblogging and social-networking service, statements 

about vaccines may have unexpected effects -- positive messages may backfire, according 

to a team of Penn State University researchers led by Marcel Salathé, an assistant professor 

of biology. The team tracked the pro-vaccine and anti-vaccine messages to which Twitter 

users were exposed and then observed how those users expressed their own sentiments 

about a new vaccine for combating influenza H1N1 -- a virus strain responsible for swine 

flu. The results... may help health officials improve strategies for vaccination-awareness 

efforts. EurekAlert!

Polio to be eradicated by 2018

3 April - The World Health Organization has stated that they aim to eradicate polio by the 

year 2018. Since 1988, when the Global Polio Eradication Initiative (GPEI) was launched, 

immunization efforts have significantly reduced the number of polio cases. However, in 

order to achieve full eradication of the disease, there needs to be a great deal more 
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funding. They estimate that the six year plan to eradicate the polio will cost close to $5.5 

billion. Through a series of immunization efforts, the incidence of polio has decreased by 

more than 99 percent since 1988 - when it was endemic in more than 125 countries.

Medical News Today

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INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

 In Week 12 (through 23 March 2013), ILI and Pneumonia and Influenza (P&I) incidence 

rates continued to decrease in all regions except ILI unvaccinated rates in EUCOM, 

which increased this week. This season, there have been 295 reportable medical event 

(RME) influenza cases among service members (82.0% were vaccinated); an additional 

311 cases have been reported among other beneficiaries. 

 Across the overseas DoD laboratory surveillance network, influenza activity was at low 

levels except in Europe, where moderate levels of influenza activity were detected with 

co-circulation of influenza A/H1, A/H3, and B. 

 Current vaccine coverage in the active component of the U.S. Armed Forces is 97%. 

AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 12 (March 17 – 23, 2013), influenza activity decreased in the United States. 

 Viral Surveillance: Of 5,332 specimens tested and reported by collaborating 

laboratories, 702 (13.2%) were positive for influenza.

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

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

 Influenza-Associated Pediatric Deaths: Five pediatric deaths were reported. 

 Geographic Spread of Influenza: Six states reported widespread influenza activity; 

Puerto Rico and 8 states reported regional influenza activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 12, 52 specimens were tested from 23 locations. There was one influenza 

A(H3N2) virus and 16 influenza B viruses detected (see Table 1).

 To date this influenza season, 3,332 specimens have been tested from 80 locations of 

which 1,031 were positive for influenza A (924 A(H3N2), 96 A(H1N1)pdm09, five co-
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infections, and six A/not subtyped).

 To date this influenza season, 297 were positive for influenza B. The onset of influenza B 

cases compared to influenza A has been somewhat later in the season.

 There have been 216 other respiratory viruses isolated (48 adenovirus, 88 RSV, 71 

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

Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

During week 12/2013 (18-24 March 2013):

 Nine countries reported wide geographic spread with seven of them reporting medium 

intensity activity. 

 Decreasing or stable trends were reported by almost all reporting countries. 

 45% of tested sentinel specimens were positive for influenza virus. This proportion has 

declined since week 5/2013, but still remained at a high level, consistent with 

continuing significant influenza activity. 

 Since week 40/2012, 47% of sentinel surveillance specimens testing positive for 

influenza virus have been type A, and 53% type B. Of the influenza A viruses subtyped, 

the proportion of A(H1N1)pdm09 viruses has been 63%. 

In all reporting countries, influenza activity continued to decline or had already returned to 

baseline levels. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

5 April – Estimates of flu activity based on certain Internet search queries indicate that the 

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

Russia and in the southern hemisphere ranges from minimal to low. Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 23 March 2013:

 Influenza: There was one case of NHRC laboratory-confirmed influenza A/H1N1 and 

three cases of influenza B among US military basic trainees.

 Adenovirus: Sporadic adenovirus cases at basic training centers in early 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 

USAPHC: U.S. Army Influenza Activity Report

For the week ending 23 March 2013 (Week 12), Army influenza-like illness (ILI) activity 

continues decreasing. The CDC reports the proportion of civilian outpatient visits for ILI is 
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now below the national baseline of 2.2%. Influenza B continues to exceed influenza A 

among typed specimens in both the Army and civilian populations.

 ILI Activity: Army incident ILI outpatient visits in week 12 were 3% higher than the same 

week last year.

 Influenza cases: One hospitalized influenza case was reported to USAPHC in week 12. 91 

hospitalized cases have been reported during this influenza season, 79 in dependents 

and 12 in Active Duty.

 Acute Respiratory Disease at BCT sites: ARD rates remain low; rates did not increase 

significantly at any sites during week 12.

 Viral specimens: During week 12, 190 of 924 (21%) laboratory specimens tested were 

positive for respiratory pathogens. Influenza B accounted for 51% of positive specimens. 

Most of the influenza positive specimens were from ERMC (44%); 18% were from PRMC, 

and 16% from WRMC. USAPHC U.S. Army Influenza Activity Report

PANDEMIC AND AVIAN INFLUENZA

China: Human infection with influenza A(H7N9) virus in 

China - update

4 April – On 4 April 2013 (14:00 CET), the Chinese health authorities notified WHO of an 

additional four laboratory-confirmed cases, including three deaths, due to human infection 

with influenza A(H7N9)... There is no link between the laboratory-confirmed cases. To date, 

the total number of confirmed cases of human infection with influenza A(H7N9) virus in 

China is 11, including 5 deaths. More than 400 close contacts of the confirmed cases are 

being closely monitored. Thus far, none of them have developed any symptoms of illness. 

The Chinese government is actively investigating this event and has heightened disease 

surveillance. Retrospective testing of recently reported cases with severe respiratory 

infection may uncover additional cases that were previously unrecognized. An intergovernment task force has been formally established, with the National Health and Family 

Planning Commission leading the coordination along with the Ministry of Agriculture and 

other key ministries. The animal health sector has intensified investigations into the possible 

sources and reservoirs of the virus. WHO

H5N1 cases dropped in 2012, but fatality rate rose

2 April – The world registered fewer human infections with H5N1 avian influenza in 2012, 

but the fatality rate was a little higher than in previous years, the World Health Organization 

(WHO) noted in a recent review of the year's data... Thirty-two human H5N1 cases were 

confirmed last year, as compared with 62 in 2011, 48 in 2010, and 73 in 2009, the WHO 

reported. There were 11 cases in Egypt in 2012, 9 in Indonesia, 4 in Vietnam, 3 in Cambodia, 

3 in Bangladesh, and 2 in China. The virus is considered endemic in poultry in five of those 

six countries, and a recent study suggested it is endemic in the sixth, Cambodia, as well... 
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The case-fatality rate for confirmed cases in 2012 was 62.5% (20 of 32 cases), the report 

says. That topped the 55% for 2011, 50% in 2010, and 44% in 2009, but it was still close to 

the overall CFR of 59% (360 of 610) for cases reported to the WHO since 2003. CIDRAP

Scientists race to gauge pandemic risk of new bird flu

3 April - Genetic sequence data on a deadly strain of bird flu previously unknown in people 

show the virus has already acquired some mutations that might make it more likely to cause 

a human pandemic, scientists say. But there is no evidence so far that the H7N9 flu - now 

known to have infected nine people in China, killing three - is spreading from person to 

person, and there is still a chance it might peter out and never fully mutate into a human 

form of flu. Just days after authorities in China announced they had identified cases of 

H7N9, flu experts in laboratories across the world are picking through the DNA sequence 

data of samples isolated from the patients to assess its pandemic potential. One of the 

world's top flu experts, Ab Osterhaus, who is based at the Erasmus Medical Center in The 

Netherlands, says the sequences show some genetic mutations that should put authorities 

on alert and entail increased surveillance in animals and humans. "The virus has to a certain 

extent already adapted to mammalian species and to humans, so from that point of view it's 

worrisome," he told Reuters in a telephone interview. Reuters

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VETERINARY/FOOD SAFETY

Canada: Botulism, gefilte fish

31 March - The Canadian Food Inspection Agency and Central-Epicure Food Products 

Limited are warning the public to not consume 2 of their gefilte fish brands. The CentralEpicure Ready to Serve Sweet and Ready to Serve Savoury gefilte fish products may be 

contaminated with _Clostridium botulinum_; toxins produced by these bacteria can cause 

botulism, a life-threatening illness. The fish was sold in Ontario and Quebec in 600 gram 

packages with a best before date of 13 Apr 2013 (UPC code 061279 00440 3 & 061279 

00440 7). There have been no illnesses reported in association with the product. ProMEDmail

U.S.: E. coli outbreak sickens 24, CDC

29 March - A U.S. outbreak of E. coli has sickened 24 people, with Farm Rich frozen food 

suspected as a likely source of the infection, the Centers for Disease Control and Prevention 

said on Friday. The outbreak strain of Shiga toxin-producing Escherichia coli O121, or STEC 

O121, has been reported in 15 states, the CDC said in a statement. New York state health 

officials found the strain in an open package of Farm Rich brand frozen chicken quesadillas 

from an ill person's home, the CDC said. Reuters

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WELLNESS

As world meat consumption grows, US appetite wanes

For the first time on record, U.S. per-capita meat consumption has declined for four 

consecutive years, according to the most recent figures from the U.S. Department of 

Agriculture. The six percent drop between 2006 and 2010 is the largest sustained decline 

since recordkeeping began in 1970. Reasons for the decline are at least partly economic: 

rising prices and a bad U.S. economy have made meat less affordable for American 

consumers. But there are intriguing signs that a cultural shift may be underway, as well. VOA

Blood test might spot pancreatic cancer early, study finds

29 March - A new blood test that detects deadly pancreatic cancer earlier than usual might 

slightly improve patients' odds for survival, a small Japanese study suggests. "This new 

diagnostic test may be a safe and easy screening method that could improve the prognosis 

of patients with pancreatic cancer through earlier detection," said lead researcher Dr. 

Masaru Yoshida, an associate professor in the division of metabolomics research at Kobe 

University Graduate School of Medicine. "A drop of blood contains a lot of information." 

Currently, the 5-year survival rate for pancreatic cancer is less than 5 percent, largely 

because the cancer usually has spread by the time it is detected. The new approach relies 

on metabolomics technology, an emerging science that focuses on small molecules. The 

blood test measures byproducts of metabolism, called metabolites, found in the blood. 

Medline Plus

Eat fish, live longer?

1 April - Regularly eating fish rich in omega-3 fatty acids might lengthen your life, new 

research suggests. A study of more than 2,600 older adults found those with the highest 

blood levels of omega-3 fatty acids -- found in salmon, mackerel, herring, lake trout and 

albacore tuna -- lived more than two years longer on average than those with lower blood 

levels. "This is not a study of fish oil supplements, it's a study of blood omega-3 levels 

related to diet," said researcher Dr. Dariush Mozaffarian, an associate professor of 

epidemiology at the Harvard School of Public Health in Boston. The study, published April 1 

in the journal Annals of Internal Medicine, doesn't prove that eating fish will increase 

longevity, but it does suggest a connection. U.S. News and World Report

Male baldness 'indicates heart risk'

3 April - Men going thin on top may be more likely to have heart problems than their 

friends with a full head of hair, according to researchers in Japan. Their study of nearly 

37,000 people, published in the online journal BMJ Open, said balding men were 32% more 

likely to have coronary heart disease. However, the researchers said the risks were less than 

for smoking or obesity... They showed that hair that went thin on the crown was associated 

with coronary heart disease. This was after adjusting for other risk factors such as age and 

family history. BBC News
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Sleep on it: How snoozing strengthens memories

April 2013 - When you learn something new, the best way to remember 

it is to sleep on it. That’s because sleeping helps strengthen memories 

you’ve formed throughout the day. It also helps to link new memories 

to earlier ones. You might even come up with creative new ideas while 

you slumber. What happens to memories in your brain while you sleep? 

And how does lack of sleep affect your ability to learn and remember? NIH-funded 

scientists have been gathering clues about the complex relationship between sleep and 

memory. Their findings might eventually lead to new approaches to help students learn or 

help older people hold onto memories as they age. NIH News in Health

When a smoker lights-up may increase risk 

2 April - The health risks of cigarette smoking are well known, such as cancer, emphysema 

and cardiovascular disease. But new research shows that when you smoke can make it even 

more risky. Tobacco remains the leading cause of preventable death, according to the 

World Health Organization. It estimates six million people die every year from smokingrelated illnesses, most in low and middle income countries. A new study looks at smokers, 

who light-up right after waking up each morning. Penn State University researchers say 

those smokers are more likely to develop lung or oral cancer. VOA

You are what you eat -- even the littlest bites

28 March - Sometimes you just can't resist a tiny piece of chocolate cake. Even the most 

health-conscious eaters find themselves indulging in junk foods from time to time. New 

research by scientists at the University of Massachusetts Medical School (UMMS) raises the 

striking possibility that even small amounts of these occasional indulgences may produce 

significant changes in gene expression that could negatively impact physiology and health.

Science Daily

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USAFRICOM

Democratic Republic of Congo: Boost for healthcare

31 March - The British government has announced a major new programme aimed at 

providing essential healthcare to six million people in the Democratic Republic of Congo 

(DRC). The five-year, US$270.7 million project will focus on rebuilding health facilities, 

training health workers, and supplying drugs and equipment. Civil war has destroyed much 

of the country’s health infrastructure, as well as the road networks and vital services such as 

electricity, meaning patients often have to travel long distances to health centres that may 

not be equipped to handle their complications. IRIN
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Nigeria: Lassa fever, fatality

1 April - Lassa fever has killed one in person in Rivers state. Rivers State Commissioner for 

Health Dr. Sampson Parker, who disclosed this to a journalist in Port Harcourt, said the 

deceased died at the University of Port Harcourt Teaching Hospital before help could come 

his way. He said: "Just a few days ago, my attention was drawn to the isolation of the virus 

in a suspected case, and we lost the patient before any spirited attempt could be made to 

rescue him." The commissioner said the state government has risen to the challenges of the 

Lassa fever outbreak by intensifying surveillance and consolidating the established control 

structures...He said the state government has procured sufficient drugs and consumables to 

manage exposed persons and called on the people to maintain the best hygiene and 

cleanliness as well as to keep rodents out of their houses and working places. Last year 

[2012], the state recorded an outbreak of Lassa fever which claimed many lives. ProMEDmail

Swaziland’s dental dilemma

3 April - Having a toothache in Swaziland can be a lot more painful than it is in many other 

places. Most Swazis have never visited a dentist, because in a country where 70 percent of 

the population lives in absolute poverty, oral hygiene is considered a luxury. Swaziland's 1.2 

million people are served by only nine private dentists: five are in the capital, Mbabane, four 

are doing business in the central commercial hub, Manzini, and one is located in the upscale Mbabane suburb of Ezulwini. A further 15 dental practitioners are employed by the 

Ministry of Health, including nurses and dental hygienists, but none are specialists who can 

perform such procedures as root canal work or the fitting of false teeth. IRIN

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USCENTCOM

Pakistan: Fighting in Pakistan’s Tirah Valley displaces 

40,000 people

1 April - Around 40,000 residents of Pakistan’s Tirah Valley, close to the border with 

Afghanistan, have fled their homes after renewed fighting in the last few weeks, according 

to the Disaster Management Authority in the Federally Administered Tribal Areas (FDMA)... 

According to the Geneva-based Internal Displacement Monitoring Centre, some 750,000 

persons are already internally displaced in Pakistan due to conflict and natural disasters.

IRIN

Pakistan: Measles - 59 cases reported in the past three 

months 

5 April - ...According to the World Health Organisation’s (WHO) Weekly Epidemiological 

Bulletin – Disease early warning system (DEWS) and response in Pakistan, 59 cases of 

measles have been reported in the Islamabad Capital Territory (ICT) so far this year.
13

According to the WHO, this figure climbs to a staggering 8,532 cases across the country, 

including 218 deaths. Express Tribune

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USEUCOM

Anthrax among heroin users in Europe possibly caused 

by same Bacillus anthracis strain since 2000

28 March - Injection anthrax was described first in 2000 in a heroin-injecting drug user in 

Norway. New anthrax cases among heroin consumers were detected in the United Kingdom 

(52 cases) and Germany (3 cases) in 2009-10. In June 2012, a fatal case occurred in 

Regensburg, Bavaria. As of December 2012, 13 cases had been reported in this new 

outbreak from Germany, Denmark, France and the United Kingdom. We analysed isolates 

from 2009-10 and 2012 as well as from the first injection anthrax case in Norway in 2000 by 

comparative molecular typing using a high resolution 31 marker multilocus variable-number 

tandem repeat analysis (MLVA) and a broad single nucleotide polymorphism (SNP) analysis. 

Our results show that all cases may be traced back to the same outbreak strain. They also 

indicate the probability of a single source contaminating heroin and that the outbreak could 

have lasted for at least a decade. However, an additional serological pilot study in two 

German regions conducted in 2011 failed to discover additional anthrax cases among 288 

heroin users. Eurosurveillance

United Kingdom: Male bowel cancer on the increase, 

says Cancer Research UK

1 April - Bowel cancer rates among men have increased by more than a quarter in the last 

35 years, a report has suggested. The Cancer Research UK study said this contrasted with a 

rise of just 6% in the rate for women over the same time. However, bowel cancer survival 

rates are improving with half of all patients living for at least 10 years after being diagnosed.

It is not known why there should be such a large difference in the increase in rates between 

men and women. BBC

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USNORTHCOM

Mexico: Staying HIV-free for $288

1 April - A new study suggests that most young gay men in Mexico City would pledge to 

stay H.I.V.-free, attend a monthly safe-sex talk and take regular H.I.V. tests to prove they 

were uninfected — all in return for just $288 a year. Most male prostitutes would make the 
14

same promise for $156 a year, the study found. Because each person receiving H.I.V. 

treatment costs Mexico’s public health system up to $7,000 a year for drugs alone, 

payments that encourage men to stay uninfected could be a bargain, the authors argue. 

New York Times

U.S.: About one in five teen births a repeat pregnancy

3 April - Teen birth rates have been falling in the United States over the last 20 years, but 

that doesn't mean that it still isn't an issue. More than 365,000 girls between the ages of 15 

to 19 gave birth in 2010, and almost 20 percent of them had previously given birth, the 

Centers for Disease Control and Prevention said in a Vital Signs report... The majority of 

repeat teen births (86 percent) are second births, but 13 percent of repeat births are a third 

child. Fourth through sixth pregnancies accounted for 2 percent of repeat teen births. CBS 

News

U.S.: A.D.H.D. seen in 11% of children as diagnoses rise

31 March - Nearly one in five high school age boys in the United States and 11 percent of 

school-age children over all have received a medical diagnosis of attention deficit 

hyperactivity disorder, according to new data from the federal Centers for Disease Control 

and Prevention. These rates reflect a marked rise over the last decade and could fuel 

growing concern among many doctors that the A.D.H.D. diagnosis and its medication are 

overused in American children. New York Times

U.S.: As OSHA emphasizes safety, long-term health risks 

fester

30 March - ...Medical researchers, government officials and even chemical companies that 

once manufactured [n-propyl bromide, or nPB ] have warned for over a decade that it 

causes neurological damage and infertility when inhaled at low levels over long periods, but 

its use has grown 15-fold in the past six years. Such hazards demonstrate the difficulty, 

despite decades of effort, of ensuring that Americans can breathe clean air on the job. Even 

as worker after worker fell ill, records from the Occupational Safety and Health 

Administration show that managers at Royale Comfort Seating, where Ms. Farley was 

employed, repeatedly exposed gluers to nPB levels that exceeded levels federal officials 

considered safe, failed to provide respirators and turned off fans meant to vent fumes. New 

York Times

U.S.: CDC releases its first guidelines on managing Q 

fever

29 March - The US Centers for Disease Control and Prevention (CDC) this week released its 

first set of national guidelines for the diagnosis and management of Q fever, a zoonotic 

disease caused by the bacterium Coxiella burnettii. The pathogen is listed by the CDC as a 

Category B bioterrorism agent, meaning it is moderately easy to disseminate and causes 

moderate morbidity and low mortality. Because diagnosing Q fever is difficult, it has long 

been considered an underreported illness, the CDC says. Infection is usually caused by 
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inhaling bacteria from animal waste or soil, and the disease is an occupational risk for 

farmers and others who work with livestock. CIDRAP News Scan

U.S.: FDA gives nod to longer use of nicotine patch, gum

1 April - Smokers who are trying to quit can use over-the-counter nicotine 

replacement gums, lozenges and skin patches for a longer period of time 

than previously recommended, the U.S. Food and Drug Administration 

announced Monday. Any nicotine-containing product is potentially 

addictive, but decades of research and use have shown that these 

products do not carry a high risk for abuse or dependence, according to the agency. Certain 

other warnings and limitations that were listed on the products' labels are also no longer 

necessary, the FDA said. This includes a warning that people should not use a nicotine 

replacement product if they are still smoking, chewing tobacco, using snuff or any other 

product that contains nicotine, including another nicotine replacement product. Medline 

Plus

U.S.: NBSB unveils situational awareness, SNS 

recommendations

3 April – The National Biodefense Science Board (NBSB) today forwarded two sets of 

recommendations to federal departments that oversee emergency preparedness, one 

focused on enhancing situational awareness in health emergencies and the other on 

improving the nation's Strategic National Stockpile (SNS) by 2020... In its draft of the 

situational awareness report, the NBSB's key recommendation was that the HHS secretary 

designate a central situational awareness authority to coordinate all public health and 

healthcare situational awareness that has been collected, processed, and analyzed by 

agencies at the national level. CIDRAP

U.S.: Self-reported hypertension and use of 

antihypertensive medication among adults

5 April - ...In 2009, the age-adjusted prevalence of self-reported hypertension ranged from 

20.9% in Minnesota to 35.9% in Mississippi. The proportion reporting use of 

antihypertensive medications among those who reported hypertension ranged from 52.3% 

in California to 74.1% in Tennessee. From 2005 to 2009, nearly all states had an increased 

prevalence of self-reported hypertension, with percentage-point increases ranging from 0.2 

for Virginia (from 26.9% to 27.1%) to 7.0 for Kentucky (from 27.5% to 34.5%). Overall, from 

2005 to 2009, the prevalence of self-reported hypertension among U.S. adults increased 

from 25.8% to 28.3%. Among those reporting hypertension, the proportion using 

antihypertensive medications increased from 61.1% to 62.6%. Morbidity and Mortality 

Weekly Report
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U.S.: Tulsa dentist may have put 7,000 patients at HIV 

risk

29 March - Health officials in the US state of Oklahoma have warned 7,000 patients their 

dentist may have exposed them to HIV and hepatitis B and C. Patients of Dr W Scott 

Harrington's practice in Tulsa were advised to test themselves at a free clinic set up by the 

state, health officials said. Health inspectors found rusty dental instruments and poor 

hygiene standards at the clinic. Dr Harrington has voluntarily closed the practice, officials 

said. BBC

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USPACOM

Bangladesh reports 5 more Nipah virus cases, 4 fatal

3 April - Bangladesh has had 24 Nipah virus infections with 21 deaths so far this year, an 

increase of 5 cases and 4 deaths since the previous update on Mar 12, the country's 

Institute of Epidemiology, Disease Control and Research (IEDCR) reported yesterday. The 

cases have occurred in 14 districts, with patients ranging from 8 months to 60 years old. The 

virus spreads through drinking raw date palm sap and close contact with an infected 

person. Previous reports said Bangladesh had an average of 18 Nipah virus cases per year 

from 2001 through 2011. CIDRAP News Scan

China's air pollution linked to millions of early deaths

2 April - More than 1 million people are dying prematurely 

every year from air pollution in China, according to a new 

analysis. "This is the highest toll in the world and it really 

reflects the very high levels of air pollution that exist in 

China today," says Robert O'Keefe of the Health Effects 

Institute in Boston, who presented the findings in Beijing this week. Alarm has been growing

in recent years about the air in China. On many days in many cities, it's thick with smog... In 

fact, about two-thirds of all the deaths from air pollution are now occurring in Asia, most of 

them in China. And air pollution has become the fourth leading cause of death in China. 

"For the most part, the air pollution effects are generally manifested in frail populations —

people with asthma are generally more susceptible to the effects of air pollution," O'Keefe 

says. "Also the very young and children who live in highly polluted areas for extended 

periods of time." NPR

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USSOUTHCOM

Brazil: 108 people die from dengue 

5 April - A total of 108 people died from dengue in the first quarter of 2013 in Brazil, where 

those infected with such diseases increased 279 percent, said the minister Health, Alexandre 

Padilha. Padilha emphasized that patients in just 12 weeks amounted to 635 000, against 

167 000 200 recorded in the same period of 2012... Among the states with the highest 

incidence of the disease appear Mato Grosso do Sul (two thousand 948 cases per 100 000 

inhabitants), Goiás billion (367 per 100,000), and Espírito Santo (801 per 100,000). Prensa 

Latina

Honduras: Dengue rises by 40 percent

4 April - With the increase of dengue cases in San Pedro Sula, authorities of the 

Metropolitan Health Region have sounded alert and have resumed abatement work, 

awareness and fumigation in all four quadrants, in order to reduce infestation rates. 

According to the director of that office, Julio Rodriguez, earlier this year had an increase of 

cases ranged between 35 and 40 percent compared to 2012, being the southeast sector of 

the city where most patients have been reported. La Tribuna

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