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15 March 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 promises improvements in evaluation of soldiers with PTSD Monday

 DOD’s top doctor details sequester’s effect on health system

 Hagel orders review of U.S. Air Force handling of sex assault case

 Incidence of genital warts among U.S. service members before and after the introduction of the 

quadrivalent human papillomavirus vaccine

GLOBAL

 Antibiotic resistance a "catastrophic threat": UK medical chief

 Drugmakers, Interpol ramp up fight against fakes

 Mobile device use while driving — United States and seven European countries, 2011

 Mummies from different times, places shared key heart risk

 Novel coronavirus infection - update

 The shelf life of donor blood

 Whooping cough vaccine protection wanes as kids age

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

 Influenza virus aerosols in human exhaled breath: Particle size, culturability, and effect of 

surgical masks

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 NIH study sheds light on role of climate in influenza transmission

 Study finds small risk of Guillain-Barre Syndrome from H1N1 vaccine

VETERINARY/FOOD SAFETY

 China: Thousands of dead pigs found in river flowing into Shanghai

 Pet frogs linked to salmonella outbreak in kids: CDC

 Ukraine denies 'killer' military dolphins escaped
2

Ready and Resilient 

Campaign

The Ready and Resilient 

Campaign integrates and 

synchronizes multiple 

efforts and programs to 

improve the readiness and 

resilience of the Army 

Family - Soldiers (Active 

Duty, Reserve, National 

Guard), Army Civilians and 

Families. 

Ready and Resilient creates 

a holistic, collaborative and 

coherent enterprise to 

increase individual and unit 

readiness and resilience. 

Ready and Resilient will 

build upon physical, 

emotional and 

psychological resilience in 

our Soldiers, Families and 

Civilians so they improve 

performance to deal with 

the rigors and challenges 

of a demanding profession.

WELLNESS

 Aspirin may lower melanoma risk

 Azithromycin poses fatal cardiac risk, FDA warns

 Benefits of quitting smoking outpace risk of modest weight gain

 Chronic insomnia affects heart

 Self-tracking apps to help you 'quantify' yourself

 Sleep less, eat more, gain weight

 Walgreen sued over Vitamin E supplement claims

USAFRICOM

 In Africa, corruption dirties the water

 Kenya’s waste management challenge

 Niger: 17 killed in measles outbreak

 Nigeria: Vaccine suspicion aggravates measles outbreak

 South Sudan's gender gap still too wide

USCENTCOM

 Afghanistan: Taliban stopping polio vaccinations, says Afghan governor

 Pakistan: Fight against polio - tribesmen fined by militants for vaccinating their children

 U.N.: Number of Syrian refugees escalating at rapid rate

USEUCOM

 Europeans are world’s biggest smokers and drinkers: WHO

 U.K.: Thirty eight hospitalised as measles cases in Swansea outbreak reaches 252

USNORTHCOM

 Royal Caribbean cruise ship hit by virus; 108 sick

 U.S.: Dengue fever no longer just a visitor to Florida Keys

 U.S.: Fatal Md. rabies case is first in state since 1976

 U.S.: Judge blocks New York City large-soda ban, Mayor Bloomberg vows fight

USPACOM

 Bangladesh: Nipah Infection in 2013

 Papua New Guinea grapples with ageing health workforce

 Thailand struggles to curb high teen pregnancy rate

USSOUTHCOM

 Haiti recycles human waste in fight against cholera epidemic

 South Americans face upheaval in deadly water battles

U.S. MILITARY

Army promises improvements in evaluation of soldiers 

with PTSD Monday

11 March - Since last summer, the Army has been examining whether its medical 

professionals have been systematically underdiagnosing Post-Traumatic Stress Disorder 

among soldiers. A report the service released Friday concludes the answer is no, but it also 
3

Performance Triad 

Pilot Program

In early 2013, U.S. Army 

Medical Command will roll 

out a new Performance 

Triad Pilot Program at Fort 

Bragg, N.C., Fort Hood, 

Texas, and Joint Base Lewis 

McChord, Wash., to test a 

new wellness program with 

Soldiers before expanding 

further across the Army. 

The Performance Triad 

Pilot Program returns the 

Army back to health basics 

by emphasizing that the 

Army family get adequate 

physical activity, nutrition 

and sleep to be mentally 

and physically fit and able 

to perform at their best. 

Enhancing Soldier and 

leader knowledge, 

attitudes and behaviors on 

these three areas will also 

help Soldier performance 

and resiliency, unit, and 

Army readiness to improve.

found plenty of room for improvement in the military's processes for handling behavioral 

health issues... To conduct the review, the Army reexamined the records of 154,000 patients 

who had been diagnosed with four separate behavioral conditions since 2001, including 

PTSD. The examination wound up revalidating 88 percent of the original diagnoses. "This 

revalidation rate is extraordinary when you compare it to the diagnostic revalidation rates 

from the civilian sector," [Lt. Gen. Patricia] Horoho said. Federal News Radio

DOD’s top doctor details sequester’s effect on health 

system

13 March – The Pentagon’s top health affairs official today detailed for Congress the 

immediate and long-term effects of sequestration on the Defense Department’s military 

health care system and its medical mission. Dr. Jonathan Woodson, assistant secretary of 

defense for health affairs, told the House Armed Services Committee that the spending cuts 

that took effect March 1 will affect patients, staff and facilities. But he emphasized that the 

Defense Department “cannot and will not” compromise care in the face of the cuts... The 

department also will ensure that wounded warriors continue to receive the care they need... 

“To the greatest extent possible, we will sustain our access to our military hospitals and 

clinics for our service members, their families, retirees and their families,” he said. “But 

sustaining patient care functions during sequestration comes at a cost. “The department will 

reduce funding from a wide range of other essential investments,” he continued...Civilian 

employee furloughs are another factor. “Forty percent of our military medical centers are 

staffed by civilians, and as a result of the furlough program, access may be impacted,” 

Woodson said. Defense.gov

Hagel orders review of U.S. Air Force handling of sex 

assault case

12 March - Defense Secretary Chuck Hagel has asked the Pentagon's top lawyer to review a 

recent sexual assault case and assess whether commanding officers should have the power 

under military law to overturn a jury verdict, according to a letter released on Monday. The 

review could have far-reaching consequences for the military judicial system, which grants 

the "convening authority" - the general responsible for a court martial proceeding - the 

ability to review a verdict from a jury trial and modify or dismiss it. Chicago Tribune

Incidence of genital warts among U.S. service members 

before and after the introduction of the quadrivalent 

human papillomavirus vaccine

February 2013 - ...During each year of the study period except 2012, crude incidence rates 

of [genital warts] GWs were higher among females than males. Among females, incidence

rates were markedly higher among those younger than 30 years versus older; and were 

highest among the youngest (<21 years), intermediate among the 21-24-yearolds, and 

relatively low among the oldest (25-29 years). Among women younger than 25 years,

annual incidence rates of GWs sharply declined from 2007 through 2010. In contrast, among 
4

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women 25 years and older and men of all age groups, annual rates of GW diagnoses 

remained relatively low and stable from 2000 through 2010. Medical Surveillance Monthly 

Report

top of page...

GLOBAL

Antibiotic resistance a "catastrophic threat": UK medical 

chief

1 March - Antibiotic resistance poses a catastrophic threat to medicine and could mean 

patients having minor surgery risk dying from infections that can no longer be treated,

Britain's top health official said on Monday. Sally Davies, the chief medical officer for 

England, said global action is needed to fight antibiotic, or antimicrobial, resistance and fill a 

drug "discovery void" by researching and developing new medicines to treat emerging, 

mutating infections. Only a handful of new antibiotics have been developed and brought to 

market in the past few decades, and it is a race against time to find more, as bacterial 

infections increasingly evolve into "superbugs" resistant to existing drugs. Reuters

Drugmakers, Interpol ramp up fight against fakes

12 March - More than two dozen of the world's largest pharmaceutical companies have 

agreed to provide funding and other support to Interpol's battle against counterfeit 

prescription drugs, the international police agency said Tuesday. Interpol's newly created 

Pharmaceutical Crime Program aims to help health agencies, police and customs bureaus in 

countries around the globe stem the supply of bogus brand-name and generic medicines, 

as well as identify and dismantle the organized crime rings distributing them. Those rings, 

which operate across borders, are raking in billions of dollars every year, costing legitimate 

drugmakers a small fortune in lost sales. Meanwhile patients who unknowingly take 

counterfeit drugs often are poisoned or get sicker because they're not receiving what the 

doctor prescribed. Yahoo! News

Mobile device use while driving — United States and 

seven European countries, 2011

15 March - Road traffic crashes are a global public health problem, contributing to an 

estimated 1.3 million deaths annually (1). Known risk factors for road traffic crashes and 

related injuries and deaths include speed, alcohol, nonuse of restraints, and nonuse of 

helmets. More recently, driver distraction has become an emerging concern (2). To assess 

the prevalence of mobile device use while driving in Belgium, France, Germany, the 

Netherlands, Portugal, Spain, the United Kingdom (UK), and the United States, CDC 

analyzed data from the 2011 EuroPNStyles and HealthStyles surveys. Prevalence estimates 

for self-reported talking on a cell phone while driving and reading or sending text or e-mail 
5

messages while driving were calculated. This report describes the results of that analysis, 

which indicated that, among drivers ages 18–64 years, the prevalence of talking on a cell 

phone while driving at least once in the past 30 days ranged from 21% in the UK to 69% in 

the United States, and the prevalence of drivers who had read or sent text or e-mail 

messages while driving at least once in the past 30 days ranged from 15% in Spain to 31% 

in Portugal and the United States. Morbidity and Mortality Weekly Report

Mummies from different times, places shared key heart 

risk

10 March - CT scans of 137 mummies spanning four geographies and 4,000 years of history 

show that hardening of the arteries was commonplace, especially in older individuals, 

suggesting this key sign of heart disease may be a part of aging rather than the byproduct 

of eating too many Big Macs. The findings, presented on Sunday at the American College of 

Cardiology meeting in San Francisco and published in the Lancet medical journal, challenge 

the commonly held belief that atherosclerosis, or hardening of the arteries - the disease that 

causes heart attacks and strokes - is a modern plague brought on by smoking, obesity and 

sedentary lifestyles Reuters

Novel coronavirus infection - update

12 March - The Ministry of Health in Saudi Arabia has informed WHO of a new confirmed 

case of infection with the novel coronavirus (nCoV). The patient, a 39-year-old male, 

developed symptoms on 24 February 2013. He was hospitalized on 28 February 2013 and 

died on 2 March 2013. Preliminary investigation indicated that the patient had no contact 

with previously reported cases of nCoV infection. Other potential exposures are under 

investigation. To date, WHO has been informed of a global total of 15 confirmed cases of 

human infection with nCoV, including nine deaths. WHO

The shelf life of donor blood

11 March - How long should blood be stored? For decades, the Food and Drug 

Administration has limited storage of refrigerated red blood cells to 42 days. But it has been 

clear for some time that stored blood degrades in various ways long before that six-week 

limit, and some research suggests that the changes may be harmful to patients who receive 

older blood. Now a study published in the journal Anesthesia & Analgesia has found that 

after even 21 days, the membranes of stored blood cells have stiffened, apparently the 

result of damage over time. That’s a problem because red blood cells are about the same 

diameter as small capillaries, and they have to change shape to get through. New York 

Times

Whooping cough vaccine protection wanes as kids age

11 March - Protection against whooping cough starts to weaken a few years after preschool 

children get their final shot, according to a U.S. study, meaning that some children may be 

at risk of developing the disease before they can get a booster shot. The U.S. Centers for 

Disease Control and Prevention (CDC) recommends a booster shot at age 11 or 12. The 
6

usual practice is to give five doses of diphtheria, tetanus and pertussis (DTaP) shots, the last 

at age four to six... Meissner and other researchers think that trend results from a change in 

the 1990s to a new type of pertussis vaccine, called an acellular vaccine, which comes with 

fewer side effects than the original whole-cell version. But researchers also said that 

switching back to the whole-cell version, at least for the first couple of shots, could improve 

protection as children get older... The CDC could also move up the booster shot to ages 

eight to 10, but it's harder to get children into the office at that point. Reuters

top of page...

INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

 In Week 9 (through 02 March 2013), ILI and Pneumonia and Influenza (P&I) incidence 

rates continued to decrease in all regions. Percents continued to be above previous 

season for all populations except Service members in the US and PACOM. 

 Across the overseas DoD laboratory surveillance network, influenza activity varied from 

low to moderate levels except in Europe, where high levels of influenza activity were 

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

 Current influenza vaccine coverage data unavailable for this report, previously reported 

at 97%. AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 9 (February 24 – March 2, 2013), influenza activity remained elevated in the 

United States, but decreased in most areas. 

 Viral Surveillance: Of 6,259 specimens tested and reported by collaborating 

laboratories, 1,074 (17.2%) were positive for influenza. 

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

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

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

 Influenza-Associated Hospitalizations: A cumulative rate for the season of 38.5 

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

reported. Of reported hospitalizations, over 51% were among adults 65 years and older. 

 Outpatient Illness Surveillance: The proportion of outpatient visits for influenza-like 

illness (ILI) was 2.3%. This is above the national baseline of 2.2%. Seven of 10 regions 

reported ILI at or above region-specific baseline levels. Four states experienced 

moderate activity; 13 states and New York City experienced low activity; 33 states 

experienced minimal activity, and the District of Columbia had insufficient data. 
7

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

Puerto Rico and 24 states reported regional influenza activity; the District of Columbia 

and 13 states reported local influenza activity; 4 states reported sporadic influenza 

activity; Guam reported no influenza activity, and the U.S. Virgin Islands did not report. 

FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 9, 77 specimens were tested from 26 locations. There were 14 influenza A 

viruses (13 A(H3N2) and one A(H1N1)pdm09); and seven influenza B viruses detected 

(see Table 1).

 To date this influenza season, 3,011 specimens have been tested from 81 locations of 

which 984 were positive for influenza A (880 A(H3N2), 93 A(H1N1)pdm09, three coinfections of A(H3N2) & B, one co-infection of A(H3N2) & A(H1N1)pdm09, one coinfection of A(H3N2) & parainfluenza, and six A/not subtyped); and 225 were positive 

for influenza B (14 B/Yamagata, two B/Victoria, and 209 B/lineage undetermined). There 

have been 200 other respiratory viruses isolated (45 adenovirus, 68 parainfluenza, nine 

enterovirus, and 78 RSV).

 On 27 February 2013, the Vaccines and Related Biological Products Advisory 

Committee... agreed to retain the Influenza A/California/7/2009 (H1N1)pdm09-like 

virus, replace the Influenza A/Victoria/361/2011 (H3N2)-like virus with a virus that is 

antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and to 

replace the influenza B/Wisconsin/1/2010-like virus with an influenza 

B/Massachusetts/2/2012-like virus (B/Yamagata lineage). The quadrivalent vaccine will 

include Influenza B/Brisbane/60/2008-like virus (B/Victoria lineage). The WHO 

convened, in Geneva, a week prior to VRBPAC and recommended the same viruses for 

inclusion into the 2013-2014 vaccine. USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

 In week 9/2013, 19 of 27 countries reporting indicated concomitantly high/mediumintensity transmission and wide geographic spread. Only two countries reported 

increasing trends in influenza-like illness compared to six in week 8 and 11 in week 7. Of 

the 18 countries that reported decreasing trends, five did so for the first time since the 

beginning of influenza transmission this season. 

 The proportion of influenza-positive cases among sentinel specimens remained high 

(54%), but has continued to decrease since the peak observed in week 5/2013 (61%). 

 Since week 40/2012, a broadly even distribution of influenza virus types has been 

observed among sentinel samples, with approximately 50% each for type A and type B 

viruses. 

 A total of 154 hospitalised laboratory-confirmed influenza cases were reported by eight 

countries (Belgium, France, Ireland, Romania, Slovakia, and Spain). 
8

In week 9/2013, influenza activity remained substantial across Europe but an increasing 

number of countries reported indications of declining transmission. Weekly Influenza 

Surveillance Overview

Google.org: Flu Trends

13 March – Estimates of flu activity based on certain Internet search queries indicate that 

the level of flu activity in the northern hemisphere ranges from low in Bulgaria, France, 

Poland, and Canada to high in Japan, Ukraine, Russia, Sweden, Austria, and the United 

States and in the southern hemisphere ranges from minimal to low in Chile and New 

Zealand. Google.org Flu Trends

Influenza virus aerosols in human exhaled breath: 

Particle size, culturability, and effect of surgical masks

7 March - ...The relative importance of direct and indirect contact, large droplet spray, and 

aerosols as modes of influenza transmission is not known but is important in devising 

effective interventions. Surgical facemasks worn by patients are recommended by the CDC 

as a means of reducing the spread of influenza in healthcare facilities... We found that total 

viral copies detected by molecular methods were 8.8 times more numerous in fine (≤5 μm) 

than in coarse (>5 μm) aerosol particles and that the fine particles from cases with the 

highest total number of viral RNA copies contained infectious virus. Surgical masks reduced 

the overall number of RNA copies by 3.4 fold. These results suggest an important role for 

aerosols in transmission of influenza virus and that surgical facemasks worn by infected 

persons are potentially an effective means of limiting the spread of influenza. PLOS

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 2 March 2013:

 Influenza: Among US military basic trainees, 12 cases of influenza (A/H3), 3 cases of 

A/H1N1, and 8 cases of influenza B were confirmed by the NHRC laboratory. There was 

an increase in influenza activity at basic training centers from mid-January into February 

and an increase in influenza A/H1N1(09) and B types in February 

 Adenovirus: Type 14 adenovirus cases continue at MCRD Parris Island, though FRI rates 

remain low.

 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 2 March 2013 (Week 9), Army Influenza-Like Illness (ILI) activity 

was slightly higher than the same time last season. For the first time this influenza 

season, influenza B predominated in typed specimens in both the Army and the civilian 

populations.
9

 ILI Activity: Army incident ILI outpatient visits in week 9 were 3% higher than the same 

week last year.

 Influenza cases: Two hospitalized influenza cases were reported to USAPHC in week 9. 

80 hospitalized cases have been reported during this influenza season, 71 in 

dependents and 9 in Active Duty.

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

report. Surveillance testing in previous weeks detected some influenza, mostly influenza 

A viruses.

 Viral specimens: During week 9, 337 of 1330 (25%) laboratory specimens tested were 

positive for respiratory pathogens. Influenza B accounted for 39% of positive 

specimens. Most of the influenza positive specimens were from ERMC (40%); 20% were 

from PRMC, and 17% from WRMC. USAPHC U.S. Army Influenza Activity Report

PANDEMIC AND AVIAN INFLUENZA

NIH study sheds light on role of climate in influenza 

transmission 

8 March - Two types of environmental conditions -- cold-dry and humid-rainy -- are 

associated with seasonal influenza epidemics, according to an epidemiological study led by 

researchers at the National Institutes of Health's Fogarty International Center. The paper, 

published in PLoS Pathogens, presents a simple climate-based model that maps influenza 

activity globally and accounts for the diverse range of seasonal patterns observed across 

temperate, subtropical and tropical regions. The findings could be used to improve existing 

current influenza transmission models, and could help target surveillance efforts and 

optimize the timing of seasonal vaccine delivery, according to Fogarty researcher Cecile 

Viboud, Ph.D., who headed the study. NIH

Study finds small risk of Guillain-Barre Syndrome from 

H1N1 vaccine

13 March - The link between the H1N1 vaccine and GuillainBarré first emerged in 1976, during the U.S.’s last urgent national 

campaign to immunize citizens against a fast-acting flu... H1N1 

immunization was called for again in 2009, however, when 

threat of a related pandemic strain of influenza against which 

most of the population wasn’t immunized, called for a massive vaccination campaign to 

avoid a pandemic. Now the latest study on adverse events reported from those 

vaccinations, published in the Lancet, shows that the risk of Guillain-Barré remained...

Researchers from the National Vaccine Program Office of the U.S. Department of Health and 

Human Services analyzed the data from 23 million people who were vaccinated as part of 
10

that effort and found 61 million cases of H1N1, 274,000 hospitalizations and 12,470 deaths 

related to the pandemic flu. Of those who were immunized, 77 developed Guillain-Barré, 

some as long as 91 days after getting their shot. Since the disorder normally affects about 

one person in 100,000, this results in an additional 1.6 cases of Guillain-Barré syndrome per 

one million people vaccinated — still a small risk. Time

top of page...

VETERINARY/FOOD SAFETY

China: Thousands of dead pigs found in river flowing 

into Shanghai

11 March - More than 3,300 dead pigs have been found in a major river that flows through 

Shanghai, igniting fears among city residents of contaminated tap water, according to 

official reports on Tuesday. Officials were trying to determine who had dumped the 

carcasses into the river, the Huangpu, which slices through the heart of Shanghai. Some 

reports blamed farmers. Officials were seeking to track the source of the pigs from marks on 

their ears, and a preliminary inquiry found that the dumping occurred in Zhejiang Province, 

which is south of Shanghai and upstream on the Huangpu... [T]he first carcasses were 

discovered Thursday near a water treatment plant in an area that is a protected water 

resource. Their numbers increased quickly over the weekend, and the tally was expected to 

grow further as search barges returned to Shanghai. Reuters

Pet frogs linked to salmonella outbreak in kids: CDC

11 March- Small water frogs marketed and sold as pets are linked to an outbreak of 

Salmonella infections from 2008 to 2011, according to a report from the U.S. Centers for 

Disease Control and Prevention (CDC). The report published in Pediatrics on Monday found 

the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to 

the hospital - mostly children. "This was the first Salmonella outbreak associated with 

aquatic frogs, and in this case the frogs are often marketed as good pets for kids," said 

Shauna Mettee Zarecki, the study's lead author from the CDC in Atlanta. Reuters

Ukraine denies 'killer' military dolphins escaped 

12 March - The Ukrainian Defense Ministry has described 

reports that three military dolphins escaped as a 

"fabrication" and a “gross provocation.” 

The website “Sobytiye Kryma” (Events of the Crimea) and 

Russia's RIA-Novosti were among several websites and 

media outlets reporting on March 11 that three dolphins at the Sevastopol Aquarium that 

were part of a Ukrainian military program escaped during a training exercise in the Black 
11

Sea on February 24. At least one of the reports suggested the dolphins were armed. Some 

quoted experts saying the animals swam off in search of mates... Without confirming the 

existence of a military dolphin program, the press center for Ukraine’s Defense Ministry said 

the information in the media reports “does not agree with reality.” Radio Free Europe / 

Radio Liberty

top of page...

WELLNESS

Aspirin may lower melanoma risk

11 March - A new study has found that women who take aspirin have a reduced risk of 

developing melanoma—and that the longer they take it, the lower the risk. The findings 

suggest that aspirin's anti-inflammatory effects may help protect against this type of skin 

cancer... In the Women's Health Initiative, researchers observed US women aged 50 to 79 

years for an average of 12 years and noted which individuals developed cancer... Overall, 

women who used aspirin had a 21 percent lower risk of melanoma relative to non-users. 

Each incremental increase in duration of aspirin use (less than one year of use, one to four 

years of use, and five or more years of use) was associated with an 11 percent lower risk of 

melanoma. EurekAlert!

Azithromycin poses fatal cardiac risk, FDA warns

12 March - The popular antibiotic azithromycin (Zithromax and Zmax, Pfizer) poses the risk 

for a potentially fatal irregular heart rhythm, which therefore warrants careful screening of 

patients for this drug, the US Food and Drug Administration (FDA) announced today. The 

macrolide-class antibiotic can cause abnormal changes in the electrical activity of the heart 

that may prolong the QT interval and trigger a rare, associated arrhythmia called torsades 

de pointes. The FDA stated that patients at risk for this azithromycin-induced arrhythmia 

include those who already have a prolonged QT interval, low blood levels of potassium or 

magnesium, and an abnormally slow heart rate, or who take drugs to treat arrhythmias. 

Elderly patients and patients with cardiac disease also may be more susceptible to the 

arrhythmogenic effects of the antibiotic. Medscape

Benefits of quitting smoking outpace risk of modest 

weight gain 

13 March - The improvement in cardiovascular health that results from quitting smoking far 

outweighs the limited risks to cardiovascular health from the modest amount of weight 

gained after quitting, reports a National Institutes of Health-funded community study. The 

study found that former smokers without diabetes had about half as much risk of 

developing cardiovascular disease as current smokers, and this risk level did not change 

when post-cessation weight gain was accounted for in the analysis. This study is the first 
12

epidemiological effort to directly address the health impact of the weight gain that many 

people experience following smoking cessation. NIH

Chronic insomnia affects heart

11 March - Insomnia may be linked to an increased risk of heart failure, according to a large 

new study, and the more insomnia symptoms, the greater the risk. The study, published last 

week in The European Heart Journal, used questionnaires to gather data on difficulty falling 

asleep, difficulty staying asleep, and waking unrefreshed among more than 54,000 

Norwegian adults in a population-wide health survey. All were free of heart disease at the 

start of the study; there were 1,412 cases of heart failure over an average of 11 years of 

follow-up. After controlling for numerous health, behavioral and demographic factors, the 

researchers found that having one symptom of insomnia was associated with a 17 percent 

increase in the risk of developing heart failure. Having two symptoms increased the chances 

by 92 percent, and having all three nearly tripled the risk. New York Times

Self-tracking apps to help you 'quantify' yourself

12 March - Technology has made it easier than ever to track your activity levels, your sleep 

cycles, how you spend your time, and more. The self-trackers who near-obsessively capture 

and analyze their own data are part of a growing "Quantified Self" movement. Interested in 

giving self-tracking a try? Self-tracker Peter Zandan, an executive at Hill+Knowlton 

Strategies who headed up a panel on Quantified Self this year at South by Southwest, 

helped us curate this list of apps and devices to get more data feedback from your daily life.

If you're just getting started, the most "mainstream" self-tracking devices are the Fitbit, 

Jawbone UP, and Nike Fuelband. Apple's getting in on this wristband-tracking market with 

its iWatch, which is expected to come out at the end of this year. For heart rate monitoring 

devices, Garmin and Polar both make options that self-trackers like. Food monitoring apps 

include MyFitnessPal and MyPlate. "[These are] great for folks who want to do more than 

count calories," Zandan said. NPR

Sleep less, eat more, gain weight

11 March - Tired? Surely those cookies will help. And a burger. Chips. And a cupcake. Yeah, 

soda, too. People do eat more when they're short of sleep. And that impulse to snarf when 

sleepy can cause quick weight gain, according to a new study. Since Americans are 

chronically sleep deprived, it's no wonder that our waistlines have been expanding. Onethird of American workers say they're sleeping six or fewer hours a night, compared with the 

seven to nine hours recommended. In the experiment, people who were allowed to sleep 

just five hours a night ate more than when they got nine hours of shuteye. In five days of 

shortened sleep, they gained almost 2 pounds. NPR

Walgreen sued over Vitamin E supplement claims

11 March - Walgreen Co has been sued by a California woman who accused the largest U.S. 

drugstore chain of deceiving customers into believing its Vitamin E dietary supplement 

contributes to cardiovascular health. The complaint, filed on Friday in federal court in 
13

Chicago, challenges a label on Walgreen's Vitamin E 400 IU Dietary Supplement that says 

the product "naturally contributes to cardiovascular health by helping to protect LDL 

cholesterol from oxidation which may cause cellular damage." Andrea Trujillo, the plaintiff, 

said the representation was false and misleading because clinical studies show that Vitamin 

E does not work as the retailer advertised. Reuters

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USAFRICOM

In Africa, corruption dirties the water

14 March - Collusion among government officials, unscrupulous water vendors and large 

farm owners results in diverted water supply lines, misappropriated funds, and failure to

implement laws on protecting water sources from encroachment and pollution. These are 

just some of the ways corruption is denying millions of poor people in Africa access to safe 

and clean drinking water, experts say. “The impact of corruption on the water sector is 

manifested by lack of sustainable delivery, inequitable investment and targeting of 

resources, and limited participation of affected communities in developmental processes,” 

Bethlehem Mengistu, regional advocacy manager at the NGO Water Aid, told IRIN. IRIN

Kenya’s waste management challenge

13 March - As the urban population in Nairobi and elsewhere in 

East Africa grows, so does the solid waste management burden 

- a situation worsened by poor funding for urban sanitation 

departments and a lack of enforcement of sanitation 

regulations. At least 100 million people in East Africa lack access 

to improved sanitation, according to UN sources. “Due to budgetary deficiencies, town 

authorities find it difficult to address solid waste management in a sustainable manner. In 

addition, insufficient public awareness and enforcement of legislation is also a hindrance,” 

Andre Dzikus, coordinator of the urban basic services section of the UN Human Settlement 

Programme (UN-HABITAT), told IRIN. In Nairobi, a large percentage of solid waste is 

managed by the private sector and NGOs due to public-private partnerships, says Dzikus. 

The city council’s solid waste department, like those in Kampala and Dar es Salaam, is not 

well equipped, with transport vehicles few and often poorly serviced, despite increasing 

waste quantities due to rapid urbanization, he added. IRIN

Niger: 17 killed in measles outbreak

14 March - A total of 17 people have been confirmed dead due to measles outbreak in 

central Nigeria's Niger State, a health official said on Tuesday. State Commissioner for 

Health Ibrahim Sule confirmed the figure to reporters in Minna, the state capital, saying 

about 620 cases of the outbreak had been recorded in the state since January. News 24
14

Nigeria: Vaccine suspicion aggravates measles outbreak

13 March - An ongoing measles outbreak, which killed 36 children and infected over 4,000 

in northern Nigeria between 16 February and 9 March, has been linked to a drop-off in 

immunizations due to vaccine shortages in regional health clinics and widespread suspicion 

of the vaccine, say government health officials. Many parents have declined to vaccinate 

their children against measles as they believe the vaccine is harmful, according to Ado 

Mohammed, director-general of Nigeria's National Primary Health Care Development 

Agency (NPHCDA). "Parents are largely to blame... for their refusal to have their children 

immunized against preventable diseases including measles due to unfounded suspicion that 

such vaccines are harmful to children, following persistent rumours that polio vaccine 

causes infertility in children," he told IRIN. IRIN

South Sudan's gender gap still too wide

8 March - Years after the end of South Sudan’s war with Sudan, the country’s women still 

find themselves on the front line - this time, battling abuse, child marriage, and a dowry 

system that commodifies them from birth. According to an assessment of gender-based 

violence (GBV) in South Sudan, released by the Conflict and Health Journal on 6 March, 68 

percent of females and 63 percent of males - out of a sample of 680 respondents - agreed 

that “there are times when a woman deserves to be beaten”. “You can’t speak to people 

about going to the police if they don’t even think it’s wrong,” said Paleki Matthew, who runs 

the NGO South Sudan Women’s Empowerment Network. IRIN

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USCENTCOM

Afghanistan: Taliban stopping polio vaccinations, says 

Afghan governor

12 March - The Taliban have halted an annual polio vaccination 

campaign in a remote part of Afghanistan, according to a 

senior official, raising concerns that opposition to the critical 

immunisation drive could be spilling across from insurgent 

groups in neighbouring Pakistan. The Taliban have controlled 

parts of poor, isolated and mountainous Nuristan province for several years, but they have 

never before prevented medical workers reaching children in their strongholds, said the 

governor Tamim Nuristani. "For the past three years Waygal district has been under the 

Taliban, they are very strong there. For the last two years the vaccine process went on in the 

district, but this year they stopped it," he told the Guardian by phone from the provincial 

capital, an island of government control in the restive area. Guardian
15

Pakistan: Fight against polio - tribesmen fined by 

militants for vaccinating their children

9 March - Salman Afridi*, a resident of Bachi Nehar in Sipah, Bara, said around 20 families in 

Speen Qabar and Bachi Nehar, Sipah vaccinated their children against polio. After the 

vaccination team left the area on Thursday evening, militants of banned outfit Lashkar-eIslam (LI) arrived in four vehicles and surrounded the area, said Salman. They then took 

parents of the immunised children to a ground and trussed them up, he added. According 

to Salman, a local LI commander, identified as Nazar had warned the tribesmen not to 

vaccinate their children. Approximately 20 people were tied by Nazar, who demanded 

Rs20,000 be paid for their release. Shahbaz Khan Afridi* from Speen Qabar, Sipah said those 

who paid the fine were released with a warning to refrain from further immunisation, which 

was deemed “a conspiracy against Islam by infidels”... Residents of Sipah have decided to 

boycott future anti-polio campaigns. Express Tribune

U.N.: Number of Syrian refugees escalating at rapid rate

10 March - The number of Syrian refugees could double -- if not triple -- by the end of the 

year if the crisis continues without change, a U.N. official said Sunday. Since the civil war 

began two years ago, more than 1 million have fled the country. The number of refugees 

recorded has gone from 3,000 on average each day in December to 8,000 daily in February, 

Antonio Guterres, the U.N. high commissioner for refugees, said Sunday in Ankara, Turkey. 

"Now if this escalation goes on -- and nothing happens to solve the problem -- we might 

have in the end of the year a much larger number of refugees, two or three times ... the 

present level." In December, the U.N.'s Regional Response Plan for Syrian Refugees 

estimated that 1.1 million displaced Syrians would move to surrounding countries by the 

end of June. The group now predicts that figure will be exceeded this month. Most flee to 

surrounding countries, such as Lebanon, Jordan, Turkey, Iraq and Egypt, but they are 

increasingly going to North Africa and Europe, according to the U.N. CNN

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USEUCOM

Europeans are world’s biggest smokers and drinkers: 

WHO

12 March- Europeans are the world’s biggest smokers and drinkers, according to a World 

Health Organization report that says higher prices on cigarettes and alcohol in the region 

may help curb the death and disease they cause. On average, 27 percent of people over 15 

smoke across the 53 nations that make up the WHO’s European region, higher than in any 

other part of the world, the Geneva-based agency said today in its triennial health report on 

the continent, home to 900 million people. Europeans also consume an average of 10.6 

liters of alcohol a year, more than in any other region, according to the report. Bloomberg
16

U.K.: Thirty eight hospitalised as measles cases in 

Swansea outbreak reaches 252

14 March – Health chiefs in Wales are urging parents to make sure their children receive the 

MMR vaccination as cases in the Swansea area outbreak reach 252, with 43 new cases 

reported in the past week alone. A total of 38 people - one in six who have contracted 

measles in this outbreak - have been hospitalised... The majority of the new cases are in the 

Swansea area but cases are being reported across South East Wales. This is South Wales

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USNORTHCOM

Royal Caribbean cruise ship hit by virus; 108 sick

8 March - Royal Caribbean Cruises Ltd said on Friday that 108 people fell sick with a 

gastrointestinal illness believed to be a norovirus on its Vision of the Seas ship, which 

docked in Port Everglades, Florida, at the end of an 11-day trip. The outbreak was the latest 

black eye for the cruise industry, trying to regain its sea legs after several high-profile 

mishaps. Royal Caribbean said those sickened had responded well to the over-the-counter 

medicine they were given. It said 105 of 1,991 passengers and 3 of 772 crew members 

aboard fell ill. Reuters

U.S.: Dengue fever no longer just a visitor to Florida Keys

13 March - ... After a 60-year hiatus, the mosquito-borne illness dengue fever has now 

officially re-established itself [in the Florida Keys.] People infected during a recent outbreak 

in Florida didn't catch the virus abroad but rather got a strain that's unique to Key West, 

virologists at the Centers for Disease Control and Prevention report Wednesday in the 

journal Emerging Infectious Disease. The virus has been circulating around the Key West 

population for at least two years, the researchers say, and it has evolved its own genetic 

fingerprint, distinct from dengue in Central America and the Caribbean... Dengue fever was 

endemic in the U.S. before World War II, until the U.S. Army led aggressive mosquitoeradication campaigns to stop malaria among troops. Their efforts wiped out malaria in the 

U.S. and took dengue along with it. But in the past decade or so, the virus and its primary 

transmitter, the Aedes aegypti mosquito, have been slowly making their way back into 

Florida. NPR

U.S.: Fatal Md. rabies case is first in state since 1976

12 March - Maryland health officials said Tuesday that an adult resident has died of rabies, 

the state’s first case of human rabies in nearly four decades. Health officials said they did 

not know how the person was exposed to the rabies virus. To protect the privacy of the 

family, they provided no additional information about the individual or location of death. In 
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a statement, the Maryland Department of Health and Mental Hygiene said doctors and 

public health officials are assessing the risk of rabies exposure in people who had direct 

contact with the individual. When people are exposed to rabies, it is usually because of a 

bite from an infected animal, not from contact with another person. The last case of human 

rabies was in 1976, the statement said. Washington Post

U.S.: Judge blocks New York City large-soda ban, Mayor 

Bloomberg vows fight

12 March - New York City Mayor Michael Bloomberg vowed on Monday to appeal a judge's 

ruling that struck down his pioneering ban on large sugary drinks sold by the city's 

restaurants, movie theaters and other food service businesses just a day before it was to 

take effect. The judge called the ban "arbitrary and capricious" in an 11th-hour decision that 

dealt a serious blow to Bloomberg, who has made public health a cornerstone of his 

administration, with laws prohibiting smoking in restaurants, bars and parks; banning trans 

fats; and requiring chain restaurants to post calorie counts. Reuters

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USPACOM

Bangladesh: Nipah Infection in 2013

12 March - Situation Update: 19 Nipah cases were identified. Among them 17 died 

(mortality rate 89%). These cases are from 13 districts (Gaibandha, Natore, Rajshahi, 

Naogaon, Rajbari, Pabna, Jhenaidah, Mymensingh, Nilphamari, Chittagong, Kurigram, 

Kustia). Age distribution of cases are 8 months to 55 years among them 13 are male and 6 

are female.

Transmission: 1. Drinking of raw date palm sap (kancha khejurer rosh) contaminated with 

NiV; 2. Close physical contact with Nipah infected patients Institute of Epidemiology, 

Disease Control and Research

Papua New Guinea grapples with ageing health 

workforce

14 March - Papua New Guinea (PNG) is a Pacific country rich in natural resources, yet its 

health staffing levels are comparable to the world’s poorest countries due to a rapidly 

retiring force and lack of qualified replacements... Despite repeated warnings of the 

shortage, first at a 2002 national health conference, again in 2008 during a government 

health resources forum, and most recently by a 2011 World Bank report, the country still 

faces what the government calls a “drastic” health worker shortage. The World Bank report 

predicted a large decline in the “backbone of rural service delivery” (nurses and midwives) -

by up to half. IRIN
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Thailand struggles to curb high teen pregnancy rate

7 March - ... Thailand's teenage pregnancy rate is the highest in Southeast Asia after 

neighboring Laos, according to the Bureau of Reproductive Health at the Thai Public Health 

Ministry. In fact, even though the overall birthrate is dropping, teen births are on the rise. 

Out of every 1,000 live births, 54 are from teen mothers aged 15-19 - higher than in the 

United States and ten times higher than Singapore's teen pregnancy rate. What's more, it's 

rising fast. The number of live births by Thai teenage mothers aged 15-18 increased 43 

percent between 2000 and 2011, a Thai annual public health report shows. Though there 

are many factors responsible, health experts put weight on cultural mores that make frank 

discussion of the issue difficult, whether in an official context or a personal one. Reuters

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USSOUTHCOM

Haiti recycles human waste in fight against cholera 

epidemic

10 March - It's a modern-day alchemy that is, on a small scale at least, helping Haitians turn 

something deadly into something valuable... Every week, Soil (Sustainable Organic 

Integrated Livelihoods) collects the human waste from 56 dry toilets built in camps for 

displaced earthquake victims, and mixes it with chips of sugar cane bagasse, a byproduct of 

local rum production... The Haitian government recently built several sewage treatment 

plants that process traditional pit latrine waste in open-air stabilisation ponds. It and 

sewage treatment companies such as Jedco are experimenting with the alchemy of 

transforming a potentially deadly substance into a rich and much-needed fertiliser. 

Guardian

South Americans face upheaval in deadly water battles

13 February- The injured and dead in Celendin, 800 kilometers (500 miles) north of Lima, are 

victims in a continent-wide conflict that pits South American governments and big, often 

foreign- based companies against people who stand to lose their homes as water is 

diverted to industrial uses. Leaders across the region, elected on promises to fuel economic 

growth and lift their populations out of poverty, are fast tracking water-use approvals for 

projects like the Conga mine... South America has more water than any other region on 

earth, with 29 percent of the world’s reserves, according to the United Nations Food and 

Agriculture Organization. The rub is that the water isn’t always where the best mineral or 

agricultural resources are located. Bloomberg

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