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7 June 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

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Contents

U.S. MILITARY

 Can the active component U.S. military achieve tuberculosis elimination?

 Hearing Center tackles troops’ no. 1 health problem

 Military leaders: Sexual assault "like a cancer"

 PTSD may be prevented, researchers find

 VA mental health summits aim to improve care

GLOBAL

 Group therapy helps rape victims in poor countries

 Hand, foot and mouth disease: First vaccine

 Measles is serious: Take care before and after travel

 Middle East respiratory syndrome coronavirus (MERS-CoV) – WHO update

 New tools to hunt new viruses

 Pressure grows to create drugs for ‘superbugs’

 UN: Global malnutrition costs are unacceptable

 Vinegar could save tens of thousands of lives

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

 Double dose of Tamiflu proves no better in severe flu

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

 PANDEMIC AND AVIAN INFLUENZA

 H7N9 bird flu drug resistance concern

 Human infection with avian influenza A(H7N9) virus – WHO update

VETERINARY/FOOD SAFETY

 Multistate 30-case hepatitis A outbreak may be linked to frozen berry mix

 Saudis to send animal samples to US in MERS-CoV probe
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WELLNESS

 Gene flaws that raise breast cancer risk are common in black women

 Smoking alcohol: The dangerous way people are getting drunk

 Vegetarian diet tied to fewer deaths over time

 Warning: Men's natural sex supplements may not be

 WHO urges ban on tobacco advertising

USAFRICOM

 Africa: Study – bad teeth, gums major problems

 DRC: Suspected Ebola fever surfaces

 Ethiopia: Yellow fever

 Kenya: Polio outbreak in refugee complex being contained, say UN agencies

USCENTCOM

 Egypt: Colon cancer “a catastrophe for families”

 Pakistan: Death toll from measles in Punjab reaches 133

 Syria: WHO warns of disease threat

USEUCOM

 EU to fine Lundbeck, others for blocking generic drugs

 France: Coronavirus death reported

 France: Elderly more likely to wait in French ERs, study

 Israel: Poliovirus detected from environmental samples

USNORTHCOM

 U.S., Alaska: Health care is spread thin on Alaskan frontier

 U.S.: Fittest US cities take exercise publicly, personally

 U.S.: Heat-related deaths after an extreme heat event — Four States, 2012, and United States, 

1999–2009

 U.S.: More adult prescription drug use leads to increased poisonings in kids

 U.S.: The $2.7 trillion medical bill

USPACOM

 China: 'Cancer villages' a reality of life

 South Korea: Four die from tickborne disease

USSOUTHCOM

 Brazil drops 'happy being a prostitute' ad campaign

 Haiti: Cholera
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U.S. MILITARY

Can the active component U.S. military achieve 

tuberculosis elimination?

May 2013 - The rate of tuberculosis (TB) disease in the active component United States 

(U.S.) military, 0.6 per 100,000 population, is very close to the Centers for Disease Control 

and Prevention’s (CDC’s) goal for TB elimination, defined as less than one per million.

Although this goal may be unattainable for several decades due to changes in the 

epidemiology of the disease and fiscal restrictions on control programs, a resurgence of TB 

in the U.S. military can be avoided through the implementation of an efficient, high quality 

program to control TB infection and disease. To achieve this goal, the articles in this 

month’s MSMR suggest that emphasis should be placed on: 1) targeted testing for latent TB 

infection (LTBI), particularly at the time of accession into military service, and 2) genotyping 

all cases of TB disease to further inform epidemiology and control efforts. Medical 

Surveillance Monthly Report

Hearing Center tackles troops’ no. 1 health problem

30 May - Post-traumatic stress disorder and traumatic brain injury are often called signature 

wounds of the wars in Afghanistan and Iraq. But there is a more common affliction for 

today’s combat veterans: hearing problems. In the past decade of war, more than 350,000 

service members have reported tinnitus --ringing in the ears – and more than 250,000 have 

reported hearing loss, making them the No. 1 and No. 2 reported service-connected 

disabilities. Just as it led in treatment for PTSD, TBI and amputations, the Defense 

Department is leading progress on auditory system injuries. In response to the growing 

prevalence and rising costs, including veterans’ benefits, of military hearing loss and 

auditory injuries, the Defense Department called for the creation of the center, which 

Congress funded in the 2009 National Defense Authorization Act. MHS

Military leaders: Sexual assault "like a cancer"

4 June - Military leaders said Tuesday that sexual assault in the ranks is "like a cancer" that 

could destroy the force, but they expressed serious concerns about far-reaching 

congressional efforts to strip commanders of some authority in meting out justice. In an 

unusual joint appearance, Army Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, 

and the head of each branch of the military testified on what is widely viewed as an 

epidemic of sexual assault plaguing the services. "The risks inherent to military service must 

never include sexual assault," said Army Gen. Martin Dempsey. "We can and must do more 

to protect victims." CBS News
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PTSD may be prevented, researchers find

5 June - Experts estimate that up to 20% of U.S. troops 

returning from Iraq and Afghanistan suffer from post-traumatic 

stress disorder, a condition that can be stubbornly difficult to 

treat. But what if PTSD could have been prevented in the first 

place? Scientists have done something similar in traumatized 

mice. Days after a harrowing experience being restrained on wooden boards, they were 

given a drug that triggers a brain receptor thought to be involved in how mice — and 

people — respond to fear. "We prevented PTSD-like symptoms," said Emory University 

neuroscientist Raul Andero Gali, lead author of a study published Wednesday in the journal 

Science Translational Medicine. Los Angeles Times

VA mental health summits aim to improve care

3 June - The Veterans Affairs Department will host mental health summits at all 151 VA 

medical centers from July to mid-September in an effort to improve coordination between 

VA and community behavioral health providers, President Obama announced today. The 

meetings will bring together mental health specialists, government officials and veterans 

service organizations to facilitate cooperation, with a goal to improve mental health 

outreach and treatment for veterans. The summits will build on lessons learned from a VA 

pilot program available in nine states where veterans have access to community mental 

health providers. Army Times

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GLOBAL

Group therapy helps rape victims in poor countries

5 June - Group therapy works better than individual support for 

women in low-income countries who have been victims of 

sexual violence, according to the results of a new study done in 

the Democratic Republic of Congo (DRC). The method has 

already been shown to be effective in wealthier countries. 

Because measures of depression, anxiety, general functioning and post-traumatic stress 

disorder improved faster with group therapy, the technique may be useful in other countries 

were war and unrest often contribute to sexual violence, researchers reported in the New 

England Journal of Medicine. Reuters
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Hand, foot and mouth disease: First vaccine

28 May - The first vaccine which protects children against 

hand, foot and mouth disease has been reported by 

scientists in China. The infection causes a rash and painful 

blisters, but in some cases results in brain infections which 

can be fatal. A trial involving 10,000 children, published in 

the Lancet, showed the vaccine was 90% effective against one virus which causes the 

disease. It does not protect against other viruses that result in the disease. BBC

Measles is serious: Take care before and after travel

3 June - Are you traveling overseas? Make sure you and your family are vaccinated for 

preventable diseases before you travel. Did you know that measles is one of the most 

contagious diseases in the world? Measles is spread through the air by breathing, coughing, 

or sneezing. It is so contagious that anyone who is exposed to it and is not immune will 

probably get the disease. Symptoms include fever; runny nose; red, watery eyes; cough; and 

a rash all over the body. Measles can cause serious illness, even death. CDC

Middle East respiratory syndrome coronavirus (MERSCoV) – WHO update 

5 June - The Ministry of Health in Saudi Arabia has notified WHO of an additional 

laboratory-confirmed case with Middle East respiratory syndrome coronavirus (MERS-CoV).

The patient is a 14-year-old girl with underlying medical conditions who became ill on 29 

May 2013. She is reported from the Eastern region, but not from Al-Ahsa where an outbreak 

began in a health care facility since April 2013. The patient is in stable condition. Globally, 

from September 2012 to date, WHO has been informed of a total of 54 laboratoryconfirmed cases of infection with MERS-CoV, including 30 deaths. WHO

New tools to hunt new viruses

27 May - A new flu, H7N9, has killed 36 people since it was first found in China two months 

ago. A new virus from the SARS family has killed 22 people since it was found on the 

Arabian Peninsula last summer. In past years, this might have been occasion for panic. Yet 

chicken and pork sales have not plummeted, as they did during flus linked to swine and 

birds. Travel to Shanghai or Mecca has not been curtailed, nor have there been alarmist calls 

to close national borders. Is this relatively calm response in order? Or does the simultaneous 

emergence of two new diseases suggest something more dire? Actually, experts say, the 

answer to both questions may well be yes. New York Times

Pressure grows to create drugs for ‘superbugs’

2 June - Government officials, drug companies and medical experts, faced with outbreaks of 

antibiotic-resistant “superbugs,” are pushing to speed up the approval of new antibiotics, a 

move that is raising safety concerns among some critics. The need for new antibiotics is so 
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urgent, supporters of an overhaul say, that lengthy studies involving hundreds or thousands 

of patients should be waived in favor of directly testing such drugs in very sick patients. 

Influential lawmakers have said they are prepared to support legislation that allows for 

faster testing. New York Times

UN: Global malnutrition costs are unacceptable

4 June - Global hunger, poor nutrition and obesity are costing the world trillions of dollars 

in health costs and lost productivity, according to a new report from the U.N. Food and 

Agriculture Organization (FAO). The FAO report says fighting hunger is not enough. 

Tackling the more complex problem of malnutrition calls for action across the entire food 

system, from farm to fork. About 870 million people worldwide are hungry, according to the 

FAO. But malnutrition is about more than just hunger. VOA

Vinegar could save tens of thousands of lives

3 June - In some parts of the world, cancer patients are 

treated with some of the newest targeted cancer drugs 

which can cost more than$100,000 per year, while in other 

regions, patients don't even know they have cancer 

because they're not being screened. But where pap smears 

are not available, there may be a decidedly low-tech way to screen for cervical cancer and 

reduce cancer deaths, according to a large clinical trial released Sunday at the annual 

meeting of the American Society of Clinical Oncology (ASCO) in Chicago: swabbing a 

woman's cervix with vinegar. This study out of India is one of the top five out of more than 

5,300 studies presented at the conference. It was given a spotlight usually reserved for the 

newest blockbuster drug research. CNN

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INFLUENZA

CDC: Weekly Influenza Surveillance Report

During week 21, 6.3% of all deaths reported through the 122-Cities Mortality Reporting 

System were due to P&I. This percentage was below the epidemic threshold of 6.9% for 

week 21. FluView
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DoD Global Laboratory-Based Influenza Surveillance 

Program

Week 21, 19-25 May:

 To date this influenza season, 3,759 specimens have been tested from 81 locations 

of which 1,072 were positive for influenza A (952 A(H3N2), 110 A(H1N1)pdm09, five 

co-infections, and five A/not subtyped).

 To date this influenza season, 367 specimens were positive for influenza B. Of these, 

there were 71 B/Yamagata, 19 B/Victoria, and two B & enterovirus co-infections. 

The lineage is pending or unknown for 275 specimens. USAF School of Aerospace 

Medicine

Double dose of Tamiflu proves no better in severe flu

30 May - There are no benefits from giving patients with severe flu a double dose of 

Roche's drug Tamiflu, despite calls by some experts for the use of higher doses in the most 

serious cases. That verdict from the first randomized clinical trial to study the issue has 

implications for global guidelines on stockpiling drugs for a potential flu pandemic, 

researchers said on Friday. "Our findings do not support routine use of double doses to 

treat severe flu infections, which could help to conserve drug stocks in the event of a 

pandemic," said Jeremy Farrar, director of the South East Asia Infectious Disease Clinical 

Research Network. MedlinePlus

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

Weeks 19-20/2013:

 For weeks 19 and 20/2013, all 25 participating countries reported low-intensity 

transmission, doing so for the fourth consecutive week. 

 The proportion of influenza-positive sentinel specimens (5%) has continued to 

decrease since the peak observed in week 5/2013 (61%). 

 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(H1)pdm09 viruses was 62%. 

 The 2012–13 influenza season is now over. Weekly Influenza Surveillance Overview
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PANDEMIC AND AVIAN INFLUENZA

H7N9 bird flu drug resistance concern

28 May - Drug resistance has been detected in patients 

infected with the new bird flu that has emerged in China, 

say doctors. The H7N9 virus became resistant to Tamiflu in 

three out of 14 patients treated with antiviral drugs at 

Shanghai Public Health Clinical Centre. The researchers, 

writing in the Lancet, said resistance emerged with "apparent ease" and was "concerning". 

There have been no new cases of the infection for more than two weeks. BBC

Human infection with avian influenza A(H7N9) virus –

WHO update

29 May - The National Health and Family Planning Commission, China notified WHO of an 

additional laboratory confirmed case of human infection with Avian Influenza A(H7N9) virus.

The patient is a six-year-old boy reported from Beijing who became ill on 21 May 2013 and 

is in stable condition. To date, WHO has been informed of a total of 132 laboratoryconfirmed cases, including 37 deaths. WHO

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VETERINARY/FOOD SAFETY

Multistate 30-case hepatitis A outbreak may be linked to 

frozen berry mix

31 May - Thirty people in five states have contracted hepatitis A in an outbreak possibly 

linked to a frozen berry blend, the CDC reported today. The same strain, genotype 1B, was 

involved in an outbreak in Europe this year linked to frozen berries and a 2012 outbreak in 

British Columbia tied to a frozen berry blend, the agency said. Patients' ages range from 25 

to 71 years, and two thirds are women. Illness-onset dates range from Apr 28 to May 17, 

and nine of the patients have been hospitalized. No deaths have been reported. Of 17 

patients interviewed, 11 (65%) reported eating Townsend Farms Organic Anti-Oxidant 

Blend, a frozen berry and pomegranate seed mix, and 11 people who provided purchase 

information said they bought this product at Costco markets. Costco has removed the 

products from its shelves and alerted customers who bought the mix since late February. 

Patients are from Colorado, New Mexico, Nevada, Arizona, and California. CIDRAP
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Saudis to send animal samples to US in MERS-CoV 

probe

24 May - Saudi Arabian officials announced today that they plan to send animal samples to 

the United States as part of the hunt for the source of Middle East respiratory syndrome 

coronavirus (MERS-CoV), and also reported that testing of scores of human samples has 

revealed no new cases in the past 2 days. Ziad Memish, MD, Saudi Arabia's deputy minister 

of public health, said in Geneva that samples from bats and other animals, including camels, 

sheep, and cats, would be sent to the United States, according to an Agence France-Presse 

(AFP) story today. CIDRAP

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WELLNESS

Gene flaws that raise breast cancer risk are common in 

black women

4 June - Gene flaws that raise the risk of breast cancer are surprisingly common in black 

women with the disease, according to the first comprehensive testing in this racial group. 

The study found that one-fifth of these women have BRCA mutations, a problem usually 

associated with women of Eastern European Jewish descent but recently highlighted by the 

plight of Angelina Jolie. The study may help explain why black women have higher rates of 

breast cancer at young ages – and a worse chance of survival. TIME

Smoking alcohol: The dangerous way people are getting 

drunk

5 June - To get drunk, people are getting creative. But a new 

form of drinking, known as “smoking” alcohol, has doctors 

concerned. Whatever happened to taking shots? Any sort of 

excessive drinking is dangerous, be it via beer bongs or pouring 

shots into the eye socket. But now some drinkers are taking it 

even further and “smoking” alcohol. The questionable practice, which has potentially scary 

consequences, has various permutations. TIME

Vegetarian diet tied to fewer deaths over time

3 June - People who limit how much meat they eat and stick to mostly fruits and vegetables 

are less likely to die over any particular period of time, according to a new study. "I think 

this adds to the evidence showing the possible beneficial effect of vegetarian diets in the 

prevention of chronic diseases and the improvement of longevity," said Dr. Michael Orlich, 

the study's lead author from Loma Linda University in California. In 2012, a Gallup poll 

found about 5 percent of Americans reported to be vegetarians. Reuters
10

Warning: Men's natural sex supplements may not be

30 May - Conventional wisdom tells us that natural 

remedies are simply gentler alternatives to prescription 

drugs like Viagra and Cialis, right? Not so fast, say experts. 

Not only are many dietary supplements marketed for 

erectile dysfunction and other male sexual problems 

ineffective, they may not even be "natural." In fact, a number of these supplements are 

adulterated with the very prescription drugs they claim to replace, according to a recent 

report published in a recent issue of JAMA Internal Medicine. CNN

WHO urges ban on tobacco advertising

30 May - May 31 is World No Tobacco Day. The message from the World Health 

Organization to governments around the globe is to ban tobacco advertising, promotion 

and sponsorship. That's to try and prevent children from taking up smoking and to 

encourage smokers to quit. Tobacco kills nearly six million people every year, and the 

numbers are only expected to rise. VOA

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USAFRICOM

Africa: Study – bad teeth, gums major problems

31 May - A new report says nearly four-billion people - more than half the world's

population - have major tooth decay, or cavities. Health officials warn that poor oral health 

can lead to social and psychological problems. Professor Wagner Marcenes led of team of 

researchers as part of the Global Burden of Disease 2010 study. It listed untreated tooth 

decay, or cavities, as the most common of all 291 major diseases and injuries. "It was a 

massive effort. We had about 500 scientists work on it. And we reviewed all literature, all 

data on all disease and then came with estimations -- that was the report that has been 

recently published," he said. All Africa

DRC: Suspected Ebola fever surfaces

30 May - The United Nations is reporting a suspected 

outbreak of Ebola fever in the north of the Democratic 

Republic of Congo. The suspected cases have been found 

in the Mongo health zone in Aketi territory, about 200 

kilometers from the border with the Central African 

Republic and about 700 kilometers from the Ugandan border. The news was announced 

Wednesday by the U.N.'s Office for the Coordination of Humanitarian Affairs (OCHA). VOA
11

Ethiopia: Yellow fever

31 May - The Ministry of Health of Ethiopia is launching an emergency mass-vaccination 

campaign against yellow fever from 10 June 2013. This is in response to laboratory 

confirmation of six cases in the country on 7 May 2013. The campaign aims to cover more 

than 527, 000 people in the following six districts: South Ari, North Ari, Benatsemay, 

Selamago, Hammer, and Gnangatom and one administrative town (Jinka) in South Omo 

Zone of the Southern Nations, Nationalities and Peoples’ region (SNNPR) of Ethiopia. WHO

Kenya: Polio outbreak in refugee complex being 

contained, say UN agencies

31 May - United Nations agencies and their partners are carrying out an intensive 

vaccination campaign to contain a polio outbreak in the world's largest refugee camp, 

Dadaab complex in north-eastern Kenya. Around 288,000 children aged 0 to 15 years are 

being targeted in the campaign, according to a news release issued by the World Health 

Organization (WHO) and the UN High Commissioner for Refugees (UNHCR). Since the first 

case was discovered on 17 May, laboratory tests have confirmed that four more people 

have polio, a highly infectious disease caused by a virus that invades the nervous system 

and can cause total paralysis in a matter of hours. All Africa

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USCENTCOM

Egypt: Colon cancer “a catastrophe for families”

31 May - Colon cancer in Egypt is more deadly and destructive 

than elsewhere, yet less understood. A new study adds to a 

small body of research, through which a picture is emerging: 

colorectal cancer, commonly known as colon cancer, strikes 

younger people in Egypt far more frequently than it does in 

Europe or the US, making it much more lethal and socially destructive. Yet, while colorectal 

cancer in European and North American contexts is well-studied, researchers have 

uncovered far less about the causes of the abnormally high rates of early-onset colorectal 

cancer in Egypt. IRIN

Pakistan: Death toll from measles in Punjab reaches 133

3 June - Lahore, the capital of Pakistan's Punjab province, saw 3 children die of measles 

yesterday, bringing the total number of deaths from the infection in that city to 81, says an 

item today in the country's The Nation newspaper. Total measles deaths in the entire 

province as of yesterday had reached 133. A ProMED-mail item from last week said that 

more than 14,000 children in Punjab were suffering from the disease. The situation is 

causing great concern among officials in Pakistan, as the outbreak is occurring despite a 

measles vaccination drive there. CIDRAP
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Syria: WHO warns of disease threat

4 June - The World Health Organization is warning of an 

increased risk of disease epidemics in Syria and 

neighbouring countries as summer approaches. The WHO 

says outbreaks of diseases carried in water - specifically 

hepatitis, typhoid, cholera and dysentery - are inevitable, 

given the severe disruption to Syria's health system. Cases of diarrhoea and hepatitis-A have 

more than doubled since January. There have also been outbreaks of measles and typhoid. 

According to the WHO, at least 35% of the country's public hospitals are out of service, and 

in some areas, up to 70% of the health workforce has fled. BBC

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USEUCOM

EU to fine Lundbeck, others for blocking generic drugs

3 June - European regulators will clamp down on "pay-for-delay" deals in the 

pharmaceutical sector this month, fining Denmark's Lundbeck and eight other generic drug 

manufacturers for limiting access of cheaper products to the market. Following an inquiry 

launched in 2009, the European Commission, the EU's anti-trust regulator, will impose a 

"significant" fine on Lundbeck and lesser fines on Germany's Merck KGaA and seven smaller 

drug firms when it announces the sanctions later this month, two officials said. The fines 

underscore the determination of EU and U.S. regulators to break agreements that involve 

brand name drug companies paying generic manufacturers not to deliver cheaper drugs to 

the market, a process that ultimately harms consumers. European regulators have estimated 

that consumers are paying up to 20 percent more for medicines in some cases. Reuters

France: Coronavirus death reported

28 May – A patient infected with the novel coronavirus has died in France, according to the 

health ministry. The virus, which is similar to those which cause Sars and the common cold, 

emerged last year. Out of 44 confirmed cases around the world, 23 people have now died 

with most infections linked to travel to the Middle East. The virus causes pneumonia and, 

sometimes, organ failure. Most patients have had other health problems. The 65-year-old, 

who had been travelling in Dubai, died in hospital on Tuesday. Another patient who shared 

a hospital room with the man has caught the infection. BBC

France: Elderly more likely to wait in French ERs, study

5 June - People age 75 and older are more likely than younger patients to wait longer than 

they should in emergency rooms, according to a new study from France. The study's lead 

author cautioned, however, that the finding doesn't mean older patients receive worse care 
13

or that they should avoid going to the ER. Instead, "we want to highlight the fact that 

physicians may be reluctant to see difficult patients, old patients and sick patients," said Dr. 

Yonathan Freund, an emergency physician at the Hospital Pitié-Salpetriere in Paris. "I'm not 

saying that any patients should be concerned," he told Reuters Health. Reuters

Israel: Poliovirus detected from environmental samples

3 June - In Israel, wild poliovirus type 1 (WPV1) was isolated from sewage samples collected 

on 9 April 2013 in Rahat, southern Israel. The virus has been detected in sewage only; no 

case of paralytic polio has been reported. Genetic sequencing and epidemiological 

investigations are ongoing to determine its origin. Preliminary analyses indicate the strain is 

not related to the virus currently affecting the Horn of Africa. The virus isolate was detected 

through routine environmental surveillance in Israel that involves regular testing of sewage 

water. Israel has been free of indigenous WPV transmission since 1988. In the past, wild 

poliovirus has been detected in environmental samples collected in this region between 

1991 and 2002 without occurrence of cases of paralytic polio in the area. Following 

detection of the wild poliovirus, health authorities in Israel are conducting a full 

epidemiological and public health investigation, actively searching for potential cases of 

paralytic polio as well as for any un-immunized persons. WHO

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USNORTHCOM

U.S., Alaska: Health care is spread thin on Alaskan 

frontier

28 May - Americans in some rural places fret at how far away big-city medical help might be 

in an emergency, or at the long drives they are forced to make for prenatal care, or stitches, 

or chemotherapy. Dr. Ellen Hodges only wishes it could be so easy. She oversees health care 

for a population of 28,000, mostly Alaska Natives, here in the state’s far west end, spread 

out over an area the size of Oregon that has almost no roads. People can travel by boat or 

snow machine at certain times of the year, but not right now: the Kuskokwim River, which 

wends through Bethel to the Bering Sea, is choked with unstable melting ice in late May, 

magnifying the isolation that defines everything in what may be America’s emptiest corner...

New York Times

U.S.: Fittest US cities take exercise publicly, personally

3 June - U.S. cities that provide parks, walking trails, playing fields and running tracks are 

setting standards for the country's healthiest urban areas and showing that if they build 

fitness opportunities, residents will come. A new ranking of the 50 healthiest U.S. cities 

weighs “community indicators” that include everything from obesity rates and percentage 

of smokers to the number of baseball diamonds and tennis courts. “Community indicators 
14

and personal health pretty much follow each other,” said Walter Thompson, the chairman of 

the American College of Sports Medicine's American Fitness Index Advisory Board, which 

compiled the report. VOA

U.S.: Heat-related deaths after an extreme heat event —

Four States, 2012, and United States, 1999–2009

7 June - On June 29, 2012, a rapidly moving line of intense thunderstorms with high winds 

swept across the midwestern and eastern United States, causing widespread damage and 

power outages. Afterward, the area experienced extreme heat, with maximum temperatures 

exceeding 100°F (37.8°C) (1). This report describes 32 heat-related deaths in Maryland, Ohio, 

Virginia, and West Virginia that occurred during the 2 weeks following the storms and 

power outages. Median age of the decedents was 65 years, and most of the excessive heat 

exposures occurred within homes. During 1999–2009, an annual average of 658 heatrelated deaths occurred in the United States (2). Heat-related deaths are preventable, and 

heat response plans should be in place before an extreme heat event (EHE). Interventions 

should focus on identifying and limiting heat exposure among vulnerable populations. 

Morbidity and Mortality Weekly Report

U.S.: More adult prescription drug use leads to increased 

poisonings in kids

3 June - Parents’ prescription drug use has dangerous implications for kids. A recent study 

published in the journal Pediatrics shows that the rise in prescription medication use among 

U.S. adults has led to more poisonings among kids — despite efforts to prevent that 

outcome. The phenomenon is so concerning that researchers are advising pediatricians to 

talk with parents about how to safely store prescription drugs away from kids of all ages.

TIME

U.S.: The $2.7 trillion medical bill

1 June - ...in Keene, N.H., Matt Meyer’s colonoscopy was billed at $7,563.56. Maggie Christ 

of Chappaqua, N.Y., received $9,142.84 in bills for the procedure. In Durham, N.C., the 

charges for Curtiss Devereux came to $19,438, which included a polyp removal. While their 

insurers negotiated down the price, the final tab for each test was more than $3,500...In 

many other developed countries, a basic colonoscopy costs just a few hundred dollars and 

certainly well under $1,000. That chasm in price helps explain why the United States is far 

and away the world leader in medical spending, even though numerous studies have 

concluded that Americans do not get better care. Whether directly from their wallets or 

through insurance policies, Americans pay more for almost every interaction with the 

medical system. They are typically prescribed more expensive procedures and tests than 

people in other countries, no matter if those nations operate a private or national health 

system. New York Times

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USPACOM

China: 'Cancer villages' a reality of life

29 May - ...The term surfaced a few years ago, when trailblazing Chinese journalists and 

activists like Deng Fei unearthed evidence of unnaturally high rates of cancer across China, 

mostly in rural areas dominated by industry. Deng, who was working for a Hong Kong 

based magazine at the time, focused on the impact of water pollution in rural China. "Since 

water is so important to people, the pollution has a more significant impact on people's 

health," he says. "China is suffering from the negative impact of improper economic growth 

patterns. And the country will continue to pay the price for heavy pollutants in the future." 

CNN

South Korea: Four die from tickborne disease 

3 June - A viral syndrome so far known as severe fever with thrombocytopenia syndrome 

(SFTS) and caused by tick bites has been fatal in four older adults in South Korea, according 

to a story today from the country's Yonhap News Agency. The Korea Centers for Disease 

Control and Prevention in May announced the country's first SFTS death, in a 63-year-old 

woman from the eastern region of the country who contracted her infection last August but 

whose case was confirmed only last month. Now the disease has also killed a 73-year-old 

man and an 82-year-old woman from the southern resort island of Jeju as well as a 74-yearold woman from southeastern South Korea. In addition, two elderly patients have been 

treated at hospitals for the disease, although no further information on those cases is given. 

Symptoms include high fever, vomiting, diarrhea, multiple organ failure, and other bloodrelated problems, the story said. CIDRAP

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USSOUTHCOM

Brazil drops 'happy being a prostitute' ad campaign

5 June - Following widespread criticism, Brazil's health ministry has scrapped an online 

campaign called "I'm happy being a prostitute." Prostitution is legal in Brazil and is expected 

to spike as the nation gears up for the FIFA World Cup in 2014 and the Olympics in 2016. 

The campaign aimed to promote safe sex and reduce the stigma against sex workers. Other 

posters in the campaign carried slogans such as "I cannot be seen without a condom, my 

love." But Tuesday, Health Minister Alexandre Padilha dropped the campaign, telling 

reporters he didn't think it was a message his office should be sending. CNN
16

Haiti: Cholera

3 June – At the Cholera Treatment Center-Saint Mary on the Soleil Wharf this afternoon, 24 

May 2013, there are 6 inpatient pediatric cases being treated with IV fluids and 1 toddler 

being treated with oral rehydration solution. All of these kids are from Soleil except one 

who is from Drouillard (a zone just outside of Soleil). There are 6 adult inpatient cholera 

patients in the adjoining room. Like clockwork, 6 to 12 hours after the rain comes in the late 

afternoon, patients present to this CTC with vomiting and diarrhea. And it is clouding up 

right now and raining almost every day now during Haiti's rainy season. ProMED-mail

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