14 September 2012

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 medic veterans finding themselves underemployed

 Mayo clinic suicide prevention expert outlines new steps to tackle military suicide

 Military mental health: An outsider takes a peek inside

 New breed of robotics aims to help people walk again

 Senate panel approves burn pit registry

 Stop-work order creates uncertainty for Ebola drug research

 Viral meningitis, active and reserve components, U.S. Armed Forces, 2002-2011

GLOBAL

 Australian scientists develop genetic test to predict autism

 Big med

 Deaf gerbils 'hear again' after stem cell cure

 Disease-spreading ticks on the move as climate changes

 Mixed results for dengue vaccine trial

 New model could help fill data gap in predicting historical air pollution exposure

 Tuberculosis: Taking high doses of vitamin D speeds recovery, scientists report

INFLUENZA

 CDC: Weekly Influenza Surveillance Report

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 PANDEMIC AND AVIAN INFLUENZA

 Flu shot issue may not be ‘Canadian problem’ after all

 Swine flu evolves under the radar

VETERINARY/FOOD SAFETY

 Mexico: Brucellosis

 U.S.: Multistate outbreak of human Salmonella Typhimurium infections linked to hedgehogs

 U.S.: Take steps now to reduce influenza risk

 U.S.: Three deaths counted in Listeria outbreak linked to cheese
Improving Food 

Safety through a 

One Health 

Approach

Globalization of the food 

supply has created 

conditions favorable for 

the emergence, 

reemergence, and spread 

of food-borne pathogenscompounding the 

challenge of anticipating, 

detecting, and effectively 

responding to food-borne 

threats to health. 

A One Health approach to 

food safety may hold the 

promise of harnessing and 

integrating the expertise 

and resources from across 

the spectrum of multiple 

health domains including 

the human and veterinary 

medical and plant 

pathology communities 

with those of the wildlife 

and aquatic health and 

ecology communities. 

WELLNESS

 Acupuncture provides true pain relief in study

 Bad sore throat? It's probably not strep, most likely viral

 Half of women may have sleep apnea: study

 Marijuana smoking tied to testicular cancer: study

 Ovarian cancer screenings are not effective, panel says

 Popular pain-relieving medicines linked to hearing loss in women

 Tattoo ink–related infections — awareness, diagnosis, reporting, and prevention

 Without alcohol, red wine is still beneficial

USAFRICOM

 Democratic Republic of Congo: Ebola outbreak risks spreading to towns

 Democratic Republic of Congo: Measles outbreaks kill 905 people in 2012

 Sierra Leone: Cholera update

 Uganda: Floods displace 15,000 in north

USCENTCOM

 Afghanistan: Flash floods kill or injure dozens in Kandahar province

 Pakistan: Factory fires claim over 300 lives

 Pakistan: Monsoon rains hit severely, leave 50 more dead

USEUCOM

 Czech Republic: Bootleg alcohol 'kills 16'

USNORTHCOM

 U.S.: 2012 West Nile virus update

 U.S.: Hantavirus update 2012

 U.S.: Whooping cough shots questioned

 Household preparedness for public health emergencies — 14 states, 2006–2010

USPACOM

 China: Bubonic plague, fatal

 Japan aims for zero nuclear power in 2030s

 Malaysia: Outbreak notice – sarcocystosis in Malaysia

USSOUTHCOM

 Guatemala: 33,000 fleeing volcano eruption

U.S. MILITARY

Army medic veterans finding themselves underemployed

11 September – Army Spc. Daniel Hutchinson once sliced a man's throat to keep him 

breathing. He knows how to slip a needle between a patient's ribs to re-inflate a lung. He 

fastened tourniquets on dozens of shredded limbs during 12 months in Iraq. Saving lives set 

him up for not much more than minimum-wage work at home. Combat medics, the Army's 
Primary Care

+ Public Health

in the Community

A new video from the IOM 

describes the clear need 

for better integration of 

primary care and public 

health. Based on the recent 

IOM report Primary Care 

and Public Health: 

Exploring Integration to 

Improve Population 

Health, the video offers 

concrete examples to show 

how primary care and 

public health can work 

together to improve 

health.

largest specialty after infantry, are hindered in the job market by a military that doesn't fully 

document their skills and a hodge-podge of state licensing laws that don't account for 

armed-forces experience. Stars and Stripes

Mayo clinic suicide prevention expert outlines new steps 

to tackle military suicide

10 September - The suicide rate in the U.S. Army now exceeds the rate in the general 

population, and psychiatric admission is now the most common reason for hospitalization 

in the Army. These concerning trends are described by Timothy Lineberry, M.D., a Mayo 

Clinic psychiatrist and suicide expert for the Army, in the September edition of Mayo Clinic 

Proceedings. In the article, he also outlines steps to assess and address military suicide — an 

issue he calls a major public health concern. Dr. Lineberry proposes greater use of gun 

locks, improving primary care for depression, and better monitoring for sleep disturbances, 

among other steps. Health Canal

Military mental health: An outsider takes a peek inside

11 September - Marjorie Morrison is a San Diego psychologist who took time out of her 

busy private practice to provide “pro-active” mental-health counseling to more than 500 

Marines at the recruit depot there. Such counseling removes stigma – because everyone 

gets it, no one feels “different.” It’s designed to prevent mental-health ailments before they 

begin, instead of trying to fix them after they’ve taken root and disrupted lives. She details 

her fight and frustrations with the military’s mental-health bureaucracy in a new book, The 

Inside Battle: Our Military Mental Health Crisis. Time

New breed of robotics aims to help people walk again

11 September - When Joey Abicca pokes a metal crutch into 

the ground with his right arm, tiny motors start whirling 

around his left leg, lifting it and moving it forward. When he 

does the same with his left arm, the motors whir to life again 

and his right leg takes a step. The metallic whine is like 

something out of the movie “RoboCop.” Mr. Abicca, a 17-year-old from San Diego, is 

essentially wearing a robot. His bionic suit consists of a pair of mechanical braces wrapped 

around his legs and electric muscles that do much of the work of walking. It is controlled by 

a computer on his back and a pair of crutches held in his arms that look like futuristic ski 

poles... Ekso is one of several companies and research labs that are working on wearable 

robots made to help disabled people or to make the human body superhuman. In 2010, 

Raytheon released a suit for soldiers that is designed to reduce injuries from heavy lifting. 

New York Times

Senate panel approves burn pit registry

12 September - An effort to create a registry of service members and veterans who may 

have been exposed to airborne toxins while serving near open-air burn pits in Iraq and 

Afghanistan advanced in Congress this week. Bills that would require the Veterans Affairs 
Communications 

and Technology for 

Violence Prevention

In the last 25 years, a major 

shift has occurred in the 

field of violence 

prevention, from the 

assumption that violence is 

inevitable to the realization 

that violence is 

preventable. 

At the same time, new 

communications 

technologies and 

distribution channels have 

altered traditional means 

of communications, and 

have made communitybased efforts to prevent 

violence possible by 

making information readily 

available. 

Department to track service members and veterans stationed near open-air disposal sites in 

the war zones were considered in both the House and Senate... If enacted, the [House]

legislation would require VA to publicize the registry and inform veterans and troops of 

their eligibility to be listed. It also would require VA to keep registry members apprised of 

research and treatment developments for illnesses and diseases associated with exposure to 

toxic chemicals and fumes. The Senate Veterans’ Affairs Committee passed similar 

legislation Wednesday as part of a veteran’s mental health care bill. Army Times

Stop-work order creates uncertainty for Ebola drug 

research

7 September - The world's first major outbreak of Ebola hemorrhagic fever since 2009 raged 

across Uganda and Congo in July and August, killing at least 26 people. Despite this 

development, two biotech firms under contract from the US government to design drugs to 

treat people infected with the deadly virus could not purchase new research supplies or 

change the course of ongoing trials last month. On 2 August, Massachusetts-based Sarepta 

Therapeutics and Canada's Tekmira Pharmaceuticals received a stop-work order from the 

US Department of Defense (DoD). Both companies are researching injectable drugs that 

block or interfere with the virus replication. As Nature Medicine went to press, the military's 

Transformational Medical Technologies (TMT) office planned to “evaluate each contractor's 

efforts independently to determine the plan for moving forward with the development of 

the best drug candidate possible,” Cicely Levingston, a DoD spokeswoman, told the journal 

in an email. However, despite a decision expected on 1 September, the nearly month-long 

pause has already created some uncertainty for future Ebola work. Nature

Viral meningitis, active and reserve components, U.S. 

Armed Forces, 2002-2011

August 2012 – Viruses are the most common causes of meningitis, a condition characterized 

by inflammation of the protective membranes that surround the brain and spinal cord. 

During the 10-year surveillance period, there were 3,205 confirmed cases, 724 probable 

cases, and 2,495 suspected cases of viral meningitis among active and reserve component 

members. In all three categories of cases, the most common diagnoses were meningitis due 

to enteroviruses; however a majority of these were unspecified enteroviruses. Nearly twothirds (64.2%) of all cases due to enteroviral infection were hospitalized; on average, cases 

were hospitalized for 3.2 days. Numbers of cases peaked in late summer/early fall; and 

higher than average numbers of cases in 2003 reflected several outbreaks that occurred in 

civilian populations that year. Six states (Texas, California, Virginia, North Carolina, Florida, 

Georgia) reported the most cases in 2003 and overall during the period. Prevention of viral 

meningitis relies upon the interruption of viral transmission, e.g., thorough hand washing 

and disinfection of contaminated surfaces. Medical Surveillance Monthly Report

top of page...
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GLOBAL

Australian scientists develop genetic test to predict 

autism

12 September – Australian scientists have developed a genetic test to predict autism 

spectrum disorder in children, which could provide a long-sought way for early detection 

and intervention, according to a study published on Wednesday. ...The researchers used U.S. 

data from more than 3,000 individuals with autism in their study, published in the journal 

Molecular Psychiatry, to identify 237 genetic markers in 146 genes and related cellular 

pathways. By measuring these markers, which either contribute to or protect an individual 

from developing autism, scientists could assess the risk of developing autism. The risk 

markers increase the score on the genetic test, while the protective markers decrease the 

score. The higher the overall score, the higher the individual risk. "This test could assist in 

the early detection of the condition in babies and children and help in the early 

management of those who become diagnosed," lead researcher Stan Skafidas said in a 

statement. Reuters

Big med

6 August – Big chains thrive because they provide goods and services of greater variety, 

better quality, and lower cost than would otherwise be available. Size is the key. It gives 

them buying power, lets them centralize common functions, and allows them to adopt and 

diffuse innovations faster than they could if they were a bunch of small, independent 

operations... Medicine, though, had held out against the trend. Physicians were always 

predominantly self-employed, working alone or in small private-practice groups. American 

hospitals tended to be community-based. But that’s changing. Hospitals and clinics have 

been forming into large conglomerates. And physicians—facing escalating demands to 

lower costs, adopt expensive information technology, and account for performance—have 

been flocking to join them. According to the Bureau of Labor Statistics, only a quarter of 

doctors are self-employed—an extraordinary turnabout from a decade ago, when a majority 

were independent. They’ve decided to become employees, and health systems have 

become chains. New Yorker

Deaf gerbils 'hear again' after stem cell cure

12 September - UK researchers say they have taken a huge step forward in treating 

deafness after stem cells were used to restore hearing in animals for the first time. Hearing 

partially improved when nerves in the ear, which pass sounds into the brain, were rebuilt in 

gerbils - a UK study in the journal Nature reports. Getting the same improvement in people 

would be a shift from being unable to hear traffic to hearing a conversation. However, 

treating humans is still a distant prospect. BBC News
Disease-spreading ticks on the move as climate changes

7 September - ...Tick species are ...expanding into new territories as 

wildlife populations, forest habitats and weather patterns change 

across North America... While Lyme disease is the most common tickborne disease in the Northeast and Upper Midwest, new research 

finds that it is not the greatest cause for concern in most 

Southeastern states, the NSF said in a news statement about a research paper in the journal 

Zoonoses and Public Health... “The Southeast is dominated by different tick species than the 

ones that attack humans in the North,” says Ellen Stromdahl, an entomologist at the U.S. 

Army Public Health Command and lead author of the paper. “The lone star tick is by far the 

most abundant tick in the Southeast, and which species of tick bites you is critical because 

different ticks carry different diseases... Most bites in the Southeast are from the tick species 

that spread spotted fever rickettsiosis and ehrlichiosis, but not Lyme disease, the NSF said. 

“A complicating factor for public health officials is that tick species are on the move, as 

wildlife populations, forest habitats and weather patterns change across the continent.”

National Geographic

Mixed results for dengue vaccine trial

11 September - The results of the first trial of the effectiveness of a vaccine for dengue, a 

sometimes fatal disease endemic throughout most tropical countries, have engendered 

both enthusiasm and disappointment. The vaccine proved safe, and it protected against 

three of the four dengue virus variants, or serotypes—but surprisingly, it provided no 

protection against the fourth. Scientists are stumped as to why and pondering what this 

means for the global fight against a serious public health threat... Public health officials and 

affected communities are eager to have a dengue vaccine because there is no treatment 

and the disease burden is growing. Spread by mosquitoes, the four dengue serotypes infect 

as many as 100 million people, mostly children, worldwide each year. Exposure to one 

serotype usually causes minor illness, and the patient is immune for life to a second 

infection of the same serotype. But for poorly understood reasons, subsequent exposure to 

a second dengue serotype increases the chance of the illness progressing to the severe and 

sometimes fatal dengue hemorrhagic fever. Science

New model could help fill data gap in predicting 

historical air pollution exposure

12 September – In a study that analyzed relationships between air quality and 

unemployment levels, a Tufts University researcher has developed a new statistical model 

that retrospectively estimates air pollution exposure for previous time periods where such 

information is not available. Mary Davis, an associate professor of urban and environmental 

policy and planning at Tufts University School of Arts and Sciences, analyzed traffic-related 

air pollution levels and unemployment rates in four separate regions of California for which 

extensive air monitoring data was available: San Francisco Bay, Sacramento Valley, San 

Joaquin Valley, and the south-central coast between 1980 and 2000... Davis's analysis 
revealed a pattern. During the highest periods of unemployment—early 1980s and early 

1990s—concentrations of the three pollutants decreased in small but discernible amounts 

for every one percent increase in unemployment. The reason for the decrease, she says, was 

due to slowdowns in commercial trucking and car trips to work, shopping malls, or 

recreational destinations. EurekAlert

Tuberculosis: Taking high doses of vitamin D speeds 

recovery, scientists report

10 September – High doses of vitamin D speed the recovery 

of tuberculosis patients, according to a new study. The 

inspiration for testing the idea, scientists from Queen Mary 

University of London and other British hospitals said, was 

that 19th-century tuberculosis patients were sent to the 

mountains to lie in the sun. Ultraviolet B rays in sunshine convert cholesterol in the skin into 

vitamin D. ...Vitamin D seems to prevent lung damage by slowing down inflammatory 

responses to the TB bacterium. Since it does not interfere with the action of antibiotics, it 

may be useful in other illnesses, like pneumonia, according to the authors of the study, 

published online by Proceedings of the National Academy of Sciences last week. In a clinical 

trial of 95 patients on antibiotics, those who also got vitamin D had less inflammation, and 

the mycobacteria in their lung phlegm cleared up 13 days earlier on average. New York 

Times

top of page...

INFLUENZA

CDC: Weekly Influenza Surveillance Report

 From July 12 through September 6, 2012, a total of 296 infections with influenza A 

(H3N2) variant (H3N2v) viruses have been reported from ten states. This is an increase 

of 8 over last week’s report... Sixteen H3N2v-associated hospitalizations and one 

H3N2v-associated death have been reported. The vast majority of cases have occurred 

after prolonged swine exposure, though instances of likely human-to-human 

transmission have been identified. At this time no ongoing human-to-human 

transmission has been identified. 

 During week 35 (ending 1 September 2012), 5.6% of all deaths reported through the 

122-Cities Mortality Reporting System were due to pneumonia and influenza This 

percentage was below the epidemic threshold of 6.5% for week 35. FluView
Google.org: Flu Trends

12 September – Estimates of flu activity based on aggregated Google search data indicate 

that the level of flu activity in the northern hemisphere is minimal to low except for Russia 

where the level is moderate and ranges from minimal to low in the southern hemisphere

except for Australia and New Zealand where the level is moderate. Google.org Flu Trends

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 8 September 2012:

Adenovirus 

Type 14 adenovirus is present at MCRD Parris Island. 

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 

PANDEMIC AND AVIAN INFLUENZA

Flu shot issue may not be ‘Canadian problem’ after all

9 September - A strange vaccine-related phenomenon spotted at the start of the 2009 flu 

pandemic may well have been real, a new study suggests. Canadian researchers noticed in 

the early weeks of the pandemic that people who got a flu shot for the 2008-2009 winter 

seemed to be more likely to get infected with the pandemic virus than people who hadn't 

received a flu shot. Five studies done in several provinces showed the same puzzling and 

unsettling results. But initially research outside of Canada did not, and the effect was 

dismissed as "the Canadian problem."... But a new study suggests the findings may indeed 

have been real. A group of Canadian researchers recreated the event in ferrets, the best 

animal model for predicting how influenza will act in humans... [Dr. Danuta Skowronski] and 

her colleagues worked with 32 ferrets, giving half the 2008 seasonal flu shot and the 

remainder a placebo injection. The work was blinded, meaning the researchers didn't know 

which ferrets received which shot. Later, all the ferrets were infected with the pandemic 

H1N1 virus. The ferrets in the vaccine group became significantly sicker than the other 

animals, though all recovered. CTV News

Swine flu evolves under the radar 

12 September – Swine flu is back with a vengeance. Two weeks ago, a woman died after 

catching flu from a pig at an agricultural fair in Ohio. Now it seems that pigs in Korea are 

harbouring a similar strain of flu that spreads more easily and is more lethal - at least in 

animals - than the experimental bird flu that caused intense controversy last year. Robert 

Webster and colleagues at St Jude Children's Research Hospital in Memphis, Tennessee, put 

an H1N2 flu virus, taken from the lungs of a pig slaughtered in South Korea in 2009, into the 
noses and windpipes of three ferrets. All the animals died, which is worrying, as ferrets catch 

and develop flu in a similar way to humans. What's more, the virus was transmitted via 

airborne droplets to three ferrets in nearby cages, killing two of them. In passing between 

the ferrets, the H1N2 strain acquired two mutations that made it both more contagious and 

more virulent. The mutated version also grew faster than the original pig virus in cells 

cultured from the human nose and the lung, and in fresh samples of human alveoli 

(Proceedings of the National Academy of Sciences). New Scientist

top of page...

VETERINARY/FOOD SAFETY

Mexico: Brucellosis

11 September – The state laboratory of the Michoacan Secretariat of Health has confirmed 

32 cases of brucellosis in the municipality of Coahuayana. According to information 

provided by Dr Maria Isabel Medina Villa, hospital epidemiologist, the 1st cases of 

brucellosis were detected in April 2012, noting that most of the 32 patients confirmed by 

the state laboratory are from the towns of El Ranchito (55 percent) and El Ticuiz (41 

percent), and the rest from Coahuayana de Hidalgo and San Vicente. 25 patients are 

receiving the appropriate treatment. The epidemiologist reported that the Secretariat of 

Health has conducted surveys of milk and milk products such as cheese, cream, yogurt, and 

other dairy products consumed in the municipality of Coahuayana and especially where a 

higher incidence of the disease has been detected, without having identified the source of 

the infection. ProMED-mail

U.S.: Multistate outbreak of human Salmonella

Typhimurium infections linked to hedgehogs

6 September - As of September 5, 2012, a total of 14 persons infected with the outbreak 

strain of Salmonella Typhimurium have been reported from 6 states... The outbreak strain 

has been rarely seen in the past. Among the persons who reported the date they became ill, 

illnesses began between December 26, 2011 and August 13, 2012. Infected individuals 

range in age from less than 1 year to 62 years, and 50% of ill persons are 10 years of age or 

younger. Sixty-two percent of ill persons are female. Among 10 ill persons with available 

information, 3 (30%) have been hospitalized. No deaths have been reported. In interviews, ill 

persons answered questions about contact with animals and foods consumed during the 

week before becoming ill. Ten (100%) of 10 ill persons interviewed reported contact with 

hedgehogs or their environments before becoming ill. CDC

U.S.: Take steps now to reduce influenza risk 

11 September - With human cases of H3N2 influenza virus, reportedly contracted from pigs 

at fairs this summer, pork producers are turning their attention to prevention measures 

among employees and in their herds. Investigations into H3N2v cases indicate that the main 
risk factor for infection is prolonged exposure to pigs, mostly in fair settings, according to 

the U.S. Centers for Disease Control and Prevention (CDC). Associated illness so far has been 

mostly mild with symptoms similar to seasonal flu and most cases have occurred in children 

who have little immunity against this virus. With influenza season ramping up, make sure 

that you take the normal precautions against infection since these viruses can move from 

pigs to people and from people to pigs, Koeman says. “Influenza viruses can move between 

pigs and people so it is important for all producers, swine workers, and their families to 

receive the seasonal influenza vaccination as soon as it is available.” ...Although this season’s 

flu vaccine will not protect against H3N2v, it will protect against seasonal influenza viruses 

expected to circulate this season and will reduce the risk of transmitting flu viruses to the 

herd,” Koeman says. Pork Network

U.S.: Three deaths counted in Listeria outbreak linked to 

cheese

12 September – A new outbreak of Listeria monocytogenes has already killed three people, 

the federal Centers for Disease Control and Prevention (CDC) said late Tuesday. The deaths 

are being blamed on cheese imported from Italy. According to CDC, a total of 14 persons 

are infected with the outbreak strain in 11 states and the District of Columbia. All have been 

hospitalized, but three have died. CDC said Listeriosis contributed to at least one of the 

deaths. The CDC report on the outbreak came 24 hours after Long Island-based Forever 

Cheese recalled one of its imported cheese brands for possible Listeria contamination. The 

number of ill persons identified in each state is as follows: California (1), Colorado (1), 

District of Columbia (1), Maryland (3), Minnesota (1), Nebraska (1), New Jersey (1), New 

Mexico (1), New York (1), Ohio (1), Pennsylvania (1) and Virginia (1). Food Safety News

top of page...

WELLNESS

Acupuncture provides true pain relief in study

11 September - A new study of acupuncture — the most rigorous and detailed analysis of 

the treatment to date — found that it can ease migraines and arthritis and other forms of 

chronic pain. The findings provide strong scientific support for an age-old therapy used by 

an estimated three million Americans each year. Though acupuncture has been studied for 

decades, the body of medical research on it has been mixed and mired to some extent by 

small and poor-quality studies. Financed by the National Institutes of Health and carried out 

over about half a decade, the new research was a detailed analysis of earlier research that 

involved data on nearly 18,000 patients. The researchers, who published their results in 

Archives of Internal Medicine, found that acupuncture outperformed sham treatments and 

standard care when used by people suffering from osteoarthritis, migraines and chronic 

back, neck and shoulder pain... Ultimately, Dr. Vickers and his colleagues found that at the 

end of treatment, about half of the patients treated with true acupuncture reported 
improvements, compared with about 30 percent of patients who did not undergo it. New 

York Times

Bad sore throat? It's probably not strep, most likely viral

10 September - Although people often say they have “strep” throat, most sore throats 

actually are caused by a virus, not streptococcus bacteria, and shouldn’t be treated with 

antibiotics, suggest guidelines published by the Infectious Diseases Society of America 

(IDSA). Antibiotics are ineffective against viruses. The IDSA’s newly revised guidelines for 

Group A streptococcal pharyngitis – strep throat – also advise that when a strep infection is 

confirmed by testing, it should be treated with penicillin or amoxicillin – if the patient does 

not have an allergy – and not azithromycin or a cephalosporin. Further, the guidelines 

recommend that children who suffer from recurrent strep throat should not have their 

tonsils surgically removed solely to reduce the frequency of infection... About 15 million 

people in the U.S. see the doctor for a sore throat every year and up to 70 percent receive 

antibiotics, although only a smaller percentage actually have strep throat: approximately 20 

to 30 percent of children and just 5 to 15 percent of adults. IDSA

Half of women may have sleep apnea: study

7 September - Fully half of the 400 women given overnight sleep tests in a new Swedish 

study turned out to have mild-to-severe sleep apnea. In the random population sample of 

adult women who answered a questionnaire and were monitored while sleeping, half 

experienced at least five episodes an hour when they stopped breathing for longer than 10 

seconds, the minimum definition of sleep apnea. Among women with hypertension or who 

were obese - two risk factors for sleep apnea - the numbers were even higher, reaching 80 

to 84 percent of women. Many of the women in the study represent mild cases of sleep 

apnea... Young said sleep apnea is often thought of as a condition of men, but identifying 

women with it is especially beneficial, because her research has shown that women are 

good at sticking with treatment. Reuters

Marijuana smoking tied to testicular cancer: study

11 September - Young men who had smoked marijuana recreationally were twice as likely 

to be diagnosed with testicular cancer as men who have never used marijuana, according to 

a U.S. study. Researchers whose findings appeared in the journal Cancer said the link 

appeared to be specific to a type of tumor known as nonseminoma. "This is the third study 

consistently demonstrating a greater than doubling of risk of this particularly undesirable 

subtype of testicular cancer among young men with marijuana use," said Victoria Cortessis 

of the University of Southern California, Los Angeles, who led the study. Reuters

Ovarian cancer screenings are not effective, panel says

10 September – Tests commonly recommended to screen healthy women for ovarian cancer 

do more harm than good and should not be performed, a panel of medical experts said on 

Monday. The screenings — blood tests for a substance linked to cancer and ultrasound 

scans to examine the ovaries — do not lower the death rate from the disease, and they yield 

many false-positive results that lead to unnecessary operations with high complication 

rates, the panel said. New York Times
Popular pain-relieving medicines linked to hearing loss 

in women

12 September - ... According to a study by researchers at Brigham and Women's Hospital 

(BWH), women who took ibuprofen or acetaminophen two or more days per week had an 

increased risk of hearing loss. The more often a woman took either of these medications, 

the higher her risk for hearing loss. Also, the link between these medicines and hearing loss 

tended to be greater in women younger than 50 years old, especially for those who took 

ibuprofen six or more days per week. There was no association between aspirin use and 

hearing loss. EurekAlert

Tattoo ink–related infections — awareness, diagnosis, 

reporting, and prevention

13 September - Tattoos have become increasingly popular 

in recent years. In the United States, the estimated 

percentage of adults with one or more tattoos increased 

from 14% in 2008 to 21% in 2012. The process of tattooing 

exposes the recipient to risks of infections with various 

pathogens, some of which are serious and difficult to treat. Historically, the control of 

tattoo-associated dermatologic infections has focused on ensuring safe tattooing practices 

and preventing contamination of ink at the tattoo parlors — a regulatory task overseen by 

state and local authorities. In recent months, however, reported outbreaks of 

nontuberculous mycobacterial infections associated with contaminated tattoo ink have 

raised questions about the adequacy of prevention efforts implemented at the tattoo-parlor 

level alone. The Food and Drug Administration (FDA) is reaching out to health care 

providers, public health officials, consumers, and the tattoo industry to improve awareness, 

diagnosis, and reporting (through the MedWatch program) in order to develop more 

effective measures for tattoo ink–related public health problems. New England Journal of 

Medicine

Without alcohol, red wine is still beneficial

10 September – Drinking red wine may help lower blood pressure, but a new study from 

Spain suggests that alcohol is not the reason. In a small randomized clinical trial, 67 men 

ages 55 to 75 who were at high risk for cardiovascular disease were assigned to daily drinks: 

four weeks drinking one ounce of gin, 10 ounces of red wine or 10 ounces of nonalcoholic 

red wine. All the men tried the three programs in succession. When the men drank gin, they 

experienced no change in blood pressure. With red wine, there was a slight but statistically 

insignificant lowering. But with nonalcoholic red wine, the men saw a significant decrease in 

both systolic and diastolic blood pressure. The study, published last week in Circulation 

Research, concludes that the blood-pressure-lowering effects of red wine are attributable 

not to its alcohol content, but to the beneficial chemicals called polyphenols that it contains, 

even in its nonalcoholic form. New York Times

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USAFRICOM

Democratic Republic of Congo: Ebola outbreak risks 

spreading to towns

13 September - An outbreak of the deadly Ebola virus in the Democratic Republic of Congo

risks spreading to major towns if not brought under control soon after the death toll 

doubled within a week, the World Health Organisation warned on Thursday. The number of 

people killed by the contagious virus for which there is no known treatment has now risen 

to 31, including five health workers. Ebola causes massive bleeding and kills up to 90 

percent of its victims. "The epidemic is not under control. On the contrary the situation is 

very, very serious," Eugene Kabambi, a WHO spokesman in Congo's capital Kinshasa, told 

Reuters by phone. Reuters

Democratic Republic of Congo: Measles outbreaks kill 

905 people in 2012

13 September - Since the beginning of this year, 34,192 cases of measles, including 905 

deaths, have been reported in 88 health zones in the Democratic Republic of Congo (DR 

Congo). The information was revealed on Wednesday in Kinshasa by the United Nations 

Office for Coordination of Humanitarian Affairs (OCHA). Equateur province in the 

Northwestern part of DR Congo is the most affected with over 4,000 cases reported. An 

anti-measles campaign was launched in the province targeting some 480,000 children ages 

six months to 14 years. Xinhua

Sierra Leone: Cholera update

8 September - The Ministry of Health and Sanitation (MOHS) is closely working with 

partners at national and international levels to step up response to the cholera outbreak 

that has affected Sierra Leone since the beginning of the year. As of 5 September 2012, a 

total of 16 360 cases including 255 deaths with a case fatality rate (CFR) of 1.6% have been 

reported from 12 out of 13 districts. The western area of the country where the capital city 

of Freetown is located, reported more than 60% of all new cases... With support from 

national and international partners and donors, including UNICEF, Oxfam, British Red Cross, 

Save the Children, Care, Concern MSF, DFID, OCHA, IRC, and WHO, the MOHS is scaling up 

the response particularly in the areas of coordination of the overall response, surveillance 

and case management. WHO

Uganda: Floods displace 15,000 in north

7 September – Floods have forced at least 15,000 people to leave their homes in northern 

Uganda, where the deluge has destroyed houses, crops, roads and bridges. The Acholi 

districts of Agago, Kitgum, Lamwo and Pader are the most affected, with Agago alone 

having a total of 3,492 households affected, almost 13,000 hectares of crops inundated and 

some 2,000 latrines destroyed, according to a report by its district disaster management 
office. ... [T]he government was going to dispatch immediate relief items such as medicines 

and disinfectant to prevent disease outbreaks. IRIN

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USCENTCOM

Afghanistan: Flash floods kill or injure dozens in 

Kandahar province

11 September - According to local authorities in southern Kandahar province of Afghanistan 

several Afghan civilians were killed or injured and dozens of houses were damaged 

following flash floods in this province. Provincial public health chief Dr. Abdul Qayoum 

Pakhla confirming the report said at least 6 people including 4 women were killed and 8 

others were injured following the flash floods. Dr. Abdul Qayoum further added more than 

30 residential houses were also damaged. This comes as several people were killed or 

injured following flash floods in eastern Ghazni province of Afghanistan earlier. Khaama 

Press

Pakistan: Factory fires claim over 300 lives

12 September - The death toll from a pair of devastating 

factory fires that broke out in Pakistan's two biggest cities rose 

on Wednesday to 314 people, many of whom perished because 

they were unable to escape buildings that lacked emergency 

exits and basic safety equipment such as alarms and sprinklers. 

The horrific toll highlights the atrocious state of industrial safety in Pakistan, where many 

factories are set up illegally in the country's densely populated cities, and owners often pay 

officials bribes to ignore safety violations. The more deadly of the two blazes, which both 

erupted on Tuesday night, was at a garment factory in the southern city of Karachi, the 

country's economic heart. The death toll there rose to 289 people Wednesday, as 

firefighters battled the flames for hours, said senior government official Roshan Ali Sheikh. It 

was one of the worst industrial accidents in Pakistan's 65-year history. Christian Science 

Monitor

Pakistan: Monsoon rains hit severely, leave 50 more dead

11 September - At least 50 persons have been died and hundreds others injured in the 

result of electrocution and house roof collapses incidents due to the heavy rains in different 

parts of Sindh, South Punjab, Balochistan and Khyber Pakhtoonkhwa (KPK) on Monday. At 

least 24 people died in Punjab, 10 in Sawabi, five in Kahirpur, 10 in Kashmore, meanwhile 

Chief Minister Sindh Qaim Ali Shah has declared rain emergency in the province; meanwhile 

emergency has also be imposed in DG Khan, Multan, Rajanpur and Jaffarabad. South Asian 

News Agency

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USEUCOM

Czech Republic: Bootleg alcohol 'kills 16'

12 September - At least 16 people in the Czech Republic have died after drinking bootleg 

alcohol, officials have said. The spirits were made from industrial chemical methanol and at 

least a further 22 people have been taken to hospital with alcohol poisoning. Police have 

arrested a 36-year-old man in connection with the deaths. Emergency measures have been 

imposed banning the sale of hard alcohol and authorities are carrying out searches to try to 

find the source of the drink... Some of those taken to hospital have gone blind after 

consuming the alcohol, with others being put into artificial comas by doctors. BBC News

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USNORTHCOM

U.S.: 2012 West Nile virus update

11 September – As of September 11, 2012, 48 states have reported West Nile virus 

infections in people, birds, or mosquitoes. A total of 2,636 cases of West Nile virus disease 

in people, including 118 deaths, have been reported to CDC. Of these, 1,405 (53%) were 

classified as neuroinvasive disease (such as meningitis or encephalitis) and 1,231 (47%) were 

classified as non-neuroinvasive disease. The 2,636 cases reported thus far in 2012 is the 

highest number of West Nile virus disease cases reported to CDC through the second week 

in September since 2003. Two thirds of the cases have been reported from six states (Texas, 

Louisiana, South Dakota, Mississippi, Michigan, and Oklahoma) and 40 percent of all cases 

have been reported from Texas. CDC

U.S.: Hantavirus update 2012

9 September – Yosemite National Park authorities have doubled the estimate of those likely 

infected in a recent outbreak of the hantavirus, a deadly pulmonary disease commonly 

carried by mice and other rodents. Given the rising number of confirmed cases (currently 

eight) and deaths (three), U.S. officials have sounded a worldwide alert to more than 22,000 

domestic and international visitors to the park who may have been exposed. Containment 

of the virus is the first priority for the National Park Service, whose officials at first estimated 

that 10,000 people were at risk of contracting the hantavirus [infection] after staying in 

Yosemite's popular Curry Village lodging area in June through August [2012]. Officials 

expanded the warning this week to an additional 12,000 visitors to Yosemite's High Sierra 

camps, now that the eighth case of hantavirus was confirmed in a man who stayed in those 

areas. Furthermore, more than 2,500 of those individuals are from outside the United States. 

ProMED-mail
U.S.: Whooping cough shots questioned 

12 September - Increasing outbreaks of whooping cough across the U.S. may be partly a 

result of the waning efficacy of the vaccine used to protect against it, a new study suggests.

The study, published in the New England Journal of Medicine Wednesday, found that 

protection against the disease diminished substantially over five years in immunized 

elementary school-aged children. That age group was once considered well immunized 

against the highly contagious disease after receiving five doses of diphtheria, tetanus and 

pertussis vaccine—the last given between the ages of 4 and 6. But public health officials and 

researchers have been scrutinizing the lasting power of the vaccine and debating how to 

improve protection ever since more than 9,000 people developed whooping cough in 

California in 2010 and 2011. About a third of cases in 2010 were in children ages 5 to 12, 

according to the California Department of Public Health. They're focusing on whether the 

vaccine currently used in the U.S. is weaker than one it replaced in the 1990s, after the older 

shot was blamed for side effects ranging from tenderness and pain to occasional high fever.

Wall Street Journal

Household preparedness for public health emergencies 

— 14 states, 2006–2010

12 September - ...To estimate current levels of self-reported household preparedness by 

state and sociodemographic characteristics, CDC analyzed Behavioral Risk Factor 

Surveillance System (BRFSS) survey data collected in 14 states during 2006–2010. The results 

of this analysis indicated that an estimated 94.8% of households had a working batteryoperated flashlight, 89.7% had a 3-day supply of medications for everyone who required 

them, 82.9% had a 3-day supply of food, 77.7% had a working battery-operated radio, 

53.6% had a 3-day supply of water, and 21.1% had a written evacuation plan. Non-English 

speaking and minority respondents, particularly Hispanics, were less likely to report 

household preparedness for an emergency or disaster, suggesting that more outreach 

activities should be directed toward these populations. Morbidity and Mortality Weekly 

Report

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USPACOM

China: Bubonic plague, fatal

11 September - The Centre for Health Protection (CHP) of the Department of Health 

received notification from the Ministry of Health (MoH) today, 10 Sep 2012, concerning a 

case of bubonic plague. A CHP spokesman said that according to the preliminary 

information from the MoH, 3 villagers in Ganzizhou, Sichuan Province, had consumed a 

dead marmot on 2 Sep 2012. One of them presented with painful swelling of lymph nodes 

on the right side on 4 Sep 2012 and was admitted to hospital on 7 Sep 2012. His condition 
deteriorated later and he died on the same day. According to the deceased's clinical 

characteristics, epidemiological investigation, and laboratory test results, the health 

authority of Sichuan Province confirmed the case as bubonic plague. Pro-MED-mail

Japan aims for zero nuclear power in 2030s

12 September - Japan aims to quit nuclear power in the 2030s in a new energy strategy to 

be unveiled soon, media said on Wednesday, a major shift from a pre-Fukushima disaster 

goal of boosting atomic energy to produce more than half the country's electricity. The 

March 2011 earthquake and tsunami triggered three meltdowns at Tokyo Electric Power 

Co's Fukushima Daiichi plant, spewing radiation and forcing about 160,000 people to flee 

their homes. It also prompted the government to scrap a 2010 plan to boost nuclear 

power's share of electricity to more than 50 percent by 2030. Prime Minister Yoshihiko 

Noda said on Monday that he wanted to decide on the new policy this week and would 

take into account a proposal by his Democratic Party for Japan to "invest all possible policy 

resources to make it possible to exit nuclear power in the 2030s". Chicago Tribune

Malaysia: Outbreak notice – sarcocystosis in Malaysia

CDC has received reports from GeoSentinel1of four cases of sarcocystosis that have been 

associated with 2012 summer travel to Tioman Island in Malaysia. Last year, 33 travelers 

returning from Tioman Island were similarly diagnosed with sarcocystosis. Sarcocystosis is a 

disease caused by a parasite called Sarcocystis. Sarcocystosis occurs in tropical or 

subtropical countries, including countries in Southeast Asia. This disease is common among 

wild and domestic animals but can also cause disease in humans. Two forms of the disease 

can occur: one causes diarrhea and the other causes muscle pain, fevers, and other 

symptoms. Muscle sarcocystosis is spread through the ingestion of food, water, or soil 

contaminated with infected animal feces. Many people infected with Sarcocystis may not 

have symptoms. The travelers described in this notice returned from Malaysia with severe 

muscle pain. Other reported symptoms included mild diarrhea and fever. Most people were 

ill for 2-4 weeks after leaving the island. CDC

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USSOUTHCOM

Guatemala: 33,000 fleeing volcano eruption

13 September - A long-simmering volcano outside one of the Guatemala's most famous 

tourist attractions exploded into a series of powerful eruptions Thursday, hurling thick 

clouds of ash nearly two miles (three kilometers) high, spewing rivers of lava down its flanks 

and forcing the evacuation of more than 33,000 people from surrounding communities. 

Guatemala's head of emergency evacuations, Sergio Cabanas, said the evacuees were 

leaving some 17 villages around the Volcan del Fuego, which sits about six miles southwest 

(16 kilometers) from the colonial city of Antigua. .. There was a general orange alert, the 
second-highest level, but a red alert south and southeast of the mountain, where, Chicna 

said, "it's almost in total darkness." Teresa Marroquin, disaster coordinator for the 

Guatemalan Red Cross, said the organization had set up 10 emergency shelters and was 

sending hygiene kits and water. "There are lots of respiratory problems and eye problems," 

she said. San Francisco Chronicle

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