15 February 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 studies special operators’ nutritional needs

 Defense Secretary urges DoD to ‘operate on every front' to end suicide

 Staphylococcus aureus and other skin and soft tissue infections among basic military trainees, 

Lackland Air Force Base, Texas, 2008-2012

 Suicide specter follows troops into civilian life

 U.S., Maryland: Fort Meade Burger King reopens after maggot infestation

GLOBAL

 Obscure Chagas' disease takes costly toll

 New case of SARS-like virus shows person-to-person transmission

 Newly developed skin cream cures parasitic illness

 NIH scientists discover promising target to block Staphylococcus infection

 Scientists find new strategy against drug-resistant superbugs

 Skin 'may restore' diseased MS brain

 Tracking system could fight fake drugs

INFLUENZA

 Armed Forces Health Surveillance Center: DoD Influenza Surveillance Summary

 CDC: Weekly Influenza Surveillance Report

 DoD Global Laboratory-Based Influenza Surveillance Program

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

 Google.org: Flu Trends

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 USAPHC: U.S. Army Influenza Activity Report

 PANDEMIC AND AVIAN INFLUENZA

 Cambodia, China report H5N1 fatalities

VETERINARY/FOOD SAFETY

 Europe: Horsemeat scandal deepens as minister says bute may be in food chain

 U.S., California: Investigation underway for bovine tuberculosis case in CA

 U.S.: Industry says government is obligated to provide meat inspection, even with sequester

 U.S.: Lean Cuisine recalled nationwide for fragments of glass
Performance TRIAD:

Sleep

The Army Surgeon General 

has championed the 

Performance Triad of 

Activity, Nutrition and 

Sleep to build resilience, 

improve readiness and 

enhance the health of the 

Army family.

Despite the growing 

research that shows sleep, 

like nutrition and physical 

activity is vital for good 

health, many people, 

Soldiers and civilians, 

adults and children are not 

getting adequate amounts 

of sleep.

Although individual sleep 

requirements vary, most 

adults need seven to eight 

hours of sleep daily, 

children and adolescents 

even more.

From STAND-TO!

WELLNESS

 Everyday activities may have same health benefits as going to gym

 Price for a new hip? Many hospitals are stumped

 Petition urges FDA to limit sugar levels

 Straining to hear and fend off dementia

 Vitamin D supplement labels grossly inaccurate about what’s inside

 Working out when to exercise in the cold and flu season

USAFRICOM

 Africa: Mothers’ health is improving across continent

 Mozambique: Cholera confirmed in northern Mozambique

 Nigerian doctor fighting killer blood disease

 Nigeria: Wazobia FM journalists held over polio deaths

 Polio in Niger

USCENTCOM

 Egypt: Poliovirus detected from environmental samples

 Syria: Syrian refugee diseases, infections on the rise

USEUCOM

 Israel: Hepatitis A outbreak reported TA, Bat Yam

 Russia: Hundreds injured by meteor explosion

 United Kingdom: Child hospital stays 'keep rising'

 United Kingdom: Measles outbreaks hit 18-year high as effects of MMR scandal are felt

USNORTHCOM

 U.S.: Acute kidney injury associated with synthetic cannabinoid use — multiple states, 2012

 U.S. fertility rates fall to all-time low

 U.S.: First cases of vaccine-resistant whooping cough found in United States

 U.S.: Big strides in reducing domestic violence

 U.S.: Powerful Northeast storm kills 4, tests officials’ emergency readiness

 U.S.: Slower growth of health costs eases deficit

USPACOM

 Australia: Feral pig outbreak after floods

 South Korea: Seoul says no nuclear radiation detected from North's nuke test

USSOUTHCOM

 Panama: MoH reports another case of hantavirus in Soná

 Paraguay: Dengue epidemic leaves more than 20 dead and hundreds of infected

U.S. MILITARY

Army studies special operators’ nutritional needs

February 2013 - A typical service member in garrison needs to consume about 3,250 

calories a day for sustenance. Maj. Aaron Crombie, Ph.D., is in the process of estimating how

much more a special operator should eat. Crombie, who works for the Military Nutrition 

Division at the U.S. Army Research Institute of Environmental Medicine, or USARIEM, at 
Contagion of 

Violence: 

Workshop Summary

The Institute of Medicine 

(IOM) Forum on Global 

Violence Prevention has 

held four workshops to 

examine crosscutting, 

evidence-based 

approaches to violence 

prevention from multiple 

perspectives and at 

multiple levels of society. 

This summary covers the 

major topics that arose 

during the 2-day 

workshop. It is organized 

by important elements of 

the infectious disease 

model so as to present the 

contagion of violence in a 

larger context and in a 

more compelling and 

comprehensive way.

Natick Soldier Systems Center, Mass., is leading a team that has been studying special 

operations forces at training venues around the country to discover that. Results will be 

used to adjust the Basic Daily Food Allowance, or BDFA, for dining facilities that serve their 

meals. "We know that these guys move a lot," Crombie said. "They train a lot. Some of them 

are doing two-a-day workouts. They spend a lot of time in the gym, a lot of time at the 

ranges." Military.com

Defense Secretary urges DoD to ‘operate on every front' 

to end suicide

8 February - Veteran and service member suicide is a problem no single approach will solve, 

Defense Secretary Leon E. Panetta told a Georgetown University audience here today. The 

secretary, who is expected to retire this month, delivered a speech on leadership and 

government this morning and then took audience questions. One student introduced 

himself as a second-year master’s student in foreign service and public policy programs, an 

Army veteran and a member of the Maryland Air National Guard. He asked what “the 

Department of Defense and our lawmakers” can do to combat suicide among veterans. “It is 

one of the most tragic issues that we deal with right now in the military,” the secretary 

responded. The rate of suicide among troops and former troops mirrors that of greater 

society, he noted, but added, “There is no question in my mind that part of this is related to 

the stress of war over the last 10 years, [and] the fact that we have deployed people time 

and time again.” MHS

Staphylococcus aureus and other skin and soft tissue 

infections among basic military trainees, Lackland Air 

Force Base, Texas, 2008-2012

January - Military training environments have been identified as high-risk settings for 

acquisition of skin and soft tissue infections (SSTIs), including those caused by methicillinresistant Staphylococcus aureus (MRSA). Among the 148,355 basic military trainees at 

Lackland Air Force Base, Texas, between 1 October 2008 and 30 September 2012, there 

were 289 SSTIs, including 48 cases of culture-confirmed MRSA and 48 cases of possible 

MRSA... The period prevalence rates of all SSTIs and MRSA SSTIs increased annually since 

fiscal year 2010. Medical Surveillance Monthly Report

Suicide specter follows troops into civilian life

11 February - The historic pace of troop suicides confounding the military through the war 

years is following servicemembers into civilian life, according to preliminary analyses of new 

veteran data. Although only 4.5% of men ages 18-34 are veterans, veterans account for

10.8% of suicides in that age group, according to statistics from the Department of Veterans 

Affairs. The numbers are based on death data collected by the VA from 21 states.

USA Today
COCA 

Conference Call

Saving Lives with 

Words: What Health 

Educators Need to 

Know About Crisis 

and Emergency 

Risk Communication

CDC’s Crisis and 

Emergency Risk 

Communication (CERC) 

manual was first published 

in 2002 to provide an 

experience and skills-based 

approach to health 

communications during 

emergencies. In 2012, the 

manual was updated and 

revised, including a new 

chapter on social media. 

This presentation will 

review the main principles 

of CERC, highlight the 

updates to the material, 

and explore ways in which

health educators in a 

variety of roles can use 

CERC principles in their 

work.

Date: February 26, 2013

Time: 1:00 - 2:00 pm (ET)

Register for the Webinar

U.S., Maryland: Fort Meade Burger King reopens after 

maggot infestation

8 February - The popular Burger King restaurant on Fort Meade, shut down this week when 

workers discovered an infestation of maggots, has reopened after an all-clear from the 

installation's public health team. Col. Edward C. Rothstein, commander of the Army base in 

Anne Arundel County, closed the restaurant Wednesday after the insect larvae were 

discovered during repairs to a soda machine. The infestation apparently developed around 

a leak behind a panel that was inaccessible to restaurant workers, according to base 

officials. Entomologists from Public Health Command said it appeared to have been a onetime event that had developed over seven to 10 days before it was discovered. Rothstein 

said he closed the restaurant not because it presented an immediate health risk, but to give 

staff time to conduct a "top-to-bottom cleaning" and a follow-up inspection. Baltimore Sun

top of page...

GLOBAL

Obscure Chagas' disease takes costly toll

10 February - There's been a lot of talk recently about an old 

malady that seems to be on the rise. It's called Chagas' disease, 

and it's transmitted by the so-called kissing bug, a bloodsucking 

insect that bites your face and lips. Health economists have now 

put a price tag on the global cost of Chagas, and the illness is 

taking a heavier toll than previously appreciated. Chagas costs the world about $7 billion 

annually, says the analysis just published in the The Lancet Infectious Diseases. NPR

New case of SARS-like virus shows person-to-person 

transmission

13 February - A third patient in Britain has contracted a new SARS-like virus, becoming the 

second confirmed UK case in a week and showing the deadly infection is being spread from 

person to person, health officials said on Wednesday. The latest case, who is a member of 

the family of another patient, brings the worldwide number of confirmed infections with the 

new virus - known as the novel coronavirus or NCoV - to 11. Of that total, five have died. 

Most of those infected had recently travelled in the Middle East and three have been 

diagnosed in Britain. Reuters
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Newly developed skin cream cures parasitic illness 

6 February - The painless but disfiguring lesions of 

cutaneous leishmaniasis, caused by the bite of a sand fly, 

may soon be treatable with an antibiotic cream.

Developed by an international team of researchers, the 

cream would replace lengthy and painful drug treatments 

for the disease, commonly known as CL, in subtropical and temperate climates. Right now, 

treatment for CL involves a 20-day course of drugs which contain toxic heavy metals that 

must be injected directly into a vein at hospitals and clinics. Public health workers in 

developing countries report some people infected with cutaneous leishmaniasis have tried 

to burn their disfiguring lesions with battery acid or red hot machetes rather than seek the 

medical treatment, which is painful, expensive and lengthy. VOA

NIH scientists discover promising target to block 

Staphylococcus infection

10 February - National Institutes of Health (NIH) scientists have identified a promising lead 

for developing a new type of drug to treat infection caused by Staphylococcus aureus, a 

bacterium that frequently resists traditional antibiotics. The researchers discovered a system 

used by S. aureus to transport toxins..., which they call Pmt, is common to all S. aureus PSMs 

and critical for bacterial proliferation and disease development in a mouse model. Their 

experiments suggest that a drug interfering with Pmt's function could not only prevent 

production of the PSM toxins, but also directly lead to bacterial death. NIH

Scientists find new strategy against drug-resistant 

superbugs 

7 February - Scientists may have found an effective new 

weapon against antibiotic-resistant bacteria. They did not 

create a new drug to kill these microbes; instead, they 

found a way to interfere with the metabolism of the extrahardy bacterium - E. coli in this case - so that the germs 

became more vulnerable to existing antibiotics. Scientists believe they have discovered the 

so-called superbugs’ Achilles heel, a biochemical weakness in the bacteria that makes it 

possible - in effect - to "kick them while they are down. VOA

Skin 'may restore' diseased MS brain

8 February - It may be possible to use a patient's own skin to repair the damage caused by 

multiple sclerosis (MS), which is currently incurable, say researchers. Nerves struggle to 

communicate in MS as their insulating covering is attacked by the immune system - causing 

fatigue and damaging movement... A team of scientists at the University of Rochester 

Medical Center, in the US, used advances in stem-cell research to attempt to repair the 

myelin. They took a sample of human skin cells and converted it into stem cells, which are 
capable of becoming any other type of cell in the body. The next step was to transform the 

stem cells into immature versions of cells in the brain that produce myelin. When these cells 

had been injected into mice born without any myelin it had had a significant effect, said 

researchers. BBC News

Tracking system could fight fake drugs

13 February - Fighting the problem of fake drugs will require putting medications through a 

chain of custody like U.S. courts require for evidence in a trial, the Institute of Medicine 

reported Wednesday. The call for a national drug tracking system comes a week after the 

Food and Drug Administration warned doctors, for the third time in about a year, that it 

discovered a counterfeit batch of the cancer drug Avastin that lacked the real tumor-killing 

ingredient... The Institute of Medicine report made clear that this is a global problem that 

requires an international response, with developing countries especially at risk from phony 

medications. Drug-resistant tuberculosis, for example, is fueled in part by watered-down 

medications sold in many poor countries. ABC News

top of page...

INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

 In Week 5 (through 2 February 2013), Influenza-Like Illness (ILI) and Pneumonia & 

Influenza (P&I) incidence rates increased substantially in unvaccinated active duty 

members in PACOM. The proportion of outpatient visits due to ILI decreased in the US 

but continued to increase in EUCOM and PACOM. The proportion of outpatient visits 

due to P&I decreased for most regions but remained elevated in EUCOM compared to 

previous seasons. 

 Across the overseas DoD laboratory surveillance network, influenza activity has 

decreased in Central and East Africa but remained at moderate levels with variable cocirculation of influenza A/H1, A/H3, and B across all sites. 

 The influenza vaccination coverage for the DoD (Active Duty component only) is 96%.

AFHSC DoD Influenza Surveillance Summary

CDC: Weekly Influenza Surveillance Report

During week 5 (January 27 - February 2, 2013), influenza activity remained elevated in the 

United States, but decreased in most areas. 

 Viral Surveillance: Of 10,132 specimens tested and reported by collaborating 

laboratories, 2,362 (23.3%) 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: Fourteen pediatric deaths were reported. 

 Geographic Spread of Influenza: Thirty-eight states reported widespread influenza 

activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During Week 5, 190 specimens were tested from 39 locations. There were 72 influenza 

A viruses (57 A (H3N2), 14 A(H1N1)pdm09, and one A/Not Subtyped) and 15 influenza 

B viruses detected.

 To date, 2,354 specimens have been tested from 75 locations of which 798 were 

positive for influenza A (727 A(H3N2), 64 A(H1N1)pdm09, two co-infections of A(H3N2) 

& B, one co-infection of A(H3N2) & A(H1N1)pdm09, one co-infection of A(H3N2) and 

Parainfluenza and three A/not subtyped); and 139 were positive for influenza B (14 

B/Yamagata, two B/Victoria, and 123 B/lineage undetermined). There have been 146 

other respiratory viruses isolated (54 Parainfluenza, 40 Adenovirus, 43 RSV, and nine

Enterovirus).

 Sequence analysis of specimens processed indicate a good match to the vaccine strains 

this season. USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

 In week 5/2013 (28 January – 3 February 2013), 19 countries reported concomitantly 

high/medium-intensity transmission and wide geographic spread. Twenty-two countries 

reported increasing trends in influenza activity. 

 The proportion of influenza-positive sentinel specimens continued to increase, reaching 

55%. 

 Since week 40/2012, the proportions of influenza A and B viruses have remained similar 

(51% vs. 49%), but among type A viruses, the percentage of A(H1)pdm09 has continued 

to increase (64%), compared to 52% in week 2/2012. 

 Of 71 hospitalised laboratory-confirmed influenza cases reported by six countries, 33 

(46%) tested positive for influenza A viruses and 38 (54%) for type B viruses. 

Influenza activity continued to rise across Europe in week 5/2013. In a few countries, the 

epidemics seemed to have passed their peaks, although some countries experienced a 

resurgence of ILI rates. Weekly Influenza Surveillance Overview

Google.org: Flu Trends

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

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

intense in France, Sweden, and Japan. In the southern hemisphere flu activity ranges from 

minimal to low. Google.org Flu Trends
Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update

For Week 6 ending 9 February 2013:

 Influenza: Three cases of NHRC laboratory-confirmed influenza (A/H3) among US 

military basic trainees.

 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 at or

below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

USAPHC: U.S. Army Influenza Activity Report

For the week ending 2 February 2013 (Week 5)

 Civilian influenza-like illness activity continues decreasing, although it remains above 

baseline. Activity continues shifting westward. CDC reports civilian hospitalizations 

continue to increase, while deaths are beginning to decrease compared to previous 

weeks.

 ILI Activity: Data unavailable.

 Influenza cases: 1 dependent hospitalized influenza case was reported to USAPHC in 

week 5. 60 hospitalized cases have been reported during this influenza season, 53 in 

dependents and 7 in Active Duty.

 Acute Respiratory Disease at BCT sites: While ARD rates remain low at all Army BCT 

sites, surveillance testing in weeks 2 & 3 detected influenza at Ft. Jackson (11/13 were 

A/H3) and Ft. Leonard Wood (3 A/H3).

 Viral specimens: During week 5, 561 of 1970 (28%) laboratory specimens tested were 

positive for respiratory pathogens. Influenza A accounted for 49% of positive 

specimens. Most of the influenza positive specimens were from SRMC (30%); 27% were 

from WRMC, and 18% from ERMC. USAPHC U.S. Army Influenza Activity Report

PANDEMIC AND AVIAN INFLUENZA

Cambodia, China report H5N1 fatalities

13 February - H5N1 avian influenza killed two more people, a young girl whose illness was 

first announced by Cambodian authorities today and a Chinese woman whose infection was 

first reported 3 days ago. Cambodia's health ministry, in a joint statement with the World 

Health Organization (WHO) said the 3-year-old girl who died was from Kampot province 

and is the country's seventh H5N1 case so far this year... An investigation into the source of 

her infection identified recent poultry deaths in the girl's village and reported that she had 
contact with sick poultry before she started having symptoms... China's two new cases fit a 

pattern of infections without exposure to poultry, raising questions about possible 

surveillance gaps in poultry or problems with China's vaccination program... If the WHO 

confirms the two cases, China's H5N1 total would rise to 45 infections and 29 deaths. Also, 

the additional case and two new H5N1 deaths would push the global H5N1 count to 619 

illnesses, including 367 deaths. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

Europe: Horsemeat scandal deepens as minister says 

bute may be in food chain

14 February - Eight horses slaughtered for food in the UK have tested positive for the 

veterinary painkiller phenylbutazone, known as bute, new tests from the Food Standards 

Agency (FSA) revealed. The minister for food and agriculture, David Heath, told the 

Commons that 206 carcasses had been tested. Six of the carcasses that tested positive may 

have entered the food chain in France in the last few weeks, according to the FSA, and 

efforts were being made to recall them. Heath said the Findus food products found to 

contain horse had tested negative for bute... In July 2012 the veterinary residues committee 

(VRC), which advises the government, warned that it had repeatedly expressed concern 

about bute entering the food chain. Guardian

U.S., California: Investigation underway for bovine 

tuberculosis case in CA 

12 February - Agriculture officials in California are currently investigating cases of bovine 

tuberculosis in a dairy cow herd first reported last Wednesday. The bacteria that causes 

bovine tuberculosis (TB) can spread to humans via raw milk, but the cow belonged to a 

dairy in Tulare County which pasteurizes all of its milk, thus eliminating the risk of 

tuberculosis transmission. Food Safety News

U.S.: Industry says government is obligated to provide 

meat inspection, even with sequester 

11 February - After the White House and Agriculture Secretary Tom Vilsack suggested that 

the automatic budget cuts, known as the sequester, could force the government to furlough 

all federal meat inspectors, the food industry is arguing that such a move would violate the 

government’s legal obligation to keep inspectors at work. Furloughing more than 6,000 

meat safety inspectors housed at the U.S. Department of Agriculture’s Food Safety and 

Inspection Service would effectively shut down American meat and poultry production 

because plants must have FSIS inspectors present to operate. Food Safety News
U.S.: Lean Cuisine recalled nationwide for fragments of 

glass 

12 February - Nestlé Prepared Foods Company recently announced it is recalling two 

production codes of LEAN CUISINE® Culinary Collection Mushroom Mezzaluna Ravioli, UPC 

13800-58358... The reason for the recall is that the meal may contain fragments of glass. 

Nestlé is taking this action after three consumers reported they had found small fragments 

of glass in the ravioli portion of the entrée. No injuries were reported by any of the 

consumers. Food Safety News

top of page...

WELLNESS

Everyday activities may have same health benefits as 

going to gym

10 February - Short stretches of physical activity -- such as taking the stairs 

or raking leaves -- throughout the day can be just as beneficial as a trip to 

the gym, according to a new study. Researchers looked at more than 6,000 

American adults and found that this "active lifestyle approach" appeared to 

be as effective as structured exercise in providing health benefits such as 

preventing high blood pressure, high cholesterol and the group of risk factors known as 

metabolic syndrome that increases the risk for coronary artery disease, stroke and type 2 

diabetes. Medline Plus

Price for a new hip? Many hospitals are stumped

11 February - Jaime Rosenthal, a senior at Washington University in St. Louis, called more 

than 100 hospitals in every state last summer, seeking prices for a hip replacement for a 62-

year-old grandmother who was uninsured but had the means to pay herself. The quotes she 

received might surprise even hardened health care economists: only about half of the 

hospitals, including top-ranked orthopedic centers and community hospitals, could provide 

any sort of price estimate, despite repeated calls. Those that could gave quotes that varied 

by a factor of more than 10, from $11,100 to $125,798. New York Times

Petition urges FDA to limit sugar levels

14 February - Consumer groups, scientists, and health-advocacy 

organizations recently urged the US Food and Drug 

Administration (FDA) to consider determining safe limits of 

high-fructose corn syrup and other forms of sugar in soft drinks, 

as high levels could affect the risk of developing diabetes, 
obesity, and heart disease. In particular, the Center for Science in the Public Interest (CSPI) 

helped spearhead the effort to urge the FDA to consider safe level of sugars in beverages. 

CSPI stated that a 20-ounce bottle of soda has approximately 16 teaspoons of sugar from 

high-fructose corn syrup, which is double the daily limit advised by the American Heart 

Association (AHA). Red Orbit

Straining to hear and fend off dementia

11 February - ... Over the past few years, [Dr. Frank Lin, an otolaryngologist and 

epidemiologist at Johns Hopkins School of Medicine] has delivered unwelcome news to 

those of us with hearing loss. His work looks “at the interface of hearing loss, gerontology 

and public health,” as he writes on his Web site. The most significant issue is the relation 

between hearing loss and dementia... In an interview, Dr. Lin discussed some possible 

explanations for the association. The first is social isolation, which may come with hearing 

loss, a known risk factor for dementia. Another possibility is cognitive load, and a third is 

some pathological process that causes both hearing loss and dementia. New York Times

Vitamin D supplement labels grossly inaccurate about 

what’s inside

12 February - ...Researchers from Kaiser Permanente Center for Health Research (KPCHR) in 

Portland, Oregon today released findings vitamin D sold in stores contain anywhere from 9 

– 140 percent of the doses listed on the supplement’s label. Though none of the pills 

studied were likely to be dangerous, many contained far too little of the vitamin to 

effectively treat people with a deficiency, the researchers said... Even more embarrassingly, 

pills from compounders were nearly as variable as the OTC brands, varying from 23 – 146 

percent of the expected dose. Red Orbit

Working out when to exercise in the cold and flu season

11 February - Sniffles, runny noses and flu-like symptoms can deter, delay and even derail 

many exercisers just when enthusiasm for that New Year's resolution is beginning to flag. 

Health and fitness experts advise to starve a fever of exercise. But feeding a cold 

moderately, with a brisk walk, may not be a bad idea. "The classic line from every sports 

medicine doctor is, ‘If you can do it, do it. If you can't, don't,'" said Dr. Lewis G. Maharam, 

author of "Running Doc's Guide to Healthy Running." Usually if symptoms are confined to 

above the neck, exercising is OK, he explained. But if you're running a fever of 101 degrees 

Fahrenheit (38.3 degrees Celsius) or higher, skip it. Reuters

top of page...
USAFRICOM

Africa: Mothers’ health is improving across continent

11 February - In recent years, the shrill cries of a newborn baby have been bringing more 

shouts of joy than of anguish in maternity wards across Africa. That is because maternal 

deaths are decreasing on the continent, says Gifty Addico, a South Africa-based adviser for 

the UN Population Fund (UNFPA). New figures in a UN report, Trends in Maternal Mortality: 

1990 to 2010, show that maternal mortality has declined by 41 per cent in the past 10 years 

in sub-Saharan Africa. "More mothers and their babies are staying alive after birth, and this 

is a very good sign," comments Ms. Addico, as the inflection of her voice rises in excitement. 

"But we need to do more to make sure that every mother lives to see her child," she told 

Africa Renewal. All Africa

Mozambique: Cholera confirmed in northern 

Mozambique

8 February - In the last 10 days, 22 cases of the waterborne disease cholera have been 

confirmed by laboratory testing in three areas in and around the northern Mozambique 

town of Pemba, in Cabo Delgado Province. Leonard Heyerdahl, project manager of Africhol

- an initiative of Paris-based NGO Agence de Médecine Préventive that is working in 

cooperation with the government's National Institute of Health (NIH) - told IRIN that from 

30 January, “samples started turning positive [for cholera].” Prior to that, there were 366 

cases of severe diarrhoea caused by the salmonella bacteria. IRIN

Nigerian doctor fighting killer blood disease

11 February - Every year, more than 200,000 African children are born with sickle-cell 

anemia -- around 150,000 of those in Nigeria. At the Lagos University Teaching Hospital 

(LUTH), rows of young women line up inside the antenatal clinic. Many of them suffer from 

sickle-cell anemia, the world's most common hereditary blood disorder. They are here to 

see Dr Bosede Afolabi, a specialist practitioner who has dedicated much of her working life 

to studying the disease and how it affects pregnant women and their babies. "We have the 

highest number of people suffering from sickle-cell disease in the world," explains Afolabi, 

an associate professor of obstetrics and gynecology who consults twice a week at LUTH. Her 

mission is to use her knowledge to cut maternal mortality in Nigeria. Around one in four

people in the West African country carries the sickle cell gene -- around 40 million people --

and virtually everyone has lost a relative or a close friend to the disease. CNN

Nigeria: Wazobia FM journalists held over polio deaths

12 February - Two Nigerian journalists have been arrested over the killing of nine female 

polio vaccinators in northern Kano state on Friday, police have said. Kano police chief 

Ibrahim Idris told the BBC the journalists would be charged with culpable homicide. They 

had incited the public to oppose vaccinations through their Wazobia FM radio station, he 

alleged. Some Muslim leaders in northern Nigeria believe polio vaccinations cause infertility 

among women. They see it as a Western conspiracy to reduce the Muslim population. Such 
opposition is a major reason why Nigeria is one of just three countries where polio is still 

endemic. There were 121 cases of polio in Nigeria last year, compared to 58 in Pakistan and 

37 in Afghanistan, according to the Global Polio Eradication Initiative. BBC News

Polio in Niger

12 February 2013 - Following the notification on 3 January 2013 of a wild poliovirus type 1 

(WPV1) case in Niger, outbreak response is continuing in the country. A WPV1 case had 

been detected from Tahoua region, with onset of paralysis on 15 November 2012 (the first 

case in the country since December 2011). Genetic sequencing confirmed that the virus was 

a new importation into Niger, most closely related to virus circulating in Kaduna state, 

Nigeria... This event confirms the risk of ongoing international spread of a pathogen (WPV) 

slated for eradication. WHO

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USCENTCOM

Egypt: Poliovirus detected from environmental samples

11 February - In Egypt, wild poliovirus type 1 (WPV1) was isolated from sewage samples 

collected on 2 and 6 December 2012 in two areas of greater Cairo. Virus has been detected 

in sewage only; no case of paralytic polio has been reported. Genetic sequencing shows that 

the virus strains are closely related to virus from northern Sindh, Pakistan. Pakistan is one of 

three countries worldwide affected by ongoing indigenous transmission of WPV (together 

with Nigeria and Afghanistan). The isolates were detected through routine environmental 

surveillance in Egypt that involves regular testing of sewage water from multiple sites.

Following detection of these isolates, the Government of Egypt is implementing a 

comprehensive response in line with international outbreak response guidelines issued by 

the World Health Assembly (WHA) in Resolution WHA59.1. WHO

Syria: Syrian refugee diseases, infections on the rise

13 February - ...Lebanese officials have reported several cases of tuberculosis and Hepatitis 

A in Syrian refugee areas. The aid organization Medecins Sans Frontieres has treated cases 

of lice, scabies and the skin disease leishmaniasis, said its Head of Mission Fabio Forgione. 

“We have seen an increase in certain diseases related to overcrowding and poor living 

conditions,” he said... The increase in health problems comes as the United Nations

struggles to help over 265,000 refugees and reach many more people who have yet to seek 

aid. Despite the U.N. registering nearly 50,000 refugees a month, according to U.N. reports, 

the number of unregistered refugees continues to increase while their living conditions 

decline. The Daily Star

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USEUCOM

Israel: Hepatitis A outbreak reported TA, Bat Yam

8 February - The Health Ministry has reported a significant outbreak of hepatitis A, with 69 

cases – almost 20 percent of them diagnosed in young drug-addicted and homeless men in 

south Tel Aviv and Bat Yam – compared to only seven reported cases in the previous year.

Jerusalem Post

Russia: Hundreds injured by meteor explosion

15 February - A meteor streaked over the city of Chelyabinsk in Russia's Ural Mountains on 

Friday morning, producing a blast that injured hundreds, caused minor damage to buildings 

and temporarily disrupted Internet communication, officials said. Yelena Smirnykh, deputy 

information chief of the Emergency Situations Ministry said 474 people sought medical 

assistance after the explosion. "Five of them were hospitalized, most of the injuries being 

cuts by shattered window glass," she said... The meteor entered the atmosphere over the 

north of Kazakhstan and flew over part of Russia before exploding over Chelyabinsk, said 

Vladimir Stepanov, chief of the Emergency Situations Ministry's crisis center. "We have 

deployed 28 stations in the area to monitor radiation levels, which up to now remain 

normal," Stepanov said. He added that officials did not have sufficient time to issue a 

warning before the meteor entered the atmosphere. Los Angeles Times

United Kingdom: Child hospital stays 'keep rising'

11February - The number of children being admitted to hospital each year in England has 

increased over the past decade, according to researchers. A report in Archives of Disease in 

Childhood showed 739,000 children under 15 were admitted in 2010, up from 594,000 in 

1999. The greatest increase was in children under five years of age. Experts said the strain of 

growing demand could lead to standards dropping. There has been a surge in births in the 

UK, but even accounting for the growing numbers of children there was still a 28% increase 

in the admissions rate between 1999 and 2010. Admissions in children under 12 months 

increased by 52% and the rate increased by 25% in those aged between one and four. 

BBC News

United Kingdom: Measles outbreaks hit 18-year high as 

effects of MMR scandal are felt

8 February - Outbreaks of measles across England and Wales 

have reached the highest levels for 18 years, leaving young 

adults and teenagers whose parents did not get them 

immunised during the 1998 MMR scare most at risk, with 

many taken to hospital. Public health campaigns are now 

being run across affected areas to persuade older people, teenagers, university students 

and young adults to get themselves vaccinated. All of these groups are not only vulnerable 

themselves but pose a risk to babies and toddlers. Guardian

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USNORTHCOM

U.S.: Acute kidney injury associated with synthetic 

cannabinoid use — multiple states, 2012

15 February - In March 2012, the Wyoming Department of Health was notified by Natrona 

County public health officials regarding three patients hospitalized for unexplained acute 

kidney injury (AKI), all of whom reported recent use of synthetic cannabinoids (SCs), 

sometimes referred to as "synthetic marijuana." SCs are designer drugs of abuse typically 

dissolved in a solvent, applied to dried plant material, and smoked as an alternative to 

marijuana. AKI has not been reported previously in users of SCs and might be associated 

with 1) a previously unrecognized toxicity, 2) a contaminant or a known nephrotoxin present 

in a single batch of drug, or 3) a new SC compound entering the market. After the Wyoming 

Department of Health launched an investigation and issued an alert, a total of 16 cases of 

AKI after SC use were reported in six states... The results of the investigation determined 

that no single SC brand or compound explained all 16 cases. Toxicologic analysis... 

identified a fluorinated SC previously unreported in synthetic marijuana products. Morbidity 

and Mortality Weekly Report

U.S. fertility rates fall to all-time low

11 February - Here we go again. The rate at which American women are having babies fell 

by 1 percent in 2011, continuing a decline that's been under way for years. There were 63.2 

births per 1,000 women aged 15 to 44 in 2011 (the lowest on record), compared with 64.1 in 

2010 and 66.2 in 2009. A deeper look at the numbers reveals some other noteworthy trends. 

Births to teenagers hit another low — 31.3 per 1,000 women aged 15 to 19, down from 34.2 

in 2010. Fertility rates rose a little for older women — climbing 1 percent to 10.3 births per 

1,000 women aged 40 to 44 from 10.2 in 2010. The rate of births was unchanged for women 

aged 45 to 49. The infant mortality rate was 6.05 deaths per 1,000 live births in 2011, about 

the same as the rate of 6.15 in 2010. There has been some improvement in the U.S. The rate 

stood at 6.91 in 2000 and 9.22 in 1990. But the U.S. could do a whole lot better. A table 

that's part of the analysis published in the latest issue of Pediatrics puts the U.S. just behind 

Hungary and Slovak Republic in a list of 30 nations ranked by infant mortality. NPR

U.S.: First cases of vaccine-resistant whooping cough 

found in United States

8 February - In a letter to the editor published in the New England Journal of Medicine, 

doctors have identified twelve cases of pertussis that do not respond to the pertussis 

vaccine. The samples were collected from children hospitalized in Philadelphia in 2011 and 

2012. These are the first cases of vaccine-resistant pertussis identified in the United States...

This new resistance to the pertussis vaccine may be why whooping cough cases have been 

increasing. Experts also believe that increased awareness about whooping cough has led to 

reporting of more cases. HealthMap
U.S.: Big strides in reducing domestic violence 

13 February - A bruised cheek. A broken bone. Verbal battering. A window shattered in an 

effort to intimidate. The rate of such violence or abuse between husband and wife – or any 

two intimate partners – has been on the wane in America, falling by a stunning 64 percent 

between 1994 and 2010. That finding, from a recent report by the US Department of Justice

on intimate partner violence (IPV), parallels the overall drop in violent crime during that 

period. Many in the field cite a broad shift in attitudes that began in the 1980s and '90s, 

crediting public awareness campaigns, national legislation protecting victims, and 

subsequent training of police and prosecutors to recognize intimate partner violence as a 

crime, rather than as a private matter. Christian Science Monitor

U.S.: Powerful Northeast storm kills 4, tests officials’ 

emergency readiness

9 February - The massive blizzard that whipped New England this weekend with hurricaneforce winds and crushing snow tested the readiness of authorities to deal with the 

increasing frequency of severe and record-breaking weather. State officials in Massachusetts 

took the rare step of ordering cars off the streets in advance of the storm, while in Long 

Island, hundreds of commuters were surprised and stranded by the blizzard, which dumped 

two to three feet of snow on the region. The storm claimed at least four lives and added to 

the march of extreme weather events in the past year that includes Hurricane Sandy, a deep 

drought, the hottest U.S. year on record and widespread wildfires in the West.

Washington Post

U.S.: Slower growth of health costs eases deficit

11 February – A sharp and surprisingly persistent slowdown in the growth of health care 

costs is helping to narrow the federal deficit... In figures released last week, the 

Congressional Budget Office said it had erased hundreds of billions of dollars in projected 

spending on Medicare and Medicaid. The budget office now projects that spending on 

those two programs in 2020 will be about $200 billion, or 15 percent, less than it projected 

three years ago... Health experts say they do not yet fully understand what is driving the 

lower spending trajectory. But there is a growing consensus that changes in how doctors 

and hospitals deliver health care — as opposed to merely a weak economy — are playing a 

role. New York Times

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USPACOM

Australia: Feral pig outbreak after floods

12 February - Feral pig numbers are on the rise after flooding presented them with prime 

breeding conditions. Regional areas affected by flooding, particularly Hervey Bay and 
Maryborough, are plagued with a boost in pig numbers. Fraser Coast councillor James 

Hansen says pigs are being seen where they've never been seen before. "This kind of event 

with flooding really lends itself to an explosion in pigs," he said. ABC Rural

South Korea: Seoul says no nuclear radiation detected 

from North's nuke test

13 February - No change has yet been detected in the level of radiation in South Korea 

following North Korea's detonation a nuclear device this week, Seoul's nuclear safety 

commission said Wednesday. "As of 14:00 today, the level of radiation remained at the 

usual level of 50 to 300 nanosieverts per hour," the Nuclear Safety and Security Commission 

said in a press release. The report came one day after the communist North said it had 

conducted what was its third nuclear test. Seoul has also said an "artificial earthquake" 

believed to have been created by the North's detonation of a nuclear device had been 

detected. The nuclear safety commission has since intensified its radiation monitoring, 

fearing a radiation leak from the North's test site could affect the country as well. Yonhap 

News Agency

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USSOUTHCOM

Panama: MoH reports another case of hantavirus in Soná

8 February - The Department of Epidemiology of the Ministry 

of Health, confirmed a new case of hantavirus in a 35-yearold, who lives in the community of Carrizal, Sona district, 

province of Veraguas. Ricardo Chong, an epidemiologist at 

the Ministry of Health, said that so far have reported three 

cases of hantavirus, all from Soná district in less than a month. Crítica

Paraguay: Dengue epidemic leaves more than 20 dead 

and hundreds of infected

14 February - At least 23 dead and nearly 10,000 infected is the preliminary balance of a 

dengue epidemic in Paraguay, which began in January, said the Ministry of Health. 

According to the general director of that institution Surveillance, Celia Martinez, to date 

there were some 31,000 suspected cases in health centers, of which one third were 

confirmed as positive. He added that in addition to the 23 deaths, 10 other cases were 

studied to determine whether they were killed by the disease. CRE Satellite

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