11 January 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

 Appendicitis and appendectomies, active and reserve components, U.S. Armed Forces, 2002-

2011

 Obama signs Murray amendment on soldier suicides

 Study: Supplements can add too much caffeine

GLOBAL

 Bioengineer developing needle-free "nanopatch" vaccines

 Cancer-killing cells grown by Japanese scientists in major breakthrough

 First cases of 'incurable' antibiotic resistant gonorrhea found in North America as CDC warns of 

public health nightmare

 WHO experts endorse inactivated polio vaccine as part of eradication effort

 Winter norovirus cases spike around globe

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

 Not too late to get flu vaccine, FDA urges

 Google.org: Flu Trends

 Indiana hospital fires 8 workers who refused flu shot

 Naval Health Research Center: Febrile Respiratory Illness Surveillance Update

 Two Chinese women die from H1N1 flu in Beijing: state media

 USAPHC: U.S. Army Influenza Activity Report

 WHO: Many northern countries see swelling flu activity

VETERINARY/FOOD SAFETY

 After cantaloupe outbreak, FDA tells farm to correct salmonella problems

 Mexico: Mexicans debate the fate of stray dogs blamed in four mauling deaths
OPSS: Fueled for 

Fitness Brochure

A new Operation 

Supplement Safety 

(OPSS) nutrition brochure 

is available from the 

Health Information 

Products eCatalog.

 Organics “thrown under the bus” in farm bill extension, say industry advocates

 Three more countries place restrictions on Brazilian beef over BSE concerns

WELLNESS

 Cockroaches could lead to new antibiotics

 Do the brain benefits of exercise last?

 Pap test could help find cancers of uterus and ovaries

 Spit test 'improves' asthma care

 Update: Workplace wellness programs

USAFRICOM

 Mauritania: Refugees face “alarming” malnutrition, mortality rates

 Nigeria: Adequate drinking water still a tall dream in Nigeria

 Rainfall, brain infection linked in sub-Saharan Africa

 Tanzania: 10,000 Sumbawanga children to get diarrhoea, pneumonia vaccinations

 Uganda: Ebola virus disease

 Zambia: Mwense cholera under control

USCENTCOM

 Iran: Annual buildup of air pollution chokes Tehran

 Snowstorm, fierce winds and deadly flooding thrash Middle East

 Syria crisis: Food aid 'cannot reach a million people'

USEUCOM

 United Kingdom: Baha Mousa death - Derek Keilloh's patients lead campaign

 United Kingdom: Health screening - top doctors attack 'scare tactics' by private companies

USNORTHCOM

 Canada: Oil sands industry tied to higher carcinogen level

 Mexico: Disease kills 5 babies in southern Mexico

 Mexico: Obese & malnourished

 U.S.: 2012 was worst year for whooping cough since 1955

 U.S.: Annual report to the nation on the status of cancer, 1975–2009, featuring the burden and 

trends in human papillomavirus (HPV)–associated cancers and HPV vaccination coverage levels

 U.S.: CDC reports 8 new fungal infections linked to steroids

 U.S.: Depression increases in areas Superstorm Sandy hit hardest

 U.S.: Ferry captain says mechanical problem preceded crash in New York

 U.S.: Health insurers raise some rates by double digits

 U.S.: HPV-related cancers on the rise

USPACOM

 Australia: Extreme weather deadly for the vulnerable

 China plans to scan travelers from Sudan

 India: Private equity pours money into India primary healthcare

 Indonesia moves to curb smoking

USSOUTHCOM

 Haiti: Cholera has struck more than 6% of Haitians
Real Warriors 

Campaign: 

Sgt. Maj. Chandler

Service members of any 

rank or service may 

experience combat stress 

or other invisible wounds 

as a result of deployment.

Sgt. Maj. Chandler, the 

senior most enlisted 

service member in the U.S. 

Army, experienced combat 

stress following 

deployment to Iraq. With 

the support of his 

command, Sgt. Maj. 

Chandler reached out for 

the care he needed and 

continues to excel in his 

career.

U.S. MILITARY

Appendicitis and appendectomies, active and reserve 

components, U.S. Armed Forces, 2002-2011

Appendicitis is common among young, healthy populations; appendectomy is one of the 

most common surgical procedures performed in the U.S. Among active and reserve 

component members, there were 31,610 cases of appendicitis and 30,183 appendectomies

during 2002 to 2011. The overall incidence rate of appendicitis in the active component was 

18.4 per 10,000 person-years (p-yrs). During the period the incidence rates of appendicitis 

in the active component and counts in the reserve component increased. Active component 

males reported greater rates of perforated appendicitis (2.6 per 10,000 p-yrs); perforation 

occurred less frequently in service members (16%) than the civilian population (22%). Active 

component females had higher rates of incidental appendectomies (2.55 per 10,000 p-yrs). 

Medical Surveillance Monthly Report

Obama signs Murray amendment on soldier suicides

3 December - U.S. Sen. Patty Murray, D-Wash., announced Thursday that President Obama 

has signed her amendment to require the Pentagon to create a new suicide prevention 

program for active military members. The new program would also expand eligibility for 

Department of Veterans Affairs mental health service to family members, improve training 

and education for health care providers and create more soldier-to-soldier counseling 

opportunities, according to Murray. The Daily News

Study: Supplements can add too much caffeine

7 January - Troops who take dietary supplements to lose weight or get ripped may be 

getting more caffeine than is healthy, according to a new study published online today at 

JAMA Internal Medicine. Chemical analysis of 31 popular supplements sold on military 

bases that contain caffeine showed that fewer than half accurately listed caffeine content, 

with some products containing more caffeine than five 12-ounce Mountain Dews. Although 

the study did not name the products tested, the research is important, author Dr. Pieter 

Cohen said, because service members who use supplements likely also consume caffeine 

from coffee, energy drinks and food and may be getting too much of a good thing.

“Caffeine is extremely safe in the amounts found in food, and research has showed with low 

to moderate doses, your performance — increased vigilance and decreased reaction time —

is better. But like any drug or medication, get too much of it, and the benefits decrease. At 

high doses, you are going to have side effects,” Cohen said. Military Times

top of page...
Accelerating 

Progress in Obesity 

Prevention: 

Solving the Weight 

of the Nation

One-third of adults are 

now obese, and children's 

obesity rates have climbed 

from 5 to 17 percent in the 

past 30 years. The causes 

of the nation's obesity 

epidemic are multifactorial, having much 

more to do with the 

absence of sidewalks and 

the limited availability of 

healthy and affordable 

foods than a lack of 

personal responsibility. 

Accelerating Progress in 

Obesity Prevention

reviews previous studies 

and their 

recommendations and 

presents five key 

recommendations to 

accelerate meaningful 

change on a societal level 

during the next decade. 

GLOBAL

Bioengineer developing needle-free "nanopatch" vaccines

10 January - When it comes to protecting millions of people from deadly infectious 

diseases, Mark Kendall thinks a fingertip-sized patch covered in thousands of vaccinecoated microscopic spikes is the future. A biomedical engineer with a fascination for 

problem solving, he has developed the so-called "nanopatch" to try to transform delivery of 

life-saving vaccines against potential killers like flu and the HPV virus that causes cervical 

cancer. After 160 years of using needles and syringes for immunization, he says, at-risk 

people - especially those living in poorer, tropical, remote countries - need something 

simpler, stabler and easier to use. Reuters

Cancer-killing cells grown by Japanese scientists in 

major breakthrough

3 January - Cancer-killing cells have been grown in a lab by Japanese researchers, possibly a 

major breakthrough in treatments for the illness. The white blood cell known as a cytotoxic 

T-cell is produced in small numbers in the body and could possibly be reinjected to fight off 

cancer. Researchers at the RIKEN Research Centre for Allergy and Immunology were able to 

grow the cells in the lab and hope then to put them into a patient to bolster the immune 

system. Prior research into creating the killer T lymphocytes has been fruitless. Previous 

efforts have not been able to create long-lasting cells, which has limited their use as an 

effective treatment. Global Post

First cases of 'incurable' antibiotic resistant gonorrhea 

found in North America as CDC warns of public health

nightmare

8 January - The long feared nightmare of U.S. public health officials has 

come to pass with the news antibiotic resistant Gonorrhea has been 

detected in North American patients. A study released today by the Journal 

of the American Medical Association announced it had found nine patients 

with a strain of the sexually transmitted disease immune to the last 

remaining effective oral antibiotic. This confirms the fears of both the Centers for Disease 

Control and the World Health Organisation who warned last year that untreatable 

gonorrhea, the world's second most common STD would soon become a reality. 

Researchers observed that 6.7 percent of patients with gonorrhea at one Toronto clinic still 

had the disease after a round of cephalosporins, which is the last antibiotic which doctors 

are able to use to cure the disease. Daily Mail
U.S. Health in 

International 

Perspective: Shorter 

Lives, Poorer Health 

No single factor can fully 

explain the U.S. health 

disadvantage. It likely has 

multiple causes and 

involves some combination 

of inadequate health care, 

unhealthy behaviors, 

adverse economic and 

social conditions, and 

environmental factors, as 

well as public policies and 

social values that shape 

those conditions. 

Without action to reverse 

current trends, the health 

of Americans will probably 

continue to fall behind that 

of people in other highincome countries. 

WHO experts endorse inactivated polio vaccine as part of 

eradication effort

9 January - The World Health Organization's (WHO's) panel of experts on immunization has 

recommended that all countries use at least one dose of inactivated polio vaccine (IPV) to 

guard against the risk of infection with vaccine-derived poliovirus type 2. The 

recommendation is noted in a report on the November meeting of the Strategic Group of 

Experts (SAGE) on immunization, published in the WHO's Jan 4 Weekly Epidemiological 

Record. CIDRAP

Winter norovirus cases spike around globe

4 January - Winter months consistently produce the highest numbers of Norovirus 

outbreaks, but early reports suggest that the bug may be striking a particularly large 

number of victims this season. In the United Kingdom, the number of confirmed Norovirus 

cases has risen to 72 percent higher than this time last year. In total, 3,877 citizens have 

been confirmed with infections, up from 2,255 a year ago. But for every confirmed case of 

Norovirus, experts estimate that another 288 cases go unreported. That means that more 

than 1.1 million UK citizens may have already suffered bouts with the bug. Food Safety 

News

top of page...

INFLUENZA

Armed Forces Health Surveillance Center: DoD Influenza 

Surveillance Summary

10 January:

 A substantial increase of outpatient visits due to ILI among non-Servicemembers was 

observed in the United States. Throughout the MHS, increased incidence rates of 

Influenza-Like Illness (ILI) and Pneumonia & Influenza (P&I) were observed for all 

regions in Week 1 (through 5 January 2013). 

 Influenza activity is at moderate levels across the overseas DoD laboratory surveillance 

network, except in Europe where the activity remains low; sites reported variable cocirculation of influenza A/H1, A/H3, and B. 

 The influenza vaccination coverage for the DoD (Active Duty component only) is 95%. 

Preliminary findings from CDC and USAFSAM indicate that there is a good match 

between the circulating strains and the current vaccine. AFHSC DoD Influenza 

Surveillance Summary
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CDC: Weekly Influenza Surveillance Report

During week 52 (December 23-29), influenza activity increased in the U.S.

 Viral Surveillance: Of 9,363 specimens tested and reported, 2,961 (31.6%) were positive 

for influenza. 

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

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

 Influenza-Associated Pediatric Deaths: Two influenza-associated pediatric deaths were 

reported and were associated with influenza B viruses. 

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

illness (ILI) was 5.6%; above the national baseline of 2.2%.

 Geographic Spread of Influenza: Forty-one states reported widespread geographic 

influenza activity. FluView

DoD Global Laboratory-Based Influenza Surveillance 

Program

 During weeks 51-52 (16-19 December 2012), 199 specimens were tested from 36 

locations. There were 12 influenza B viruses and 96 influenza A viruses (95 influenza 

A(H3) and 1 A(H1N1)pdm09) detected. Results are preliminary and may change as more 

results are received.

 In Week 51 and 52, 54.2% of respiratory specimens collected and tested were positive 

for influenza, which is higher than the previous report of week 50.

 To date, 1,060 specimens have been tested from 61 locations of which 304 were 

positive for influenza A (two co-infections of A/H3 & B, 291 A/H3, and 11 

A(H1N1pdm09); and 43 were positive for influenza B. There have been 90 other 

respiratory viruses isolated (27 adenovirus, 13 RSV, eight enterovirus, and 42 

parainfluenza).

 Seventeen A (H3N2) viruses collected between 6 October - 20 November 2012 were 

analyzed. The H3N2 specimens characterized by USAFSAM exhibited an overall HA 

protein identity of 97.1% - 98.5%, M1 protein identity of 99.6% and M2 protein identity 

of 99.0%-100.0% as compared to A/Victoria/361/2011-like virus, the H3N2 component 

of the 2012-2013 vaccine formulation. USAF School of Aerospace Medicine

European Centre for Disease Prevention and Control:

Weekly Influenza Surveillance Overview

4 January - In week 52 (24–30 December 2012), influenza activity continues to rise in a 

number of EU/EEA countries, especially in western Europe. Greater numbers of severe 

laboratory-confirmed cases are now being reported. 

 During week 52/2012, four countries (France, Italy, the Netherlands and Norway) 

reported medium intensity transmission; geographic spread of influenza activity was 
reported as widespread by five countries (Belgium, Denmark, France, Norway and the 

UK (England)); and nine countries reported increasing trends. 

 Of 375 specimens from sentinel patients, 25% were positive for influenza virus; a small 

decrease compared with 27% in the previous week. This may be related to a lower 

number of physician consultations over the New Year holiday. 

 Since week 40/2012, 46% of sentinel specimens were type A and 54% were type B, 

though the proportion of B viruses has decreased somewhat in recent weeks. Subtyping 

of type A viruses has shown proportions of 56% A(H3) and 44% A(H1).

 Viruses characterised to date match well with the vaccine viruses.

 Countries undertaking surveillance of laboratory-confirmed severe influenza cases 

requiring hospitalisation are starting to report increasing numbers of such individuals.

Weekly Influenza Surveillance Overview

Not too late to get flu vaccine, FDA urges

10 January - A nationwide rise in flu activity has Americans on edge. As of Wednesday, 44 

U.S. states are declaring widespread flu activity, CBS News medical correspondent Dr. Jon 

LaPook reported, and the Centers for Disease Control and Prevention added that the 

percentage of Americans going to the hospital has doubled within the past month...With 

influenza sweeping the country, the Food and Drug Administration is reminding everyone 6 

months and older to get a flu shot, warning the disease could be especially dangerous for 

kids... Dr. William Shaffner, an infectious disease researcher at Vanderbilt University who 

served on the committee that decided what went into the vaccine, told the CBS Evening 

News Wednesday that this year's shot is well-matched to most of the strains out there.

However, "There is an influenza B strain that's out there, an additional strain that's causing 

about 10 percent of the mischief," he said. "And that's not in the vaccine and that accounts 

for some of the influenza that's out there." CBS News

Google.org: Flu Trends

10 January – Estimates of flu activity based on flu-related Internet search queries indicate 

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

intense in the United States and ranges from minimal to low in the southern hemisphere.

Google.org Flu Trends

Indiana hospital fires 8 workers who refused flu shot

1 January - A northern Indiana hospital has fired eight 

employees who refused to get flu shots under a new policy 

intended to protect patients from the potentially deadly 

illness. IU Health Goshen Hospital officials told its staff in 

September that flu shots would no longer be optional for 

staff, affiliated physicians, volunteers and vendors. Hospital spokeswoman Melanie 

McDonald told The Elkhart Truth for a Monday story that the new requirements came as a 

recommendation from the U.S. Centers for Disease Control and Prevention, the American 
Medical Association and other major health agencies. McDonald said patients with 

compromised immune systems are at a heightened risk for illness and death from the flu 

and protecting them is the hospital's "top priority." Fox News

Naval Health Research Center: Febrile Respiratory 

Illness Surveillance Update 

For the week ending 5 January 2013:

 Influenza: Two new cases of A/H3 influenza were laboratory confirmed by NHRC among 

US Military Basic Trainees at MRCD San Diego.

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

remain low. 

 FRI surveillance at all eight U.S. military basic training centers indicated FRI rates were at 

or below expected values. NHRC Febrile Respiratory Illness Surveillance Update 

Two Chinese women die from H1N1 flu in Beijing: state 

media

6 January - Two Chinese women have died from the H1N1 flu strain in Beijing in the past 10 

days, Chinese state media said on Sunday, the first reported deaths from the virus in China's 

capital since 2010. A 65-year-old cancer patient died on Friday and a 22-year-old migrant 

worker died on December 27, the Beijing Daily said on its website, citing the city's Center for 

Disease Control and Prevention. Flu cases in Beijing are at their highest level in five years 

and the H1N1 strain has become the most dominant, the centre's director Deng Ying said. 

Reuters

USAPHC: U.S. Army Influenza Activity Report

For the week ending 29 December 2012 (week 52), influenza activity remains higher than 

the same time last year. Civilian activity is nearing levels that represented previous seasonal 

peaks. Vaccine appears to be well-matched to circulating strains; unimmunized persons 

without contraindications to influenza vaccine can still benefit from vaccination.

 ILI Activity: Army incident ILI outpatient visits in week 52 were 4% higher than the same 

week last year.

 Influenza cases: Nine hospitalized influenza cases were reported in DRSi in week 52. A 

total of 26 hospitalized cases have been reported during this influenza season.

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

despite high civilian rates in the southeast, no increased influenza activity has been 

noted in trainees.

 Viral specimens: During week 52, 183 of 694 (26%) laboratory specimens tested were 

positive for respiratory pathogens. Influenza A accounted for 51% of positive 

specimens; RSV and influenza B for 20% each. USAPHC U.S. Army Influenza Activity 

Report
WHO: Many northern countries see swelling flu activity

7 January - Many Northern Hemisphere countries, from North America to temperate Asia, 

have seen rising flu activity in recent weeks, while cases ebbed or remained scarce in most 

of the rest of the world, the World Health Organization (WHO) said today. In its biweekly 

update, the WHO said actual virus detections have dropped in recent weeks because of the 

holiday season in many countries, but most countries in northern temperate regions have 

reported evidence of growing activity. They include countries in North America, Europe, 

North Africa, the eastern Mediterranean, and temperate Asia. CIDRAP

top of page...

VETERINARY/FOOD SAFETY

After cantaloupe outbreak, FDA tells farm to correct 

salmonella problems 

4 January - The U.S. Food and Drug Administration issued a warning to Chamberlain Farms, 

Inc. this week, months after the Indiana farm’s cantaloupe was linked to a 24-state 

Salmonella outbreak tied to cantaloupe that caused 261 illnesses and 3 deaths. According 

to FDA, which inspected and tested the farm and packinghouse in August and September, 

the firm has a Salmonella problem and needs to take corrective actions... Chamberlain 

Farms has reportedly suspended its cantaloupe operation. During the inspection, FDA 

collected 50 environmental swabs from food contact surfaces and other areas in the 

company’s packing house. Food Safety News

Mexico: Mexicans debate the fate of stray dogs blamed in 

four mauling deaths

9 January - Authorities in Mexico City have jailed 25 stray dogs 

accused of the recent mauling deaths of a young couple, a 

mother and her baby in a local park. The canine roundup has 

sparked on uproar on social media where some dog lovers are 

advocating on behalf of the strays at the Twitter hashtag 

#yosoycan26. Journalist and blogger Jennifer Schmidt has investigated the plight of the 

hundreds of thousands of strays in the Mexican capital. Schmidt says there is a growing 

recognition in Mexico of the need to do more to protect dogs. Still, she says the population 

of strays is exploding, in part because dogs are considered by many to be “disposable.” 

PRI’s The World
Organics “thrown under the bus” in farm bill extension, 

say industry advocates 

6 January - “We’ve been thrown under the bus.” That’s how some organic farmers and 

advocates are describing the government’s “eleventh-hour” decision on Jan. 1 to extend the 

2008 farm bill for 9 months instead of enacting a new 2012 farm bill. Their dismay is based 

on how organics fared when the 2008 farm bill was extended until September 2013 (Section 

701). Pure and simple, mandatory funding for a variety of organic programs written into the 

2008 farm bill didn’t qualify for automatic inclusion into the farm bill extension. That 

outcome is in contrast to the proposed Senate and House versions of the 2012 farm bill, 

hammered out last summer, that had included funding for all of the organic programs 

(except for one in the House version). Food Safety News

Three more countries place restrictions on Brazilian beef 

over BSE concerns 

5 January - Three more countries — Taiwan, Chile and Jordan — have imposed restrictions 

on Brazilian beef after it was revealed in early December the country had a case of bovine 

spongiform encephalopathy (BSE) in 2010, according to Meatingplace. China, Japan, South 

Africa, Lebanon, Peru, and Saudi Arabia have also all reportedly put bans in place since in 

the past few weeks, but not all of those countries have yet informed Brazil. Food Safety 

News

top of page...

WELLNESS

Cockroaches could lead to new antibiotics 

8 January - Most people might see cockroaches as goodfor-nothing pests, but this germ-ridden insect could be an 

indirect source of new antibiotics for humans. Cockroaches 

host the larvae of a parasitic type of wasp, which spend 

their formative days eating the bacteria-laden body of the 

cockroach from the inside out. Researchers have discovered the wasp larva secretes 

chemicals that sanitize the decidedly unsanitary guts of the cockroach. These germ-killing 

chemicals could eventually be developed for human uses. VOA

Do the brain benefits of exercise last?

9 January - It is well established that exercise bolsters the structure and function of the 

brain. Multiple animal and human studies have shown that a few months of moderate 

exercise can create new neurons, lift mood and hone memory and thinking. But few studies 

have gone on to examine what happens next. Are these desirable brain changes 

permanent? Or, if someone begins exercising but then stops, does the brain revert to its 
former state, much like unused muscles slacken?... [T]he brain benefits “wear off quickly,” 

said Dr. Michael Mazurek, a professor of neurology at McMaster, who oversaw the study. 

“This is analogous to what happens to muscle bulk or heart rate following exercise 

withdrawal.” Gilberto Xavier, a professor of psychology at the University of Sao Paulo and 

senior author of the study of hippocampal neurons, agrees. “Brain changes are not 

maintained when regular physical exercise is interrupted,” he said, adding that, “though our 

observations are restricted to rats, indirect evidence suggests that the same phenomenon 

occurs in human beings.” New York Times

Pap test could help find cancers of uterus and ovaries

9 January – The Pap test, which has prevented countless deaths from cervical cancer, may 

eventually help to detect cancers of the uterus and ovaries as well, a new study suggests. 

For the first time, researchers have found genetic material from uterine or ovarian cancers in 

Pap smears, meaning that it may become possible to detect three diseases with just one 

routine test. But the research is early, years away from being used in medical practice, and 

there are caveats. The women studied were already known to have cancer, and while the 

Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian 

cancers. And the approach has not yet been tried in women who appear healthy, to 

determine whether it can find early signs of uterine or ovarian cancer. New York Times

Spit test 'improves' asthma care

7 Jan - A simple spit test could identify thousands of 

children with severe asthma who are taking medication 

which will never help them, scientists say. One in seven 

people will not respond to salmeterol, found in purple or 

green inhalers, which is given to tens of thousands of 

children in the UK. A study of 62 children showed those patients could be identified and 

given effective treatment. BBC News

Update: Workplace wellness programs

4 December 2012 - The poor health habits of many workers, growing rates of chronic 

disease, and the rising cost of health benefits have created new interest in workplace 

wellness programs. Employers value these programs as a way to reduce absenteeism and 

employee turnover, and to offer a benefit that is appealing to many current and prospective 

employees. Some evidence also suggests that comprehensive wellness programs may pay 

off for employers by reducing their expenditures for employees' health care... The 

Affordable Care Act will, as of 2014, expand employers' ability to reward employees who 

meet health status goals by participating in wellness programs--and, in effect, to require 

employees who don't meet these goals to pay more for their employer-sponsored health 

coverage. Some consumer advocates argue that this ability to differentiate in health 

coverage costs among employees is unfair and will amount to employers' policing workers' 

health. Health Affairs

top of page...
USAFRICOM

Mauritania: Refugees face “alarming” malnutrition, 

mortality rates

10 January - In Mbéra refugee camp in eastern Mauritania, 

home to 55,000 Malians, just under one child in five is 

malnourished, and 4.6 percent are severely malnourished - two 

to three times the national average, according to a justreleased November survey by NGO Médecins sans Frontières 

(MSF). Children under five are dying mainly from a combination of malnutrition and malaria, 

respiratory infections and diarrhoea, according to MSF head in Mauritania Karl Nawezi, who 

describes the situation as “alarming and unacceptable”. Only 70 percent of under-fives have 

been vaccinated against measles, causing concern about further deaths as the combination 

of measles and malnutrition is usually fatal. MSF is calling for an emergency measles 

vaccination campaign to bring coverage up to 95 percent. IRIN

Nigeria: Adequate drinking water still a tall dream in 

Nigeria

5 January - In a report, the World Health Organisation (WHO) and UNICEF ranked Nigeria 

third globally on the list of countries with inadequate water supply and sanitation coverage. 

The 2012 report placed Nigeria behind China and India, as countries with large population 

without adequate water supply and sanitation coverage. Nigeria also occupied the 130th 

position on the Global Water Poverty Index of developing countries still battling with water 

and sanitation accessibility. Based on this scenario, experts insist that if tangible efforts are 

not made to achieve the water and sanitation goals of the Millennium Development Goals 

(MDGs), efforts to attain the other goals of ending poverty, achieving food security, 

improved health and economic empowerment will remain futile. All Africa

Rainfall, brain infection linked in sub-Saharan Africa

7 January - The amount of rainfall affects the number of infant infections leading to 

hydrocephalus in Uganda, according to a team of researchers who are the first to 

demonstrate that these brain infections are linked to climate. Hydrocephalus -- literally 

"water on the brain" -- is characterized by the build-up of the fluid that is normally within 

and surrounding the brain, leading to brain swelling. The swelling will cause brain damage 

or death if not treated. Even if treated, there is only a one-third chance of a child 

maintaining a normal life after post-infectious hydrocephalus develops, and that chance is 

dependent on whether the child has received the best treatment possible. Infection Control 

Today
Tanzania: 10,000 Sumbawanga children to get diarrhoea, 

pneumonia vaccinations

7 January - A total of 9,959 children below the age of five years in Sumbawanga 

Municipality in Rukwa Region will be vaccinated against Rotavirus diarrhoea and 

Pneumonia, the Municipal Medical in-Charge, Dr Ally Makori Mussa, disclosed. According to 

Dr Mussa, statistics show that in 2011, about 5,927 children under five years of age were 

attacked by diarrhoea, among them 27 died... Similarly, in 2011 a total of 4,134 children 

under the age of five years were admitted to health facilities in the municipality as a result 

of pneumonia and 41 of them died. All Africa

Uganda: Ebola virus disease

10 January - The [Ugandan] Ministry of Health will declare Luwero district to be Ebola-free 

on 16 Jan 2013 if no new cases are registered in the area, Permanent Secretary Asuman 

Lukwago has said. The declaration will follow the completion of the 42 days countdown 

period since the last patient was discharged from the Isolation Centre. It comes at a time 

when the Ministry has just declared Kabale and Ibanda free of Marburg virus disease. The 

countdown period is a prerequisite of the World Health Organization requiring any affected 

country to monitor the situation for 42 days before finally declaring an end to an outbreak. 

Lukwago said the declaration will be made in [respect of] Luwero alone. "Due to the 

[sporadic nature] of the outbreaks we have decided to declare district by district free from 

outbreaks meaning that if Luwero is declared free of Ebola virus disease, [the declaration 

applies to that district only]". ProMED-mail

Zambia: Mwense cholera under control

7 January - The cholera situation in Mwense District has been brought under control as the 

volunteer medical mission Doctors Without Borders (MSF) arrived in Luapula Province. The 

group boosted the Zambian health authorities and supplied medical facilities at the 

weekend to contain the water-borne disease. District Commissioner Victor Kasuba said 

about 25 patients were admitted to the cholera centre set up at Mulundu Basic School. Mr 

Kasuba said there were no new cases and that with the help of the MSF team, villagers were 

being advised to stop drawing water from shallow wells and from Luapula River. All Africa

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USCENTCOM

Iran: Annual buildup of air pollution chokes Tehran

6 January - ...Iranians living here in the capital are now trying to cope with what has become 

an annual pollution peril: a yellowish haze that engulfs Tehran this time of year. For nearly a 

week, officials here and in other large cities have been calling on residents to remain 
indoors or avoid downtown areas, saying that with air pollution at such high levels, 

venturing outside could be tantamount to “suicide,” state radio reported Saturday. On 

Sunday, government offices, schools, universities and banks reopened after the government 

had ordered them to shut down for five days to help ease the chronic pollution. Tehran’s 

normally bustling streets were largely deserted. Residents who dare to go outside cover 

their mouths and noses with scarves or surgical masks, but their eyes tear up and their 

throats sting from the mist of pollutants, which a report by the municipality of Tehran says 

is made up of a mixture of particles containing lead, sulfur dioxins and benzene. New York 

Times

Snowstorm, fierce winds and deadly flooding thrash 

Middle East

10 January - Brutal winter weather is making dire conditions even more so in parts of the 

Middle East, especially for thousands of Syrian refugees enduring frigid temperatures in 

tents. The coldest air of the season was moving in behind a heavy snowstorm that 

blanketed refugee camps in Turkey and Lebanon. In Syria, residents in cities pummeled by 

warfare were taking drastic measures to stay alive... More than 500 Palestinians have been 

injured and more than 400 homes submerged by floodwater this week from a storm that 

struck the West Bank area, Palestinian media reported. The flooding claimed the lives of two 

women who were in a taxi that was swept away, a Palestinian medical official told CNN. 

More than 500 Palestinians have been injured and more than 400 homes submerged by 

floodwater this week from a storm that struck the West Bank area, Palestinian media 

reported. The flooding claimed the lives of two women who were in a taxi that was swept 

away, a Palestinian medical official told CNN... At a Syrian refugee camp in Amman, Jordan, 

temperatures plunged early Wednesday to 4 degrees Celsius (39 degrees Fahrenheit) with 

fierce winds. Torrential rain and increasing snowfall paralyzed much of the country, and 

most government and public offices in Jordan closed Wednesday and were to remain 

closed Thursday, the state-run Petra news agency said. CNN

Syria crisis: Food aid 'cannot reach a million people'

8 January - One million Syrians are going hungry and helpless due to the 22-month civil 

conflict in the country, the UN says. The World Food Program (WFP) says it is helping 1.5 

million Syrians, but continued fighting and an inability to use the port of Tartus to deliver 

food mean many people are not receiving aid. The UN estimates that more than 60,000 

people have been killed in the uprising, which began in March 2011. Rebels have gained 

control of swathes of northern Syria in recent months. The increasingly dangerous situation 

meant the WFP had pulled its staff out of its offices in Homs, Aleppo, Tartus and Qamisly, 

said agency spokeswoman Elisabeth Byrs... Meanwhile, the UN refugee agency said the 

number of refugees fleeing the violence in Syria had leapt by nearly 100,000 in the past 

month. It said there were 597,240 registered refugees and individuals awaiting registration

as of 6 January - up from 509,559 the month before. The UN estimates that around four 

million Syrians are in need of humanitarian aid. BBC News

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USEUCOM

United Kingdom: Baha Mousa death - Derek Keilloh's 

patients lead campaign

8 January - Derek Keilloh, 38, was an army medic in Iraq in 2003 

when Baha Mousa was severely beaten by British soldiers. The 

Medical Practitioners Tribunal Service (MPTS) found Dr Keilloh 

guilty of misconduct last month. About 300 people attended 

the meeting and Dr Keilloh was described as "of the highest 

integrity" by his supporters... Mr Mousa suffered 93 injuries after he was arrested by soldiers 

who believed, wrongly, that he was an insurgent involved in the murder of four of their 

colleagues the month before. Dr Keilloh supervised a failed resuscitation attempt, and the 

MPTS said he did "everything possible" to save Mr Mousa's life. But, the panel said by not 

reporting the injuries to senior officers he failed in his duty to protect his patients from 

further mistreatment. BBC News

United Kingdom: Health screening - top doctors attack 

'scare tactics' by private companies

5 January - Private health screening companies are using scare tactics to persuade people 

to part with their cash, according to leading medical practitioners. An increasing number of 

companies offer screening for everything from coronary heart disease to celiac disease and 

cancer of the colon. They advertise in the national press, online and some also mail people 

directly. The companies offering these services write to potential customers inviting them, 

ahead of arriving in an area, to a screening day at a local venue. The packages offered vary. 

One company, Lifescan , for example, runs testing and assessments including checking a 

single mole for £75 up to a £1,010 package aimed at the over 45s, which includes low-dose 

CT scans of the lungs, heart checks and a virtual colonoscopy. Another company, Prescan , 

advertises breast awareness consultations from £250 and brain scans for £1,280 on its 

website. Guardian

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USNORTHCOM

Canada: Oil sands industry tied to higher carcinogen 

level

7 January - The development of Alberta’s oil sands has increased levels of cancer-causing 

compounds in surrounding lakes well beyond natural levels, Canadian researchers reported 

in a study released on Monday. And they said the contamination covered a wider area than 

had previously been believed. For the study, financed by the Canadian government, the 
researchers set out to develop a historical record of the contamination, analyzing sediment 

dating back about 50 years from six small and shallow lakes north of Fort McMurray, 

Alberta, the center of the oil sands industry. Layers of the sediment were tested for deposits 

of polycyclic aromatic hydrocarbons, or PAHs, groups of chemicals associated with oil that 

in many cases have been found to cause cancer in humans after long-term exposure. New 

York Times

Mexico: Disease kills 5 babies in southern Mexico

6 Jan – Authorities in the southern Mexican state of Chiapas say a bacterial disease has 

killed five babies and sickened 41 others in a remote indigenous community that is 

experiencing a wave of intense cold and rains. Chiapas’ health department said Sunday in a 

statement that residents of Emiliano Zapata in the municipality of Yajalon have been urged 

to stay in their homes and avoid contact with others to prevent the spread of the bacteria 

that is causing the infection, which is characterized by coughing and fever. Ledger-Enquirer

Mexico: Obese & malnourished

5 January - No More Poverty and co-founders Michael Omidi and Julian Omidi are pleased 

to announce their sponsorship of the Himalayan Institute’s Vida Project, an initiative that 

seeks to provide rural Mexican communities with the technical knowledge and counseling 

needed to grow high-yield garden crops and maintain healthy eating practices. The easy 

availability of empty calories in the form of processed and inexpensive foods has caused the 

bewildering problem of both obesity and malnutrition in poor communities. Mexico has one 

of the highest obesity rates in the world with 70 % of Mexican adults classified as 

overweight or obese. All Voices

U.S.: 2012 was worst year for whooping cough since 1955

4 January - The nation just suffered its worst year for whooping cough in nearly six decades, 

according to preliminary government figures. Whooping cough ebbs and flows in multiyear cycles, and experts say 2012 appears to have reached a peak with 41,880 cases. 

Another factor: A vaccine used since the 90s doesn't last as long as the old one. The vaccine 

problem may continue to cause higher than normal case counts in the future, said Dr. Tom 

Clark of the Centers for Disease Control and Prevention. Yahoo! News

U.S.: Annual report to the nation on the status of cancer, 

1975–2009, featuring the burden and trends in human 

papillomavirus (HPV)–associated cancers and HPV 

vaccination coverage levels 

7 January - ... Death rates continued to decline for all cancers combined for men and 

women of all major racial and ethnic groups and for most major cancer sites; rates for both 

sexes combined decreased by 1.5% per year from 2000 to 2009. Overall incidence rates 

decreased in men but stabilized in women. Incidence rates increased for two HPVassociated cancers (oropharynx, anus) and some cancers not associated with HPV (e.g., liver, 

kidney, thyroid). Nationally, 32.0%... of girls aged 13 to 17 years in 2010 had received three 
doses of the HPV vaccine, and coverage was statistically significantly lower among the 

uninsured... and in some Southern states (e.g., 20.0% in Alabama,... where cervical cancer 

rates were highest and recent Pap testing prevalence was the lowest. Journal of the National 

Cancer Institute

U.S.: CDC reports 8 new fungal infections linked to 

steroids

7 January - The US Centers for Disease Control and Prevention (CDC) today confirmed eight 

new fungal infections linked to tainted steroids since its last update on Dec 28, including a 

fatal case. Total cases have now reached 664, including 40 deaths, the agency said... Cases 

have been confirmed in 19 states, with the highest case counts in Michigan, 234; Tennessee, 

140; Indiana, 70; and Virginia, 51. The cases have been linked to contaminated injectable 

methylprednisolone acetate from New England Compounding Center in Framingham, Mass. 

CIDRAP

U.S.: Depression increases in areas Superstorm Sandy hit 

hardest

4 January -- While federal and state government authorities identified Superstorm Sandy as 

the second costliest storm in U.S. history at over $71.3 billion in damages, this figure does 

not reflect the emotional costs. Residents in the ZIP codes most affected by Superstorm 

Sandy experienced a 25% increase in depression diagnoses in the six weeks immediately 

following the storm. Similarly, those living elsewhere in New Jersey, New York, and 

Connecticut also saw an increase in depression diagnoses of 17% compared to pre-storm 

levels. Gallup Wellbeing

U.S.: Ferry captain says mechanical problem preceded 

crash in New York

10 January - The captain of a ferry that crashed into a pier near 

New York's Wall Street told investigators the reverse thrusters 

failed to work as the vessel neared the dock, leading to the 

crash that injured 57 people, federal officials said on Thursday. 

The 36-year-old captain, the Seastreak ferry line's most 

experienced with 12 years at the helm, told the National Transportation Safety Board that 

he attempted to slow the vessel on Wednesday morning but the commands did not 

respond, the board said after its first full day of inquiry. Reuters

U.S.: Health insurers raise some rates by double digits

5 January - Health insurance companies across the country are seeking and winning doubledigit increases in premiums for some customers, even though one of the biggest objectives 

of the Obama administration’s health care law was to stem the rapid rise in insurance costs 

for consumers. Particularly vulnerable to the high rates are small businesses and people who 

do not have employer-provided insurance and must buy it on their own. In California, Aetna 
is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and 

Blue Shield of California 20 percent for some of those policy holders, according to the 

insurers’ filings with the state for 2013. These rate requests are all the more striking after a 

39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, 

known as the Affordable Care Act, which was passed the same year and will not be fully in 

effect until 2014. New York Times

U.S.: HPV-related cancers on the rise 

8 January - Cancer rates linked with human papillomavirus (HPV) may be on the rise in the 

U.S. says a new study from researchers at the American Cancer Society. According to their 

study, incidents of cervical cancer have steadily fallen in recent years but those linked to 

HPV have spiked. HPV is a sexually transmitted virus that is most often associated with 

cervical cancer and genital warts. Lead researcher Otis Brawley of the ACS says that HPVrelated cancers of the vagina, vulva, penis, anus, tongue, throat and mouth have spiked 

between 2000 and 2009. "This is one of the epidemics of the 21st century. This is a huge 

problem," said Brawley. Brawley adds that increased use of an HPV vaccine could reverse 

the trend, especially for upper body cancers. RTT News

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USPACOM

Australia: Extreme weather deadly for the vulnerable

6 January – Australia’s most vulnerable people are at 

increased risk of injury and death because community 

organisations are struggling to cope with day-to-day 

operations let alone plan for extreme weather events, the 

country's peak social services group has warned. The 

Australian Council of Social Service says many community organisations are likely to 

permanently collapse and be unable to provide services after extreme weather, leaving 

society's most disadvantaged, including the elderly, mentally ill and the homeless, ''at real 

and increased risk of death''. The findings, from ACOSS's Climate Change and the 

Community Sector - Risks and Adaptations project, highlight the susceptibility of Australia's 

most vulnerable to extreme weather conditions, some of which are being experienced in the 

current heatwave. Sydney Morning Herald

China plans to scan travelers from Sudan

7 January - In a move that underlines how many Chinese citizens now work in Africa, China’s 

quarantine officials recently urged greater efforts to make sure that a yellow fever epidemic 

now raging in Sudan does not come back to China. Local health authorities were asked to 

scan all travelers arriving from Sudan for fevers. Chinese citizens planning travel to Sudan 
were advised to get yellow fever shots. Customs officers were told that containers arriving 

from Sudan might have stray infected mosquitoes inside. Sudan’s epidemic is considered 

the world’s worst in 20 years. New York Times

India: Private equity pours money into India primary 

healthcare

4 January - Private equity funds quadrupled their investment in India's primary healthcare, 

betting the sick and ailing will stop seeing family doctors in often cramped and dingy 

quarters and check into modern chains sprouting up across Asia's No.3 economy... 

Organized healthcare providers including Apollo Hospitals Enterprise Ltd and Fortis 

Healthcare Ltd are betting that growing numbers of patients will be willing to pay two or 

three times more for better-equipped clinics - all under a model that can be replicated fast 

and offers investors the potential for quick returns. Reuters

Indonesia moves to curb smoking

10 January - Anti-smoking activists in Indonesia have welcomed a new law requiring health 

warnings on cigarettes. “It’s long overdue, but it’s progress,” Hakim Sorimuda Pohan, a 

member of the National Commission on Tobacco Control, told IRIN on 10 January. 

Yesterday’s new law comes more than three years after parliament passed a bill listing 

tobacco as an addictive substance. Tobacco farmers and cigarette companies have long 

opposed such a move, saying it threatened the livelihoods of hundreds of thousands of 

people who work in the industry. According to the Healthy Ministry, Indonesia, with a 

population of 240 million, ranks third in the world in terms of the number of smokers. IRIN

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USSOUTHCOM

Haiti: Cholera has struck more than 6% of Haitians

9 January – The death toll in Haiti's cholera epidemic is approaching 8,000, and more than 

6% of Haitians have had the disease since it invaded the country in October 2010, according 

to reports released this week. In a Jan 7 cholera update, the Pan American Health 

Organization (PAHO) said fatalities in Haiti reached 7,912 as of Dec 31, out of 635,980 cases 

and 350,679 hospitalizations. The case-fatality rate is 1.2%. The tally of cases and deaths was 

lower in 2012 than in 2011, but the epidemiologic patterns were similar in both years, with 

peaks occurring during rainy periods from May through July and in September and October, 

PAHO said. CIDRAP

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