23 february 2018 army public health weekly update … library...4 classified version of the weekly...
TRANSCRIPT
1
23 February 2018
Army Public Health
Weekly Update
Army Public Health Center
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
Subscription or
Comments
If you wish to be added to
the APH Weekly Update
mailing list removed from
the mailing list or if you
have comments or
questions about the
update please contact us
We welcome your
comments Please feel free
to share this update with
others who may be
interested
Approved for public release distribution unlimited
Contents
US MILITARY
New Executive Order guarantees a year of mental healthcare after separation from service
Non-citizens can provide an untapped pool of military recruits experts say
The cliniciansrsquo role in building a system of care Army Behavioral Health since 2001
GLOBAL
Ethical dilemma over treating civilians injured in the battle for Mosul
Evidence-based guidelines for supportive care of patients with Ebola virus disease
Heart alert Pacemakers can be hacked new research shows
Single blood test can accurately detect Lyme Babesia and half dozen other tick-borne diseases
Studies note viral transfer doffing errors in Ebola PPE practice
Vaccine protects non-human primates against Ebola and Marburg viruses
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
AFHSB DoD Seasonal Influenza Surveillance Summary
APHC US Army Influenza Activity Report
CDC Flu View - Weekly US Influenza Surveillance Report
ECDC Flu News Europe
Human infection with avian influenza A(H7N4) virus ndash China
NHRC Operational Infectious Diseases - Weekly Surveillance Report
Outbreak of influenza and rhinovirus co-circulation among unvaccinated recruits US Coast
Guard Training Center Cape May NJ 24 Julyndash21 August 2016
Senate bill would jump-start universal flu vaccine efforts
USAFSAM amp DHA DoD Global Laboratory-Based Influenza Surveillance Program
WHO Influenza Update
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more than doubles to 172
FDA updates spice risk profile 7200 samples analyzed
Germany gives free rein to boar hunters to contain swine fever risk
Scientists develop a way to use a smartphone to prevent food poisoning
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 Command
2
Follow us
YouTube
WELLNESS
Counting calories is not the key to weight loss new study finds
DoD science blog highlights opioids research
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
Multistate outbreak of Salmonella I 4[5]12b- infections linked to kratom
Study finds link between physical fitness and brain health
Study seeks to end antidepressant debate the drugs do work
US FDA says recalls destroys certain kratom-containing dietary products
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26 Congolese refugees in Uganda infects
hundreds
Liberia Lassa fever
Malawi Malawi cholera cases pass 500 eight people dead
Mozambique Cholera
Nigeria Four meningococcal meningitis deaths reported in Niger State
Nigeria Nigerias Lassa fever total grows by 19 new cases
South Africa Cape Towns Day Zero moved back to July 9
USCENTCOM
Pakistan Study finds new superbug typhoid strain behind Pakistan outbreak
Saudi Arabia New Saudi MERS case linked to camels
USEUCOM
Europe WHO warns of soaring rates of measles in Europe
USNORTHCOM
US Black lung disease comes storming back in coal country
US Florida House declines debate on assault rifles calls porn a health risk
US NIOSH and NHCA present 2018 Safe-in-Sound Excellence in Hearing Loss Prevention
Awardstrade
US NIOSH study - Hearing loss prevalence in the health care and social assistance sector
US Prevalence of amyotrophic lateral sclerosis mdash United States 2014
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
China Doctors in China lead race to treat cancer by editing genes
USSOUTHCOM
South America South America records most yellow fever cases in decades
Venezuela Venezuelans report big weight losses in 2017 as hunger hits
3
Epi-tech Training
Improving your
Medical Event
Reporting Process
The next Epi-tech training
will be held
Tuesday 27 February 2018
Contact the Disease
Epidemiology Division for
more information and
registration instructions
US MILITARY
New Executive Order guarantees a year of mental
healthcare after separation from service
February 2018 - President Donald Trump has signed an executive order directing the DoD
VA and Homeland Security departments develop a plan to ensure that all new veterans
receive mental healthcare for at least one year following their separation from service The
plan that the three departments are tasked with developing must ensure that the 60 of
new veterans who currently do not qualify for enrollment in healthcare primarily due to lack
of verified service connection related to the medical issue will be able to access services for
mental health care for one year following their separation from service US Medicine
top of page
Non-citizens can provide an untapped pool of military
recruits experts say
20 February - As the Pentagon tries to increase troop numbers the military is accepting
recruits it would have rejected in years past A different option several experts say would
be to recruit troops who arent citizens hellip The military typically looks for recruits between
the ages of 18 and 30 who are physically fit have at least high school diplomas and dont
have arrest records -- the same people who are in demand in higher-paying private-sector
jobs according to Kelly Ward a professor at the National War College hellip In a 2015 paper
[Margaret] Stock and co-author Naomi Verdugo a former senior recruiting official for the
Army argues that with fewer native-born Americans looking to join the armed forces the
United States must eventually turn to its foreign-born population for military recruitment
The foreign-born population of the United States in 2015 was 432 million -- or 14 percent -
- according to the Pew Research Center That number is expected to increase and the
foreign-born population may reach 15 percent in 2025 according to the Census Bureau UPI
top of page
The cliniciansrsquo role in building a system of care Army
Behavioral Health since 2001
February 2018 - hellip The transformation of Army behavioral health care has encompassed all
aspects of the treatment system but it has been led by clinicians working at the local and
headquarters levels Although many challenges remain todayrsquos outpatient system is more
efficient and effective For example Army medical facilities are now able to meet more of
the total demand for outpatient behavioral health care of its beneficiaries 77 in
September 2017 compared with a low of 59 in January 2013 based on Army Strategic
Management System data as of December 1 2017 With a better organized outpatient
system clinicians have less frequently relied on costly and stigmatizing inpatient care
Soldiers required 40 fewer inpatient bed days in 2016 than they did in 2012 based on
4
Classified Version of
the Weekly Update
An Army Public Health
Weekly Update is available
with articles classified up to
the SECRET level from the
USAPHC SIPRNet site
httpphcarmysmilmil
Look under Hot Topics amp
Current Issues
To access this version you
will need a SECRET
clearance and a SIPRNet
account
Links
A-Z Index
About APHC
Army Public Health
Weekly Update Archives
Medical Surveillance
Monthly Report
Medical Threat Briefings
(AKO)
Request APHC Services
APHC Resource Materials
APHC Homepage
APHC Training
Contact APHC
Military Health System Management and Reporting Tool (M2) data as of July 1 2017
Federal Practitioner
top of page
GLOBAL
Ethical dilemma over treating civilians injured in the
battle for Mosul
16 February - Under the Geneva Conventions warring parties
are responsible for providing medical care to civilians in the
territory they control But what happens if the warring parties
dont have the will or the capacity to treat the civilian
casualties Or if they could not care less about the civilians
Thats a question that erupted in Iraq late in 2016 when the
Iraqi military launched a massive military offensive to retake the city of Mosul from ISIS hellip
The Iraqi Army was ready for the battle hellip But what the Iraqi Army lacked was a plan for
how to provide medical care to civilians who were bound to be injured during the assault hellip
The World Health Organization feared a massive humanitarian disaster So they stepped in
and tried to set up an emergency medical system to treat civilian casualties hellip WHO
proposed embedding humanitarian health-care workers with the Iraqi military hellip WHOs
plan raised serious questions about the neutrality and impartiality of humanitarian aid
groups Aid groups fear that if they appear to be working for one side in a war that they
become a legitimate target NPR
top of page
Evidence-based guidelines for supportive care of patients
with Ebola virus disease
17 February - The 2013ndash16 Ebola virus disease outbreak in west Africa was associated with
unprecedented challenges in the provision of care to patients with Ebola virus disease
including absence of pre-existing isolation and treatment facilities patients reluctance to
present for medical care and limitations in the provision of supportive medical care Case
fatality rates in west Africa were initially greater than 70 but decreased with
improvements in supportive care To inform optimal care in a future outbreak of Ebola virus
disease we employed the Grading of Recommendations Assessment Development and
Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of
supportive care to patients admitted to Ebola treatment units Key recommendations
include administration of oral and as necessary intravenous hydration systematic
monitoring of vital signs and volume status availability of key biochemical testing adequate
staffing ratios and availability of analgesics including opioids for pain relief The Lancet
top of page
5
Heart alert Pacemakers can be hacked new research
shows
21 February - A new study is warning that pacemakers and other electrical medical devices
could be targeted by hackers for political financial or personal gain While there have been
no reports of malicious hacking or malware attacks affecting cardiac devices research hellip
shows that is indeed a possibility mdash and has been for over a decade For better protection
the Food and Drug Administration has guidelines in place for the security of medical
devices along with several legislative proposals in Congress hellip Patients with pacemakers
could be vulnerable when batteries are overworked or depleted which can lead to a device
being unable to deliver therapies during life-threatening attacks For patients with devices
that pump the heart it is possible for hackers to interrupt wireless communications
Fox News
top of page
Single blood test can accurately detect Lyme Babesia and
half dozen other tick-borne diseases
20 February - A new blood test called the Tick-Borne Disease Serochip (TBD Serochip)
promises to revolutionize the diagnosis of tick-borne disease by offering a single test to
identify and distinguish between Borrelia burgdorferi the pathogen responsible for Lyme
disease and seven other tick-borne pathogens hellip The researchers hellip sought to improve on
existing tests for tick-borne diseases (TBDs) which have limited diagnostic accuracy and
cannot test for more than one infection simultaneously hellip The TBD Serochip can
simultaneously test for the presence of antibodies in blood to more than 170000 individual
protein fragments Version 10 can identify exposure to eight tick-borne pathogens present
in the US hellip As new tick-borne infectious agents are discovered the TBD-Serochip will be
modified to target themndasha process the researchers say can be done in less than four weeks
Outbreak News Today
top of page
Studies note viral transfer doffing errors in Ebola PPE
practice
19 February - In two new studies in Clinical Infectious Diseases researchers from Georgia
assess doffing (taking off) of personal protective equipment (PPE) for Ebola disease noting
viral transfer to inner gloves and errors that could lead to contamination The first study
involved 10 healthcare workers (HCWs) experienced in Ebola care donning and doffing PPE
following biocontainment unit protocols that incorporate trained observer guidance and
alcohol-based hand rub (ABHR) After the HCWs performed a patient care task they
removed their PPE and the investigators sampled inner glove faces hands and scrubs for
virus and they also tested environmental sites using a visible fluorescent marker The
researchers found no presence of the enveloped phage (one with an outer coating) except
for low levels on the scrubs of one HCW The nonenveloped phage however was detected
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
2
Follow us
YouTube
WELLNESS
Counting calories is not the key to weight loss new study finds
DoD science blog highlights opioids research
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
Multistate outbreak of Salmonella I 4[5]12b- infections linked to kratom
Study finds link between physical fitness and brain health
Study seeks to end antidepressant debate the drugs do work
US FDA says recalls destroys certain kratom-containing dietary products
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26 Congolese refugees in Uganda infects
hundreds
Liberia Lassa fever
Malawi Malawi cholera cases pass 500 eight people dead
Mozambique Cholera
Nigeria Four meningococcal meningitis deaths reported in Niger State
Nigeria Nigerias Lassa fever total grows by 19 new cases
South Africa Cape Towns Day Zero moved back to July 9
USCENTCOM
Pakistan Study finds new superbug typhoid strain behind Pakistan outbreak
Saudi Arabia New Saudi MERS case linked to camels
USEUCOM
Europe WHO warns of soaring rates of measles in Europe
USNORTHCOM
US Black lung disease comes storming back in coal country
US Florida House declines debate on assault rifles calls porn a health risk
US NIOSH and NHCA present 2018 Safe-in-Sound Excellence in Hearing Loss Prevention
Awardstrade
US NIOSH study - Hearing loss prevalence in the health care and social assistance sector
US Prevalence of amyotrophic lateral sclerosis mdash United States 2014
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
China Doctors in China lead race to treat cancer by editing genes
USSOUTHCOM
South America South America records most yellow fever cases in decades
Venezuela Venezuelans report big weight losses in 2017 as hunger hits
3
Epi-tech Training
Improving your
Medical Event
Reporting Process
The next Epi-tech training
will be held
Tuesday 27 February 2018
Contact the Disease
Epidemiology Division for
more information and
registration instructions
US MILITARY
New Executive Order guarantees a year of mental
healthcare after separation from service
February 2018 - President Donald Trump has signed an executive order directing the DoD
VA and Homeland Security departments develop a plan to ensure that all new veterans
receive mental healthcare for at least one year following their separation from service The
plan that the three departments are tasked with developing must ensure that the 60 of
new veterans who currently do not qualify for enrollment in healthcare primarily due to lack
of verified service connection related to the medical issue will be able to access services for
mental health care for one year following their separation from service US Medicine
top of page
Non-citizens can provide an untapped pool of military
recruits experts say
20 February - As the Pentagon tries to increase troop numbers the military is accepting
recruits it would have rejected in years past A different option several experts say would
be to recruit troops who arent citizens hellip The military typically looks for recruits between
the ages of 18 and 30 who are physically fit have at least high school diplomas and dont
have arrest records -- the same people who are in demand in higher-paying private-sector
jobs according to Kelly Ward a professor at the National War College hellip In a 2015 paper
[Margaret] Stock and co-author Naomi Verdugo a former senior recruiting official for the
Army argues that with fewer native-born Americans looking to join the armed forces the
United States must eventually turn to its foreign-born population for military recruitment
The foreign-born population of the United States in 2015 was 432 million -- or 14 percent -
- according to the Pew Research Center That number is expected to increase and the
foreign-born population may reach 15 percent in 2025 according to the Census Bureau UPI
top of page
The cliniciansrsquo role in building a system of care Army
Behavioral Health since 2001
February 2018 - hellip The transformation of Army behavioral health care has encompassed all
aspects of the treatment system but it has been led by clinicians working at the local and
headquarters levels Although many challenges remain todayrsquos outpatient system is more
efficient and effective For example Army medical facilities are now able to meet more of
the total demand for outpatient behavioral health care of its beneficiaries 77 in
September 2017 compared with a low of 59 in January 2013 based on Army Strategic
Management System data as of December 1 2017 With a better organized outpatient
system clinicians have less frequently relied on costly and stigmatizing inpatient care
Soldiers required 40 fewer inpatient bed days in 2016 than they did in 2012 based on
4
Classified Version of
the Weekly Update
An Army Public Health
Weekly Update is available
with articles classified up to
the SECRET level from the
USAPHC SIPRNet site
httpphcarmysmilmil
Look under Hot Topics amp
Current Issues
To access this version you
will need a SECRET
clearance and a SIPRNet
account
Links
A-Z Index
About APHC
Army Public Health
Weekly Update Archives
Medical Surveillance
Monthly Report
Medical Threat Briefings
(AKO)
Request APHC Services
APHC Resource Materials
APHC Homepage
APHC Training
Contact APHC
Military Health System Management and Reporting Tool (M2) data as of July 1 2017
Federal Practitioner
top of page
GLOBAL
Ethical dilemma over treating civilians injured in the
battle for Mosul
16 February - Under the Geneva Conventions warring parties
are responsible for providing medical care to civilians in the
territory they control But what happens if the warring parties
dont have the will or the capacity to treat the civilian
casualties Or if they could not care less about the civilians
Thats a question that erupted in Iraq late in 2016 when the
Iraqi military launched a massive military offensive to retake the city of Mosul from ISIS hellip
The Iraqi Army was ready for the battle hellip But what the Iraqi Army lacked was a plan for
how to provide medical care to civilians who were bound to be injured during the assault hellip
The World Health Organization feared a massive humanitarian disaster So they stepped in
and tried to set up an emergency medical system to treat civilian casualties hellip WHO
proposed embedding humanitarian health-care workers with the Iraqi military hellip WHOs
plan raised serious questions about the neutrality and impartiality of humanitarian aid
groups Aid groups fear that if they appear to be working for one side in a war that they
become a legitimate target NPR
top of page
Evidence-based guidelines for supportive care of patients
with Ebola virus disease
17 February - The 2013ndash16 Ebola virus disease outbreak in west Africa was associated with
unprecedented challenges in the provision of care to patients with Ebola virus disease
including absence of pre-existing isolation and treatment facilities patients reluctance to
present for medical care and limitations in the provision of supportive medical care Case
fatality rates in west Africa were initially greater than 70 but decreased with
improvements in supportive care To inform optimal care in a future outbreak of Ebola virus
disease we employed the Grading of Recommendations Assessment Development and
Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of
supportive care to patients admitted to Ebola treatment units Key recommendations
include administration of oral and as necessary intravenous hydration systematic
monitoring of vital signs and volume status availability of key biochemical testing adequate
staffing ratios and availability of analgesics including opioids for pain relief The Lancet
top of page
5
Heart alert Pacemakers can be hacked new research
shows
21 February - A new study is warning that pacemakers and other electrical medical devices
could be targeted by hackers for political financial or personal gain While there have been
no reports of malicious hacking or malware attacks affecting cardiac devices research hellip
shows that is indeed a possibility mdash and has been for over a decade For better protection
the Food and Drug Administration has guidelines in place for the security of medical
devices along with several legislative proposals in Congress hellip Patients with pacemakers
could be vulnerable when batteries are overworked or depleted which can lead to a device
being unable to deliver therapies during life-threatening attacks For patients with devices
that pump the heart it is possible for hackers to interrupt wireless communications
Fox News
top of page
Single blood test can accurately detect Lyme Babesia and
half dozen other tick-borne diseases
20 February - A new blood test called the Tick-Borne Disease Serochip (TBD Serochip)
promises to revolutionize the diagnosis of tick-borne disease by offering a single test to
identify and distinguish between Borrelia burgdorferi the pathogen responsible for Lyme
disease and seven other tick-borne pathogens hellip The researchers hellip sought to improve on
existing tests for tick-borne diseases (TBDs) which have limited diagnostic accuracy and
cannot test for more than one infection simultaneously hellip The TBD Serochip can
simultaneously test for the presence of antibodies in blood to more than 170000 individual
protein fragments Version 10 can identify exposure to eight tick-borne pathogens present
in the US hellip As new tick-borne infectious agents are discovered the TBD-Serochip will be
modified to target themndasha process the researchers say can be done in less than four weeks
Outbreak News Today
top of page
Studies note viral transfer doffing errors in Ebola PPE
practice
19 February - In two new studies in Clinical Infectious Diseases researchers from Georgia
assess doffing (taking off) of personal protective equipment (PPE) for Ebola disease noting
viral transfer to inner gloves and errors that could lead to contamination The first study
involved 10 healthcare workers (HCWs) experienced in Ebola care donning and doffing PPE
following biocontainment unit protocols that incorporate trained observer guidance and
alcohol-based hand rub (ABHR) After the HCWs performed a patient care task they
removed their PPE and the investigators sampled inner glove faces hands and scrubs for
virus and they also tested environmental sites using a visible fluorescent marker The
researchers found no presence of the enveloped phage (one with an outer coating) except
for low levels on the scrubs of one HCW The nonenveloped phage however was detected
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
3
Epi-tech Training
Improving your
Medical Event
Reporting Process
The next Epi-tech training
will be held
Tuesday 27 February 2018
Contact the Disease
Epidemiology Division for
more information and
registration instructions
US MILITARY
New Executive Order guarantees a year of mental
healthcare after separation from service
February 2018 - President Donald Trump has signed an executive order directing the DoD
VA and Homeland Security departments develop a plan to ensure that all new veterans
receive mental healthcare for at least one year following their separation from service The
plan that the three departments are tasked with developing must ensure that the 60 of
new veterans who currently do not qualify for enrollment in healthcare primarily due to lack
of verified service connection related to the medical issue will be able to access services for
mental health care for one year following their separation from service US Medicine
top of page
Non-citizens can provide an untapped pool of military
recruits experts say
20 February - As the Pentagon tries to increase troop numbers the military is accepting
recruits it would have rejected in years past A different option several experts say would
be to recruit troops who arent citizens hellip The military typically looks for recruits between
the ages of 18 and 30 who are physically fit have at least high school diplomas and dont
have arrest records -- the same people who are in demand in higher-paying private-sector
jobs according to Kelly Ward a professor at the National War College hellip In a 2015 paper
[Margaret] Stock and co-author Naomi Verdugo a former senior recruiting official for the
Army argues that with fewer native-born Americans looking to join the armed forces the
United States must eventually turn to its foreign-born population for military recruitment
The foreign-born population of the United States in 2015 was 432 million -- or 14 percent -
- according to the Pew Research Center That number is expected to increase and the
foreign-born population may reach 15 percent in 2025 according to the Census Bureau UPI
top of page
The cliniciansrsquo role in building a system of care Army
Behavioral Health since 2001
February 2018 - hellip The transformation of Army behavioral health care has encompassed all
aspects of the treatment system but it has been led by clinicians working at the local and
headquarters levels Although many challenges remain todayrsquos outpatient system is more
efficient and effective For example Army medical facilities are now able to meet more of
the total demand for outpatient behavioral health care of its beneficiaries 77 in
September 2017 compared with a low of 59 in January 2013 based on Army Strategic
Management System data as of December 1 2017 With a better organized outpatient
system clinicians have less frequently relied on costly and stigmatizing inpatient care
Soldiers required 40 fewer inpatient bed days in 2016 than they did in 2012 based on
4
Classified Version of
the Weekly Update
An Army Public Health
Weekly Update is available
with articles classified up to
the SECRET level from the
USAPHC SIPRNet site
httpphcarmysmilmil
Look under Hot Topics amp
Current Issues
To access this version you
will need a SECRET
clearance and a SIPRNet
account
Links
A-Z Index
About APHC
Army Public Health
Weekly Update Archives
Medical Surveillance
Monthly Report
Medical Threat Briefings
(AKO)
Request APHC Services
APHC Resource Materials
APHC Homepage
APHC Training
Contact APHC
Military Health System Management and Reporting Tool (M2) data as of July 1 2017
Federal Practitioner
top of page
GLOBAL
Ethical dilemma over treating civilians injured in the
battle for Mosul
16 February - Under the Geneva Conventions warring parties
are responsible for providing medical care to civilians in the
territory they control But what happens if the warring parties
dont have the will or the capacity to treat the civilian
casualties Or if they could not care less about the civilians
Thats a question that erupted in Iraq late in 2016 when the
Iraqi military launched a massive military offensive to retake the city of Mosul from ISIS hellip
The Iraqi Army was ready for the battle hellip But what the Iraqi Army lacked was a plan for
how to provide medical care to civilians who were bound to be injured during the assault hellip
The World Health Organization feared a massive humanitarian disaster So they stepped in
and tried to set up an emergency medical system to treat civilian casualties hellip WHO
proposed embedding humanitarian health-care workers with the Iraqi military hellip WHOs
plan raised serious questions about the neutrality and impartiality of humanitarian aid
groups Aid groups fear that if they appear to be working for one side in a war that they
become a legitimate target NPR
top of page
Evidence-based guidelines for supportive care of patients
with Ebola virus disease
17 February - The 2013ndash16 Ebola virus disease outbreak in west Africa was associated with
unprecedented challenges in the provision of care to patients with Ebola virus disease
including absence of pre-existing isolation and treatment facilities patients reluctance to
present for medical care and limitations in the provision of supportive medical care Case
fatality rates in west Africa were initially greater than 70 but decreased with
improvements in supportive care To inform optimal care in a future outbreak of Ebola virus
disease we employed the Grading of Recommendations Assessment Development and
Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of
supportive care to patients admitted to Ebola treatment units Key recommendations
include administration of oral and as necessary intravenous hydration systematic
monitoring of vital signs and volume status availability of key biochemical testing adequate
staffing ratios and availability of analgesics including opioids for pain relief The Lancet
top of page
5
Heart alert Pacemakers can be hacked new research
shows
21 February - A new study is warning that pacemakers and other electrical medical devices
could be targeted by hackers for political financial or personal gain While there have been
no reports of malicious hacking or malware attacks affecting cardiac devices research hellip
shows that is indeed a possibility mdash and has been for over a decade For better protection
the Food and Drug Administration has guidelines in place for the security of medical
devices along with several legislative proposals in Congress hellip Patients with pacemakers
could be vulnerable when batteries are overworked or depleted which can lead to a device
being unable to deliver therapies during life-threatening attacks For patients with devices
that pump the heart it is possible for hackers to interrupt wireless communications
Fox News
top of page
Single blood test can accurately detect Lyme Babesia and
half dozen other tick-borne diseases
20 February - A new blood test called the Tick-Borne Disease Serochip (TBD Serochip)
promises to revolutionize the diagnosis of tick-borne disease by offering a single test to
identify and distinguish between Borrelia burgdorferi the pathogen responsible for Lyme
disease and seven other tick-borne pathogens hellip The researchers hellip sought to improve on
existing tests for tick-borne diseases (TBDs) which have limited diagnostic accuracy and
cannot test for more than one infection simultaneously hellip The TBD Serochip can
simultaneously test for the presence of antibodies in blood to more than 170000 individual
protein fragments Version 10 can identify exposure to eight tick-borne pathogens present
in the US hellip As new tick-borne infectious agents are discovered the TBD-Serochip will be
modified to target themndasha process the researchers say can be done in less than four weeks
Outbreak News Today
top of page
Studies note viral transfer doffing errors in Ebola PPE
practice
19 February - In two new studies in Clinical Infectious Diseases researchers from Georgia
assess doffing (taking off) of personal protective equipment (PPE) for Ebola disease noting
viral transfer to inner gloves and errors that could lead to contamination The first study
involved 10 healthcare workers (HCWs) experienced in Ebola care donning and doffing PPE
following biocontainment unit protocols that incorporate trained observer guidance and
alcohol-based hand rub (ABHR) After the HCWs performed a patient care task they
removed their PPE and the investigators sampled inner glove faces hands and scrubs for
virus and they also tested environmental sites using a visible fluorescent marker The
researchers found no presence of the enveloped phage (one with an outer coating) except
for low levels on the scrubs of one HCW The nonenveloped phage however was detected
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
4
Classified Version of
the Weekly Update
An Army Public Health
Weekly Update is available
with articles classified up to
the SECRET level from the
USAPHC SIPRNet site
httpphcarmysmilmil
Look under Hot Topics amp
Current Issues
To access this version you
will need a SECRET
clearance and a SIPRNet
account
Links
A-Z Index
About APHC
Army Public Health
Weekly Update Archives
Medical Surveillance
Monthly Report
Medical Threat Briefings
(AKO)
Request APHC Services
APHC Resource Materials
APHC Homepage
APHC Training
Contact APHC
Military Health System Management and Reporting Tool (M2) data as of July 1 2017
Federal Practitioner
top of page
GLOBAL
Ethical dilemma over treating civilians injured in the
battle for Mosul
16 February - Under the Geneva Conventions warring parties
are responsible for providing medical care to civilians in the
territory they control But what happens if the warring parties
dont have the will or the capacity to treat the civilian
casualties Or if they could not care less about the civilians
Thats a question that erupted in Iraq late in 2016 when the
Iraqi military launched a massive military offensive to retake the city of Mosul from ISIS hellip
The Iraqi Army was ready for the battle hellip But what the Iraqi Army lacked was a plan for
how to provide medical care to civilians who were bound to be injured during the assault hellip
The World Health Organization feared a massive humanitarian disaster So they stepped in
and tried to set up an emergency medical system to treat civilian casualties hellip WHO
proposed embedding humanitarian health-care workers with the Iraqi military hellip WHOs
plan raised serious questions about the neutrality and impartiality of humanitarian aid
groups Aid groups fear that if they appear to be working for one side in a war that they
become a legitimate target NPR
top of page
Evidence-based guidelines for supportive care of patients
with Ebola virus disease
17 February - The 2013ndash16 Ebola virus disease outbreak in west Africa was associated with
unprecedented challenges in the provision of care to patients with Ebola virus disease
including absence of pre-existing isolation and treatment facilities patients reluctance to
present for medical care and limitations in the provision of supportive medical care Case
fatality rates in west Africa were initially greater than 70 but decreased with
improvements in supportive care To inform optimal care in a future outbreak of Ebola virus
disease we employed the Grading of Recommendations Assessment Development and
Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of
supportive care to patients admitted to Ebola treatment units Key recommendations
include administration of oral and as necessary intravenous hydration systematic
monitoring of vital signs and volume status availability of key biochemical testing adequate
staffing ratios and availability of analgesics including opioids for pain relief The Lancet
top of page
5
Heart alert Pacemakers can be hacked new research
shows
21 February - A new study is warning that pacemakers and other electrical medical devices
could be targeted by hackers for political financial or personal gain While there have been
no reports of malicious hacking or malware attacks affecting cardiac devices research hellip
shows that is indeed a possibility mdash and has been for over a decade For better protection
the Food and Drug Administration has guidelines in place for the security of medical
devices along with several legislative proposals in Congress hellip Patients with pacemakers
could be vulnerable when batteries are overworked or depleted which can lead to a device
being unable to deliver therapies during life-threatening attacks For patients with devices
that pump the heart it is possible for hackers to interrupt wireless communications
Fox News
top of page
Single blood test can accurately detect Lyme Babesia and
half dozen other tick-borne diseases
20 February - A new blood test called the Tick-Borne Disease Serochip (TBD Serochip)
promises to revolutionize the diagnosis of tick-borne disease by offering a single test to
identify and distinguish between Borrelia burgdorferi the pathogen responsible for Lyme
disease and seven other tick-borne pathogens hellip The researchers hellip sought to improve on
existing tests for tick-borne diseases (TBDs) which have limited diagnostic accuracy and
cannot test for more than one infection simultaneously hellip The TBD Serochip can
simultaneously test for the presence of antibodies in blood to more than 170000 individual
protein fragments Version 10 can identify exposure to eight tick-borne pathogens present
in the US hellip As new tick-borne infectious agents are discovered the TBD-Serochip will be
modified to target themndasha process the researchers say can be done in less than four weeks
Outbreak News Today
top of page
Studies note viral transfer doffing errors in Ebola PPE
practice
19 February - In two new studies in Clinical Infectious Diseases researchers from Georgia
assess doffing (taking off) of personal protective equipment (PPE) for Ebola disease noting
viral transfer to inner gloves and errors that could lead to contamination The first study
involved 10 healthcare workers (HCWs) experienced in Ebola care donning and doffing PPE
following biocontainment unit protocols that incorporate trained observer guidance and
alcohol-based hand rub (ABHR) After the HCWs performed a patient care task they
removed their PPE and the investigators sampled inner glove faces hands and scrubs for
virus and they also tested environmental sites using a visible fluorescent marker The
researchers found no presence of the enveloped phage (one with an outer coating) except
for low levels on the scrubs of one HCW The nonenveloped phage however was detected
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
5
Heart alert Pacemakers can be hacked new research
shows
21 February - A new study is warning that pacemakers and other electrical medical devices
could be targeted by hackers for political financial or personal gain While there have been
no reports of malicious hacking or malware attacks affecting cardiac devices research hellip
shows that is indeed a possibility mdash and has been for over a decade For better protection
the Food and Drug Administration has guidelines in place for the security of medical
devices along with several legislative proposals in Congress hellip Patients with pacemakers
could be vulnerable when batteries are overworked or depleted which can lead to a device
being unable to deliver therapies during life-threatening attacks For patients with devices
that pump the heart it is possible for hackers to interrupt wireless communications
Fox News
top of page
Single blood test can accurately detect Lyme Babesia and
half dozen other tick-borne diseases
20 February - A new blood test called the Tick-Borne Disease Serochip (TBD Serochip)
promises to revolutionize the diagnosis of tick-borne disease by offering a single test to
identify and distinguish between Borrelia burgdorferi the pathogen responsible for Lyme
disease and seven other tick-borne pathogens hellip The researchers hellip sought to improve on
existing tests for tick-borne diseases (TBDs) which have limited diagnostic accuracy and
cannot test for more than one infection simultaneously hellip The TBD Serochip can
simultaneously test for the presence of antibodies in blood to more than 170000 individual
protein fragments Version 10 can identify exposure to eight tick-borne pathogens present
in the US hellip As new tick-borne infectious agents are discovered the TBD-Serochip will be
modified to target themndasha process the researchers say can be done in less than four weeks
Outbreak News Today
top of page
Studies note viral transfer doffing errors in Ebola PPE
practice
19 February - In two new studies in Clinical Infectious Diseases researchers from Georgia
assess doffing (taking off) of personal protective equipment (PPE) for Ebola disease noting
viral transfer to inner gloves and errors that could lead to contamination The first study
involved 10 healthcare workers (HCWs) experienced in Ebola care donning and doffing PPE
following biocontainment unit protocols that incorporate trained observer guidance and
alcohol-based hand rub (ABHR) After the HCWs performed a patient care task they
removed their PPE and the investigators sampled inner glove faces hands and scrubs for
virus and they also tested environmental sites using a visible fluorescent marker The
researchers found no presence of the enveloped phage (one with an outer coating) except
for low levels on the scrubs of one HCW The nonenveloped phage however was detected
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
6
on 2 HCWs scrubs 1 HCWs hands and 7 HCWs inner gloves Neither phage was detected
on environmental samples hellip In the second study the investigators used video to identify
errors among 11 HCWs who participated in simulations under the same conditions as the
first study They identified 51 doffing errors with hand hygiene mistakes and missteps in
removing the powered air-purifying respirator topping the list
CIDRAP News Scan (third item)
top of page
Vaccine protects non-human primates against Ebola and
Marburg viruses
21 February - A new prophylactic vaccine was immunogenic and effective against multiple
filoviruses including Ebola and Marburg in monkeys according to a study yesterday in
PLoS One The vaccine which expresses glycoproteins from Ebola virus (EBOV) Sudan virus
(SUDV) Tai Forest virus (TAFV) and Marburg virus (MARV) is being investigated as a
universal filovirus vaccine Unlike ring vaccines which have been used during filovirus
outbreaks a single-prophylactic vaccine could be introduced in childhood and offer life-
long protection hellip A multivalent filovirus vaccine would be optimal for prophylactic
administration for example of populations who are deemed to be at risk of geographical or
occupational exposure and also for aid workers and other professionals who may be called
into filovirus endemic regions the authors concluded The results from our studies
combined with clinical data indicate that a prophylactic multivalent filovirus vaccine is a
realistic goal CIDRAP News Scan (third item)
top of page
INFLUENZA
ACIP reinstates FluMist for 2018-2019 flu season
21 February - After a 2-year absence FluMist is back on the 2018-2019 influenza vaccine
schedule following a vote from the CDC Advisory Committee on Immunization Practices
(ACIP) here The panel also gave a unanimous endorsement to the Heplisav-B vaccine
against hepatitis B virus ACIP members voted 12-2 to include the live attenuated influenza
vaccine (LAIV) as an option for influenza vaccination for persons for whom it is
appropriate in the 2018-2019 influenza season MedPage Today
top of page
AFHSB DoD Seasonal Influenza Surveillance Summary
For Week 6
NORTHCOM Influenza activity continued to decrease in several states but
remained moderate to high in many states especially in the South
EUCOM Influenza activity decreased to minimal in the United Kingdom and Spain
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
7
but remained similar to last week for other EUCOM countries Italy continued to
have moderate activity
PACOM Influenza activity in PACOM continued to vary by country but remained
high in the Republic of Korea during week 06
CENTCOM and AFRICOM Influenza activity decreased to moderate in Afghanistan
and remained minimal in other CENTCOM locations with available data
SOUTHCOM Influenza activity remained minimal in Honduras for week 06
DHA -Armed Forces Health Surveillance Branch
top of page
APHC US Army Influenza Activity Report
For the week ending 10 February 2018 (week 6)
The overall number of specimens submitted continues to decrease in week 6 however the
number of influenza-associated hospitalizations remains relatively steady in the non-AD
population The number of hospitalizations this season is 205 higher than the same time
last season with 125 so far reported this season compared to 41 reported this time last
season Although the number of influenza A positive specimens has decreased by 14 since
last week the number of positive influenza B specimens has remained steady It is possible
to become ill with the flu more than once in a flu season given the many strains circulating
throughout the population Therefore recommendations are still in place to take personal
precautions to avoid getting sick and plan for several more weeks of flu season APHC
top of page
CDC Flu View - Weekly US Influenza Surveillance
Report
During week 6 (February 4-10 2018) influenza activity remained elevated in the United
States
Viral Surveillance The most frequently identified influenza virus subtype reported
by public health laboratories during week 6 was influenza A(H3) The percentage of
respiratory specimens testing positive for influenza in clinical laboratories remained
elevated
Pneumonia and Influenza Mortality The proportion of deaths attributed to
pneumonia and influenza (PampI) was above the system-specific epidemic threshold
in the National Center for Health Statistics (NCHS) Mortality Surveillance System
Influenza-associated Pediatric Deaths Twenty-two influenza-associated pediatric
deaths were reported CDC
top of page
ECDC Flu News Europe
Week 62018 (5-11 February 2018)
Influenza activity was widespread in the majority of reporting countries
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
8
Both influenza virus types A and B were co-circulating with a higher proportion of
type B viruses Different proportions of circulating influenza virus types and A
subtypes were observed between countries
Of the individuals sampled on presenting with ILI or ARI to sentinel primary
healthcare sites 51 tested positive for influenza viruses The detection rate
decreased compared to the previous week (55)
The majority of severe cases reported this season are due to influenza B and occur
in persons above the age of 15 years In confirmed influenza cases in ICU similar
numbers of cases were infected with influenza A or influenza B In laboratory
confirmed cases reported in wards other than ICU influenza B was detected
approximately twice as frequently as influenza A and mainly in the gt65 age group
WHO is convening the Vaccine Composition Meeting on 19ndash21 February to decide
on the composition of the 2018ndash2019 Northern hemisphere vaccine
European Center for Disease Prevention and ControlWHO
top of page
Human infection with avian influenza A(H7N4) virus ndash
China
22 February - On 14 February 2018 the National Health and Family Planning Commission
(NHFPC) of China notified the World Health Organization (WHO) of one case of human
infection with avian influenza A(H7N4) virus This is the first human case of avian influenza
A(H7N4) infection to be reported worldwide The case-patient was a 68-year-old woman
from Jiangsu Province with pre-existing coronary heart disease and hypertension and she
developed symptoms on 25 December 2017 Seven days later she was admitted to a local
hospital for treatment of severe pneumonia and was discharged after 21 days On 12
February the Chinese Center for Disease Control and Prevention (China CDC) confirmed
that the case-patientrsquos samples were positive for avian influenza A(H7N4) The case-
patient had reported a history of exposure to live poultry before onset of symptoms WHO
top of page
NHRC Operational Infectious Diseases - Weekly
Surveillance Report
15 February - Febrile respiratory illness cases
Military Recruits - 44 positive of 63 tested
CDC Border Infectious Disease Surveillance and Zika Surveillance - 121 positive of
201 tested
DoD Beneficiaries ndash 19 positive of 33 tested Naval Health Research Center
top of page
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
9
Outbreak of influenza and rhinovirus co-circulation
among unvaccinated recruits US Coast Guard Training
Center Cape May NJ 24 Julyndash21 August 2016
January 2018 - Military and Coast Guard recruits are particularly susceptible to respiratory
infections Although seasonal influenza vaccinations are mandatory for recruits the vaccine
expires annually in June On 29 July 2016 the US Coast Guard Training Center Cape May
NJ identified an increase in febrile respiratory illness (FRI) among recruits During 24 Julyndash21
August a total of 115 recruits reported symptoms A total of 74 recruits tested positive for
respiratory infections influenza A (H3) (n=34) rhinovirus (n=28) influenzarhinovirus co-
infection (n=11) and adenovirusrhinovirus co-infection (n=1) while 41 recruits had no
laboratory-confirmed specimen but were considered suspected cases Only one recruit
reported receiving the seasonal influenza vaccine within the previous 12 months Influenza
predominated during 24 Julyndash6 August whereas rhinovirus predominated during 7 Augustndash
20 August Medical Surveillance Monthly Report
top of page
Senate bill would jump-start universal flu vaccine efforts
19 February - hellip [A] group of US senators last week unveiled a proposal to invest $1 billion
in research over the next 5 years to create a universal flu vaccine that would provide lifetime
protection against a range of influenza strains hellip The [Ed] Markey press release pointed to
the mounting number deaths and hospitalizations this season plus the toll the disease
takes on the nations pocketbook and workforce The flu costs the nation $104 billion in
direct medical costs annually and $87 billion in total economic burden yet our current
investment is significantly lacking it said CIDRAP
top of page
USAFSAM amp DHA DoD Global Laboratory-Based
Influenza Surveillance Program
During 28 January - 10 February 2018 (Surveillance Weeks 5 amp 6 a total of 1616
specimens were collected and received from 68 locations Results were finalized for
1361 specimens from 67 locations The percent influenza positive for Week 5 and 6
were 45 and 42 respectively The influenza percent positive for the season is
approximately 36
Canadarsquos Sentinel Practitioner Surveillance Network (SPSN) has released their
interim 2017-2018 vaccine estimate (VE) report for influenza A(H3N2) and influenza
B hellip The overall adjusted VE was 42 while VE against influenza A(H3N2) and
influenza B were 17 and 55 respectively
US Air Force School of Aerospace Medicine amp Defense Health Agency
top of page
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
10
WHO Influenza Update
19 February - Influenza activity remained high in the temperate zone of the northern
hemisphere while in the temperate zone of the southern hemisphere activity was at inter-
seasonal levels Worldwide influenza A accounted still for the majority of influenza
detections but influenza B (mostly B-Yamagata lineage) increased in recent weeks
Up to now the majority of countries which are in the influenza season reported influenza-
like illness reaching moderate levels in comparison with previous years with few reaching
levels exceeding those of previous years Some countries however have reported levels of
hospitalization and ICU admissions reaching or exceeding peak levels of previous influenza
seasons WHO
top of page
VETERINARYFOOD SAFETY
Death toll from listeria outbreak in South Africa more
than doubles to 172
22 February - The death toll from an outbreak of the food-borne disease listeria in South
Africa has more than doubled from previous numbers given in January to 172 deaths the
government said on Thursday The National Institute of Communicable Diseases (NICD) said
915 cases of the disease have been confirmed since January last year up from the previous
figures given last month of 61 deaths and 720 confirmed outbreaks The government said
the source of the outbreak was still unknown Reuters
top of page
FDA updates spice risk profile 7200 samples analyzed
21 February - hellip Earlier this month the FDA announced the availability of an updated risk
profile on pathogens and filth in spice The 2017 Risk Profile Pathogens and Filth in Spices
(2017) includes data from an FDA survey that evaluated Salmonella prevalence and aerobic
plate counts in packaged dried spices offered for sale at retail establishments in the US The
survey showed that the prevalence of Salmonella in nine out of 11 types of retail spices in
the US was significantly lower than that for shipments of spices at import according to a
summary published by the National Law Review The findings from the study were based on
more than 7000 retail samples of 11 different spice types that were collected November
2013-September 2014 and October 2014-March 2015 The FDA pointed out that the
findings from its recently published survey are consistent with public comments from the
domestic food industry stating that responsible manufacturers apply a pathogen reduction
treatment to many spices after they enter the US but prior to retail sale Food Safety News
top of page
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
11
Germany gives free rein to boar hunters to contain swine
fever risk
21 February - Germany issued a decree on Wednesday to allow hunters to shoot wild boar
year-round to stop the animals which can carry African swine fever from passing the
deadly infection on to farm pigs While no case has yet been detected in Germanyrsquos wild
boar population the spread of the disease in eastern Europe is causing immense concern in
Germany whose pork industry has seen huge growth in exports to countries including
China A government spokesman said the cabinetrsquos decision was taken to bring about a
ldquosignificant reductionrdquo in the wild boar population and contain the risk of farm pigs being
infected Reuters
top of page
Scientists develop a way to use a smartphone to prevent
food poisoning
19 February - Food scientists at the University of Massachusetts
Amherst have come up with a technique they say could make it
a lot easier to avoid food poisoning The main piece of
equipment Your smartphone hellip and a smartphone app that
uses a $30 microscope attachment The device works in
conjunction with a chemically-coated chip that binds to
bacteria even in tiny amounts Dipping the chip into contaminated water for half an hour
will reveal bacteria as Adam Salhaney an undergraduate in Hes lab demonstrated You
can take this microscope attachment for any smart phone Salhaney said hellip and you can
clip it right onto the camera After pointing the microscope at a gold chip theyd coated
with salmonella Salhaney enlarged an image with a number of black dots set against the
gold background of the chip The dots were bacteria hellip They hope consumers will
eventually buy the testing kit for their own kitchens It could also prove useful after natural
disasters to test drinking water NPR
top of page
WELLNESS
Counting calories is not the key to weight loss new study
finds
20 February - hellip [A] new study hellip found that people who cut back on added sugar refined
grains and highly processed foods while concentrating on eating plenty of vegetables and
whole foods mdash without worrying about counting calories or limiting portion sizes mdash lost
significant amounts of weight over the course of a year The strategy worked for people
whether they followed diets that were mostly low in fat or mostly low in carbohydrates And
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
12
their success did not appear to be influenced by their genetics a finding that casts doubt on
the increasingly popular idea that different diets should be recommended to people based
on their DNA makeup The research lends strong support to the notion that diet quality not
quantity is what helps people lose and manage their weight most easily in the long run
The New York Times
top of page
DoD science blog highlights opioids research
21 February - The US Department of Defense Science Blog featured an article Feb 16 that
highlights opioids research by Michael Feasel PhD of the Armys Edgewood Chemical
Biological Center with support from the Defense Threat Reduction hellip trying to determine
how to treat exposure to carfentanil an especially powerful opioid that poses a risk to both
civilians and warfighters according to the article The drug naloxone can reverse the
effects of the narcotic but carfentanil is so potent that larger doses of naloxone may be
required to counter its effects hellip Higher-potency versions of naloxone are available
however the Food and Drug Administration has not seen a need to get them approved for
human use until now These ultra-potent opioid exposures are not only a chemical defense
issue but they are also a public health issue Feasel says in the article
Occupational Health and Safety
top of page
Lead and other toxic metals found in e-cigarette lsquovaporsrsquo
21 February - Significant amounts of toxic metals including lead leak from some e-
cigarette heating coils and are present in the aerosols inhaled by users hellip In the study
published online in Environmental Health Perspectives on February 21 the scientists
examined e-cigarette devices owned by a sample of 56 users They found that significant
numbers of the devices generated aerosols with potentially unsafe levels of lead chromium
manganese andor nickel Chronic inhalation of these metals has been linked to lung liver
immune cardiovascular and brain damage and even cancers The Food and Drug
Administration has the authority to regulate e-cigarettes but is still considering how to do
so Johns Hopkins Bloomberg School of Public Health News
top of page
Multistate outbreak of Salmonella I 4[5]12b-
infections linked to kratom
20 February - As of February 16 2018 28 people infected with the outbreak strain of
Salmonella I 4[5]12b- have been reported from 20 states hellip [Whole genome sequencing
(WGS)] performed on isolates from ill people were closely relatedly genetically This means
that people in this outbreak are more likely to share a common source of infection As of
February 16 2018 28 people infected with the outbreak strain of Salmonella I 4[5]12b-
have been reported from 20 states hellip Epidemiologic evidence indicates that kratom is a
likely source of this multistate outbreak Kratom is a plant consumed for its stimulant effects
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
13
and as an opioid substitute Kratom is also known as Thang Kakuam Thom Ketom and
Biak CDC recommends that people not consume kratom in any form The investigation
indicates that kratom products could be contaminated with Salmonella and could make
people sick hellip hellip At this time CDC recommends that people not consume kratom in any
form CDC
top of page
Study finds link between physical fitness and brain
health
20 February - A new study adds evidence to the argument that
exercise can help preserve brain health particularly in the aging
brain Unlike many studies that look for a connection
between exercise and brain health this one [tested] the
participantsrsquo maximum oxygen consumption during aerobic
exercise (known as the V02 max test The study included 81
participants [T]heir brains were examined with a type of brain scan called diffusion tensor
imaging (DTI) that reveals the health of the brainrsquos white matter hellip The first [result] was that
lower levels of aerobic fitness hellip were linked with weaker white matter in certain parts of the
MCI participantsrsquo brains hellip The second result was that the MCI participants with lower
aerobic fitness and weaker white matter also performed worse on the memory and
reasoning tests Taken together the results suggest that greater physical fitness correlates
with healthier white matter which in turn correlates with better memory and reasoning
abilities even for those already suffering from a level of cognitive impairment Forbes
top of page
Study seeks to end antidepressant debate the drugs do
work
21 February - A vast research study that sought to settle a long-standing debate about
whether or not anti-depressant drugs really work has found they are indeed effective in
relieving acute depression in adults The international study - a meta-analysis pooling
results of 522 trials covering 21 commonly-used antidepressants and almost 120000
patients - uncovered a range of outcomes with some drugs proving more effective than
others and some having fewer side effects But all 21 drugs - including both off-patent
generic and newer patented drugs - were more effective than placebos or dummy pills the
results showed Reuters
top of page
US FDA says recalls destroys certain kratom-
containing dietary products
21 February - The US Food and Drug Administration on Wednesday said it recalled and
destroyed a large volume of kratom-containing dietary supplements made by a company in
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
14
Missouri Kratom is a natural plant grown in parts of Asia that advocates say can help ease
pain and reduce symptoms of opioid withdrawal but which critics say can lead to addiction
and death The FDA has long been skeptical of the benefits of kratom having placed import
alerts on the substance in 2012 and 2014 There are currently no FDA-approved therapeutic
uses of kratom The regulator has earlier said it was aware of 36 deaths associated with the
plant however declined to say over what period the deaths occurred The regulator said it is
recalling all kratom-containing dietary supplements distributed under the brand names
Botany Bay Enhance Your Life and Divinity The brands are manufactured by Divinity
Products Distribution of Grain Valley Missouri Reuters
top of page
USAFRICOM
Democratic Republic of CongoUganda Diarrhea kills 26
Congolese refugees in Uganda infects hundreds
22 February - Twenty-six refugees from the Democratic Republic of Congo have died in a
camp in Uganda from acute diarrhea and hundreds more cases have been registered an
official from the United Nations refugee agency UNHCR said on Thursday The East African
countryrsquos refugee population has risen sharply recently as people flood in from eastern
Congo where resurgent ethnic and inter-communal violence has uprooted hundreds of
thousands Duniya Aslam Khan spokeswoman for the UNHCR in Uganda said health
workers from the World Health Organisation UN childrenrsquos fund UNICEF and Medecins
Sans Frontieres had identified ldquoacute watery diarrheardquo in camps in western Uganda She said
the condition had already killed 26 refugees from Feb 15 to 19 while 424 cases were being
treated Reuters
top of page
Liberia Lassa fever
22 February - On 9 January 2018 a patient from Guinea with fever neck pain body pain and
vomiting was admitted to a hospital in Ganta in Nimba County Liberia The patient was
treated with Ribavirin until her death on 11 January 2018 Prior to hospitalization in
Liberia she sought medical care at a health facility in hellip Guinea where she was treated for
typhoid and malaria On 10 January 2018 a specimen was collected and tested positive for
Lassa Lassa fever is endemic in Liberia From 1 January 2017 through 23 January 2018 91
suspected cases were reported from six counties WHO
top of page
Malawi Malawi cholera cases pass 500 eight people
dead
19 February - Cholera cases in Malawi have tripled and four more people have died the
Ministry of Health said on Monday a month after the spread of the disease from Zambia
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
15
was thought to have been contained Ministry of Health spokesman Joshua Malango said
the number of cases had increased to 527 from 157 recorded in January and that deaths
had doubled from four to eight He said new cases continued to emerge in Central and
Northern Malawi districts including the administrative capital Lilongwe where 10 new cases
were recorded at the weekend Reuters
top of page
Mozambique Cholera 19 February - On 27 October 2017 the Ministry of Health in Mozambique notified WHO of
an outbreak of cholera From 14 August 2017 through 11 February 2018 1799 cases and
one death (case fatality rate = 006) of cholera were reported from the two provinces
Nampula (1580 cases) and Cabo Delgado (219 cases) Underreporting of the number of
cases and deaths is likely hellip Case incidence peaked in mid-November with 252 cases
reported in one week this peak was followed by a rapid decrease in reported cases A slow
increase in the number of cases reported has been observed since late December 2017 hellip In
2018 so far the weekly number of cases have fluctuated between 30 and 60 cases WHO
top of page
Nigeria Four meningococcal meningitis deaths reported
in Niger State
22 February - According to Nigerian health authorities yesterday 31 meningitis C cases
were reported in Niger State including four fatalities local media reports Health
Commissioner Dr Mustapha Jibril said the cases were reported in two councilsndashMagama
(27 cases) and Katcha (4) The health ministry has activated all outbreak response
mechanisms Jibril also noted that there could be a more severe outbreak and higher
mortality rate due to the intensely hot weather Cerebrospinal meningitis outbreaks usually
occur in the dry season due to low humidity and dusty conditions and end with the onset of
the rainy season Outbreak News Today
top of page
Nigeria Nigerias Lassa fever total grows by 19 new cases
20 February - The World Health Organization (WHO) Regional Office for Africa said there
were 19 new cases including 6 deaths reported last week during Nigerias ongoing Lassa
fever outbreak Between Jan 1 and Feb 11 of this year there have been 615 suspected Lassa
fever cases and 57 deaths with a case-fatality rate of 93 Of the suspected cases 193
have been confirmed of which 47 were fatal In confirmed cases the case-fatality rate is
239 Though Lassa fever is usually transmitted to humans by rats 14 health care workers
have contracted the disease from sick patients during this outbreak Four of the health care
worked have died Lassa fever is endemic in Nigeria but this outbreak is unusually large in
size the WHO said The virus which can cause hemorrhagic symptoms that mimic Ebola is
spread through contact with infected rats or via the bodily fluids of an infected person
CIDRAP News Scan (third item)
top of page
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
16
South Africa Cape Towns Day Zero moved back to
July 9
21 February - Residents of the South African city of Cape Town are breathing a little easier
as city officials have moved back Day Zero when municipal drinking water supplies would
be largely turned off to July 9 It had been April 12 as of last month but water conservation
by the residents has slowed the decline of key reservoirs Alderman Ian Neilson the citys
executive deputy mayor wrote in a statement titled Defeating Day Zero is in sight if we
sustain our water-saving efforts Occupational Health and Safety
top of page
USCENTCOM
Pakistan Study finds new superbug typhoid strain
behind Pakistan outbreak
20 February - An outbreak of typhoid fever in Pakistan is being caused by an extensively
drug resistant ldquosuperbugrdquo strain a sign that treatment options for the bacterial disease are
running out scientists said on Tuesday Researchers from Britainrsquos Wellcome Sanger
Institute who analyzed the genetics of the typhoid strain found it had mutated and acquired
an extra piece of DNA to become resistant to multiple antibiotics An outbreak of drug-
resistant typhoid that began in Hyderabad in Pakistan in November 2016 is still spreading
according to experts from Aga Khan University who worked with the Sanger team hellip The
researcher found the bacterial strain causing the outbreak is now resistant to five antibiotics
in total more than seen in any outbreak before Reuters
top of page
Saudi Arabia New Saudi MERS case linked to camels
19 February - The Saudi Arabian Ministry of Health (MOH) confirmed one new case of
MERS-CoV on Feb 17 The MOH has issued only sporadic updates this month and this is the
second update in 3 weeks A 74-year-old Saudi woman from Rafha was diagnosed as having
MERS-CoV (Middle East respiratory syndrome coronavirus) She is in stable condition The
probable source of her infection is indirect contact with camels a likely risk factor for the
virus The new case brings Saudi Arabias MERS totals since 2012 to 1796 including 731
deaths Five people are still being treated for their infections the MOH said
CIDRAP News Scan (first item)
top of page
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
17
USEUCOM
Europe WHO warns of soaring rates of measles in
Europe
20 February - Europe has seen a big surge in measles cases in 2017 which the World Health
Organization says is a tragedy after a record low of 5273 cases in 2016 Cases increased
four-fold with more than 20000 people affected and 35 deaths Fifteen European region
countries including the UK had large outbreaks Measles cases were highest in Romania
Italy and Ukraine People shunning vaccination is part of the problem say experts hellip The
WHO says there have been declines in overall routine immunisation coverage as well as
consistently low coverage among some marginalised groups and interruptions in vaccine
supply or underperforming disease surveillance systems BBC News
top of page
USNORTHCOM
US Black lung disease comes storming back in coal
country
22 February - Federal investigators this month identified the largest cluster of advanced
black lung cases ever officially recorded More than 400 coal miners frequenting three
clinics in southwestern Virginia between 2013 and 2017 were found to have complicated
black lung disease an extreme form characterized by dense masses of scar tissue in the
lungs The cluster hellip adds to a growing body of evidence that a new black lung epidemic is
emerging in central Appalachia hellip Scientists have linked the new wave of lung disease to
miners breathing in more silica dust the likely result of a decades-long shift toward mining
thinner coal seams that require cutting into the surrounding rock Silica dust from
pulverized rock can damage lungs faster than coal dust alone The New York Times
top of page
US Florida House declines debate on assault rifles
calls porn a health risk
21 February - As high school students who survived the shooting in Parkland Fla travel to
the state Capitol to demand action on guns lawmakers offered a glimpse of the battle they
face In Tuesdays session which opened with prayer for the community of Marjory
Stoneman Douglas High School where 17 students and staff were killed last week Florida
House lawmakers declined to open debate on a bill that would ban assault weapons and
large-capacity ammunition magazines The motion to debate the bill introduced by a
Democrat required a two-thirds vote and failed Thirty-six lawmakers supported it while 71
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
18
voted no Its merits were not considered
In that same session lawmakers supported a bill that declares pornography a public health
risk That bill recognizes public health risk created by pornography amp acknowledges need
for education prevention research amp policy change to protect citizens of this state NPR
top of page
US NIOSH and NHCA present 2018 Safe-in-Sound
Excellence in Hearing Loss Prevention Awardstrade
15 February - The National Institute for Occupational Safety and Health (NIOSH) in
partnership with the National Hearing Conservation Association (NHCA) is pleased to
announce the US Armyrsquos Tactical Communications and Protective System (TCAPS) as the
recipient of the 2018 Safe-in-Sound Excellence in Hearing Loss Prevention Awardtrade hellip Safe-
in-Sound awards honor those that have contributed to the prevention of noise-induced
hearing loss and tinnitus through effective practices or innovations directed to those who
are exposed to noise at work This yearrsquos award recognizes the US Armyrsquos TCAPS system for
being successful in obtaining authority to evaluate and procure commercial off the shelf
Hearing Protection Devices (HPDs) to designated Dismounted Infantry Soldiers The
program developed new and innovative procedures to procure test deliver and train users
on new active hearing protection devices The success of the TCAPS program represents a
recognition by the Army of the importance of hearing protection and communication
among the force NIOSH
top of page
US NIOSH study - Hearing loss prevalence in the
health care and social assistance sector
20 February - A new study from the National Institute for Occupational Safety and Health
(NIOSH) breaks down the prevalence of hearing loss experienced by workers in the Health
Care and Social Assistance (HSA) sector The overall prevalence of hearing loss among
noise-exposed exposed workers was found to be 19 while some subsectors within the
HSA had up to 31 prevalence of hearing loss hellip Hearing loss is the third most common
chronic physical condition in the United States Although a smaller percentage of workers in
the Health Care and Social Assistance sector are exposed to hazardous noise ndash unlike
industries like Mining or Construction ndashNIOSH researchers found that some subsectors in
the HSA had higher than expected prevalences of hearing loss for an industry that has had
assumed ldquolow-exposurerdquo to noise hellip Most of the HSA subsector prevalence estimates
ranged from 14 to 18 but the Medical and Diagnostic Laboratories subsector had 31
prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24
prevalence The Child Day Care Services subsector also had a 52 higher risk than the
reference industry NIOSH
top of page
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
19
US Prevalence of amyotrophic lateral sclerosis mdash
United States 2014
23 February - hellip Amyotrophic lateral sclerosis (ALS) commonly known as Lou Gehrigrsquos
disease is a progressive and fatal neuromuscular disease Familial ALS a hereditary form of
the disease accounts for 5ndash10 of cases the remaining sporadic cases have no clearly
defined etiology A total of 15927 persons were identified as having definite ALS across
three national databases (Medicare Veterans Health Administration and Veterans Benefits
Administration) and through web portal registration for 2014 The estimated ALS prevalence
for 2014 was 50 cases per 100000 population the same as 2013 estimate
Morbidity and Mortality Weekly Report
top of page
USPACOM
Asia Another volcano just erupted in the ldquoRing of Firerdquo
19 February - A massive column of smoke and ash shot nearly
10 miles into the sky above Sumatra Monday morning as
Mount Sinabung one of three currently active volcanos in
Indonesia began erupting Itrsquos the latest rumble in whatrsquos
already been a very rowdy couple of months along the Ring
of Fire the geological region that follows the 25000-mile
perimeter of the Pacific Ocean hellip No fatalities or injuries were reported after Mondayrsquos
eruption Over in the Philippines Mount Mayon which began erupting on January 13 and
forced 75000 to flee saw another eruption of ash and lava on Monday Mount Kusatsu-
Shirane 100 miles northwest of Tokyo also erupted in January leaving one soldier dead in
an avalanche and injured a dozen at a ski resort Indonesiarsquos Mount Agung which has been
spewing ash since November also had four distinct eruptions MSNcom
top of page
China Doctors in China lead race to treat cancer by
editing genes
21 February - hellip China is starting to pull ahead of other parts of the world mdash maybe for the
time mdash in regards to biomedicine says Hallam Stevens an anthropologist at the Nanyang
Technological University in Singapore who studies Chinese bioscience Theyve been really
investing heavily in it over the last couple of decades and its starting to pay off in a big
way The treatment [Shixiu] Wu is testing involves taking a sample of blood from each
patient A lab at a biotech company two hours away by bullet train extracts T cells from the
blood Scientists then use CRISPR to knock out a gene in the T cells known as PD-1 This
engineering feat modifies the T cells so that they zero in on and attack the cancer cells
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
20
once theyre infused back into each patient hellip Its still too early to draw firm conclusions
about how effective the treatment will be or what the full extent of side effects from it
Deng is one of just 21 patients with advanced incurable cancer of the esophagus that Wu
has treated so far with CRISPR-edited T cells But Wu says about 40 percent of the patients
appear to have responded One patient is still alive almost a year later NPR
top of page
USSOUTHCOM
South America South America records most yellow fever
cases in decades
19 February - A new report from the Pan American Health Organization (PAHO) documents
yellow fever cases in animals and humans from January 2016 through January 2018 in South
America showing the most cases reported in decades Seven countriesmdashBolivia Brazil
Colombia Ecuador French Guiana Peru and Surinamemdashreported yellow fever activity in
the last 2 years with Brazil hosting the majority of cases since that country began
experiencing the current outbreak at the end of 2016 Only Brazil and Peru have reported
cases in 2018 As noted in the Feb 16 report Brazils Ministry of Health confirmed 941
human cases since Jul 1 2016 which includes 284 deaths Sao Paulo Minas Gerais and Rio
de Janeiro have reported the most cases All confirmed cases correspond to areas with
documented epizootic cases in non-human primates PAHO said CIDRAP
top of page
Venezuela Venezuelans report big weight losses in 2017
as hunger hits
21 February - Venezuelans reported losing on average 11 kilograms (24 lbs) in body weight
last year and almost 90 percent now live in poverty according to a new university study on
the impact of a devastating economic crisis and food shortages The annual survey
published on Wednesday by three universities is one of the most closely-followed
assessments of Venezuelansrsquo well-being amid a government information vacuum and shows
a steady rise in poverty and hunger in recent years Over 60 percent of Venezuelans
surveyed said that during the previous three months they had woken up hungry because
they did not have enough money to buy food About a quarter of the population was eating
two or less meals a day the study showed Reuters
top of page
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center
21
US Military | Global | Influenza | VeterinaryFood Safety | Wellness | Contact Us
USAFRICOM | USCENTCOM | USEUCOM | USNORTHCOM | USPACOM | USSOUTHCOM
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the US Army and is not a medical
intelligence product Medical intelligence is available from the National Center for Medical Intelligence
External Links The appearance of external hyperlinks does not constitute endorsement by the US Army of this Web site or the information products
or services contained therein For other than authorized activities such as military exchanges and MWR sites the US Army does not exercise any
editorial control over the information you may find at these locations Such links are provided consistent with the stated purpose of this product
Although we avoid links to sites that may be blocked all sites may not be accessible from all locations While we verify the links at the time of
publication we cannot guarantee that they will be active in the future
Articles appearing in the Update do not necessarily represent US Army Medical Command opinionsviews policy or guidance and should not be
construed or interpreted as being endorsed by the US Army Medical Command
The Army Public Health Weekly Update is published by the Public Health Information Directorate Army Public Health Center