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Armed Forces Health Surveillance Branch

Health Surveillance, Analysis and Insight for Action

Armed Forces Health Surveillance Branch is the central epidemiology health resource for the US Military and Public Health

The Armed Forces Health Surveillance Branch (AFHSB) is the central epidemiologic resource for the U.S. Armed Forces, conducting medical surveillance to protect those who serve our nation in uniform and allies who are critical to our national security interests. Explore our website to learn about the critical role AFHSB plays in force health protection.

AFHSB provides timely, relevant, actionable and comprehensive health surveillance information to promote, maintain, and enhance the health of military and military-associated populations.

AFHSB critical functions are:

  • Acquire, analyze, interpret, disseminate information, and recommend evidence-based policy
  • Develop, refine, and improve standardized health surveillance methods
  • Serve as the focal point for sharing health surveillance products expertise and information
  • Coordinate a global program of military-relevant infectious disease surveillance

Explore our health surveillance resources to learn how to utilize our data applications, systems and the ways our health information analysis supports worldwide disease surveillance and public health activities to improve the U.S. military's Force Health Protection (FHP) program.

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Medical Surveillance Monthly Report

Medical Surveillance Monthly Report MSMR Online SubscriptionThe Medical Surveillance Monthly Report (MSMR) is AFHSB's flagship publication. The monthly peer-reviewed journal provides evidence-based estimates of the incidence, distribution, impact, and trends of health-related conditions among service members. Additionally, the MSMR focuses one issue per year on the absolute and relative morbidity burden attributable to various illnesses and injuries among service members and beneficiaries.

View Current Report  View Archived Reports

Health Surveillance Explorer

The Health Surveillance Explorer (HSE) is a dynamic CAC-enabled mapping application that allows the Geo­graphic Combatant Commands (GCCs) to identify global health threats and disease outbreaks in near-real time. It provides timely, relevant and actionable health surveillance information to military leaders around the globe. The HSE makes it more efficient and effective to assemble surveillance data.

Launch HSE

Proposal Management Information System

Launch Proposal Management Information SystemThe Proposal Management Information System (ProMIS) program is a web-based application used to facilitate program management at the AFHSB's Global Emerging Infections Surveillance (GEIS) section. Investigators in the GEIS partner network submit proposals for funding consideration and GEIS operations staff monitors the progress of those projects.

Go to ProMIS

Defense Medical Epidemiology Database

DMED ButtonThe Defense Medical Epidemiology Database (DMED) provides worldwide access to de-identified data contained in the Defense Medical Surveillance System (DMSS). Through this user-friendly interface, authorized users can create customized queries of disease and injury rates in active duty populations.

Go to DMED

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Chlamydia Trachomatis Infections

Infographic
3/17/2017
This report characterizes the rates of Chlamydia Trachomatis (CT) during the pre-deployment, deployment, and post-deployment phases for active component members of the U.S. Army, Navy, Air Force and Marine Corps. The surveillance period was 2008 through 2015.  For incidence rates of laboratory-confirmed Chlamydia Trachomatis diagnoses, by deployment cycle and sex, active component, U.S. Armed Forces, 2008-2015, there were 84,783 cases for men and 54,867 cases for women. The surveillance period findings show: •	Rates of CT were highest during the pre-deployment phase for both sexes •	Males tended to have similar rates of CT across pre-, post-, and non-deployed phases •	Women had substantial rate differences between phases  The results of these analyses underscore the need for better screening and documentation of STIs during deployment to assess the true burden of disease. Learn more about rates of CT among U.S. Armed Forces by visiting Health.mil/MSMR

This report characterizes the rates of Chlamydia Trachomatis (CT) during the pre-deployment, deployment, and post-deployment phases for active component members of the U.S. Army, Navy, Air Force and Marine Corps. The surveillance period was 2008 through 2015.

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Armed Forces Health Surveillance Branch

5 Major Categories of Abdominal Hernia

Infographic
3/17/2017
An abdominal hernia is an abnormal protrusion of an organ or tissue through a defect in the abdominal wall. This infographic provides information on incident diagnoses of the five types of abdominal hernia that were documented in health records of 72,404 active component service members from 1 January 2005 through 31 December 2014.  A total of 87,480 incident diagnoses of the five types of abdominal hernia were documented in health records of 72,404 active component service members. Here are highlights of the findings from this study: •	The give types of abdominal hernia categories used in this analysis were: inguinal, umbilical ventral/ incisional, femoral and “other.” •	 During the 10-year interval, incidence rates for most of the five types of hernia trended downward but increased for umbilical hernias in both males and females and ventral/ incisional hernias among females. •	Overall incidence rate of inguinal hernias among males was six times the rate among females. •	Incidence rates of femoral, ventral/ incisional and umbilical hernias were higher among females than males. •	For most types of hernia incidence rates tend to be higher among older age groups.  Abdominal hernias are diagnosed most frequently in the inguinal, umbilical, and femoral regions, but another category of relatively common hernias of the anterior abdominal wall includes ventral and incisional hernias. Health records contained documentation for 35,624 surgical procedures whose description corresponded to the types of hernia diagnoses in U.S. military service members. Learn more about the findings of the study at Health.mil/MSMR

An abdominal hernia is an abnormal protrusion of an organ or tissue through a defect in the abdominal wall. This infographic provides information on incident diagnoses of the five types of abdominal hernia that were documented in health records of 72,404 active component service members from 1 January 2005 through 31 December 2014.

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Armed Forces Health Surveillance Branch | Men's Health

Diabetes Mellitus

Infographic
3/17/2017
Diabetes Mellitus (DM) is a group of chronic metabolic conditions characterized by high blood glucose levels resulting from a decreased ability to produce and or use insulin. DM-related metabolic abnormalities are associated with damage to various organs and tissues. From 2008 - 2015, a total of 9,092 incident cases of DM were reported among active duty service members. This infographic provides details on the overall incidence rates of type 1 and 2 DM cases per 100,000 person-years. It also provides information about service members at higher risk of diabetes. Here are some key findings from the study: •	Type 1 DM (previously known as “insulin-dependent diabetes”) overall incidence rate was 3.0 cases per 100,000 p-yrs. •	Type 2 DM ( “non-insulin-dependent diabetes) was 74.5 cases per 100,000 p-yrs. And rates doubled within each successive age group.  Service members at higher risk of diabetes are male, black, non-Hispanic, unknown race/ ethnicity, Hispanic and enlisted in the Army and Navy. Learn more by visiting Health.mil/AFHSB

Diabetes Mellitus (DM) is a group of chronic metabolic conditions characterized by high blood glucose levels resulting from a decreased ability to produce and or use insulin. DM-related metabolic abnormalities are associated with damage to various organs and tissues. From 2008 - 2015, a total of 9,092 incident cases of DM were reported among active duty service members. This infographic provides details on the overall incidence rates of type 1 and 2 DM cases per 100,000 person-years. It also provides information about service members at higher risk of diabetes.

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Conditions and Treatments | Armed Forces Health Surveillance Branch

Leishmaniasis

Infographic
3/17/2017
Leishmaniasis is a zoonotic disease caused by protozoan parasites of the genus Leishmania that are transmitted to humans by the bites of infected female sand flies. The disease remains a military medical surveillance interest because of deployments to endemic areas of the Middle East. It is also endemic in many other regions including Africa, Mexico, Southern Europe, Asia, and South and Central America. This report provides an update on the frequencies, rates, and demographic characteristics of U.S. service members who were diagnosed/ reported with leishmaniasis while expanding analysis to include information on the location of acquisition of leishmaniasis infection during a 2001-2016 surveillance period. Here are key findings from the surveillance period: •	There were 2,040 incident diagnoses/ reports of leishmaniasis among members of the U.S. Armed Forces. •	Cutaneous Leishmaniasis accounted for 61.0% of total diagnoses/ reports among active duty service members. •	71.1% of the total leishmaniasis case were diagnosed or reported during the 7 months from early autumn to spring (September – March) in the northern hemisphere. •	The majority of cases diagnosed or reported during this 7-month interval were acquired in the Middle East, South/Central America and other or unknown locations.  Learn more information at Health.mil/MSMR

Leishmaniasis is a zoonotic disease caused by protozoan parasites of the genus Leishmania that are transmitted to humans by the bites of infected female sand flies. This report provides an update on the frequencies, rates, and demographic characteristics of U.S. service members who were diagnosed/ reported with leishmaniasis while expanding analysis to include information on the location of acquisition of leishmaniasis infection during a 2001-2016 surveillance period.

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Armed Forces Health Surveillance Branch

Global Influenza Summary: March 12, 2017

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3/12/2017

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Global Influenza Summary: March 5, 2017

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3/5/2017

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March 10 is National Women & Girls HIV/AIDS Awareness Day

Infographic
3/3/2017
This graphic shows the results of routine screening for antibodies to Human Immunodeficiency Virus (HIV) among both female civilian applicants for U.S. military service and female service members of the U.S. Armed Forces, active component - Army during  January 2015 through June 2016 surveillance period. 94,763 females out of 463,132 civilian applicants for U.S. military service were tested for antibodies to HIV. Out of 124 civilian applicants that were HIV positive, 10 were female. Throughout the period, seroprevalences were much higher among males than females.  During 2015 – 2016 seroprevalences dropped to zero among female applicants.  As for U.S. Armed Forces active component, 81,963 female service members out of 548,974 were tested for antibodies to HIV. Out of 120 soldiers that were HIV positive 3 were female. Annual seroprevalences for male active component Army members greatly exceed those of females. During the 2015, on average, one new HIV infection was detected among active duty army soldiers per 5,265 screening tests.  HIV-1 is the cause of Acquired Immune Deficiency Syndrome (AIDS) and has had major impacts on the health of populations and on healthcare systems worldwide. Of 515 active component soldiers diagnosed with HIV infections since 2011, a total of 291 (57%) were still in the military. Get tested and learn more by reading the Medical Surveillance Monthly Report at Health.Mil/MSMR.

Human Immunodeficiency Virus type 1 (HIV-1) is the cause of Acquired Immune Deficiency Syndrome (AIDS) and has had major impacts on the health of populations and on healthcare systems worldwide. This infographic provides information on routine screening for antibodies to HIV among female civilian applicants of the U.S. Military Service and U.S. Armed Forces, January 2011 – June 2016.

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Counts, Rates, & Trends of Incedent Diagnoses of Melanoma

Infographic
3/3/2017
Melanoma is a leading cause of cancer death. This graphic shows facts from an analysis for counts, rates, and trends of incident diagnoses of Melanoma among active component military members conducted during a 10-year surveillance period from 2005 through 2014.   Although melanoma is more common among males in the general U.S. population, in this analysis, females had a higher crude rate of malignant melanoma compared to males. From 2005 – 2014, there were 1,571 malignant melanoma cancers diagnosed in the U.S. Armed Forces. Here are other key facts from the analysis: •	Among male service members, malignant melanoma was one of the most frequent cancer diagnoses after testicular cancer. •	Among females, malignant melanoma was the 2nd most frequent cancer diagnoses after breast cancer. •	White, non-Hispanic service members had a much higher crude rate of malignant melanoma relative to their counterparts in other race/ ethnicity groups. •	In general, the strongest demographic correlate of increased risk of cancer diagnosis was older age. To learn more information, visit Health.mil/AFHSB

Melanoma is a leading cause of cancer death. This infographic provides information on an analysis for the counts, rates, and trends of incident diagnoses of melanoma among active component military members. The analysis was conducted during a 10-year surveillance period from 2005 through 2014.

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Global Influenza Summary: February 12, 2017

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Global Influenza Summary: February 5, 2017

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Cold injuries among active duty U.S. service members drop to lowest level since winter 2011–2012

Article
1/23/2017
U.S. service members often perform duties in cold weather climates where they may be exposed to frigid conditions and possible injury.

Cold injuries among active duty U.S. service members drop to the lowest level since winter 2011-2012, according to a study published in Defense Health Agency’s Armed Forces Health Surveillance Branch (AFHSB) peer-reviewed journal, the Medical Surveillance Monthly Report.

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Global Influenza Summary: January 22, 2017

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1/22/2017

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Human Physiologic Responses to Cold Exposure

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1/9/2017
Human Physiologic responses to cold exposure preserve core body temperature, but those responses may not be sufficient to prevent hypothermia if heat loss is prolonged. This infographic offers helpful information on preserving core body temperature to counter the threat from cold environments. Physiologic responses include: •	Constriction of the peripheral (superficial) vascular system – may result in non-freezing injuries or hasten the onset of actual freezing of tissues (frostbite) •	Minimizing loss of body heat •	Protecting superficial tissues Protection includes:	 •	Nutrition •	Shelter •	Physical Activity •	Protective Clothing Learn more about preserving core body temperature by reading the Medical Surveillance Monthly Report at www.Health.mil/AFHSB

Human Physiologic responses to cold exposure preserve core body temperature, but those responses may not be sufficient to prevent hypothermia if heat loss is prolonged. This infographic offers helpful information on preserving core body temperature to counter the threat from cold environments.

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Global Influenza Summary: January 1, 2017

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1/1/2017

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Rift Valley Fever Virus Ecology

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12/5/2016
This infographic describes Rift Valley Fever (RVF) virus ecology and how RVF infects livestock and humans.   •	First the enzootic cycle begins. It is maintained via transfer from parent mosquito to offspring. This is a local, low-level transfer of disease to livestock and happens during periods of average rainfall. •	Next, high rainfall and flooding enable Aedes mosquito breeding environments to flourish. This is followed by epizootic outbreaks, which cause abortion storms in animals, with > 90% mortality in newborns and 10-20% mortality in adults. Secondary vectors, including other mosquito genera such as Culex, can pass on the virus to humans and animals.  Spillover to humans includes exposure to blood and tissue of infected livestock and occurs during slaughter or birthing activities. Humans can also be infected with RVF via bites of infected mosquitos.

This infographic describes Rift Valley Fever (RVF) virus ecology and how RVF infects livestock and humans.

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Armed Forces Health Surveillance Branch | Mosquito-Borne Illnesses
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