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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.

More About Us

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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Update: Exertional Hyponatremia U.S. Armed Forces, 2001-2016

Infographic
4/4/2017
Exertional Hyponatremia occurs during or up to 24 hours after prolonged physical activity. It is defined by a serum, plasma or blood sodium concentration below 135 millequivalents per liter. This infographic provides an update on Exertional Hyponatremia among U.S. Armed Forces, information on service members at high risk. Exertional hyponatremia can result from loss of sodium and/or potassium as well as relative excess of body water. There were 1,519 incident diagnoses of exertional hyponatremia among active component service members from 2001 through 2016. 86.8 percent were diagnosed and treated without having to be hospitalized. 2016 represented a decrease of 23.3 percent from 2015. In 2016, there were 85 incident diagnoses of exertional hyponatremia among active component service members and 77.6 percent of exertional hyponatremia cases affected males.  The annual rate was higher among females. Service members age 40 and over were most affected by exertional hyponatremia. High risk service members of exertional hyponatremia were: •	Females •	Service members aged 19 years or younger •	White, non-Hispanic and Asian/ Pacific Islander service members •	Recruit Trainees •	Marine Corps members Learn more at www.Health.mil/MSMR

Exertional Hyponatremia occurs during or up to 24 hours after prolonged physical activity. It is defined by a serum, plasma or blood sodium concentration below 135 millequivalents per liter. This infographic provides an update on Exertional Hyponatremia among U.S. Armed Forces, information on service members at high risk. Exertional hyponatremia can result from loss of sodium and/or potassium as well as relative excess of body water.

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Armed Forces Health Surveillance Branch | Physical Activity

Minority Health Heat Illness Active Component U.S. Armed Forces, 2016

Infographic
4/4/2017
Heat illness refers to a spectrum of disorders that occur when the body is unable to dissipate heat absorbed from the external environment and the heat generated by internal metabolic processes. As heat illness progresses, failure of one or more body systems can occur. This report summarizes reportable medical events of heat illnesses, heat-related hospitalizations and ambulatory visits among minority active component members (Black, non-Hispanic, Hispanic, and Asian/Pacific Islanders) during 2016. In 2016, incidence rates of heat stroke were highest among Asian/ Pacific Islanders than any other ethnicity. Crude incidence rate of “other heat illnesses” was higher among females than males.  Heat Incidence cases: •	Black, non-Hispanic heat illness incidence cases – 64 for heatstroke and 389 for other heat illnesses •	Hispanic heat illness incidence cases—  63 for heatstroke and 320 for other heat illnesses •	Asian/ Pacific Islander heat illness incidence cases – 32 for heatstroke and for  117 other heat illnesses Incidence rates: •	Black, non-Hispanic incidence rates – 0.30 for heatstroke and 1.84 for other heat illnesses •	Hispanic incidence rates – 0.33 for heatstroke and 1.67 for other heat illnesses •	Asian/Pacific Islander – 0.62 for heatstroke and 2.26 for other heat illnesses Of all military members, the youngest and most inexperienced marines and soldiers – particularly those training at installations in the south eastern U.S. – are at highest risk of heat illnesses including heat stroke, exertional hyponatremia, and exertional rhabdomyolysis. Learn more at www.Health.mil/MSMR

Heat illness refers to a spectrum of disorders that occur when the body is unable to dissipate heat absorbed from the external environment and the heat generated by internal metabolic processes. As heat illness progresses, failure of one or more body systems can occur. This report summarizes reportable medical events of heat illnesses, heat-related hospitalizations and ambulatory visits among minority active component members (Black, non-Hispanic, Hispanic, and Asian/Pacific Islanders) during 2016.

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Global Influenza Summary: April 2, 2017

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4/2/2017

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Rhabdomyolysis by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet

Fact Sheet
3/30/2017

This fact sheet provides details on Rhabdomyolysis by location for active component, U.S. Armed Forces during a five-year surveillance period from 2012 through 2016. The medical treatment facilities at nine installations diagnosed at least 50 cases each and, together approximately half (49.9%) of all diagnosed cases.

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Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Demographic and Military Traits of Service Members Diagnosed as Traumatic Brain Injury Cases

Fact Sheet
3/30/2017

This fact sheet provides details on the demographic and military traits of service members diagnosed as traumatic brain injury (TBI) cases during a 16-year surveillance period from 2001 through 2016, a total of 276,858 active component service members received first-time diagnoses of TBI - a structural alteration of the brain or physiological disruption of brain function caused by an external force.

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Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Heat Illnesses by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet

Fact Sheet
3/30/2017

This fact sheet provides details on heat illnesses by location during a five-year surveillance period from 2012 through 2016. 11,967 heat-related illnesses were diagnosed at more than 250 military installations and geographic locations worldwide. Three Army Installations accounted for close to one-third of all heat illnesses during the period.

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Routine Screening for Antibodies to Human Immunodeficiency Virus

Infographic
3/17/2017
The 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 an update on routine screening for antibodies to HIV among civilian applicants for the U.S. military service and U.S. Armed Forces during a January 2011 - June 2016 surveillance period.  Since October 1985, the U.S. military has conducted routine screening for antibodies to HIV-1 to enable adequate and timely medical evaluations, treatment and counseling; to prevent unwitting transmission; and protect the battlefield blood supply. From January 2015 through June 2016, 463,132 civilian applicants for U.S. military service were tested. 124 were identified as HIV antibody positive. During 2015, one was detected with antibodies to HIV per 3,267 screening tests. Annual seroprevalences peaked in 2015, up 29% from 2014. The seroprevalences were much higher among males than females and among black, non-Hispanics than other race/ethnicity groups. Seroprevalences decreased by approximately 26% among male applicants, dropped to zero among female applicants, and decreased by 43% among black, non-Hispanic applicants.  As for the active component of the U.S. Army, 548,974 soldiers were tested from January 2015 through June 2016. 120 were identified as HIV antibody positive. During 2015, one was detected with antibodies to HIV per 5,265 screening tests. Of the 515 active component soldiers diagnosed with HIV infections since 2011, a total of 291 (57%) were still in military service in 2016. Annual seroprevalences for male active component Army members greatly exceed those of females.  Among active and reserve component service members, seroprevalences continue to be higher among Army and Navy members and males than their respective counterparts. Service members who are infected with HIV receive clinical assessments, treatments, and counseling; they may remain in service as long as they are capable of performing their military duties. Learn more at Health.mil/AFHSB

The 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 an update on routine screening for antibodies to HIV among civilian applicants for the U.S. military service and U.S. Armed Forces during a January 2011 - June 2016 surveillance period.

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Armed Forces Health Surveillance Branch | HIV/AIDS Prevention and Treatment

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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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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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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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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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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Armed Forces Health Surveillance Branch
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