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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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Accidental Drownings Among U.S. Service Members

Infographic
5/25/2017
Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. Increase your awareness today to lower your risks: Drowning prevention: Water-related recreational activities in or near water can be potentially dangerous – particularly for non-swimmers and weak swimmers – in hazardous conditions and settings (e.g., storms, currents, riptides), and when safety measures are not observed. Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. Here are four ways you can prevent unintentional drowning: •	Wear life jackets. •	Take swim lessons to become a stronger swimmer. •	Swim with a buddy; never swim alone. •	Be knowledgeable of water environments you are in. Increase your awareness and lower your risks by reading the Medical Surveillance Monthly Report (MSMR) Vol. 22 No. 6 – June 2015 report “Update: Accidental drownings, active component, U.S. Armed Forces, 2005 – 2014 at www.Health.mil/MSMR  #SwimSafe Follow us on Twitter for more information at AFHSBPAGE. Also check out hashtag #SwimSafe. Source: Defense Health Agency, Armed Forces Health Surveillance Branch. Graphic shows: •	Man swimming in pool •	Mom with three children swimming in pool. •	Woman swimming in pool

Military members are at risk for unintentional drownings during training, occupational activities and off-duty recreation. This infographic provides swim safety information to help increase awareness and lower the risks of accidental drownings among service members.

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Armed Forces Health Surveillance Branch | Summer Safety

Absolute and Relative Morbidity Burdens Attributable to Various illnesses and Injuries, Active Component, U.S. Armed Forces, 2016

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5/18/2017
everal classification systems and morbidity measures have been developed to quantify absolute and relative morbidity burdens attributable to various illnesses and injuries among the active component of the U.S. Armed Forces in 2016. They determine to a large extent the conclusions that may be drawn regarding the relative “importance” of various conditions – and, in turn, the resources that may be indicated to prevent or minimize their impacts. This annual summary provides: •	142 categories based on a modified version of the classification system developed for the Global Burden of Disease (GBD) study. •	25 burden of disease-related conditions for all illness-and injury-specific diagnoses (as defined by the ICD-10). Findings: •	In 2016, 550,213 service members received medical care for injury/poisoning, more than any other morbidity related category. •	Injury/poisoning accounted for more medical encounters (n= 2,755,387) than any other morbidity category – that is 24.8% of all medical encounters overall. •	Together, injury/poisoning and mental disorders accounted for 56.2% of all hospital bed days and 41.8% of all medical encounters. Medical Encounters Pie Chart Display: •	There were a total of 11,113,506 medical encounters overall (whole pie chart or 100%) •	A total of 2,755,387 for the injury/poisoning category or 24.793% for injury/poisoning ( purple slice of pie chart that is labeled Injury/poisoning) •	A total of 1,895,156 categorized as mental disorders or 17.053% for mental disorders ( lime green slice of pie chart that is labeled mental disorders) •	Together, injury/poisoning and mental disorders accounted  for 41.8 of all medical encounters •	All other medical encounters is approximately 58.2% (dark green slice of the pie chart that is labeled all other medical encounters). For more findings, view the full MSMR report at Health.mil/AFHSB Images included on graphic: DHA logo, Military vehicle and helicopter propellers.

Several classification systems and morbidity measures have been developed to quantify absolute and relative morbidity burdens attributable to various illnesses and injuries among the active component of the U.S. Armed Forces. This graphic highlights findings about the active component of the U.S. Armed Forces in 2016.

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Absolute and Relative Morbidity Burdens Attributable to various illnesses and injuries: Non-service member beneficiaries of the Military Health System, 2016

Infographic
5/18/2017
Individuals who are eligible for care through the Military Health System (MHS) are known as beneficiaries. MHS beneficiaries include family members of active component service members, the National Guard and Reserve service members, retirees and eligible family members of retirees. In 2016, there were approximately 9.4 million beneficiaries eligible for health care in the MHS. Findings: •	In 2016, a total of 6,589,843 non-service member beneficiaries of the MHS had 86,486,080 medical encounters. •	On average, each individual who accessed care from the MHS had 13.1 medical encounters over the course of the year. •	The top three morbidity-related categories accounted for 34.5% of all medical encounters. Top Three Morbidity-Related Categories Pie Chart •	Injuries and poisonings (10.5%) – pie slice shown in the color of lavender.  •	Signs, symptoms, and ill-defined conditions (11.9%) – pie slice shown in green. •	Musculoskeletal diseases (12.2%) - pie slice shown in dark blue. •	Orange of pie chart indicates the other morbidity related categories (make up approximately 65.4% of the pie chart). Signs, symptoms, and ill-defined conditions, injuries and poisonings, and disorders of the sense organs were the illness/injury categories that affected the most individuals (44.9%, 34.7%, and 30.3% of all beneficiaries who received any care, respectively). Learn more at Health.mil/MSMR Other images seen on graphic:  Father and baby daughter at medical appointment with a family doctor from the MHS.

Individuals who are eligible for care through the Military Health System (MHS) are known as MHS beneficiaries. This graphic provides information on the absolute and relative morbidity burdens attributable to various illnesses and injuries among non-service member beneficiaries of the MHS in 2016.

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Ambulatory visits, Active Component, U.S. Armed Forces, 2016

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5/18/2017
This infographic documents the frequencies, rates, trends and characteristics of ambulatory healthcare visits of active component members of the U.S. Army, Navy, Air Force, and Marine Corps during 2016. Findings •	During 2016, there were 19,158,557 reported ambulatory visits of active component service members. •	On average each service member had approximately 15 ambulatory encounters during the year. •	In 2016, four major diagnostic categories accounted for 72.6% of all illness-and injury-related ambulatory visits among active component service members. Pie Chart •	Signs, Symptoms, and ill-defined conditions (8.8%) – pie slice is blue;  military woman with illness seen. •	Disorders of the nervous system and sense organs (10.8%) – pie slice shows many getting his eye examined by a doctor. •	Mental Disorders (16.8%) –  pie slice is green; shows man sitting on the floor who is seeking mental health treatment. •	Musculoskeletal system/connective tissue disorders (36.3%) – pie slice is red; physician is treating patient for musculoskeletal system/ connective tissue disorders. The 2016 number of visits for musculoskeletal disorders (n= 4,198,896) is the highest annual count in the past 13 years. Learn about the largest percentage increases and decreases in ambulatory visits during 2012-2016 at www.Health.mil/MSMR.  Other images seen on graphic: transparent background shows entrance to an Emergency Center.

This infographic documents the frequencies, rates, trends and characteristics of ambulatory healthcare visits of active component members of the U.S. Army, Navy, Air Force, and Marine Corps during 2016.

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Armed Forces Health Surveillance Branch

DoD Global, Laboratory-Based Influenza Surveillance Program, 2014- 2015 Season

Infographic
4/17/2017
The DoD Global, Laboratory-Based, Influenza Surveillance Program is a DoD-wide, year-round program that tests respiratory specimens from DoD beneficiaries presenting to military treatment facilities with influenza-like illness (ILI). ILI is defined as an illness characterized by a fever 100.5 degrees F or greater and cough or sore throat within 72 hours of seeking treatment. Sentinel sites submit 6-10 specimens per week from beneficiaries presenting with ILI. Each specimen is tested via reverse transcription-polymerase chain reaction (RT-PCR) and viral culture. The 2014-2015 influenza season was dominated by influenza A (H3N2) at the beginning; however by Week 10, identifications of influenza B viruses were more numerous than for influenza A. Out of a total of 6,432 specimens, 32.7% were positive for influenza. Additionally 19.6% of specimens were positive for other respiratory pathogens while 47.7% specimens were negative. The molecular characterization of specimens showed that the majority of influenza A (H3N2) viruses circulating had drifted from the vaccine strain by December 2014. This finding was in agreement with the Centers for Disease Control and Prevention and World Health Organization observations during the 2014-2015 influenza season. For more information visit Health.mil/AFHSB

The DoD Global, Laboratory-Based, Influenza Surveillance Program is a DoD-wide, year-round program that tests respiratory specimens from DoD beneficiaries presenting to military treatment facilities with influenza-like illness (ILI).

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Zika Virus Infections in Military Health System Beneficiaries

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4/17/2017
The introduction and rapid spread of the Zika virus (ZIKV), a Flavivrus of the Flaviviridae family, across the Western Hemisphere have posed a risk of infection to Military Health System (MHS) beneficiaries. This report documents: •	The impact of ZIKV transmission on MHS beneficiaries. •	ZIKV spread to nearly 50 countries and territories within a 17-month period. •	Among affected service members, the Army reported the most Zika cases. •	There have been 156 confirmed cases of Zika in MHS beneficiaries. •	A majority of cases reported exposure in Puerto Rico (n=91, 58.3%). Geographic regions of potential exposure to Zika cases in MHS beneficiaries between 01 Jan – 30 Nov 2016 included: •	Puerto Rico ( 91 cases) •	Caribbean ( 41 cases) •	Central America & Mexico (15 cases) •	South America (6 cases) •	Asia ( 3 cases) •	Unknown (3) •	U.S. Florida (1 case) Cases in Service Members Between 01 Jan – 30 Nov 2016 were: •	Army (48 cases) •	Coast Guard (29 cases) •	Air Force (16 cases) •	Navy (10 cases) •	Marine Corps (7 cases) Although most ZIKV infections are asymptomatic or have a relatively mild illness, the gravity of pregnancy and neurologic issues linked to infection remains a significant impetus for the continued surveillance of ZIKV in the MHS population. For more Zika surveillance and information on signs and symptoms, visit Health.mil/AFHSB

The introduction and rapid spread of the Zika virus (ZIKV), a Flavivrus of the Flaviviridae family, across the Western Hemisphere have posed a risk of infection to Military Health System (MHS) beneficiaries.

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Armed Forces Health Surveillance Branch | Zika Virus | In the Spotlight

Findings from The Department of Defense Global, Laboratory-Based Influenza Surveillance Program, 2015-2016 Influenza Season

Infographic
4/17/2017
The Department of Defense (DoD) Global, Laboratory-Based, Influenza Surveillance Program monitors the circulation of influenza viruses throughout each influenza season. Each season runs from the beginning of October through end of the next September. During the 2015 – 2016 influenza season, a total of 4,591 specimens were tested from 80 locations. The predominant influenza strain was A (H1N1) pdm09. Additionally peak influenza activity occurred during weeks 7 – 13 (14 February – 2 April 2016). Of those submitted for routine surveillance, 1,182 (25.7%) tested positive for other respiratory pathogens, 377 (8.2%) tested positive for influenza B, 755 (16.5%) tested positive for influenza A, and 2,277 (49.6%) tested negative. For more information on the 2015-2016 influenza season and how to identify influenza-like illness (ILI), read the Medical Surveillance Monthly Report (MSMR) at Health.mil/AFHSB.

The Department of Defense (DoD) Global, Laboratory-Based, Influenza Surveillance Program monitors the circulation of influenza viruses throughout each influenza season. Each season runs from the beginning of October through end of the next September.

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New and Improved Defense Medical Epidemiology Database

Infographic
4/4/2017
The new and improved Defense Medical Epidemiology Database (DMED), known as DMED 5.0, is now only available online.  DMED provides timely and efficient access to data of active component personnel and medical event data.  It contains a subset of data from the Defense Medical Surveillance System (DMSS), offering remote access to tri-service epidemiologic data. Moreover, it protects privacy using only de-identified data and updates monthly.  The new DMED features an enhanced user interface, query data using ICD-9 and ICD-10 diagnostic codes granting authorized users to search multiple databases simultaneously. These users are U.S. military personnel (DoD-CaC users) or Federal partners and civilian collaborators in military medical research and operations. Authorized U.S. military personnel with access to DMED include medical providers, epidemiologists, medical researchers, safety officers, and medical operations and clinical support staff. Sign up for a new account at www.health.mil/dmed

The new and improved Defense Medical Epidemiology Database (DMED), known as DMED 5.0, is now only available online. DMED provides timely and efficient access to data of active component personnel and medical event data.

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Armed Forces Health Surveillance Branch | Defense Medical Epidemiology Database

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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Routine Screening for Antibodies to Human Immunodeficiency Virus

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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

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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

Diabetes Mellitus

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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

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

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
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