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AFHSB's health surveillance program supports Defense Department global health engagement efforts

U.S. Air Force Senior Airman Joshua Douglass, left, an aerospace medical technician, watches as Liberian health care workers properly put on their personal protective equipment as part response by the Defense Department operation to provide logistics, training and engineering support during the Ebola virus outbreak. (U.S. Army photo by Staff Sgt. Terrance D. Rhodes) U.S. Air Force Senior Airman Joshua Douglass, left, an aerospace medical technician, watches as Liberian health care workers properly put on their personal protective equipment as part response by the Defense Department operation to provide logistics, training and engineering support during the Ebola virus outbreak. (U.S. Army photo by Staff Sgt. Terrance D. Rhodes)

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Armed Forces Health Surveillance Branch | Global Emerging Infections Surveillance | Antimicrobial Resistance (AMR) Surveillance | Febrile and Vector-Borne Infections (FVBI) Surveillance | Enteric Infections (EI) Surveillance | GEIS Partners | Global Health Engagement | Global Health Engagement

Both the U.S. Armed Forces’ operational posture and the emergence and spread of infectious diseases relevant to military operations have evolved in recent decades. Worldwide, people are more mobile and interconnected than ever before. At the same time, land use in the developing world is changing in such a way that long-dormant pathogens have the opportunity to re-emerge and become health problems for a significant proportion of the population again. These conditions threaten not only the health of populations, but also the security and stability of nations around the world.

The Defense Department has long recognized the link between global health and security, and its global health engagement efforts address the intersection of these concerns. Defense Department health agencies are primarily focused on protecting the health of the force and medical readiness, but their global health engagement efforts also address other security priorities for the U.S. government such as helping partner nations build health capacity, combatting global health threats (e.g., emerging infectious diseases and antibiotic-resistant bacteria), and supporting U.S. government humanitarian assistance and disaster relief initiatives.

The Global Emerging Infections Surveillance (GEIS) section of the Armed Forces Health Surveillance Branch (AFHSB) supports global health engagement by leveraging a network of Defense Department laboratory partners that are positioned in critical locations globally and work with partner nations to combat infectious disease threats. Defense Department laboratories around the world execute coordinated, integrated surveillance efforts to detect and respond to febrile and vector-borne infections, respiratory infections, antimicrobial-resistant and sexually transmitted infections, and enteric infections regardless of the source. These efforts are conducted in more than 70 countries and serve to protect the health of a highly mobile force by informing risk assessments and countermeasure development, providing support to outbreak response efforts when they arise, and supporting operational access and freedom of movement in high-threat areas.

In support of the Defense Health Agency’s combat support efforts, the GEIS network’s ultimate goal is early, accurate detection of emerging infectious disease and rapid communication regarding those that potentially threaten the health of U.S. forces so that preventive measures can be taken to enable operational readiness and mitigate the risk of mission failure. Surveillance efforts are conducted in partnership with partner nation ministries of health and defense, thereby improving their health capacity by enabling rapid identification and response to infectious disease threats to their population and strengthening relationships with key U.S. partners. In this way, the GEIS program supports the U.S. geographic combatant commands (GCCs) in their areas of responsibility, advancing their campaign plans, lines of efforts, and end states. Additionally, by providing direct technical support to GCC-led international scientific coalitions and strategic engagement efforts, GEIS enhances Defense Department global health engagements and advances information sharing with partner nations. These activities ultimately better inform force health protection decision making at the GCCs and enable global health security for partner nations and U.S. government assets abroad.

Throughout December, in celebration of the Global Health Engagement Month, AFHSB will showcase some of the surveillance efforts conducted by GEIS’s laboratory partners around the world. These stories are available on DHA’s Global Health Engagement Spotlight page.

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Malaria

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3/1/2019
Malaria

Since 1999, the Medical Surveillance Monthly Report has published regular updates on the incidence of malaria among U.S. service members. The MSMR’s focus on malaria reflects both historical lessons learned about this mosquito-borne disease and the continuing threat that it poses to military operations and service members’ health.

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Cardiovascular disease-related medical evacuations

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1/29/2019
Cardiovascular disease-related medical evacuations

This descriptive analysis summarizes the demographic characteristics, counts, rates and temporal trends for Cardiovascular disease-related medical evacuations from the CENTCOM area of responsibility. In addition, the percentage of those evacuated who had received pre-deployment diagnoses indicating cardiovascular risk is summarized. Responses to questions regarding health status and physician referrals on the DD2795 are also summarized.

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Malaria

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11/20/2018
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This report describes a cluster of 11 soldiers with vivax malaria among U.S. military personnel who trained at Dagmar North training area, near the demilitarized zone (DMZ), in the Republic of Korea (ROK) in 2015.

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DoD Flu VE

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10/26/2018
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Each season, several entities within the(DoD) perform surveillance for influenza among beneficiaries and utilize these data to perform VE analyses to estimate how well the seasonal vaccine protects against medically-attended influenza.

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Pelvic Inflammatory Disease

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10/26/2018
Pelvic Inflammatory Disease

The purpose of this study was to update previous MSMR analyses of the incidence of acute Pelvic inflammatory disease (PID) among U.S. active component women using a 21-year surveillance period from 1996 through 2016. A secondary objective was to report on the proportion of service women with previously diagnosed PID who were subsequently diagnosed with infertility or ectopic pregnancy.

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Psychiatric Medical Evaluations

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10/26/2018
Psychiatric Medical Evaluations

This study evaluated incidence of pre-deployment family problem diagnoses and psychiatric medical evacuations among a population of active component service members without a history of previous mental health diagnoses, who deployed to the U.S. Central Command Area of Responsibility for the first time between 1 January 2002 and 31 December 2014.

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CVD

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10/3/2018
CVD

As of part of WOMEN’S HEALTH MONTH, we focus on the findings related to female service members. If the risk factors are recognized, these service members can take steps to modify their lifestyles or obtain appropriate medical intervention, and reduce the likelihood of significant CVD while serving in the Armed Forces, and also after leaving service.

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Gynecologic Disorders

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10/3/2018
Gynecologic disorders are conditions that affect the female reproductive organs, including the uterus, ovaries, fallopian tubes, vagina, and vulva. As part of Women’s Health Month, this report describes the incidence and burden of four commonly occur-ring gynecologic disorders (menorrhagia, polycystic ovary syndrome (PCOS), uterine fibroids, and endometriosis) among active component service women from 2012 through 2016. This report also documents the number and percentage of women with co-occurring incident diagnoses during the surveillance period.

Gynecologic disorders are conditions that affect the female reproductive organs, including the uterus, ovaries, fallopian tubes, vagina, and vulva. As part of Women’s Health Month, this report describes the incidence and burden of four commonly occur-ring gynecologic disorders (menorrhagia, polycystic ovary syndrome (PCOS), uterine fibroids, and endometriosis) among active component service women from 2012 through 2016. This report also documents the number and percentage of women with co-occurring incident diagnoses during the surveillance period.

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HPV

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9/24/2018
HPV

Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the U.S., and is the second most frequently diagnosed STI in U.S. military service members. Currently, HPV is not a mandatory vaccine for U.S. military service. However, it is encouraged and offered to service members.

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Drowning

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9/24/2018
Drowning

Service members are at risk for unintentional drownings during training, occupational activities, and off-duty recreation. In the U.S., unintentional drowning ranks as the fifth leading cause of unintentional injury death and accounted for an average of 3,558 deaths (non-boating related) annually between 2007 and 2016. The current analysis extends and updates the findings of the June 2015 MSMR article by summarizing counts, rates, and correlates of risk of medical encounters related to accidental drownings among U.S. military members during 2013–2017.

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Staphylococcus

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8/27/2018
Staphylococcus

Staphylococcus: Staphylococcus aureus is a major cause of skin and soft tissue infection (SSTI). Military personnel in congregate settings (e.g., training, deployment) are at increased risk for S. aureus colonization and SSTI. For a 7-month period in 2016, an observational cohort study of S. aureus colonization and SSTI among U.S. Navy submariners was conducted.

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Norovirus

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8/27/2018
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Beginning in 2011, the Operational Infectious Diseases (OID) laboratory at the Naval Health Research Center has undertaken routine surveillance of four U.S. military training facilities to systematically track the prevalence of acute gastroenteritis and to establish its etiologies among U.S. military recruits.

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Diagnoses of Eating Disorders, Active Component Service Members, U.S. Armed Forces, 2013–2017 Eating Disorders

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7/3/2018
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Absolute and Relative Morbidity Burdens, Attributable to Various Illnesses and Injuries, 2017

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Mental Health Problems

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4/4/2018
This report summarizes the numbers, natures, and rates of incident mental health disorder diagnoses as well as mental health problems among active component U.S. service members during 2007–2016.

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