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Surveillance Snapshot: Illness and Injury Burdens, Recruit Trainees, Active Component, U.S. Armed Forces, 2018

U.S. Navy sailors graduate from boot camp at Recruit Training Command (RTC) in 2018. (Photo courtesy of U.S. Navy) Navy Sailors graduate from boot camp at Recruit Training Command in 2018. (U.S. Navy photo)

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Hospitalizations, Active Component, U.S. Armed Forces, 2018

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5/1/2019
Hospitalizations

Hospitalizations, Active Component, U.S. Armed Forces, 2018 This report documents the frequencies, rates, trends, and distributions of hospitalizations of active component members of the U.S. Army, Navy, Air Force, and Marine Corps during calendar year 2018.

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Absolute and Relative Morbidity Burdens Attributable to Various Illnesses and Injuries, Non-Service Member Beneficiaries of the Military Health System, 2018

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5/1/2019
Morbidity Burdens

The current report represents an update and provides a summary of care provided to non-service members in the MHS during calendar year 2018. Healthcare burden estimates are stratified by direct versus outsourced care and across 4 age groups of healthcare recipients.

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Ambulatory Visits, Active Component, U.S. Armed Forces, 2018

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5/1/2019
Ambulatory Visits

Ambulatory Visits, Active Component, U.S. Armed Forces, 2018 This report 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 2018.

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Ambulatory visits, active component, U.S. Armed Forces, 2018

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5/1/2019
A U.S. naval officer listens through his stethoscope to hear his patient’s lungs at Camp Schwab in Okinawa, Japan in 2018. (Photo courtesy of U.S. Marine Corps) photo by Lance Cpl. Cameron Parks)

Musculoskeletal disorders and mental health disorders accounted for more than half (52.6%) of all illness- and injury-related ambulatory encounters among active component service members in 2018. Since 2014, the number of ambulatory visits for mental health disorders has decreased, while the numbers of ambulatory visits for musculoskeletal system/connective tissue disorders, nervous system and sense organ disorders, and respiratory system disorders have increased.

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Medical Surveillance Monthly Report

Hospitalizations, active component, U.S. Armed Forces, 2018

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5/1/2019
U.S. Navy sailors graduate from boot camp at Recruit Training Command (RTC) in 2018. (Photo courtesy of U.S. Navy)

As in prior years, mental health disorders, pregnancy-related conditions, and injury/poisoning accounted for the majority (59.8%) of all hospitalizations among active component service members in 2018. However, the hospitalization rate for all causes was the lowest rate in the past 10 years.

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Surveillance Snapshot: Illness and Injury Burdens, Reserve Component, U.S. Armed Forces, 2018

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5/1/2019
U.S. Navy sailors graduate from boot camp at Recruit Training Command (RTC) in 2018. (Photo courtesy of U.S. Navy)

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Medical evacuations out of the U.S. Central Command, active and reserve components, U.S. Armed Forces, 2018

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5/1/2019
Airmen from the 19th Medical Group litter-carry a simulated patient onto a C-130J during an aeromedical evacuation training mission at Little Rock Air Force Base in 2019. (Photo Courtesy of U.S. Air Force)

The number of medical evacuations for battle injuries has decreased considerably since 2014. Most medical evacuations in 2018 were attributed to mental health disorders, followed by non-battle injury/poisoning; signs, symptoms, and ill-defined conditions; musculoskeletal disorders; and digestive system disorders.

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Absolute and relative morbidity burdens attributable to various illnesses and injuries, non-service member beneficiaries of the Military Health System, 2018

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5/1/2019
A senior airman of 366th Medical Support Squadron pediatric clinic checks vitals of the child of its service member at Mountain Home Air Force Base in Idaho. (Photo courtesy of U.S. Air Force)

In 2018, mental health disorders accounted for the largest proportions of the morbidity and healthcare burdens that affected the pediatric and younger adult beneficiary age groups. Among adults aged 45–64 years, musculoskeletal diseases accounted for the most morbidity and healthcare burdens, and among adults aged 65 years or older, cardiovascular diseases accounted for the most.

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Medical Surveillance Monthly Report

Morbidity burdens attributable to various illnesses and injuries, deployed active and reserve component service members, U.S. Armed Forces, 2018

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5/1/2019
A U.S. naval officer listens through his stethoscope to hear his patient’s lungs at Camp Schwab in Okinawa, Japan in 2018. (Photo courtesy of U.S. Marine Corps) photo by Lance Cpl. Cameron Parks)

Among service members deployed during 2018, injury/poisoning, musculoskeletal diseases, and signs/symptoms accounted for more than half of the total healthcare burden while deployed. Compared to the distribution of major burden of disease categories documented in garrison, a relatively greater proportion of in-theater medical encounters due to respiratory infections, skin diseases, infectious/parasitic diseases, and digestive diseases was documented.

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Medical Surveillance Monthly Report

Absolute and relative morbidity burdens attributable to various illnesses and injuries, active component, U.S. Armed Forces, 2018

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5/1/2019
A U.S. naval officer listens through his stethoscope to hear his patient’s lungs at Camp Schwab in Okinawa, Japan in 2018. (Photo courtesy of U.S. Marine Corps) photo by Lance Cpl. Cameron Parks)

In 2018, mental health disorders accounted for the largest proportions of the morbidity and healthcare burdens that affected the pediatric and younger adult beneficiary age groups. Among adults aged 45–64 years, musculoskeletal diseases accounted for the most morbidity and healthcare burdens, and among adults aged 65 years or older, cardiovascular diseases accounted for the most.

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Heat Illness

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4/1/2019
Heat Illness

This report summarizes reportable medical events of heat illness as well as heat illness-related hospitalizations and ambulatory visits among active component service members during 2018 and compares them to the previous 4 years. Episodes of heat stroke and heat exhaustion are summarized separately.

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Exertional Rhabdomyolysis

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4/1/2019
Exertional Rhabdomyolysis

Each year, the MSMR summarizes the numbers, rates, trends, risk factors, and locations of occurrences of exertional heat injuries, including exertional rhabdomyolysis. This report includes the data for 2014–2018.

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Exertional Hyponatremia

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4/1/2019
Exertional Hyponatremia

Each year, the MSMR summarizes the numbers, rates, trends, risk factors, and locations of occurrences of exertional heat injuries, including exertional rhabdomyolysis. This report includes the data for 2014–2018.

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Lyme Disease

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4/1/2019
Lyme Disease

Each year, the MSMR summarizes the numbers, rates, trends, risk factors, and locations of occurrences of exertional heat injuries, including exertional rhabdomyolysis. This report includes the data for 2014–2018.

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Update: Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2014–2018

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4/1/2019
U.S. Marines sprint uphill during a field training exercise at Marine Corps Air Station Miramar, California. to maintain contact with an aviation combat element, teaching and sustaining their proficiency in setting up and maintaining communication equipment.  (Photo Courtesy: U.S. Marine Corps)

Among active component service members in 2018, there were 545 incident diagnoses of rhabdomyolysis likely due to exertional rhabdomyolysis, for an unadjusted incidence rate of 42.0 cases per 100,000 person-years. Subgroup-specific rates in 2018 were highest among males, those less than 20 years old, Asian/Pacific Islander service members, Marine Corps and Army members, and those in combat-specific or “other/unknown” occupations. During 2014–2018, crude rates of exertional rhabdomyolysis increased steadily from 2014 through 2016 after which rates declined slightly in 2017 before increasing again in 2018. Compared to service members in other race/ethnicity groups, the overall rate of exertional rhabdomyolysis was highest among non-Hispanic blacks in every year except 2018. Overall and annual rates were highest among Marine Corps members, intermediate among those in the Army, and lowest among those in the Air Force and Navy. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or the Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain or swelling, limited range of motion, or the excretion of dark urine (possibly due to myoglobinuria) after strenuous physical activity, particularly in hot, humid weather.

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