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Health Readiness

The Deputy Assistant Secretary of Defense (DASD) for Health Readiness Policy and Oversight is the principal staff assistant and advisor to the Assistant Secretary of Defense (Health Affairs) for all medically related Department of Defense policies, programs, and activities. The office is responsible for deployment medicine, force health protection, medical readiness, international health agreements, deployment related health policy, theater information systems, humanitarian and health missions, and national disaster support.

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Global Influenza Summary: March 11, 2018

Report
3/11/2018

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Health Readiness | Armed Forces Health Surveillance Branch | AFHSB Reports and Publications | Influenza Summary and Reports

Pediatric care in the military rated 'excellent' but can improve

Article
2/27/2018
Experts say pediatric care within the Military Health System is excellent as they strive to improve and provide top-quality care for military children. (U.S. Navy photo by Jacob Sippel)

Experts say pediatric care within the Military Health System is excellent as they strive to improve and provide top-quality care for military children

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Children's Health | Health Readiness | Preventive Health | Military Health System Review Report

Focus on prevention … not the cure for heart disease

Article
2/21/2018
Navy Lt. Cmdr. Cecily Dye is chief cardiologist at Naval Medical Center Camp Lejeune, North Carolina. (U.S. Navy photo by Petty Officer 2nd Class Nicholas N. Lopez)

Many heart health problems can be avoided

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Health Readiness | Heart Health | Preventive Health

‘Kissing disease’ exhausting, but it strikes only once

Article
2/15/2018
Mononucleosis is nicknamed the “kissing disease” because it’s spread through saliva. U.S. Navy Logistics Specialist 3rd Class Michael Zegarra shares the traditional first kiss with his wife Caterina Zegarra, after the aircraft carrier USS Nimitz pulled into port at Naval Base Kitsap, Washington, Dec. 10, 2017. (U.S. Navy photo by Seaman Greg Hall)

Mononucleosis: Learn how virus spreads, who’s most vulnerable

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Health Readiness | Preventive Health | Public Health

Surveillance for Vector-Borne Diseases, Active and Reserve Component Service Members, U.S. Armed Forces, 2010 – 2016

Infographic
2/14/2018
Within the U.S. Armed Forces considerable effort has been applied to the prevention and treatment of vector-borne diseases. A key component of that effort has been the surveillance of vector-borne diseases to inform the steps needed to identify where and when threats exist and to evaluate the impact of preventive measures. This report summarizes available health records information about the occurrence of vector-borne infectious diseases among members of the U.S. Armed Forces, during a recent 7-year surveillance period. For the 7-surveillance period, there were 1,436 confirmed cases of vector-borne diseases, 536 possible cases, and 8,667 suspected cases among service members of the active and reserve components. • “Confirmed” case = confirmed reportable medical event. • “Possible” case = hospitalization with a diagnosis for a vector-borne disease. • “Suspected” case = either a non-confirmed reportable medical event or an outpatient medical encounter with a diagnosis of a vector-borne disease. Lyme disease (n=721) and malaria (n=346) were the most common diagnoses among confirmed and possible cases. • In 2015, the annual numbers of confirmed case of Lyme disease were the fewest reported during the surveillance period. • Diagnoses of Chikungunya (CHIK) and Zika (ZIKV) were elevated in the years following their respective entries into the Western Hemisphere: CHIK (2014 and 2015); ZIKV (2016). The available data reinforce the need for continued emphasis on the multidisciplinary preventive measures necessary to counter the ever-present threat of vector-borne disease. Access the full report in the February 2018 MSMR (Vol. 25, No. 2). Go to www.Health.mil/MSMR Background graphic shows service member in the field and insects which spread vector borne diseases.

This infographic summarizes available health records information about the occurrence of vector-borne infectious diseases among members of the U.S. Armed Forces, during a recent 7-year surveillance period (2010 – 2016).

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Health Readiness | Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report | Preventing Mosquito-Borne Illnesses | Chikungunya | Malaria | Zika Virus

Malaria U.S. Armed Forces, 2017

Infographic
2/14/2018
Since 1999, the Medical Surveillance Monthly Report (MSMR) has published periodic updates on the incidence of malaria among U.S. service members. Malaria infection remains an important health threat to U.S. service members, who are located in endemic areas because of long-term duty assignments, participation in shorter-term contingency operations, or personal travel. This update for 2017 describes the epidemiologic patterns of malaria incidence in active and reserve component service members of the U.S. Armed Forces. Findings • A total of 32 service members were diagnosed with or reported to have malaria, which is the lowest number of cases in any given year during the 10-year surveillance period. • Health records documented the performance of laboratory tests for malaria for 22 of the cases. The tests for 17 of the 22 were positive for malaria ( stick figure graphic visually depicts this information). • In 2017, 75.0% (24 of 32) of malaria cases among U.S. service members were diagnosed during May – October (calendar graphic showing the months visually). • Of the 32 malaria cases in 2017, more than 1/3 of the infections were considered to have been acquired in Africa. Two bar charts display the following information: • Bar chart 1: Numbers of malaria cases by Plasmodium species and calendar year of diagnosis/report, active and reserve components, U.S. Armed Forces, 2008 – 2017 • Bar chart 2: Annual numbers of cases of malaria associated with specific locations of acquisition, active and reserve components, U.S. Armed Forces, 2008 – 2017 The majority of U.S. military members diagnosed with malaria in 2017 were: • Male (96.9%) • Active component (81.3%) • In the Army (75.0%) • In their 20’s (56.3%) Access the full report in the February 2018 MSMR (Vol. 25 No. 2). Go to www.Health.mil/MSMR Picture of a mosquito displays on the graphic.

This update for 2017 describes the epidemiologic patterns of malaria incidence in active and reserve component service members of the U.S. Armed Forces.

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Health Readiness | Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report

Lose to win: Some service members struggle with weight

Article
2/7/2018
Navy Petty Officer 3rd Class Jovanei Taito, shown here receiving his information warfare qualification certificate, credits the ShipShape program for enabling him to pass the Navy's body composition and physical fitness assessments. (Courtesy photo)

With numbers rising, programs help keep you shipshape

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Health Readiness | Heart Health

Department of Defense Global, Laboratory-based Influenza Surveillance Program’s Influenza vaccine effectiveness estimates and surveillance trends, 2016 – 2017 Influenza Season

Infographic
2/5/2018
Each year, the Department of Defense (DoD) Global, Laboratory-based Influenza Surveillance Program performs surveillance for influenza among service members of the DoD and their dependent family members. In addition to routine surveillance, vaccine effectiveness (VE) studies are performed and results are shared with the Food and Drug Administration, Centers for Disease Control and Prevention, and the World Health Organization for vaccine evaluation. This report documents the annual surveillance trends for the 2016 – 2017 influenza season and the end-of-season VE results. The analysis was performed by the U.S. Air Force School of Aerospace Medicine Epidemiology Laboratory, and the DoD Influenza Surveillance Program staff at Wright-Patterson Air Force Base, OH. FINDINGS: A total of 5,555 specimens were tested from 84 locations: • 2,486 (44.7%) negative • 1,382 (24.9%) influenza A • 1,093 (19.7%) other respiratory pathogens • 443 (8.0%) influenza B • 151 (2.7%) co-infections The predominant influenza strain was A (H3N2), representing 73.8% of all circulating influenza. Pie chart displays this information. Graph showing the numbers and percentages of respiratory specimens positive for influenza viruses, and numbers of influenza viruses identified, by type, by surveillance week, Department of Defense healthcare beneficiaries, 2016 – 2017 influenza season displays. The vaccine effectiveness (VE) for this season was slightly lower than for the 2015 – 2016 season, which had a 63% (95% confidence interval: 53% - 71%) adjusted VE. The adjusted VE for the 2016 – 2017 season was 48% protective against all types of influenza. Access the full report in the January 2018 MSMR (Vol. 25, No. 1). Go to: www.Health.mil/MSMR

This infographic documents the annual surveillance trends for the 2016 – 2017 influenza season and the end-of-season vaccine effectiveness.

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Health Readiness | Armed Forces Health Surveillance Branch | Influenza Summary and Reports | Medical Surveillance Monthly Report | Influenza Seasonal | Immunizations | Vaccine-Preventable Diseases | Force Health Protection

Outbreak of Influenza and Rhinovirus co-circulation among unvaccinated recruits, U.S. Coast Guard Training Center Cape May, NJ, 24 July – 21 August 2016

Infographic
2/5/2018
On 29 July 2016, the U.S. Coast Guard Training Center Cape May (TCCM), NJ, identified an increase in febrile respiratory illness (FRI) among recruits who were unvaccinated against seasonal influenza as a result of the annual vaccine’s expiration. This report characterizes the outbreak and containment measures implemented at TCCM during the outbreak period. In 2016, respiratory infections affected more than 250,000 U.S. service members and comprised approximately 22% of medical encounters among military recruit populations – who are highly susceptible to respiratory infections. Seasonal influenza and rhinovirus are two of the leading respiratory pathogens. During the Surveillance Period: 115 recruits reported respiratory infection symptoms. Pie chart 1 shows the following data: • 41 (35.7%) suspected cases • 74 (64.3%) confirmed cases Among confirmed cases, lab specimens tested positive for: • Influenza A 34 (45.9%) • Rhinovirus 28 (37.8%) • Influenza A and rhinovirus co-infection 11 (14.9%) • Rhinovirus and adenovirus co-infection 1 (1.4%) Data above depicted in pie chart 2. • 24 July – 6 August, Influenza predominated • 7 August – 20 August, Rhinovirus predominated Although the outbreak significantly affected operations at TCCM, a timely and comprehensive response resulted in containment of the outbreak within 5 weeks. Key Factor for Outbreak Control • Rapid detection through FRI sentinel surveillance • Quick decision-making • Streamlined response by using a single chain of command • Rapid implementation of both nonpharmaceutical and pharmaceutical interventions Access the full report in the January 2018 MSMR (Vol. 25, No. 1). Go to: www.Health.mil/MSMR

This report characterizes the outbreak and containment measures implemented at the U.S. Coast Guard Training Center Cape May (TCCM), New Jersey, during a July 24 – August 21, 2016 outbreak period.

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Health Readiness | Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report | Integrated Biosurveillance | Influenza Summary and Reports

2018 #ColdReadiness Twitter chat recap: Preventing cold weather injuries for service members and their families

Fact Sheet
2/5/2018

To help protect U.S. armed forces, the Armed Forces Health Surveillance Branch (AFHSB) hosted a live #ColdReadiness Twitter chat on Wednesday, January 24th, 12-1:30 pm EST to discuss what service members and their families need to know about winter safety and preventing cold weather injuries as the temperatures drop. This fact sheet documents ...

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Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report | Winter Safety | Preventive Health | Health Readiness

Global Influenza Summary: February 4, 2018

Report
2/4/2018

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Health Readiness | Armed Forces Health Surveillance Branch | AFHSB Reports and Publications | Influenza Summary and Reports

Global Influenza Summary: January 28, 2018

Report
1/28/2018

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Health Readiness | Armed Forces Health Surveillance Branch | AFHSB Reports and Publications | Influenza Summary and Reports

Insomnia and motor vehicle accident-related injuries, Active Component, U.S. Armed Forces, 2007 – 2016

Infographic
1/25/2018
Insomnia is the most common sleep disorder in adults and its incidence in the U.S. Armed Forces is increasing. A potential consequence of inadequate sleep is increased risk of motor vehicle accidents (MVAs). MVAs are the leading cause of peacetime deaths and a major cause of non-fatal injuries in the U.S. military members. To examine the relationship between insomnia and motor vehicle accident-related injuries (MVAs) in the U.S. military, this retrospective cohort study compared 2007 – 2016 incidence rates of MVA-related injuries between service members with diagnosed insomnia and service members without a diagnosis of insomnia. After adjustment for multiple covariates, during 2007 – 2016, active component service members with insomnia had more than double the rate of MVA-related injuries, compared to service members without insomnia. Findings: • Line graph shows the annual rates of motor vehicle accident-related injuries, active component service members with and without diagnoses of insomnia, U.S. Armed Forces, 2007 – 2016 • Annual rates of MVA-related injuries were highest in the insomnia cohort in 2007 and 2008, and lowest in 2016 • There were 5,587 cases of MVA-related injuries in the two cohorts during the surveillance period. • Pie chart displays the following data: 1,738 (31.1%) in the unexposed cohort and 3,849 (68.9%) in the insomnia cohort The highest overall crude rates of MVA-related injuries were seen in service members who were: • Less than 25 years old • Junior enlisted rank/grade • Armor/transport occupation • • With a history of mental health diagnosis • With a history of alcohol-related disorders Access the full report in the December 2017 (Vol. 24, No. 12). Go to www.Health.mil/MSMR Image displays a motor vehicle accident.

To examine the relationship between insomnia and motor vehicle accident-related injuries (MVAs) in the U.S. military, this retrospective cohort study compared 2007 – 2016 incidence rates of MVA-related injuries between service members with diagnosed insomnia and service members without a diagnosis of insomnia.

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Armed Forces Health Surveillance Branch | Health Readiness | Medical Surveillance Monthly Report

Seizures among Active Component service members, U.S. Armed Forces, 2007 – 2016

Infographic
1/25/2018
This retrospective study estimated the rates of seizures diagnosed among deployed and non-deployed service members to identify factors associated with seizures and determine if seizure rates differed in deployment settings. It also attempted to evaluate the associations between seizures, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD) by assessing correlations between the incidence rates of seizures and prior diagnoses of TBI and PTSD. Seizures have been defined as paroxysmal neurologic episodes caused by abnormal neuronal activity in the brain. Approximately one in 10 individuals will experience a seizure in their lifetime. Line graph 1: Annual crude incidence rates of seizures among non-deployed service members, active component, U.S. Armed Forces data • A total of 16,257 seizure events of all types were identified among non-deployed service members during the 10-year surveillance period. • The overall incidence rate was 12.9 seizures per 10,000 person-years (p-yrs.) • There was a decrease in the rate of seizures diagnosed in the active component of the military during the 10-year period. Rates reached their lowest point in 2015 – 9.0 seizures per 10,000 p-yrs. • Annual rates were markedly higher among service members with recent PTSD and TBI diagnoses, and among those with prior seizure diagnoses. Line graph 2: Annual crude incidence rates of seizures by traumatic brain injury (TBI) and recent post-traumatic stress disorder (PTSD) diagnosis among non-deployed active component service members, U.S. Armed Forces • For service members who had received both TBI and PTSD diagnoses, seizure rates among the deployed and the non-deployed were two and three times the rates among those with only one of those diagnoses, respectively. • Rates of seizures tended to be higher among service members who were: in the Army or Marine Corps, Female, African American, Younger than age 30, Veterans of no more than one previous deployment, and in the occupations of combat arms, armor, or healthcare Line graph 3: Annual crude incidence rates of seizures diagnosed among service members deployed to Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn, U.S. Armed Forces, 2008 – 2016 • A total of 814 cases of seizures were identified during deployment to operations in Iraq and Afghanistan during the 9-year surveillance period (2008 – 2016). • For deployed service members, the overall incidence rate was 9.1 seizures per 10,000 p-yrs. • Having either a TBI or recent PTSD diagnosis alone was associated with a 3-to 4-fold increase in the rate of seizures. • Only 19 cases of seizures were diagnosed among deployed individuals with a recent PTSD diagnosis during the 9-year surveillance period. • Overall incidence rates among deployed service members were highest for those in the Army, females, those younger than age 25, junior enlisted, and in healthcare occupations. Access the full report in the December 2017 MSMR (Vol. 24, No. 12). Go to www.Health.mil/MSMR

This infographic documents a retrospective study which estimated the rates of seizures diagnosed among deployed and non-deployed service members to identify factors associated with seizures and determine if seizure rates differed in deployment settings. The study also evaluated the associations between seizures, traumatic brain injury (TBI), and post ...

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Health Readiness | Posttraumatic Stress Disorder | Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Global Influenza Summary: January 23, 2018

Report
1/23/2018

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Health Readiness | Armed Forces Health Surveillance Branch | AFHSB Reports and Publications | Influenza Summary and Reports
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