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2016 marks first year of zero combat amputations since the start of the Afghan, Iraq wars

An analysis by the Medical Surveillance Monthly Report recently reported 2016 marks the first year without combat amputations since the wars in Afghanistan and Iraq began. U.S. Armed Forces are at risk for traumatic amputations of limbs during combat deployments and other work hazards. (DoD photo) An analysis by the Medical Surveillance Monthly Report recently reported 2016 marks the first year without combat amputations since the wars in Afghanistan and Iraq began. U.S. Armed Forces are at risk for traumatic amputations of limbs during combat deployments and other work hazards. (DoD photo)

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Medical Surveillance Monthly Report | Epidemiology and Analysis

Amputations of upper and lower extremities profoundly alter the lives of both active duty and reserve components of U.S. Armed Forces. Our troops are at risk for traumatic amputations of limbs during combat deployments and other hazards such as motor vehicle accidents and falls. Moreover, the permanent disability results in restricted or lost duty time for military members.

Service members, such as 1st Lt. Melissa Stockwell, who lost her left leg from a roadside bomb, “felt very lucky” to have only lost a limb as one of about a dozen U.S. troops in Iraq who suffered an amputation. But the year 2016 had good news for troops - it is the first year the U.S. military had no combat amputations of deployed troops since the Afghan, Iraq wars began. This was assessed recently in the Medical Surveillance Monthly Report (MSMR), a publication from the Defense Health Agency’s Armed Forces Health Surveillance (AFHSB), tracking amputations involving deployed troops by month since 2003.

To accurately track amputations, AFHSB breaks out by service in order to help military officials identify incidence, distribution, impact and trends. Col. Douglas Badzik, AFHSB chief said such analyses help provide “a force that is healthy and ready to carry out its mission.” Additionally, improvements in protective equipment and innovations in medical procedures and battlefield trauma care continue to strengthen force health protection of U.S. service members. For more details on this assessment, See the December 2016 issue of the MSMR. You also may be interested in reading amputation surveillance reports listed in the MSMR Index


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Adrenal Gland Disorders, Active Component, U.S. Armed Forces, 2002–2017

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During 2002–2017, the most common incident adrenal gland disorder among male and female service members was adrenal insufficiency and the least common was adrenomedullary hyperfunction. Adrenal insufficiency was diagnosed among 267 females (crude overall incidence rate: 8.2 cases per 100,000 person-years [p-yrs]) and 729 males (3.9 per 100,000 p-yrs). In both sexes, overall rates of other disorders of adrenal gland and Cushing’s syndrome were lower than for adrenal insufficiency but higher than for hyperaldosteronism, adrenogenital disorders, and adrenomedullary hyperfunction. Crude overall rates of adrenal gland disorders among females tended to be higher than those of males, with female:male rate ratios ranging from 2.1 for adrenal insufficiency to 5.5 for androgenital disorders and Cushing’s syndrome. The highest overall rates of adrenal insufficiency for males and females were among non-Hispanic white service members. Among females, rates of Cushing’s syndrome and other disorders of adrenal gland were 31.6 per 100,000 active component service members in 2017. Validation of ICD-9/ICD-10 diagnostic codes for MetS using the National Cholesterol Education Program Adult Treatment Panel III criteria is needed to establish the level of agreement between the two methods for identifying this condition.

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Although Germany is rabies-free for terrestrial land mammals, rabies exposure remains a concern for U.S. military personnel assigned there because of personal and military travel and deployments to rabies endemic countries. Deployments have become much more variable both in location and duration. Deployments have increasingly focused on enhancing partnerships and peacekeeping.

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Cold Weather Injuries

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This update summarizes the frequencies, incidence rates, and correlates of risk of cold injuries among members of both active and reserve components of the U.S. Armed Forces during the past 5 years.

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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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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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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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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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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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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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Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the U.S.; HPV is the second most frequently diagnosed STI in U.S. military service members. Currently, HPV vaccine is not mandatory for U.S. military service members, but the Defense Health Agency and each individual service have policies encouraging and offering HPV vaccination to service members. As part of women's health month, we examine initiation, coverage and completion rates of HPV vaccine among female service members.

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