Back to Top Skip to main content

Military infectious disease surveillance guards service members against illness

GEIS laboratory partners conduct surveillance of vector-borne diseases that are transmitted to humans, animals, and plants through arthropods such as mosquitoes. A U.S. Air Force Senior Airman sets up a dry ice trap to catch mosquitoes to test for viruses. GEIS laboratory partners conduct surveillance of vector-borne diseases that are transmitted to humans, animals, and plants through arthropods such as mosquitoes. A U.S. Air Force Senior Airman sets up a dry ice trap to catch mosquitoes to test for viruses. (U.S. Air Force file photo)

Recommended Content:

Armed Forces Health Surveillance Branch | Global Emerging Infections Surveillance | Febrile and Vector-Borne Infections (FVBI) Surveillance

YONGSAN, SEOUL, South Korea – When it comes to the potential disease risk that mosquitoes, ticks, mites, biting midges and rodents pose to U.S. service members, entomologist Terry Klein stands on the front lines.

Klein, of the 65th Medical Brigade, collects these blood-feeding species at various spots along the edge of the demilitarized zone (DMZ) between North and South Korea. The specimens are later tested to determine the risk for vector-borne diseases, such as malaria, Zika virus, dengue fever, Japanese encephalitis, Lyme disease, hantaviruses, and rickettsiae that deployed service members might face in this particular region.

Susceptibility to infectious disease has long been a concern of the military, threatening the health and readiness of service members. Klein’s surveillance work is part of broader effort by the Defense Department to inform and utilize preventive measures available to protect service members and their beneficiaries against often life-threatening diseases.

As part of its work under the Defense Health Agency, the Armed Forces Health Surveillance Branch funds and coordinates a robust global surveillance program of militarily relevant disease surveillance like Klein’s through its Global Emerging Infections Surveillance (GEIS) section. In 2016, GEIS provided $56.9 million in funding to 21 Defense Department service laboratories that operate in the U.S. and overseas to implement infectious disease surveillance in support of force health protection. GEIS’s Febrile and Vector-Borne Infections Focus Area supported 67 projects totaling $17.4 million.

“You can’t predict with certainty when service members are going to get a virus without surveillance,” said Klein, a former Army colonel who has been conducting vector-borne disease surveillance in South Korea for 17 years. “It’s important to get the information about potential diseases to the medical community so that they are familiar with the signs and symptoms and can help our service members take precautions and stay healthy.”

For example, malaria has been a threat to service members in the region for a long time. In 2016, malaria was diagnosed at or reported from 25 different medical facilities in the U.S., Afghanistan, Germany and Korea, based on an analysis in Medical Surveillance Monthly Report. More recent military engagements in Africa, Asia, Southwest Asia, the Caribbean, and the Middle East have necessitated heightened vigilance, preventive measures, and treatment of cases.The number of cases in Korea has increased since 2012, including a cluster of 11 Plasmodium vivax cases in 2015.

Over the past several months, Klein has been setting up mosquito traps laced with lactic acid that attract mosquitoes at a variety of locations near or in the DMZ in Korea. He has just set mosquito traps at Camp Bonifas where 100 U.S. soldiers, along with the Republic of Korea Army, monitor the DMZ. Traps also were set at the Warrior Base, a U.S. training site and at Dagmar North, another training site and the location where the 2015 cluster of 11 Plasmodium vivax malaria cases among U.S. service members occurred. Klein captured more mosquitoes there during his recent surveillance effort than at other trapping locations.

Klein also collects ticks near the DMZ where three cases of severe fever with thrombocytopenia syndrome were diagnosed among soldiers at two Republic of Korea Army bases in May.

Klein sends all mosquito specimens to the Walter Reed Army Institute of Research in Silver Spring, Maryland, where they are tested for novel viruses and bacteria. Dr. Jun Hang of WRAIR identified rickettsiae, a group of bacteria that can cause typhus and various other febrile diseases in humans, in the mosquitoes. The rickettsiae were later identified by the Naval Medical Research Center as three new species. While the human health impact of these three new species is yet unknown, the finding demonstrates the importance of surveillance for novel viruses and bacteria.

In addition to mosquitoes and ticks, Klein also collects rodents for surveillance of hantaviruses, in collaboration with Korea University. Hantaviruses are transmitted to humans by direct or indirect contact with the saliva and excrement of rodents and can cause high fever and kidney failure. He has collected more than 12,000 small mammals, of which at least 60 percent were striped field mice, a primary reservoir for Hantaan virus, the most serious form of hemorrhagic fever with renal syndrome in Korea.

At training sites near the DMZ, rates of striped field mice infection with hantavirus average about 15 percent to 20 percent, which is considered to be high risk. Korea University is working with the Korea Agency for Advanced Development and the U.S. Army Medical Research Institute of Infectious Diseases to map out the geographical variability of Hantaan virus, which will allow the U.S. military to better track the source of infections among service members when the virus is detected in their blood.

Since arriving in Korea, Klein has seen firsthand the impact surveillance can have on military operations. “Surveillance allows the infantry and medical to take more precautions to make sure that our forces are healthy and able to conduct their missions,” he said.

You also may be interested in...

GEIS funds medical surveillance at military laboratories to assist Combatant Commands

Article
12/14/2017
Nazia Rahman, right, manager of the Uniformed Services University’s Neisseria gonorrhoeae (GC) Repository, discusses a poster on the sexually-transmitted infection with U.S. Air Force Major Trinette Flowers-Torres, lead for GEIS’s Antimicrobial Resistance (AMR) Focus Area, left, and Navy Commander Franca Jones, front, chief of GEIS, examine poster on AMR surveillance. (AFHSB photo by Briana Booker).

At the crux of infectious disease surveillance is the Armed Forces Health Surveillance Branch’s (AFHSB) Global Emerging Infections Surveillance (GEIS) Section that funds the majority of surveillance at military laboratories. Learn about AFHSB's role as a Combat Support Agency within the Defense Health Agency (DHA).

Recommended Content:

Armed Forces Health Surveillance Branch | Global Emerging Infections Surveillance

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

Article
11/30/2017
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)

Navy Commander Franca R. Jones, chief of the Global Emerging Infections section at the Armed Forces Health Surveillance Branch (AFHSB) discusses how AFHSB's health surveillance program supports the Defense Department global health engagement efforts.

Recommended Content:

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

2017 to 2019 GEIS Strategy

Report
11/22/2017

This Strategy describes how GEIS will support infectious disease surveillance and outbreak response to enhance FHP decision making in the future operating environment. GEIS will achieve this end state through direct support to the six Geographic Combatant Commands (GCC) and the global DoD laboratory network that operates in all of their areas of ...

Recommended Content:

Global Emerging Infections Surveillance

Global Influenza Summary: November 19, 2017

Report
11/19/2017

Recommended Content:

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

Five cold seasons: July 2012 – June 2017, Cold injuries during deployments

Infographic
11/3/2017
During the 5-year surveillance period, 105 cold injuries were diagnosed and treated in service members deployed outside of the U.S. Of these 105 cold injuries, 68% occurred in the first two cold seasons. Total no. of cold injuries, by season: •	35 cold injuries during cold season 2012 – 2013 •	36 during 2013 – 2014 •	13 during 2014 – 2015 •	11 during 2015 – 2016 •	10 during 2016 – 2017 The decrease in the number of cases is most likely a byproduct of: •	The dramatic decline in the number of service members deployed to Iraq and Afghanistan •	Changes in the nature of military operations there Access the full report in MSMR Vol. 24 No. 10 October 2017 at Health.mil/MSMR Pie Chart showing cold injuries during deployments: •	39 Immersion •	33 Frostbite •	17 unspecified  •	16 Hypothermia Background image shows service member walking in the snow.

This infographic documents cold injuries during deployments outside of the United States for the July 2012 – June 2017 cold seasons (five-year surveillance period).

Recommended Content:

Armed Forces Health Surveillance Branch | Winter Safety

Measles, Mumps, Rubella, and Varicella: Among service members and other beneficiaries of the Military Health System, 2010 – 2016

Infographic
11/3/2017
Measles, mumps, rubella, and varicella (MMR/V) are highly communicable infectious diseases whose causative agents are spread through contact with contaminated surfaces or airborne droplets. MMR/V were common in the U.S. before the introduction of licensed vaccines: measles (1963), mumps (1967), rubella (1969), and varicella (1995). Since then, these vaccines have been important components of routine pediatric preventive care. This report highlights the recent trends in MMR/V in both military and civilian populations as well as the importance of primary and booster vaccinations.  During 2010 – 2016, there were: •	11 confirmed measles cases – one was in a service member. •	76 confirmed mumps cases – 28 were in service members. •	7 confirmed rubella cases – two were in service members. •	62 confirmed varicella cases among service members. The reporting of cases of varicella in non-military personnel was not mandated until 2017. Individuals at highest risk for MMR/V •	Infants •	Unvaccinated persons •	Inadequately vaccinated persons •	Individuals living in communities with low vaccination rates •	Persons living in crowded and unsanitary conditions •	Those with compromised immune systems Access the full report in MSMR Vol. 24 No. 10 October 2017 for more information at Health.mil/MSMR A picture of service members in communal area displays as well as an image of team work activities.

This infographic highlights the recent trends in Measles, Mumps, Rubella, and Varicella (MMR/V) in both military and civilian populations as well as the importance of primary and booster vaccinations.

Recommended Content:

Armed Forces Health Surveillance Branch | Measles-Mumps-Rubella

Surveillance Snapshot: Influenza Immunization among U.S. Armed Forces Healthcare Workers, August 2012 – April 2017

Infographic
10/31/2017
Did you know …?  During the 2016 – 2017 influenza season, each of the three services attained greater than 94% compliance among healthcare personnel. The U.S. Advisory Committee on Immunization Practices recommends that all healthcare personnel be vaccinated against influenza to protect themselves and their patients. The Joint Commission requires that healthcare organizations have influenza vaccination programs for practitioners and staff, and that they work toward the goal of 90 percent receipt of influenza vaccine. This snapshot of a five-year surveillance period (August 2012 – April 2017) shows  that the active component healthcare personnel of the Army, Navy, and Air Force has exceeded the percentage compliance with influenza immunization requirement in each year. •	Line graph showing the percentage of healthcare specialists and officers with records of influenza vacation by influenza year (1 August through 30 April) and service, active, U.S. Armed Forces, August 2012 – April 2017 displays. Access the full snapshot in MSMR Vol. 24 No. 10 October 2017 at Health.mil/MSMR There are two photos featured on the infographic: 1.	A service member being vaccinated with the flu vaccine displays  2.	A photo of vaccine administrators shows.

This snapshot of a five-year surveillance period (August 2012 – April 2017) details influenza immunization compliance among the active component healthcare personnel of the Army, Navy, and Air Force.

Recommended Content:

Armed Forces Health Surveillance Branch | Immunization Healthcare | Influenza Seasonal

Global Influenza Summary: October 29, 2017

Report
10/29/2017

Recommended Content:

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

Global Influenza Summary: October 22, 2017

Report
10/22/2017

Recommended Content:

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

Global Influenza Summary: October 15, 2017

Report
10/15/2017

Recommended Content:

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

Global Influenza Summary: October 8, 2017

Report
10/8/2017

Recommended Content:

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

Review of the U.S. Military’s Human Immunodeficiency Virus program: A legacy of the progress and a future of promise

Infographic
10/3/2017
HIV infection is a threat of the Department of Defense (DoD) because sexually active service members and their beneficiaries are stationed throughout the U.S. and around the globe, including in areas with high rates of HIV transmission. Fortunately, blood testing and a negative test result for HIV infection are required for entry into military service. All U.S. military service members must undergo testing for HIV infection every 2 years. As a result, the incidence and prevalence of HIV in the DoD remains much lower than in the U.S. civilian population.

This infographic documents the incidence and prevalence of the human immunodeficiency virus (HIV) among service members, active and reserve components, of the U.S. Armed Forces, 1990 – 2017.

Recommended Content:

HIV/AIDS Prevention and Treatment | Armed Forces Health Surveillance Branch

Global Influenza Summary: October 1, 2017

Report
10/1/2017

Recommended Content:

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

Multiple Sclerosis among service members of the active and reserve components of the U.S. Armed Forces and among other beneficiaries of the Military Health System, 2007 – 2016

Infographic
9/14/2017
Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of the central nervous system, affecting approximately 400,000 people in the U.S. and more than two million people worldwide. The inflammatory demyelination and axonal injury that characterize MS result in significant clinical disability and economic burden. This study makes a useful contribution to the literature on temporal changes in the incidence of MS by sex and race/ ethnicity. A map of the U.S. displays to show a visual about the 400,000 people affected by MS in the country. An image of Earth displays to show a visual about the more than 2 million people worldwide affected by MS. FINDINGS •	Between 2007 and 2016, a total of 2,031 active component service members received incident diagnoses of MS •	The overall unadjusted incidence rate was 14.9 cases per 100,000 p-yrs •	During the surveillance period, unadjusted annual incidence rates of MS decreased by 25.4% •	The highest overall incidence rates were observed among service members diagnosed after age 30 with rates peaking among those aged 40 years or older. First line graph shows:  annual incidence rates of MS were higher among female service members than male service members and decreased by 42.2% during the 10-year period.  Second line graph shows:  The higher overall incidence of MS among non-Hispanic blacks was found among females, and to a lesser degree among males. Median age at MS case-defining diagnosis •	Age 32 years among active component members •	Age 37 years among reserve / guard members •	Age 48 years among non-service member beneficiaries  Common MS Symptoms •	Numbness •	Tingling in limbs •	Visual Loss •	Double Vision •	Mother Weakness •	Gait Disturbance Images showings these symptoms display. Access the full report in MSMR Vol. 24 No. 3 August 2017 at Health.mil/MSMR

Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of the central nervous system, affecting approximately 400,000 people in the U.S. and more than two million people worldwide. This infographic documents data on the temporal changes in the incidence of MS by sex and race/ ethnicity.

Recommended Content:

Armed Forces Health Surveillance Branch

Challenges with diagnosing and investigating suspected active Tuberculosis disease in military trainees

Infographic
9/14/2017
The incidence rates of active tuberculosis (TB) disease in the general U.S. population and the U.S. military have declined over the past two decades, with foreign birth remaining one of the strongest correlates of risk. Recently, there have been several atypical and asymptomatic presentations of active and suspected TB cases among the population of trainees at Joint base San Antonio – Lackland, TX. Between 1 January 2010 and 31 December 2016, a total of 14 U.S. and international military personnel in training at JBSA – Lackland were hospitalized for suspected pulmonary TB. The variety of atypical presentations and their resulting diagnostic and public health challenges promoted this retrospective review of all hospitalized cases. This case series raises concerns about the increasing reliance on molecular tests for rapid diagnosis of active TB, especially in patients with minimal to no pulmonary symptoms. Findings •	The incidence rate in the training population was 1.89 per 100,000 population •	5 of 14 U.S. and international military personnel were diagnosed with active TB disease •	All were male, aged 19 – 29 years •	Only one TB case had pulmonary symptoms, but these were not suggestive of TB •	8 of 14 trainees were asymptomatic at the time of hospital admission, and tuberculin skin test and interferon gamma release assay results were highly variable Chart displays with descriptions and diagnoses of trainees hospitalized for suspected active tuberculosis, Joint Base San Antonio  – Lackland, TX, 2010 – 2016 (N=14). Access the report in MSMR Vol. 24 No. 8 August 2017 at Health.mil/MSMR  Images featured on infographic: •	Human lungs •	Image of TB

The incidence rates of active tuberculosis (TB) disease in the general U.S. population and the U.S. military have declined over the past two decades, with foreign birth remaining one of the strongest correlates of risk. This infographic documents findings from several atypical and asymptomatic presentations of active and suspected TB cases among the ...

Recommended Content:

Armed Forces Health Surveillance Branch | Tuberculosis
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 14

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.