Back to Top Skip to main content Skip to sub-navigation

Update: Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2015–2019

Recommended Content:

Medical Surveillance Monthly Report

ABSTRACT

Among active component service members in 2019, there were 512 incident cases of exertional rhabdomyolysis, for an unadjusted incidence rate of 38.9 cases per 100,000 person-years (p-yrs). Subgroup-specific rates in 2019 were highest among males, those less than 20 years old, non-Hispanic black service members, Army or Marine Corps members, and those in “other/unknown” or combat-specific occupations. During 2015–2019, crude rates of exertional rhabdomyolysis fluctuated between a low of 35.2 per 100,000 p-yrs in 2015 and a high of 42.4 per 100,000 p-yrs in 2018, after which the rate decreased to 38.9 per 100,000 p-yrs in 2019. Compared to service members in other race/ethnicity groups, non-Hispanic blacks had the highest overall rate of exertional rhabdomyolysis 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 darkened urine after strenuous physical activity, especially in hot, humid weather.

WHAT ARE THE NEW FINDINGS?   

During the 5-year period, the annual numbers and rates of incident exertional rhabdomyolysis cases peaked in 2018 and then dropped in 2019. Exertional rhabdomyolysis continued to occur most frequently from late spring through early fall at installations that support basic combat/recruit training or major Army or Marine Corps combat units.

WHAT IS THE IMPACT ON READINESS AND FORCE HEALTH PROTECTION?

Prompt recognition and treatment of exertional rhabdomyolysis usually prevent severe complications. However, some service members who experience exertional rhabdomyolysis may be at risk for recurrences, which may limit their military effectiveness and potentially predispose them to serious injury. Moreover, untimely recurrences may compromise a unit’s mission. Commanders and supervisors should be vigilant for early signs of exertional heat injuries and, when such signs are detected, should intervene aggressively.

BACKGROUND

Rhabdomyolysis is characterized by the breakdown of skeletal muscle cells and the subsequent release of intracellular muscle contents into the circulation. The characteristic triad of rhabdomyolysis includes weakness, myalgias, and red to brown urine (due to myoglobinuria) accompanied by an elevated serum concentration of creatine kinase.1,2 In exertional rhabdomyolysis, damage to skeletal muscle is generally caused by high-intensity, protracted, or repetitive physical activity, usually after engaging in unaccustomed strenuous exercise (especially with eccentric and/or muscle-lengthening contractions).3 Even athletes who are used to intense training and who are being carefully monitored are at risk of this condition,4especially if new overexertion-inducing exercises are being introduced.5 Illness severity ranges from elevated serum muscle enzyme levels without clinical symptoms to life-threatening disease associated with extreme enzyme elevations, electrolyte imbalances, and acute kidney failure.1–3,6

Risk factors for exertional rhabdomyolysis include exertion in hot and humid conditions, younger age, male sex, a lower level of physical fitness, a prior heat illness, impaired sweating, and a lower level of education.1,3,7–10 Acute kidney injury, due to an excessive concentration of free myoglobin in the urine accompanied by volume depletion, renal tubular obstruction, and renal ischemia, represents a serious complication of rhabdomyolysis.6,11 Severely affected patients can also develop compartment syndrome, fever, dysrhythmias, metabolic acidosis, and altered mental status.10

In U.S. military members, rhabdomyolysis is a significant threat during physical exertion, particularly under heat stress.7,9,12 Moreover, although rhabdomyolysis can affect any service member, new recruits, who are not yet accustomed to the physical exertion required of basic training, may be at particular risk.9 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 2015–2019. Additional information about the definition, causes, and prevention of exertional rhabdomyolysis can be found in previous issues of the MSMR.12

METHODS

The surveillance period was 1 January 2015 through 31 December 2019. The surveillance population included all individuals who served in the active component of the Army, Navy, Air Force, or Marine Corps at any time during the surveillance period. All data used to determine incident exertional rhabdomyolysis diagnoses were derived from records routinely maintained in the Defense Medical Surveillance System (DMSS). These records document both ambulatory encounters and hospitalizations of active component members of the U.S. Armed Forces in fixed military and civilian (if reimbursed through the Military Health System [MHS]) treatment facilities worldwide. In-theater diagnoses of exertional rhabdomyolysis were identified from medical records of service members deployed to Southwest Asia/Middle East and whose healthcare encounters were documented in the Theater Medical Data Store.

For this analysis, a case of exertional rhabdomyolysis was defined as an individual with 1) a hospitalization or outpatient medical encounter with a diagnosis in any position of either “rhabdomyolysis” (International Classification of Diseases, 9th Revision [ICD-9]: 728.88; International Classification of Diseases, 10th Revision [ICD-10]: M62.82) or “myoglobinuria” (ICD-9: 791.3; ICD-10: R82.1) plus a diagnosis in any position of 1 of the following: “volume depletion (dehydration)” (ICD-9: 276.5*; ICD-10: E86.0, E86.1, E86.9), “effects of heat and light” (ICD-9: 992.0–992.9; ICD-10: T67.0*–T67.9*), “effects of thirst (deprivation of water)” (ICD-9: 994.3; ICD-10: T73.1*), “exhaustion due to exposure” (ICD-9: 994.4; ICD-10: T73.2*), or “exhaustion due to excessive exertion (overexertion)” (ICD-9: 994.5; ICD-10: T73.3*).13 Each individual could be considered an incident case of exertional rhabdomyolysis only once per calendar year.

To exclude cases of rhabdomyolysis that were secondary to traumatic injuries, intoxications, or adverse drug reactions, medical encounters with diagnoses in any position of “injury, poisoning, toxic effects” (ICD-9: 800.*–999.*; ICD-10: S00.*–T88.*, except the codes specific for “sprains and strains of joints and adjacent muscles” and “effects of heat, thirst, and exhaustion”) were not considered indicative of exertional rhabdomyolysis.13

For surveillance purposes, a “recruit trainee” was defined as an active component member in an enlisted grade (E1–E4) who was assigned to 1 of the services’ recruit training locations (per the individual’s initial military personnel record). For this report, each service member was considered a recruit trainee for the period of time corresponding to the usual length of recruit training in his or her service. Recruit trainees were considered a separate category of enlisted service members in summaries of rhabdomyolysis cases by military grade overall.

In-theater diagnoses of exertional rhabdomyolysis were analyzed separately; however, the same case-defining criteria and incidence rules were applied to identify incident cases. Records of medical evacuations from the U.S. Central Command (CENTCOM) area of responsibility (AOR) (e.g., Iraq and Afghanistan) to a medical treatment facility outside the CENTCOM AOR also were analyzed separately. Evacuations were considered case defining if affected service members met the above criteria in a permanent military medical facility in the U.S. or Europe from 5 days before to 10 days after their evacuation dates.

The new electronic health record for the MHS, MHS GENESIS, was implemented at 4 military treatment facilities in the state of Washington in 2017 (Naval Hospital Oak Harbor, Naval Hospital Bremerton, Air Force Medical Services Fairchild, and Madigan Army Medical Center). Implementation of the second wave of MHS GENESIS sites began in 2019 and included 3 facilities in California (Travis Air Force Base [AFB], the Presidio of Monterey, and Naval Air Station Lemoore) and 1 in Idaho (Mountain Home AFB). Medical data from facilities using MHS GENESIS are not available in the DMSS. Therefore, medical encounter data for individuals seeking care at any of these facilities after their conversion to MHS GENESIS during 2017–2019 were not included in the current analysis.

RESULTS

In 2019, there were 512 incident cases of rhabdomyolysis likely associated with physical exertion and/or heat stress (exertional rhabdomyolysis) (Table 1). The crude (unadjusted) incidence rate was 38.9 cases per 100,000 person-years (p-yrs). Subgroup-specific incidence rates of exertional rhabdomyolysis were highest among males (43.3 per 100,000 p-yrs), those less than 20 years old (88.0 per 100,000 p-yrs), non-Hispanic black service members (66.1 per 100,000 p-yrs), Marine Corps or Army members (91.9 per 100,000 p-yrs and 47.3 per 100,000 p-yrs, respectively), and those in “other/unknown” or combat-specific occupations (72.1 per 100,000 p-yrs and 66.0 per 100,000 p-yrs, respectively) (Table 1). Of note, the incidence rate among recruit trainees was more than 6 times that among other enlisted members and officers, even though cases among this group accounted for only 13.3% of all cases in 2019.

During the surveillance period, crude rates of exertional rhabdomyolysis fluctuated between a low of 35.2 per 100,000 p-yrs in 2015 and a high of 42.4 per 100,000 p-yrs in 2018, after which the rate decreased to 38.9 per 100,000 p-yrs in 2019 (Figure 1). The annual incidence rates of exertional rhabdomyolysis were highest among non-Hispanic blacks in every year except 2018, when the highest rate occurred among Asian/Pacific Islanders (data not shown). Overall and annual rates of incident exertional rhabdomyolysis were highest among service members in the Marine Corps, intermediate among those in the Army, and lowest among those in the Air Force and Navy (Table 1, Figure 2). Among Marine Corps and Army members, annual rates increased between 2015 and 2018 (35.7% and 21.0% increases, respectively) and then dropped in 2019 (Figure 2). Annual rates among Navy members increased 41.1% over the course of the 5-year surveillance period, while rates among service members in the Air Force remained relatively stable. During 2015–2019, approximately three-quarters (75.3%) of the cases occurred between May and October (Figure 3).

Rhabdomyolysis by location

During the 5-year surveillance period, the medical treatment facilities at 13 installations diagnosed at least 50 cases each; when combined, these installations diagnosed more than half (57.3%) of all cases (Table 2). Of these 13 installations, 4 provide support to recruit/basic combat training centers (Marine Corps Recruit Depot [MCRD] Parris Island/Beaufort, SC; Fort Benning, GA; Joint Base San Antonio–Lackland, TX; and Fort Leonard Wood, MO). In addition, 6 installations support large combat troop populations (Fort Bragg, NC; Marine Corps Base [MCB] Camp Pendleton, CA; MCB Camp Lejeune/Cherry Point, NC; Fort Shafter, HI; Fort Hood, TX; and Fort Campbell, KY). During 2015–2019, the most cases overall were diagnosed at MCRD Parris Island/Beaufort, SC (n=282), and Fort Bragg, NC (n=274), which together accounted for more than one-fifth (21.8%) of all cases (Table 2).

Rhabdomyolysis in Iraq and Afghanistan

There were 7 incident cases of exertional rhabdomyolysis diagnosed and treated in Iraq/Afghanistan during the 5-year surveillance period (data not shown). Deployed service members who were affected by exertional rhabdomyolysis were most frequently non-Hispanic black or non-Hispanic white (n=5; 71.4% and n=2; 28.6%, respectively), male (n=7), aged 20–29 years (n=4; 57.1%), in the Army (n=7), enlisted (n=7), and in communication/intelligence (n=2; 28.6%) or repair/engineering occupations (n=2; 28.6%). One active component service member was medically evacuated from Iraq/Afghanistan for exertional rhabdomyolysis during the surveillance period; this medical evacuation occurred in September 2015 (data not shown).

EDITORIAL COMMENT

This report documents that the crude annual incidence rates of exertional rhabdomyolysis among active component U.S. military members fluctuated between a low of 35.2 per 100,000 p-yrs in 2015 and a high of 42.4 per 100,000 p-yrs in 2018, after which rates decreased to 38.9 per 100,000 p-yrs (8.2% decrease) in 2019. Exertional rhabdomyolysis continued to occur most frequently from late spring through early fall at installations that support basic combat/recruit training or major Army or Marine Corps combat units.

The risks of heat injuries, including exertional rhabdomyolysis, are elevated among individuals who suddenly increase overall levels of physical activity, recruits who are not physically fit when they begin training, and recruits from relatively cool and dry climates who may not be acclimated to the high heat and humidity at training camps in the summer.1,2,9 Soldiers and Marines in combat units often conduct rigorous unit physical training, personal fitness training, and field training exercises regardless of weather conditions. Thus, it is not surprising that recruit camps and installations with large ground combat units account for most of the cases of exertional rhabdomyolysis.

The annual incidence rates among non-Hispanic black service members were higher than the rates among members of other race/ethnicity groups in 4 of the 5 previous years, with the exception of 2018. This observation has been attributed, at least in part, to an increased risk of exertional rhabdomyolysis among individuals with sickle cell trait14–17 and is supported by at least 1 other study among U.S. service members.9 Supervisors at all levels should ensure that guidelines to prevent heat injuries are consistently implemented and should be vigilant for early signs of exertional heat injuries, including rhabdomyolysis, among all service members.

The findings of this report should be interpreted with consideration of its limitations. A diagnosis of “rhabdomyolysis” alone does not indicate the cause. Ascertainment of the probable causes of cases of exertional rhabdomyolysis was attempted by using a combination of ICD-9/ICD-10 diagnostic codes related to rhabdomyolysis with additional codes indicative of the effects of exertion, heat, or dehydration. Furthermore, other ICD-9/ICD-10 codes were used to exclude cases of rhabdomyolysis that may have been secondary to trauma, intoxication, or adverse drug reactions.

The measures that are effective at preventing exertional heat injuries in general apply to the prevention of exertional rhabdomyolysis. In the military training setting, the risk of exertional rhabdomyolysis can be reduced by emphasizing graded, individual preconditioning before starting a more strenuous exercise program and by adhering to recommended work/rest and hydration schedules, especially in hot weather. The physical activities of overweight and/or previously sedentary new recruits should be closely monitored. Strenuous activities during relatively cool mornings following days of high heat stress should be particularly closely monitored; in the past, such situations have been associated with increased risk of exertional heat injuries (including rhabdomyolysis).8

Management after treatment for exertional rhabdomyolysis, including the decision to return to physical activity and duty, is a persistent challenge among athletes and military members.9,10,18It is recommended that those who have had a clinically confirmed exertional rhabdomyolysis event be further evaluated and risk stratified for recurrence before return to activity/duty.10,18–20Low-risk patients may gradually return to normal activity levels, while those deemed high risk for recurrence will require further evaluative testing (e.g., genetic testing for myopathic disorders).18,19

Commanders and supervisors at all levels should be vigilant for early signs of exertional heat injuries and should intervene aggressively when dangerous conditions, activities, or suspicious illnesses are detected. Finally, 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 darkened urine (possibly due to myoglobinuria) after strenuous physical activity, especially in hot, humid weather.

REFERENCES

1.  Zutt R, van der Kooi AJ, Linthorst GE, Wanders RJ, de Visser M. Rhabdomyolysis: review of the literature. Neuromuscul Disord. 2014;24(8):651–659.

2.  Giannoglou GD, Chatzizisis YS, Misirli G. The syndrome of rhabdomyolysis: pathophysiology and diagnosis. Eur J Intern Med. 2007;18(2):90–100.

3.  Rawson ES, Clarkson PM, Tarnopolsky MA. Perspectives on exertional rhabdomyolysis. Sports Med. 2017;47(suppl 1):33–49.

4.  McKewon S. Two Nebraska football players hospitalized, treated after offseason workout. Omaha World-Herald. 20 January 2019. https://www.omaha.com/huskers/football/two-nebraskafootball-players-hospitalized-treated-after-offseason-workout/article_d5929674-53a7-5d90-803e-6b4e9205ee60.html. Accessed 10 March 2020.

5.  Raleigh MF, Barrett JP, Jones BD, Beutler AI, Deuster PA, O'Connor FG. A cluster of exertional rhabdomyolysis cases in a ROTC program engaged in an extreme exercise program. Mil Med. 2018;183(suppl 1):516–521.

6.  Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009;361(1):62–72.

7.  Hill OT, Wahi MM, Carter R, Kay AB, McKinnon CJ, Wallace RF. Rhabdomyolysis in the U.S. active duty Army, 2004–2006. Med Sci Sports Exerc. 2012;44(3):442–449.

8.  Lee G. Exercise-induced rhabdomyolysis. R I Med J (2013). 2014;97(11):22–24.

9.  Hill OT, Scofield DE, Usedom J, et al. Risk factors for rhabdomyolysis in the U.S. Army. Mil Med. 2017;182(7):e1836–e1841.

10.  Knapik JJ, O’Connor FG. Exertional rhabdomyolysis: epidemiology, diagnosis, treatment, and prevention. J Spec Oper Med. 2016;15(3):65–71.

11.  Holt S, Moore K. Pathogenesis of renal failure in rhabdomyolysis: the role of myoglobin. Exp Nephrol. 2000;8(2):72–76.

12.  Armed Forces Health Surveillance Branch. Update: Exertional rhabdomyolysis among active component members, U.S. Armed Forces, 2014–2018. MSMR. 2019;26(4):21–26.

13.  Armed Forces Health Surveillance Branch. Surveillance case definition. Exertional rhabdomyolysis. https://www.health.mil/Reference-Center/Publications/2017/03/01/Rhabdomyolysis-Exertional. Accessed 10 March 2020.

14.  Gardner JW, Kark JA. Fatal rhabdomyolysis presenting as mild heat illness in military training. Mil Med. 1994;159(2):160–163.

15.  Makaryus JN, Catanzaro JN, Katona KC. Exertional rhabdomyolysis and renal failure in patients with sickle cell trait: is it time to change our approach? Hematology. 2007;12(4):349–352.

16.  Ferster K, Eichner ER. Exertional sickling deaths in Army recruits with sickle cell trait. Mil Med. 2012;177(1):56–59.

17.  Nelson DA, Deuster PA, Carter R, Hill OT, Wolcott VL, Kurina LM. Sickle cell trait, rhabdomyolysis, and mortality among U.S. Army soldiers. N Engl J Med. 2016;375(5):435–442.

18.  O’Connor FG, Brennan FH Jr, Campbell W, Heled Y, Deuster P. Return to physical activity after exertional rhabdomyolysis. Curr Sports Med Rep. 2008;7(6):328–331.

19.  Atias D, Druyan A, Heled Y. Recurrent exertional rhabdomyolysis: coincidence, syndrome, or acquired myopathy? Curr Sports Med Rep. 2013;12(6):365–369.

20.  O’Connor FG, Deuster P, Leggit J, et al. Clinical Practice Guideline for the Management of Exertional Rhabdomyolysis in Warfighters. Bethesda, Maryland: Uniformed Services University. 2017.

Incident cases and incidence rates of extertional rhabdomyolysis, by source of report and year of diagnosis, active component, U.S. Armed Forces, 2015–2019

Annual incidence rates of exertional rhabdomyolysis, by service, active component, U.S. Armed Forces, 2015–2019

Cumulative numbers of exertional rhabdomyolysis cases, by month of diagnosis, active component, U.S. Armed Forces, 2015–2019

 Incident casesa and incidence ratesb of exertional rhabdomyolysis, by demographic and military characteristics, active component, U.S. Armed Forces, 2019

Incident cases of exertional rhabdomyolysis, by installation (with at least 30 cases during the period), active component, U.S. Armed Forces, 2015–2019

You also may be interested in...

Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2006–2021

Article
4/1/2022
Marine Corps Cpl. Luis Alicea drinks water after a combat conditioning exercise at Naval Air Station Joint Reserve Base New Orleans, May 20, 2019. Photo By: Marine Corps Lance Cpl. Jose Gonzalez.

Exertional (or exercise-associated) hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 mEq/L) that develops during or up to 24 hours following prolonged physical activity. Acute hyponatremia creates an osmotic imbalance between fluids outside and inside of cells.

Recommended Content:

Medical Surveillance Monthly Report

Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2017–2021

Article
4/1/2022

Exertional rhabdomyolysis is a potentially serious condition that requires a vigilant and aggressive approach. Some service members who experience exertional rhabdomyolysis may be at risk for recurrences, which may limit their military effectiveness and potentially predispose them to serious injury.

Recommended Content:

Medical Surveillance Monthly Report

Exertional Heat Illness at Fort Benning, GA: Unique Insights from the Army Heat Center

Article
4/1/2022
Navy Petty Officer 3rd Class Ryan Adams is being used as an example victim for cooling a heat casualty at the bi-annual hot weather standard operating procedure training aboard Marine Corps Base Camp Lejeune, N.C., Aug. 24. Adams is demonstrating the "burrito" method used to cool a heat related injury victim. Photo by Pfc. Joshua Grant.

Exertional heat illness (hereafter referred to as heat illness) spans a spectrum from relatively mild conditions such as heat cramps and heat exhaustion, to more serious and potentially life-threatening conditions such as heat injury and exertional heat stroke (hereafter heat stroke).

Recommended Content:

Medical Surveillance Monthly Report

Heat Illness, Active Component, U.S. Armed Forces, 2021

Article
4/1/2022

From 2020 to 2021, the rate of incident heat stroke was relatively stable while the rate of heat exhaustion increased slightly

Recommended Content:

Medical Surveillance Monthly Report

Obesity prevalence among active component service members prior to and during the COVID-19 pandemic, January 2018–July 2021

Article
3/1/2022
Maintaining a healthy weight is important for military members to stay fit to fight. The body mass index is a tool that can be used to determine if an individual is at an appropriate weight for their height. A person’s index is determined by their weight in kilograms divided by the square of height in meters. (U.S. Air Force photo illustration by Airman 1st Class Destinee Sweeney)

This study examined monthly prevalence of obesity and exercise in active component U.S. military members prior to and during the COVID-19 pandemic. These results suggest that the COVID-19 pandemic had a small effect on the trend of obesity in the active component U.S. military and that obesity prevalence continues to increase.

Recommended Content:

Medical Surveillance Monthly Report

Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries

Article
3/1/2022
Air Force 1st Lt. Anthony Albina, a critical care nurse assigned to Joint Base Andrews, Md., checks a patient’s breathing and heart rate during an intubation procedure while supporting COVID-19 response operations in Cleveland, Jan. 20, 2022.

SARS CoV-2 and the illness it causes, COVID-19, have exacted a heavy toll on the global community. Most of the identified disease has been in the elderly and adults. The goal of this analysis was to ascertain if user-built ESSENCE queries applied to records of outpatient MHS health care encounters are capable of detecting MIS-C cases that have not been identified or reported by local public health departments.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Medical Separation from Service Among Incident Cases of Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
3/1/2022
Marines hike to the next training location during Exercise Baccarat in Aveyron, Occitanie, France, Oct.16, 2021. Exercise Baccarat is a three-week joint exercise with Marines and the French Foreign Legion that challenges forces with physical and tactical training. Photo By: Marine Corps Lance Cpl. Jennifer Reyes

Osteoarthritis (OA) is the most common adult joint disease and predominantly involves the weight-bearing joints. This condition, including spondylosis (OA of the spine), results in significant disability and resource utilization and is a leading cause of medical separation from military service.

Recommended Content:

Medical Surveillance Monthly Report

Update: Malaria, U.S. Armed Forces, 2021

Article
3/1/2022
Mosquitos – like this one, collected as part of a military study in North Carolina – were used during USAMRDC’s initial RTS,S vaccine studies nearly 40 years ago. (Photo courtesy: AFC Kimberly Barrera)

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. In 2021, a total of 20 service members were diagnosed with or reported to have malaria.

Recommended Content:

Medical Surveillance Monthly Report

Brief Report: Refractive Surgery Trends at Tri-Service Refractive Surgery Centers and the Impact of the COVID-19 Pandemic, Fiscal Years 2000–2020

Article
3/1/2022
Cadet Saverio Macrina, U.S. Military Academy West Point, receives corneal cross-linking procedure at Fort Belvoir Community Hospital, Va., Nov. 21, 2016. (DoD photo by Reese Brown)

Since the official introduction of laser refractive surgery into clinical practice throughout the Military Health System (MHS) in fiscal year 2000, these techniques have been heavily implemented in the tri-service community to better equip and improve the readiness of the U.S. military force.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Health care burden attributable to osteoarthritis and spondylosis, active component, U.S. Armed Forces, 2016–2020

Article
2/1/2022
Air Force security forces trainees climb a hill during a 3-mile ruck march to commemorate National Police Week at Joint Base San Antonio, May 13, 2019. Photo By: Sarayuth Pinthong, Air Force

This snapshot summarizes the total numbers of inpatient and outpatient encounters with an OA or spondylosis diagnosis in the first diagnostic position and the total numbers of unique individuals affected by these conditions during the same 5-year surveillance period.

Recommended Content:

Medical Surveillance Monthly Report

A new approach to categorization of ocular injury among U.S. Armed Forces

Article
2/1/2022
Air Force and Space Force Surgeon General Lt. Gen. Dorothy Hogg receives an eye exam from Air Force Reserve Maj. Leslie Wilderson at Joint Base Anacostia-Bolling, Washington, D.C., March 26, 2021. Photo By: Air Force Staff Sgt. Kayla White

Ocular injuries present an ongoing threat to readiness and retention of service members. This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data.

Recommended Content:

Medical Surveillance Monthly Report

Diagnosis of hepatitis C infection and cascade of care in the active component, U.S. Armed Forces, 2020

Article
2/1/2022
Navy Petty Officer 2nd Class Cecil Dorse, left, and Navy Petty Officer 3rd Class Janet Rosas test blood samples aboard the Military Sealift Command hospital ship USNS Comfort while the ship is in New York City in support of the nation’s COVID-19 response, April 6, 2020. Photo By: Navy Petty Officer 2nd Class Sara Eshleman

Hepatitis C virus (HCV) infection rates are rising in the U.S. despite widely available tools to identify and effectively treat nearly all of these cases. This cross-sectional study aimed to use laboratory data to evaluate the prevalence of HCV diagnoses among active component U.S. military service members.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Lengths of Hospital Stays for Service Members Diagnosed with Sepsis, Active Component, U.S. Armed Forces, 2011–2020

Article
1/1/2022
The (left to right) Senior Airman Austin Shrewsbury, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, works with student, Airman 1st Class Taylor Altman, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, to identify bacteria of patient’s cultures inside the microbiology laboratory at Wright-Patterson Air Force Base medical center June 30, 2017.

Sepsis is a serious and life-threatening organ dysfunction caused by a dysregulated host response to infection. In the U.S., sepsis is a leading cause of in-hospital mortality and 1 of the most expensive conditions treated in U.S. hospitals.

Recommended Content:

Medical Surveillance Monthly Report

Description of a COVID-19 Beta Variant Outbreak, Joint Base Lewis-McChord, WA, February–March 2021

Article
1/1/2022
U.S. Army Soldiers from 1-17th Infantry Battalion, 2nd Stryker Brigade, 2nd Infantry Division, clear an objective during the training exercise Bayonet Focus 19-02 at Yakima Training Center, Wash., May 6, 2019. Bayonet Focus is a training exercise designed to assess Soldiers’ ability to preform tasks and complete objectives under conditions experienced during combat situations. (U.S. Army photo by Spc. Angel Ruszkiewicz)

This report describes an outbreak of SARS-CoV-2, the causative agent of COVID-19, that peaked during 21–26 February 2021 and was tied to a single military training event. A total of 143 laboratory-confirmed cases were identified.

Recommended Content:

Medical Surveillance Monthly Report

COVID-19 and Depressive Symptoms Among Active Component U.S. Service Members, January 2019–July 2021

Article
1/1/2022
With the holiday season upon us, the cold, dark days that winter brings, and the social distancing and movement restrictions brought about by COVID-19, it’s not uncommon for people to feel depressed. (Photo by Erin Bolling)

This study examined the rates of depressive symptoms in active component U.S. service members prior to and during the COVID-19 pandemic and evaluated whether SARS-CoV-2 test results (positive or negative) were associated with self-reported depressive symptoms.

Recommended Content:

Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 16
Refine your search
Last Updated: July 30, 2020

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.