Back to Top Skip to main content

Summary of the 2018–2019 Influenza Season Among Department of Defense Service Members and Other Beneficiaries

A flu shot vaccination sits on a table at 184th Sustainment Command headquarters in Monticello, Mississippi on Feb. 8, 2020. The single best way to prevent seasonal flu is to get vaccinated each year, but good wellness habits like covering your cough and washing your hands often can help prevent the spread of germs. (Mississippi Army National Guard photo by Staff Sgt. Veronica McNabb) A flu shot vaccination sits on a table at 184th Sustainment Command headquarters in Monticello, Mississippi on Feb. 8, 2020. The single best way to prevent seasonal flu is to get vaccinated each year, but good wellness habits like covering your cough and washing your hands often can help prevent the spread of germs. (Mississippi Army National Guard photo by Staff Sgt. Veronica McNabb)

Recommended Content:

Medical Surveillance Monthly Report

WHAT ARE THE NEW FINDINGS?

The 2018–2019 influenza season was longer than the preceding 2 seasons. Unlike most prior seasons, 2 strains were common. Influenza A(H1N1)pdm09 was the most common strain early in the season, but influenza A(H3N2) predominated later in the season. Total influenza vaccine effectiveness was low during this season in part because the A(H3N2) strain was antigenically drifted from the vaccine strain.

WHAT IS THE IMPACT ON READINESS AND FORCE HEALTH PROTECTION?

Surveillance data about influenza disease inform the planning and strategy for efforts to reduce the future impact of influenza on the health and medical readiness of the Armed Forces. The data and findings in this report reinforce the importance of the use of up-to-date multivalent influenza vaccines that protect against several different specific virus strains that may become common in the coming influenza season.

ABSTRACT

The Armed Forces Health Surveillance Branch conducts weekly surveillance of influenza activity among Department of Defense (DoD) populations each influenza season. This report provides a summary of the data from the 2018–2019 influenza season. Ambulatory data for influenza-like illnesses (ILIs), influenza hospitalization data, and lab data for influenza-confirmed cases were used for the surveillance. The 2018–2019 season differed from past seasons in that it was much longer, had a later peak, and the predominant strain of influenza changed from influenza A(H1N1)pdm09 at the beginning of the season to influenza A(H3N2) in the middle of the season. Non-service member beneficiaries accounted for the majority of ILI-related encounters and hospitalizations. However, there were still 149 influenza-related hospitalizations among service members during the 2018–2019 season. Continued weekly surveillance of influenza among DoD populations is crucial to track increases in activity each season and the potential emergence of new and/or severe influenza subtypes.

BACKGROUND

Influenza infects an estimated 8% of the U.S. population annually, with children and the elderly at highest risk.1 Service members may also be at a higher risk for exposure to influenza because of increased crowding and mixing in the recruit setting and duty assignments abroad where influenza subtypes may differ.2 Each influenza season is different because of antigenic drift in the circulating influenza subtypes, the degree of match between vaccine subtypes and circulating subtypes, and vaccine coverage of the population. As such, it is important to conduct annual surveillance of each influenza season to identify the onset and patterns of activity, emergence of drifted or shifted subtypes, and severity of the season.

The Armed Forces Health Surveillance Branch of the Defense Health Agency utilizes electronic sources of ambulatory medical encounters, hospitalizations, and laboratory data to conduct annual influenza surveillance among all Department of Defense (DoD) beneficiaries across the world. Weekly reports are generated to provide near real-time influenza surveillance data for each of the DoD Combatant Commands. This report provides a summary of DoD influenza surveillance data for the 2018–2019 influenza season.

METHODS

Medical encounter and demographic data from the Defense Medical Surveillance System (DMSS) and Health Level 7 (HL7)-formatted laboratory data from the Navy and Marine Corps Public Health Center (NMCPHC) were used for this analysis. The HL7-formatted laboratory data are nonstandardized, so NMCPHC applies an algorithm to the data to identify influenza tests and standardize results. The surveillance period for the 2018–2019 influenza season was 30 September 2018 through 1 June 2019 (influenza weeks 40 through 22). Data from the 2016–2017 and 2017–2018 influenza seasons are also presented for comparison. The surveillance population included all individuals who were Military Health System (MHS) beneficiaries (i.e., active and reserve/guard component service members, retired service members, family members and other dependents of service members and retirees, and other authorized government employees and family members) who accessed care through either a military medical facility/provider or a civilian facility/provider (if paid for by the MHS). However, medical data from military treatment facilities (MTFs) that were using MHS GENESIS at the time of this surveillance (Naval Hospital Oak Harbor, Naval Hospital Bremerton, Air Force Medical Services Fairchild, and Madigan Army Medical Center) are not captured in the DMSS data. Therefore, medical encounter and laboratory data from these MTFs are not included in the analysis. For the analysis, populations were grouped as service members or other beneficiaries.

Outpatient medical encounters were classified as an influenza-like illness (ILI) encounter if they had an ILI diagnosis code (International Classification of Diseases, 10th Revision [ICD-10] codes B97.89, H66.9, H66.90, H66.91, H66.92, H66.93, J00, J01.9, J01.90, J06.9, J09, J09.X, J09.X1, J09.X2, J09.X3, J09.X9, J10, J10.0, J10.00, J10.01, J10.08, J10.1, J10.2, J10.8, J10.81, J10.82, J10.83, J10.89, J11, J11.0, J11.00, J11.08, J11.1, J11.2, J11.8, J11.81, J11.82, J11.83, J11.89, J12.89, J12.9, J18, J18.1, J18.8, J18.9, J20.9, J40, R05, R50.9) in any diagnostic position. The percentage of all outpatient encounters that were classified as ILI encounters was calculated for each week for each study population. Baseline ILI activity for the season was defined as the mean percentage of all outpatient encounters during noninfluenza weeks (weeks 22–39) over the prior 3 years.

Hospitalized influenza cases were defined as having a hospitalization with a diagnosis of influenza (ICD-10: J09, J10, J11) in any diagnostic position. The number of hospitalized influenza cases each week for each study population was calculated. For other beneficiaries, counts of influenza hospitalizations by age group (0–4, 5–9, 10–17, 18–35, 36–49, 50–64, 65+) were calculated.

Laboratory-confirmed influenza cases were defined as having a positive polymerase chain reaction, viral culture, or rapid influenza assay result. Laboratory-confirmed influenza cases were stratified by influenza types/subtypes (influenza A (not subtyped), influenza A(H1N1)pdm09, influenza A(H3N2), influenza A and B coinfection, and influenza B. The total number of laboratory-confirmed influenza cases stratified by type/subtype and the percentage of all influenza laboratory tests performed that had positive test results were calculated for each week of the influenza season for service members and for other beneficiaries separately.

RESULTS

Virus surveillance

Among all beneficiaries, there were 149,254 respiratory specimens tested for influenza during the 2018–2019 influenza season (data not shown). Of those, 30,464 (20.4%) were positive for influenza. Service members had a lower percentage of specimens testing positive for influenza (16.7%) compared to other beneficiaries (21.8%). Among all populations, influenza A (any subtype) predominated during this season, with 28,454 (93.4%) of all positive specimens testing positive for influenza A. The distribution of subtypes among influenza A positive specimens was 73.3% influenza A (not subtyped), 12.6% A(H3N2), and 7.5% A(H1N1)pdm09. The remaining specimens were positive for influenza B (1,805; 5.9%) or an influenza A/B coinfection (205; 0.7%). The distribution of subtypes was similar between service members and other beneficiaries (data not shown).

The distribution of influenza serotypes and the percentage of specimens positive for influenza by week are presented in Figures 1a and 1b for service members and other beneficiaries, respectively. Among subtyped influenza A specimens, A(H1N1) pdm09 predominated early in the season, but A(H3N2) was predominant after week 3. The highest numbers of positive specimens and the highest percentages of positives occurred during week 9 for service members and weeks 6 and 7 for other beneficiaries. These results indicate peak influenza activity for the season during the month of February 2019.

Outpatient encounter ILI surveillance

During the 2018–2019 season, the weekly percentages of outpatient encounters due to an ILI for service members were above baseline (2.1%) for 22 weeks (weeks 46–15) (Figure 2a). A similar pattern was seen among other beneficiaries, for whom the percentages were above baseline (3.4%) for 20 weeks (weeks 47–14) (Figure 2b). This pattern is similar to the percentage of outpatient encounters due to ILI during the prior 2 influenza seasons.

Earlier in the 2018–2019 season, between weeks 40–52, the trend and magnitude of the percentages of encounters due to ILI were also similar to those of the past 2 seasons (Figures 2a and 2b). All seasons had peaks during weeks 52 and 1. This timing coincides with the end-of-year holiday period. Rather than a true peak in ILI activity though, this peak was being driven by a differential decrease in the total number of medical encounters and ILI encounters during that time. Specifically, for the 2018–2019 season, the total number of outpatient medical encounters decreased 58% from week 51 to week 52; however, ILI encounters decreased only 36% between those 2 weeks. Therefore, this peak in ILI percentage is considered an artifact of the overall decline in total outpatient encounters and is not reflected in the peak influenza weeks for the season. After week 1, the 2018–2019 season ILI percentages began to diverge from the prior 2 seasons. Among service members, the percentage of encounters due to ILI had a later peak (week 8) than the prior 2 seasons (weeks 2 and 3), but the magnitude of the 2018–2019 peak was similar to that of the 2017–2018 peak (Figure 2a). Among other beneficiaries, the trend was similar to the 2 prior seasons, with peak activity occurring during week 6 (2017–2018: week 5; 2016–2017: week 6), and the magnitude was similar to the 2016–2017 season (Figure 2b).

Influenza-related hospitalizations

Of the total 5,847 influenza-related hospitalizations during the 2018–2019 season, 149 occurred among service members (Figure 3). The majority of hospitalizations occurred among other beneficiaries (n=5,698; 97.5%). Hospitalizations peaked overall during week 11 (n=471), but service member hospitalizations peaked during week 10 (n=18) (Figure 3). Among other beneficiaries, the majority of influenza-related hospitalizations occurred among those 65 years of age or older (n=3,778; 66.3%) (Figure 4).

EDITORIAL COMMENT

The 2018–2019 influenza season among service members and other DoD beneficiaries was a longer season with a later peak compared to the prior 2 seasons. The season also differed from prior seasons in that the beginning of the season was predominated by influenza A(H1N1)pdm09 while influenza A(H3N2) predominated after week 3; most seasons have just 1 influenza A subtype predominating. As expected, the influenza season among DoD service members and beneficiaries was similar to the season among the general U.S. population.3 Although the DoD influenza surveillance data include information from around the world, the majority of encounter and laboratory data came from the U.S. and to a lesser extent Europe, which also had an influenza season similar to that in the U.S.4 As with the general U.S. population, the elderly (> 64 years of age) accounted for the majority of influenza hospitalizations among other beneficiaries. The elderly population accounted for 66% of all other beneficiary hospitalizations for the season compared to 47% among the general U.S. population.3

A seasonal influenza vaccine is still the best way to protect against influenza. Service members are required to receive a seasonal influenza vaccine annually. During the 2018–2019 season, DoD policy set a goal of 90% of service members vaccinated by 15 January 2019.5 Although vaccination rates of service members were very high, influenza cases still occurred among this population during the 2018–2019 season. Cases of influenza among service members may be attributable to infections occurring before receipt of the influenza vaccine, within the 14 days following vaccination when the vaccine may not provide complete protection, or after vaccination because the vaccine is less than 100% effective. During the 2018–2019 season, vaccine effectiveness among the general U.S. population was particularly low because of the emergence of a drifted A/H3N2 (clade 3C.3a) circulating virus that differed from the vaccine strain.6 Although the influenza vaccine is not 100% effective at preventing influenza infection, a recent study showed that vaccination also decreased the risk of hospitalization and admission to the intensive care unit and decreased severity of illness.7 Continued vaccination of service members and other DoD beneficiaries is crucial to combat influenza infections and lessen disease severity. This season also demonstrated the importance of annual influenza surveillance, as the seasons differ from year to year.

REFERENCES

1. Tokars JI, Olsen SJ, Reed C. Seasonal incidence of symptomatic influenza in the United States. Clin Infect Dis. 2018;66(10):1511–1518.

2. Sanchez JL, Cooper MJ. Influenza in the US military: an overview. J Infec Dis Treat. 2016;2(1).

3. Xu X, Blanton L, Elal AIA, et al. Update: Influenza activity in the United States during the 2018–19 season and composition of the 2019–20 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2019;68(24):544–551.

4. European Centre for Disease Prevention and Control. Weekly influenza update, week 20, May 2019. https://www.ecdc.europa.eu/en/publications-data/weekly-influenza-update-week-20-may-2019. Accessed 28 January 2020.

5. Department of Defense Assistant Secretary of Defense. Memorandum: Guidance for the 2018–2019 Annual Influenza Immunization Program. 05 July 2018.

6. Flannery B, Kondor RJG, Chung JR, et al. Spread of antigenically drifted influenza A(H3N2) viruses and vaccine effectiveness in the United States during the 2018–2019 season. J Infect Dis. 2020;221(1):8–15.

7. Thompson MG, Pierse N, Sue Huang Q, et al. Influenza vaccine effectiveness in preventing influenza-associated intensive care admissions and attenuating severe disease among adults in New Zealand 2012–2015. Vaccine. 2018;36(39):5916–5925.

 

FIGURE 1a. Numbers of laboratory-confirmed influenza specimens by serotype and percentages of respiratory specimens positive for influenza by surveillance week, service members, U.S. Armed Forces, 2018–2019 influenza season

FIGURE 1b. Numbers of laboratory-confirmed influenza specimens by serotype and percentages of respiratory specimens positive

FIGURE 2a. Percentages of outpatient encounters due to ILI, service members, U.S. Armed Forces, 2018–2019 influenza season

FIGURE 2b. Percentages of outpatient encounters due to ILI, other DoD beneficiaries, 2018–2019 influenza season

IGURE 3. Influenza-related hospitalizations, service members and other DoD beneficiaries, 2018–2019 influenza season

FIGURE 4. Age distribution of beneficiaries with influenza-related hospitalizations, 2018–2019 influenza season

You also may be interested in...

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).

Recommended Content:

Health Readiness | 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.

Recommended Content:

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

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.

Recommended Content:

Health Readiness | Influenza Summary and Reports | Medical Surveillance Monthly Report | Vaccine-Preventable Diseases | Force Health Protection | Global Health Engagement

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.

Recommended Content:

Health Readiness | 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 highlights from the Twitter chat.

Recommended Content:

Medical Surveillance Monthly Report | Winter Safety | Preventive Health | Health Readiness

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.

Recommended Content:

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-traumatic stress disorder (PTSD) by assessing correlations between the incidence rates of seizures and prior diagnoses of TBI and PTSD.

Recommended Content:

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

Exertional heat injuries pose annual threat to U.S. service members

Article
7/20/2017
Two U.S. service members perform duties in warm weather where they may be exposed to extreme heat conditions and a higher risk of heat illness.

Exertional heat injuries pose annual threat to U.S. service members, according to a study published in Defense Health Agency’s Armed Forces Health Surveillance Branch (AFHSB) peer-reviewed journal, the Medical Surveillance Monthly Report.

Recommended Content:

Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report | Summer Safety

Rhabdomyolysis by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet

Fact Sheet
3/30/2017

This fact sheet provides details on Rhabdomyolysis by location for active component, U.S. Armed Forces during a five-year surveillance period from 2012 through 2016. The medical treatment facilities at nine installations diagnosed at least 50 cases each and, together approximately half (49.9%) of all diagnosed cases.

Recommended Content:

Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Demographic and Military Traits of Service Members Diagnosed as Traumatic Brain Injury Cases

Fact Sheet
3/30/2017

This fact sheet provides details on the demographic and military traits of service members diagnosed as traumatic brain injury (TBI) cases during a 16-year surveillance period from 2001 through 2016, a total of 276,858 active component service members received first-time diagnoses of TBI - a structural alteration of the brain or physiological disruption of brain function caused by an external force.

Recommended Content:

Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

Heat Illnesses by Location, Active Component, U.S. Armed Forces, 2012-2016 Fact Sheet

Fact Sheet
3/30/2017

This fact sheet provides details on heat illnesses by location during a five-year surveillance period from 2012 through 2016. 11,967 heat-related illnesses were diagnosed at more than 250 military installations and geographic locations worldwide. Three Army Installations accounted for close to one-third of all heat illnesses during the period.

Recommended Content:

Armed Forces Health Surveillance Branch | Medical Surveillance Monthly Report

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

Article
3/28/2017
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 (MSMR) recently reported 2016 marks the first year of zero combat amputations since the wars in Afghanistan and Iraq began.

Recommended Content:

Medical Surveillance Monthly Report | Epidemiology and Analysis

Cold injuries among active duty U.S. service members drop to lowest level since winter 2011–2012

Article
1/23/2017
U.S. service members often perform duties in cold weather climates where they may be exposed to frigid conditions and possible injury.

Cold injuries among active duty U.S. service members drop to the lowest level since winter 2011-2012, according to a study published in Defense Health Agency’s Armed Forces Health Surveillance Branch (AFHSB) peer-reviewed journal, the Medical Surveillance Monthly Report.

Recommended Content:

Armed Forces Health Surveillance Branch | Epidemiology and Analysis | Medical Surveillance Monthly Report | Winter Safety
<< < ... 11 12 > >> 
Showing results 166 - 178 Page 12 of 12

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.