Back to Top Skip to main content

Armed Forces Health Surveillance Branch

Health Surveillance, Analysis and Insight for Action

Armed Forces Health Surveillance Branch is the central epidemiology health resource for the US Military and Public Health

The Armed Forces Health Surveillance Branch (AFHSB) is the central epidemiologic resource for the U.S. Armed Forces, conducting medical surveillance to protect those who serve our nation in uniform and allies who are critical to our national security interests. Explore our website to learn about the critical role AFHSB plays in force health protection.

AFHSB provides timely, relevant, actionable and comprehensive health surveillance information to promote, maintain, and enhance the health of military and military-associated populations.

AFHSB critical functions are:

  • Acquire, analyze, interpret, disseminate information, and recommend evidence-based policy
  • Develop, refine, and improve standardized health surveillance methods
  • Serve as the focal point for sharing health surveillance products expertise and information
  • Coordinate a global program of military-relevant infectious disease surveillance

Explore our health surveillance resources to learn how to utilize our data applications, systems and the ways our health information analysis supports worldwide disease surveillance and public health activities to improve the U.S. military's Force Health Protection (FHP) program.

More About Us

Medical Surveillance Monthly Report

Medical Surveillance Monthly Report MSMR Online SubscriptionThe Medical Surveillance Monthly Report (MSMR) is AFHSB's flagship publication. The monthly peer-reviewed journal provides evidence-based estimates of the incidence, distribution, impact, and trends of health-related conditions among service members. Additionally, the MSMR focuses one issue per year on the absolute and relative morbidity burden attributable to various illnesses and injuries among service members and beneficiaries.

 View Current Report  View Archived Reports

Launch Proposal Management Information SystemThe Proposal Management Information Solution (ProMIS) program is a web-based application used to track surveillance projects funded by AFHSB's Global Emerging Infections Surveillance (GEIS) Operations section. Investigators in the GEIS partner network submit proposals for funding through the system, and GEIS Operations monitors the progress of those projects.

Launch ProMIS

DMED ButtonThe Defense Medical Epidemiology Database (DMED) provides worldwide access to de-identified data contained in the Defense Medical Surveillance System (DMSS). Through this user-friendly interface, authorized users can create customized queries of disease and injury rates in active duty populations.

Launch DMED

You also may be interested in...

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

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

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

Mid-season influenza vaccine effectiveness estimates for the 2016 – 2017 influenza season

Infographic
8/28/2017
The Department of Defense (DoD) conducts year-round influenza surveillance for military healthcare beneficiaries and select civilian populations. Data from routine respiratory surveillance are used to estimate mid-season influenza vaccine effectiveness (VE) and these findings are shared at the Food and Drug Administration’s advisory committee meeting on U.S. influenza vaccine strain selection. DoD VE estimates from the Defense Health Agency’s Armed Forces Health Surveillance Branch (AFHSB) and Naval Health Research Center (NHRC) are presented in this report. Findings •	For all influenza types: VE was 42% as found by AFHSB-Air Force Satellite Cell, similar to NHRC’s overall VE of 45% •	Influenza A (H3N2) VE was 42% by AFHSB-AF estimation and VE was 46% as estimated by NHRC •	VE for Influenza B was slightly higher at 53% as estimated by AFHSB-AF •	AFHSB analysis found that VE against influenza A was 3% and VE against influenza A (H3N2) was 33% Table showing the mid-season influenza effectiveness estimates, 2016 –2017 displays. The mid-season influenza VE estimates indicated that vaccination reduced the odds of medically attended influenza infection by approximately 45% among DoD dependents and civilians. Access the full report in MSMR Vol. 24 No. 8 August 2017 at Health.mil/MSMR  Three photos display on this infographic: 1.	An elderly woman receiving a flu show from a female service member 2.	Female service member receives a flu shot 3.	Male physician hold a flu shot

This infographic documents Department of Defense mid-season influenza vaccine effectiveness estimates from the Defense Health Agency’s Armed Forces Health Surveillance Branch and Naval Health Research Center for the 2016 – 2017 influenza season.

Recommended Content:

Armed Forces Health Surveillance Branch | Influenza Summary and Reports

Tdap vaccination coverage during pregnancy, active component service women, 2006 – 2014

Infographic
8/14/2017
Pertussis, commonly known as “whooping cough,” is a vaccine-preventable illness more common and more severe in children than in adults. Infections during the first few months of life can be particularly severe, with almost all deaths from pertussis occurring in infants less than 6 months of age. A vaccinated mother’s antibodies against pertussis protect the baby during pregnancy until it can receive the vaccine at two months of age. Approximately 400 probable and 50 confirmed cases occur annually among service members and other adult beneficiaries of the Military Health System. In 2012, the Advisory Committee on Immunization Practices recommended Tdap for every pregnancy to reduce the burden of pertussis in infants. This surveillance study assessed Tdap vaccination coverage among pregnant service women during 2006 through 2014. FINDINGS: •	There were records of a total of 137,133 live birth deliveries to service women •	Only 1%  – 3% of service women received a Tdap vaccine during pregnancy from 2006  – 2011 •	Tdap vaccination coverage increased substantially  – 8% in 2012 to 54% in 2014 •	Navy women had the highest  annual proportion of vaccine coverage at 65% in 2014 •	First deliveries had the highest vaccination coverage at 57% in 2014 •	Fourth or subsequent deliveries had the lowest coverage at 41% in 2014 More education and attention by military physicians and pregnant service women about the benefits of Tdap vaccination are needed to bring coverage closer to 100%. Learn more in MSMR Vol. 22 No. 5 May 2015 at Health.mil/MSMR  Images on graphic: •	Baby icon to depict live birth deliveries •	Pie charts showing the findings in visual form •	Line graph showing the percent vaccinated among Navy, Marine Corps, Army, Air Force and Coast Guard The line graph shows the annual percentages of active component service women with a live birth delivery who received a Tdap vaccine during pregnancy, by year of delivery and service, 2011– 2014.

This infographic documents findings from a surveillance study that assessed Tdap vaccination coverage among pregnant service women during 2006 through 2014.

Recommended Content:

Armed Forces Health Surveillance Branch | Tetanus-Diphtheria-Pertussis | Women's Health

Surveillance Snapshot Norovirus Outbreaks among Military Forces, 2008 – 2016

Infographic
8/8/2017
Norovirus (NoV) is a highly contagious virus and a leading cause of gastroenteritis among military populations. There are many different strains of norovirus and immunity to one strain does not protect against another. Why Norovirus Strains Are Leading Causes of Acute Gastrointestinal Illness Outbreaks •	Multiple transmission routes include person-to-person direct contact, contaminated food and water, clothes or utensils that carry infection  •	Resistant to extreme temperatures and standard cleaning solutions •	No lasting immunity This report summarizes the NoV outbreaks in military forces in both garrison and deployed settings during 2008 – 2016. Table from this MSMR article displays and includes month/year of outbreak onset, setting, estimated attack rate (EAR)/ no. of NoV cases, and description. Access the report in MSMR Vol. 24 No.7 July 2017 at Health.mil/MSMR

Norovirus (NoV) is a highly contagious virus and a leading cause of gastroenteritis among military populations. There are many different strains of norovirus and immunity to one strain does not protect against another. This report summarizes the NoV outbreaks in military forces in both garrison and deployed settings during 2008 – 2016.

Recommended Content:

Armed Forces Health Surveillance Branch

Body Site of Skin and Soft Tissue Infections Active Component U.S. Armed Forces, 2013 – 2016

Infographic
7/24/2017
Did you know…? The arm, finger, leg, and toe were the most commonly affected body sites for cases of cellulitis/abscess and carbuncle/furuncle skin and soft tissue infections (SSTIs). The total number of inpatient and outpatient diagnoses for which the body location was specified was 142,214.

This report documents body sites affected by skin and soft tissue infections among active component, U.S. Armed Forces, 2013 – 2016.

Recommended Content:

Armed Forces Health Surveillance Branch

Skin and Soft Tissue Infections Active Component, U.S. Armed Forces, 2013 – 2016

Infographic
7/24/2017
Skin and soft tissue infections (SSTIs) are common in both military and non-military populations. Due to the nature of the military training environment, risk factors associated with SSTIs such as crowding, infrequent hand washing/ bathing, skin abrasions and trauma, and environmental contamination favor the acquisition and transmission of Staphylococcus spp. and Streptococcus spp. These pathogens are the major causative agents of SSTIs and lead to outbreaks of disease.

This report documents the incident cases of skin and soft tissue infections among active component U.S. military member during a 4-year surveillance period.

Recommended Content:

Armed Forces Health Surveillance Branch

Age-Period-Cohort Analysis of Colorectal Cancer Service Members Aged 20-59 Years Active Component U.S. Armed Forces, 1997 – 2016

Infographic
7/24/2017
Among cancers affecting both men and women, colorectal cancer is the third most common cancer and the second leading cause of death from cancer in the U.S. This report documents the time-varying elements of age, period, and birth cohort effects in the epidemiology of colorectal cancer among members of the active component.

This report documents the time-varying elements of age, period, and birth cohort effects in the epidemiology of colorectal cancer among members of the active component.

Recommended Content:

Armed Forces Health Surveillance Branch

Heat Illness Prevention: Use the Buddy System to Stay Cool and Safe

Infographic
7/20/2017
Did you know that exposure to heat and heat-related illnesses can cause a spectrum of disorders that includes minor conditions such as heat cramps to the more severe condition known as heat stroke? To protect U.S. service members, it is important for commanders, small unit leaders, training cadre, and supporting medical personnel to encourage the use of the buddy system to prevent these conditions – especially during training at recruit centers and installations. The buddy system pairs service members to stay motivated and hold each other accountable of their physical limits during training exercises. Protecting Service Members from Heat Illness •	Do not exercise when sick. Intense workouts can increase susceptibility to illness, including infection and diarrhea. •	Dump heat by taking a cold shower or ice slush immersion before a workout. •	Wear a cooling vest to keep skin cool and dry in the heat. Learn more about heat illness prevention at Health.mil/AFHSB Stay cool. Stay hydrated. Stay informed. #BeatTheHeat Source: Dr. Francis G. O’Connor, a professor and chair of Military and Emergency Medicine and associate director for the Consortium on Health and Military Performance at the Uniformed Services University of the Health Sciences.

This infographic documents the use of the buddy system to prevent heat-related illnesses.

Recommended Content:

Armed Forces Health Surveillance Branch | Summer Safety

Preventable and Treatable: Know the Signs of Heat Exhaustion

Infographic
7/20/2017
Warmer temperatures and strenuous physical activity put service members at higher risk of heat illnesses. It is important for commanders, small unit leaders, training cadre, and supporting medical personnel – particularly at recruit training centers and installations with large combat troop populations – to educate service members about the risks early signs and symptoms, and preventive treatment measures related to heat illnesses. Signs of Dehydration •	Light-headed/ Dizzy/ Headache •	Fever •	Lack of sweat •	Dark yellow urine •	Thirst Under the signs of dehydration section an image of a man experiencing these early signs and symptoms of heat illnesses. Staying Hydrated •	Hydrate with water and eat rich foods with water before, during, and after exercise. •	Decrease the intensity of the physical activity. Under the staying hydrated section graphics of a water bottle, glass of water, runner and cyclist appear. Signs of Heat Stroke •	Fatigue •	Combative •	Confused •	Muscle cramps Under the signs of heat stroke section, a man experiencing these symptoms of heat stroke displays. Effective Ways to Cool Off a Heat Stroke Victim •	Make an “ice burrito” by wrapping the victim in cold sheets, ice packs, and wet towels •	Immerse victim in cold water Images of ice and a man under a shower appear.  Ways to Treat Heat Exhaustion •	Use a rectal thermostat to read core body temperatures to diagnose and treat heat stroke •	Provide IV fluid replacement •	Spray with cool mist Image of rectal thermostat, man in a hospital bed with an IV and a man being sprayed with cool mist appear. Learn more about heat illness by reading MSMR Vol. 24 No. 3 – March 2017 at Health.mil/MSMR Source: Dr. Francis FG. O’Connor, a professor and chair of Military and Emergency Medicine and associate director for the Consortium on Health and Military Performance at the Uniformed Services University of the Health Sciences.

This infographic documents the risks, early signs and symptoms, and preventive treatment measures related to heat illnesses.

Recommended Content:

Armed Forces Health Surveillance Branch | Summer Safety

Most frequent diagnoses: Hospitalizations, Males, Active Component, U.S. Armed Forces

Infographic
7/11/2017
Did you know…? In 2016, alcohol dependence (n= 1,656) was the second most frequent diagnosis among males discharged from the hospital. The most frequent diagnosis was adjustment disorder (n=3,768). The third most frequent diagnosis was major depressive disorder [single episode, unspecified] (n= 1,308), followed by acute appendicitis (n=1,091) and post-traumatic stress disorder (PTSD) (n=832). Two charts display on infographic: First chart is the ‘Most frequent diagnoses during hospitalizations, males, active component, U.S. Armed Forces 2016. Information below: Mental disorders (ICD-10: F01-F99) – 12,571 •	Adjustment disorders: 3,768 / 30.0 % of all hospitalizations of males •	Alcohol dependence: 1,656 / 12.2 % of all hospitalizations of males •	Major depressive disorder, single episode, unspecified: 1,308 / 10.4% •	Post-traumatic stress disorder (PTSD): 832/ 6.6% •	Major depressive disorder, recurrent severe without psychotic features: 638/ 5.1% Second chart is the ‘Most frequent diagnoses during ambulatory visits for diagnoses of mental disorders, males, active component, U.S. Armed Forces, 2016 Mental disorders (ICD-10: F01-F99) 1,452,655 •	Adjustment disorder: 282,610 / 19.5% of all ambulatory visits for males •	Post-traumatic stress disorder (PTSD): 238,061/16.4% of all ambulatory visits for males •	Alcohol dependence: 219,260/ 15.1% of all ambulatory visits for males •	Anxiety disorder, unspecified: 98,861/ 6.8%  of all ambulatory visits for males •	Alcohol abuse: 69,581 / 4.8% all ambulatory visits for males Learn more about healthcare burdens attributable to various diseases and injuries by reading April 2017 – Volume 24/4 of the Medical Surveillance Monthly Report (MSMR) at Health.mil/MSMRArchives. #MensHealth Graphic shows soldier’s commitment to sobriety.

This infographic documents alcohol dependence hospitalizations and ambulatory visits among males, active component, U.S. Armed Forces in 2016.

Recommended Content:

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

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.