jueves, 1 de febrero de 2018

Cutting-edge interactive disease surveillance maps support Combatant Commands | Health.mil

Cutting-edge interactive disease surveillance maps support Combatant Commands

This image shows Middle East respiratory syndrome coronavirus particle envelope proteins immunolabeled with rabbit HCoV-EMC/2012 primary antibody and goat anti-rabbit 10-nanometer gold particles. (National Institute of Allergy and Infectious Disease photo)

As an organization that receives countless streams of data and information, the staff at the Armed Forces Health Surveillance Branch (AFHSB) knows quite a bit about the global threats posed by known and emerging infectious diseases of military relevance. Today, AFHSB’sIntegrated Biosurveillance (IB) Section is taking revolutionary steps to produce even more relevant, user-driven health surveillance products that enable its customers, especially the U.S. Combatant Commands, to focus on what they need to know to provide a medically ready military force in peace and wartime.

Interactive surveillance maps created by the Armed Forces Health Surveillance Branch show the global threats posed by endemic and emerging infectious diseases that help Combatant Commands provide a medically ready military force.

AFHSB recently released new, web-based interactive disease surveillance maps that allow Combatant Commanders to zoom to an area of interest, click on individual points, and extract exactly what they need to know about a particular disease event. The accompanying text can contain relevant links, sources, and images in their native, high resolution format. With the click of a button, an analyst can instantly upload data from his or her terminal in Washington, D.C., for a decision-maker stationed in Germany, with information that is specifically tailored for that organization’s needs.

As part of the Defense Health Agency’s role as a combat support agency, “it is vital for AFHSB to provide timely health surveillance information to the Combatant Commands with the appropriate flexibility and agility required to support Force Health Protection decisions,” said Mr. Juan Ubiera, chief of the IB section. “These dynamic products provide Department of Defense leaders with a large amount of information in a manner that supports both rapid operational decisions and a deeper understanding of what's going on.”

AFHSB’s latest product in this gallery is The Avian Influenza Epidemic. This product leverages data from near real-time disease reporting systems along with geocoding capabilities to present an emerging picture of the avian influenza A (AI) virus subtypes currently affecting avian populations globally. An overlay of the global flight paths of the wild birds that carry AI viruses enables the viewer to connect outbreaks of particular AI subtypes to the migratory routes that may have facilitated their introduction. This product also depicts human cases of infection with novel and variant influenza A viruses, conveying Defense Department relevance of these occurrences through an in-house designed infographic, all within a dynamic environment.

This new release joins other products in the IB interactive gallery such as The MERS-CoV Epidemic, an interactive surveillance product that guides the user through the Middle East respiratory syndrome coronavirus (MERS-CoV) epidemic in a new and captivating format. Users will also find surveillance products on the 2014 Ebola outbreak in West Africa and the emergence of the Chikungunya virus in the Americas.

To create these visualizations, AFHSB is implementing leading-edge, commercial-off-the-shelf tools designed by Esri, a geospatial service provider. Our analysts are able to standardize and edit data directly from their desktops; with a few keystrokes, the data are sent to the cloud, instantly updating our products with the latest information. This represents a major leap forward from AFHSB’s current email-based distribution system.

“This type of product and [the] attractive and easy to read visuals are very useful for the education of leadership and others in our division on the importance of avian influenza,” Dr. Jennifer Steele, the Infectious Disease Subject Matter Expert for U.S. European Command after previewing The Avian Influenza Epidemic product. “The maps and graphics help explain why [avian influenza] elsewhere in the world and in other species is important from a human health and operational perspective.”

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.

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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 ...

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Cold weather injuries during deployments, July 2012 – June 2017

Infographic

1/18/2018

During the 5-year surveillance period, 105 cold weather injuries were diagnosed and treated in service members deployed outside the U.S. of these, 39 (37%) were immersion injuries; 33 (31%) were frostbite; 16 (15%) were hypothermia; and 17 (16%) were “unspecified” cold weather injuries. Pie chart for cold weather injuries during deployments displays depicting the information above. Number of cold weather injuries bar chart: Of all 105 cold weather injuries during the surveillance period, 68% occurred during the first two cold seasons. Bar chart shows the number of cold weather injuries by year: • 2012-2013 cold season had 35 cold weather injuries • 2013-2014 cold season had 100 cold weather injuries • 2014 -2015 cold season had 13 cold weather injuries • 2015-2016 cold season had 11 cold weather injuries • 2016 – 2017 had 10 cold weather injuries Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR #ColdReadiness

This infographic documents cold weather injuries during deployments for the July 2012 – June 2017 cold seasons.

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Five cold seasons: July 2012-June 2017, Active reserve component service members who were diagnosed with a cold weather injury

Infographic

1/18/2018

Did you know during the 5-year surveillance period, the 2,717 service members who were affected by any cold weather injury included 2,307 from the active component and 410 from the reserve component. Overall, Army members comprised the majority (61.6%) of all cold injuries affecting active and reserve component service members. Of all affected reserve component members, 71.7% (n=294) were members of the Army. Cold weather injuries During Basic Training Of all active component service members who were diagnosed with a cold weather injury (n= 2,307), 230 (10.0% of the total) were affected during basic training. Additionally, during the surveillance period, 60 service members who were diagnosed with cold weather injuries during basic training (2.6% of the total) were hospitalized, and most (93.3%) of the hospitalized cases were members of either the Army (n=32) or Marine Corps (n=24). Cold weather injuries during basic training pie chart: The Army (n=122) and Marine Corps (n=99) comprised 96.1% of all basic trainees who were diagnosed with a cold weather injury. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR #ColdReadiness Image of service member tracking in the snow is the infographic background graphic.

This infographic provides information on active and reserve component service members who were affected by any cold weather injury during the July 2012 – June 2017 cold seasons.

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Update: Cold Weather Injuries, Active and reserve components, U.S. Armed Forces, July 2012 – June 2017

Infographic

1/18/2018

The total number of cold weather injuries among active component service members in 2016 – 2017 cold season was the lowest since 1999. 2016 – 2017 versus the previous four cold seasons • A total of 387 members of the active (n=328) and reserve (n=59) components had at least one medical encounter with a primary diagnosis of cold weather injury. • Rates tended to be higher among service members who were in the youngest age groups, female, non-Hispanic black, or in the Army. • Cold weather injuries associated with overseas deployments have fallen precipitously in the past three cold seasons due to changes in military operations in Iraq and Afghanistan. There were just 10 cases in the 2016 – 2017 season. • Frostbite was the most common type of cold weather injury. Bar chart displays numbers of service members who had a cold injury (one per person per year), by service and cold season, active and reserve components, U.S. Armed Forces, July 2012 – June 2017. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR #ColdReadiness

This infographic provides an update for cold weather injuries among active and reserve components, U.S. Armed Forces, July 2012 – June 2017.

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Incidence rates of cold weather injuries: Non-Hispanic black service members, five cold weather seasons, July 2012 – June 2017

Infographic

1/18/2018

Did you know for all of the services, overall rates of cold weather injuries were higher among non-Hispanic black service members than among those of other race/ethnicity groups? • Rates of cold weather injuries among non-Hispanic black service members were two-times as high as those among non-Hispanic white or other race/ethnicity groups. • The rates of frostbite among non-Hispanic black service members were three-times those of the other race/ethnicity groups. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to www.Health.mil/MSMR #ColdReadiness Image of non-Hispanic black service member in the snow displays.

This infographic documents incidence rates of cold weather injuries among non-Hispanic black service members during the July 2012 – June 2017 cold weather seasons.

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Percentages of each Service’s cold weather injuries, 2016 – 2017 cold season

Infographic

1/18/2018

Did you know when all cold weather injuries were considered, not just the numbers of individuals affected, frostbite was the most common type of cold weather injury, comprising 53% (n=177) of all cold weather injuries among active component service members in 2016 – 2017? • In the Air Force and Army respectively, 60.9% and 58.9% of all cold weather injuries were frostbite, whereas the proportions in the Marine Corps (42.9%) and Navy (25.0%) were much lower. • For the Navy, the 2016-2017 number and rate of frostbite injuries in active component service members were the lowest of the past 5 years. • The number of immersion injury cases in 2016 – 2017 in the Marine Corps was the lowest of the 5-year surveillance period. Bar graph: Percentages of each Service’s cold weather injuries that were frostbite, 2016 – 2017 cold season • Air Force (60.9%) • Army (58.9%) • Marine Corps (42.9%) • Navy (25.0%) For all active component service members during the 2016 – 2017, the proportions of non-frostbite cold weather injuries were as follows: • 19.5% hypothermia • 17.7% immersion injuries • 9.9% Other & unspecified cold weather injuries Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR #ColdReadiness

This infographic documents the percentages of each service’s cold weather injuries, U.S. Armed Forces for the 2016 – 2017 cold season.

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Cold weather injuries by military location, U.S. Armed Forces, July 2012 – June 2017

Infographic

1/18/2018

From July 2016 through June 2017, a total of 24 military locations had at least 30 incident cold weather injuries (one per person, per year) among active and reserve component service members. The locations with the highest 5-year counts of incident injuries were: • Fort Wainwright, AK (175) • Bavaria (Grafenwoehr/Vilseck), Germany (110) • Marine Corps Recruit Depot Parris Island/ Beaufort, SC (102) • Fort Benning, GA (99) • Fort Carson, CO (88) • Marine Corps Base Quantico, VA (86) • Fort Bragg, NC (78) Map displays the information above. 2016 – 2017 cold season During the 2016 – 2017 cold season, the numbers of incident cases of cold weather injuries were higher than the counts for the previous 2015-2016 cold season at seven of the 24 locations. The most noteworthy increase was found at the Army’s Fort Wainwright, where there were 48 total cases diagnosed in 2016 – 2017 , compared to just 16 during the 2015 – 2016 cold season. Bar chart shows annual number of cold weather injuries (cold season 2016 – 2017) and median number of cold weather injuries (cold seasons 2012 – 2016) at military locations with at least 30 cold weather injuries during the surveillance period, active component, U.S. Armed Forces, July 2012 – June 2017. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR Image in background includes service members out in the snow.

This infographic documents cold weather injuries by military location among U.S. Armed Forces for the July 2012 – June 2017 cold seasons.

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2016 – 2017 Cold Season, Cold Weather Injuries, Active and Reserve Components, U.S. Armed Forces

Infographic

1/18/2018

or the 2016 – 2017 cold season, the number of active component service members with cold weather injuries was the lowest of the last 18 cold seasons since the Medical Surveillance Monthly Report (MSMR) began reporting such data in the 1999-2000 cold season. Findings • The overall incidence rate for cold weather injuries for all active component service members in 2016 – 2017 was 15% lower than the rate for the 2015 – 2016 cold season. • The 2016 – 2017 rate was the lowest of the entire five year surveillance period. • In the 2016 – 2017 cold season, the Army’s incidence rate of 41.0 per 100,000 person-years for active component soldiers was 18% lower than the Army’s lowest previous rate in 2012 – 2013. • In the Navy, Air Force, and Marine Corps, the active component rate for 2016 – 2017 was only slightly higher than their lowest rates during the 2012—2017 surveillance period. Pie chart 1 (left side of infographic): Cold Weather Injuries, By Service, Active Component, 2016 – 2017 data • Army 57.6% (n=189) • Marine Corps 21.0% (n=69) • Air Force - 13.1% (n=43) • Navy – 8.2% (n=27) • The sharp decline in the Army rate during the 2016 – 2017 cold season drove the overall decline for all services combined. Pie chart 2 (right side of infographic): Percentage distribution by service of cold weather injuries among reserve component service members during cold season 2016 – 2017 • Army 72.9% (n=43) • Marine Corps 13.5% (n=8) • Air Force 13.5% (n=8) • Navy (n= 0) • For the 2016 – 2017 cold season, the overall rate of cold weather injuries for the reserve component and the rates for each of the services except the Air Force were lower than in any of the previous four seasons. Access the full report in the October 2017 MSMR (Vol. 24, No. 10). Go to: www.Health.mil/MSMR

This infographic documents cold weather injuries among the active and reserve components of the U.S. Armed Forces for the 2016 – 2017 cold season.

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Guarding the health of service members

Article

1/9/2018

James Coker focuses on protecting service member health every day as deputy chief of the Public Health Division at the Defense Health Agency. Here he is exploring a Mount Denali glacier “off the clock” while stationed in Alaska as a public health flight commander at Elmendorf Air Force Base. (Courtesy photo)

The vital role of the Public Health Division

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Global Influenza Summary: January 7, 2018

Report

1/7/2018

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Complications and Care Related to Pregnancy, Labor and Delivery among Active Component Service Women U.S. Armed Forces, 2012 – 2016

Infographic

1/5/2018

Maternal complications and delivery outcomes are important components of the overall health and well-being of reproductive-age service women. This analysis provides an update on pregnancy complications and characterizes the counts, rates, and trends of several specific pregnancy complications. FINDINGS • 55,601 U.S. service women whose pregnancies resulted in 63,879 live births had 657,060 medical encounters • For all age groups, percentages of live births affected by preterm labor decreased, but during 2012 – 2016, the percentages of pregnant service members diagnosed with obesity increased. • The percentage of pregnant service members affected by gestational diabetes was more than twice as high for obese women, compared with non-obese women (12.4% vs. 5.5%). Bar graph shows the number of medical encounters with a primary (first-listed) diagnosis of any pregnancy-related complication or indication for care decreased each year between 2012 and 2016. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR Background image: New born being provided medical attention by nurse. Secondary image: babies of diverse background on a blanket.

This analysis provides an update on pregnancy complications and characterizes the counts, rates, and trends of several specific pregnancy complications.

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Contraception among active component service women, U.S. Armed Forces, 2012 – 2016

Infographic

1/5/2018

Because the majority of women serving in the Armed Forces are of childbearing age, and women’s military career opportunities have expanded into combat roles, contraceptive health care is an increasingly important public health issue. The lack of available, population-based descriptive information on contraceptive use among U.S. service women has generated questions and concerns about ready access to these medical products. This infographic summarizes the annual prevalence of permanent sterilization, as well as use of long – and short-acting reversible contraceptives (LARCs and SARCs, respectively), contraceptive counseling services, and use of emergency contraception from 2012 through 2016, among active component service women. FINDINGS • 2012 through 2016, Sterilization decreased from 4.2% to 3.6% LARC use increased from 17.2% to 21.7%; SARC use decreased from 38.5% to 30.4%. • Emergency contraception use increased from 0.4% to 1.9%. • Among deployed women, the average annual prevalence of permanent sterilization was 4.2%. • For deployed women, LARC use was 17.9% SARC use was 28.0%. • Emergency contraception use among deployed women was 0.4%. • 262,907 (76.2%) women of childbearing potential (WOCBP) used either a LARC or a SARC at some time during the surveillance period. • The vast majority of service women have utilized at least one form of contraception, and women are selecting LARCs in greater numbers with each passing year. The bar graph displays information on the annual prevalence of contraceptive utilization, by type, service women of child-bearing potential, active component, U.S. Armed Forces, 2012– 2016. Graphic displayed: contraception option. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR

This infographic summarizes the annual prevalence of permanent sterilization, as well as use of long – and short-acting reversible contraceptives (LARCs and SARCs, respectively), contraceptive counseling services, and use of emergency contraception from 2012 through 2016, among active component service women.

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Gestational diabetes among pregnant service members, active component, U.S. Armed Forces 2012 – 2016

Infographic

1/5/2018

Gestational diabetes is an abnormal increase in blood sugar levels that can adversely affect the health of both a pregnant woman and her baby. During 2012 – 2016, 4,017 (6.3%) of active component female service members who had live births were affected by gestational diabetes. Women aged 25-34 and 35-49 years had consistently higher annual prevalences of gestational diabetes than younger females. The percentage of pregnant service members affected by gestational diabetes was more than twice as high for obese women as for non-obese women (12.4% vs. 5.5%). The percentage of live births affected by gestational diabetes increased with increasing age and was highest among Asians/Pacific Islanders. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR

This infographic documents the incidence and prevalence of gestational diabetes pregnant service members, active component, U.S. Armed Forces, 2012 – 2016.

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