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Armed Forces Communicable Disease Weekly Report 1 Summary of Communicable Reportable Events by Service Army Navy Air Force Coast Guard 7 Days 28 Days 7 Days 28 Days 7 Days 28 Days 7 Days 28 Days Enteric Amebiasis. 1... 1.. Campylobacter 3 18 1 4. 2. 1 Cryptosporidiosis. 1...... Giardiasis. 2... 1. 1 Norovirus. 7... 4.. Salmonellosis 1 3. 1. 10. 1 Shiga toxin-producing E. coli. 1...... Shigellosis. 1. 1.... Vaccine-preventable Hepatitis A... 1.... Pertussis.. 2 3. 1.. Zoonotic Rabies *........ Tropical Malaria. 1... 1.. Other Coccidioidomycosis... 1... 1 Syphilis 2 8. 7. 1.. Tuberculosis.. 1 1.... * Rabies case listed on previous report determined to be false Only those diseases with at least 1 reported event are displayed. Service displayed is of the affected individual's service or the sponsor's service.

Armed Forces Communicable Disease Weekly Report 2 Amebiasis 7 days Campylobacte r 28 Enteric Shiga Cryptosporidi Giardiasis Norovirus Salmonellosis toxin-produci Shigellosis osis ng E. coli days AF-TC-332nd EXPMED-AL JABBER, KU. 1.............. IA-UNITED ARAB EMIRATES, AE........... 9.... AF-TH-379th EMDS-AL UDEID, QA........... 1.... AHC BAUMHOLDER, GM... 1......... 1.. AHC KAISERSLAUTERN, GM........... 1.... AF-C-86th MED GRP-RAMSTEIN, GM... 1. 1... 2...... AHC WIESBADEN, GM......... 1...... AHC PATCH BKS-STUTTGART, GM......... 1...... AHC VILSECK, GM......... 2...... AF-C-52nd MED GRP-SPANGDAHLEM, GM......... 1...... LANDSTUHL REGIONAL MEDCEN, GM......... 1...... NH ROTA, SP... 2............ FAIRFAX HEALTH CENTER, VA. 1.............. FT BELVOIR COMMUNITY HOSP-FBCH, VA... 1............ AHC ANDREW RADER-MYER-HENDERSN,....... 1........ VA AMC WOMACK-BRAGG, NC.. 2 10....... 1.... NH JACKSONVILLE, FL.. 1 1....... 1.... NH PENSACOLA, FL... 1............ AF-H-96th MED GRP-EGLIN, FL... 1............ ACH BLANCHFIELD-CAMPBELL, KY.......... 1 1.... JAMES A LOVELL FHCC, IL... 1........... 1 AMC DARNALL-HOOD, TX... 3..... 2...... AMC WILLIAM BEAUMONT-BLISS, TX... 1..... 1...... ACH EVANS-CARSON, CO....... 1........ AF-C-21st MED GRP-PETERSON, CO....... 1........ AF-H-366th MED GRP-MT HOME, ID....... 1........ AHC-CAMP RED CLOUD-UIJONGBU, KS.. 1 1............ AMC TRIPLER-SHAFTER, HI... 1....... 1.... NH GUAM-AGANA, GU............... 1

Armed Forces Communicable Disease Weekly Report 3 Vaccine-preventable Hepatitis A Pertussis 7 days 28 days WALTER REED NATL MIL MED CNTR, MD... 1 NBHC NAVSTA SEWELLS, VA. 1.. NH BREMERTON, WA.. 2 3

Armed Forces Communicable Disease Weekly Report 4 Zoonotic Rabies 7 days 28 days NH OKINAWA, JA. 1* * Rabies case determined to be false

Armed Forces Communicable Disease Weekly Report 5 Tropical Other Malaria Coccidioidomyc osis Syphilis Tuberculosis 7 days 28 days AHC GRAFENWOEHR, GM. 1...... WALTER REED NATL MIL MED CNTR,..... 1.. MD NMC PORTSMOUTH, VA..... 2 1 1 ACH BAYNE-JONES-POLK, LA..... 1.. AF-C-19th MED GRP-LITTLE ROCK, AR..... 1.. AMC DARNALL-HOOD, TX..... 1.. AF-C-359 MDG-JBSA-RANDOLPH, TX..... 1.. AMC BAMC-FSH, TX..... 2.. AMC WILLIAM BEAUMONT-BLISS, TX..... 1.. AF-ASU-10th MED GRP-ACADEMY, CO. 1...... NH LEMOORE, CA... 2. 1.. ACH BRIAN ALLGOOD-SEOUL, KS.... 1 1.. AMC TRIPLER-SHAFTER, HI.... 1 4..

Armed Forces Communicable Disease Weekly Report REPORT DESCRIPTION PURPOSE/DESCRIPTION This report provides a weekly snapshot of communicable diseases for which reporting is mandated by the Armed Forces Reportable Medical Events Guidelines & Case Definitions (revised March 2012). Its purpose is to facilitate geographic and cross-service comparisons of communicable disease trends across the Armed Forces, particularly: a. at Medical Treatment Facilities (MTFs) that serve beneficiaries of multiple Services; and, b. in regions served by multiple MTFs belonging to different Services. FREQUENCY The Armed Forces Communicable Disease Weekly Report is released each week by Armed Forces Health Surveillance and is posted on the AFHS website at: http://www.health.mil/military-health-topics/health-readiness/armed-forces-health-surveillance-branch/ Reports-and-Publications DATA SOURCE Reportable events using data collected from the Services (Army, Navy, Air Force, Marine Corps, and Coast Guard) electronic Disease Reporting System internet (DRSi) which feeds specific variables into AFHS s Defense Medical Surveillance System (DMSS). CASE DEFINITIONS & CAVEATS 1.Case Inclusion: Reportable events as per the Armed Forces Reportable Medical Event Guidelines & Case Definitions (March 2012). For this report, communicable diseases are grouped into 6 mutually exclusive categories: enteric, vector-borne, zoonotic, tropical, vaccine-preventable, and other. Enteric: Amebiasis, Botulism, Campylobacter infection, Cholera, Cryptosporidiosis, Cyclospora infection, Shiga-toxin producing E. Coli, Giardiasis, Norovirus, Salmonellosis, Shigellosis Vector-borne: Anaplasmosis/Ehrlichiosis, Arboviral Encephalitis, Lyme Disease, Plague, Rocky Mountain Spotted Fever, Typhus Fever Zoonotic: Anthrax, Brucellosis, Hantavirus disease, Leptospirosis, Listeriosis, Q Fever, Rabies, Trichinosis, Tularemia Vaccine-preventable: Diphtheria, invasive Haemophilis influenza, Hepatitis A, Measles, Meningococcal Disease, Mumps, Pertussis, Poliomyelitis, Rubella, Smallpox, Tetanus, Typhoid Fever, Varicella (active duty only), Yellow Fever Tropical: Chikungunya Fever, Dengue Fever, Filariasis, Hemorrhagic Fever, Leishmaniasis, Leprosy, Malaria, Relapsing Fever, Rift Valley Fever, Schistosomiasis, Trypanosomiasis Other: Coccidioidomycosis, Legionellosis, Rheumatic Fever, Severe Acute Respiratory Syndrome, invasive Group A Streptococcus, Syphillis, Toxic Shock Syndrome, Tuberculosis 2. Exclusion Criteria: Armed Forces reportable medical events excluded from this report include influenza (due to detailed coverage in other reports), prevalent sexually transmitted infections (chlamydia and gonorrhea), parenterally transmitted infections (hepatitis B and C), heat/cold weather injuries, vaccine adverse events and generalized outbreaks. Report Appendix

7 3. Case Confirmation: Cases included in this report are confirmed, suspect, probable, or pending, thus providing visibility of potential outbreaks while laboratory confirmation is pending. The reporting of cases definitions of confirmed, suspect or probable are available in the Armed Forces Reportable Medical Event Guidelines (March 2012). 4. Surveillance Period: The surveillance periods for this summary include the 7-day and 28-day windows preceding the date of each weekly report; events are categorized by the date that they occurred, rather than the date they were reported. 5. Population: The population under surveillance includes all Armed Forces beneficiaries seeking medical care at MTFs. The Service affiliation of the sponsor is considered to be the Service of the affected individual for the purposes of this report. Individuals without a designated Service are not included in this report. 6. Definition/Clarifications: Counts represent unique individuals from any data source. Cases counted in the 7-day column are included the 28-day column. The Summary by Service table provides counts of communicable disease events by service of the sponsor. Only those diseases with events are displayed. The Cases by MTF tables provide counts of communicable disease events by the geographic location and name of the reporting MTF. The Cases by MTF tables are displayed by precedence of the MTFs ZIP codes thereby providing a regional/geographical arrangement to the MTFs displayed. The only identifiable data included in this report are the locations of the reporting MTFs. When needed, information sharing for public health investigations is provided through secure channels to public health personnel identified by agreement among the Services Public Health hub representatives. The Armed Forces Reportable Medical Events Guidelines & Case Definitions (revised March 2012), are available on-line at: http://www.health.mil/military-health-topics/health-readiness/armed-forces-health-surveillance-branch/ Reports-and-Publications Report Appendix