U.S. Army Medical Department journal最新文献

{"title":"Georgia's collaborative approach to expanding mosquito surveillance in response to Zika virus: a case study.","authors":"R Christopher Rustin,&nbsp;Deonte Martin,&nbsp;Varadan Sevilimedu,&nbsp;Sarbesh Pandeya,&nbsp;Haresh Rochani,&nbsp;Rosmarie Kelly","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Zika virus (ZIKV) was declared an international public health emergency by the World Health Organization on February 1, 2016. Due to the known and estimated range of the ZIKV mosquito vectors, southern and central US states faced increased risk of ZIKV transmission. With the state of Georgia hosting the world's busiest international airport, a climate that supports the ZIKV vectors, and limited surveillance (13 counties) and response capacity, the Department of Public Health (DPH) was challenged to respond and prevent ZIKV transmission. This case study describes and evaluates the state's surveillance capacity before and after the declaration of ZIKV as a public health emergency.</p><p><strong>Method: </strong>We analyzed surveillance data from the DPH to compare the geographical distribution of counties conducting surveillance, total number, and overall percentage of mosquito species trapped in 2015 to 2016. Counties conducting surveillance before and after the identification of the ZIKV risk were mapped using ArcMap 10.4.1. Using SAS (version 9.2) (SAS Institute, Inc, Cary, NC), we performed the independent 2 sample t test to test for differences in prevalence in both years, and a χ² analysis to test for differences between numbers of species across the 13 counties. In addition, weighted frequency counts of mosquitoes were used to test (χ²) an association between major mosquito vector species and 7 urban counties. Lastly, using data from 2012-2016, a time-trend analysis was conducted to evaluate temporal trends in species prevalence.</p><p><strong>Results: </strong>From 2015 to 2016, surveillance increased from 13 to 57 (338% increase) counties geographically dispersed across Georgia. A total of 76,052 mosquitoes were trapped and identified in 2015 compared to 144,731 (90.3% increase) in 2016. Significant differences between species (P<.001) and significant associations (P<.0001) between 7 urban counties and major mosquito vectors were found. Significant differences in prevalence were found between several species and year highlighting species-year temporal trends.</p><p><strong>Conclusions: </strong>The DPH collaborative response to ZIKV allowed a rapid increase in its surveillance footprint. Existing and new partnerships were developed with the military and local health departments to expand and share data. This additional surveillance data allowed DPH to make sound public health decisions regarding mosquito-borne disease risks and close gaps in data related to vector distribution.</p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 1-17","pages":"23-33"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35001385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of Chagas cardiomyopathy following infection in south central Texas.","authors":"Bryant J Webber,&nbsp;Edward J Wozniak,&nbsp;David Chang,&nbsp;Kelvin N Bush,&nbsp;Matthew C Wilson,&nbsp;James A Watts,&nbsp;Heather C Yun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Between 5 and 8 million people globally are infected with Trypanosoma cruzi, the causative parasitic agent of Chagas disease. The vast majority of incident infections originate in pockets of Latin America where domestic vector-borne transmission cycles are more common. Since 1955, when the first locally-acquired case was reported, fewer than 30 autochthonous cases have been documented in the United States. We describe the case of an 18-year-old US Air Force trainee, a native Texan with no travel history beyond the continental United States, who screened positive for T cruzi infection on blood donation and was subsequently found to have chronic Chagasic cardiomyopathy. This is the first documented case of Chagas disease in a US military trainee and one of the first known autochthonous cases of Chagasic cardiomyopathy in a Texas resident. Diagnostic, therapeutic, and military implications are discussed.</p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 1-17","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35001388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct detection of Leishmania from clinical samples.","authors":"John N Waitumbi,&nbsp;Joshua Bast,&nbsp;Nancy Nyakoe,&nbsp;Charles Magiri,&nbsp;Miguel Quintana,&nbsp;Ratree Takhampunya,&nbsp;Anthony L Schuster,&nbsp;Marshall T Van de Wyngaerde,&nbsp;James C McAvin,&nbsp;Russell E Coleman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The ability to rapidly and accurately diagnose leishmaniasis is a military priority. Testing was conducted to evaluate diagnostic sensitivity and specificity of field-expedient Leishmania genus and visceral Leishmania specific dual-fluorogenic, hydrolysis probe (TaqMan), polymerase chain reaction assays previously established for use in vector surveillance. Blood samples of patients with confirmed visceral leishmaniasis and controls without the disease from Baringo District, Kenya, were tested. Leishmania genus assay sensitivity was 100% (14/14) and specificity was 84% (16/19). Visceral Leishmania assay sensitivity was 93% (13/14) and specificity 80% (4/5). Cutaneous leishmaniasis (CL) skin scrapes of patients from Honduras were also evaluated. Leishmania genus assay sensitivity was 100% (10/10). Visceral Leishmania assay specificity was 100% (10/10) from cutaneous leishmaniasis samples; no fluorescence above background was reported. These results show promise in a rapid, sensitive, and specific method for Leishmania direct detection from clinical samples.</p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 1-17","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35001389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blast-associated traumatic brain injury in the military as a potential trigger for dementia and chronic traumatic encephalopathy.","authors":"James Hasoon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traumatic brain injuries (TBIs) resulting from blast exposures have significantly affected US military personnel throughout the world, particularly in Iraq and Afghanistan. From 2000-2016, more than 350,000 military service members were diagnosed with a TBI. Since the majority of blast-related TBIs are classified as mild with no definitive findings on physical examination or diagnostic studies, it is difficult to accurately diagnose individuals inflicted with such injuries. There are likely far more mild TBIs that remain undiagnosed in the military. Traumatic brain injury is a serious public health concern since it can lead to long-term neuropsychiatric changes such as posttraumatic stress disorder and various forms of dementia. Blast-related TBI has also been linked with neuropsychiatric dysfunction that is commonly seen in athletes that have suffered chronic traumatic encephalopathy. Further research is needed to aid in prevention, diagnostic studies, and care of military service members and veterans who have suffered a TBI.</p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 1-17","pages":"102-105"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35002851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service Animals: A New Legal Dimension Within the US Military.","authors":"Joseph B Topinka,&nbsp;Jack Nichols,&nbsp;Matthew Brooks","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"108-11"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34734254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Tick-borne Rickettsia and Ehrlichia at Joint Base Langley-Eustis, Fort Eustis, Virginia.","authors":"Melissa K Miller,&nbsp;Ju Jiang,&nbsp;Melissa Truong,&nbsp;Tamasin Yarina,&nbsp;Holly Evans,&nbsp;Timothy P Christensen,&nbsp;Allen L Richards","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Four species of ticks known to parasitize humans (Amblyomma americanum (lone star tick), Dermacentor variabilis (American dog tick), Amblyomma maculatum (Gulf Coast tick), and Ixodes scapularis (black-legged tick)) were collected at Joint Base Langley-Eustis, Fort Eustis, Virginia during 2009. These ticks were tested individually (adults and nymphs) and in pools of 15 (larvae) for pathogens of public health importance within the genera: Rickettsia, Borrelia, and Ehrlichia, by quantitative real-time polymerase chain reaction (qPCR) assays and, where appropriate, multilocus sequence typing (MLST). Of the 340 A americanum ticks tested, a minimum of 65 (19%), 4 (1%), 4 (1%), and one (<1%) were positive for Rickettsia amblyommii, B lonestari, E ewingii and E chaffeensis, respectively. One of 2 (50%) A maculatum ticks collected was found to be positive for R parkeri by MLST and qPCR analyses. All 33 D variabilis ticks were negative for evidence of rickettsial infections. Likewise, no pathogenic organisms were detected from the single Ixodes scapularis tick collected. Pathogenic rickettsiae and ehrlichiae are likely emerging and cause under-recognized diseases, which threaten people who live, work, train, or otherwise engage in outdoor activities at, or in the vicinity of, Fort Eustis, Virginia. </p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"22-8"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34722629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss and Tinnitus in Military Personnel with Deployment-Related Mild Traumatic Brain Injury.","authors":"Stephanie J Karch,&nbsp;José E Capó-Aponte,&nbsp;D Scott McIlwain,&nbsp;Michael Lo,&nbsp;Sridhar Krishnamurti,&nbsp;Roger N Staton,&nbsp;Kendra Jorgensen-Wagers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The objective of this study was to analyze differences in incidence and epidemiologic risk factors for significant threshold shift (STS) and tinnitus in deployed military personnel diagnosed with mild traumatic brain injury (mTBI) due to either a blast exposure or nonblast head injury. A retrospective longitudinal cohort study of electronic health records of 500 military personnel (456 met inclusion criteria) diagnosed with deployment-related mTBI was completed. Chi-square tests and STS incidence rates were calculated to assess differences between blast-exposed and nonblast groups; relative risks and adjusted odds ratios of developing STS or tinnitus were calculated for risk factors. Risk factors included such characteristics as mechanism of injury, age, race, military occupational specialty, concurrent diagnosis of posttraumatic stress disorder (PTSD), and nicotine use. Among blast-exposed and nonblast patients, 67% and 58%, respectively, developed STS, (P=.06); 59% and 40%, respectively, developed tinnitus (P<.001). Incidence of STS was 24% higher in the blast-exposed than nonblast group. Infantry service was associated with STS; Marine Corps service, PTSD, and zolpidem use were associated with tinnitus. Unprotected noise exposure was associated with both STS and tinnitus. This study highlights potential risk factors for STS and tinnitus among blast-exposed and nonblast mTBI patient groups. </p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"52-63"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34722633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap Between Burn Pits and Waste-to-Energy Technology: Safe and Effective Waste Management in Contingency Operations.","authors":"Matthew T Barnes,&nbsp;Coleen P Baird,&nbsp;Anthony D Suh,&nbsp;John A Crutchfield,&nbsp;Kawakahi Amina,&nbsp;Robert M Eninger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"85-98"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34734250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemical Weapons Exposures in Iraq: Challenges of a Public Health Response a Decade Later.","authors":"Coleen Baird,&nbsp;Raul Mirza,&nbsp;Jessica M Sharkey,&nbsp;Ron Teichman,&nbsp;Romarius Longmire,&nbsp;Deanna Harkins,&nbsp;Joseph Llanos,&nbsp;Joseph Abraham,&nbsp;Charles McCannon,&nbsp;Jack Heller,&nbsp;Carole Tinklepaugh,&nbsp;William Rice","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An October 14, 2014 article in The New York Times reported that the US Department of Defense (DoD) concealed, for nearly a decade, circumstances surrounding service members' exposure to chemical warfare agents (CWA) while deployed to Iraq in support of Operations Iraqi Freedom and New Dawn from March 13, 2003, to December 31, 2011, and alleged failure of the DoD to provide expedient and adequate medical care. This report prompted the DoD to devise a public health investigation, with the Army Public Health Center (Provisional) as the lead agency to identify, evaluate, document, and track CWA casualties of the Iraq war. Further, the DoD revisited and revised clinical guidelines and health policies concerning CWA exposure based on current evidence-based guidelines and best practices. </p>","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"75-84"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34734252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Military Medicine of the Russo-Japanese War and its Influence on the Modernization of the US Army Medical Department.","authors":"Justin Barr","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":88789,"journal":{"name":"U.S. Army Medical Department journal","volume":" 3-16","pages":"118-28"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34734257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}