Zika virus infections in Military Health System beneficiaries since the introduction of the virus in the Western Hemisphere, 1 January 2016 through 30 November 2016.

The introduction and rapid spread of Zika virus (ZIKV) across the Western Hemisphere have posed a risk of infection to Military Health System (MHS) beneficiaries. The associated consequences of infection and the dynamics of transmission may place a unique burden on military personnel, their dependents, and the MHS. This article summarizes the impact of ZIKV transmission on MHS beneficiaries between 1 January and 30 November 2016. Cases were identified from a variety of sources, including direct reporting from the services, extraction of laboratory data, and data from the Defense Medical Surveillance System (DMSS) Reportable Medical Events database. There have been 156 confirmed cases of Zika in MHS beneficiaries, including five Zika cases in pregnant beneficiaries and 110 cases in service members. A majority of cases reported exposure in Puerto Rico (n=91, 58.3%). Although most ZIKV infections are asymptomatic or have a relatively mild illness, the gravity of pregnancy and neurologic issues linked to infection remains a significant impetus for the continued surveillance of ZIKV in the MHS population.

Chikungunya infection in DoD healthcare beneficiaries following the 2013 introduction of the virus into the Western Hemisphere, 1 January 2014 to 28 February 2015.

The introduction and rapid spread of chikungunya virus (CHIKV) into the Western Hemisphere after December 2013 pose a potentially significant risk to Department of Defense (DoD) personnel, operations, and the military healthcare system. This report describes the DoD experience with CHIKV between January 2014 and February 2015 using case reports in the Defense Medical Surveillance System's (DMSS) Reportable Medical Events database and the Navy and Marine Corps Public Health Center's laboratory test results database. Case finding identified 157 confirmed cases; of these, 118 (75.2%) were either active or reserve component service members and 39 (24.8%) were other beneficiaries. Exposure locations were known for 117 (74.5%) of all cases, and of these, 113 (96.6%) reported likely exposures in the Western Hemisphere; 85 (75.2%) of those cases occurred in Puerto Rico. Although historical data on CHIKV in DoD populations are scant, introduction of CHIKV into the Western Hemisphere with ongoing transmission appears to have resulted in a significant increase in the number of cases among DoD healthcare beneficiary populations.

Caribbean Public Health Laboratory Surveillance Project: a Department of Defense-sponsored humanitarian mission.

This report describes a Department of Defense humanitarian assistance project to develop and build a regional computer-assisted laboratory-based electronic disease surveillance system in the Caribbean basin. From 1997 through 2000, the project donated 146 computer systems and trained more than 250 personnel from 14 ministries of health to operate this system. This humanitarian mission provided the region with a sustainable and locally maintained and operated surveillance system having a broad and long-term impact on public health. It has improved data gathering, analysis, and reporting at the local, national, and regional level. Benefits to the region include the dissemination through the Internet of increasingly timely and accurate information on the incidence and prevalence of endemic, epidemic, and newly emerging diseases. This serves the Caribbean residents, travelers, and U.S. national interests. The project is a model for cooperative Department of Defense capacity building and training programs in support of partner countries and international public health agencies.

Innovative surveillance methods for rapid detection of disease outbreaks and bioterrorism: results of an interagency workshop on health indicator surveillance.

A system designed to rapidly identify an infectious disease outbreak or bioterrorism attack and provide important demographic and geographic information is lacking in most health departments nationwide. The Department of Defense Global Emerging Infections System sponsored a meeting and workshop in May 2000 in which participants discussed prototype systems and developed recommendations for new surveillance systems. The authors provide a summary of the group's findings, including expectations and recommendations for new surveillance systems. The consensus of the group was that a nationally led effort in developing health indicator surveillance methods is needed to promote effective, innovative systems.