USACHPPM
HEALTH
INFORMATION OPERATIONS (HIO) UPDATE
20
September 2002
The HIO Update provides information regarding global
medical and veterinary issues of interest to the United States (US) Army. The
update does not attempt to analyze the information regarding potential strategic
or tactical impact to the US Army and as such, should not be regarded as a medical
intelligence product. Medical intelligence products are available at http://mic.afmic.detrick.army.mil/.
The information in the HIO Update should provide an increased awareness of current
and emerging health-related issues.
HOT
ISSUES.
2
Anthrax Investigation
– Florida.
2
Combat Veterans
Medical Services – VA..
2
Critical
Incident Stress Debriefing – Lancet
2
Drug Testing
– DOE.
3
Gulf War
Syndrome Study – BMJ.
3
Hazardous
Waste Reduction – EPA..
3
Hepatitis
B Vaccine – BMJ.
3
Osteoporosis
Screening in Postmenopausal Women – USPSTF.
4
Pests of
Significant Public Health Importance – EPA..
4
Smallpox
Vaccine – US.
4
Sudden Infant
Death Syndrome (SIDS) and Nicotine – PNAS.
4
West Nile
Virus (WNV) and Blood Transfusions – CDC..
4
USCENTCOM...
5
Crimean-Congo
Hemorrhagic Fever (CCHF) – Kenya.
5
Dracunculiasis
– Sudan.
5
Foot and
Mouth Disease (FMD) – Kenya.
5
Rift Valley
Fever (RVF) – Egypt
5
USEUCOM...
6
Acute Gastroenteritis
Syndrome – South Africa.
6
Anthrax,
Cutaneous – UK..
6
El Niño
– Uganda.
6
Foot and
Mouth Disease (FMD) – European Union (EU)
6
Meningitis
– Central Africa.
6
Nickel Sensitivity
and Euro Coins – Europe.
7
Spinal Cord
in Frozen Beef – Germany.
7
USJFCOM...
7
Adverse Event
Reporting System, New – FDA..
7
Anthrax,
Bovine – South Dakota.
7
Emergency
Plan – Washington DC Metro Area.
8
Food Micro
2002 – International Committee on Food Microbiology and Hygiene (ICFMH)
8
Hepatitis
C Strategic Plan – Texas.
9
Listeria
Advisory – FDA and USDA..
9
Neurologic
Disease Cluster Investigation – Wisconsin.
9
Oculo-Respiratory
Syndrome (ORS) and 2002-03 Influenza Season – Canada.
9
West Nile
Virus (WNV), Equine – Canada.
10
West Nile
Virus (WNV) Surveillance – US.
10
USPACOM...
11
Drought and
Flooding – Cambodia.
11
Febrile Syndrome
– Nepal
11
Mass Food
Poisoning – China.
12
USSOUTHCOM...
12
Visceral
Leishmaniasis (VL) and El Niño
– Brazil
12
6 September:
CBS News reported FBI investigators found that all of the more than two dozen
photocopy machines at the American Media Inc., were contaminated with anthrax
spores. Investigators are reportedly considering the theory that spores spread
from the first-floor mailroom where the tainted letter was first opened and
onto reams of copier paper stored there. The spores might then have spread
into the air by fans inside the machines loaded with the copier paper. This
latest theory would help explain for the first time the presence of anthrax
throughout the three-story, 68,000 square foot building. Results of the investigation
are pending. [View
report]
11
September: The VA published VHA Directive 2002-049. This directive established
policy and procedures for offering hospital care, medical services, and nursing
home care to recent combat veterans for a two-year period beginning on
the date of the veteran’s discharge for any illness, notwithstanding that there
is insufficient medical evidence to conclude that their illness is attributable
to their military service. [View
directive]
11
September: The VOA
reported the Lancet recently published a meta-analysis study in which
Dutch researchers found that critical stress debriefing did not have any positive
effects on individuals exposed to trauma compared to other methods of counseling
and it did not improve natural recovery from trauma related disorders. The
Dutch researchers state the critical stress debriefing approach might not be
as effective as therapists believe because it may prevent trauma victims from
seeking out the support of family and friends. In a related study, the US National
Institute of Mental Health (NIMH) cited evidence that early intervention in
the form of a single one-to-one recital of events and discussion of emotions
evoked by a traumatic event does not consistently reduce risk and may even put
some survivors at heightened risk for later developing mental health problems.
The Lancet study is van Emmerik AAP, Kamphuis JH, Hulsbosch AM, and Emmelkamp
PMG. Single session debriefing after psychological trauma: a meta-analysis.
Lancet 360 (7 September 2002): 766-71. [View
VOA report
or View
NIMH report]
16
September: DOE reported a new drug test developed by scientists at DOE's Idaho
National Engineering & Environmental Laboratory in collaboration with Miragen,
Inc., promises to crack down on drug test cheaters. Unlike urine tests, theirs
relies on a few drops of saliva, making it possible to get samples without the
privacy of a bathroom. Additionally, the drug-testing strips uncover illegal
drugs while decoding an individual's unique auto-antibody signature—a barcode-like
pattern of proteins that links a test's results to its taker to further prevent
sample swapping. Further evaluation will follow. [View
report]
14
September: The BMJ published a two-phase cohort study that showed most
psychiatric disorders are 2-10 times more common in disabled Gulf War veterans
than in non-disabled Gulf veterans. Disabled Gulf veterans and similarly disabled
non-Gulf veterans do not differ in their pattern of mental health problems,
except that disabled veterans have a threefold increase in somatoform disorders.
Rates of post-traumatic stress disorder were not higher in Gulf veterans than
other veterans, leading the authors to suggest that ill health in Gulf veterans
is not explained by events or exposures conventionally understood to be psychologically
traumatic. [View
report]
11
September: DENIX
reported on 9 September the EPA released a list of 30 priority chemicals found
in hazardous wastes that federal regulators want manufacturers to voluntarily
reduce by 50% or eliminate from their production processes. Three metals –
cadmium, lead, and mercury – are included on this list, in addition to 27 organic
chemicals, such as dioxins/furans, naphthalene, and fluorine. The list replaces
a draft list of 53 chemicals EPA identified in a 1998 Federal Register notice
regarding waste minimization. [View
report;
requires registration or View
EPA listing]
14
September: The BMJ published an observational study in which researchers
found the efficacy of hepatitis B vaccination in infancy in a highly endemic
country wanes with time, but efficacy against chronic infection remains high
over 14 years. Researchers measured vaccine efficacy in 172 children and teenagers
in a Gambian village who had been immunized against hepatitis B in infancy.
Efficacy of the vaccine against infection was 65%, and against chronic carriage
was 88%. The authors concluded that due to the small numbers in the study a
larger study of efficacy during adolescence is needed to decide whether a booster
dose of hepatitis B vaccine is necessary in teenagers. [View
report]
16
September: USPSTF released recommendations that women aged 65 and older be screened
routinely for osteoporosis. They recommended that routine screening begin at
age 60 for women at increased risk for osteoporotic fractures. The USPSTF made
no recommendation for or against routine osteoporosis screening in postmenopausal
women who are younger than 60 or in women aged 60-64 who are not at increased
risk for osteoporotic fractures. [View
report]
11
September: The EPA issued the final Pesticide Registration Notice identifying
pests of significant public health importance. The list will likely not remain
static since possible additional species may be found to present public health
problems. EPA will update the listing as necessary. [View
report]
14
September: CBS News reported a Bush administration smallpox vaccination plan
in the final stages of development would begin vaccinations for those at the
greatest risk of contacting a patient with smallpox. This group includes infectious
disease specialists and emergency room personnel (doctors, nurses, technicians,
security officers) working at hospitals and clinics. The first group will likely
include more than one million people. In the second stage, vaccination would
be offered to other healthcare workers, including those in private practice
and others who work in hospitals but are not at direct risk. At some point,
emergency personnel, such as police and firefighters would also be offered the
vaccination. Eventually, the vaccine would be offered to the general public.
[View
report]
10
September: New Scientist reported researchers found nicotine directly disrupts
a baby’s breathing as well as the early development of the neural circuits that
guard against sleep apnea. This study suggests why babies whose parents smoke
tobacco are more likely to die of SIDS. [View
New Scientist report
or View
PNAS study]
13
September: The CDC reported it has confirmed transmission of WNV from a single
organ donor to four organ recipients. During treatment for injuries that eventually
proved fatal, the organ donor received numerous transfusions of blood products.
However, the source of the organ donor’s infection remains unknown. Subsequently,
the CDC was informed of four other patients with WNV infection diagnosed after
receiving units of blood in the weeks before WNV diagnosis. In each instance,
precautionary measures have included a withdrawal of any remaining blood products
obtained from the donors whose blood was given to these patients. In cases
of suspected WNV meningitis or encephalitis in recent (£
four weeks before onset of illness) recipients of blood or organs, clinicians
should contact local public health authorities to initiate an investigation.
Serum or tissue samples should be retained for later studies. [View
report]
The
September issue of Emerging Infectious Diseases published a letter in
which the authors report the first documented case of acute human CCHF infection
in Kenya. A previously healthy 25-year-old male farmer was admitted to a mission
hospital in western Kenya with an acute hemorrhagic illness on 21 October 2000.
RT-PCR
for CCHF virus was positive. No virus isolation could be made possibly due
to a delay in forwarding to a biosafety level four facility and following freeze-thaw
conditions. Previous evidence for CCHF in Kenya is limited and based on serology
(human and bovine) and two isolations of CCHF from non-human sources. [View
report]
13
September: The CDC
reported dracunculiasis declined worldwide with only two remaining endemic foci
of the disease remaining in southern Sudan and northern Ghana. Efforts are
now underway to stop transmission of dracunculiasis in northern Ghana; however,
in southern Sudan the 19-year-old civil war is the main cause for the continued
high rate of disease. If the intensified political negotiations now under way
between the two sides in Sudan succeed in ending hostilities, full access to
the final areas of endemic dracunculiasis in southern Sudan might be possible
soon. After the war ends and healthcare workers gain access to this area, at
least four to five years would be required to eliminate dracunculiasis, given
the extent to which the disease is endemic and southern Sudan’s enormous size,
geographic barriers, and poor infrastructure and communications networks. [View
report]
9
September: The East African Standard reported Busia District veterinary officers
have imposed quarantine in Matayos and Butula divisions following an outbreak
of FMD in cows. Vaccination has already been conducted in the Matayos division
and is scheduled for Butula division. [View
report]
11
September: AFMIC
reported that the Alexandria Veterinary Medicine Directorate declared a state
of emergency after RVF appeared in livestock in Upper Egypt last week. The
exact location and number of cases was unspecified. [View
report;
registration required]
9 September: News 24 reported at least
four people have died and two miscarriages occurred as a result of a serious
gastroenteritis epidemic in Rouxville in the Free State during the past two
weeks. According to the report, the Mohokare municipality manager earlier had
sent out a letter apologizing to residents for any inconvenience caused by water
problems. Results for testing of the water supply and stools from sick residents
are pending. [View
report]
10 September: ProMED posted a Reuters
report in which a researcher at the Centre [sic] for Applied Microbiological
Research stated cutaneous anthrax might be more common in Britain than previously
thought. Only 14 cases of cutaneous anthrax were detected in Britain in the
last 20 years, but two British cases were reported soon after the 11 September
2001 attacks in the US. Both cases were the result of occupational exposure:
one person worked with imported animal skins and the other with old building
materials [View
report]
El Niño
– Uganda
16 September: IRIN
reported Uganda had issued a national alert predicting unusually high rainfall
associated with El Niño,
a weather phenomenon typically associated with warming of the equatorial Pacific
Ocean. The increased rainfall is expected to peak in October. The flooding
is not expected to be as destructive as the previous El Niño
rains, which caused severe flooding and destroyed much of East Africa’s infrastructure
between 1997 and 1998. In neighboring Kenya and Tanzania, no significant changes
in rainfall patterns are anticipated for the rest of the year. [View
report]
12 September: BBC reported that the EU
is considering compulsory vaccination against the spread of FMD. A draft proposal
seen by the BBC suggests that the decision to vaccinate could be taken by the
commission if it were not possible to stamp the disease out through slaughter
within 48 hours. According to the report, using the vaccine as a preventive
is not feasible given the large number of strains of the disease. [View report]
11 September: VOA
reported that a meningitis outbreak in Rwanda continues to threaten the lives
of two million people and may spread to Kigali endangering another million people.
Nearly 700 cases of the disease have been confirmed with 83 deaths. The disease
has also been reported in Burundi and Tanzania. [View
report]
11 September: New Scientist reported that
Swiss researchers have found the use of two alloys in the one and two Euro coins
make them prone to release large amounts of nickel in the presence of human
sweat. The coins can cause allergic reactions in people sensitive to the metal,
while other coins containing similar amounts of nickel do not produce the same
symptoms. According to the study, the coins release 240 to 320 times more nickel
than is allowed under the European Union Nickel Directive. The European Central
Bank says the study is flawed, as people that have nickel contact allergy should
not have prolonged contact with any nickel-containing material. Twelve countries
adopted the Euro in January 2002. About one in 10 people are allergic to nickel,
developing eczema-like skin rashes during prolonged contact. Before the currency’s
introduction, dermatologists raised fears that the content could cause allergic
reactions in susceptible people. But nickel was chosen partly because it can
be more easily recycled than other metals used in coins. [View
report]
17 September: UK
Food Standards Agency (FSA) reported spinal
cord was found in frozen beef imported from Germany into the UK. Bovine spinal
cord is classified as specified risk material (SRM) and is therefore among those
parts of the animal most likely to contain BSE infectivity. Under European law,
SRM must be removed immediately after slaughter, stained, and disposed of safely.
The discovery, made during an inspection by the Meat Hygiene Service (MHS) on
16 September, involved one hindquarter of frozen beef out of a consignment of
162 beef quarters being unloaded at ADM (UK) Ltd, Eastbourne. This is the eleventh
case of SRM in imported beef from Germany reported by the FSA. [View
report]
13 September: CIDRAP
News reported that the FDA Center for Food Safety and Applied Nutrition (CFSAN)
announced it would begin a single adverse event reporting system “on or after
16 September” that will replace separate systems for the three categories of
products: food, supplements, and cosmetics. The new tracking system, called
CFSAN Adverse Events Reporting System (CAERS), will eventually provide adverse-event
information on a website. [View
report]
4 September: South Dakota Animal Industry Board reported
anthrax was diagnosed on a cattle ranch in eastern Butte County, South Dakota.
The outbreak involves a herd of approximately 240 cow/calf pairs and 15 bulls.
Deaths included 12 cows and one calf. The herd was treated with antibiotics
and vaccinated against anthrax. The carcasses are being properly disposed of
under the direction of the Animal Industry Board. The remaining herd was scheduled
for antibiotic treatment and vaccination 5 September. Significant climate changes
such as drought, floods, and winds can expose anthrax spores to grazing livestock.
In alkaline soils, high humidity and high temperatures present conditions for
the anthrax spores to vegetate and become infectious to grazing livestock.
This is the third confirmed outbreak of anthrax in South Dakota in 2002. The
other two outbreaks were in Jerauld County. The first outbreak was confirmed
on 26 June and involved a herd of 35 buffalo in which one cow died. The second
outbreak was confirmed on 9 July in a herd of 256 cattle in which the only unvaccinated
cow died. [View
report]
12 September: Washington Post reported Washington
DC area officials released the region’s first comprehensive emergency plan,
recommending measures to help quickly evacuate the nation’s capital, prevent
a bioterrorism epidemic from spilling across state lines, and mobilize in the
aftermath of a natural disaster. The evacuation plan included “super-carpooling”
to supplement the overburdened mass transit system. To combat bioterrorism,
the plan calls for creating a four-level disease surveillance and alert system
in the District, Maryland, and Virginia. This plan will be compared to a $420
million Pentagon initiative to build a biodefense network around Washington
and three other US cities. The recommendations will now go before the 17-member
Metro area jurisdictions for adoption. They will have to be coordinated with
local and state governments that have separate police forces, public works departments,
and health services. [View
report]
5 September: Eurosurveillance Weekly reported
that review articles for the 18th symposium of the ICFMH have been
published in a special issue of the International Journal of Food Microbiology.
Highlights from the conference included the CDC’s
report of US estimates from 1997 on cases of foodborne infections. The CDC
reported calici-/Norwalk-like viruses caused a total of 9.2 million cases for
that year, Campylobacteriosis accounted for around 1.9 million cases, Salmonellosis
(non-typhoid group) for 1.3 million cases. E. coli O157:H7 or other
non-O157 strains accounted for 92,000 cases. Shigella spp. and Yersinia
enterocolitica were estimated to have caused 90,000 and 87,000 cases respectively.
The US investigation revealed the causative agent was microbiologically confirmed
in only one fifth of the reported cases despite increased knowledge and improved
surveillance systems. Worldwide infections caused by Salmonella typhimurium
decreased whereas infections caused by S. enteritidis had increased.
The emergence of multi-resistant strains of S. typhimurium such as phage-type
DT 104 was also noted. In 2000 the proportion of human strains of Salmonella
serovars in the US that were resistant to at least five antibiotics was
11%. In 2002 it was demonstrated that some of the penta-resistant strains have
also acquired resistance to gentamicin and third generation cephalosporins.
[View report]
10 September, Texas Department of Health announced
that it would consider adopting a California hepatitis C strategic plan. [View
California plan or View
Texas report]
13 September: FDA and USDA advised the public
of a recent increase in cases of Listeria monocytogenes in Pennsylvania
and monitoring for possible increases in adjacent states. The specific food
associated with the increased incidence of illness has not been identified.
Those at highest risk of contracting the disease include the elderly, pregnant
women, newborns, and people with weakened immune systems. The FDA recommends
that people at risk use the following precautions: (1) do not eat hot dogs
and luncheon meats unless they are reheated until steaming hot, (2) do not eat
soft cheeses, such as Feta, Brie, Camembert, etc., (3) do not eat refrigerated
pâtés or meat spreads, (4) do not eat refrigerated
smoked seafood, unless it is contained in a cooked dish, and (5) do not drink
raw (unpasteurized) milk or eat foods that contain unpasteurized milk. [View
report]
12 September: Wisconsin Department of Health
and Family Services released information on the status of an investigation into
fatal cases of degenerative neurologic illnesses in three men who consumed wild
game. Media reports generated considerable public interest due to the concern
that these illnesses might somehow be linked to chronic wasting disease (CWD)
of deer and elk. The investigation is still ongoing, but the following information
was provided. The first component of the investigation is a re-examination
of brain tissue collected from the patients during their autopsies. Two of the
patients died in 1993 and the third died in 1999. Tissue samples from all three
men were recently forwarded to the National Prion Disease Pathology Surveillance
Center in Cleveland, Ohio. Pathologists there are examining the tissue specimens
for evidence of Creutzfeldt-Jakob Disease (CJD) and the presence of abnormal
prion protein. Test results from the National Prion Disease Surveillance Center
are complete on one of the three sets of samples. Pathologists concluded that
the samples from a male patient, whose death in 1993 was attributed to Pick’s
disease, showed no evidence of CJD and did not contain any detectable prions.
[View
report]
13 September: Health Canada reported the National
Advisory Committee on Immunization recommended continued use of the 2001 ORS
case definition for enhanced surveillance of influenza vaccine-associated adverse
events during the 2002-03 season. During the 2000-01 influenza season, Health
Canada was first notified of the occurrence of an increased number of persons
who reported ocular and/or respiratory symptoms in association with receiving
the influenza vaccination. The 2001 ORS case definition is the onset of bilateral
red eyes and/or respiratory symptoms (cough, wheeze, chest tightness, difficulty
breathing, difficulty swallowing, hoarseness, or sore throat) and/or facial
swelling occurring within 24 hours of influenza immunization. [View
report]
13 September: ProMED reported the following cases
of equine WNV in Canada: six cases in Saskatchewan, 101 cases in Manitoba,
and seven cases in Ontario that extended from the Toronto area westward. The
Manitoba Provincial Government also posted a notice to hunters warning them
that the extent to which WNV may be present in wild game is unknown. According
to the report, the risk of WNV transmission from handling or consuming game
is considered very low. There have been no documented cases of WNV being transmitted
to hunters from game. However, the Manitoba Government encouraged hunters to
take precautions when handling, cleaning and cooking game birds and mammals
including wearing gloves, washing hands and cooking animals thoroughly. [View
ProMed report or View
Manitoba Bulletin]
17 September: CDC
reported 1,540 human cases (71 deaths) in 32 states during 2002. Colorado reported
its first laboratory-positive human case since the last HIO Update. On 12 September,
GEIS reported that no cases of
human or equine WNV have been reported by DoD
sources. On DoD installations, there have been 208 WNV positive mosquito pools
(DC, MD, GA, OK, and VA), 51 WNV positive dead birds (DC, FL, GA, IL, MD, NJ,
OH, TN, TX, and VA), and 11 positive sentinel chickens at Folk Polk, LA. [View
CDC report or View
GEIS report]
Map courtesy
of the CDC at http://www.cdc.gov/ncidod/dvbid/westnile/surv&control.htm
10 September: World Vision reported that droughts and floods
in Cambodia have affected 1.2 million people, killed 18, and forced at least
30,000 others to move to Phnom Penh to survive. The Prime Minister declared
a “disaster situation” for the country and appealed for international aid after
the Mekong River flooded some areas of the country in late August following
Cambodia’s worst drought in some 20 years. Drought and flooding affected the
following provinces: Battambang, Kandal, Kompong Chhang, Kompong Speu, Kompong
Thom, and Takeo. [View report]
14 September: ProMED reported 100 cases (15 deaths) of an
illness attributed to an infectious disease outbreak of unknown etiology occurred
in Dolakha district, Nepal. Dolakha district is 130 km northeast of Kathmandu
in a remote Himalayan region wracked by six years of guerilla warfare. Speculation
regarding the etiology includes an influenza-like illness (usual season is December
through April) and Japanese encephalitis (annual outbreaks during the rainy
season June through September). [View
report]
15 September: VOA reported that China’s top Communist Party leaders have sent
police and health officials to investigate a mass poisoning that occurred on
14 September in Tangshan, an industrial center near Nanjing. Customers, mostly
laborers and school children, at a branch of the Hengshengyuan Soy Milk fast
food chain began to collapse shortly after eating fried dough sticks, sesame
cakes, and other traditional breakfast foods. On 14 September, the official
Xinhua News Agency reported that 400 people were hospitalized and 41 dead, but
on 15 September official government newspapers reported that 200 people were
rushed to the hospital and a “number of them” had died. On 17 September, CBS
News reported that a man jealous of a business rival confessed to spiking his
competitor’s breakfast snacks with rat poison. In July, a noodle shop owner
in southern China was arrested on charges that he poisoned customers at a rival
business across the street by putting rat poison in its soup. In that incident,
57 people were sickened but no deaths were reported. [View
VOA report or View
CBS News report]
September: Emerging Infectious Diseases, researchers
reported that El Niño episodes are related to variation in the annual incidence
of VL in the State of Bahia, Brazil and suggest that an El Niño–based early
warning system for VL may help reduce the health impact of the disease in susceptible
regions in Brazil. According to the results, the annual incidence of VL in
Bahia tends to reach its lowest level in the first year after El Niño episodes
and begins to increase in the second year after El Niño. The delay of this
correlation pattern is unusual in light of the well-studied association between
malaria and El Niño reported in different regions of the world. Increases in
malaria incidence have been reported to accompany El Niño episodes or occur
in the year immediately following such episodes. [View report]
Please contact the below-listed POC for suggested improvements
and/or comments regarding this report. This report is also available on the
USACHPPM website at http://chppm-www.apgea.army.mil/Hioupdate/.
POC: Barbara E. Davis, DVM, MPH, Dipl.
ACVPM
mailto:Barbara.Davis1@APG.amedd.army.mil
Approved:
Kevin Delaney
Chief, Health Information Operations
(410) 436-5217 or DSN 584-5217
ACRONYMS
ACIP
- Advisory Committee on Immunization Practices
AFMIC - Armed Forces
Medical Intelligence Center
AFIS –
American Forces Information Service
ATSDR
– Agency for Toxic Substances and Disease Registry
AVIP - Anthrax Vaccine
Immunization Program
BCG
- Bacille Calmette-Guerin Vaccine against Tuberculosis
BMJ
– British Medical Journal
BSE – Bovine Spongiform
Encephalopathy
CDC – Centers
for Disease Control and Prevention
CDR – Communicable
Disease Report (England)
CIDRAP – Center for Infectious Disease Research and Policy
CJD
- Creutzfeldt-Jakob Disease
DARPA – Defense Advanced Research Projects Agency; http://www.darpa.mil/
DENIX – Defense
Environmental Network & Information eXchange [sic]
DHF – Dengue
Hemorrhagic Fever
DHHS – Department
of Health and Human Services
DoD - Department
of Defense
DOE – Department
of Energy
DTRA – Defense Threat Reduction Agency
EPA – Environmental Protection Agency
ESSENCE – Electronic Surveillance System for the Early Notification of Community-Based
Epidemics
FDA – Food and Drug Administration
GAO – General Accounting Office
GEIS – Global Emerging Infections Systems
GPS – Global Positioning System
HIV/AIDS – Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
IFRC – International
Federal of Red Cross and Red Crescent Societies
IRIN - Integrated Regional Information Networks,
part of the UN Office for the Coordination of Humanitarian
Affairs (OCHA).
NAS – National Academies of Science
NIH – National Institutes of Health
NIOSH – National Institute for Occupational Safety and Health
OIE – World Organisation [sic] for Animal Health
OSHA - Occupational Safety and Health Administration
PAHO – Pan American Health Organization
PNAS – Proceedings of the National Academy of Sciences
RT-PCR – Reverse Transcriptase Polymerase Chain Reaction
SCIEH – Scottish Centre [sic] for Infection and Environmental Health
TB – Tuberculosis
UK – United Kingdom – England, Northern Ireland, Scotland, and Wales
UN – United Nations
USAMRIID - United States Army Medical Research Institute of Infectious Diseases
USDA – United States Department of Agriculture
USPSTF
– United States Preventive Services Task Force
vCJD - variant Creutzfeldt-Jakob Disease
VA
– Department of Veterans Affairs
VOA – Voice of America, an international multimedia broadcasting service funded
by the US Government
WHO – World Health Organization
WMD – Weapons of Mass Destruction
