USACHPPM
HEALTH INFORMATION OPERATIONS (HIO)
WEEKLY UPDATE
15 March 2002
The HIO Weekly Update provides information regarding global
medical and veterinary issues of interest to the United States (US) Army. The
weekly 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 Weekly Update should provide an increased awareness
of current and emerging health-related issues.
HOT ISSUES..
Agent Orange - IOM Study.
Anthrax Vaccine Adsorbed (AVA)
- IOM Study.
Immunization Safety Review -
IOM..
Influenza A (H1N2) Surveillance
- WHO..
Influenza Surveillance DoD..
Influenza Surveillance US..
Childhood Vaccine Shortages
- CDC..
USCENTCOM..
Child Malnutrition - Gaza.
Medical Staff Protection Appeals
- ICRC..
Chromated Copper Arsenate (CCA)
Spill - Djibouti
Unidentified Epidemic - Afghanistan.
Weather Implications - Greater
Horn of Africa.
Meningococcal Disease (MCD)
- Ethiopia.
USEUCOM..
Ebola / Viral Hemorrhagic Fever
- Gabon and Republic of the Congo.
HIV Lookback Denied - England.
Influenza Surveillance Europe.
Meningococcal Disease (MCD)
- Burkina Faso.
Post-Traumatic Stress Disorder
- UK Lawsuit
Third Generation Contraceptive
Pill - UK Lawsuit
USJFCOM..
Joint Task Force Surgeon's Seminar
- USJFCOM..
Nitrofurans Ban - Food-Producing
Animals.
Psychologists Prescription Authority
- New Mexico.
Tularemia, 1990-2000 - US..
USPACOM..
Agent Orange Conference - Vietnam..
Earthquake - Philippines.
Leaded Gasoline - Asia.
USSOUTHCOM..
Dengue Fever - Brazil
River Blindness - Onchocerca
volvulus?.
USACHPPM New Products.
Irradiated Mail - Web Resource.
ACRONYMNS..
On 27 February, the IOM released a report, "Veterans
and Agent Orange: Herbicide/ Dioxin Exposure and Acute Myelogenous Leukemia (AML)
in the Children of Vietnam Veterans." The report found inadequate or insufficient
evidence that an association exists between exposure to herbicides used in Vietnam
or their contaminants and AML in the children of Vietnam veterans. This finding
updates an earlier report released on 19 April that found limited or suggestive
evidence of an association. The new report is based on a corrected study and
other newly reviewed research results. The report is at http://www.nap.edu/catalog/10309.html.
On 6 March, the IOM released a report, "The Anthrax
Vaccine: Is it Safe? Does it Work?" The report concluded that the AVA,
as licensed, is an effective vaccine and acceptably safe to protect against anthrax,
including inhalational anthrax. The IOM also recommended: (1) studies to determine
a quantitative correlation between antibody levels in vaccinated test animals
that protect them from bacterial challenge and antibody levels in fully-vaccinated
humans so that these correlates can be used to test the efficacy of AVA, (2) DoD
support additional studies to determine how long after exposure antibiotics should
be given to vaccinated individuals to provide protection, (3) DoD continue support
of a CDC
study to assess a reduced-dose vaccination schedule with intramuscular administration,
(4) future studies continue to include separate analyses for women and men in
monitoring and studying health events following vaccination, (5) DoD develop systems
to enhance monitoring of later-onset health conditions that might be associated
with vaccination, (6) monitoring of AVA be continued in the renovated production
facility to assess immunogenicity, stability, and possible adverse events, (7)
DoD develop the Defense Medical Surveillance System to regularly test hypotheses
that emerge from the Vaccine Adverse Event Reporting System and other sources,
(8) DoD evaluate options for longer-term follow-up of possible health effects
of AVA and other service-related exposures, (9) DoD expedite research efforts
on anthrax disease, the organism, and the vaccine. The report mentioned that
DoD should encourage participation in the Millennium Cohort Study, which will
follow 140,000 military personnel during and for up to 21 years after their active
service to evaluate the health risks of military deployment. The report is at
http://www.nap.edu/catalog/10310.html?se_side.
On 20 February, the IOM released the report, "Immunization
Safety Review: Multiple Immunizations and Immune Dysfunction." The report
found that epidemiological evidence did not support a causal relationship between
multiple immunizations and an increased risk for infections and for type 1 diabetes.
The report also concluded that epidemiological evidence was inadequate to accept
or reject a causal relationship between multiple immunizations and risk for allergic
disease, particularly asthma. The Committee recommended a continued focus on
policy analysis, research, and communication strategy development. The Committee
did not recommend a review of the vaccine licensure or immunization schedule for
infants based on concerns about immune dysfunction. The report is at http://www.nap.edu/catalog/10306.html.
On 8 March, the WHO reported that between September 2001
and February 2002, influenza A (H1N2) viruses have now been isolated from cases
in Canada, Egypt, France, India, Israel, Latvia, Malaysia, Oman, Singapore, the
UK,
and the US. The 2001-02 influenza vaccine is expected to provide good protection
against this virus, as it is a reassortment of the influenza A (H1N1) and (H3N2)
strains that are represented in the vaccine. The WHO also reported that existing
serological and molecular reagents could be used for identification and characterization
of the influenza A (H1N2) viruses. The report is at http://www.who.int/wer/pdf/2002/wer7710.pdf.
The DoD Worldwide Influenza Surveillance Program is
a laboratory-based influenza surveillance program managed by the Air Force.
As of 7 March, 420 (19%) of 2,247 submitted specimens have been identified as
positive for influenza since the start of the influenza season (29 September):
415 (99%) were influenza A and 5 (1%) were influenza B. One influenza B virus
identified during the past week was of the B/Victoria lineage (NAB Little Creek,
VA). The CDC
reported last week that the B component of the influenza vaccine for 2001-02
is expected to provide lower levels of protection against viruses of the B/Victoria
lineage. Natural immunity to B/Victoria is also expected to be low since this
substrain has not circulated for over a decade. The influenza vaccine for 2002-03
will provide protection against the B/Victoria lineage. Of the influenza A
isolates, 77 (18%) have been subtyped, and 72 (94%) were influenza A (H3N2)
and 5 (6%) were influenza A (H1N1). The first influenza A (H1N2) reassortment
strain was identified in a sample from Kunsan, South Korea. Further info, including
data from the CDC and international sites, is available at: https://pestilence.brooks.af.mil/Influenza/
Note: Some users may experience difficulty accessing
this link directly from this document; if this occurs, copy and paste the hyperlink
in your browser address bar.
The report for the week ending 23 February (week 8)
indicated that during this week overall national visits to physicians for influenza-like
illness were 3.5%, which is above the national baseline of 1.9%. Deaths attributed
to pneumonia and influenza were 8.1%, which is below the epidemic threshold
of 8.3% for this week. For week eight, laboratory reports indicated 752 (25.9%)
of 2,902 respiratory specimens were positive for influenza: 164 influenza A
(H3N2), 13 influenza B, and 575 influenza A viruses with unspecified subtype.
Since 30 September, 7,499 (13.4%) of 55,876 submitted specimens were positive
for influenza: 7,402 (99%) were influenza A and 97 (1%) were influenza B. Of
the 7,402 influenza A viruses, 2,188 (30%) were subtyped with the following
results: 2,162 (99%) were influenza A (H3) and 26 (1%) were influenza A (H1)
viruses. All viruses that have been antigenically characterized (258) were
similar to the vaccine strains A/Panama/2007/99 (H3N2), A/New Caledonia/20/99
(H1N1), and B/Sichuan/379/99 (H3N2). The CDC
classified influenza during the eighth week of the 2002 influenza season as
in the map below. The report is at http://www.cdc.gov/ncidod/diseases/flu/weekly.htm.
Picture courtesy of the CDC at http://www.cdc.gov/ncidod/diseases/flu/weekly.htm.
On 8 March, the CDC reported that Varicella vaccine
shortages would not be resolved until possibly early summer 2002. The highest
incidence of disease is among elementary school aged children. The ACIP
recommends all vaccine providers in the US delay administration of the routine
childhood Varicella vaccine dose from age 12-18 months until age 18-24
months. If the shortage persists after delaying the 12-18 months dose and is
of sufficient severity to require further prioritization, then ACIP recommends
the following prioritizations (from highest to lowest) for vaccination: (1) healthcare
workers, family contacts of immunocompromised persons, adolescents 13 years of
age and older, and adults and high risk children (children with HIV and children
with asthma or eczema), (2) susceptible children age 5-12 years, particularly
children entering school and adolescents aged 11-12 years, and (3) children 2-4
years of age. States may prioritize these categories further.
The measles, mumps and rubella (MMR) vaccine supply shortage is expected to last
for 1-3 more months. Two doses of MMR separated by at least a month and administered
on or after the first birthday, are recommended for persons who lack adequate
documentation of vaccination or other acceptable evidence of immunity. The first
dose is recommended at age 12-15 months and the second dose at age 4-6 years.
If providers are unable to obtain sufficient MMR vaccine for these recommendations,
then ACIP recommends the second dose be deferred. Due to the severity of measles
in young children, providers should not delay administration of the first dose.
The CDC recommends that records be maintained such that persons who experience
a delay in vaccination can be recalled when vaccine becomes available. The report
is at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5109a6.htm.
On 7 March, the UN
reported that cases of malnutrition among Palestinian children under five years
of age had more than doubled in the past year, which was believed to be due to
decreased delivery of relief supplies caused by the economic blockade of the Gaza
Strip. According to the report, the World Bank issued a statement indicating
that economic collapse remained a real prospect if confrontations in the region
continue and that "serious health and environmental problems are emerging."
The report is at http://www.reliefweb.int/w/rwb.nsf/6686f45896f15dbc852567ae00530132/ed6c394bff3ddeca85256b75005b9c46?OpenDocument.
On 7 March, the ICRC issued an appeal to Israeli authorities to take immediate
steps to protect medical personnel and conduct a full inquiry into the recent
deaths of medical personnel. On 7 March in two separate incidents in Tulkarem,
the Israel Defense Forces shot and killed an ambulance driver and a UN
employee, who were attempting to aid wounded. A physician inside the Tulkarem
ambulance station suffered a leg wound, and shrapnel critically wounded another
paramedic as he was trying to evacuate casualties. These latest incidents follow
the death on 4 March of the head of the emergency medical service in Jenin and
the wounding of five medical staff when Israeli troops shot at their ambulances
in the Jenin refugee camp. All ambulances were reportedly marked clearly with
the Red Crescent emblem, and the ICRC had cleared their mission in Jenin and Tulkarem
with the Israeli authorities. The report is at http://www.icrc.org/icrceng.nsf/8f7eed1263126d254125634d00375313/72f40615d42bd8e8c1256b7600567631?OpenDocument.
On 11 March, the IRIN
reported that a four-member UN team and an ecotoxicologist
from Switzerland are assessing a CCA spill that occurred in the port of Djibouti
in January. The team has determined that five sites have been contaminated and
a number of people are under treatment in local hospitals. Also, some domestic
animals that entered the site have died. The Djibouti authorities state that
they have completed the first phase clean up, which consisted of isolating the
contaminated areas and equipment. The second phase may involve isolating the
toxic material itself and treating the contaminated soil, which will likely require
international assistance. The report is at http://www.irinnews.org/report.asp?ReportID=24452&SelectRegion=Horn_of_Africa&SelectCountry=DJIBOUTI.
On 8 March, Reuters Health reported the WHO
was attempting to evacuate two physicians and six aid workers as well as provide
medication to villagers and collect blood samples from the isolated Taiwara village
in the Ghor province of central Afghanistan, where 40 people had died of an "unidentified
epidemic." The WHO had not been able to gain access to the mountainous location
as of the report. The report is at http://www.reutershealth.com/archive/2002/03/08/eline/links/20020308elin021.html.
On 4 March, the IRIN
reported on the forecasts developed by the ninth Climate Outlook Forum held in
Kenya during mid-February. March to May is the important rainfall season over
equatorial areas of the Greater Horn of Africa. The forum predicted normal- to
above-normal rainfall during March-May in much of Kenya and Uganda, northern Tanzania,
Rwanda, Burundi, southern and central Sudan, western Eritrea, Somalia, and eastern
Ethiopia. The positive aspects include normal- to above-normal agricultural and
livestock production, adequate water supply for domestic and industrial use, and
stable hydroelectric power. The negative aspects include localized flooding,
an increase in water-related diseases, especially malaria, soil erosion and landslides,
and severe, potentially damaging storms. Potential for an El-Nino type weather
system is possible, but modeling systems will be more accurate towards May. In
1997-98 El Nino caused considerable health and economic loss in the region. The
forum also predicted below normal rainfall for northern coastal and northwest
Kenya, southern Somalia, northeastern Uganda, southern Tanzania, and northern
parts of southern Sudan. These regions can expect declining livestock numbers,
poor health among pastoralists and their livestock, poor food security and high
poverty with increased conflicts over limited water and pasture. Concerns are
especially grave in northern Kenya and southern Somalia, where prolonged drought
has already caused considerable hardships. The report is at http://www.reliefweb.int/w/rwb.nsf/6686f45896f15dbc852567ae00530132/83b08f0b3bb0d42649256b7300151575?OpenDocument.
Map Courtesy of http://www.lib.utexas.edu/maps/africa/africa_pol01.jpg
On 8 March the WHO
reported that as of 3 March, a total of 2,329 reported cases of MCD (118 deaths)
had occurred in Ethiopia since the onset of the outbreak began in September 2001.
This is an increase of 1,029 reported cases and 33 deaths since last month. The
worst affected region is the Southern Nations, Nationalities and Peoples Region
(SNNPR) with 2,022 cases and 89 deaths. Ethiopia issued an appeal for $2.5 million
to carry out a mass immunization campaign in five SNNPR priority zones. The report
is at http://www.who.int/disease-outbreak-news/2002/march/8amarch2002.htm.
On 6 March, the WHO
reported that as of 4 March, the Gabon Ministry of Health had reported 60 confirmed
Ebola cases and 49 deaths. This is an increase of 11 confirmed cases and 7 deaths
since the last HIO report on 7 February. On 8 March, the VOA News
reported that the international humanitarian group Doctors Without Borders is
sending members to a northeastern area near the town of Mbomo in the Republic
of the Congo, where cases have been discovered in recent days. The WHO report
is at http://www.who.int/disease-outbreak-news/n2002/march/6march2002.html.
HIV
Lookback Denied - England
On 9 March, the British Medical Journal reported that
an appeal court ruling last week barred the media from identifying an English
health authority that has not contacted former patients of an HIV positive dentist
almost a year after learning of his HIV status. No decision has yet been reached
on whether to contact dental patients of the dentist, who has now developed AIDS.
New official guidelines are expected as early as mid-March regarding the contact
and counsel of patients who had invasive procedures performed by HIV positive
healthcare workers. Last November, ministers agreed in principle that contact
of patients should not be automatic but should be considered on a case-by-case
basis. The public interest in preserving the confidentiality of healthcare workers
with AIDS is that it would encourage self-reporting of HIV positive status. The
report is at http://bmj.com/cgi/content/full/324/7337/564.
For week nine, 25 February - 3 March, the EISS
reported a decrease in influenza activity across the majority of the European
countries. Widespread influenza activity was reported in four countries: Italy,
the Netherlands, Norway, and Switzerland. Of these four countries, the weekly
clinical morbidity rates were only increasing in the Netherlands. Three networks
reported increasing influenza activity with a geographic spread described as sporadic
(Poland) or regional (Germany and Romania). Influenza A was dominant in 11 networks
of which seven reported the dominant subtype was H3N2; one network reported co-circulation
of H1N1 and H3N2. Influenza B was dominant in Belgium, Italy, Slovenia, Spain,
and Switzerland. No cases of influenza A (H1N2) or influenza B/Victoria/2/87-like
viruses were reported during this week. The report is at http://www.eiss.org/cgi-files/bulletin_v2.cgi?display=1&code=58&bulletin=58
Picture
Courtesy of EISS at http://www.eiss.org/cgi-files/bulletin_v2.cgi?display=1&code=55&bulletin=55.
On 8 March, the WHO
reported that as of 3 March, a total of 1,874 reported cases of MCD (329 deaths)
had occurred in Burkina Faso since the outbreak began in December. The districts
of Diebougou, Pama, Pissy, and Yako have reached the epidemic threshold. A mass
immunization campaign is underway in Diebougou, Pissy, and Yako. The report is
at http://www.who.int/disease-outbreak-news/n2002/march/8march2002.html.
On 9 March, the British Medical Journal reported that
nearly 2,000 veterans of combat in Northern Ireland, the Gulf War, the Falklands,
and the Balkans, who have been diagnosed with post-traumatic stress disorder and
other stress conditions are suing the UK's Ministry of Defense for negligence
in failing to prepare them for the horrors of battle, screen out vulnerable individuals,
debrief them properly, recognize and treat post-traumatic stress disorder, and
help them cope with a return to civilian life. The high court trial is expected
to last seven months and to hear evidence from the US, the UK, and Israel. The
report is at http://bmj.com/cgi/content/full/324/7337/563.
On 9 March, the British Medical Journal reported that
over 100 women and the families of seven dead women filed a compensation claim
under the 1987 Consumer Protection Act in the High Court in London against Schering
Healthcare (manufacturer of Femodene), Wyeth (Minulet and Tri-Minulet), and Organon
Laboratories (Marvelon and Mercilon). The claim cites independent studies that
reportedly show third generation contraceptive pills have more than twice the
risk of venous thromboembolism as second-generation predecessors. Studies by
the manufacturers show little or no increased risk of venous thromboembolism.
The case is scheduled to last five months and will likely generate media interest.
The report is at http://bmj.com/cgi/content/full/324/7337/561.
On 11-15 March, the eighth annual Joint Task Force
(JTF) Surgeon's Seminar will be held for senior medical officers from across
DoD. The topics that will be discussed include crisis action planning, force
health protection, health service support for all branches of the armed forces,
special operations, and for the first time, planning for a homeland security
incident. The seminar is designed to better prepare senior medical officers
for the role of the JTF surgeon in the joint operational environment. The report
is at http://www.jfcom.mil/NewsLink/StoryArchive/2002/pa022502.htm.
On 7 May 02, the extra-label, e.g., topical, use of
nitrofuran drugs in food-producing animals will be prohibited because of a public
health risk, unless the FDA modifies the rule or extends the comment period.
The FDA decision is based on evidence that nitrofuran drugs may induce carcinogenic
residues in animal tissues. Systemic use of nitrofurans in poultry and swine
has been banned since 1991. A recent (1998) carbon-14 radiolabel residue depletion
study by FDA demonstrated that cattle treated with an ophthalmic preparation
had residues of the drug present in edible tissues (milk, meat, kidney, and
liver). The report is at http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_register&docid=02-2751-filed.
On 6 March, the American Psychological Association
(APA) reported that New Mexico was the first state to institute a law allowing
properly trained psychologists to prescribe psychotropic medications to patients.
Psychologists will be given a prescription-training program, which is based
on a model used by the DoD to train psychologists in the military to prescribe
psychotropic medication for patients. Only a handful of US Army psychologists
have completed the rigorous two-to-three year test program and are currently
authorized to prescribe medication. The APA report cites that there are only
18 psychiatrists for 72% of the state's residents who live outside of Albuquerque
and Santa Fe. The waiting time for a psychiatrist ranges from six weeks to
five months in these areas, and 75% of those with mental health disorders are
not receiving treatment. Suicide in New Mexico is 75% higher than the national
average. The report is at http://www.apa.org/practice/nm_rxp.html.
On 8 March, the CDC released a report summarizing tularemia cases reported
during 1990-2000, which indicated a low level of natural transmission. During
this time, 1,368 cases were reported from 44 states, which averaged 124 cases
per year. Four states accounted for 56% of all reported cases: Arkansas (315
cases, 23%), Missouri (265 cases, 19%), South Dakota (96 cases, 7%), and Oklahoma
(90 cases, 7%). The age range with the highest incidence was in persons 5-9
years of age and persons over 75 years of age. Males had a higher incidence
in all age categories. Of the 936 cases reported with date of onset, 654 cases
(70%) reported onset during May-August, but cases were reported during all months
of the year. Historically, most cases of tularemia during the summer were related
to arthropod bites and during the winter were related to hunters coming into
contact with infected rabbit carcasses. Outbreaks of tularemia in the US have
been associated with muskrat handling, tick bites, deer fly bites, and lawn
mowing or cutting brush. Outbreaks of pneumonic tularemia, particularly in
low-incidence areas, should prompt consideration of bioterrorism. The report
is at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5109a1.htm.
On 6 March, the VOA News reported
that US and Vietnamese scientists had concluded a joint conference in Hanoi
and agreed on actions to deal with the effects of the toxic defoliant Agent
Orange used by US forces in the Vietnam War. The EPA recently launched a pilot
project to improve test methods for detecting Agent Orange and its main toxic
ingredient, dioxin at a known Agent Orange hotspot near Danang. Vietnam estimates
that nearly one million of its citizens have been affected by the "chemical
warfare." The US says no scientific evidence exists to link dioxin to
a variety of illnesses, such as birth defects, cancer, and nervous disorders.
The US military sprayed nearly 11 million gallons of Agent Orange and other
defoliants over Vietnam from 1962 until 1971, when their use was halted after
their toxic nature became known. The report is at http://www.voanews.com/article.cfm?objectID=4DC74A0D-3930-4015-89F8E2B68E8B53A2&Title=US%2C%20Vietnam%20End%20Conference%20on%20Agent%20Orange&CatOID=45C9C786-88AD-11D4-A57200A0CC5EE46C.
On 5 March, The National Earthquake Information Center
reported an earthquake measuring 6.8-magnitude with an epicenter near Mindanao
island in the southern Philippines. On 8 March, The Manila Times reported 15
deaths, which were primarily caused by falling debris but included four heart
attacks at the height of the tremor. Over 27,000 people fled the coastal areas
in fear of tsunamis or tidal waves or an eruption of Mount Parker volcano, neither
of which occurred. The Manila Times report is at http://www.manilatimes.net/national/2002/mar/08/top_stories/20020308top7.html.
On 7 March, the WHO announced that more than 300 environmental and health
experts, who met at the First International Conference on Environmental Risks
to Children's Health in Thailand, had called for Asian governments to move quickly
to remove lead from gasoline. The experts cited studies in Europe and the US
that have shown removal of lead from gasoline had led to reduced levels of lead
in children's blood by 90 percent, which in turn led to a 30-40 percent reduction
in learning disabilities. The conference attendees also recommended governments
should take measures to eliminate environmental tobacco smoke in public areas
and encourage parents to stop tobacco smoking in homes which have children.
The report is at http://www.who.int/inf/en/pr-2002-15.html.
On 4 March, the CDC reported that 75,000 recent cases (25 deaths) of dengue
fever, including about 35,000 (14 deaths) in Rio de Janeiro, have been reported
in Brazil through February 2002. Dengue fever is common in Brazil, but these
figures represent a significant increase when compared to recent years. Many
other countries in South and Central America are also reporting increased dengue
activity. The risk for contracting dengue fever is less in rural areas and
at altitudes above 4,500 feet. The CDC advised that disease surveillance varies
from country to country and that epidemics are not always reported in all countries.
The report is at http://www.cdc.gov/travel/other/dengue-brazil-mar2002.htm.
On 8 March, Science Magazine reported that antibiotic
treatment to clear Wolbachia, a ubiquitous bacterium that colonizes the
nematode O. volvulus and thought to be at least partially responsible
for river blindness or ocular onchocerciasis, might reduce and prevent the disease.
Historically, the disease was thought to be caused by a severe inflammatory
response caused by O. volvulus microfilaria, which migrated to the eye
after transmission from female black fly bites. The disease occurs in Central
and South America, Africa, and Yemen. The report is at v. Saint Andre, A, et
al. The role of endosymbiotic Wolbachia bacteria in the pathogenesis
of river blindness. Science 2002 295: 1892-95.
The anthrax attacks of October 2001 targeted Federal offices
and affected mail processed in the Brentwood Postal Facility in Washington,
D.C. Other Federal agencies in the Washington area may become targets for this
kind of attack, or they may receive mail affected by attacks on other agencies.
This website provides a fact sheet and current information on irradiated mail
as a countermeasure: http://chppm-www.apgea.army.mil/IrradiatedMail/.
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/MCHB-CS-OHD/584-7663
mailto:Barbara.Davis1@APG.amedd.army.mil
ACIP
- Advisory Committee on Immunization Practices
AFPS
American Forces Press Service
AIDS
Acquired Immunodeficiency Syndrome
APHIS
Animal and Plant Health Inspection Service
BSE
Bovine Spongiform Encephalopathy
CBRN Chemical, Biological,
Radiological, and Nuclear
CDC Centers for
Disease Control and Prevention
CDR
Communicable Disease Report (England)
DHHS Department of Health and Human Services
DoD
- Department of Defense
DOE Department of Energy
DOS Department
of State
EISS European Influenza Surveillance Scheme
EPA Environmental Protection Agency
FBI Federal Bureau of Investigation
FCC - Federal Communications Commission
FDA Food and Drug Administration
FEMA Federal Emergency Management Agency
FMD Foot and Mouth Disease
FSIS Food Safety Inspection Service
GAO US General Accounting Office
HIV Human Immunodeficiency Virus
IAEA International Atomic Energy Agency
ICBM Intercontinental Ballistic Missile
ICRC International
Committee of the Red Cross
IDP Internally Displaced Persons
ILI Influenza-Like Illness
IOM - Institute of Medicine, part of the National Academy of Sciences
IRCS International Red Cross Society
IRIN - Integrated Regional Information Networks,
part of the United Nations (UN) Office for the Coordination of Humanitarian
Affairs (OCHA), a UN humanitarian information unit that may not necessarily
reflect the views of the UN or its agencies
NAS National Academy of Sciences
NATO North Atlantic Treaty Organization
NCI National Cancer Institute
NIH National Institutes of Health
NIOSH National Institute for Occupational Safety and Health
NRC Nuclear Regulatory Commission
OIE World Organisation [sic] for Animal Health
OSHA - Occupational Safety and Health Administration
PCR Polymerase Chain Reaction
PHLS Public Health Laboratory Service
PHS Public
Health Service
PPE Personal
Protective Equipment
UK United Kingdom England, Northern Ireland, Scotland, and Wales
UN United Nations
UNHCR United Nations High Commissioner for Refugees
USDA United States Department of Agriculture
USPSTF
United States Preventive Services Task Force
VOA Voice of America, an international multimedia broadcasting service funded
by the US Government
WHO World Health Organization
