Update: Plant dermatitis among active component service members, U.S. Armed Forces, 2010-2020.

Dermatitis (skin inflammation) caused by the oil of poisonous plants is an occupational hazard for U.S. military members who are assigned and train in endemic areas. Plant dermatitis can cause significant disability, substantial medical costs, and lost duty time. During the 11-year surveillance period there were 73,725 cases of plant dermatitis diagnosed in active component service members (rate: 5.3 per 1,000 person-years [p-yrs]). The overall incidence rates remained relatively stable between 2010 and 2015, increased in 2016 and 2017, then decreased in 2018 through 2020. Compared to their respective counterparts, incidence rates were highest among male service members (5.7 per 1,000 p-yrs), the youngest (<20 years) service members (8.4 per 1,000 p-yrs), non-Hispanic White service members (7.5 per 1,000 p-yrs), members of the Army (7.7 per 1,000 p-yrs) and Marine Corps (6.5 per 1,000 p-yrs), and among those in combat-related occupations (11.9 per 1,000 p-yrs). More than half of the cases occurred during summer months and about one-third of all cases were diagnosed at 4 installations: Fort Benning, Georgia (n=11,257); Camp Pendleton, CA (n=5,399); Fort Bragg, NC (n=4,259), and Fort Campbell, KY (n=3,221). Service members, particularly young individuals in combat-training in endemic states, should be informed of the risks associated with exposures to toxic plants and advised on personal protective measures.

Morbidity burdens attributable to various illnesses and injuries in deployed (per Theater Medical Data Store [TMDS]) active and reserve component service members, U.S. Armed Forces, 2008-2014.

This report estimates illness and injury-related morbidity and the healthcare "burden" for service members during deployments to the CENTCOM and AFRICOM theaters of operation during 2008-2014. During the 7-year surveillance period, a total of 2,863,834 medical encounters occurred among 1,596,935 service members who were deployed. Four burden categories comprised 50% or more of the total healthcare burden among both male and female deployers: injury and poisoning, mental disorders, musculoskeletal diseases, and signs and symptoms. In both genders, injuries and poisonings, and signs and symptoms, were the top two categories that affected the most individuals. Both genders had the same top four hospitalization categories: injuries and poisonings, signs and symptoms, genitourinary diseases, and digestive diseases. The limitations of the data used in the analysis are discussed.

Incidence of gastroesophageal reflux disease (GERD), active component, U.S. Armed Forces, 2005-2014.

Gastroesophageal reflux disease (GERD) is a common condition among adults that can cause symptoms such as frequent heartburn, substernal chest pain, and regurgitation of food. During 2005-2014, a total of 137,081 active component service members had an incident (first-ever) diagnosis of GERD (incidence rate: 101.3 per 10,000 person-years). Incidence rates were higher than their respective counterparts among females, black and white non-Hispanics, service members in the Coast Guard and Air Force, officers, and those in healthcare occupations. Rates increased monotonically with increasing age groups. Most GERD cases (79.2%) were uncomplicated GERD; however, 20.8% were identified as having a symptom or complication linked to their GERD diagnosis. Lifestyle changes, medication, and prevention of serious complications should be emphasized among individuals diagnosed with GERD, particularly those at risk for severe disease.

Incidence of joint replacement among active component service members, U.S. Armed Forces, 2004-2014.

In the U.S., joint replacements have become more common and the average age of individuals who undergo joint replacements has decreased. Joint replacements among active component service members increased 10.5% during 2004-2009, then 61.9% during 2009-2014. Knees and hips were the most frequently replaced joints among service members. During the surveillance period (and particularly after 2009), incidence rates increased in each age group of service members 30 years or older. Relative to their respective counterparts, rates of joint replacement overall--and of the hip and knee specifically--were higher among service members who were black, non-Hispanic; officers; and healthcare workers. One year after joint replacement, 18.2% had retired; 5.2% had been medically disqualified from service; 6.3% had otherwise left service; and 70.3% were still in service. By 2 years post-joint replacement, 30.2% had retired; 13.0% had been medically disqualified; 10.0% had otherwise left service; and 46.8% were still in service. Service members aged 30-44 years were the most likely to remain in service post-joint replacement. Given the increases in the frequency of joint replacement among younger service members, the number of service members who remain in service post-joint replacement may continue to increase.

Measles and mumps among service members and other beneficiaries of the U.S. Military Health System, January 2007-December 2014.

Measles and mumps are highly communicable infectious diseases whose causative viruses are spread through airborne droplets and infected surfaces. Individuals at highest risk are infants and unvaccinated individuals. Despite effective vaccines, there have been recent increases in incidence in the U.S. of both infections. During the surveillance period, there were 14 confirmed measles cases and 99 confirmed mumps cases among U.S. military members and other beneficiaries of the U.S. Military Health System. Only one of the confirmed cases of measles was in a service member. Children aged 5 years and younger accounted for the greatest proportion of confirmed measles cases (50.0%); the greatest proportions of confirmed mumps cases were for children aged 1-5 years and adults aged 26-30 years (22.2% and 17.2%, respectively). California had more cases of both measles and mumps than any other state. Recent trends in measles and mumps in civilian populations in the U.S. highlight the importance of primary and booster vaccinations.

Incidence of Salmonella infections among service members of the active and reserve components of the U.S. Armed Forces and among other beneficiaries of the Military Health System, 2000-2013.

This report reviews the incidence of cases of typhoidal and non-typhoidal Salmonella infections based on diagnoses recorded in healthcare records and reported through the Armed Forces reportable medical event (RME) system. During 2000-2013, there were 1,815 incident cases of non-typhoidal Salmonella and 456 incident cases of typhoidal Salmonella diagnosed in the active component force. The crude incidence rate for non-typhoidal Salmonella was 0.91 cases per 10,000 person years (p-yrs) and the rate for typhoidal Salmonella was 0.23 cases per 10,000 p-yrs. Among retirees and family members, children under 5 years of age and those aged 75 years or older comprised the greatest number of non-typhoidal Salmonella cases. Preventive measures for reducing the risk of infection with Salmonella are discussed.