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July 2012 Vol. 19 No. 7, 28 pgs.. The original document contains color images.

Viruses are the most common causes of meningitis, a condition characterized by inflammation of the protective membranes that surround the brain and spinal cord. During the 10-year surveillance period, there were 3,205 confirmed cases, 724 probable cases, and 2,495 suspected cases of viral meningitis among active and reserve component members. In all three categories of cases, the most common diagnoses were meningitis due to enteroviruses; however a majority of these were unspecified enteroviruses. Nearly two-thirds (64.2%) of all cases due to enteroviral infection were hospitalized; on average, cases were hospitalized for 3.2 days. Numbers of cases peaked in late summer/early fall; and higher than average numbers of cases in 2003 reflected several outbreaks that occurred in civilian populations that year. Six states (Texas, California, Virginia, North Carolina, Florida, Georgia) reported the most cases in 2003 and overall during the period. Prevention of viral meningitis relies upon the interruption of viral transmission, e.g., thorough hand washing and disinfection of contaminated surfaces., Pub. in Medical Surveillance Monthly Report, v19 n8, p2-23, Aug 2012.

The original document contains color images.

The original document contains color images.

Suicide is a leading cause of deaths of U.S. service members. Medical care providers may play a role in suicide prevention. We summarized the outpatient experiences of service members prior to suicide or self-infl icted injury and compared them with service members without suicidal behavior. During 2001-2010, 45 percent of individuals who completed suicide and 75 percent of those who injured themselves had outpatient encounters within 30 days prior to suicide/self-harm. Primary care was the most frequently visited clinical service prior to suicide/self-harm. As compared to their counterparts, service members with suicidal behavior had especially excessive outpatient visit rates within, but not prior to, 60 days of their deaths/injuries. Th e fi nding suggests that there may be one or more triggering events that lead to care-seeking. Th ese results may help identify individuals that should be screened for suicide risk., Medical Surveillance Monthly Report, v19 n2, p1-27, February 2012. The original document contains color images.

CONTENTS: Relationships between increasing outpatient encounters for neurological disorders and introductions of associated diagnostic codes, active duty military service members, 1998-2010; Alcohol-related diagnoses, active component, U.S. Armed Forces, 2001-2010; Update: Cold weather injuries, U.S. Armed Forces, July 2006-June 2011; Surveillance Snapshot: Reportable medical events of heat injury in relation to heat index, June-September 2011; Deployment-related conditions of special surveillance interest (summary tables and figures), October 2011, Vol. 18, No. 10. Th e MSMR provides evidence-based estimates of the incidence, distribution, impact and trends of illness and injuries among United States military members and associated populations. Most reports in the MSMR are based on summaries of medical administrative data that are routinely provided to the AFHSC and integrated into the Defense Medical Surveillance System for health surveillance purposes. The original document contains color images.

Obstructive sleep apnea (OSA) is characterized by the complete or near-complete cessation of airfl ow during sleep due to obstruction of the upper airway. Common symptoms of OSA include snoring, choking or gasping during sleep, insomnia, morning headache, and daytime sleepiness. Risk factors for the development of OSA include obesity, increasing age, male gender, and smoking. OSA has a significant public health impact due to its co-occurrence with other health-related conditions; OSA has been linked to increased risk of motor vehicle accidents, neurocognitive impairment, and cardiovascular disease. Prevalence estimates of OSA cluster around 2.5% for women and 4% for men. An analysis of Veterans Health Administration records revealed that approximately three percent of more than four million U.S. military veterans had documented diagnoses of sleep apnea; of note, the veterans included in that study were signifi cantly older and contained proportionally more males than the current active military population. Th e gold standard for diagnosing OSA is polysomnography, a study performed in a laboratory by a sleep technician. Th roughout a night of sleep, physiologic parameters including airfl ow, respiratory eff ort, and oxygen., Pub. in Medical Surveillance Monthly Report (MSMR), v17 n5, p1-27, May 2010.