MEDCOM Situation Report

• From: Army Office of the Surgeon General/MEDCOM HQ
• To: Army Operations Center
• Col. Wilson DASG-HCO
• 3 pages
• For Official Use Only
• June 26, 2009

1. SITUATION: “On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. A Phase 6 designation indicates that a global pandemic is underway. More than 70 countries are now reporting cases of human infection with novel H1N1 flu. This number has been increasing over the past few weeks, but many of the cases reportedly had links to travel or were localized outbreaks without community spread. The WHO designation of a pandemic alert Phase 6 reflects the fact that there are now ongoing community level outbreaks in multiple parts of world. WHO’s decision to raise the pandemic alert level to Phase 6 is a reflection of the spread of the virus, not the severity of illness caused by the virus.” (CDC Update 19 June 2009).

• The DoD response phase level remains at Phase 0 (Shape). No Change.
• The federal government response phase level remains at Phase 0. No Change.
• WHO response phase level remains at 6. No change.

A. International: As of 19 June 2009 06:00 GMT, 94 countries (+20 from the last report) have officially reported 44,287 (+14,618) cases of influenza A(H1N1) infection, including 180 deaths (+35).
B. National: U.S. Federal Government continues to remain in Pandemic Phase 0. Department of Health and Human Services (DHHS) is the lead federal agency for H1N1 preparedness and response.
As of 19 June 2009, 1100 ET, there are 21,449 (+3,594) cases in all 50 states including DC, Puerto Rico, and the Virgin Islands. There are 87 (+42) reported deaths.
C. DoD: Supported Combatant Command is USNORTHCOM.
As of 16 June 2009, the Armed Forces Health Surveillance Center (AFHSC) is reporting a total of 1046 (+357) cumulative probable/confirmed DOD beneficiaries with H1N1 (Since 1 Apr 09):
MEDCOM MTF reports do not indicate a significant increase since last report or any issues with providing care.
The breakout for Army numbers follows (as of 1200 hours 19 June 2009):

• Total Cases: 458 (+104) confirmed cases:
• 244 (+53) Active Duty
• 213 (+50) Dependents
• 1 Recruit

*Note: The total Army numbers listed above will not match the totals listed in the DoD Global Surveillance Summary as reported by the Armed Forces Health Surveillance Center (AFHSC) in paragraph 1.C. AFHSC reports weekly every Wednesday whereas OTSG/MEDCOM reports weekly as of Friday.

CONUS Army Sites
-3 cases at Ft. Belvoir, 1 Active Duty, 2 Dependent
-108 (+26) cases at Ft. Bliss, 48 (+19) Active Duty, 60 (+7) Dependents
– 4 cases at Ft. Carson, 3 (+3) Active Duty, 1 (+1) Dependent
-11 (+8) cases at Ft. Drum, 1 (+1) Active Duty, 10 (+7) Dependents
-1 case at Ft. Eustis, 1 Active Duty
-9 (+2) cases at Ft. Gordon, 4 (+1) Active Duty, 5 (+1) Dependents
-4 (+2) cases at Ft. Hood, 2 (+1) Active Duty, 2 (+1) Dependent
-15 (+1) cases at Ft. Irwin, 9 (+1) Active Duty, 6 Dependent
-4 cases at Ft. Jackson, 4 Active Duty
-1 case at Ft. Knox, 1 Dependent
-99 (+21) cases at Ft. Lewis, 45 (+10) Active Duty, 54 (+11) Dependents
-1 case at Ft. Meade, 1 Dependent
-4 cases at Ft. Polk, 4 Dependents
-33 (+4) cases at Ft. Riley, 20 (+1) Active Duty, 13 (+3) Dependents
-20 cases at Ft. Sam Houston, 3 Active Duty, 17 dependents
-17 (+10) cases at West Point, 8 (+2) Active Duty, 9 (+8) Dependent
-2 (+2) cases at Walter Reed, 1 (+1) Active Duty, 1 (+1) Dependent

OCONUS
-1 case at Landstuhl, Germany, 1 Active Duty
-1 case at Mannheim, Germany, 1 Active Duty
-1 case at Stuttgart, Germany, 1 Active Duty
-14 (+7) cases at Tripler, 4 (+2) Active Duty, 10 (+5) Dependents
-72 (+3) cases in Kuwait, 72 (+3) Active Duty (Note: ARCENT reports separately)
-1 (+1) case at Balad AB, Iraq, 1 (+1) Active Duty

Non-Army Sites
-7 (+5) cases at Andrews AFB, 2 Active Duty, 5 (+5) Dependents
-1 case at Chicago Heights Recruiting Station, 1 Dependent
-1 case at Great Lakes, 1 Dependent
-3 cases at Hanscom AFB, 1 Active Duty, 2 Dependents
-3 cases at Little Rock AFB, 3 Active Duty
-2 cases at Luke AFB, 2 Dependents
-13 (+11) cases at McGuire AFB, 12 (+10) Active Duty, 1 (+1) Dependent
-1 case at McConnell AFB, 1 Dependent
-3 cases at Randolph AFB, 3 Dependents
-1 case at Naval Hospital Bremerton, 1 Dependent
-1 case at Naval Hospital Lemoore, 1 Dependent

-1 Probable Cases: 1 (+1) case at Ft. Irwin, Dependent; and 1 case at Vilseck, Germany, 1 Active Duty

-51 Ruled Out Cases

2. MISSION: No change.

3. EXECUTION:
a. LAST 72 HRS: Monitor the situation and coordinated with ARCENT.
b. CURRENT FOCUS AND ACTIVITIES: Coordinating with DA G3 to ensure effective screening of all Soldiers prior to arrival in Kuwait.
c. NEXT 24 HOURS: Continued monitoring of new and confirmed cases.

4. SERVICE SUPPORT:
CDC Definitions can be found at: http://www.cdc.gov/swineflu/recommendations.htm. A probable case of S-OIV infection is defined as a person with an acute febrile respiratory illness who is positive for influenza A, but negative for H1 and H3 by influenza RT-PCR. A confirmed case of S-OIV infection is defined as a person with an acute febrile respiratory illness with laboratory confirmed S-OIV infection at CDC by one or more of the following tests: 1. Real-time RT-PCR 2. Viral culture

5. COMMANDER’S NARRATIVE ASSESSMENT: OTSG/MEDCOM continues to assess the situation and prepare for the future. Despite the World Health Organization raising its alert level to 6, the DoD remains at level 0. The WHO alert level is based on the geographic distribution of the outbreak (it is now sustained at locations world wide) while the DoD alert levels are related to the severity or impact of the outbreak. Because DoD operations are relatively unaffected the alert level has not increased. We are focusing current staff and command effort in support of CENTCOM pre deployment screening requirements.

COL Wilson/DASG-HCO/(703)681-8052

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