This month’s edition of the MSMR Reportable Medical Events at Military Health System facilities feature provides an overview of annual data for 2024 for active component service members and MHS beneficiaries. RMEs are reported in the Disease Reporting System internet by health care providers and public health officials throughout the MHS for monitoring, controlling, and preventing the occurrence and spread of diseases of public health interest. These reports are validated by the Defense Health Agency–Public Health.

The DRSi collects reports on over 70 different RMEs, including infectious and non-infectious conditions, outbreak reports, sexually transmitted infection risk surveys, and tuberculosis contact investigation reports. A complete list of RMEs is available in the 2022 Armed Forces Reportable Medical Events Guidelines and Case Definitions.¹ Data reported in this report are considered provisional and do not represent conclusive evidence until case reports are fully validated.

Top 5 RMEs in 2024, by MMWR Week, for ACSMs and MHS Beneficiaries

The top five RMEs reported to DRSi in 2024 are displayed on the following page, by week, for ACSMs and MHS beneficiaries. The top five RMEs reported for ACSMs were chlamydia, gonorrhea, norovirus, heat illness, and syphilis (Figure 1). Among MHS beneficiaries, the top five RMEs reported were chlamydia, norovirus, COVID-19-associated hospitalization or death, gonorrhea, and campylobacteriosis (Figure 2). 

Ratios of RMEs for 2024 Compared to 2023 for ACSMs and MHS Beneficiaries

The current ratio data are based on incidence counts comparing year 2024 to 2023; low numbers for many conditions limit data interpretation and are not included in the figures. Conditions with less than 10 medical event reports per year, as well as COVID-19-associated hospitalizations and deaths, and syphilis, were excluded from the ratio comparisons. COVID-19-associated hospitalizations and deaths were excluded due to changes in the case definition in May 2023; syphilis cases were excluded due to changes in case validation processes implemented in January 2024. Ratios presented in Figures 3 and 4 include any RMEs that had, at minimum, a 30% increase or decrease in MERs in 2024 compared to MERs in 2023.

For ACSMs, the total number of MERs submitted to DRSi in 2024 decreased by 8.4% compared to 2023. Cases of pertussis and influenza-associated hospitalizations had the most prominent increases in 2024 compared to 2023, with 153% and 86% increases, respectively. Increases of case counts in 2024 were also seen for norovirus infections (53%), coccidioidomycosis (47%), Lyme disease (44%), Shiga toxin-producing E. coli (35%), and varicella (31%) (Figure 3).

Three RMEs decreased among ACSMs in 2024 versus 2023: spotted fever rickettsiosis (-32%), acute and chronic hepatitis B (-34%), and acute and chronic hepatitis C (-44%). 

For MHS beneficiaries, the total number of MERs submitted to DRSi in 2024 increased by 1.6% compared to 2023. Like ACSMs, MHS beneficiaries also saw the most prominent increases for cases of pertussis and influenza-associated hospitalizations in 2024, with 161% and 81% increases, respectively. Increases were also seen for varicella (74%), giardiasis (71%), norovirus infections (57%), Shiga toxin-producing E. coli (49%), and cryptosporidiosis (33%) (Figure 4). There were no substantial decreases in specific RMEs in 2024 versus 2023 for MHS beneficiaries.

Like the DHA-PH, the Centers for Disease Control and Prevention have reported similar trends for increased incidence of pertussis, influenza-associated hospitalizations, and norovirus. According to preliminary CDC data, as of week 52 of 2024 over 6 times as many cases of pertussis had been reported compared to the same period in 2023.² An increase in influenza-associated hospitalizations was reported during the 2023-2024 influenza season compared to the 2022-2023 influenza season.³ The CDC also noted an increase in norovirus outbreaks between August 1 and December 11, 2024, with 495 outbreaks versus 363 during the same period the preceding year.⁴

For questions about this report, please contact the Disease Epidemiology Branch at the Defense Centers for Public Health–Aberdeen. Email: dha.apg.pub-health-a.mbx.disease-epidemiologyprogram13@health.mil

Authors' Affiliation

Disease Epidemiology Branch, Defense Centers for Public Health–Aberdeen, MD: Ms. Aguirre, Mr. Allman, Mr. Marquez, Ms. Kotas, Dr. Ambrose

References

1. Armed Forces Health Surveillance Division. Armed Forces Reportable Medical Events: Guidelines and Case Definitions. Defense Health Agency, U.S. Dept. of Defense. Accessed Feb. 28, 2024. https://health.mil/reference-center/publications/2022/11/01/armed-forces-reportable-medical-events-guidelines 
2. Centers for Disease Control and Prevention. Pertussis Surveillance and Trends. U.S. Dept. of Health and Human Services. Accessed Jan. 21, 2025. https://www.cdc.gov/pertussis/php/surveillance/index.html 
3. Centers for Disease Control and Prevention. About Estimated Flu Burden. U.S. Dept. of Health and Human Services. Accessed Jan. 21, 2025. https://www.cdc.gov/flu-burden/php/about/index.html 
4. Centers for Disease Control and Prevention. NoroSTAT Data. U.S. Dept. of Health and Human Services. Accessed Jan. 21, 2025. https://www.cdc.gov/norovirus/php/reporting/norostat-data.html