Although mental health conditions are the leading underlying cause of maternal mortality, there is limited research on the prevalence of perinatal mental health conditions among active duty service women (ADSW). In this study of live-born deliveries among U.S. ADSW (n=62,729) with pregnancy start and end dates (i.e., dates of last menstrual period and infant delivery, respectively) from October 1, 2016 through December 31, 2021, International Classification of Diseases, 10th Revision, Clinical Modification diagnosis codes were used to identify mental health conditions: trauma and stressor-related disorders, anxiety and panic disorders, depressive disorders, suicidal ideation or attempt, and eating disorders. Data were collected through 1 year postpartum, until December 31, 2022. The prevalence of diagnosed mental health conditions from 1 year prior to pregnancy through 1 year postpartum was 33.8%. Trauma and stressor-related disorders were most prevalent (23.1%), followed by anxiety and panic disorders (16.9%), depressive disorders (14.6%), suicidal ideation or attempt (1.6%), and eating disorders (0.4%). The prevalence of mental health conditions was higher in the postpartum period (22.0%) compared to pregnancy (18.4%) and prior to pregnancy (15.0%). Overall, higher prevalence of these conditions was found among non-Hispanic Black ADSW (37.4%), and those who were unmarried (38.4%), never deployed (34.9%), or in the Army (37.4%) and Navy (36.4%). One in 3 active duty service women were diagnosed with a mental health condition in the year preceding pregnancy through 1 year postpartum. Overall, non-Hispanic Black and junior enlisted active duty service women demonstrated higher prevalences of mental health conditions compared to all other racial and ethnic groups and military ranks.

Few studies have investigated body mass index (BMI) and physical fitness factors related to coronavirus disease (COVID)-19 hospitalizations among U.S. active duty service members. This investigation examined associations between measures of physical fitness, BMI, and Army physical fitness test (APFT) performance with COVID-19 hospitalizations of U.S. Army active duty soldiers. From May 2020 through November 2021, 13,074 male soldiers were diagnosed with COVID-19 (90 hospitalized, 12,984 non-hospitalized) who also had an APFT and BMI record no more than 9 months from the COVID-19 diagnosis date. Female soldiers were excluded due to insufficient numbers of COVID-19 hospitalizations. In adjusted logistic regression models controlling for race and ethnicity as well as comorbidities, and including age, BMI, and their interactions, both BMI (adjusted odds ratio [aOR] 1.07; 95% CI 1.01, 1.14; p=0.021), and the age and BMI interaction were statistically significant (aOR 1.01; 95% CI 1.00, 1.02; p=0.004). Each additional year of age amplified the odds of hospitalization by an additional 1% for every 1 unit increase in BMI. Development and maintenance of a healthy body weight may reduce likelihood of COVID-19 hospitalization and sustain individual and unit health and medical readiness. For male U.S. Army active duty soldiers, the association between having a higher BMI and COVID-19 hospitalization was amplified by age, indicating about a 1% increase in the odds of hospitalization per BMI unit for each additional year of age. Maintaining a healthy body weight may reduce the risk of COVID-19 related hospitalization for military personnel. The U.S. Army's Holistic Health and Fitness Program is one example of a comprehensive health program established to simultaneously enhance several facets of military health and fitness.

Exertional rhabdomyolysis is a pathologic muscle breakdown associated with strenuous physical activity. A largely preventable condition, it persists as an occupational hazard of military training and operations, especially in high heat environments among individuals pushing their endurance limits. A total of 464 cases of exertional rhabdomyolysis were identified in 2024, corresponding to a crude incidence rate of 35.9 cases per 100,000 person-years, and is the lowest case count recorded during the 2020-2024 period of surveillance. The 2024 case numbers demonstrated a 9.6% reduction from the peak rate in 2023, and the proportion of 39.7% hospitalized in 2024 represented a 4.0% decrease from 2023. In 2024, all services, excepting the Navy, showed declines in incidence rates, ranging from 2.0% in the Coast Guard to 29.1% in the Air Force, compared to 2023. Consistent with prior reports, subgroup-specific crude rates in 2024 were highest among men, those less than 20 years old, non-Hispanic Black service members, Marine Corps or Army members, and those in combat-specific or 'other' military occupations. Recruit trainees continued to experience the highest rates of exertional rhabdomyolysis in 2024, with a rate more than 13 times greater than officers and enlisted members. During the 2020-2024 surveillance period, 2024 evinced the lowest incidence rate of exertional rhabdomyolysis, nearly 10% lower than the peak observed in 2023. The Air Force showed the largest reduction, with incidence rates decreasing approximately 30% from the previous year.

Exertional hyponatremia, or hyponatremia associated with exercise, occurs within 24 hours after physical activity due to a serum, plasma, or blood sodium concentration ([Na+]) below the normal reference range of 135 mEq/L. Hyponatremia can be fatal if not detected early and managed properly. From 2009 to 2024, 1,829 cases of exertional hyponatremia were diagnosed among U.S. active component service members (ACSMs), with an overall incidence rate of 8.4 cases per 100,000 person-years (p-yrs). In 2024, 134 cases of exertional hyponatremia were diagnosed among ACSMs, resulting in a crude incidence rate of 10.4 per 100,000 p-yrs. Female service members, those older than 40 years, non-Hispanic White service members, Marine Corps members, recruits, those in health care occupations, and ACSMs stationed in the Midwest U.S. had higher incidence rates of diagnosis for exertional hyponatremia than their respective counterparts. From 2009 to 2024, annual rates of incident exertional hyponatremia diagnoses peaked in 2010 (12.8 per 100,000 p-yrs) and then decreased to a low of 5.3 cases per 100,000 p-yrs in 2013. The incidence rate has fluctuated since then, rising from 6.1 per 100,000 p-yrs in 2017 to the second-highest level (11.2 per 100,000 p-yrs) in 2023 before decreasing to 10.4 per 100,000 p-yrs in 2024. Service members and their supervisors must be aware of the dangers of excessive consumption of water and the prescribed limits of water intake during prolonged physical activity, including field training exercises, personal fitness training, as well as recreational activities, particularly in hot, humid weather. Incidence rates of exertional hyponatremia changed from 2023 to 2024, with the overall incidence rate decreasing from 11.2 to 10.4 per 100,000 p-yrs. Rates increased, however, in the 25-29 years age group and in the Coast Guard, while decreasing sharply among non-Hispanic Black individuals and recruits. The highest incidence rates were observed in non-Hispanic White individuals and health care personnel.

Australian Defence Force (ADF) personnel train and operate in malarious regions that include neighboring countries with high burden and species with latent hepatic parasites.1 We summarized longitudinal malaria case data, following a prior 10-year period review to 2007.2 Malaria case entries within the ADF Malaria and Infectious Diseases Institute (ADFMIDI)-managed Central Malaria Register (CMR) were examined. Data from cases confirmed between January 1, 2008 through December 31, 2022 were analyzed. Sixty ADF members were diagnosed with malaria, including 1 with a mixed Plasmodium falciparum and P. vivax infection. Of 61 malaria infections, 69% (42 of 61) were P. vivax. P. vivax infection resulted in delayed initial case presentation (more than 4 weeks after exposure) in at least 36% (15 of 42) of cases, and 5 personnel experienced further relapse. Most P. vivax infections were acquired in the U.S. Indo-Pacific Command (INDOPACOM) and P. falciparum in the U.S. Africa Command (AFRICOM) regions. The ADF experienced ongoing reduced malaria case incidence following high rates in the early 2000s. Maintenance of prophylactic vigilance, both for eradicating dormant hypnozoites and preventing P. vivax relapse, remains important, however.