MEDICAL SURVEILLANCE AND MEDICAL EVENT REPORTING

Department of Navy policy and guidance for medical surveillance and medical event reporting is set forth in BUMED Instructions series 6220.12 and 6200.17; fleet policy is set forth via fleet messaging. The purpose of medical surveillance in the Navy is to ensure timely recognition and control of disease threats and estimate distribution of disease and disease risk in order to inform policy and resource allocation decisions. NMCPHC supports this effort by maintaining Disease Reporting System, internet (DRSi) and supporting the use of the syndromic surveillance tools Electronic Surveillance System for Early Notification of Community based Epidemics (ESSENCE) and Disease and Injury Surveillance (D&I). NMCPHC also works to improve reporting and to analyze medical surveillance data to inform leadership decisions.

Navy Medical Department personnel who diagnose a patient with a reportable disease shall report those cases as outlined in BUMEDINST 6220.12 series, preferably via DRSi. Syndromic surveillance is one component of the comprehensive, continuous and consistent military health surveillance required under DoD Directive 6490.02 series. DoD Instruction 6200.03 directs installations within the United States to ensure two trained ESSENCE users are actively monitoring ESSENCE. For units without access to ESSENCE, surveillance via the conduct of D&I surveillance can enable early detection and monitoring of disease threats.

In January 2020, the DoD implemented mandatory reporting of all confirmed and probable cases of COVID-19 via the Disease Reporting System internet (DRSi) for military service members and other beneficiaries. Cases must be classified according to the most recent DoD case definition for COVID-19.

Policy and Guidance

• Armed Forces Reportable Medical Events Guidelines and Case Definitions
• DHA Reportable Medical Event Memo (1 May 23 | CAC-enabled)
• Article 2-17 of the Manual of the Medical Department
• BUMED Instruction 6220.12C: Medical Surveillance and Medical Event Reporting
• NMCPHC-TM 6220.12: Medical Surveillance and Reporting

Surveillance and Reporting Tools

• DRSi
• ESSENCE
• Disease and Injury D&I Surveillance (Formerly DNBI)

Web Resources

• Centers for Disease Control and Prevention: National Notifiable Disease Surveillance System Case Definitions
• Council of State and Territorial Epidemiologists: State Reportable Conditions Websites
• NMCPHC EpiData Center Reportable Medical Events

Publications and Products

• Navy List of Reportable Medical Events
• Reporting an Outbreak
• Barriers and Practical Solutions to Reporting
• Monthly Disease Surveillance Training

• CDC Mpox Page
• WHO Mpox Page
• IHD Mpox Vaccine Resource Center
• DHA Mpox Guidance Update_5Sept2024

Clinical guidance, including recognition, management and clinical isolation guidance are generally covered by CDC: CDC Clinical Overview

Clinical management for Fleet medical personnel can be found in the NMCFHPC Fleet Mpox Medical Guidance

Clinical guidance for MTFs can be found in the DHA Mpox Guidance Update_5Sept2024

Currently, neither mpox testing nor treatment are readily available in a forward deployed operational setting. Units should identify suspected cases, isolate them, and move them for care at an MTF when operationally feasible.