An official website of the United States government
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.










 

Medical Surveillance and Reporting

Medical surveillance and medical event reporting are vital activities for maintaining threat awareness and enabling timely, coordinated response at every level.

By understanding emerging health threats, we can strengthen Navy and Marine Corps readiness before exposure occurs and improve response efforts through targeted access to subject matter experts (SMEs) and essential resources. The Navy Environmental and Prevention Medical Units (NEPMUs) are the Preventive Medicine reach back support for the numbered fleet, training centers and NMRTCs with SMEs in medical surveillance, reporting, epidemiologic risk assessment, and outbreak response.

Medical Surveillance

All Navy Medical Departments should know the health threats in their area of responsibility (AOR), the health of the forces they serve, and the baseline/expected rates of Disease and Non-Battle Injuries (DNBI) in order to detect unusual patterns or emerging concerns early. Below are key activities:

  • All Navy medical departments supporting operational units should be conducting DNBI surveillance of those units.
    • Navy medical departments supporting installation populations should be doing syndromic surveillance.
    • Refer to BUMEDINST 6220.12D for more details.

Tools for Medical Surveillance

  • Paper or Microsoft Excel DNBI Surveillance
    • DNBI surveillance can be done manually in low resource environments; Microsoft Excel can also be used to collect and organize information.
    • Paper SF600s or manual sick call logs can provide simple counts of DNBI categories. Staff using an electronic medical health system (AHLTA-T, MHS GENESIS, GENESIS-theater) without reliable access to ESSENCE/MedCOP may be able to pull a daily extract to provide counts. The responsible Medical Department may delegate this task to their subordinate units and collate them to create a weekly DNBI report.
  • Microsoft EXCEL DNBI templates are available HERE. Contact your cognizant NEMPU for assistance.
  • Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE)
    • Syndromic surveillance application available to select medical departments using an electronic medical record. It is also in use by numbered fleets and other Navy components to track ships regularly recording their medical care in AHLTA-T.
      • Dashboards for installation surveillance, Streptococcal infection surveillance in training populations, and shipboard surveillance are available through the NEPMUs.
      • NMCFHPC is working with Fleet Forces Command (FFC), Marine Forces, and AFHSD to develop additional operational surveillance capabilities.
    • How to get account:
    • How to get started:
      • Training available on Joint Knowledge Online (JKO):
        • Basic Course (DHA US046-V5 (CUI)
        • Advanced Course (DHA US465 (CUI)
      • AFHSD ESSENCE Training | CarePoint (Coming Soon)
      • Contact your NEPMU to get dashboards and set up assistance.
      • Medical Common Operating Picture (MedCOP)
        • MedCOP is a suite of tools designed to provide medical operations and health surveillance visibility to medical leadership in operational environments.
        • Used by operational DON medical departments regularly recording their medical care in an electronic medical health system or manually entering DNBI counts into the MedReport module.
        • NMCFHPC is currently working with Fleet Forces Command (FFC) and BUMED to improve the DNBI module within MedCOP for the numbered fleet.
        • How to get started:
    • Health Surveillance Explorer (HSE)
  • Note: Medical surveillance can also be supported by Disease Reporting System internet (DRSi) queries, by using the MHS GENESIS DISCERN portal, and through local public health and stakeholder networks.
 

Medical Reporting

All Navy Medical Departments must report Reportable Medical Events (RMEs) that occur in their area of responsibility (AOR) within the Disease Reporting System internet (DRSi), as well as, to their chain of command and their local NEPMU. The cognizant NEPMU can ensure an adequate public health response is initiated. Reporters will use the latest version of the Armed Forces Reportable Medical Events: Guidelines and Case Definitions, maintained by AFHSD, which provides the list of DoD RMEs consolidated from the Centers for Disease Control and Prevention (CDC) and the Council of State and Territorial Epidemiologists (CSTE) lists of notifiable diseases, and events that military public health experts have identified as representing significant military threats

  • RME Reporting:​
    • Events are identified through provider diagnosis and/or laboratory results.
    • Operational medical departments should report reportable medical events in DRSi within 30 days. Medical Departments reporting on behalf of an MTF should follow DHA Guidance.​
    • Reporting Tool: Disease Reporting System internet (DRSi)
    • Navy Medicine reporting:
      • Report urgently reportable events (encl (2) of INST) to the nearest NEPMU, in addition to the chain of command, within 24 hours of suspicion. |NEPMU Contact information|​
      • These events may indicate a breakdown in unit/installation level public health protections or may have operationally significant consequences.
      • They are often listed in guiding Annex Qs as well.
    • Refer to BUMEDINST 6220.12D for more guidance.​

Web Resources

Policy and Guidance

Epidemiology and Publications

Pulmonary Tuberculosis (TB) in Department of Navy Beneficiaries (2008-2021): 2022 Report | NMCFHPC PPS
Key Takeaways
  • Pulmonary TB incidence in the DON continue to be observed at lower rates than the U.S. civilian and global populations, however, the threat still exists.
  • Most cases continued to be observed in family members and retirees, followed by active-duty service members, and recruits.
  • Over the fourteen-year lookback, on average once a year an investigation occurred requiring reach back TB subject matter expertise and resources, most of which occurred in high-risk settings.
  • Diagnostic delays have occurred due to failure to recognize that TB may still progress after successful completion of Latent TB infection therapy.
Malaria in the Navy and Marine Corps Active Duty Population (2005-2018): 2019 Report | NMCFHPC PPS
Key Takeaways
  • Malaria rates among Sailors and Marines vary from year to year.
  • Increased rates tend to appear in clusters and are often associated with specific missions or exposures.
DRSi Medical Event Reports Among Navy and Marine Corps Populations and Ten-Year Historical Trends (2012 -2021): 2021 Report [CAC-Enabled] | NMCFHPC PPS
Key Takeaways
  • Military members face continued threat against a wide array of illnesses.
  • Across the board, STIs remain a significant portion of cases.
  • Cold weather and warm weather injuries have been increasing.
  • COVID-19 heavily affected the DON and impacted reporting capabilities.
Development of a New Fleet Disease and Injury Surveillance Capability Using ESSENCE – February 2025 | Medical Surveillance Monthly Report
Key Takeaways
  • New capability using in-theater data in ESSENCE enables unprecedented, near real-time D&I surveillance for the U.S. Navy Fleet.
  • The infrastructure has flexibility to add new modules in response to fleet and preventive medicine requirements.
  • High quality D&I surveillance of operational forces by Navy preventive medicine assets accelerates technical support and response to outbreaks and other public health threats.


 



Guidance-Card-Icon Dept-Exclusive-Card-Icon