Army Public Health Weekly Update, 01 October 2021

Date Published: 10/1/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link.

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Table of Contents

    ANNOUNCMENTS 

    Army plans to increase housing pay for Soldiers strained by pandemic

    27 September- Soldiers and families paying unusually high living costs may qualify for a short-term increase in their housing allowance from October through December 2021, finance officials said Thursday. To receive the payout, Soldiers in designated areas will need to apply through their unit S-1s and show they have incurred higher housing costs, said Larry Lock, chief of compensation and entitlements for the Army's G-1 office. Once approved, payouts should kick in within weeks, Lock added. The temporary increase in Basic Allowance for Housing, or BAH, will apply to 56 of the over 300 Military Housing Areas, or MHAs, with five areas receiving a 20% increase, 11 receiving a 15% increase, and the rest slated for a 10% increase over current rates, said Vincent Gallman, a BAH compensation analyst for G-1. Because of COVID-19, the rental market has faced scarce housing shortages and ballooned rental costs, especially in metropolitan areas, Lock said. The announcement follows concerns across the military from service members who have experienced financial strains, he said. “They were complaining about the housing shortage due to the COVID-19 pandemic," Lock said. “As we continued to receive inquiries the question obviously became: What is the Department [of Defense] doing about it?" In response, DOD senior leaders assembled a working group across the military branches, including Lock and his team who represented the Army. “As part of that team, we had a department-wide discussion in terms of feasible alternatives to address the issue," he said. Although answers didn't come overnight, the nature of the issue demanded they come quickly. “We came up with a proposed solution within three weeks, from the time we assembled [and got] to work, to getting a decision from the secretary [of defense] is really a testament to the Department of Defense, our sister services and the leaders of those services to take this issue seriously and do something about it," Lock continued. Army.mil External Link

    DoD, VA officials prep for a possible government shutdown later this week

    27 September- In anticipation of a possible government shutdown later this week, leaders from the Departments of Defense and Veterans Affairs have begun warning employees of possible office closures, program interruptions and potential furloughs that will result from a budget lapse. The moves won't mean any work stoppage for active-duty service members, but it could mean a disruption in their pay until the federal financial issues are resolved. On Monday evening, Senate Republicans blocked a bid by Democrats to push through legislation to extend the current federal budget past Oct. 1 and raise the country's borrowing limit. Unless lawmakers can find a compromise plan on the issues by the end of the week, many government agencies will run out of funding and be forced to shutter temporarily. Last week, Veterans Affairs officials released their shutdown contingency plan, which will be less severe than other department's because of advance appropriations approved by Congress in last year's budget agreement. As a result, 96 percent of VA employees will not have to worry about furloughs if a shutdown occurs, and most VA programs — including medical care, benefits processing and burials at department cemeteries — will continue uninterrupted. Some staff in the office of the VA Secretary could face work stoppages, and some department call centers and job assistance programs would temporarily close. The effects at the Defense Department would be more severe. In a memo to defense employees and troops on Monday, Deputy Secretary of Defense Kathleen Hicks said even in the event of a shutdown, the military “must continue operations necessary for the safety of human life or the protection of property." That includes continuing operations overseas and efforts related to the evacuation and resettlement of individuals from Afghanistan. Military Times External Link

    U.S. MILITARY

    COVID-19 can lead to long-term health concerns

    20 September- Debra Lamb has a message for anyone who believes the coronavirus is a hoax. Lamb, a 30-year civil service veteran and a Directorate of Public Works (DPW) housing manager, contracted the COVID-19 virus late in 2020 and experienced a harrowing ordeal before partially recovering months later. Even now, she uses a heart defibrillator and goes about her daily life at a slower pace than she did a year ago. “This virus is very real," she said. “People should continue to take precautions and do what's necessary to safeguard their health." Lamb explained that while others around her didn't end up catching the virus, she contracted it the last week in October 2020, long before vaccines were available to the public. While many people who contract the virus experience fever, cold symptoms and lose their sense of smell and taste, Lamb said she experienced none of those. “Back then, the only way to combat the virus was to wear a mask, maintain social distance and sanitize hands and work areas," she said. “I exercised all of the precautions, like my coworkers and family members, but I'm around a lot of people most of the time. Somehow, I caught the virus." Oct. 22, 2021, stands out as the day she noticed something peculiar. Short of breath, she visited Evans Army Community Hospital and tested for the virus. Hospital personnel informed her the very next day that she, indeed, was positive for COVID-19 and instructed her to quarantine. She was also instructed to inform her immediate family members and anyone she had come in contact with that week to also quarantine. “Of everyone I work with and live with, I was the only one who tested positive at the time," she said. “What was weird was (that) the shortness of breath was my only symptom. I didn't feel sick; I just couldn't breathe very well." With each passing day, her symptoms worsened and by Oct. 30, 2021, an X-ray test revealed fluid was building up in her lungs. Medical staff at UCHealth Memorial Hospital ultimately drained more than a gallon of fluid from her lungs and she was admitted to the Intensive Care Unit at the hospital. “That was a really scary time, and I prayed a lot," she said. “Doctors and nurses there were dressed in full virus preventive gear. I was placed in a room and not allowed (to have) visitors, which made the situation even more scary. I had IVs connected as medical staff delivered medication to treat my symptoms and I was given shots to control my diabetes (type II)." Army.mil External Link 

    DODEA schools keeps on with in-person classes, and fall sports, too

    23 September- The thud of kicked soccer balls, the clash of shoulder pads at football games, and cheers from classmates and parents are once again being heard around the world at Department of Defense Education Activity schools. Despite continued concerns about COVID-19, fall sports and activities have resumed after a tough autumn in 2020, when those sounds were absent. "The coaches worked really hard with our public health partners and the military to come up with a plan so we can do that safely," said Josh Adams, community superintendent for DODEA's schools in Kentucky (at Fort Knox and Fort Campbell). While fall sports were a casualty of COVID-19 in 2020, DODEA schools in general weathered the pandemic rather well, superintendents at home and abroad said. And with the new year well underway, DODEA officials are optimistic they can carry on the success experienced during the worst months of the pandemic, when many DOD schools remained open for in-person learning, in contrast to most civilian schools. Adams noted that some sports resumed in the spring and went smoothly, and that his Kentucky district is seeking to provide the most normal and positive learning environment that it possibly can. "The entire DODEA community rose to meet this challenge during [school years] 2019-20 and 2020-21 with flexibility and determination," wrote DODEA Director Thomas Brady, in his message in the DODEA COVID-19 Operational Guidelines and Protocols for Schools, Version 7, released shortly before the school year began. Brady said infection rates remained low throughout the pandemic for both students and staff. "I remain incredibly grateful for all the effort put in last year by administrators and teachers and our partners in command, and parents, the students, to put in place and then maintain all the mitigation we had last year," said Adams. "It allowed us to stay in in-person schooling almost the entire year." Adams said there were a few occasions that called for the closure of individual classrooms or an entire school for periods of quarantine. "The low infection rates coupled with DoDEA's ability to provide uninterrupted instruction serve as evidence of the efficacy of this plan and of DoDEA's unwavering commitment to the total force and the warfighter's mission readiness," Brady wrote. Health.mil External Link

    Protect yourself in the war against sexually transmitted infections

    23 September- The Centers for Disease Control and Prevention and local health departments continue to fight the war on sexually transmitted infections. The CDC has reported rising STI rates for years and recently published findings from an analysis of 2018 STI data indicating that one in five people in the U.S. had an STI. The Army Public Health Center has found that soldiers are a high-risk subgroup of the overall U.S. population because they largely fall within the highest risk age group of 15-24 years old. Soldiers also report frequent risky behavior, such as binge drinking, and they may also have unique risks due to increased travel and mission-related stressors. As part of September's Sexual Health Month, the APHC wants to re-engage soldiers and leaders in the war on STIs. STIs happen. That should be accepted and acknowledged by Soldiers and leaders. What should not be accepted is shame or stigma that prevents Soldiers from getting tested and treated. Many STIs can be easily cured and all can be treated. They can also be prevented with, for example, condoms. According to the CDC, STI symptoms can show up days to months after an exposure. These include pelvic, vaginal, or penile pain, swelling, burning, discharge, odors, rashes, painful or painless blisters or warts, bleeding between periods or painful intercourse. Flu-like symptoms, sore throat, joint pain, and brain or eye inflammation can also be signs. The CDC notes that if not treated, an infected person can not only pass infection along, but also can develop long term effects such as infertility, pelvic inflammatory disease, chronic pain, increased risk of Human Immunodeficiency Virus, commonly known as HIV, neurological problems, certain types of cancer, organ failure and potentially death. Untreated STIs can also be dangerous to a mother and her baby. “The CDC provides a wealth of information about STIs and how to prevent, detect, and treat them", says Maggie Stover, a registered nurse with the APHC Army Public Health Nursing Branch. “We rely on the CDC to provide quality medical guidance." DVIDS External Link

    September is National Hunger Action Month - is food insecurity an issue in your unit?

    27 September- With the COVID-19 pandemic, and the additional economic challenges facing families as a result, the topic of food insecurity has received more attention in the news. While food insecurity might be thought of as an issue for the civilian public, there has been very little discussion of food insecurity within the military until recently. Creating awareness is a first step in guiding military service members to resources. As a leader, have you ever worried about a military service member or family in your unit experiencing financial difficulties? Have you ever had a conversation asking if they were worried about whether they had enough food to last until the next pay day? Leaders may not think about asking service members these questions or even discussing it in formations. However, leaders should be aware that service members may be quietly dealing with food insecurity. Leaders can create open and safe spaces to disclose challenges and potential unique circumstances. Leaders should also be aware that food security exists on a spectrum with different levels of both food security and food insecurity. For example, marginal food insecurity reflects compromised economic access to food. Marginal food insecurity means some families are choosing foods that are less expensive but also have less nutritional value to stretch resources, others are skipping meals to feed their children, or are seeking out food banks and other community resources to make ends meet. Marginal food insecurity can influence eating patterns and long-term habits for children and adults. Food insecurity is associated with numerous adverse health outcomes in adults including obesity in the overall population. Army.mil External Link

    Soldiers aid LRMC efforts amid OAW

    27 September- More than 50 Soldiers from across the U.S. are supporting operations at Landstuhl Regional Medical Center, aiding in the ongoing mission to provide medical care to Afghan evacuees currently in Germany. For over a month, Soldiers ranging in professions from interpreters to physicians, have augmented personnel at LRMC in support of operations at the hospital and across Germany, including Ramstein Air Base and Rhine Ordnance Barracks, which has housed up to 12,000 and 5,000 Afghan evacuees at a time, respectively. The mission, part of overall Army efforts supporting Operation Allies Welcome, in coordination with State Department and Homeland Security, is providing essential medical care during the reception, processing and transfer of Afghan evacuees to the U.S. At Rhine Ordnance Barracks, also known as ROB, a few medical stations are set up amongst the military installation's sprawling tent city, where medical professionals from various units are caring for and treating evacuees 24/7. “I flew in on 26 August, so I've been supporting the mission at LRMC, Ramstein Air Base and Rhine Ordnance Barracks," said U.S. Army Maj. Regina Velasco, an obstetrics nurse assigned to Bassett Army Community Hospital, Fort Wainwright, Alaska. “We're making sure they're aware of health care services available and that they can feel safe coming to the medical tent when they need to." In addition to supporting medical efforts at ROB, Velasco has branched out to other sections in LRMC where extra hands are needed in response to the sudden increase in patients. “The (Soldiers) were brought out (to Germany) to support whatever missions given to us. Some of us are supporting Medical / Surgical operations, labor and delivery and OB/GYN," said Velasco, a native of O'ahu, Hawaii. “This has been a great opportunity to work with (Afghan evacuees) also being able to let them know we care about their wellbeing and letting them know they can trust us with their health." The sudden request for support of OAW also tested the U.S. Army Medical Force's readiness and ability to respond to unexpected operations with little notice. Army.mil External Link

    GLOBAL

    A pill to treat Covid-19: 'We're talking about a return to, maybe, normal life'

    27 September- Within a day of testing positive for covid-19 in June, Miranda Kelly was sick enough to be scared. At 44, with diabetes and high blood pressure, Kelly, a certified nursing assistant, was having trouble breathing, symptoms serious enough to send her to the emergency room. When her husband, Joe, 46, fell ill with the virus, too, she really got worried, especially about their five teenagers at home: "I thought, 'I hope to God we don't wind up on ventilators. We have children. Who's going to raise these kids?" But the Kellys, who live in Seattle, had agreed just after their diagnoses to join a clinical trial at the nearby Fred Hutch cancer research center that's part of an international effort to test an antiviral treatment that could halt covid early in its course. By the next day, the couple were taking four pills, twice a day. Though they weren't told whether they had received an active medication or placebo, within a week, they said, their symptoms were better. Within two weeks, they had recovered. "I don't know if we got the treatment, but I kind of feel like we did," Miranda Kelly said. "To have all these underlying conditions, I felt like the recovery was very quick." CNN External Link

    Common painkiller acetaminophen could alter fetal development, researchers warn

    24 September- A group of researchers is calling for greater caution in the use of paracetamol during pregnancy. Paracetamol, commonly known as acetaminophen or APAP, is the most common drug ingredient in America, according to The Acetaminophen Awareness Coalition. The organization notes that it is the active ingredient in more than 600 pain-relieving medications, including Tylenol. Acetaminophen, an external analgesic, works as a pain reliever for mild to moderate pain and as a fever reducer. However, in a new study and consensus statement published Thursday in the journal Nature Reviews Endocrinology, an international group of experts urged precautionary action through focused research efforts and by raising awareness. "A new Consensus Statement summarizes human epidemiological studies and experimental research in cells and animal models, which suggest that APAP exposure during pregnancy can alter fetal development and might increase the risk of certain neurodevelopmental, reproductive and urogenital disorders. The authors make several recommendations around minimizing exposure to APAP during pregnancy and increasing awareness, and present a call for focused research," the statement began. However, Nature noted both that paracetamol is widely considered to be the safest option for relief of pain and fever in pregnancy and that the UK National Institute for Health and Care Excellence states that APAP use during pregnancy is not thought to be harmful. The European Medicines Agency (EMA) advises that APAP can be used during pregnancy at the lowest effective dose for the shortest possible time and at the lowest possible frequency, while the U.S. Food and Drug Administration and EMA say studies investigating a possible connection between APAP use in pregnancy and disorders in offspring were inconclusive. Fox News External Link

    COVID-19 pill developers aim to top Merck, Pfizer efforts

    28 September- As Merck & Co (MRK.N) and Pfizer Inc. (PFE.N) prepare to report clinical trial results for experimental COVID-19 antiviral pills, rivals are lining up with what they hope will prove to be more potent and convenient oral treatments of their own. Enanta Pharmaceuticals (ENTA.O), Pardes Biosciences, Japan's Shionogi & Co Ltd (4507.T) and Novartis AG (NOVN.S) said they have designed antivirals that specifically target the coronavirus while aiming to avoid potential shortcomings such as the need for multiple pills per day or known safety issues. Infectious disease experts stressed that preventing COVID-19 through wide use of vaccines remains the best way to control the pandemic. But they said the disease is here to stay and more convenient treatments are needed. "We need to have oral alternatives for suppression of this virus. We have people who aren't vaccinated getting sick, people whose vaccine protection is waning, and people who can't get vaccinated," said Dr. Robert Schooley, an infectious diseases professor at UC San Diego School of Medicine. Pfizer and Merck, as well as partners Atea Pharmaceuticals (AVIR.O) and Roche AG (ROG.S) have all said they could seek emergency approval for their COVID-19 antiviral pills this year. Rivals are at least a year behind. Pardes began an early-stage trial last month, Shionogi plans to start large-scale clinical trials by year-end, Enanta aims to start human trials early next year and Novartis is still testing its pill in animals. Reuters External Link

    Life expectancy falls in 27 of 29 nations amid COVID-19

    27 September- Life expectancy dipped during the COVID-19 pandemic, the magnitude of which had not been seen in a single year since World War II in Western Europe and the dissolution of the Soviet Union in Eastern Europe, according to a study of 29 countries. The results, published yesterday in the International Journal of Epidemiology, showed that COVID-19 offset most life expectancy gains in the 5 years leading up to the pandemic in many countries. Declines were most precipitous in the United States, where males lost 2.2 years in 2020 relative to 2019 and where COVID-19 contributed significantly to high death rates in the under-60 age-group. A team led by University of Oxford researchers used public health data to construct life tables by sex from 2015 to 2020 for 29 countries, which spanned most of Europe, Chile, and the United States. They compared life expectancy at birth and at age 60 for 2020 with trends over 2015 to 2019. In 2019, life expectancy at birth among females ranged from 78.6 years in Bulgaria to 86.5 years in Spain, while male life expectancy ranged from 71.4 years in Lithuania to 82.2 years in Switzerland. Life expectancy at birth fell from 2019 to 2020 in 27 of 29 countries, with US and Lithuanian males seeing the largest declines, at 2.2 and 1.7 years, respectively. Males in 11 countries and females in 8 countries lost more than 1 year of life expectancy. "To contextualize, it took on average 5.6 years for these countries to achieve a 1-year increase in life expectancy recently: progress wiped out over the course of 2020 by COVID-19," the authors wrote. CIDRAP External Link

    Lyme Disease vaccine benefits from booster dose

    28 September- France-based Valneva SE and Pfizer Inc. today announced further positive Phase 2 study results, including booster vaccination response, for Lyme disease vaccine candidate VLA15. VLA15 is the only active Lyme disease vaccine candidate in clinical development. The Phase 2 study, VLA15-202, evaluates the immunogenicity and safety of VLA15 in a Month 0-2-6 vaccination schedule with 246 healthy adults 18 to 65 years of age in the U.S. Participants who received a complete primary vaccination series with 180 µg doses of VLA15 were invited to continue the study in a booster extension phase and were randomized to receive an additional 180 µg dose of VLA15 (N=39) or placebo (N=19) at Month 18. VLA15's acceptable safety profile was confirmed through a one-month post-booster. Administration of a booster dose elicited a strong anamnestic response yielding a 2.9-fold (ST3) to 4.2-fold (ST1, ST4) increase (Geometric Mean Fold Rise) in anti-OspA IgG antibody titers compared with titers observed after primary immunization. All participants seroconverted to anti-OspA IgG after the booster dose, meaning Seroconversion Rates (SCRs) were 100% for all OspA serotypes. SCR was defined as the rate of subjects that changed from seronegative at baseline to seropositive. Additionally, seropositive subjects at baseline needed to show at least a 4-fold increase in anti-OspA IgG compared to baseline titer. Precision Vaccinations External Link

    Pfizer-BioNTech seek authorization to vaccinate children

    28 September- New York-based Pfizer Inc. and BioNTech SE today announced they had submitted data to the U.S. Food and Drug Administration (FDA) from the Phase 2/3 trial of their COVID-19 vaccine in children 5 to <12 years of age. The Companies previously announced positive topline results from the pivotal trial on September 20, 2021. The trial enrolled children with or without prior evidence of SARS-CoV-2 infection. These data have been shared with the FDA for the Agency's initial review. A formal submission to request Emergency Use Authorization (EUA) of the companies' COVID-19 vaccine in children 5 to <12 years of age is expected to follow in the coming weeks. In addition, submissions to the European Medicines Agency and other regulatory authorities are also planned. Furthermore, topline immunogenicity and safety readouts for the other two age cohorts from the trial – children 2 to <5 years of age and six months to <2 years of age – are expected as soon as the fourth quarter of 2021. The Phase 1/2/3 trial initially enrolled up to 4,500 children ages six months to <12 years of age in the United States, Finland, Poland, and Spain from more than 90 clinical trial sites. It was designed to evaluate the safety, tolerability, and immunogenicity of the Pfizer-BioNTech vaccine on a two-dose schedule (approximately 21 days apart) in three age groups: ages 5 to <12 years; ages 2 to <5 years; and ages six months to <2 years. Based on the Phase 1 dose-escalation portion of the trial, children 5 to <12 years of age received a two-dose schedule of 10 μg each while children under age 5 received a lower 3 μg dose for each injection in the Phase 2/3 study. The Pfizer-BioNTech Comirnaty COVID-19 Vaccine, which is based on BioNTech's proprietary mRNA technology, was developed by BioNTech and Pfizer. BioNTech is the Marketing Authorization Holder in the United States, the European Union, the United Kingdom, Canada, and the holder of emergency use authorizations or equivalents in the United States (jointly with Pfizer) and other countries. The Comirnaty vaccine is administered as a 2-dose series, three weeks apart. In addition, a third dose may be administered at least four weeks after the second dose to individuals determined to have certain kinds of immunocompromised. Precision Vaccinations External Link

    What it's like to be a nine-year-old in a vaccine clinical trial

    27 September- In Charlottesville, Virginia, fraternal twins Evan and Lizzy are enrolled in Pfizer's vaccine trial for children between ages five and 11. The BBC follows them as they go to their second appointment where they receive a placebo or the vaccine. Their father, John, explains that though the family is very comfortable with the safety of the vaccine, consent from the children was the priority. BBC External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    2020-2021 Influenza Season for Week 37, ending September 18, 2021:

    Influenza-Associated Hospitalizations- The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in 14 states and represents approximately 9% of the U.S. population. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2021, will not be included in FluSurv-NET. Data on patients admitted through April 30, 2021, will continue to be updated as additional information is received.

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths were reported to CDC during week 37. CDC External Link

    VETERINARY/FOOD SAFETY

    California raw milk dairyman is nonplussed about recall and quarantine

    28 September- Valley Milk Simply Bottled is the California raw milk that's been quarantined and ordered recalled four times since 2019, most recently last week. The Modesto Bee just paid a visit to the dairy, which is located six miles west of the City of Modesto. The local dairy newspaper reports finding dairyman Joe Bento “unfazed." “Even though we're going through stuff like this, I still enjoy it," Bento told the Bee. When he says “stuff like this, “ Bento means the recent report by the California Department of Health about illegal levels of Campylobacter jejuni found by the state's Department of Food and Agriculture in raw cow milk produced and bottled by his company.  A mandatory recall and quarantine resulted from “stuff like this." Bento told the Bee that he is looking forward to getting back to selling raw, unpasteurized milk directly to consumers.  With the recall and quarantine,  the raw milk is being poured down the drain rather than into plastic jugs. “We still have all the costs associated with it and no income coming in," Bento told the Bee while being amid his nearly 200 cows. His goat and sheep milk are also under quarantine. As of the posting of the latest recall and quarantine notice no illnesses had been reported. Health officials say people who have consumed the milk or served it to others should monitor themselves for symptoms of Campylobacter infections. The agriculture department said Campylobacter jejuni can cause diarrhea, abdominal cramps, and fever, but most people recover completely. The symptoms usually occur two to five days after exposure and last about a week. Children and elderly people or people with compromised immune systems can develop severe infections and require hospitalization. Food Safety News External Link

    Consumer finds hard plastic in frozen chicken potstickers; recall initiated

    26 September- Ajinomoto Foods North America Inc. of Hayward, CA, is recalling more than 16 tons of pounds of raw, frozen chicken and vegetable potsticker products that may be contaminated with extraneous materials, specifically clear flexible and hard plastic, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced. “The problem was discovered after the firm received consumer complaints reporting clear flexible and hard plastic in the chicken and vegetable potsticker products. There have been no confirmed reports of adverse reactions due to consumption of these products. Anyone concerned about an injury or illness should contact a healthcare provider," according to the recall notice. The raw, frozen chicken and vegetable potsticker items were produced on July 22, 2021, and have best-by dates of Oct. 22. 2022. “FSIS is concerned that some product may be in consumers' freezers. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase," according to the recall notice. The following products are subject to recall. View the labels here.

    - 4.2-lb. plastic bags containing “Ling Ling POTSTICKERS CHICKEN & VEGETABLE" with lot code 1911203 and a “BEST BUY" date of 22 OCT 2022 on the label.

    The products subject to recall bear establishment number “P20069" printed on the back of the package. These items were shipped to distribution centers in California and Washington and from there sent to retailer locations. FSIS routinely conducts recall effectiveness checks to verify recalling firms notify their customers of the recall and that steps are taken to make certain that the product is no longer available to consumers. When available, the retail distribution list(s) will be posted on the FSIS website at www.fsis.usda.gov/recalls. Consumers with questions about the recall can contact Willis Hwang, Ajinomoto Foods North America, at 510-361-5003 or email at Willis.Hwang@ajinomotofoods.com. Food Safety News External Link

    WELLNESS

    Medication tracker apps to download so you won't forget to take your medicines

    27 September- Medication, especially the oral kind, is one of the things that people can be forgetful or lazy about. Taking pills and other medication at the same time every single day can be easier said than done. While there are daily, weekly, and even monthly pillboxes, such as the cases for birth control pills, that can be bought to help organize people's medicine intake, sometimes they are not enough to guarantee that a person does drink their medicines. If you think that you need help in tracking and remembering your medication, there are actually medication tracker apps available for iOS and Android that you can download. These are some examples of medication trackers and reminder apps that will help you remember to take your oral medication regularly:  

    Medication Tracker Apps: CareZone

    Medication tracker apps usually include pill reminders, calendars, and the like. CareZone takes it a step further by offering pharmacy services. 

    According to an article by Healthline, Carezone's pharmacy services can deliver medications monthly. Per the article, "the medications can be packaged in bottles or sorted and organized into individual packets" depending on the choice of the patient...

    Medication Tracker Apps: Mango Health

    Mango Health is an app that both helps you manage your medication as well as keep track of your overall health. 

    According to an article by SingleCare, "You can create a schedule of healthy habits you want to track, and the app offers helpful reminders to remain consistent with the routine." Tech Times External Link

    USAFRICOM

    Meningitis outbreak update: 777 total cases reported in Tshopo Province, DRC

    27 September- In a follow-up on the meningococcal meningitis outbreak in Tshopo Province, Democratic Republic of the Congo (DRC), as of September 21, 777 total suspected and confirmed cases have been reported including 167 deaths (CFR= 21.5%) in Panga, Banalia territory, in Kisangani district. Twelve samples have been confirmed for Neisseria meningitidis serogroup W. Meningococcal meningitis is causes the most severe form of bacterial meningitis. Meningitis is an infection of the membranes covering the brain and spinal cord. It can also be found in the bloodstream. This particular type of meningitis is very severe and can result in death if not treated promptly. Even in cases where treatment has been given, the fatality rate is around 15%. The symptoms of bacterial meningitis are sudden, with fever, stiff neck, body aches and headaches. As the disease progresses other symptoms may include nausea, vomiting, photophobia and seizures. A petechial rash seen on the trunk and lower extremities, bleeding complications, multi-organ failures and shock are usually final signs. This disease has the ability to kill within hours of getting it. Up to 10-20% of older children and young adults carry this organism in the mouth and nose, though the carriage rate will vary with age and closeness of population. The majority of people that carry this bacterium have no clinical disease. The organism is spread person to person through respiratory secretions from the nose and mouth (coughing, sneezing and kissing). Experts are unsure why some people advance to meningitis disease while many do not. Outbreak News Today External Link

    USCENTCOM

    Pfizer supplies Jordan, Lebanon with Covid vaccines for refugees

    14 September- Pfizer Inc. and BioNTech SE are donating hundreds of thousands of Covid-19 vaccine doses to Jordan and Lebanon as part of a broader push to aid refugees during the pandemic. On Monday, 100,000 doses of the companies' coronavirus vaccine arrived at the coastal Beirut-Rafic Hariri International Airport. There, the donated doses are being loaded into UPS trucks and delivered to nearby warehouses at the Rafic Hariri Hospital, the largest Lebanese public hospital located on the outskirts of Beirut. That's not the coveted vaccine's final destination, however. The Lebanese government will then ship supply across the small country that borders Syria and Israel. Just two-thirds the size of Connecticut, Lebanon hosts the largest number of refugees per capita of any country, according to the United Nations, with an estimated 1.5 million Syrian refugees, as well as refugees from Ethiopia, Iraq and Sudan. The vast majority live in extreme poverty. Those conditions, coupled with the pandemic, have been described as “a crisis within a crisis". Arabian Business External Link

    USEUCOM

    Bulgaria reports cutaneous anthrax case in Shumen Province

    27 September- Bulgaria health officials reported a cutaneous anthrax case in a man from Shumen Province in northeastern Bulgaria. The patient contracted the bacterium after handling the skins of a dead animal. The individual sought medical case and was treated on an outpatient basis. This first case of the year was confirmed during the week ending September 11. This is the first anthrax case reported in Bulgaria since 2016, according to National Center for Infectious and Parasitic Diseases data. Anthrax is a serious infectious disease caused by gram-positive, rod-shaped bacteria known as Bacillus anthracis. Anthrax can be found naturally in soil and commonly affects domestic and wild animals around the world. Although it is rare, people can get sick with anthrax if they come in contact with infected animals or contaminated animal products​. Outbreak News Today External Link

    USINDOPACOM

    Bangladesh: Two additional dengue deaths reported in Dhaka

    26 September- The Directorate General of Health Services (DGHS) reported an additional 242 dengue hospitalizations in the past day, including two fatalities. Of the total new patients, 185 were reported in Dhaka, while the remaining  were reported outside the city. The cumulative total cases since the beginning of the year now stands at 17,357. The two new deaths were reported from Dhaka, bringing this total to 61, with 56, or about 92 percent of the deaths reported from Dhaka. Two years ago, the worst dengue outbreak in Bangladesh since 2000 left 101,354 sick with the dangerous serotype-3 variant of the virus-the same one is at work in 2021 as well- and caused at least 179 deaths, according to the DGHS. Dengue is a viral infection transmitted by the bite of an infected mosquito. There are four closely related but antigenically different serotypes of the virus that can cause dengue (DEN1, DEN 2, DEN 3, DEN 4). Dengue Fever (DF) – marked by an onset of sudden high fever, severe headache, pain behind the eyes, and pain in muscles and joints. Some may also have a rash and varying degree of bleeding from various parts of the body (including nose, mouth and gums or skin bruising).Dengue has a wide spectrum of infection outcome (asymptomatic to symptomatic). Symptomatic illness can vary from dengue fever (DF) to the more serious dengue hemorrhagic fever (DHF). Dengue Hemorrhagic Fever (DHF) – is a more severe form, seen only in a small proportion of those infected. DHF is a stereotypic illness characterized by 3 phases; febrile phase with high continuous fever usually lasting for less than 7 days; critical phase (plasma leaking) lasting 1-2 days usually apparent when fever comes down, leading to shock if not detected and treated early; convalescence phase lasting 2-5 days with improvement of appetite, bradycardia (slow heart rate), convalescent rash (white patches in red background), often accompanied by generalized itching (more intense in palms and soles), and diuresis (increase urine output). Outbreak News Today External Link

    USNORTHCOM

    U.S.: California- Wound botulism case investigated in Butte County

    26 September- County health officials in Butte County, California report investigating a case of wound botulism in a Butte County resident who injected drugs, including black tar heroin. Laboratory test results to confirm the diagnosis are pending. The source of the heroin is unknown at this time. Black tar heroin has been linked to other wound botulism cases and outbreaks in injection drug users, so there is concern that locally available black tar heroin may be contaminated. California has the highest rate of wound botulism in the United States. This is the third case reported in Butte County this year. Since 2016, there have been 22 to 59 cases of wound botulism annually in California. Wound botulism occurs when a wound becomes infected with Clostridium botulinum (the cause of foodborne botulism) or a closely related Clostridium bacterium. The bacteria multiply in the wound and create a toxin that acts on the nerves. Most, but not all, people with wound botulism will have a visibly infected wound. Persons injecting black tar heroin into their muscles (“muscling") or under their skin (“skin popping") are at highest risk of wound botulism. Persons with wound botulism cannot transmit the illness to others. Symptoms of wound botulism occur within days or weeks of injecting contaminated drug and may be mistaken for drug overdose. Symptoms can include weak or drooping eyelids, blurred or double vision, dry mouth, sore throat, slurred speech, trouble swallowing, difficulty breathing, and a progressive symmetric paralysis that begins at the face and head and travels down the body. Outbreak News Today External Link

    USSOUTHCOM

    Malaysia: 13K new COVID-19 cases reported Sunday, 59% fully vaccinated

    26 September- The Ministry of Health Malaysia (MOH) reported Sunday an additional 13,104 new COVID-19 cases Sunday, with Sarawak state reporting the most (2,943) followed by Selangor (1,558) and Johor (1,455). This brings the cumulative total to 2,198,235 cases. More than 25,000 COVID-19 related deaths have also been reported. Malaysia has seen more than a half million cases in just the past month. Malaysia has fully vaccinated 58.7% of its 32 million population and gave at least one dose to 68.8%. Malaysia is one of several countries in Southeast Asia that are looking at abandoning their former restrictive, Zero-COVID policies including nationwide lockdowns. Langkawi was recently reopened to domestic tourism and several states have also begun relaxing restrictions for vaccinated people, including dining in at restaurants and interstate travel. Outbreak News Today External Link