Army Public Health Weekly Update, 02 October 2020

Date Published: 10/2/2020
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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

    3rd Annual One Health Day Seminar Day - Now a 2 Day Virtual Event!

    In celebration of One Health Week 2020, the Veterinary One Health Division is hosting the 3rd Annual One Health Day Seminar Day as a 2 Day Webinar Event on Microsoft CVR Teams. Come join us for part of the day or the entire event to listen, learn, collaborate and discuss One Health topics. APHC

    U.S. MILITARY

    As military suicides rise, Army brass reassessing outreach

    28 September- If there were any signs that Staff Sgt. Jason Lowe was struggling, the soldiers he served alongside didn't see them. The 27-year-old paratrooper was a top performer. He was on the Commandant's List and had just finished second in his class in the Army's Advanced Leader Course, setting him up for a promotion within the storied 82nd Airborne Division at Fort Bragg. Yet, five days after graduation, after Lowe left texts and calls unreturned, Staff Sgt. Ryan Graves drove to Lowe's apartment in Fayetteville, North Carolina, with a bad feeling. "On the way there I think it set in that maybe there's something a lot worse going on," Graves said. Graves opened Lowe's unlocked apartment door to discover his friend had taken his own life. Weeks later, the why remains unanswered. "Everything they teach you, that you're supposed to look for, doesn't exist in this situation," Graves told The Associated Press. "No financial trouble, no relationship trouble." Lowe's was the tenth suicide the 82nd Airborne Division has endured so far this year, a number that stood at four last year. In 2018, six division paratroopers took their own lives; four did so in 2017. While the driving factors of the suicides remain unknown, Maj. Gen. Christopher Donahue, who assumed command of the division in July, believes that the forced periods of isolation and other stressors the coronavirus pandemic have imposed on his troops and their families have been a major factor. The increase has pushed Donahue to make suicide prevention a priority and frequent topic of conversation within his ranks. "There is absolutely a stigma that's out there," Donahue said. "And if we don't acknowledge that, we're lying." This year has been an unprecedented one for the 82nd Airborne Division. In January, for the first time in three decades, the Division's Immediate Response Force was activated amid rising tensions with Iran. Within hours, thousands of paratroopers went from ringing in the new year with family to boarding military transport planes bound for the Middle East. Army Times External Link 

    DHA's Vaccine Safety Hubs emphasize safety

    29 September- It's very, very easy to do vaccines wrong; it's very hard to do it right. "When Dr. Bruce McClenathan, medical director of the South Atlantic Region Vaccine Safety Hub for the Defense Health Agency's Immunization Healthcare Division, teaches courses on vaccine safety, he often makes this statement to his students. To do it right, according to McClenathan, is to know the exceptions to every rule and the nuances of delivering high-quality immunization health care. Within the Military Health System that job falls on the four regional vaccine safety hubs of the DHA, which are strategically located throughout the U.S. "The vaccine safety hubs are designed to place immunization experts in the field and assist stakeholders with various needs; this could be recommendations on clinical care, education and training, answering questions on policy, providing recommendations on clinic operations, best practices, vaccine hesitancy, conducting vaccine research, etc.," said McClenathan. "Our team helps with all things related to vaccines." A physician serves as medical director in leading each hub, which includes nurse practitioners, registered nurses, immunization health care specialists, education experts, and research assistants, as well as a hub administrator, each having various areas of responsibility. Health.mil External Link

    Military suicides have increased by as much as 20% during the coronavirus pandemic

    28 September- Military suicides have increased by as much as 20% this year compared to the same period in 2019, and some incidents of violent behavior have spiked as service members struggle under COVID-19, war-zone deployments, national disasters and civil unrest. While the data is incomplete and causes of suicide are complex, Army and Air Force officials say they believe the pandemic is adding stress to an already strained force. And senior Army leaders - who say they've seen about a 30% jump in active duty suicides so far this year - told The Associated Press that they are looking at shortening combat deployments. Such a move would be part of a broader effort to make the wellbeing of soldiers and their families the Army's top priority, overtaking combat readiness and weapons modernization. The Pentagon refused to provide 2020 data or discuss the issue, but Army officials said discussions in Defense Department briefings indicate there has been up to a 20% jump in overall military suicides this year. The numbers vary by service. The active Army's 30% spike - from 88 last year to 114 this year - pushes the total up because it's the largest service. The Army Guard is up about 10%, going from 78 last year to 86 this year. The Navy total is believed to be lower this year. CBS News External Link

    North Carolina Marines warned not to jog at night because of coyote attacks

    28 September- After at least four coyote attacks, Marines at Camp Lejeune, North Carolina, are being advised against jogging in the Wallace Creek area of the base at night. An official in the game warden's office at the Marine Corps base told Marine Corps Times on Friday that the advisory was still in effect. There have been four reported coyote attacks in vicinity of the II Marine Expeditionary Force Information Group area command, according to a Wednesday Facebook post. The most recent attack occurred at 4 a.m. "Until further notice, please do not run in this area after dark until the animal can be removed," the post read. The Marines and sailors were bitten on their legs, but the injuries were not serious, Nat Fahy, a Camp Lejeune, North Carolina, spokesman told Military.com.
    "They all received medical treatment ... including rabies post-exposure treatment, which is standard protocol," Fahy said. Fahy said the game warden's office believes the same coyote was involved in the attacks. Situated near the North Carolina coast, Camp Lejeune sits on 161,000 acres of federal land with 26,000 acres of water bodies. Defense Department personnel are allowed to hunt and fish on the undeveloped property. Coyote attacks are rare, according to the North Carolina Wildlife Resources Commission, but certain measures ― like refraining from feeding the animal ― should be taken to prevent any conflict.
    The coyote population has grown significantly across North Carolina since the late 1970s, the commission said, and encounters with humans have become more common as a result. Hunting coyotes is permitted by state law, but it's unclear if that's the case on Camp LeJeune. Because of the base's proximity to nature, contact with wildlife is common. Marines at nearby Air Station New River were warned against feeding an alligator in 2018. Marine Corps Times External Link

    Women's mental health mini residency engages with DHA/VA providers

    28 September- A strong mind and body are essential for a medically ready military force. Within the Department of Defense, the Military Health System maintains this force by providing quality health care to patients, including mental health care. Health care providers need to understand their patients and the unique health concerns of each to provide this care. The Department of Defense uses channels like the Women's Mental Health Mini Residency series to train its providers on these topics. The annual three-day training gives health care providers throughout the Department of Veterans Affairs and the DoD knowledge and skills to deliver gender-sensitive care to female patients. Typically held in person, the Defense Health Agency's Psychological Health Center of Excellence and the VA co-hosted the event online for the first time Sept. 22-24. Kate McGraw, acting division chief of PHCoE, explained how the VA and DoD collaboration on women's needs regarding mental health began in 2011. From that work, the VA developed the mini residency out of a need to help providers better understand the mental health concerns unique to women service members and veterans. "Women, although still minorities in the military and veteran populations, have contributed to fighting the battles that have challenged our nation for decades," McGraw said, "but the focus on the health of women and how to address gender-specific mental health issues has not always had as much attention as would be optimal." Teams at the VA and PHCoE have been working together on the mini residency series for the last few years. Recently, the Department of Health and Human Services joined these efforts. Together, the teams look for gaps in women's mental health care and share treatment, policy, and research advancements to address those gaps. McGraw said the women's mental health training delivers presentations on state-of-the-art treatments and research for providers to best address the needs of women, whether service members or veterans. During the September mini residency, mental health experts from the VA and DoD tackled topics from sexual health and dysfunction to intersectionality and cultural competence. Each speaker brought expertise about women's mental health, including the key influences of sex, gender, and reproductive cycle stages. Health.mil External Link

    GLOBAL

    College restarts tied to COVID-19 rises in young adults

    29 September- As college students returned to campuses in August, COVID-19 cases in that age-group at the national level more than doubled, researchers from the Centers for Disease Control and Prevention (CDC) reported today, a day after federal officials announced a new push to help elementary and secondary schools reopen by arming them with rapid tests. In global developments, COVID-19 deaths passed the grim 1 million case mark amid more reports of second surges in Europe. Currently, the worldwide total is 33,484,120 with 1,004,082 deaths, according to the Johns Hopkins online dashboard. The report on the COVID-19 spike in college-age adults came from an analysis of state health department data spanning Aug 2 to Sep 5, a time when many schools resumed in-person learning for the first time since March. The CDC said about 45% of people ages 18 to 22 are enrolled in colleges and universities. Details about the COVID-19 spike in college-age adults appear today in Morbidity and Mortality Weekly Report, alongside a separate report on COVID-19 clusters that emerged soon after students returned to a North Carolina university campus. In the first study, researchers found that during the study period, 15.6% of COVID-19 cases were among the college-age group. Incidence increased 55% nationally, with the biggest increases seen in the Northeast and the Midwest. The level of testing increased over that time frame as well, likely due to screening practices at colleges, but researchers found that not all of the rise in cases was driven by the increase in testing. Cases rose 2.1-fold, while testing increased by 1.5-fold. Several factors could have fueled the rise in college-age cases, including behavior changes or increased risk related to multiple policy changes over that period. Detailed exposure analysis could help shed light on drivers of those trends, the authors said. To prevent spread on campuses and in the broader community, college students, staff, and faculty must take steps to curb spread in campus settings, such as wearing masks and observing hand hygiene, the researchers noted, adding that transmission by young adults outside of campus settings can also occur in any community where they live, work, and socialize. In the second study, North Carolina health officials described COVID-19 tracking in the first 3 weeks of August after school resumed at a university. Cases rapidly increased in the first 2 weeks, which included 18 clusters of 5 or more epidemiologically linked cases. In total, there were 670 cases among students, staff, and faculty. On Aug 19, following the steep rise in cases, all classes transitioned to online and the school took steps to reduce on-campus housing density. CIDRAP External Link 

    Coronavirus antibodies present in less than 10% of Americans, study finds

    28 September- Most Americans are still vulnerable to coronavirus infection, according to the findings of a study published Friday that echo recent comments made by a top official at the Centers for Disease Control and Prevention. The study, published in The Lancet and led by University of Stanford scientists and Ascend Clinical laboratory, which processes lab tests for kidney dialysis patients, estimated that less than 10% of Americans have antibodies to the novel virus. Researchers for the study analyzed blood plasma samples from 28,500 randomly selected dialysis patients who used one of the laboratory's 1,300 centers across 46 states, finding that only about 8% had developed antibodies. Adjusting for the general population, the researchers determined that about 9.3% of the public has antibodies. However, the prevalence rate changed for different parts of the country. The rate ranged from 3.5% in the West to 27.2% in the Northeast. Fox News External Link

    Coronavirus deaths rise above a million in 'agonizing' global milestone

    29 September- The global coronavirus death toll rose past a million on Tuesday, according to a Reuters tally, a grim statistic in a pandemic that has devastated the global economy, overloaded health systems and changed the way people live. The number of deaths from the novel coronavirus this year is now double the number of people who die annually from malaria - and the death rate has increased in recent weeks as infections surge in several countries. "Our world has reached an agonizing milestone," U.N. Secretary-General Antonio Guterres said in a statement. "It's a mind-numbing figure. Yet we must never lose sight of each and every individual life. They were fathers and mothers, wives and husbands, brothers and sisters, friends and colleagues." It took just three months for COVID-19 deaths to double from half a million, an accelerating rate of fatalities since the first death was recorded in China in early January. Reuters External Link

    Coronavirus: New global test will give results 'in minutes'

    28 September- A test that can diagnose Covid-19 in minutes will dramatically expand the capacity to detect cases in low- and middle-income countries, the World Health Organization (WHO) has said. The $5 (£3.80) test could transform tracking of Covid-19 in less wealthy countries, which have shortages of healthcare workers and laboratories. A deal with manufacturers will provide 120 million tests over six months. The WHO's head called it a major milestone.
    Lengthy gaps between taking a test and receiving a result have hampered many countries' attempts to control the spread of coronavirus . In some countries with high infection rates, including India and Mexico, experts have said that low testing rates are disguising the true spread of their outbreaks. The "new, highly portable and easy-to-use test" will provide results in 15-30 minutes instead of hours or days, WHO Director General Tedros Adhanom Ghebreyesus told a news conference on Monday. Drugs manufacturers Abbott and SD Biosensor have agreed with the charitable Bill and Melinda Gates Foundation to produce 120 million of the tests, Dr. Tedros explained. The deal covers 133 countries, including many in Latin America which is currently the region hardest-hit by the pandemic in terms of fatality and infection rates. BBC News External Link 

    COVID-19 Update: Trained dogs sniff virus 94% to 100% accuracy; Finland airport tries this test

    26 September- We've all heard of dogs knowing people's emotions or read facial expressions. But can it detect a positive COVID-19 person from sniffing his skin? Apparently, a study proves this. In fact, one airport from Finland already tries this method to know which person has the virus or not. Have you heard about 'virus-sniffing dogs'? It turns out that dogs have the ability to sniff the virus from a person infected with it. But they require special training to do so. In fact, an airport in Finland currently does this method in order to know which person has the virus or not. Finland's Helsinki-Vantaa airport has recently run a test trial of the virus-sniffing dogs. People can volunteer to have the dogs sniff their skin. Once the dog reacts on the person-- through yelping, pawing, or lying down-- that person may be positive with the virus. To those who are afraid of dogs, airport staff could also ask passengers to wipe their skin with a cloth tested by the dog through sniffing its smell. To make sure the dog's sniff is accurate, the same person that the dog found COVID positive will undergo a free nasal swab test. Tech Times External Link

    Lessons from AIDS for the COVID-19 pandemic

    29 September- "We are now engaged in another deadly episode in the historic battle of man versus microbe. These battles have shaped the course of human evolution and of history. We have seen the face of our adversary, in this case a tiny virus." I spoke these words in testimony before a U.S. Senate subcommittee on September 26, 1985. I was talking about HIV, but I could say the same thing today about the coronavirus we are facing. Like all viruses, coronaviruses are expert code crackers. SARS-CoV-2 has certainly cracked ours. Think of this virus as an intelligent biological machine continuously running DNA experiments to adapt to the ecological niche it inhabits. This virus has caused a pandemic in large part because it acted on three of our most human vulnerabilities: our biological defenses, our clustering patterns of social behavior and our simmering political divides. How will the confrontation unfold in the next years and decades? What will be the human toll in deaths, ongoing disease, injuries and other impairments? How effective will new vaccines and treatments be in containing or even eradicating the virus? No one can say. But several lessons from the long battle with HIV, the human immunodeficiency virus that causes AIDS, suggest what may lie ahead. HIV/AIDS is one of the worst scourges humans have encountered. As a code cracker, HIV is an expert. By the end of 2019 the global death toll from this virus was roughly 33 million people. In all, 76 million people have been infected, and scientists estimate another 1.7 million people acquire the virus every year. Scientific American External Link

    Millions of COVID-19 tests shipping to US states

    29 September- The U.S. federal government announced on September 28, 2020, it will begin distributing tens of millions of rapid coronavirus tests to US states and urged governors to use them to reopen schools for students in kindergarten through 12th grade. Officials said the administration is emphasizing testing in schools because it's important to the development of students to be back in classrooms. The Abbott Laboratories 'rapid' tests would allow parents to know whether their symptomatic child has COVID-19 within 15-minutes. 'Governors have the flexibility to use these tests as they deem fit, but we strongly encourage governors to utilize them in settings that are uniquely in need of rapid, low-tech, point-of-care tests, like opening and keeping open K-through-12 schools,' stated ADM Brett P. Giroir, M.D. Precision Vaccinations External Link

    Only 10 states are seeing downward trends in new Covid-19 cases, and NYC now has a surge

    28 September- In this uphill battle against Covid-19, letting your foot off the gas too soon can send you backward. That's what places like New York City are discovering after months of steady progress in fighting the pandemic. And this is a very bad time to be going backward, as Americans face a trio of major challenges this fall: more indoor gatherings, a potential coronavirus-and-flu "twin-demic," and trying to get or keep students back in school safely. Nationwide, 21 states reported more new cases this past week compared to the previous week, according to data from Johns Hopkins University.  But in many states, "it's not only that the number of infections keeps on going up. It's also that the test positivity rates are trending in the wrong direction," emergency medicine physician Dr. Leana Wen said Monday. A test positivity rate is the percentage of test results that turn out to be positive. The World Health Organization has recommended test positivity rates stay at or below 5% for at least 14 days before businesses reopen. "We're seeing more than a dozen states with a test positivity is over 10%. And there are two states -- Idaho and South Dakota -- where the test positivity is over 20%," Wen said. "That means that not only do we have increasing infections in these states, we also don't have nearly enough testing." CNN External Link

    INFLUENZA

    CDC: Flu View - Weekly U.S. Influenza Surveillance Report

    2019-2020 Influenza Season Week 38, ending September 19, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states.

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on September 24, 2020, 5.4% of the deaths occurring during the week ending September 19, 2020 (week 38) were due to P&I. This percentage is below the epidemic threshold of 5.6% for week 38.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 38. CDC External Link

    VETERINARY/FOOD SAFETY

    Potential botulism threat spurs recall of spaghetti sauce

    28 September- Spaghetti sauce with virtually no identifying labeling information is under recall because of a risk of botulism poisoning. Érablière Godbout distributed its brand of "Sauce spaghetti" in the Canadian province of Quebec, according to a recall notice from the Canadian Food Inspection Agency. The agency is urging consumers to check their homes for the product. "Recalled products should be thrown out or returned to the store where they were purchased," according to the recall notice. "Food contaminated with Clostridium botulinum toxin may not look or smell spoiled but can still make you sick."... The government did not provide details, but reported that the potential contamination with the botulism-causing had not resulted in any confirmed illnesses as of the posting of the recall. "This recall was triggered by Canadian Food Inspection Agency (CFIA) test results. The CFIA is conducting a food safety investigation, which may lead to the recall of other products," the recall notice states. Botulism poisoning symptoms in adults can include facial paralysis or loss of facial expression, paralysis of breathing muscles, unreactive or fixed pupils, difficulty swallowing, drooping eyelids, blurred or double vision, difficulty speaking or including slurred speech, and a change in sound of voice, including hoarseness. Symptoms of foodborne botulism in children can include difficulty swallowing, slurred speech, generalized weakness and paralysis. In all cases, botulism does not cause a fever. In severe cases of illness, people may die. Food Safety News External Link

    WELLNESS

    Best foods to eat before and after your workout

    28 September- THERE HAVE BEEN MANY disruptions to daily life in 2020 – including the upending of workout routines. A recent study conducted found that as of August, nearly 71% of gym members across the U.S. haven't returned – the lowest rate worldwide – and about 43% say they won't return. For many, this has meant changing exercise routines to include more outdoor activities like trail running, hiking, mountain biking and swimming, as well as at-home cycling and strength training. With this shift, I've been fielding more questions about how to fuel up before exercise and what to eat post-workout. While there is no one-size-fits-all answer, there are some guidelines that can help. What and how much you should eat before and after training depends upon what your body can metabolize during the activity you're going to do and at what intensity. This may require some experimentation until you find the optimal snacks and meals for you. For true endurance routines of an hour or more, you'll want to have a meal or snack that provides a good source of carbohydrates and at least 300 calories. Having some carbohydrate before your workout helps you exercise at a higher intensity for a longer period of time. What's more, for a.m. exercisers, it's important to raise blood sugar levels to provide much-needed energy to get more out of a workout. For post-workouts, rehydrating with water is most important followed by replenishing depleted carbohydrate stores (glycogen) as well as getting enough amino acids from protein to stimulate muscle growth and repair. It's important to replenish carbs in the first few hours post-exercise as the body is primed during that period to store carbs as fuel in muscles that can be used at a later time The combination that's recommended includes 15 to 25 grams of quality protein, with 0.5 to 0.75 grams of carbohydrate per pound of body weight post exercise. Keep in mind that if you're exercising for weight loss, you'll want to reduce the calories of your meals and snacks while trying to keep the similar ratio of carbs to protein. U.S. News External Link

    USAFRICOM

    Chikungunya outbreak: 27,540 cases reported in Chad, Most in Abéché

    24 September- In a follow-up on the chikungunya outbreak in Chad, about 3,000 additional cases have been reported in the north-central African country. From July through 20 September 2020, a total of 27,540 cases were reported in three provinces, distributed as follows: 24,302 cases in the health district of Abéché, 3237 cases in the health district of Biltine, and one case in the health district of Abdi. One death has been reported to date in district of Abéché. In July 2020 health authorities were alerted to the occurrence of a disease-causing high fever, headache, intense and disabling joint pain, and sometimes associated with vomiting. It was eventually determined to be the chikungunya virus once it was confirmed in a 63-year-old female farmer. She had no reported travel outside of Abéché district. A total of 13 samples from Abéché district, Ouaddai Province, were sent for analysis at the N'Djamena mobile laboratory on 12 August 2020 and 11 samples tested positive for chikungunya virus. The World Health Organization says chikungunya is an arboviral disease transmitted to humans by the bites of infected Aedes mosquitoes. The disease is characterized by an abrupt onset of fever frequently accompanied by joint pain and inflammation which is often very debilitating and may last for several months, or even years. Fatalities associated with infection can occur but are typically rare and most reported in older adults with underlying medical conditions or perinatally-infected infants. Some patients might have a relapse of rheumatologic symptoms (e.g. polyarthralgia, polyarthritis, and tenosynovitis) in the months following acute illness. There is no specific antiviral treatment or commercially available vaccine for chikungunya. Outbreak News Today External Link

    USCENTCOM

    Coronavirus: Israel tightens second lockdown amid acrimony

    25 September- Israel has tightened restrictions on its population in the fight against coronavirus, one week after a second lockdown came into effect. From Friday afternoon, businesses not officially considered essential were ordered closed, and travel restricted to 1km (0.6 miles) from people's homes. Other planned rules which would affect protesters and synagogue-goers have not yet been approved amid acrimony. Covid-19 cases in Israel have continued to rise despite the latest lockdown. Some 1,405 people have died with the disease, with the total number of confirmed cases reaching 215,273 out of a population of 9.2 million. Prime Minister Benjamin Netanyahu said on Thursday the stricter measures were a necessity. "Wake up. Enough is enough. We are in a different reality. Something needs to be done and it must be done now." Under the latest restrictions, almost all businesses have been told to close for at least the next two weeks, with a possibility the lockdown might be extended depending on the situation. Restaurants are only being permitted to serve home-deliveries. People are also restricted to staying within a reduced radius from their homes, apart from in emergencies and for specific exemptions. The government's most controversial planned measure - limits on public gatherings - has not yet been approved after a parliamentary committee that must amend the law to allow it could not reach agreement. BBC News External Link

    USEUCOM

    Coronavirus: New rules in Netherlands to cope with virus surge

    29 September- Many residents in the Netherlands will, for the first time, be advised to wear a face mask in shops as the country introduces a range of measures to control a second coronavirus wave. Compared to its neighbors, the Netherlands had largely avoided strict restrictions until now. This week nearly 3,000 infections daily are being recorded in the nation of 17 million people. The new measures will start on Tuesday and last for at least three weeks. "We are doing our best, but the virus is doing better," Health Minister Hugo de Jong admitted on Monday. In a televised press conference, Dutch Prime Minister Mark Rutte explained that the situation in the country's three largest cities - Amsterdam, Rotterdam and The Hague - had become "serious" and required urgent action. From Tuesday people should avoid non-essential travel between the three cities, he said. Restaurants and bars will be required to close by 22:00 - a move that echoes other European countries including the UK, Spain and France which have introduced similar earlier closing times. People will be advised to work from home; social gatherings inside people's homes must not exceed three people, and fans will no longer be allowed to attend sports events. Mask-wearing was already compulsory on public transport, but the Dutch government had so far avoided suggesting customers wear one inside shops. The new measures advise that shoppers in the three largest cities should cover their face from Tuesday. Shops will be allowed to deny entry to those who do not wear a mask. BBC News External Link

    USINDOPACOM

    Leptospirosis outbreak in Fiji prompts CDC travel warning

    28 September- Health officials in Fiji have reported an outbreak of leptospirosis; most cases have been recorded in the Central and Northern divisions. In response to the outbreak, the Fiji Ministry of Health is working to manage the situation, increasing disease surveillance and conducting clean-up and awareness campaigns. This has prompted the Centers for Disease Control and Prevention (CDC) to issue a travel notice Thursday. Officials note that Leptospirosis is a bacterial disease and people (and animals) can get infected when they are exposed to the urine of infected animals. They can also get infected from water, soil, or food contaminated with infected animal urine. Leptospirosis bacteria can enter the body through skin or mucous membranes (eyes, nose, or mouth). Outbreak News Today External Link

    Plague: Bubonic case reported in Khovd province, Mongolia

    28 September- Mongolia's National Center for Zoonotic Diseases (NCZD) reported a suspected case of bubonic plague in western Mongolia's Khovd province has been confirmed by lab test results Sunday. The patient is a 25-year-old female who was found to have eaten marmot meat last week. While hunting marmots is illegal in Mongolia, many Mongolians regard the rodent as a delicacy and ignore the law. According to the NCZD, As of September 2020, 21 suspected cases of marmot plague were registered in Mongolia, 5 cases were confirmed and 60% of them died. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Naegleria fowleri- Lake Jackson, Texas issues a disaster declaration after the brain-eating amoeba is detected in its water system

    26 September- Authorities with the City of Lake Jackson, Texas, in the Greater Houston metropolitan area issued a disaster declaration Saturday after the parasite, Naegleria fowleri was found in water samples during an investigation of a child that contracted the amoeba. Earlier this month, Brazoria County Health officials contacted city officials about a 6-year-old child that was hospitalized with a Naegleria fowleri infection. Based on what the information from the family, water samples were collected from the Lake Jackson Civic Center Splash Pad and tested negative by a private lab. The Centers for Disease Control and Prevention (CDC) were contacted and more intensive testing was performed to include from the splash pad and water at the child's home. It was announced that three of 11 water samples tested preliminarily positive for the parasite–the splash pad storage tank, a hose at the child's home and a dead end fire hydrant near the splash pad. Officials note that chlorine was detected in the water samples. The Brazosport Water Authority issued a Do-Not-Use water advisory Friday for 10 other areas and Lake Jackson and today lifted the advisory for all areas except Lake Jackson. Lake Jackson Mayor, Bob Sipple issued the Disaster declaration and opened the Emergency Operations Center (EOC) this morning. Outbreak News Today External Link

    USSOUTHCOM

    New cases in Brazilian city dash herd immunity hopes

    28 September- Manaus is the largest city and capital of the Brazilian state of Amazonas, in the vast Amazon rainforest. After being hit hard by the outbreak in April and May - with cemeteries reportedly struggling to dig graves fast enough to bury the dead - deaths have dropped dramatically in the city. A scientific study posted on the website medRxiv suggested that Manaus may have reached herd immunity, the point at which enough people have antibodies to the virus that it slows or stops the spread. Scientists estimated that up to 66% of the population there had antibodies to Covid-19. "All signs indicate that it was the very fact of being so exposed to the virus that brought about the reduction in the number of new cases and deaths in Manaus," the study's coordinator was quoted as saying. But now cases are once more on the rise. After reopening quickly, authorities on Friday banned gatherings and parties for 30 days and restricted opening hours for shops and restaurants. Mayor Arthur Virgilio told Reuters news agency that President Jair Bolsonaro was to blame. "The government must take this seriously and speak the truth," he said. Critics of the president accused him of downplayed the risks of the virus throughout the pandemic, ignoring expert advice on social distancing and other measures. BBC News External Link