Army Public Health Weekly Update, 04 June 2021

Date Published: 6/4/2021
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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


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    AZNG partners with Active Component for COVID vaccinations

    26 May- The Arizona National Guard is partnering with its active-duty counterparts from the 56th Medical Group at Luke Air Force Base, Glendale, and the 355th Medical Group at Davis-Monthan Air Force Base, Tucson, to vaccinate active duty members, dependents, Department of Defense civilians and military retirees. Army Col. Tom Leeper, Arizona National Guard's state surgeon, said due to deployments, Luke AFB and Davis-Monthan AFB had identified opportunities where vaccination teams from the Arizona Guard could help supplement their losses. "The partnership between the Guard and Active Duty is really important because we help support one another, whether it's in times of a pandemic or national contingencies," said Air Force Capt. Jessica Bunker, 161st Medical Group, and officer in charge of infection prevention. "We [the National Guard] can help step up and support them in areas they need." Airmen from the 161st MDG, who don't always have the opportunity to work alongside active-duty service members, are seeing a different way of doing things and building relationships that will benefit both components. External Link

    Improving mental health of our military

    30 May- Every May, mental health organizations share educational information and provide resources for Mental Health Awareness Month. During this same period, as we approach Memorial Day, we're reminded to honor the men and women who died while serving our country. However, these two topics share more than space on the calendar — the mental health of our military members is suffering. For years, we've talked about the mental health of veterans. The U.S. Department of Veterans Affairs reported suicides are 50% more likely for veterans than in the civilian population. While experts say it's too early to know the full impact from the coronavirus, they suspect social isolation, economic problems, anxiety and substance abuse stemming from the pandemic will contribute to increased suicide rates. Active-duty members are struggling, as well. The Pentagon recently reported suicides among active-duty members increased for the fourth straight year. Before we can begin helping the ones we love, we must understand three points. Trib Live External Link

    "Shots in arms" – OPT planned & coordinated to meet COVID-19 mission

    28 May- On May 24, the Department of Defense's COVID-19 Operational Planning Team (OPT) transitioned its mission to the Coronavirus Vaccine Immunization Program (CVIP) working group. The OPT was established last November by the Secretary of Defense and given the authority to oversee the Department of Defense's COVID-19 vaccination operations. Under the direction of Defense Health Agency Director, Army Lt. Gen (Dr.) Ronald Place; and leadership of Army Maj. Gen. (Dr.) George "Ned" Appenzeller, DHA's assistant director for combat support, the OPT brought together a diverse team of nearly 85 representatives from across the DOD to develop and execute the complex plan to safely and efficiently administer COVID-19 vaccines to the DOD's globally dispersed population. The team consisted of representatives from the DHA, service branches, National Guard Bureau, Coast Guard, Joint Staff Surgeon's Office, combatant commands, Defense Logistics Agency, and U.S. Army Medical Materiel Agency - Distribution Operations Center, and worked closely with the Countermeasures Acceleration Group (previously known as Operation Warp Speed), the DOD COVID-19 Task Force, the Department of Health And Human Services, and the Centers for Disease Control and Prevention. External Link


    Accidental drownings a concern as pandemic postponed swimming lessons for some

    1 June- In June 2020 the U.S. Consumer Product Safety Commission released a report that found child drownings to be the leading cause of unintentional death among children ages 1 to 4 years old. Now, with an increase in at-home pool installations and the pandemic-related cancellation or delay of youth swimming lessons, some are concerned that the number of drownings could increase even further.  "This summer, we're going to see a surge in accidental drownings," Rowdy Gaines, a three-time Olympic gold medalist swimmer who partnered with the Pool & Hot Tub Alliance (PHTA) said in a statement. "As excited as we are about getting back in the water, it's important that we stay focused on safe pool behaviors. Parents have to keep a close eye on their children 100% of the time, even when lifeguards are nearby."  The Centers for Disease Control and Prevention (CDC) last updated coronavirus guidance for public pools, hot tubs and water playgrounds Feb. 1, and advised that lifeguards actively monitoring swimmers not also be tasked with enforcing social distancing, mask use or other prevention measures. Fox News External Link

    Based on data, experts encourage vaccines for teens

    26 May- Air Force Col. Heather Yun enrolled her teenagers in COVID vaccine trials in back in the winter. An infectious disease physician, Yun spoke with her children at length about the vaccine studies, and they were eager to do their part in the battle against the pandemic. More nervous about the blood draw than the shot, her children "overcame their fears and got it done," she said. "I am so incredibly proud of my brave kids for doing their part for their community and the nation," said Yun, who also serves as Brooke Army Medical Center's Deputy Commander of Medical Services. With the recent authorization of the Pfizer vaccine for youth ages 12 to 15, Yun is now encouraging other parents to consider the vaccine for their adolescents as well. "The data continues to demonstrate that the vaccine is safe and effective," Yun said. "Vaccinating this population is an important step in ending the pandemic."  With emergency use authorization and a 100 percent efficacy rate for this age group, "we are strongly recommending the vaccine for adolescents," noted Army Maj. Megan Donahue, BAMC's chief, pediatric infectious diseases. However, vaccine hesitancy continues to be an ongoing challenge, particularly among young people who feel less threatened by the virus due to lower infection rates and reports of mild illness, noted Air Force Lt. Col. Alice Barsoumian, associate professor of medicine, San Antonio Uniformed Services Health Education Consortium Infectious Disease Fellowship Program. While it's true that fewer children have been infected with COVID than adults, experts are tracking an increase in COVID infection and hospitalizations within younger populations, Barsoumian said, citing reopening schools and the easing of face covering requirements as potential causes. Additionally, some strains appear to be more contagious to children. External Link

    Managing stress and anxiety during coronavirus

    14 April- The ongoing coronavirus outbreak has created new challenges for everyone. Normal routines have been replaced by unfamiliar isolation and adjustments to home-life, work, and school. Fear and anxiety about the disease can be overwhelming and cause strong emotions. How can you avoid becoming stressed and overwhelmed? "I recommend you limit your exposure to social media and the news," said Lt. Col. Emile Wijnans, the director of psychological health for Regional Health Command Europe. "You can alleviate stress by focusing on the things that are positive and what you can control." According to the Center for the Study of Traumatic Stress, stressors during a period of social distancing/quarantine can include: frustration and boredom related to the isolation, inadequate supplies and access to regular medical care, insufficient information, and fears about becoming infected and/or infecting others. "It's important to get what rest you can, eat well and exercise when possible," said Wijnans. "These are normal things we tell people, but they really do in fact help." It is also recommended to stick to a routine, take small breaks throughout the day and avoid a reliance on tobacco and alcohol. "If someone is drinking heavily, it can suppress their immune system," said Dr. Cheryl Owen, the regional manager for RHCE's Substance Use Disorder Services. "We also know that people who drink often smoke, and that increases their risk of respiratory illness. The other issue is that drinking can also dampen your mood so if you're already stressed out, it's not going to help at all." According to the U.S. Centers For Disease Control and Prevention, common signs of distress include: feelings of numbness, disbelief, anxiety or fear; changes in appetite, energy, and activity levels; difficulty concentrating; difficulty sleeping or nightmares and upsetting thoughts and images; physical reactions, such as headaches, body pains, stomach problems, and skin rashes; worsening of chronic health problems; anger or short-temper; increased use of alcohol, tobacco, or other drugs. The isolation and stress can also create friction points for married couples and those with children. External Link

    Masks, distancing still important even with vaccination, study suggests

    1 June- Vaccination alone might not be enough to end the Covid-19 pandemic, researchers reported Tuesday. Even with a majority of the population vaccinated, the removal of pandemic precautions could lead to an increase in virus spread, the researchers reported in the medical journal JAMA Network Open. Mehul Patel, an assistant professor of emergency medicine at the University of North Carolina at Chapel Hill, and colleagues used a mathematical model to simulate coronavirus spread among the approximately 10 million people of North Carolina. They found that coronavirus infections, hospitalizations and deaths would continue to rise if pandemic precautions such as quarantine, school closures, social distancing and mask-wearing were lifted while vaccines were being rolled out. "Our study suggests that, for a population of 10.5 million, approximately 1.8 million infections and 8,000 deaths could be prevented during 11 months with more efficacious COVID-19 vaccines, higher vaccination coverage, and maintaining NPIs (non-pharmaceutical interventions), such as distancing and use of face masks," they wrote. CNN External Link

    Moderna's COVID-19 vaccine seeks U.S. FDA approval

    1 June- Massachusetts-based Moderna, Inc. announced that it had initiated the rolling submission process with the U.S. Food and Drug Administration (FDA) for a Biologics License Application (BLA) for the licensure of its mRNA COVID-19 Vaccine for people 18 years of age and older. Moderna confirmed in a press release issued on June 1, 2021, it will continue to submit data to support the BLA to the FDA on a rolling basis over the coming weeks and include a request for a Priority Review. Once the rolling BLA submission is complete, FDA will notify the Company when it is formally accepted for review. The Moderna COVID-19 Vaccine is currently available in the USA under an Emergency Use Authorization, granted on December 18, 2020. The FDA has not approved Moderna's experimental mRNA vaccine. The Moderna COVID-19 Vaccine is an mRNA vaccine against COVID-19 encoding for a prefusion stabilized form of the Spike (S) protein co-developed by Moderna and investigators from the National Institute of Allergy and Infectious Diseases' Vaccine Research Center. Precision Vaccinations External Link

    mRNAs are the future of vaccines after Pfizer, Moderna's success against COVID—HIV, cancers next-in-line

    1 June- mRNAs or Messenger RNAs are now the next big thing in the medical field, especially with its breakthrough of being an effective component in the fight against COVID-19 and helping people be safe against the virus. Pharmaceutical companies like Pfizer & BioNTech and Moderna were highly regarded for their efforts, with the next step looking into vaccines against HIV, cancers, and more. Nurses draw vaccine doses from a vial as Maryland residents receive their second dose of the Moderna coronavirus vaccine at the Cameron Grove Community Center on March 25, 2021 in Bowie, Maryland. The vaccinations were provided by Prince George's County's Mobile Units as vaccinations in Maryland are now over the 20 percent threshold. The world has evolved and improved dramatically over the years, especially as it has contained and has been working for more than a year now to stop the pandemic, initially feared to be years long. Before this, pandemics have been observed for more than three years (even more), as technology was not that advanced before. However, the world's advancements and evolution in terms of health and biotechnology have proven that we can surpass a pandemic, and this is because of the experimental drug component known as the mRNA. After COVID-19, the next steps are what organizations and pharmaceutical companies are thinking of, especially with creating vaccines against diseases with no cure. Tech Times External Link

    New formulation to treat people exposed to Hepatitis B

    1 June- Barcelona-based Grifols announced the commercialization of HyperHEP B, a new formulation of its hepatitis B immune globulin for hepatitis B post exposure prophylaxis. HyperHEP B is the newest version of Grifols' current HBIG, HyperHEP B S/D, which is presently prescribed globally in over 20 countries. The new formulation, approved by the U.S. Food and Drug Administration (FDA) in December 2020, uses a unique caprylate chromatography process, which significantly reduces procoagulant activity and IgG aggregates. It also includes FDA labeling for the capacity to remove pathogenic prions. "Since the launch of the first version of HyperHEP B 45 years ago, millions of patients worldwide have relied on this critical product to decrease risks associated with hepatitis B exposure," said Bill Zabel, President, Grifols North America Sales and Commercial Operations, in a press release. "With a continued commitment to improving the lives of patients, we're establishing new purification standards around this critical treatment. This new formulation increases the long-standing confidence physicians have in Grifols' market-leading hyper immune portfolio." For patients who have not been previously vaccinated, the Advisory Committee on Immunization Practices and Centers for Disease Control and Prevention recommends immediate prophylaxis following exposure to hepatitis B, including both HBIG and hepatitis B (HepB) vaccine as soon as possible after exposure. Precision Vaccinations External Link


    COVID-19 or influenza, which is riskier for children

    31 May- An international study published by the American Academy of Pediatrics on May 28, 2021, found increases in hospitalization, hypoxemia, and pneumonia in people 18 years and younger who contracted COVID-19 than those diagnosed with influenza. This study reported 4% of those with COVID-19 from January to June 2020 were hospitalized. Among the hospitalized COVID-19 patients, asthma was the most common comorbidity, with obesity ranked second. These researchers confirmed that the 30-day mortality rate in this age group was insignificant. Future studies will be challenged to identify influenza - COVID-19 comparison since the global rate of influenza during the 2020-2021 flu season was the lowest in fifteen years. In the USA, just (1) influenza-associated pediatric death has occurred during the 2020-2021 flu season. This compares with (199) influenza-associated pediatric deaths last flu season. Precision Vaccinations External Link 


    Consent decree shuts down production of Real Water because of violations and link to outbreak

    2 June- A federal court permanently enjoined a Henderson, NV, company from preparing, processing, and distributing adulterated and misbranded bottled water. In a complaint filed on May 19, at the request of the U.S. Food and Drug Administration (FDA), the United States alleged that Inc. and Real Water Inc., along with company officers Brent A. Jones and his son, Blain K. Jones, violated the Federal Food, Drug, and Cosmetic Act by distributing adulterated and misbranded bottled water. The companies formerly distributed bottled water and concentrate under the brand names "Re2al Water Drinking Water" and "Re2al Alkalized Water." While the companies marketed their products as a healthy alternative to tap water, the government alleged that the products in fact consisted of municipal tap water that the defendants processed with various chemicals in violation of current good manufacturing practices, relevant food safety standards, and hazard prevention measures. Food Safety News External Link

    Large Salmonella outbreak linked to melons

    1 June- Melons have been linked to a Salmonella Braenderup outbreak that has affected 200 people in more than 10 countries. Patients have been reported in Denmark, Belgium, Finland, France, Germany, Ireland, the Netherlands, Norway, Sweden, the United Kingdom, Canada and Switzerland. Illnesses started in late March. Czech Republic and Spain have also recorded recent Salmonella Braenderup infections but it is not yet clear if they belong to this outbreak. Food Safety News External Link

    More enoki mushrooms recalled; fourth company in less than a week

    1 June- Concord Farms of Vernon, CA, is recalling enoki mushrooms, grown in Korea, because of potential Listeria monocytogenes contamination. This is the fourth enoki mushroom recall in recent days. The recalled product was distributed from California to retail stores through produce distributors, according to the company's recall notice posted by the Food and Drug Administration. Complete distribution details regarding what states were not provided in the company notice. The recall notice did not include any product expiration information. Consumers can use the following information to determine whether they have the recalled enoki mushrooms in their homes. The product is packaged in black, yellow and transparent plastic packaging, printed with the "Concord Farms" logo above "fresh enoki mushrooms." Enoki mushrooms are white with stringy stems and small white caps. The weights of the recalled products are 5.3-ounce (150-gram) or 7-ounce (200 gram). The UPC barcode numbers are 049995041049. As of the posting of this recall, no infections have been reported or confirmed. Consumers who have purchased the enoki mushrooms are urged to return  them to the place of purchase for a full refund. Food Safety News External Link


    Benefits of avocados: 5 ways they are good for your health

    1 June- Avocados have become an increasingly popular food in recent years, with people blending the creamy fruit in their smoothies or slicing it to layer on top of toast. The green fruit has become a true staple in kitchens around the world -- and for good reason. Avocados deliver a variety of health benefits and are a versatile ingredient when cooking, said CNN nutrition contributor Lisa Drayer. She uses the fatty fruit in soups, dips and even chocolate truffles. Depending on how you bake with it, avocados can be an excellent fat substitute that won't make your desserts taste like an avocado, she noted. CNN External Link


    Guinea worm infection investigated in Ghana

    31 May- A suspected case of Guinea worm disease, or dracunculiasis, is being investigated in Agorkpoe Eloekope Community, North Tongu District, Volta Region in Ghana. The patient is a 54-year-old man who noticed a blister on his right foot which burst on May 1 with a whitish worm emerging from the resultant wound. A sample of the worm will be taken and shipped to WHO/CDC Collaborative laboratory in Atlanta for laboratory investigation. Outbreak News Today External Link

    Rift Valley fever death recorded in Uganda

    31 May- Samples from a 19-year-old female from Mbarara district in Southwestern Uganda tested positive for Rift Valley Fever (RVF) at the Uganda Virus Research Institute (UVRI) on May 13, according to the World Health Organization (WHO). The patient presented to a hospital in Kampala on May 12 with symptoms of infection, kidney injury and bleeding from the nose and mouth. In total, the woman consulted with five health facilities for medical attention but failed to improve. On May 13, she died. Officials report there are reported abortions in goats in neighboring areas. Rift Valley Fever is an acute viral hemorrhagic fever that causes illness in animals (such as cattle, buffalo, sheep, goats, and camels). Outbreak News Today External Link


    Israel sees probable link between Pfizer vaccine and myocarditis cases

    2 June- Israel's Health Ministry said on Tuesday it had found the small number of heart inflammation cases observed mainly in young men who received Pfizer's COVID-19 vaccine in Israel were likely linked to their vaccination. Pfizer has said it has not observed a higher rate of the condition, known as myocarditis, than would normally be expected in the general population. In Israel, 275 cases of myocarditis were reported between December 2020 and May 2021 among more than 5 million vaccinated people, the ministry said in disclosing the findings of a study it commissioned to examine the matter. Most patients who experienced heart inflammation spent no more than four days in the hospital and 95% of the cases were classified as mild, according to the study, which the ministry said was conducted by three teams of experts. The study found "there is a probable link between receiving the second dose (of Pfizer) vaccine and the appearance of myocarditis among men aged 16 to 30," it said in a statement. According to the findings, such a link was observed more among men aged 16 to 19 than in other age groups. Pfizer said in a statement that it is aware of the Israeli observations of myocarditis, noting that no causal link to its vaccine has been established. Reuters External Link


    Norway investigates Yersinia enterocolitica outbreak

    23 May- The Norwegian Institute of Public Health reports 15 people with infection caused by the bacterium Yersinia enterocolitica O3. All are sampled in late April and early May. The patients are between 16 and 54 years old and most (66 per cent) are women. The infected live in different parts of the country: Viken (3), Trøndelag (5), Rogaland (2), Vestland (3), Møre og Romsdal (1) and Vestfold and Telemark (1). Bacteria with the same DNA profile have been detected in all fifteen people. The patients are interviewed and the local Norwegian Food Safety Authority takes samples from food products in the homes of those who are infected, if residues are available, in order to find the source of the outbreak if possible. Such investigative work can be complicated and time consuming, and in many cases it will not be possible to find the source of the infection or to clarify whether it is a common source. Yersiniosis is an infection caused by the bacterium Yersinia enterocolitica. The most common symptoms are diarrhea, fever and abdominal pain, usually lasting 1-3 weeks. The reservoir for the bacterium is primarily pig. Dogs and cats can also be carriers of the bacterium. Yersinia bacteria are transmitted mainly through food, usually through infected pork products, contaminated vegetables or salads and the use of non-disinfected drinking water. Every year, between 40 and 80 cases of yersiniosis are reported to the National Institute of Public Health. Most are infected domestically (60-80 percent of reported cases). Outbreak News Today External Link


    China reports 1st known human case of H10N3 avian influenza

    1 June- Chinese health authorities have reported the first known human case of H10N3 avian influenza in a man from Jiangsu Province in east-central China. The patient, a 41-year-old man, presented with fever and other symptoms on April 23. At present, the patient's condition is stable and basically meets the discharge standard. On May 28th, the Chinese Center for Disease Control and Prevention conducted a whole genome sequence determination of the patient specimens sent from Jiangsu Province , and the result was positive for the H10N3 virus. All close contacts were monitored and no additional cases were detected. The National Health Commission has instructed Jiangsu Province to carry out prevention and control in accordance with relevant plans, and organized expert risk assessments. Experts assessed that the whole gene analysis of the virus showed that the H10N3 virus was of avian origin and did not have the ability to effectively infect humans. No human cases of H10N3 have been reported globally and the H10N3 virus among poultry is low pathogenic to poultry. Large-scale spread of epidemic risk is extremely low. Experts suggest that the public in their daily lives should avoid contact with sick or dead poultry, try to avoid direct contact with live birds; attention to food hygiene, improve self-protection awareness, appear fever and respiratory symptoms should wear a mask, just as soon as doctors. Outbreak News Today External Link


    U.S.: Lyme disease prevention- Rhode Island officials concerned that 2021 may be a bad year

    31 May- Rhode Island health and environment officials are urging residents to safely enjoy the outdoors and to take additional precautions to avoid direct contact with ticks that can transmit Lyme disease as the summer nears. With a very mild winter in which many more ticks than usual have likely survived until spring and with many more people expected to be outside this year, the Rhode Island Department of Health (RIDOH) and the Department of Environmental Management (DEM) are concerned that 2021 may be a bad year for tick bites and the transmission of Lyme disease and other diseases. As Rhode Islanders enjoy Rhode Island's outdoors safely, it is also important to be aware of ticks and the diseases they carry. Rhode Island continues to be a high incidence state for Lyme disease. According to 2019 RIDOH disease data, Rhode Island had 971 cases of Lyme disease, with an incidence rate of 91.8 cases per 100,000 people. Reported cases of Lyme disease in Rhode Island increased by approximately 20% in 2017 and has remained at a similar level in 2018 and 2019. "Summer is a wonderful time to enjoy the outdoors in Rhode Island, but there are also some health risks associated with the season and tick bites are near the top of the list," said Director of Health Nicole Alexander-Scott, MD, MPH. "Rhode Islanders should reduce exposure to ticks, check their bodies for ticks, and remove ticks whenever they are found to help protect against Lyme disease. Lyme disease is a common but frequently misunderstood illness that, if not diagnosed early and treated properly, can cause very serious health problems. But the first step is prevention. All Rhode Islanders can help keep themselves and their family members safe by being tick aware this year!" Lyme disease is caused by a bacterium transmitted to humans through the bite of an infected tick. An infected tick usually needs to be attached to a person for at least 24 hours to transmit Lyme disease. The ticks that carry Lyme disease can be found in parks, playgrounds, and backyards, but they are most common in very grassy areas and the woods. Ticks can be as small as a poppy seed. Outbreak News Today External Link


    Argentina reports 1st human rabies case since 2008

    30 May- The Ministry of Health of the Province of Buenos Aires together with the Ministry of Health of the Nation of Argentina recently reported a confirmed case of human rabies, according to a Communique from the Uruguay Ministry of Health.  Argentina has not reported a case of human rabies since 2008; however, it registered cases in bats every year in several provinces including Buenos Aires. The case involved a 33-year-old woman living in Coronel Suárez, south center of the Province of Buenos Aires, who had consulted the health service on April 18 due to nervous symptoms (weakness in upper limbs and altered sensation ) that evolved into a deterioration in the level of consciousness, leading to a coma and subsequent death. During the investigation and talks with her relatives, the antecedent of a bite by a feline emerged at the beginning of March, and she had not consulted at that time. In this case, by genetic sequencing, the rabies variant has been identified as a bat. Outbreak News Today External Link