Army Public Health Weekly Update, 06 August 2021

Date Published: 8/6/2021
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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 

    Plan your Float: Boating Safety Tips from the Coast Guard

    2 August- Plenty of people are out on the water this summer, with record heat bearing down. For those operating boats - whether you're new to boating or experienced, out on the ocean, in lakes, or on rivers - there are some basic safety tips to keep in mind. A "Float Plan" is the first thing recommended by Coast Guard Public Affairs Specialist 3rd Class Gregory Schell, at the District 9 Great Lakes Region in Cleveland, Ohio. "We encourage all recreational boaters to file a Float Plan, a form that's left with a trusted source on shore," Schell said. "It has identifying information - your departure time, your destination, return time, description of the vessel. In case you're overdue, all that information can be sent to the rescue agency and really jump-start the search and rescue process." On the water: Don't drink and boat. Alcohol is the leading known factor in fatal boating accidents. USCG and local law enforcement officials keep sharp eyes out for those tipping a beer or driving erratically while out on the water. If your blood alcohol level is at .08 or higher, you'll be arrested, lose your license, a lot of money, and maybe your rank. Wear a life jacket. The Coast Guard recommends everyone onboard wear one at all times, just like a car safety belt. And by law, on an underway vessel, kids under 13 must wear an appropriate USCG-approved wearable life jacket. Check out the USCG's official boating safety web site. Health.mil External Link 

    U.S. MILITARY

    COVID-19 Vaccines: Benefits Still Outweigh the Risks

    30 July- Only a small fraction of people in the military community have experienced breakthrough infections after receiving a COVID-19 vaccination - and none of them have died, according to Defense Health Agency Director Army Lt. Gen. (Dr.) Ronald Place. Place revealed new data about breakthrough infections among people who are fully vaccinated against COVID-19 at a July 20 virtual town hall for DHA employees. Place explained that the evidence shows how effective the vaccine has been and he encouraged all service members and others to get fully vaccinated. "The fact of the matter is the efficacy is very good," Place said. "From a safety perspective, for those of us who are [fully] vaccinated, it is exceptionally uncommon for us to need hospitalization." More than 2 million people in the Military Health System have received full COVID-19 vaccinations, Place said. Of that number, about 1,600 people have been infected with the novel coronavirus. "How many of those have had to be hospitalized? Less than 50," he told nearly 2,000 employee town hall participants. "There have been no deaths among that hospitalized group." Yet despite strong evidence of the vaccine's safety and efficacy, significant portions of the military and civilian populations remain hesitant to get the shot. For those who remain skeptical, Place encouraged them to: "Have a true, meaningful conversation with somebody you trust or some buddies that you trust." He suggested also talking to "your health care team, those family members that you trust and other members of the DHA that you may trust." Place also shared his thoughts on the potential impact the unvaccinated population can have on their broader community. Health.mil External Link

    Distinguished Army veteran, veterinarian celebrates 100 years

    30 July- Retired U.S. Army Brig. Gen. Charles V.L. "Chuck" Elia celebrated his 100th birthday July 27, 2021, at a ceremony hosted by U.S. Army North (Fifth Army) at their Quadrangle headquarters on Joint Base San Antonio-Fort Sam Houston. The event featured jazz music played by members of "Fort Sam's Own," the 323d Army Band, then special guests highlighted Elia's many accomplishments and contributions to the U.S. Army. As part of the celebration and in honor of Elia's dedication to Army Veterinary Medicine, a Percheron draft horse from the JBSA-Fort Sam Houston Caisson was led into view and officially renamed Elia. The retired general, in turn, donated the brown leather veterinary kit his mother gifted him when he joined the Veterinary Corps to the U.S. Army Medical Museum. A native Texan, Elia was born in Marshall and attended the North Texas Agriculture College, now the University of Texas at Arlington. He was commissioned into the U.S. Army in 1942 as a second lieutenant in the Medical Administration Corps. In 1943, the proud Aggie graduated from Texas A&M as a Doctor of Veterinary Medicine, moving on to attend the University of California, George Washington University, and Johns Hopkins University, and graduating with a Master's in Public Health. Elia went on to become the 16th Chief of the U.S. Army Veterinary Corps and retired from military service in 1976. Throughout his service, Elia held numerous prestigious positions, to include consultant to the Greek Army; deputy director of Public Health and Welfare and veterinary consultant to U.S. Civil Affairs, Ryukyu Islands, Japan; commandant to the U.S. Army Medical Department Veterinary School; chief Army Veterinarian to the 4th, 5th and 6th Armies; and finally, chief of the U.S. Army Veterinary Corps. DVIDS External Link 

    Sexual assault prevention starts on day one, Army senior leaders say

    30 July- While leaders continue to expect a lot from their Soldiers, the Army should get "back to the basics of taking care of our people", the Army secretary said Tuesday during an event for the Resiliency Program Improvement Forum. "As our great Army undertakes a fundamental strategic shift, from 20 years of counterterrorism operations to competing effectively against and deterring conflict with China and Russia, we're also grappling with a host of harmful behaviors that are hurting our people," said Secretary of the Army Christine E. Wormuth during the event. Wormuth and other Army leaders spoke to members from across the SHARP program on the importance of prevention efforts in the fight against those behaviors. "Whether it's sexual assault/harassment, suicides, substance abuse, or other behavioral health challenges, the last 20 years have placed a lot of strain on our Army," she continued. "Army leaders must address these issues by changing the culture within their units while focusing on building cohesive teams that are highly trained, disciplined and fit," said Chief of Staff of the Army Gen. James C. McConville. This comes amid changes already made by the Army, like the ongoing restructuring of the U.S. Army Criminal Investigation Command, the Army secretary said. "We're in the process now of evaluating candidates to lead CID," Wormuth said. "We will move soon to hire more civilian investigators to build out our investigative capabilities" under suggestions outlined in a Defense Department report published earlier this month. To achieve this, Army leaders are working with top Pentagon officials on ways to implement the recommendations in four priority areas of change: accountability; prevention; climate and culture; and victim care and support. Army.mil External Link

    'We're all responsible for preventing suicides every day'

    30 July- Although September is National Suicide Prevention Awareness Month, "We're all responsible for preventing suicides every day," according to Fort Leonard Wood's suicide prevention program manager. To help do this, leaders on post have brought together the skills of professionals from the General Leonard Wood Army Community Hospital, the Army Substance Abuse Program, Army Community Service and others to provide a holistic suicide awareness program focused on not only treatment but prevention. The Fort Leonard Wood Suicide Prevention Program falls under the Army Substance Abuse Program, and according to Polly Guthrie, ASAP manager, the trainings and campaigns her specialists organize bring a mindset here that suicide prevention is something that needs to be remembered daily. "We don't just look at [suicide prevention] as a once-per-year event," she said. "We really emphasize the importance of reaching out to Soldiers, friends, families and teammates daily. That begins by connecting with peers and supervisors connecting with their employees, seeing changes in their behavior and being able to step in and ask the hard questions: Are you ok? Do you need help? What's going on? Because we never want to lose anybody to suicide." Army.mil External Link

    Why Simone Biles' mental health struggle matters for Military troops

    3 August- Like many Americans, military service members and commanders have taken notice of the withdrawal from Olympic competition last week of superstar gymnast Simone Biles, who cited mental health concerns after uncharacteristic missteps in the early stages of competition. "Gymnasts are some of the strongest athletes in the world and elite masters of complex skills unrivaled by other athletes," said Air Force Lt. Col. Regina Owen, a psychiatric mental health nurse practitioner and a professor at the Uniformed Services University (USU) in Bethesda, Maryland. Many members of the military have comparable traits, she said. Like Biles, service members are typically young, fit, well-trained and routinely strong - both physically and mentally. To Owen, Biles is "an elite individual" who displayed great strength by forgoing Olympic competition and chose instead to focus on building her mental strength. "She had more numerous endorsements - i.e. "mental noise" - clamoring for her attention than most American Olympians leading up to the Olympics," she said. "Those types of distractions undermine mental wellbeing and physical capabilities." Owen likened Biles's situation to military service members who are training or preparing for deployments, when "mental focus is essential [and] improved physical preparation will follow." "Military members need to be empowered to prioritize building mental strength and provided adequate resources to avoid distractions undermining their mental wellbeing" Owens said. Biles returned to compete in the balance beam final on Tuesday, August 3rd, the last event of the women's gymnastics competition, and won a bronze medal. The message of prioritizing mental health fitness and performance psychology has been reverberating throughout the military community, especially in light the global pandemic, when many troops and veterans have reported increased feelings of isolation, depression and increased drinking. "Mental health is health - period," said Secretary of Defense Lloyd J. Austin III, during a visit to Alaska on July 24. Austin said he's particularly concerned about the number of suicides in the military. He stressed reducing stigma associated with seeking mental health assistance. Health.mil External Link

    GLOBAL

    CDC shares 'pivotal discovery' on Covid-19 breakthrough infections that led to new mask guidance

    30 July- A new study shows the Delta Covid-19 variant produced similar amounts of virus in vaccinated and unvaccinated people if they get infected -- illustrating a key motivation behind the federal guidance that now recommends most fully vaccinated Americans wear masks indoors. Experts say that vaccination makes it less likely that you'll catch Covid-19 in the first place -- but for those who do, this data suggests they could have a similar tendency to spread it as unvaccinated folks. "High viral loads suggest an increased risk of transmission and raised concern that, unlike with other variants, vaccinated people infected with Delta can transmit the virus," Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said in a statement Friday. The study, published by CDC Friday, describes 469 Massachusetts residents who were infected in a July outbreak in Barnstable County, which includes the summer vacation destination Provincetown. No deaths were reported among them. About 74% -- or 346 cases -- had been fully vaccinated. Of those cases, 79% reported symptoms. Genetically sequenced cases revealed the Delta variant as the main culprit. CNN

    External Link

    Does delta COVID-19 variant raise risk of reinfection?

    3 August- With the emergence of the delta variant driving new breakthrough infections, some are wondering what impact the strain may have on reinfection rates. In the fall, the Centers for Disease Control and Prevention (CDC) advised that some cases of reinfection are expected, but "remain rare." However, that guidance published by the agency was last updated in Oct. 2020, which was prior to the vaccination rollout and before the discovery of the delta variant. The frequency regarding reinfection is not well known, one expert warned, and is difficult to track. "It's important to emphasize how difficult it is to come up with good quality evidence on reinfection because it requires documentation by a second PCR test and ideally sequencing of the virus," Dr. Ricardo Franco, MD, Infectious Disease Society of America (IDSA) member and associate professor of medicine at the University of Alabama at Birmingham (UAB), said Tuesday.  Franco also noted the difficulty in determining whether it's reinfection or a reemergence of the virus that the patient was harboring.  Another expert said low test rates in the U.S. are hampering efforts to get a clear picture of breakthrough cases and asymptomatic spread. Emerging data suggest that asymptomatic vaccinated individuals are capable of transmitting the virus to others, but with mass testing sites closing and a decrease in accessibility outside of working hours, it's likely many cases are going undetected. Fox News External Link

    Mobile Health Clinics bridge gap to underprivileged communities, bridging comms with iPad translators

    3 August- Mobile Health Clinics are here to bridge the underprivileged, less fortunate, and disabled people's need for accessible health care. Not everyone in the United States has access to medical care, and this has led people to keep their ailments to themselves, being hesitant to approach the proper attention they need. Now is the time that this notion is removed, especially as accessible health care figuratively rolls near people, parking near major establishments in a certain community. The clinics would help in addressing the basic to intermediate needs regarding medical assistance, which some fail to receive due to a lack of money to pay for proper healthcare and checkups. This would also be open for everyone, especially those who are hesitant to go to hospitals, as COVID-19 is characterized by its aggressive infection rate. Tech Times External Link

    Oral JAK inhibitor reduced deaths among COVID-19 patients receiving invasive mechanical ventilation

    3 August- Indiana-based Eli Lilly and Company and Delaware-based Incyte announced today results from an additional cohort of 101 adult patients from the COV-BARRIER clinical trial, focused on Olumiant (Baricitinib), a Janus kinase inhibitor. Olumiant is a once-daily, oral JAK inhibitor approved in the U.S. and more than 70 countries to treat moderate to severe rheumatoid arthritis adults. In this sub-study, patients with COVID-19 on mechanical ventilation or extracorporeal membrane oxygenation (ECMO) who received baricitinib plus standard of care were 46% less likely to die by Day 28 compared to patients who received placebo plus standard of care (nominal p-value=0.0296; hazard ratio [HR] [95% CI] = 0.54 [0.31, 0.96]; analysis not adjusted for multiplicity). The cumulative proportion of patients who died by Day 28 was 39.2% in the baricitinib arm versus 58% in the placebo arm. Similar mortality benefit was observed by Day 60 (HR [96% CI] = 0.56 [0.33, 0.97]) with a cumulative proportion of death of 45.1% for baricitinib compared to 62% for placebo. Precision Vaccinations External Link

    Second MMR vaccine seeks FDA approval

    2 August- Pennsylvania-based GlaxoSmithKline (GSK) today announced it has submitted a Biologics License Application (BLA) to the US Food and Drug Administration (FDA) for its Priorix vaccine and is seeking Approval for use in active immunization against infection by measles, mumps, and rubella (MMR). If approved, the Priorrix vaccine would offer US-based healthcare providers an alternative MMR vaccine. Merck, Inc.'s M-M-R®II is the leading vaccine. GSK stated in its press release it is also seeking approval for Priorix administration as a second dose to individuals who received another MMR vaccine. The Priorix MMR vaccine developed by GSK was first registered in Germany in 1997 and is currently licensed in more than 100 countries worldwide, with more than 400 million doses distributed to date. "If approved (the BLA), Priorix will increase the number of vaccine offerings from GSK against childhood diseases in the US market and strengthen GSK's long-term commitment to prioritizing public health in the US," commented Judy Stewart, SVP and Head of US Vaccines at GSK, in the press statement issued on August 2, 2021. Priorix is a lyophilized mixed preparation of the attenuated Schwarz measles, RIT 4385 mumps (derived from Jeryl Lynn strain), and Wistar RA 27/3 rubella strains of viruses. The measles and mumps components of the vaccine are produced in chick embryo cell culture and may contain traces of egg protein. The safety of PRIORIX was evaluated in six clinical studies, in which a total of 17,393 subjects received at least one dose of either Priorix or Merck's M-M-R®II. The efficacy of Priorix was demonstrated based on comparative immunogenicity data with M-M-R®II. The most commonly reported adverse reactions were pain, redness, swelling, loss of appetite, irritability, drowsiness, and fever. Precision Vaccinations External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    2020-2021 Influenza Season for Week 29, ending July 24, 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 29. CDC External Link

    VETERINARY/FOOD SAFETY

    Hepatitis A outbreak spurs recall of frozen mangos; additional patients likely

    31 July- An outbreak of hepatitis A infections has been confirmed in relation to frozen mangos. Patients live in the Canadian provinces of Quebec and Nova Scotia. It is not yet known whether the products were distributed in the United States. The Canadian Food Inspection Agency posted a recall notice for four products in relation to the outbreak. See chart below for details. "This recall was triggered by findings during an investigation into a foodborne illness outbreak. The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation, which may lead to the recall of other products," Canadian officials reported in the recall notice. There is urgent concern that consumers may have the products in their homes because of the long shelf life of the frozen fruit — best-by dates stretch through December 2022.  Freezing does not kill the hepatitis A virus, which causes liver problems. Confirmed patients became sick between late March and mid June, according to Public Health Canada. No hospitalizations or deaths have been reported. The three individuals who became ill are between 23 and 63 years of age. Food Safety News External Link 

    Pure Eire Dairy closes in wake of E. coli outbreak

    2 August- Pure Eire Dairy in Washington state has closed down for good. State officials linked the dairy to an outbreak of E. Coli infections beginning in May. As of June 24 there were 17 confirmed patients in the outbreak. Ten of the patients are younger than 10 years old. Ten of the 17 patients have had such severe symptoms they had to be admitted to hospitals. The Washington health department has not released the ages of those who have hospitalized. Of the 17 outbreak patients, four have developed hemolytic uremic syndrome (HUS), a type of kidney failure that can be fatal. Three of the patients live in Arizona and are thought to have become infected through person-to-person contact by visitors from Washington. Most of the sick people reported eating organic yogurt made by the Pure Eire Dairy in Othello, WA. Both PCC brand and Pure Eire brand yogurt have been recalled. In a Facebook statement the owners of the dairy thanked supporters and said they would be selling their cows. Following is their statement in its entirety. Food Safety News External Link

    WELLNESS

    Why you shouldn't soak a splinter, and other ways first aid has changed

    26 July- Now that we're relishing our post-shutdown freedom, we're making the most of the season of barbecues, picnics and other outdoor fun with friends and family members. That's all good, but it also means that we're at increased risk for summer bummers such as splinters, sprains and burns. When it comes to treating injuries like these, the strategies our parents used may no longer be the right things to do. In some cases, old wives' tales have been debunked; in others, doctors have found better, evidence-based treatments. "As we learn new things from science, the guidelines change — and that's happening with first aid. We now have better evidence of what works," says Sean McGann, a clinical assistant professor of emergency medicine at Thomas Jefferson University in Philadelphia and a spokesman for the American College of Emergency Physicians. If your first-aid techniques aren't on target, you could end up exacerbating an injury. In a study in which 654 adults took a multiple-choice test on recommended first-aid skills, not a single one answered every question correctly, and only half of the adults were familiar with 60 percent of the questions. It shouldn't be that way. The Washington Post  External Link

    USAFRICOM

    Reunion dengue fever update: Cases continue to decrease but remain higher than in previous years

    1 August- From July 12 to 18, 295 cases of dengue were confirmed. The number of cases and emergency visits continues to decrease but remains higher than in previous years, according to ARS La Reunion. The recorded cases are mainly located in the West of the island (60%): Saint-Paul, La Possession, St-Leu, Le Port and Trois-Bassins. Since the beginning of the year, Reunion has reported 28,906 confirmed dengue cases, including 769 hospitalizations and 15 deaths directly linked to dengue. 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). Outbreak News Today External Link 

    USCENTCOM

    Saudi Arabia reports 2nd MERS case in a week from Riyadh

    2 August- The Saudi Arabia Ministry of Health reported an additional Middle East respiratory syndrome coronavirus (MERS-CoV) case from Riyadh, the second case in a week. The patient is a 65-year-old man who had contact with camels. This is the eleventh MERS case of 2021 in the Kingdom and the 12th overall (one in the United Arab Emirates). Middle East respiratory syndrome coronavirus (MERS-CoV) is a virus transferred to humans from infected dromedary camels, according to the World Health Organization. It is a zoonotic virus, meaning it is transmitted between animals and people, and it is contractible through direct or indirect contact with infected animals. MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa and South Asia. In total, 27 countries have reported more than 2,500 cases since 2012, leading to nearly 900 known deaths due to the infection and related complications. Outbreak News Today External Link

    USEUCOM

    Portugal: 52% of eligible population fully vaccinated against COVID-19

    1 August- In a follow-up on the COVID-19 vaccination situation in Portugal, according to the Vaccination Report released on the 27th of July, which  indicates that 52% (5.389,935) of the Portuguese have already completed vaccination against COVID-19. According to the same report, at least one dose has been administered to 67% of people (6,865,047). Since the start of the vaccination plan, Portugal has received 12,886,770 vaccines, with 12,043,017 million doses being distributed by vaccination centers in the Autonomous Regions and mainland territory. By age groups, 99% of people over 80 years old (679,085) have already been vaccinated with the first dose and 96% (652,322) completed the vaccination process. Likewise, 99% (1,632,149) of the Portuguese aged between 65 and 79 years old have the first dose and 94% (1,530,817) the complete vaccination schedule. In the age group between 50 and 64 years, 2,022,572 (93%) took at least the first dose and 1,791,420 (82%) completed the vaccination. Outbreak News Today External Link

    USINDOPACOM

    Dhaka records more than 200 dengue cases in a day for the first time, Dengue control room to open Monday

    1 August- In a follow-up on the Bangladesh dengue fever situation, the Bangladesh Directorate General of Health Services (DGHS) reported 237 dengue fever cases today, of which 218 were reported in Dhaka alone. This is the first time in 2021 that the daily tally has topped 200. This brings the dengue total in the country to 2,895, a rise of about 1,000 cases in less than a week. The bulk of the cases were reported in July (~2,500). To eradicate dengue larvae in Dhaka South City Corporation (DSCC) areas, a control room will be opened on Monday, said DSCC Mayor Barrister Sheikh Fazle Noor Taposh. "It is not possible to eradicate Aedes mosquitoes without destroying the source. We will now go from house to house and destroy the sources," he said. Local Government and Rural Development (LGRD) Minister Md TaZul Islam instructed all the councilors of the city corporation to eradicate Aedes mosquitoes and bring dengue to a tolerable level within the next two weeks. He said: "Even after repeated warnings, people are not becoming aware. The government's job is to make people aware and the government is constantly doing that." Outbreak News Today External Link

    USNORTHCOM

    U.S.: New Jersey- Reports West Nile virus death in Camden man

    1 August- A Camden man in his 60s has tested positive for West Nile Virus (WNV). On July 16, the resident was admitted to a local hospital displaying symptoms consistent with WNV. Following treatment, he was discharged to a local sub-acute care center where he later expired. Laboratory testing returned positive results for WNV. "West Nile Virus typically affects a small number of New Jersey residents each year, however the prevalence of the virus has been increasing recently," said County Health Officer Dr. Paschal Nwako. "Our thoughts and prayers are with the victim and his family. The Camden County Department of Health is continuing to work with the Mosquito Commission to ensure that additional spraying and testing will be conducted in the area." Symptoms of WNV include, but are not limited to, fever, headache, altered mental status, and other neurologic dysfunctions. WNV is the leading cause of mosquito-borne disease in the continental United States, though 4 out of 5 who are infected do not feel symptoms. Only 1 in 50 develop serious illness. The best way to protect yourself from mosquitoes is to use insect repellent. Use Environmental Protection Agency (EPA)-registered insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women. Outbreak News Today External Link

    USSOUTHCOM

    Chile suspect Q fever update: Patient confirmed as having psittacosis

    1 August- In a follow-up on the suspected Q fever case in a veterinarian in the Los Lagos Region of Chile, the Health Ministry of the province of Osorno ruled out Q fever in the 28-year-old veterinarian who remains seriously hospitalized at the Las Condes Clinic. After receiving the results of the study carried out by the Institute of Public Health, the provincial head of the seremi, Vania Rojas, confirmed that the patient did become infected with another zoonotic bacteria: psittacosis. "The result was negative for Q fever, however, this serological study tested positive for psittacosis, which is another zoonotic bacterium, so we are attentive to the treatment of this patient," explained the authority. The 28-year-old woman works as a veterinarian at the dairy company Manuka, and last Friday she entered the emergency service of the Osorno Base Hospital with a picture of pneumonia. Due to her seriousness, she had to be transferred to the Las Condes Clinic, in Santiago, where she is kept in the Intensive Care Unit and connected to mechanical ventilation. Psittacosis is a disease caused by bacteria called Chlamydophila psittaci. It is usually transmitted by inhaling the agent from dried droppings or secretions of infected birds. Outbreak News Today External Link