Army Public Health Weekly Update, 08 January 2021

Date Published: 1/8/2021
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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 

    COVID-19 Vaccination

    A safe and effective vaccine is an important tool for protecting yourself and those around you and ending the global pandemic. Visit APHC for more vaccination information.

    U.S. MILITARY

    DHA's IT innovation continues during COVID-19 pandemic

    31 December- The Defense Health Agency's innovations in Information Technology in 2020 not only aided the immediate response to the COVID-19 pandemic, but also proved that such challenges cannot dim the future of IT utility, convenience, and interoperability. The DHA is moving forward with the nationwide installment of its MHS GENESIS electronic health records (EHR) system, which should be finished – on time – by the end of 2023, Holly Joers, acting program executive officer, Program Executive Office-Defense Healthcare Management Systems, told a recent media roundtable. The momentum has continued despite competing priorities from the COVID-19 pandemic on military health care centers across the U.S., Joers noted. In fact, the installation of MHS GENESIS, the joint EHR for the DOD and the Department of Veterans Affairs, already has proven helpful in adding system alerts for COVID-19, opioid overuse, and mass inoculations, she said. MHS GENESIS offers a patient portal as one of its key features. The portal is a one-stop shop, around-the-clock access point for viewing personal health care and history. It also provides two-way communication between patient and provider. Beneficiaries can use the secure website to access individual and family health information and to aid in online prescription renewal. In October, CommonWell Health Alliance was added to the joint health information exchange (HIE), bringing with it a network of more than 15,000 health care providers. The joint HIE was launched in April 2020 and is a network of private sector providers across the United States who have agreed to securely share clinical information with DOD, Department of Veterans Affairs and U.S. Coast Guard providers. Shared clinical information includes prescriptions, allergies, illnesses, lab and radiology results, immunizations, medical procedures, and medical notes in the form of electronic health records, "resulting in more informed care for patients who are navigating between different health care providers" in both the public and private sectors," DOD said. The CommonWell connection was a "critical step forward in significantly expanding DOD, VA and the U.S. Coast Guard's private sector partnerships and interoperability capabilities," according to DOD. The deal provides a single point of entry for providers to the more than 2,000 hospitals, 8,800 pharmacies, 33,000 clinics, 1,100 labs, 800 federal qualified health centers, and 300 nursing homes participating in joint HIE. Health.mil External Link

    DoD-wide PFAS testing yields no significant preliminary findings at Fort Knox

    31 December- Initial results from DoD-mandated Per- and Polyfluoroalkyl Substance, or PFAS, testing at seven locations here conducted earlier this year show minimal environmental contamination. The Environmental Protection Agency defines PFAS as a group of about 600 man-made chemicals that have been manufactured and used in a variety of industries around the world, including in the United States since the 1940s. Perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) have been the most extensively produced and studied of these chemicals. Both are persistent in the environment and in the human body – meaning they don't break down and can accumulate over time. These chemicals are found in a number of everyday household items, including stain- and water-repellent fabrics, nonstick products (e.g., Teflon), polishes, waxes, paints and cleaning products. In May 2016, the EPA also set a lifetime health advisory level for PFAS in drinking water of 70 parts per trillion. While this is not currently an enforceable standard, it sets a guideline for municipalities to follow. In June 2016, the DoD proactively mandated the testing of more than 400 military installations in an effort to discover and mitigate any potential risk to humans and the environment. In February 2020, the EPA announced a proposed decision to regulate PFOS and PFOA in drinking water throughout the United States. The past release of PFAS chemicals here stems from the Fort Knox Fire Department's use of Aqueous Film Forming Foam, or AFFF, in past training exercises and aircraft/fuel firefighting applications. Seven sites of known AFFF release were chosen for evaluation here, five of which are at Godman Army Airfield, where the foam was stored and used in training exercises. PFAS in the ground water/soil at the other two testing sites was either non-detectable or well below the EPA lifetime health advisory level. Testing conducted in the area in and around the airfield training location predictably showed slightly elevated levels of PFAS chemicals in the soil and surface water within drainage areas in the immediate vicinity of the site. DVIDS External Link

    MHS operational innovations continue in battle against COVID-19

    5 January- Operational medicine performed by deployed military medical personnel has always driven innovation, and this was more important than ever in responding to the COVID-19 pandemic. Military Health System innovations in 2020 include a new registry for real-time COVID-19 data and a system to free up hospital beds and protect patients from the disease. Service Members also developed inexpensive ventilator designs and adapted safer ways to transport and perform surgical procedures on COVID-19 patients. Meeting the need for real-time COVID-19 data, the Joint Trauma System (JTS) developed a global COVID-19 registry to track patients and their outcomes. The COVID-19 registry exceeded 90,000 patients in the Department of Defense as of the first week of December, said JTS Chief, Air Force Col. (Dr.) Stacy Shackelford. The registry began collecting real-time COVID-19 data in May. The JTS is conducting detailed patient chart analyses of the COVID-19 registry to look at items such as deaths within the MHS and other COVID-19 subpopulations of interest, Shackelford said. So far, 3,200 charts have been analyzed. "In general, the registry has an important capability to look at treatments and outcomes. That's our number one goal," she said. For example, the registry compares outcomes of COVID-19 available treatments including convalescent plasma, steroids and remdesivir. "Our number two goal is long-term tracking of patients and links to other outcomes," Shackelford said. Health.mil External Link

    GLOBAL

    Coronavirus cases in children surpass 2 million mark

    31 December- A surge in pediatric coronavirus cases over the last several weeks has seen the number of illnesses in kids surpass 2 million, according to the American Academy of Pediatrics (AAP). More than 1 million of those coronavirus cases in kids have been reported nationwide since Nov. 12, according to the medical group's data. "Nearly 179,000 new child COVID-19 cases were reported last week, ending 12-24-20," the AAP said, in a news release posted Tuesday. "At this time, it appears that severe illness due to COVID-19 is rare among children. However, there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects." Children now represent approximately 12.4% of all cases in the U.S., according to the data, and as of Dec. 17, at least 172 children had died due to the illness. About 1.8% of all COVID-19 hospitalizations involve children, but more in-depth data on testing, hospitalizations and morbidity were expected in a forthcoming report. Fox News External Link

    Covaxin: Concern over 'rushed' approval for India Covid jab

    4 January- Experts have raised concerns over India's emergency approval of a locally-produced coronavirus vaccine before the completion of trials. On Sunday, Delhi approved the vaccine - known as Covaxin - as well as the global AstraZeneca Oxford jab, which is also being manufactured in India. Prime Minister Narendra Modi touted the approval as a "game changer" but health experts warn it was rushed. Health watchdog All India Drug Action Network said it was "shocked". It said that there were "intense concerns arising from the absence of the efficacy data" as well a lack of transparency that would "raise more questions than answers and likely will not reinforce faith in our scientific decision making bodies". The statement came after India's Drugs Controller General, VG Somani, insisted Covaxin was "safe and provides a robust immune response". He added the vaccines had been approved for restricted use in "public interest as an abundant precaution, in clinical trial mode, to have more options for vaccinations, especially in case of infection by mutant strains". "The vaccines are 100% safe," he said, adding that side effects such as "mild fever, pain and allergy are common for every vaccine". BBC News External Link

    Experts develop smart mattress that accurately monitors premature babies' temperature to avoid complications

    4 January- Nottingham Trent University experts are now working with Rober Ltd, a Chesterfield-based company, in developing smart mattresses to accurately monitor and keep premature babies at their ideal temperature to prevent any health complications. According to Daily Mail, premature babies cannot maintain their body temperature on their own because of their system are not yet fully developed. Thus, they need to have a person or system to monitor their temperature at all time. With advanced technology progressing fast, tech companies are developing smart gadgets built with artificial intelligence on mobile phones, cars, speakers, light bulbs, and homes as a whole. They would generally make life much easier and technologically connected. If temperatures of premature babies are not properly managed, it can lead to breathing difficulty, metabolic problems, and other health issues. This is the reason AI is now being used in medicine to help improve the care and supervision standard for patients. NTU School of Art and Design product design expert Professor Peter Ford who leads the project, said that it is vital for clinicians to provide reliable and accurate thermal management. However, it is quite difficult to do so outside an incubator since newborn babies and those very young premature ones cannot thermoregulate like adults, "so maintaining an appropriate body temperature at such a vulnerable age is essential." Products creators claim the new smart bed can even detect minimal temperature fluctuations as well as warm up instantly to avoid the baby from getting any colder. This would make the healthcare staff's work much easier, but manual supervision is still necessary. The smart bed has significant advantages in the health of the babies and may even prevent untoward risks and even deaths. Tech Times External Link

    'It's a desperate time': Crush of Covid-19 patients strains U.S. hospitals

    3 January- On New Year's Day at Kaiser Permanente Baldwin Park Medical Center in Southern California, the overflowing emergency room spilled into the hallway. Doctors treated patients on oxygen in the waiting room after running out of beds. Some 80% of patients admitted in recent days have Covid-19. In Texas, patients who need to be transferred from small facilities to big metropolitan hospitals sit in limbo for hours or days, putting them at risk of developing complications from delays. Desperate smaller hospitals have flown patients as far as Albuquerque, N.M., and Oklahoma City for an open bed. In North Carolina, rising numbers of intensive-care patients in Charlotte have forced doctors to save those beds for the "sickest of the sickest" from Covid-19 and find somewhere else in hospitals for all other critically ill patients, one hospital official said. Across the nation, the surge of coronavirus cases is crowding large metro hospitals with Covid-19 patients, pushing occupancy against the limits of space and overwhelming nurses and doctors. More than 40% to 60% of ICU patients in some metro areas are critically ill from Covid-19, according to an analysis of federal data by the University of Minnesota Hospitalization Tracking Project. The Wall Street Journal External Link

    "Premature" to change authorized COVID-19 vaccines dosing, schedules, FDA says

    4 January- The U.S. Food and Drug Administration said on Monday that the idea of changing the authorized dosing or schedules of COVID-19 vaccines was premature and not supported by the available data. The FDA said it had been following discussions and news reports about reducing the number of doses, extending the length of time between doses, cutting the dosage in half, or mixing and matching vaccines in order to immunize more people. Although these were "reasonable" questions to consider, the U.S. regulator said, "at this time suggesting changes to the FDA-authorized dosing or schedules of these vaccines is premature and not rooted solidly in the available evidence." "Without appropriate data supporting such changes in vaccine administration, we run a significant risk of placing public health at risk," the agency said in a statement. Pfizer and partner BioNTech SE as well as Moderna Inc. recently won U.S. emergency use authorization for their vaccine candidates. The available data continues to support the use of two specified doses of each authorized vaccine at specified intervals, the FDA said. Reuters External Link

    Sixth COVID-19 vaccine authorization pending

    3 January- Bharat Biotech's Covaxin vaccine became the sixth experimental COVID-19 vaccine approaching authorization on January 2, 2021. The India Subject Expert Committee of Central Drugs Standard Control Organization has reportedly recommended Covaxin for emergency use authorization, reported news agency ANI. The Drug Controller General of India will now take up this recommendation for a final decision. Previously, five other COVID-19 vaccines were issued emergency authorization considerations, including BioNTech - Pfizer's Comirnaty, the Moderna COVID-19 Vaccine, and recently, the UK Medicines and Healthcare products Regulatory Agency provided authorization for an emergency supply of COVID-19 Vaccine AstraZeneca on December 30, 2020. Furthermore, Russia's Sputnik V vaccine and CanSinoBIO's adenovirus-based viral vector Ad5-nCoV vaccine have received various authorizations. And in the USA, the Janssen Vaccines & Prevention B.V. adenovirus serotype 26 (Ad26) vector-based vaccine and Novavax's NVX-CoV2373 perfusion protein subunit coronavirus vaccine candidate are currently conducting late-stage, phase 3 studies. Recently, the U.S. Food and Drug Administration Commissioner Stephen M. Hahn, M.D. stated in a press release issued on December 28, 2020, "We've continued to make important scientific progress, with each day bringing new knowledge and understanding of the SARS-CoV-2 coronavirus and the disease it causes, COVID-19, leading to the issuance of Emergency Use Authorizations for two vaccines, and an increased availability of testing and treatment options," Precision Vaccinations External Link

    Survey: COVID vaccine willingness waned since April

    30 December- National survey results published yesterday in JAMA Network Open show that the number of people who say they are somewhat or very likely to seek COVID-19 vaccination fell from 74% to 56% from April to December, after press coverage of high effectiveness for two vaccines in phase 3 trials but before they were authorized for emergency use in the United States. The study results, published as a research letter, were based on biweekly, online, probability-based tracking surveys of 8,167 community-dwelling adult US participants in the Understanding America Study, led by researchers at the University of California, Los Angeles. Each survey prompted responses from 5,259 to 6,139 participants, with completion rates of 75% to 97%. From Apr 1 to Dec 8, the survey asked "How likely are you to get vaccinated for coronavirus once a vaccine is available to the public?" Response options were classified as "somewhat or very likely" versus all other choices/options. The percentage of participants indicating that they were somewhat or very likely to be vaccinated—considered key to helping end the pandemic—dropped 18 percentage points over that time, with substantial declines across both sexes and all ages, races, and education levels. In the Nov 25 to Dec 8 survey, respondents reporting that they were somewhat or very likely to seek COVID-19 vaccination were more often men than women (62% vs 51% [adjusted rate ratio (aRR), 0.9]), white than black (59% vs 38% [aRR, 0.7]), 65 years and older than 18 to 49 years (69% vs 51% [aRR, 1.4]). Those with at least a bachelor's degree versus a high school education or less were also more likely to seek vaccination (70% vs 48% [aRR, 1.5]). CIDRAP External Link

    U.S. officials address questions on coronavirus variant, vaccines

    30 December- Amid concerns about the identification of a more-transmissible coronavirus variant in Colorado and mounting frustration over the slow pace of COVID-19 vaccination, the third wave of coronavirus infections in the United States continues unabated. The US reported 201,555 new COVID-19 cases yesterday, and 3,725 virus-related deaths, according to data from the Johns Hopkins Coronavirus Resource Center. The nation's total number of cases has climbed to 19,653,653, with 340,956 deaths. The COVID Tracking Project reports that 124,686 Americans are currently hospitalized with COVID-19, and 22,838 are in intensive care units. There have now been more than 71,000 COVID-19 deaths in December, the deadliest month of the pandemic. Among the recent deaths is 41-year-old congressman-elect Luke Letlow, who died yesterday at a hospital in Shreveport, Louisiana, from COVID-19 complications. Letlow won a Dec 5 runoff election to represent Louisiana's 5th Congressional District. CIDRAP External Link

    Virtual screening identifies drug that inhibits coronavirus

    4 January- A novel computational drug screening strategy combined with lab experiments suggest that pralatrexate, a chemotherapy medication originally developed to treat lymphoma, could potentially be repurposed to treat COVID-19. Researchers used this hybrid approach to screen 1,906 existing drugs for their potential ability to inhibit replication of SARS-CoV-2 by targeting a viral protein called RNA-dependent RNA polymerase. This study was published in the journal PLOS Computational Biology on December 31, 2020, suggesting that pralatrexate could be repurposed to treat COVID-19 patients.  However, 'this chemotherapy drug can prompt significant side effects', added the press statement. "We have demonstrated the value of our novel hybrid approach that combines deep-learning technologies with more traditional simulations of molecular dynamics," stated Haiping Zhang of the Shenzhen Institutes of Advanced Technology in Shenzhen, China. He and his colleagues are now developing additional computational methods for generating novel molecular structures that could be developed into new drugs to treat COVID-19. Precision Vaccinations External Link 

    What you need to know about the coronavirus right now

    4 January- Here's what you need to know about the coronavirus right now: UK first to roll out AstraZeneca shots. Britain began vaccinating its population with Oxford University and AstraZeneca's COVID-19 shot on Monday in a world first, as a new surge of cases threatened to overwhelm hospitals. Britain touted a scientific "triumph" that puts it at the vanguard of the West as dialysis patient Brian Pinker, 82, became the first person to get the Oxford/AstraZeneca shot outside of a trial. As major powers eye the benefits of being first out of the pandemic, Britain is rushing to vaccinate its population faster than the United States and the rest of Europe, though Russia and China have been inoculating their citizens for months. France tries to speed up vaccinations. France sought to accelerate inoculations on Monday after an initial roll-out slowed by bureaucracy and government wariness in one of the most vaccine-sceptical countries in the world. Reuters External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 52, ending December 26, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts 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. A total of 101 laboratory-confirmed influenza-associated hospitalizations occurring between October 1, 2020 and December 26, 2020 were reported by FluSurv-NET sites. This number is lower than average for this point in the season and comparable to counts seen at this point during the 2011-12 season. Hospitalization rates will be presented once case counts increase to a level that produces stable rates; in the interim, case counts will be reported each week.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths were reported to CDC during week 52. A total of one influenza-associated pediatric death occurring during the 2020-2021 season has been reported to CDC. CDC External Link

    WHO: Influenza update

    21 December 2020, based on data up to 06 December 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has influenced to varying extents health seeking behaviours, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission have likely played a role in reducing influenza virus transmission.

    - Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.

    - In the temperate zone of the northern hemisphere, influenza activity remained below inter-seasonal levels, though sporadic detections of influenza A and B viruses were reported in some countries.

    - In the temperate zone of the southern hemisphere, influenza activity was reported at inter-seasonal level.

    - In the Caribbean and Central American countries, sporadic influenza B detections were reported in recent weeks. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, was elevated in some reporting countries.

    - In tropical South America, there were no influenza detections in this reporting period.

    - In tropical Africa, influenza activity continued to be reported in Western Africa.

    - In Southern Asia, no influenza detections were reported.

    - In South East Asia, influenza detections of predominately influenza A(H3N2) continued to be reported in Lao People's Democratic Republic (PDR).

    - Worldwide, influenza A and B viruses were detected in similar proportions. WHO External Link

    VETERINARY/FOOD SAFETY

    Attention focuses on COVID-19 while foodborne outbreaks continue in 2020

    30 December- Any discussion of outbreaks in 2020 must be dominated by the coronavirus pandemic, even though it is not considered a foodborne outbreak. There is no solid evidence that the virus can be transmitted by foods or food packaging. Experts say COVID-19 has roots in a live animal meat market in China. It was soon determined that it is transmitted person-to-person via microscopic droplets released when people speak, sing, cough and sneeze. Foodborne illnesses are rarely transmitted person-to-person. Foodborne illnesses and injuries can be caused by bacteria, viruses, parasites, extraneous materials and intentional tampering, with no foods or beverages being immune to possible contamination. Unfortunately, because of federal protections for corporate information and a snarl of red tape and businesses' record keeping, the sources of foodborne outbreaks are sometimes impossible to determine, according to the Food and Drug Administration and the Centers for Disease Control and Prevention. The CDC was able to log and investigate 10 multistate foodborne outbreaks in 2020, with three E. Coli O157:H7 outbreaks being labeled as "source unknown." Federal officials declared two of them over on Dec. 18 with the other officially ending Dec. 22. Despite the "source unknown" determination, the CDC reported that two of the outbreaks were likely caused by leafy greens including but not limited to spinach and romaine and iceberg lettuce. As of the CDC's most recent update on Dec. 22, the FDA is still analyzing samples collected from several leafy greens sources.  The other seven foodborne outbreaks reported by the CDC involved a wide variety of foods ranging from deli meats to fresh peaches. Here, in chronological order are the details of the 10 multistate foodborne outbreaks investigated by the CDC in 2020. Food Safety News External Link

    Certain Dungeness crabs recalled because of poisoning risk

    31 December- The Quinault Tribe of the Northwestern United States is voluntarily recalling almost 58,000 pounds of live or un-eviscerated Dungeness crab because of possible domoic acid contamination, which can cause amnesic shellfish poisoning in people.  With Dungeness crab being a popular New Year's dish, public health officials in Washing state posted the recall notice today in hopes of reaching holiday cooks before meals are prepared. It is not clear how far the crab may have been distributed. Domoic acid is a naturally occurring toxin produced by certain types of algae and can be harmful to humans if contaminated shellfish is consumed. Domoic acid can cause amnesic shellfish poisoning (ASP) with symptoms including vomiting, nausea, diarrhea, and abdominal cramps within 24 hours of ingestion. In severe cases, ASP can cause permanent short-term memory loss. All live or un-eviscerated Dungeness crab harvested from Dec. 23 through Dec. 28 from the Point Chehalis to Destruction Island GHPO056 zone by the Quinault Tribe are subject to recall. Food Safety News External Link

    WELLNESS

    Mental health is one of the biggest pandemic issues we'll face in 2021

    4 January- With progress in efforts for Covid-19 vaccines and predictions for when the population will receive them, there seems to be a light at the end of the long, harrowing pandemic tunnel. As the physical risks are better managed with vaccines, however, what will likely still remain is the indelible impact of the pandemic weighing on the collective psyche. "The physical aspects of the pandemic are really visible," said Lisa Carlson, the immediate past president of the American Public Health Association and an executive administrator at the Emory University School of Medicine in Atlanta. "We have supply shortages and economic stress, fear of illness, all of our disrupted routines, but there's a real grief in all of that." "We don't have a vaccine for our mental health like we do for our physical health," Carlson added. "So, it will take longer to come out of those challenges." Based on the mental struggles endured by so many this year, these are the issues mental health professionals anticipate coming to the fore in 2021. CNN External Link

    USAFRICOM

    Plague in the Democratic Republic of the Congo: Nearly 300 cases in Ituri since August

    2 January- According to a recent UNICEF Humanitarian Report, in Ituri province in northeastern Democratic Republic of the Congo (DRC), officials have reported 286 cases of bubonic plague, including 27 deaths were reported since August. Rethy and Biringi health zones have the highest number of cases, with 210 registered cases, including 15 deaths. In a letter to ProMED mail published Thursday, officials with EcoHealth Alliance also report on the bubonic plague outbreak in Biringi health zone reporting some 150 suspected cases from mid-November to mid-December. Of the total, overall, women and men are equally affected; however, adolescents (under 17 years old) seem the most at risk, representing 78.9% of the sick people, they write in the letter. The authors write: In this region, where there are nearly 47,000 internally displaced refugees from South Sudan, with some moving freely between the 2 countries, the risk of a regional flare-up is to be considered if the epidemic also reaches this camp.  Plague is an infectious disease caused by the bacterium, Yersinia pestis. It is found in animals throughout the world, most commonly rats but other rodents like ground squirrels, prairie dogs, chipmunks, rabbits and marmots in China. Fleas typically serve as the vector for plague. People can also get infected through direct contact with an infected animal, through inhalation and in the case of pneumonic plague, person to person. Yersinia pestis is treatable with antibiotics if started early enough. There are three forms of human plague; bubonic, septicemic and pneumonic. Outbreak News Today External Link

    USCENTCOM

    Leishmaniasis outbreak in Deir ez-Zor, Syria

    26 December- Officials at Hajin Hospital are reporting a widespread surge of cutaneous leishmaniasis, aka Aleppo boil, among children in Hajin and its villages east of Deir ez-Zor, according a Radio Al-kul report.  It is reported that 1750 cases among children have been seen this year in the area and demonstrates the need for urgent medical intervention. Leishmaniasis lesions require lengthy and expensive treatment because the medicine is imported. It is difficult for the people to treat leishmaniasis in light of the deteriorating financial and living conditions. Suheir Al-Atta, a specialist and head of the leishmaniasis treatment committee in Deir ez-Zor said that most of the cases are concentrated in the regions of eastern Deir ez-Zor and among children within schools, especially between the age group of 7 to 15 years. She indicated that it is expected that the number of cases will exceed 3000 in the coming days. The Centers for Disease Control and Prevention (CDC) says Leishmaniasis is a parasitic disease that is found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis is caused by infection with Leishmania parasites, which are spread by the bite of infected sand flies. There are several different forms of leishmaniasis in people. The most common forms are cutaneous leishmaniasis, which causes skin sores, and visceral leishmaniasis, which affects several internal organs (usually spleen, liver, and bone marrow). People with cutaneous leishmaniasis who develop clinical evidence of infection have one or more sores on their skin. The sores can change in size and appearance over time. The sores may start out as papules (bumps) or nodules (lumps) and may end up as ulcers (like a volcano, with a raised edge and central crater); skin ulcers may be covered by scab or crust. The sores usually are painless but can be painful. There is not a vaccine available to prevent leishmaniasis. The best way is to avoid sandfly bites. Outbreak News Today External Link

    USEUCOM

    Norway reports 3 additional UK COVID-19 virus variant cases, total now 19

    3 January- The Norway Institute of Public Health, or Folkehelseinstituttet (FHI) reported today three new cases of the United Kingdom virus variant in the country. The people in question came to Norway from the United Kingdom in December. Two of the people are from Western Norway, and one from Rogaland. The people are followed up by the municipal health service according to current routines. The three are in addition to the 16 cases already known. A total of 19 cases of this variant of the virus have now been detected in Norway. FHI says this is not unexpected and expects that new cases will be found in Norway. Outbreak News Today External Link

    Sweden reports 1st South African COVID-19 virus variant

    3 January- In a follow-up from Sweden's health officials, the Public Health Agency reported the first case of the virus variant of COVID-19 reported from South Africa. The case of the South African virus variant, known as 501.V2, is linked to travelers from South Africa. "This shows that the extended recommendations for testing and sample analyzes have an impact, and that the special treatment of travelers who have visited these countries needs to continue", says state epidemiologist Anders Tegnell. In addition, health authorities have now reported a total of eleven cases of the UK virus variant in Sweden, after recording six additional cases Saturday. The cases are reported from several different regions. All cases are linked to travelers from Britain. The Public Health Agency urges all entrants who have stayed in the UK or South Africa to stay at home for at least seven days, to avoid contact with others as far as possible, and to be tested as soon as possible after arrival with follow-up tests five days after arrival. The rest of the household should also stay at home waiting for test results. Outbreak News Today External Link

    USINDOPACOM

    New Zealand reports 6 UK COVID-19 variant cases

    3 January- The New Zealand Ministry of Health confirms six positive cases of COVID-19 have been found to match the recently identified UK variant of COVID-19 known as 20B/501Y.V1 (Lineage B.1.1.7). All positive COVID-19 tests in New Zealand are sent to ESR for whole genome sequencing as part of our overall elimination strategy. As part of routine sequencing of these particular cases, matches to the UK variant were confirmed. The six cases, five of whom travelled from the United Kingdom and one who travelled from South Africa, arrived into New Zealand between 13 and 25 December and underwent routine testing in managed isolation as part of routine surveillance testing or because they developed symptoms. Once confirmed positive they were transferred to the Auckland quarantine facility. Four of these cases are now recovered and, after a final health check, were able to leave the facility. The cases are all cared for with the same high level of infection prevention measures  as all COVID-19 positive cases, with daily health checks and use of PPE. Infection prevention control protocols are in place for all staff and we can assure the public that there is no increased risk to the community. Outbreak News Today External Link

    Tokyo officials seek state of emergency as COVID-19 cases rise

    2 January- On December 22, 2020, the 19th meeting of the COVID-19 advisory board of Ministry of Health, Labour and Welfare met to look at the latest infection trends in Japan. At that time, the advisory board said concerning Tokyo: The number of new infections in Japan continues to increase, reaching a record high level. It maintains an upward trend in the Tokyo metropolitan area (mainly in Tokyo), and no obvious decrease is seen in the Kansai and Chubu areas. The number of new infections in Tokyo continues to increase, exceeding 30 per 100,000 persons in the last week. The medical care provision system also continues to be in a very tough situation. It is becoming difficult to accept severe patients. There is a growing need to divert the beds for usual care in order to secure beds for patients with coronavirus disease. Effective efforts are required to suppress infections. While the route of infection is unknown in many cases, the spread of infection via gathering to drink and eat is anticipated. The number of new infections also increases in Saitama, Kanagawa and Chiba throughout the metropolitan area, making the medical care provision system be in a severe situation. In Tokyo, the effective reproduction number was below 1 temporarily in late November. But it turned to be 1 or more after that, and the same level continues. Despite a request for shortened opening hours, no decrease in the flow of people has been seen. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Delaware- Reports 1st flu-related death of the season

    1 January- Delaware health officials reported this week the  first flu-related death of the 2020-2021 season. The individual was a 56-year-old Kent county male infected with influenza B, who also had underlying health conditions.  As of Dec. 19, 2020, the most recent date for which flu statistics are available, there have been five laboratory-confirmed cases of the flu in Delaware for the current season. Two cases each are to residents of Kent and New Castle counties, and one resident is from Sussex County. This number reflects only the number of lab-confirmed cases; the actual number of cases circulating statewide is likely much higher as not all people with the flu seek treatment, and many cases are diagnosed through rapid test kits in a provider's office versus a lab. "This tragedy reminds us that while we are diligently fighting COVID-19, we cannot forget about influenza as it also can be extremely dangerous and deadly, particularly to individuals who already have weakened immune systems," said DPH Director Dr. Karyl Rattay. "We are keeping this person's family in our thoughts as well as everyone battling illness in this difficult time. We encourage Delawareans to get their flu vaccines if they have not done so already and to make sure everyone in their family gets theirs, too. The vaccine will lessen your likelihood of getting the flu and can lower the severity of your symptoms if you catch it. You should also take antiviral medicines if your primary care provider prescribes them." Outbreak News Today External Link

    U.S.: Shigella increase reported in Seattle area in recent weeks

    1 January- Officials with Public Health – Seattle & King County are reporting an increase in shigellosis cases since mid-December in King County. Since the end of October, Public Health has received 40 total reports of Shigella infection, with 22 of those reported since December 14th. This compares to an average of 2-3 cases reported during a typical week this year. Public Health has had 173 reported cases of Shigella in 2019 and 129 cases in 2020 from preliminary data. Among the recent infections, 28 cases occurred among people who reported experiencing homelessness or unstable housing or who accessed homeless services. These cases have occurred across multiple settings and no common source among the cases has been identified. "Outbreaks of Shigella among people living homeless are often a reflection of the lack of access to medical care, basic hygiene and sanitation resources," said Elysia Gonzales, Medical Epidemiologist, Public Health – Seattle & King County. "Shigella is highly contagious. It's important that anyone with symptoms of Shigella contact a healthcare provider for potential testing and treatment to help decrease the spread of preventable illnesses among our most vulnerable residents." Outbreak News Today External Link

    USSOUTHCOM

    Brazil reports decrease in COVID-19 cases and deaths

    2 January- Brazil has recorded a reduction in COVID-19 cases and deaths, according to data from the new Epidemiological Bulletin on the disease. The data shows that the country registered a drop of 24% in the number of new cases of the disease and regarding deaths, there was a 15% reduction in the same period. The number of COVID-19 recoveries in Brazil has been growing every week, reaching more than 87% of the total confirmed cases. The Epidemiological Bulletin also highlights the reduction, stabilization and increase in cases and deaths by COVID-19 in Brazil. Regarding the registration of new deaths, a reduction was observed in 12 states and the Federal District, an increase in 9 and stabilization in 5. To date, Brazil has recorded 7,700,578 total confirmed cases, which include 195,411 deaths from coronavirus. Outbreak News Today External Link