Army Public Health Weekly Update, 11 March 2022

Date Published: 3/11/2022
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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

    ANNOUNCEMENTS

    BAMC campaign aims to build back grit, resilience

    7 March- Healthcare professionals have taken center stage in recent years as COVID-19 swept across the nation and the globe. They donned head-to-toe protective gear, worked long shifts and stepped up when others fell ill. While the quality of care didn't falter, the challenging months took their toll on these healthcare heroes. In a renewed effort to fortify a team of nearly 9,000 healthcare and support personnel, Brooke Army Medical Center has dedicated the month of March to “building back grit and resilience." “Team BAMC has faced every obstacle with agility, professionalism and a can-do attitude," said Brig. Gen. Clinton Murray, BAMC commanding general. “Even as they faced resource and personnel constraints, they sustained the highest level of care both here and in support of military missions around the world. “However, this sustained operation tempo can lead to burnout and exhaustion," Murray added. “We want to remind our teammates this month that self-care is just as important as the care they provide to others." BAMC kicked off “Grit and Resilience Month" with leadership lining the halls to welcome the morning and night shifts to work. JBSA External Link

    U.S. MILITARY

    Are heat-related medical conditions among Soldiers rising?

    2 March- The Occupational Safety and Health Administration is targeting occupational Heat Injury and Illness Prevention as part of their recent efforts to establish a universal standard to protect workers. According to OSHA, “Heat is the leading cause of death among all weather-related phenomena, and it is becoming more dangerous as 18 of the last 19 years were the hottest on record." OSHA tracks workers who develop medical conditions or die from excessive heat exposures, and describes those in construction and agriculture to be at highest risk. These medical conditions, referred to as heat illnesses or injuries, occur when the body is unable to compensate for increased body temperatures due to hot and humid environmental conditions and exertion. Military personnel are also at risk, especially during outdoor training exercises that involve rigorous physical exertion. Physically intense military activities such as Basic Combat Training, field training exercises, and road marches over 8 kilometers are examples of high-risk activities. Physical training tests and running competitions are also risky events. Soldiers also usually must wear full uniforms, sometime with additional protective layers, and may carry heavy gear, which can further increase internal body temperatures. Severe cases can be life threatening. Even mild illnesses can mean a person is at greater risk during future heat exposures. “The most severe condition is heat stroke, which can be fatal if not treated immediately and properly, says Maj. Aeri Hodges, chief of Public Health Nursing at Bayne-Jones Army Community Hospital, Fort Polk, Louisiana. She says though heat exhaustion is a less severe diagnosis, it could progress to heat stroke if the exposure is not stopped and the condition not treated. The risk to Soldiers is highest when outdoor temperatures and humidity are high, which is the case at some of the Army installations where outdoor training occurs. Of the 43 Army installations tracked for the 2020 Health of the Force report, 10 experienced more than 100 heat risk days in 2019, mostly concentrated in the south and southeast U.S. Nearly 40 percent of active-duty Soldiers were stationed at one of these locations. Army.mil External Link

    Army develops high-tech solution to keep hands warm without gloves

    5 March- There are pros and cons to finding the right pair of winter gloves. The challenge comes between sacrificing warm hands or dexterous fingers. For civilians, the choice between form and function might limit the ability to text with friends in freezing temperatures. For soldiers, however, the loss of hand function in the cold can have a negative impact on performance, survivability and lethality.  One of the most significant issues for warfighters, and people in general, is that cold exposure severely impacts hand function. “This is due to the fact that in cold environments, the body reduces blood flow to the periphery to protect core temperature," said Dr. John Castellani, of the US Army Research Institute of Environmental Medicine. “So areas like the hands and feet see less blood flow and therefore skin temperature decreases. "Army researchers, like Castellani, have spent the past 80 years developing technology for different parts of the body to increase blood flow in the hands without obstructing hand movement. Castellani has spent decades studying the effects of cold weather on warfighter health and performance. Along with other scientists, he has developed a new device that warms the hands and fingers in cold weather without the use of gloves. The Personal Heating Dexterity Device, or PHD2, helps prevent the loss of hand function in the cold. NY Post External Link

    DOD adding 63,500 virtual mental health appointments for troops, but a whole lot more can be done

    2 March- The Pentagon plans to ramp up its use of telehealth to help service members with mental health concerns as the number of service member suicides continues to trend the wrong way, leaders told a Congressional panel March 2. Dr. Richard Mooney, acting deputy assistant secretary of defense for health services policy and oversight, and Dr. Karen Orvis, director of the Defense Suicide Prevention Office, faced sharp questioning from the House Armed Services military personnel subcommittee, with lawmakers and activists criticizing the military for not doing enough to support service members. “The military's suicide prevention effort is failing, and we must find out why," said subcommittee chair Rep. Jackie Speier (D-Calif.), who noted a recent string of suicides among Soldiers stationed in Alaska. According to the most recent Pentagon data, the total number and the rate of suicides among Active-duty service members has increased by a statistically significant amount since 2015—in 2020, 580 service members killed themselves. There is no one solution to the suicide issue, Mooney and Orvis told the panel. But one area where the Defense Department is looking to expand its efforts is telehealth—providing counseling and mental health resources to service members virtually. “The tele-behavioral health expansion is going to be key and essential in the future," Mooney said. “[Experts] agree that 50 to 75 percent of behavioral health diagnoses can be treated effectively, depending on acuity, through tele-behavioral health. And the Defense Health Agency, by the fall of 2022, is going to add 63,500 annual appointments virtually for tele-behavioral health to be used across the system. They're central appointments used across the system to be able to deliver this needed care." Air Force Mag External Link

    Injured by TBI and suffer from insomnia? This USU study could help you catch some ZZZs

    3 March- A potential solution for a good night's sleep for military members struggling with insomnia is currently being studied by the Uniformed Services University's Center for Neuroscience and Regenerative Medicine (CNRM). Helping military members with a history of traumatic brain injuries (TBI) treat their insomnia symptoms is tricky and deployments make in-person visits with trained providers challenging. This virtual study hopes to give service members and veterans a convenient, more effective, and drug-free solution. To make that happen, the study uses a remote version of cognitive-behavioral therapy, a proven technique for treating insomnia, within the Military Healthcare System. The study, “A Randomized, Controlled, Blinded Study of Internet-guided Cognitive Behavioral Therapy for Insomnia in Military Service Members with History of Traumatic Brain Injury" is completely online and requires no in-person visits. Service members and veterans can simply utilize the program from their smartphone or computer, anywhere and at any time. The USU study is nearly halfway through its two-year plan and aims to enroll 200 participants total in a six- to nine-week, internet-guided program to examine virtual cognitive-behavioral therapies in the military populations. Funded by CNRM, the project is using a modified version for the military of a web-based program called SHUTi or “Sleep Healthy Using the Internet." “The need is really what kicked it off," says the study's associated investigator Navy Lt. Cmdr. (Dr.) Kent Werner, assistant professor in the Department of Neurology at USU and director of Research at Walter Reed National Military Medical Center. “Cognitive behavioral therapy for insomnia, or CBT-i, is established as the most promising therapy for insomnia, above medication, even though most people are started on medication when they have insomnia." However, Werner says it is difficult to get access to someone able to deliver that care, it is often demanding on one's schedule, and so the ability to do it online without traveling is an attractive option. “When the data came out that the online version works about as well as the in-person version, then it seemed like a natural question 'well, how well does the online version work on TBI patients?'" Werner asked. He adds, in the military, there are high levels of insomnia, and nearly all TBI patients, even with mild cases including concussions, complain of suffering from sleep issues. DVIDS External Link

    GLOBAL

    Clostridioides Difficile vaccine candidate indicates strong potential effect

    8 March- New York-based Pfizer Inc. announced results from the CLOVER pivotal Phase 3 study evaluating its Clostridioides difficile (C. difficile) vaccine candidate (PF-06425090) in the prevention of C. difficile infection (CDI). Initial analyses of two protocol-defined secondary endpoints indicated a highly favorable benefit in reducing CDI severity and 100% vaccine efficacy in preventing medically attended CDI. However, the trial did not meet its pre-specified primary endpoint of prevention of primary CDI. "We are encouraged by the promising potential benefit observed against more severe C. difficile infection, as a large portion of cases leads to extended diarrhea episodes that can require hospitalization," said Kathrin U. Jansen, Ph.D., SVP and Head of Vaccine Research & Development, Pfizer, in a press release issued on March 1, 2022. "We will evaluate the next steps for our program in coordination with regulatory agencies." Currently, there is no vaccine to prevent initial or recurrent CDI. Clostridioides difficile infection is a serious infection associated with diarrhea that may progress to severe and debilitating illnesses with potentially fatal outcomes. The U.S. CDC has classified CDI as an urgent public health threat. Close to 10% of patients aged 65 or older with a healthcare-associated C. difficile infection are at risk of death within 30 days of diagnosis and constitute 90 percent of those with risk for fatal outcome. Precision Vaccinations External Link

    COVID-19 can cause brain shrinkage, memory loss - study

    8 March- COVID-19 can cause the brain to shrink, reduce grey matter in the regions that control emotion and memory, and damage areas that control the sense of smell, an Oxford University study has found. The scientists said that the effects were even seen in people who had not been hospitalized with COVID, and whether the impact could be partially reversed or if they would persist in the long term needed further investigation. "There is strong evidence for brain-related abnormalities in COVID-19," the researchers said in their study, which was released on Monday. Even in mild cases, participants in the research showed "a worsening of executive function" responsible for focus and organizing, and on an average brain sizes shrank between 0.2% and 2%. Reuters External Link

    Do common drugs affect responses to COVID-19 infections?

    8 March- According to a peer-reviewed study from researchers with the University of Sydney, the most extensive clinical review of immune responses to paracetamol, non-steroidal anti-inflammatory drugs, and opioid analgesics focused on infectious diseases provided insights into the unintended impacts of commonly used medicines. This study's findings highlight the potential for some of these medicines to join the fight against old and new infectious diseases. Key findings of the clinical review:

    - For pain: Morphine suppresses key cells of the immune system and increases the risk of infection, particularly after cancer surgery.

    - For fever: Antipyretics – e.g., Paracetamol, Ibuprofen, Aspirin – can reduce the desirable immune response when taken for vaccination.

    - Aspirin could be an affordable and accessible therapeutic option for tuberculosis – which mainly afflicts developing countries, with beneficial results shown in animals and humans.

    - Anti-inflammatory medicine indomethacin may reduce viral replication in Covid-19, but large-scale human trials are needed.

    Researchers led by the University of Sydney's Faculty of Medicine and Health opted for a 'clinical' review to have a broader scope to synthesize the available evidence, noting the importance of further research and trials regarding infectious disease responses. Precision Vaccinations External Link

    Don't ignore those lumps, bumps and weird moles on your skin

    4 March- Beware of lumps and bumps. When it comes to your skin, anything out of the ordinary is a potential cause for concern. Keep an eye out for moles that are changing or growing in size. Maybe it's just acne. But it also could be skin cancer. You might be surprised to hear that your skin is the largest organ in your body. It protects against the environment, including sunlight, bacteria, chemicals, and extreme temperature. Skin problems are among the top 10 reasons active duty service members seek out medical care, military medical data show. A common reason that service members seek out medical attention is for inflammatory skin conditions, including acne, shaving bumps, or ingrown hairs. Others report unusual lumps and bumps. These are generally the top reasons service members seek dermatology care, said Dr. Neil Gibbs, dermatology residency program director at Naval Medical Center San DiegoNaval Medical Center San Diego website. Eczema or psoriasis are other skin conditions. They can be treated but not cured, Gibbs added. Health.mil External Link

    Meta researchers conclude Facebook, other media platforms make people more lonely

    4 March- Meta researchers recently found out that Facebook users are becoming lonelier in the social media space, according to an internal document.  From scratch, we know that there are a lot of things that are going on in cyberspace aside from connecting to our peers. The common notion for social media sites is their ability to connect people from all walks of life. Whether you're American, Asian, single, widowed, or anything in between, you use these apps for a typical purpose: to establish connection and communication with other individuals. The latest study about Facebook and other social media platforms appears to be contradicting their goals. Instead of making them happier and more satisfied, they only generate loneliness among users, per Bloomberg's report. Regarding the internal documents, the news site wrote that some of them were recently leaked by Frances Haugen, a known Facebook whistleblower. The particular study that the Meta researchers conducted has reportedly tackled the impact of the app on people's loneliness. According to one internal study, people feel lonelier whenever they see certain types of posts in their feed. Tech Times External Link

    Omicron sub-variant BA.2 makes up 11.6% of COVID variants in U.S. - CDC

    8 March- The BA.2 sub-variant of Omicron was estimated to be 11.6% of the coronavirus variants circulating in the United States as of March 5, the U.S. Centers for Disease Control and Prevention (CDC) said on Tuesday. Scientists are tracking a rise in cases caused by BA.2, the dominant variant in South Africa, which is spreading rapidly in parts of Asia and Europe. The World Health Organization said last month that the BA.2 variant appears to be more transmissible than the original BA.1 sub-variant, based on initial data. Africa's top public health body last month said BA.2 does not cause more severe disease than BA. 1 U.S. daily cases have started to decline in recent weeks after touching record levels in January, with the CDC dramatically easing its COVID-19 guidelines for masks, including in schools. Reuters External Link

    Seattle teachers union demands forced masking until May to ensure 'sense of normalcy'

    7 March- Seattle public schoolchildren could be required to wear masks until at least May, despite mandates being lifted in the state and county, as the school district negotiates further steps with the teachers union. The union is arguing mask requirements bring a sense of "normalcy" to children. Washington state Gov. Jay Inslee, a Democrat, has lifted his state's indoor mask mandate beginning March 11, including in schools, and King County will follow suit. Seattle Public Schools, however, announced in a recent statement that it would keep its mask mandate for students "until further notice." Fox News  External Link

    These US counties still have 'high' Covid-19 levels as their states lift mask mandates, CNN analysis shows

    4 March- Most people in the United States now live in counties where those who are healthy no longer need to wear masks, but there are still about 472 counties nationwide where mask-wearing is recommended, according to the latest data from the US Centers for Disease Control and Prevention. Florida's Hillsborough County is one of them. In that county on Wednesday, Gov. Ron DeSantis approached a group of students wearing masks who were standing behind a podium at the University of South Florida, where the Republican governor was scheduled to hold a news conference. He told the students, "You do not have to wear those masks. I mean, please take them off." But according to the CDC's latest guidance, people are recommended to still wear masks indoors in counties that have "high" levels of Covid-19, including Hillsborough County. The CDC said Thursday that "more than 90%" of US residents are now in a location with low or medium Covid-19 community levels. A CNN analysis of the data finds that 7% of the US population is in counties with "high" Covid-19 community levels, down from 28% last week. CNN External Link 

    INFLUENZA

    China reports two fatal H5N6 avian influenza cases from late 2021

    8 March- Hong Kong health authorities reported today on two fatal human cases of avian influenza A(H5N6) in the Mainland from last year. The first case involves a 12-year-old female living in Liuzhou in Guangxi, who had visited a live poultry market before onset. She developed symptoms on November 17 last year and was admitted for treatment on November 20. She passed away on December 4. The second case involves a 79-year-old man living in Liuzhou in Guangxi, who had visited a live poultry market before onset. He developed symptoms on November 18 last year and was admitted for treatment on November 22. He passed away on December 3. From 2014 to date, 73 human cases of avian influenza A(H5N6) have been reported by Mainland health authorities. Outbreak News Today External Link

    VETERINARY/FOOD SAFETY

    Government test shows listeria contamination in jerky; recall initiated

    4 March- Boyd Specialties LLC of Colton, CA, is recalling 1,634 pounds of ready-to-eat (RTE) jerky products that may be contaminated with Listeria monocytogenes, the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS) announced today. “FSIS is concerned that some product may be in consumers' pantries. These products should be thrown away or returned to the place of purchase," according to the recall notice. The problem was discovered by FSIS during follow-up procedures after a routine FSIS product sample confirmed positive for Listeria monocytogenes. The dozens of jerky products were produced on Feb. 23, 2022...The products subject to recall bear establishment number “EST. 40269" inside the USDA mark of inspection. These items were shipped to retail locations in Alabama, California, Connecticut, Michigan, New Jersey, North Carolina, Pennsylvania and Texas. Food Safety News External Link

    Questions loom as FDA remains quiet on investigation into infant formula outbreak

    5 March- Parents, consumer groups, and a congresswoman want to know why it took the FDA months to begin investigations into infant formula after learning of the beginning of a cronobacter outbreak that has seen at least five babies develop infections with two deaths under investigation. The Food and Drug Administration has yet to answer many questions including those posed by Food Safety News. We asked the agency on March 1 why there was a lag time from September 2021 to February 2022 before the agency began investigating Abbott Nutrition, which posted a recall for the implicated infant formula in late February. On March 2 the FDA responded, to Food Safety News saying they were “working on a response for you and will respond as soon as possible." On March 4 they responded to the same question saying: “We're continuing to work on this for you." One plausible reason for the lag between when the FDA was notified of the first cronobacter infection this past September and when the recall and investigation began in February is that illnesses caused by the bacteria are not reportable in 49 of the 50 states. The infection has a 50 percent death rate. Food Safety News External Link

    WELLNESS

    Is drinking coffee bad for your health? Personal trainer dies, Ireland Baldwin reports anxiety attacks due to caffeine

    7 March- Drinking coffee is a lifestyle for some, and it is a staple drink during the morning and afternoons, but some reports claim it is a cause of death for an isolated case and triggering mental health issues. "Is drinking coffee bad for the health?" is the question that most people look into when consuming a more than adequate amount of the drink daily. Consuming something less or more than its supposed or safe parameters is lethal to the body. That happened to a British personal trainer who consumed as much as 200 cups of coffee dosed in 5 grams of caffeine powder on improper use of a digital scale. The recommended dosage to weigh was 60 to 300 milligrams of the powder but miscalculated it to almost a thousand times its recommended dosage, resulting in his fatal death. After a few minutes lying down as he clutched his chest, the BBC said that his mouth began foaming. Paramedics rushed in 45 minutes later to resuscitate the man, but he was pronounced dead when he arrived at the hospital. The typical caffeine in the blood reaches two to four mg only after drinking filtered coffee. However, the man's post mortem reported that his samples showed over 392 milligrams of caffeine. Tech Times External Link

    USAFRICOM

    Yellow fever outbreak in Isiolo County, Kenya; Three dead

    7 March- In Kenya, the government has activated its health emergency response mechanisms following the death of three persons attributed to an outbreak of yellow fever in Isiolo County. According to Acting Director General of Health Patrick Amoth, the first case was detected on January 12th this year while 15 patients presenting with fever, jaundice, muscle and joint pains have been line-listed. “Out of the six samples analyzed at KEMRI ,3 turned positive through serology (immunoglobulin M) and PCR.  This is therefore to raise the alert in 47 counties, more so the high-risk counties of Wajir, Garissa, Marsabit, Meru, Samburu, Baringo, Elgeyo Marakwet, West Pokot and Turkana." Said Amoth. He says the ministry has put in place a national incident management structure to manage the outbreak and is developing a response plan to deploy a rapid response team to Isiolo and neighboring counties to establish the magnitude and extent of the outbreak, determine at-risk population, conduct a risk assessment, initiate risk communication and community engagement activities and to implement integrated vector control measures. According to Amoth, the national government and partners are mobilizing resources to support response activities even as he advised high-risk counties to mobilize resources to support response and prevention activities. Outbreak News Today External Link

    USCENTCOM

    Israel: Jerusalem child tests positive for polio, 1st case in over three decades

    6 March- The Israel Ministry of Health reported today a case of polio (child paralysis) in a 4-year-old child in Jerusalem who was unvaccinated. The source of the disease in this case, a polio virus that has undergone changes and may cause disease in those who are not vaccinated. This is the first case in Israel since 1989. The Jerusalem District Health Bureau has opened an epidemiological investigation and will contact the child in close contact to provide specific instructions. Based on the findings of the investigation, further recommendations will be decided. It should be noted that the virus is found in sewage samples in the area, a finding that occurs occasionally, but so far in similar incidents in the past there have been no clinical cases. The most important means of preventing polio is to adhere to routine immunizations at the recommended time according to the guidelines of the Ministry of Health. It is recommended to complete routine immunizations as soon as possible for those who have not yet done so. Outbreak News Today External Link

    USEUCOM

    Polio vaccination campaign during the war: Ukraine officials

    6 March- Since the beginning of the offensive of the enemy troops of the Russian Federation, our medical system of the majority is aimed at helping the defenders of the Armed Forces of Ukraine. However, work to overcome the outbreak in the regions continues as far as possible. Monitoring of cases of acute flaccid paralysis from polio continues. Epidemiological investigation and timeliness of case investigations is 100%. Laboratories freeze the obtained samples for further storage. As of March 3, 2022, 49,329 children aged 6 months to 6 years (1 or 2 doses of IPV) received protection. Of these, 25,426 received 1 dose (29%) and 23,903 received a second dose (43%). Some regions launched a campaign in January. Outbreak News Today External Link

    USINDOPACOM

    Vietnam records 142K COVID-19 cases Sunday, 1.9 million in past month

    6 March- The Vietnam Ministry of Health on Sunday reported “The number of new cases of COVID-19 skyrocketed to 142,136", more than 10,000 cases higher than the previous one day high yesterday (131,780). Hanoi (29,578), Bac Ninh (8,355), Nghe An (7,579) and Hai Phong (5,154) saw the most cases today. Since the beginning of the epidemic, Vietnam has recorded 4,434,700 infections. In the past 28 days, 1.9 million cases have been recorded in Vietnam, the 10th most of any country. The total number of deaths from COVID-19 in Vietnam so far is 40,813, accounting for 1% of the total number of infections. Compared to other Southeast Asian countries, cases were recorded as follows today: Indonesia increased 30,156 cases, Philippines increased 864 cases, Malaysia increased 33,406 cases, Thailand increased 21,881 cases, Singapore increased 16,274 cases, Myanmar increased 1,596 cases, Laos increased 0 cases, Cambodia increased 330 cases, East Timor increased 0 cases. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Eureka Shigella outbreak update- 5 confirmed cases, 11 others investigated

    6 March- In a follow-up on the Shigella outbreak in Eureka, California, Humboldt County Public Health Nurse Daniel Tran reported Friday that the outbreak in the greater waterfront area has grown to five confirmed cases and 11 currently under investigation. ​“Shigella is a gastrointestinal bacteria, which is really just a fancy way of saying that it causes diarrhea, upset stomach, gas, and that kind of stuff. Typically this bacteria is found within a person's feces or stool and even though that's where it's typically found, you could still spread it if you've made contact with different surfaces that are not clean and disinfected," Tran said. Shigella is transmitted by oral ingestion, meaning it must travel into the body through food or drink. The bacteria can come into contact with food and drink through contact with surfaces where the bacteria is located. Outbreak News Today External Link

    USSOUTHCOM

    Brazil: Rio Preto reports more than 1,000 dengue cases since beginning of year

    4 March- The city of São José do Rio Preto in São Paulo state, Brazil has recorded more than 1,000 cases of dengue in the first two months of 2022. According to the Municipal Health Department, there were 1,093 cases registered between January and February. No deaths were recorded in the period. The most affected neighborhoods are Estoril (111), São Deocleciano (109), São Francisco (85), Parque Industrial (76) and Centro (74), in the eastern and southern regions of the city. Outbreak News TodayExternal Link​​