Army Public Health Weekly Update, 12 August 2022

Date Published: 8/12/2022
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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.

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Table of Contents


    MHS Virtual Education Center Empowers Patients to Improve Outcomes

    14 July- As providers, we seek to empower patients to engage in their health care planning and decision-making to help improve outcomes. To support this aim, the Defense Health Agency is developing the Virtual Education Center (pronounced “vek"). This web-based library and communications platform enables providers and patients to access, store, and use vetted MHS education resources more easily than ever before. The current prototype is designed to promote a culture of proactive prevention and collaboration through quality education. Over the next three years, the system will be tested and integrated with MHS GENESIS, the Department of Defense's new electronic health record. With the VEC, providers and patients can customize personal digital dashboards that provide securely access anywhere and use wherever they are stationed or happen to be. The dashboards enable sharing written, audio, visual, and interactive educational materials in ways that work best for providers and patients alike. The VEC ensures patients have the awareness, knowledge, and willingness to use MHS education resources effectively. This will help save time, improve processes, and remove barriers to care. The VEC offers MHS providers opportunities to improve all care, both virtual and in-person. We know patients will have the material, that they won't lose it, and if they have reviewed it. The system should increase provider efficiency, decrease meeting times and unnecessary visits, and reduce readmissions and other adverse outcomes related to common diseases. This should help increase patients' engagement in their care and overall satisfaction with providers. External Link


    How performance nutrition can help you maintain readiness

    29 July- Performance nutrition is not just a part of the military lifestyle; it's the linchpin to mission readiness. “We define [performance nutrition] as having high-quality nutrition — the appropriate amount at the right time for the right event for our service members," said Patricia Deuster, who holds a doctorate in nutritional sciences and biochemistry and serves as acting director of the Consortium of Health and Military Performance (CHAMP) at the Uniformed Services University. CHAMP hosts the Human Performance Resources by CHAMP program, which has resources on performance nutrition. “You want to make sure the nutritional quality is high, that the amount is adequate, and that it's readily accessible," said Deuster. “It's about really optimizing the performance of our warfighters through the appropriate fueling." This approach fits into the paradigm of the 'whole' person, she explained. “You need to feed your body properly by giving it the right fuel if you want to be able to perform optimally cognitively, mentally, psychologically, and physically." External Link

    Looking for connection, community? Join DHA's soul care series

    29 July- The COVID pandemic and other events around the world have resulted in long-term stress for individuals at the Defense Department and worldwide. To support its staff, the Defense Health Agency launched a program aimed at building a sense of community and promoting spiritual health. The DHA Office of Religious Affairs designed the biweekly program to foster connection and address isolation and other topics affecting employees' spiritual and overall well-being. “Soul Care is as an opportunity for us to gather as a community of support for one another, said Army Chaplain (Maj.) Daniel Garnett, the DHA's staff chaplain and leader of the series. “We desire to give people the opportunity to regain their spiritual centeredness, which is vital to our holistic well-being as we connect with others in meaningful community." Soul Care also fits into the Department of Defense's Total Force Fitness framework, which includes spirituality as a key component. The series is part of DHA's commitment to a fulfilled staff and offers the DHA community, including military personnel, civilians, and contactors, “the opportunity to connect with one another in a spiritual community," said Garnett. “The past couple of years have taken their toll on us as we have dealt with the pandemic and other issues along the way, and many people have simply lost that sense of community working remotely," said Garnett. “Soul Care gives them an opportunity to connect with others while at the same time strengthening the spiritual fiber of their souls." External Link


    2nd Monkeypox vaccination needed to prevent breakthrough infections

    8 August- A recent non-peer-reviewed study conducted in Paris, France, describes the outcomes of high-risk contacts receiving the third-generation IMVANEX® (Jynneos) vaccine as an early post exposure ring vaccination (EPRV) and potential monkeypox virus (MPXV) breakthrough infections after the first dose. In this cohort of 276 individuals vaccinated with IMVANEX at the Bichat Claude Bernard University Hospital between May 27 and July 13, 2022, 4% (12) of the participants had MPXV breakthrough infections. Ten of these 12 patients developed an MPXV infection in the five days following the first vaccination, and two others had a breakthrough infection at 22 and 25 days. Ten other patients declared skin lesions compatible with an MPXV infection on the study questionnaire. However, six had a negative PCR, and four declined to return to the center for PCR testing. Since the incubation of the MPXV has been described to range from 5 to 21 days, delaying the second vaccination may be too late to prevent the disease in some patients, stated these researchers on August 4, 2022. 'A previous phase 1 study found that with a single dose of the IMVANEX (MVA) smallpox vaccine in humans, the peak of antibody titer was reached at day 14 with a decrease of antibodies until the second dose of vaccine.' Therefore, the fact that 10 out of 12 cases occurred five days after vaccination is not surprising. Precision Vaccinations External Link

    Biopharma creates new generation LNPs in a run for a more efficient COVID-19 vaccine

    9 August- The COVID-19 pandemic highlighted the need for fast-produced and adaptable vaccines that could be equally distributed around the world. Developing an efficient mRNA vaccine that is effective, thermostable, and has fewer side effects strongly depends on lipid nanoparticles (LNPs) which preserve and deliver mRNA to cells. Lipid nanoparticles appear to be the sole solution to global health issues, and that is why well-known biopharma companies and startups are currently focusing exactly on this. Messenger RNA (mRNA) vaccines gained worldwide recognition during the COVID-19 pandemic. These vaccines use mRNA that teaches body cells to create a protein that triggers an immune response. There is one major downside to mRNA - it is fragile and quickly falls apart. We, therefore, need lipid nanoparticles, tiny balls of fat that preserve mRNA and deliver it to the body cells. In the case of COVID-19 vaccines, once mRNA is released into the cells, the process of making the spike protein begins, and the LNP's work is complete. It might sound easy, but it is not. COVID-19 mRNA vaccines widely used worldwide, such as Comirnaty by Pfizer/BioNTech and Spikevax by Moderna, are proven effective and safe. There are, however, some downsides to current mRNA technologies. Tech Times External Link

    Lyme disease vaccine candidate launches late-stage study

    8 August- France-based Valneva SE and Pfizer Inc. today announced the initiation of a Phase 3 clinical study, Vaccine Against Lyme for Outdoor Recreationists (VALOR), to investigate the efficacy, safety, and immunogenicity of their investigational Lyme disease vaccine candidate, VLA15. As of August 8, 2022, VLA15 is the only Lyme disease vaccine candidate currently in clinical development. The VALOR study plans to enroll approximately 6,000 participants 5 years of age and older. It is being conducted at up to 50 sites in areas where Lyme disease is highly endemic, including Finland, Germany, the Netherlands, Poland, Sweden, and the USA. The study participants will receive four doses; three doses of VLA15 180 µg or saline placebo as a primary vaccination series, followed by one booster dose of VLA15 or saline placebo (1:1 ratio). Pending successful completion of the Phase 3 study, Pfizer could potentially submit a Biologics License Application to the U.S. FDA and Marketing Authorization Application to the European Medicines Agency in 2025. Precision Vaccinations External Link

    Major test of first possible Lyme vaccine in 20 years begins

    8 August- Researchers are seeking thousands of volunteers in the U.S. and Europe to test the first potential vaccine against Lyme disease in 20 years -- in hopes of better fighting the tick-borne threat. Lyme is a growing problem, with cases rising and warming weather helping ticks expand their habitat. While a vaccine for dogs has long been available, the only Lyme vaccine for humans was pulled off the U.S. market in 2002 from lack of demand, leaving people to rely on bug spray and tick checks. Now Pfizer and French biotech Valneva are aiming to avoid previous pitfalls in developing a new vaccine to protect both adults and kids as young as 5 from the most common Lyme strains on two continents. “There wasn't such a recognition, I think, of the severity of Lyme disease" and how many people it affects the last time around, Pfizer vaccine chief Annaliesa Anderson told The Associated Press. AP News External Link

    Yoga shield: Building mental and physical resiliency

    9 August- More than 30 Airmen assigned to the Ohio National Guard's 178th Wing and the Iowa National Guard's 132nd Wing began a week-long, 60-hour yoga training program July 18 at the 178th Wing in Springfield, Ohio. The training is a part of a pilot program called Yoga Shield, which aims to teach Airmen to reduce stress and to build mental and physical resiliency through yoga. The Airmen who complete the training program will become certified yoga instructors and will be able to provide yoga classes for their fellow Airmen. “A lot of people hear the word yoga and think we're teaching people how to stretch or relax we're really teaching people how to master their own mind and nervous system." said Olivia Mead, the CEO of Yoga for First Responders and lead instructor of the course. “There is a missing skill set in our Armed Forces training. And that is a proactive way to combat the mental and neurological consequences of such a high stress job and we see that in the statistics, and not all resilience training has been able to make a dent." Mead said the Airmen are learning a training protocol and how to deliver that to others. When the Airmen complete the program, they'll be able to teach other Airmen how to process stress, build resilience and enhance performance proactively, addressing stress and other work-related issues before they become unmanageable. The program began in 2021 as a proposal for the Warrior Resilience and Fitness Innovation Incubator, which aims to develop, implement, and evaluate new wellness initiatives, analytics platforms, and strategic partnerships. Upon receiving initial funding, the program training 60 Airmen and Soldiers in Iowa and has expanded to eight new sites. Clare Long, The Sexual Assault Response Coordinator for the 132nd Wing and director of Yoga Shield, said the program has already had a lot of success. “People are finding connectedness, they are having better sleep, because they're able to have neurological reset, mindfulness, less burnout, and it's also helping with our recruiting and retention," Long said. “This is important for the longevity, the health and the welfare of our Airmen. It's another tool in our toolbox. It's not the only tool, but it's one that can definitely help Airmen." Mead said it will help Airmen train for the mental and neurological impact of high stress professions, in the same way the military has proactively trained for the physical demands of military service. External Link


    Flu may be coming back with a vengeance, experts say, and children could be at risk

    9 August- After a two-year hiatus, the flu may be back this season – and with a vengeance. Data from the Southern Hemisphere, which is in its flu season, show cases surpassing pre-pandemic levels, prompting health experts to worry about what's in store for Americans this year. “This might be an early warning system for us that this is the time now to start thinking about influenza," said Dr. Gregg Sylvester, chief medical officer at Seqirus, a flu vaccine manufacturer headquartered in New Jersey. “If we're not prepared … we could have a very naïve population and we could see quite high rates." Health experts point to data in Australia, where flu season runs from May through September, to get a sense of what's possible for Americans. Like residents of the U.S., Australians saw unprecedentedly low levels of flu during the pandemic. By mid-July last year, only about 400 cases were reported. There with no hospitalizations or deaths, according to the country's flu surveillance system. USA Today External Link


    Dog food recalled in Canada because of Listeria contamination

    9 August- Primal Pet Foods is recalling certain raw frozen Primal Patties for Dogs Beef Formula because of potential Listeria monocytogenes contamination. People can become sick by handling contaminated food or touching surfaces that have been exposed to Listeria monocytogenes, according to the recall notice posted by the Canadian Food Inspection Agency. The recalled products were sold in British Columbia, Canada. This product was also recalled on July 7 in the U.S. The affected products were sold from April 2022 to July 2022. Food Safety News External Link

    Oysters recalled in Canada because of E. coli contamination

    9 August- A.C. Covert Distributors/True North Seafood Company is recalling Sober Island brand OG Oysters because of generic E. coli contamination. The recalled product was sold in Nova Scotia, Canada, according to the recall notice posted by the Canadian Food Inspection Agency. Anyone who has eaten any of the implicated product and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible food poisoning. Specific tests are required to diagnose the infections, which can mimic other illnesses. The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC). About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. Food Safety News External Link


    8 reasons why you wake up tired, and how to fix it

    10 August- You sleep for seven to eight hours almost every night, only to feel unrested through the morning or even most of the day. How could you be following a golden rule of sleep so right, yet feel so wrong? This discrepancy is often due to a heightened state of sleep inertia, a circadian process that modulates memory, mood, reaction time and alertness upon waking, according to a 2015 study. Some people experience impaired performance and grogginess in this period after first turning off the alarm. The effects of sleep inertia usually go away after 15 to 60 minutes but can last for up to a few hours. Sleep inertia impairs more sophisticated cognitive skills such as evaluative thinking, decision-making, creativity and rule usage, and gets worse the more sleep deprived a person is. But even if your job isn't saving lives or driving a truck overnight, experiencing sleep inertia for hours can still affect your quality of life. The way to address this begins with evaluating your sleep using the "two Qs," said pulmonary and sleep specialist Dr. Raj Dasgupta, a clinical associate professor of medicine at the University of Southern California's Keck School of Medicine. "If you're getting the good quantity sleep, the next question is, 'Am I getting good quality sleep?'" Dasgupta suggested seeing a sleep specialist, who can check for an underlying or primary sleep disorder. But there are other more easily modifiable factors that could be interfering with the restoration and recovery processes -- such as memory consolidation, hormone regulation and emotional regulation or processing -- that need to happen during sleep. CNN External Link


    Exclusive: Rotavirus childhood vaccine shortage hits four African countries

    10 August- Supplies of a vaccine to prevent the deadly rotavirus infection in children have either run out in Kenya, Tanzania, Senegal and Cameroon or are close to doing so, officials close to the roll-out told Reuters, after disruptions at drugmaker GSK. The World Health Organization estimates that up to 200,000 children die each year of the highly contagious infection, which is the leading cause globally of severe, dehydrating gastroenteritis in children under the age of five.  Officials in Kenya, Tanzania, Senegal and Cameroon had no immediate response to requests for comment from Reuters. GSK (GSK.L) confirmed that there is a shortfall of around 4 million doses of its Rotarix vaccine this year, with a drop to 42 million from an expected 46 million. The British drugmaker had already cut its agreed deliveries by 10 million a year for the period 2022-2028, Gavi, the Vaccine Alliance, said. GSK acknowledged the fall in supply and said it was pursuing plans to address the deficit. "GSK communicated to Gavi earlier this year on manufacturing challenges leading to an unplanned, short-term drop in Rotarix production for 2022, for which priority mitigation plans are fully in place," a GSK spokesperson told Reuters. GSK did not give any further details on the manufacturing issues or what plans were in place. Reuters External Link


    Israel Ministry of Health statement on Naegleria fowleri case/death

    7 August- In a follow-up on a report Friday, the Israel Ministry of Health released the following statement on the 36-year-old resident from the Northern District, with no underlying illnesses, who died of a rare amoeba encephalitis: This is a rare case that was diagnosed thanks to the vigilance of an infectious disease doctor who suspected the diagnosis and involved the district health office and the central laboratory of the Ministry of Health. In view of the rarity of the case, it was necessary to send the clinical sample to the Center for Disease Control in the USA. About 400 cases have been reported worldwide. It is a rare disease with a high mortality rate. The amoeba is found in fresh water, puddles, or stagnant water sources of various types. 
    The investigation into possible exposure is ongoing. The Ministry of Health is working with the Ministry of Environmental Protection and the Ministry of Agriculture and will update the public on the findings. Outbreak News Today External Link


    Spain reports first deaths from acute hepatitis in children

    5 August- Spain has reported its first two deaths from acute hepatitis, or liver inflammation, among children — an illness that has unknown causes and is being monitored by world health officials. Spain's Health Ministry said that 46 cases of the illness have been reported in Spain and that three required liver transplants. Of the three transplant patients, two died — a 15-month-old baby in June and a 6-year-old in July. The ministry said in a statement Thursday that 507 cases were reported in 21 countries in Europe as of July 28, with 273 of them in Britain. In the United States there have been at least 180 cases and six reported deaths. Health officials remain perplexed by the causes of the hepatitis and say the best available evidence points to a stomach bug that isn't known to cause liver problems in otherwise healthy kids. Spain says it began closely monitoring the situation following an alert to the World Health Organization by Britain following a spike in cases. The ministry said that so far it has not noticed an increase in the number of cases of this type of hepatitis compared to estimates made with data from previous years. Fox News External Link


    New Zealand fully reopens borders after long pandemic closure

    1 August- New Zealand's borders are fully open for the first time since March 2020, when they shut in an effort to keep out Covid-19. Immigration authorities will now begin accepting visitors with visas and those on student visas again. Prime Minister Jacinda Ardern called it an "enormous moment", adding it was part of a "cautious process". Most visitors will still need to be fully vaccinated, but there are no quarantine requirements. The country's maritime border has also reopened, with cruise ships and foreign recreational yachts now allowed to dock. New Zealand first announced a phased reopening plan in February. It allowed vaccinated citizens to return from Australia that month, and those coming from elsewhere to return in March. In May, it started welcoming tourists from more than 50 countries on a visa-waiver list. "We, alongside the rest of the world, continue to manage a very live global pandemic, while keeping our people safe," said Ms. Ardern in a speech at the China Business Summit in Auckland on Monday. "But keeping people safe extends to incomes and wellbeing too." BBC News External Link


    The US is on a Covid plateau, and no one's sure what will happen next

    10 August- The United States seems to have hit a Covid-19 plateau, with more than 40,000 people hospitalized and more than 400 deaths a day consistently over the past month or so. It's a dramatic improvement from this winter -- there were four times as many hospitalizations and nearly six times as many deaths at the peak of the first Omicron wave -- but still stubbornly high numbers. And there are big question marks around what might happen next, as the coronavirus' evolution remains quite elusive 2½ years into the pandemic. "We've never really cracked that: why these surges go up and down, how long it stays up and how fast it comes down," said Dr. Eric Topol, a cardiologist and professor of molecular medicine at Scripps Research. "All these things are still somewhat of a mystery." BA.5 remains the dominant sub variant in the US for now, causing most new cases as it has since the last week of June. Data from the US Centers for Disease Control and Prevention, published Tuesday, shows that the Omicron offshoot accounted for 87% of new cases in the first week of August, inching up a few percentage points from the week before. That slight increase in prevalence is a sign that no other variants are outcompeting it -- and promising for future trends. BA.5 "has been very formidable because it's so transmissible and has so much immune evasion," Topol said. But the plateau in hospitalizations is "encouraging" because it means the sub variant probably has worked its way through most of the hosts it can find. "Right now, the question is what comes as we descend from BA.5. It could take weeks." CDC ensemble forecasts predict stable trends in hospitalizations and deaths over the coming weeks, and experts agree that the worst of the wave has probably passed. But it's hummed along at a high level because it continues to find people whose immunity from vaccination or infection has waned over time -- something that will continue to happen, said William Hanage, an epidemiologist and associate professor at the Harvard T.H. Chan School of Public Health. CNN External Link


    Brazil: Minas Gerais reports nearly 60,000 confirmed dengue cases

    9 August- Through August 2, health officials in Minas Gerais state, Brazil recorded 86,442 probable cases of dengue. Of this total, 58,386 cases were confirmed for the disease. 40 deaths were confirmed by the disease in Minas Gerais and 49 deaths are investigated so far. Regarding chikungunya fever, 7,213 probable cases of the disease were registered, of which 4,099 were confirmed. So far, there are no confirmed deaths from Chikungunya in Minas Gerais, and two are still under investigation. As for the Zika virus, 74 probable cases were recorded, 20 of which were confirmed for the disease. There are no deaths from Zika in Minas Gerais so far. Brazil has reported 1,910,657 total dengue cases through the end of July 2022. Of this total, 962,000 cases were confirmed. 774 deaths have been reported year to date. Outbreak News Today External Link