Army Public Health Weekly Update, 12 November 2021

Date Published: 11/12/2021
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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

    ANNOUNCEMENTS 

    Regional Health Command-Pacific conducts 2021 Fall Commander's Conference

    5 November- Regional Health Command-Pacific's Fall Commander's Conference was held here, Nov. 2-4. Due to COVID-19 restrictions for indoor gatherings, the event was a hybrid of in-person and virtual attendees that included the region's medical, dental and public health commanders, senior enlisted advisors, and other leaders from around the region. The conference theme, 'Pivot to Medical Readiness in the Pacific,' set the stage for a series of strategic discussions regarding readiness, the reorganization of the U.S. Army Medical Command, Defense Health Agency transition, and RHC-P's pending reflag to a medical readiness command. Brig. Gen. Ned Bailey, RHC-P's commanding general, welcomed more than 40 in-person attendees and dozens more via Microsoft Teams. He said the conference was about building relationships, and encouraged them to take advantage of the opportunity to get to know their fellow command teams. “No two commands are alike," Bailey said, “but you do have some similar problem sets, and I ask that you reach out and take advantage of those relationships at the personal level. The two-and-a-half day event provided a platform for commanders to learn from each other while receiving key updates to facilitate a common understanding of today's operational environment. Addressing the team virtually on day one, Lt. Gen. R. Scott Dingle, the Army surgeon general and commanding general of the U.S. Army Medical Command, talked about Army Medicine's pivot to readiness and the ever-important role that commanders of readiness platforms have in maintaining a ready, medical force. “As the Army modernizes, we're modernizing also," Dingle said. “Building readiness is what we do, so we can deploy today and fight tonight, and return to duty when called upon to conserve the fighting strength," he said. Dr. Brian Lein, assistant director, DHA Healthcare Operations, led an engaging discussion about the DHA transition, the importance of generating and maintaining readiness in military treatment facilities, the future vision for the Military Health System, and the inextricable link between healthcare and readiness. Army.mil External Link

    U.S. MILITARY

    Army medical teams compete for Best Medic title

    30 October- Army medical personnel from the 30th Medical Brigade and Regional Health Command Europe squared off against their peers to earn the title of Best Medic Oct. 30 at Sembach Kaserne, Germany. When the dust settled, four competitors were selected to compete in the 2022 Command Sgt. Maj. Jack L. Clark Jr. U.S. Army Best Medic Competition at Ford Hood, Texas in January. Sgt. 1st Class, Andrew Keum and Staff Sgt. Dusty Edwards will represent the 30th Medical Brigade, and Staff Sgt. Timothy Rebich and Staff Sgt. Alejandro Preciado, will represent Regional Health Command Europe. The Army's Best Medic Competition is an annual event that challenges two-Soldier teams to compete in a demanding, continuous, and realistic simulated operational environment. The teams compete for bragging rights as the most technically competent, physically and mentally tough medic team in the United States Army. “Best Medic tests an individual's tactical, technical and institutional knowledge on medical tasks and basic warrior tasks," said Sgt 1st Class Brian Phillips, the Noncommissioned Officer in Charge of the Best Medic competition. “It's a culmination of multiple events, and based on each competitor's overall score, we determine who will move on to the Army-level competition." The competition consists of multiple events, starting with a road march, followed by the Army Combat Fitness Test and a written exam. From that point, each team is given a road map to help them navigate to additional competition areas where they completed tasks ranging from providing tactical combat casualty care in a simulated combat environment, to properly donning a chemical, biological, Radiological, and nuclear protective suit. RHCE's Command Sgt. Major Kyle Brunell was the guest speaker for the Best Medic awards ceremony. “Each of you represent not just what we DO, but what we medical personnel are FOR," Brunell said. “You are the best of our respective commands, and four of you will go on to represent all of us at the Army Best Medic competition. DVIDS External Link

    DOD's PHC-P tests new field concept for real time vector-borne disease threat analysis during pre-exercise surveillance

    5 November- After completing a 14-day deployment to Okinawa, the Public Health Command-Pacific's Entomology and Environmental Molecular Biology Laboratory is one step closer to achieving its goal of providing on-the-spot and rapid results for vector-borne diseases pre-exercise and during the entirety of a deployment. The team's target was to study mosquitos and ticks on the island, which are both known to be carriers of diseases. Broken down into two surveillance/collection sub-teams and one molecular team (that processed the collected specimens for genotypic analysis), the team as a whole set out to not only make history, but ensure the Army warfighter would be better prepared while conducting operations in remote areas. The end result is to have teams such as these deploy in advance of or with the units. “Places such as motor pools (old tires that collect water) and jungle-type environments are great places to collect mosquito specimens", said Staff Sgt. Matthew Pascual, Entomology noncommissioned officer in charge, who not only set traps for mosquitoes, but dragged areas for tick collection with team mate, entomologist Kei Jimbo. Once the traps were set and specimens collected, they were then handed-off to the molecular team for nucleic acid sequencing. The specimens collected during the Okinawa study, were taken from Camps Hansen, Schwab, Courtney and Gonsalves and labeled accordingly so each area in which the specimen was collected can be identified after sequencing is complete. The laboratory was set up on Camp Shields, a small U.S. Navy Seabee installation near Kadena Air Base. which was done at another Okinawa location. Army.mil External Link

    Medical experts urge community members to get flu shot, get it early

    4 November- While the COVID-19 vaccine has been the focus of many recent health talks, it's the time of year for another important vaccination discussion: the annual flu shot. Doctor James Stephens, chief of Preventive Medicine at Fort Knox's U.S. Army Medical Command, explained many have become complacent about this recurring illness over the past couple years...Because a different illness has been dominating the headlines for nearly two years, Stephens said many people don't realize the flu is still rampant. “When we talk about those high numbers with COVID — 35-37 million people — we still have that every single year with the flu," said Stephens. “Depending on what year and how well we've done, we've lost as many as 25,000 up to 60,000 just from the flu, but you don't hear about it because it's a more common everyday scenario and it has been for over 100 years." According to Stephens, there are three main ways to battle the flu: herd immunity, medications to treat it, and vaccines. He said while some pose the argument “the flu shot doesn't prevent the flu," there's something they may not be considering. “Very few vaccines are developed to keep you from getting the disease," said Stephens. “The whole point of a vaccine is to keep you from getting a severe form of the disease. When you get the flu shot you can get the flu, but it will decrease it's severity by 40%...Stephens urged community members who have not received their flu shot to act quickly. “The flu season starts Oct. 1 and really goes until March," said Stephens. “We would always prefer people get it a little bit earlier, especially going into the holidays. You don't want that spreading around." Another point Stephens highlighted was to get the flu shot in addition to a COVID vaccine. “When we get one, we want to get the other," said Stephens. “You can get them both together — they're safe to get and there's no concern with getting both. They work totally separately and don't interfere with each other or cause increased medical problems." Stephens stated every person — from six months and older — needs a flu shot. For children 8 years old and younger, a second dose is best to build up immunity, and those 65 and older need a more potent dose because their immune systems may not work as well. Stephens also had one important message for parents of school-age kids. Army.mil External Link

    The impact of sleep deprivation on the U.S. Navy

    5 November- “I'm tired" is a saying used to describe one who needs sleep or rest. In the Navy, the lack of sleep can cost Sailors their lives, like in the collision between USS John S. McCain (DDG 56) and a commercial ship. The National Transportation Safety Board maritime accident report, Collision between US Navy Destroyer John S McCain and Tanker Alnic MC Singapore Strait, 5 Miles Northeast of Horsburgh Lighthouse August 21, 2017, cite sleep deprivation as a factor that impacted the decision-making capabilities of the Sailors onboard, which cost 10 Sailors their lives and injured 48 more. The March 2021 Pentagon report, Study on Effects of Sleep Deprivation on Readiness of Members of the Armed Forces, explains that “In the United States, 37 percent of people regularly don't get their recommended seven to nine hours of sleep per night. For military personnel, that number climbs to 76 percent," highlighting sleep deprivation issues that many face within the military community. According to Kirsten Diller, NSA Souda Bay's Fleet and Family Support Center director, the lack of sleep has detrimental impacts on one's life. As Diller puts it, “the lack of sleep impairs attention, alertness, concentration, reasoning, and problem solving." These attributes are vital for basic functioning. Without the functioning fundamentals people can't perform to the highest of their abilities, says Diller. Furthermore, these attributes are even more vital for service members and the intense workload that they face. If a Sailor is not functioning with these attributes they may fall short in performing at their peak. Hospital Corpsman 2nd Class Greggory Kent, Navy Medicine Readiness and Training Unit Souda Bay Leading Petty Officer, describes sleep as “…important for watch standers on base. If they're sleepy or drowsy, they are putting everyone else in danger." This applies to not only watch standing, but also the dangerous nature of various other duties that Sailors perform. A proper sleep schedule can also be applied to Sailor's physical readiness. Without the correct amount of sleep, Kent stresses that the requirements of the Physical Fitness Assessment are less likely to be met. If service members can't sleep a reasonable amount of time, then medical has many resources to assist. Kent explains that medical has resources that help service members learn sleep hygiene, which includes information on factors that prohibit adequate sleep. Likewise, Diller recommends a multitude of ways to get the correct amount for your body such as: sticking to a schedule, exercising, avoiding alcohol and cigarettes, practicing a relaxing activity, and much more. DVIDS External Link

    GLOBAL

    Covid: Pfizer says antiviral pill 89% effective in high-risk cases

    6 November- A pill to treat Covid developed by the US company Pfizer cuts the risk of hospitalization or death by 89% in vulnerable adults, clinical trial results suggest. The drug - Paxlovid - is intended for use soon after symptoms develop in people at high risk of severe disease. It comes a day after the UK medicines regulator approved a similar treatment from Merck Sharp and Dohme (MSD). Pfizer says it stopped trials early as the initial results were so positive. The UK has already ordered 250,000 courses of the new Pfizer treatment, which has not yet been approved, along with another 480,000 courses of MSD's molnupiravir pill. Health and Social Care Secretary Sajid Javid called the results "incredible", and said the UK's medicines regulator would now assess its safety and effectiveness. "If approved, this could be another significant weapon in our armory to fight the virus alongside our vaccines and other treatments," he said. The Pfizer drug, known as a protease inhibitor, is designed to block an enzyme the virus needs in order to multiply. When taken alongside a low dose of another antiviral pill called ritonavir, it stays in the body for longer. BBC News External Link

    Global COVID-19 total tops 250 million infections

    8 November- Over the weekend, the global total topped 250 million cases as Delta (B1617.2) variant activity fuels fresh surges in Europe and keeps countries on other continents on an uncertain path heading into winter. The notable global high mark for infections comes about a week after the world passed 5 million deaths and as the pandemic's 2-year mark approaches. At a World Health Organization (WHO) media briefing on Nov 4, the group's COVID-19 technical lead, Maria Van Kerkhove, PhD, said virus activity is rising in places where it shouldn't be—in countries with ample vaccine and tools to fight the pandemic. She urged world leaders and health officials to channel their grief and anger over the pandemic's grim totals into actions to bring transmission under control and cut severe impacts and deaths. The trajectory of the pandemic is in our hands. It has always been in our hands. What happens now and into 2022 is up to us," she said. In Europe, currently the world's main hot spot, Russia's week-long work stoppage designed to curb virus transmission has ended, but cases are still near record daily highs. Meanwhile, Germany's 7-day incidence rate climbed to its highest level of the pandemic, according to the latest update from the Robert Koch Institute. Health officials are facing the prospect of postponing some surgeries, and some regions are already transferring patients to cope with increased burden on hospitals from COVID-19 patients. CIDRAP External Link

    Monoclonal antibody therapy 68% effective with seniors

    7 November- The journal Open Forum Infectious Disease published a study on November 3, 2021, which supports the timely delivery of monoclonal antibody (mAb) therapy to outpatients with Covid-19 who are most likely to benefit. These U.S.-based researchers found the mAb bamlanivimab was effective in reducing Covid-19 related hospitalizations in older patients (65+) or with a BMI of 35 or greater. Patients participating in the mAb therapy study had a statistically significant, 68% reduction in the odds of hospitalization within 30 days of a positive SARS-CoV-2 test. And there was a statistically significant difference in the odds of death between patients who received bamlanivimab and those who did not (OR 0.03, 95% CI [0, 0.25), P<0.01). During the time covered by this analysis, most of the SARS-CoV-2 infections in Massachusetts were likely with the alpha variant (B.1.1.7). However, we do not have specific viral genomic information in our medical records. 'Our findings are broadly in line with those of other groups that have conducted similar studies on different populations and using different criteria for study inclusion, and they are in agreement with both the phase 2 and phase 3 results from randomized, placebo-controlled clinical trials of bamlanivimab and bamlanivimab together with etesevimab.' Bamlanivimab emerged from the collaboration between Indiana-based Eli Lilly and AbCellera. Lilly scientists developed the antibody in less than three months after being discovered and tested by the NIAID Vaccine Research Center scientists. The U.S. FDA has issued an Emergency Use Authorization to permit the use of the bamlanivimab and etesevimab administered together with certain people. Precision Vaccinations External Link

    Pfizer COVID-19 booster shots to ask for FDA approval for adults—Is it available for 'mix and match'?

    8 November- Pfizer and BioNTech's vaccine is aiming to debut is COVID-19 "booster shots" for approval to the US Food and Drug Administration (FDA) for inoculation among adults. The need for the booster shot is debated by different health organizations, especially for those who have received their complete shots already, with some thinking about the "mix and match" of these shots. According to the report by The Washington Post, Pfizer and BioNTech are yet again approaching the FDA for its approval of their COVID-19 booster vaccine that is needed to further the immunity of a person. Several people familiar with the matter have confirmed this approval process says The Post, but none is confirmed by the FDA and Pfizer yet. Currently, it remains unknown if the booster is effective or has done its phases of clinical trials, which are needed to ensure its safety and inoculation to different people. The vaccine shot was said to be intended for adults only, but it may be so that other booster shots would be available or eligible for the inoculation of the younger population. Tech Times External Link

    Single-Dose monoclonal antibody cocktail produces long-term protection

    8 November- New York-based Regeneron Pharmaceuticals, Inc. today announced additional positive results from a Phase 3 trial jointly run with the National Institute of Allergy and Infectious Diseases, which assessed the use of a single dose of investigational REGEN-COV®  to prevent COVID-19 in uninfected individuals. The new analyses show REGEN-COV (1,200 mg administered via four subcutaneous injections) reduced the risk of contracting COVID-19 by 81.6% during the pre-specified follow-up period (months 2-8). During the 8-month assessment period, there were (0) hospitalizations for COVID-19 in the REGEN-COV group and (6) in the placebo group. And REGEN-COV maintained the 81.4% risk reduction during the first month after administration, as previously reported in The NEJM during September 2021. "Today's new data demonstrate how a single dose of REGEN-COV can help protect people from COVID-19 for many months after administration," said Myron S. Cohen, M.D., who leads the monoclonal antibody efforts for the NIH-sponsored COVID Prevention Network and is Director of the Institute for Global Health & Infectious Diseases at the University of North Carolina at Chapel Hill. Precision Vaccinations External Link

    Space exploration and potential brain damage: A closer look

    8 November- Space exploration is bound to expand into the furthest reaches of the cosmos. As such, organizations like NASA and even private companies have been trying to see how long-term space missions affect the human body. One of the most recent topics in contention is whether long-term exposure to the environment of space could lead to brain damage. As per a report by ABC News, various studies suggest that astronauts who spend more than several months in space exhibited notable changes in their brains. As exhibited by several astronauts shortly after returning to Earth, these changes allegedly caused vision problems and even swollen optic nerves upon returning home. Furthermore, another report by Space.com is saying that long-term space exploration missions are producing brain damage symptoms similar to having concussions. Tech Times External Link

    What the end of the Covid-19 pandemic could look like

    8 November- Covid-19 is here to stay. It's highly unlikely that the United States, let alone the world, will be able to completely eliminate the coronavirus that causes Covid-19. But there will come a day when it's no longer a pandemic, when cases are no longer out of control and hospitals aren't at great risk of overflowing with patients. Many experts predict the spread of coronavirus will look and feel more like seasonal influenza. What's less clear is how and when that will happen. "There's not even a measurement to say that something is an epidemic or pandemic. All of this is in the eye of the beholder -- and that's part of the issue," Dr. Arnold Monto, a professor of epidemiology at the University of Michigan and acting chair of the US Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee, told CNN. "So, all of this is not based on rules. It's based typically on what you have to do to control the outbreak," Monto said. "What is so different here is that our vaccines are much more effective than what we usually see." CNN External Link

    INFLUENZA

    Canine influenza outbreak: What dog owners need to know

    5 November- A canine influenza outbreak in Los Angeles is drawing up concern among pet owners on the West Coast. According to data published by the County of Los Angeles Public Health from July 2021 to October 2021, the dog flu – also known as CIV H3N2 – had been detected in approximately 800 canines in Los Angeles County. In that three-month period, seven deaths have been reported have been associated with the virus. FOX 11 Los Angeles reporter Gigi Graciette is one of the hundreds of Angelinos who have been directly impacted by the canine influenza outbreak. Graciette's two rescue dogs – Miss Maywood and Casper – are currently battling the virus. Both dogs are more than a decade old and couldn't be vaccinated for CIV H3N2 due to underlying conditions, she told FOX 11. "One of them may not make it. And, the other one is struggling," she told the local news station. "While primarily found on the East Coast, the Canine Influenza Virus (CIV) is emerging and making its way more west of the United States," said White Mountain Animal Hospital's doctor of veterinary medicine Ole Alcumbrac – who's also the face of Nat Geo Wild's "The Wild Life of Dr. Ole." Miss Maywood is experiencing kidney failure while Casper has developed pneumonia and needs to be nebulized several times a day to help him breathe. Fox News External Link

    VETERINARY/FOOD SAFETY

    Additional product information available on mushrooms recalled for Listeria risk

    8 November- A company in Canada is updating a recall notice on sliced mushrooms to include additional product information. The recall was initiated because of possible contamination with Listeria monocytogenes. Carleton Mushroom reported the mushrooms were sold in Ontario and Quebec and might have been distributed in other provinces and territories, according to a recall notice posted by the Canadian Food Inspection Agency. The recall was triggered by test results from the federal food inspection agency, but no further details were provided in the recall notice. The agency is investigating and will post additional recall information if necessary. As of the posting of the notice no illnesses had been confirmed in relation to the recalled mushrooms. Consumers are advised to discard any of the recalled mushrooms that they have in their homes. They can use the following information to determine whether they have any of the recalled mushrooms. Click here for photos of all of the recalled mushroom labels. Food Safety News External Link

    Krimpets' added to recall for Tastykake products; bits of metal mesh found

    4 November- Flowers Foods Inc. has amended its Oct. 31 recall to include other products in addition to cupcakes, after a vendor reported pieces of metal mesh in the product. The company is now recalling Tastykake brand multi-pack cupcakes and certain “Krimpets" products. The Tastykake multi-pack cupcakes products being recalled were distributed to retail customers in Delaware, Maryland, New Jersey, New York, Pennsylvania, Virginia, Washington D.C. and West Virginia. The Tastykake Krimpets products being recalled were distributed to retail customers throughout the United States. There is concern that consumers may have the products in their possession because of their long shelf life, which reaches into December for some of the products. Food Safety News External Link

    WELLNESS

    Explaining insulin resistance, and how to reverse it

    25 October- You may see the phrase “insulin resistance" a lot these days, especially if you use social media. This condition has been linked to conditions such as prediabetes, weight gain and high cholesterol, and social media influencers and diet purveyors often reference it to promote sometimes-dubious eating plans. But is a “three-day meal plan to lower insulin resistance" or the addition of a few “superfoods" into the diet really going to help? Nope. Insulin resistance is a precursor to many chronic conditions, so it needs to be kept at bay with a sustainable exercise and eating plan, not with a silly fad diet. From the ubiquitous mentions, it may also seem as if every person who is overweight has insulin resistance and as if people who don't have weight issues don't need to worry about it. But that's not necessarily true. Here are the facts about insulin resistance, including what it is, how to know whether you might have it, and how it can be managed. Insulin is a hormone made by the pancreas. It helps the sugar (glucose) in your blood enter the cells throughout your body, where it's turned into usable energy. After you eat a meal or snack, the amount of glucose in your bloodstream rises. In response, your pancreas will release insulin into your bloodstream, where it will help the glucose get to the cells that need it. This brings the amount of sugar in your bloodstream back to the normal range (a fasting plasma glucose level of 100 mg/dL or less). Insulin resistance occurs when the body doesn't respond as well to insulin and glucose is less able to enter the cells. Imagine that the cells are a locked door, but the keyhole is rusty, so it's difficult for glucose to get inside. The pancreas keeps pumping out more insulin to help, but glucose still has a hard time getting into the cells. This causes blood sugar levels to rise. The Washington Post External Link

    USAFRICOM

    Kenya: Tharaka Nithi County on high alert over visceral leishmaniasis outbreak

    5 November- Health officials in Tharaka Nithi County in central Kenya are reporting an outbreak of  kala-azar, or visceral leishmaniasis (VL). Over the last few months, 33 cases and 5 deaths have been reported, prompting officials to issue an alert over the vector-borne disease. In Kenya since January 2020, a total of 1 170 visceral leishmaniasis confirmed cases with 10 deaths (CFR 0.9% percent), have been reported in eight counties namely: Marsabit, Garissa, Kitui, Baringo, West Pokot, Mandera, Wajir, and Tharaka Nithi. Visceral leishmaniasis is the most serious form of leishmaniasis (a parasitic disease), which affects some of the internal organs of the body (such as the spleen, liver, and bone marrow). Outbreak News Today External Link

    USCENTCOM

    Israel: AY4.2 Delta variant detected

    20 October- The Israel Ministry of Health reported Tuesday the AY4.2, previously detected in several European destinations, variant was detected in Israel. The patient in question is an 11-year-old boy who was detected already upon arrival in Ben Gurion International Airport, ordered to go into isolation and currently there are no additional confirmed contacts. Investigation is underway. The Ministry of Health regularly monitors variants of concern of all types and their development. Scientists said AY4.2 carries two characteristic mutations in the spike, Y145H and A222V, both of which have been found in various other coronavirus lineages since the beginning of the pandemic. The first strains carrying both mutations were sequenced in April 2020. AY4.2 is rare outside the UK. Outbreak News Today External Link

    USEUCOM

    Ukraine reports polio case in Transcarpathia, not related to earlier case

    4 November- In a follow-up on the polio situation in Ukraine, Ukrainian health officials report a polio case in a 12-year-old child from Transcarpathia. Health officials report during the epidemiological surveillance of cases of acute flaccid paralysis in Transcarpathia, a child suspected of polio was identified. Samples of biomaterials were sent to the reference laboratory of the World Health Organization in Helsinki, where they confirmed the infection with type 1 poliovirus. The infected child was not vaccinated. She is now in need of rehabilitation and rehabilitation and is under medical supervision. According to the results of the detection of this case, an epidemiological investigation was conducted. No people the child were found to be infected with the poliovirus. They emphasize that the case of poliovirus infection detected in Ukraine earlier are not related. The last time a polio case was reported in Transcarpathia was in  2015. Outbreak News Today External Link

    USINDOPACOM

    Ivermectin does not reduce risk of severe illness from COVID-19: Malaysia study

    4 November- The Institute for Clinical Research (ICR) NIH today announced findings for the Ivermectin study (I-TECH) in 500 hospitalized patients with Stage 2 or 3 COVID-19. This multi-center open-label randomized controlled trial evaluated a 5-day course of ivermectin (0.4mg/kg/day) plus standard of care (IVM group), compared to standard of care (SOC group) according to Ministry of Health Malaysia (MOH) guidelines for COVID-19 patients at 20 government hospitals and MAEPS 2.0 Quarantine and COVID-19 Treatment Centre (PKRC). The trial was conducted by infectious disease physicians and clinicians who were actively involved in COVID-19 management in collaboration with the Institute for Clinical Research (ICR), National Institute of Health (NIH). The main outcome of the I-TECH study was to see if ivermectin administered during the first week of illness prevented deterioration to severe COVID-19 Stage 4 or 5 among hospitalized patients aged 50 years and above with at least one comorbidity. ICR Director, Dr.Kalaiarasu M. Peariasamy, said the I-TECH findings showed that patients in the IVM group compared to SOC group had similar rates of progression to severe COVID-19 disease at 21.2 percent and 17.3 percent respectively (OR 1.29 [95% CI 0.82-2.02]; p = 0.30). For the same primary outcome, the mean time to progression was 3.0 days for the IVM group compared to 2.9 days for the SOC group, but the difference was not statistically significant; p=0.68. This MOH initiated study obtained Medical Research and Ethics Committee (MREC) approval on 25th May 2021. In order to disclose to the public key information about the I-TECH study, the trial was registered in ClinicalTrials.gov on 31st May 2021 (NCT04920942). From the sample of 500 subjects enrolled in the trial, four (4) were excluded for not meeting study criteria and six (6) withdrew after expressing concerns about ivermectin side effects. The last subject was recruited on 9th October and the follow-up ended on 25th October 2021. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Idaho- Reports 1st human rabies case/death in over 40 years

    4 November- The Idaho Department of Health and Welfare and Central District Health are reporting the first human case of rabies and subsequent death reported in Idaho since 1978. The rabies case was confirmed by the Centers for Disease Control and Prevention (CDC). In late August, a Boise County man encountered a bat on his property. It flew near him and became caught in his clothing, but he did not believe he had been bitten or scratched. In October, he fell ill and was hospitalized in Boise, where he subsequently died. It was not until after the investigation into his illness began that the bat exposure was discovered. Public health officials are working closely with the family and healthcare providers. Central District Health is working with the hospital where he was treated to identify people who may have been exposed. Those who had contact with secretions from the individual are being assessed and will be given rabies preventive treatment as needed. “This tragic case highlights how important it is that Idahoans are aware of the risk of rabies exposure," said State Epidemiologist Dr. Christine Hahn. “Although deaths are rare, it is critical that people exposed to a bat receive appropriate treatment to prevent the onset of rabies as soon as possible." “Idahoans are reminded that bats can become infected with rabies. While bats can be beneficial to our environment, people should be wary of any bat encounter, including waking up to a bat in your room, or any situation where there may have been a bite or scratch," said Dr. Leslie Tengelsen, state public health veterinarian. Outbreak News Today External Link 

    USSOUTHCOM

    Chikungunya in the Americas: More than 120K cases reported, 97% in Brazil

    30 October- The Pan American Health Organization (PAHO) reports 122,203 chikungunya cases year to date in the Americas. This compares with 103,000 total cases reported in all of 2020. Brazil accounted for more than 97 percent of the total with 119,019 cases, including 57,221 confirmed cases. This is followed by Guatemala with 1,091 cases and Belize with 737. Eight fatalities were reported in the region, all in Brazil. Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain, which is often debilitating. Other symptoms include muscle pain, headache, nausea, fatigue, and rash. The disease shares some clinical signs with dengue and Zika, and can be misdiagnosed in areas where they are common. As there is no cure, treatment is focused on relieving the symptoms. Outbreak News Today External Link