Army Public Health Weekly Update, 13 November 2020

Date Published: 11/13/2020
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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 

    Army Medicine Campaign Research to Practice Education Series

    The Army Medicine Campaign Research to Practice Education Series for military providers and staff covers medical readiness topics such as injury prevention, health promotion, and physical performance optimization.  The series is held five times a year on Defense Collaboration Services (DCS) and is co-sponsored by OTSG Physical Performance Service Line and APHC Injury Prevention. Next Seminar: 7 December 2020 (1300-1410 ET) Presentation Topics:

    1. Traumatic Brain Injury (TBI) among Veterans with Substance Use Disorder: Rethinking Polytrauma

    2. Understanding the Relationship between Lifestyle Factors, Body Composition, and Performance APHC

    U.S. MILITARY

    DoD fails to address the health care needs of female troops, advisory board claims

    9 November- Despite more than three decades of studies and recommendations on military women's health, the Defense Department fails to provide female service members the medical care and equipment needed for their well-being -- a deficiency that costs millions and hurts operational readiness, a Pentagon advisory board has concluded. In an exhaustive review of the state of health services and support of active-duty women, members of the Defense Health Board found that previous DoD efforts to bolster gender-specific health care across the services have not led to "sustained improvements." Instead, such inaction causes women to leave the military in their first year of service for disability at twice the rate of men and experience 57% more limited-duty days than their male counterparts in their first enlistment. "We're paying for the disability and injuries now, oftentimes for the remainder of the service member's life," said Army National Guard Col. Lee Norman, a Defense Health Board member, at a virtual meeting Wednesday. Military.com External Link

    Mental health and suicide crisis among US veterans getting new approach

    9 November- About 20 veterans take their own lives each day. If that devastating statistic sounds familiar, it might be because you've seen viral social media challenges or moving public service campaigns seeking to bring awareness to this tragedy. Sadly, that figure has remained roughly unchanged for around a decade. Clearly our national approach to suicide prevention and mental health care has not worked to the degree we would like. Isn't it time to try something different? The good news is that a national strategy to better reach and provide mental health care and resources to former service members is on the cusp of being deployed. With the passage of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act, landmark legislation to address this heartbreaking situation, we can empower groups and organizations with proven records of success to expand their ability and available resources to foster healing and provide vital support. This will save lives and help veterans process trauma in a safe and caring environment. What gives us such a high level of optimism for a significant reduction in the rate of suicide among veterans is the fact that an initiative we authored was included in the broader measure that President Donald Trump signed into law last month. The IMPROVE Well-Being for Veterans Act, which we originally introduced in June 2019, has been described by Department of Veterans Affairs (VA) Secretary Robert Wilkie as the "key" to unlocking the problem of veteran suicide. With this law, we are poised to create a new grant structure and program enabling the VA to conduct additional outreach by partnering with veteran-serving nonprofits. Military Times External Link

    Navy personnel readiness: Corry Station embraces and participates in SafeTALK

    8 November- Service members onboard Naval Air Station Pensacola Corry Station, Pensacola, Florida, are participating in a course, facilitated by the base chapel, that teaches the participants to watch for, and prevent or aid people with suicidal tendencies or ideations. It also helps them monitor their own mental health as well. The program is called safeTALK. It is a training program that teaches participants to recognize and engage persons who might be having thoughts of suicide and to connect them with community resources trained in suicide intervention. SafeTALK stresses safety while challenging taboos that inhibit open talk about suicide. The 'safe' stands for 'suicide alertness for everyone', while the 'TALK'stands for the practice actions that one does to help those with thoughts of suicide: Tell, Ask, Listen, and KeepSafe. These skills are important to have for service members. "Events like safeTALK are important because they help create a suicide safer community with everyone working together to make that possible," said Cmdr. John Ismach-Eastman, one of the Corry Station chaplains. "The caregivers are usually pretty limited in number. We only have so many chaplains, fleet and family members and so on, but when we utilize peers who know how to identify or recognize suicidal ideation or behavior, they can help intervene to prevent that or get them the help they need." SafeTALK is available to every service member of every branch, and is encouraged to fight the stigma of service members seeking help and giving help to their peers. "The stigma of seeking help is actually one of the topics we go over in the course," said Religious Program Specialist 3rd Class Tyler Freda, a Sailor who has conducted the safeTALK course. "I would encourage people to avoid believing the stigma, no one has ever got in trouble for seeking help, the mission is to get them better and back in the fight as soon as possible. This program aims to add another resource to get them that help, the member taking the course. It makes it easier, it can be a hard and awkward situation, but with anything practice is key and it could save a life." DVIDS External Link

    Senior Leader Forum focuses on medical support to European theater

    6 November- More than 150 senior Army medical leaders, staff members and guest speakers from across Regional Health Command Europe and other organizations participated in the command's first ever virtual senior leader forum Nov. 3 - 4. The purpose of the medical forum was to provide a sight picture of the current operational environment in Europe and discuss the challenges and way forward for Regional Health Command Europe and its military treatment facilities as the size, shape and mission of medical and operational forces in Europe is continually evolving. "I am personally very proud of this team in a number of ways," said Brig. Gen. (Dr.) Mark Thompson, Regional Health Command Europe commanding general and U.S. Army Europe command surgeon. "Your integrated support of U.S. Army Europe, our Soldiers, Civilians and families has been essential, not only in the COVID response, but your efforts have allowed U.S. Army Europe to maintain its operational readiness. You are doing great work each and every day." Gen. Christopher G. Cavoli, U.S. Army Europe commanding general, gave a virtual presentation to RHCE leaders and commended the RHCE team for its efforts in the fight against the COVID-19 epidemic. Army.mil External Link

    Women veterans with PTSD have higher rate of heart disease

    9 November- Women veterans with posttraumatic stress disorder (PTSD), especially those who are younger and non-white, have an increased risk of developing heart disease, according to a study to be presented at the American Heart Association's Scientific Sessions 2020. According to the National Institute of Mental Health, PTSD is a mental health condition that develops in some people who have experienced or witnessed a shocking, scary or dangerous event. "Previous research has linked PTSD to higher risks of ischemic heart disease, including heart attacks and heart pain or angina. However, most of those studies have been in men," according to study author Ramin Ebrahimi, M.D., professor of medicine at University of California Los Angeles and director of interventional cardiovascular research and co-director of the Cardiac Catheterization Laboratory at the Greater Los Angeles VA (Veterans Affairs) Medical Center. "PTSD occurs twice as frequently in women as in men, and rates are particularly high among women veterans. Women veterans are the fastest growing group of patients within the VA health care system. And, despite being at high risk for many disorders including cardiovascular disorders, they have been understudied, underdiagnosed, undertreated and underrepresented in cardiovascular research," Ebrahimi said. Ebrahimi and colleagues evaluated the medical records of women veterans cared for at all U.S. Veterans Health Administration centers between the start of 2000 and the end of 2017. They identified nearly 130,000 female veterans with PTSD and nearly 260,000 without the mental health condition. Women with a heart disease diagnosis before or within 90 days of the initial study-related visit were excluded from analysis. Records for annual exams, emergency room visits and other exams or hospitalizations were assessed for new diagnoses of coronary artery disease, angina or heart attacks. Medical Xpress External Link

    GLOBAL

    Aspirin being tested in coronavirus patients for potential treatment

    7 November- A common painkiller is being tested as a potential treatment for hospitalized coronavirus patients to see if it reduces the risk of blood clots, according to researchers. Aspirin, a known blood thinner, will be given to patients enrolled in the RECOVERY trial in the U.K., according to a news release. The researchers plan to give aspirin to about 2,000 patients in the trial in addition to standard-of-care treatment. The results will be compared with 2,000 patients who only receive standard-of-care treatment and assess for mortality after 28 days, as well as the impact on hospital stay and need for ventilation. "We felt it was particularly important to add aspirin to the trial since there is a clear rationale for believing that it might be beneficial and it is safe, inexpensive and widely available," Peter Horby, professor at the Nuffield Department of Medicine and co-chief investigator of the RECOVERY trial, said in the news release. "We are looking for medicines for COVID-19 that can be used immediately by anyone, anywhere in the world. We do not know if aspirin is such a medicine but we will find out." Fox News External Link

    Cold virus antibodies may confer some protection against SARS-CoV-2 in children: Study

    8 November- Researchers at the Francis Crick Institute and University College London have found that some antibodies, created by the immune system during infection with common cold coronaviruses, can also target SARS-CoV-2 and may confer a degree of protection against the new viral strain.  In response to infection with a virus, the immune system creates antibodies to help fight it. These antibodies remain in the blood for a period after infection, and in the case of re-infection, they are able to tackle the virus again. In their paper, published in Science Friday, the scientists found that some people, notably children, have antibodies reactive to SARS-CoV-2 in their blood, despite not ever having being infected with the virus. These antibodies are likely the result of exposure to other coronaviruses, which cause a common cold and which have structural similarities with SARS-CoV-2. The researchers made this discovery while developing highly sensitive antibody tests for COVID-19. To see how well their assay tests were performing, they compared the blood of patients with COVID-19 to patients who had not had the disease. Surprisingly, they found that some people who had not been exposed to SARS-CoV-2 had antibodies in their blood which would recognize the virus. To confirm their findings, they analyzed over 300 blood samples collected before the pandemic, between 2011 and 2018. Nearly all samples had antibodies that reacted with common cold coronaviruses, which was expected given how everyone has been exposed to these viruses at some point in their lives. However, a small fraction of adult donors, about 1 in 20, also had antibodies that cross-reacted with SARS-CoV-2, and this was not dependent on recent infection with a common cold coronavirus. Outbreak News Today External Link

    Covid-19: Global coronavirus cases pass 50 million

    8 November- The total of confirmed coronavirus cases has surged past 50 million following record numbers of new cases in several countries. More than 1.25 million people have now died after contracting the virus, according to Johns Hopkins university. But the numbers are thought to be higher because of insufficient testing in many countries. A second wave of the virus has accounted for a quarter of all cases, Reuters reported. Europe, with more than 12.5 million cases and 305,700 deaths, is again a hotspot after being the first epicenter of the pandemic earlier this year. In the US just under 10 million have tested positive. It has seen more than 125,000 cases per day three days in a row. The states of North and South Dakota have the highest rates of death per capita. BBC News External Link

    COVID-19 neutralizing antibody authorized by the U.S. FDA

    9 November- An Emergency Use Authorization (EUA) for Eli Lilly investigational neutralizing antibody Bamlanivimab (LY-CoV555) 700 mg was issued by the U.S. Food and Drug Administration on November 9, 2020. Bamlanivimab should be administered via a single intravenous infusion as soon as possible after a positive COVID-19 test and within 10-days of symptom onset. Bamlanivimab is authorized for the treatment of mild to moderate COVID-19 in adults and pediatric patients 12 years and older with a positive COVID-19 test, who are at high risk for progressing to severe COVID-19 and/or hospitalization. "This emergency authorization allows us to make Bamlanivimab available as a COVID-19 treatment for recently diagnosed, high-risk patients – adding a valuable tool for doctors fighting the now-increasing burden of this global pandemic," said David A. Ricks, Lilly's chairman, and CEO, in a press release. Furthermore, the U.S. government stated it will allocate 300,000 doses of Bamlanivimab to high-risk patients, with no out-of-pocket costs for the medication. Precision Vaccinations External Link

    COVID-related shortages of malarial, other drugs spotlighted

    11 November- Recent publications from the COVID-19 Global Rheumatology Alliance and from France's consumer interest association UFC-Que Choisir hinted at global drug supply shortages through different scopes and methods. The first, results from the alliance's 9,000-person survey, was presented at the annual ACR Convergence 2020 late last week and reported that 6.2% of global respondents were unable to receive their antimalarial, rheumatic disease treatments (eg, hydroxychloroquine and chloroquine) because of pharmaceutical shortages. Hydroxychloroquine has been prescribed to treat COVID-19, with little proven success, but its use has led to shortages for the diseases for which it has been approved. The second is an analysis of 140 drugs of major therapeutic interest that were on the French National Agency for Medicines and Health Products Safety (ANSM) shortage list in July. Among calls for a better approach to drug shortages, the writers added that, while there were 1,200 supply chain disruptions in 2019—already a 38.2% increase from 2018—in 2020, there have been 2,400. CIDRAP External Link

    How AI can step into the treatment of mental disorders

    9 November- Already, we are integrating technological advancement into psychotherapy by the way of online counseling, we are gradually replacing traditional or face-to-face counseling with this innovation. But, what if we can go all the way? "How are you doing today?" "How are you coping with the challenges in the new normal?" "How do you feel?"  These are certainly everyday questions you may expect to hear from a friend or a relative, however, with how things are turning out in mental health care today, they can also be the beginning of a session with your virtual counselor. According to a study by the WHO, it has been estimated that 44.3 million people suffer from depression and 37.3 million suffer from anxiety in Europe alone. Also, the National Institute of Mental Health (NIMH) findings from 2017, reveals that approximately one in five adults in the United States (18.9%) experiences some type of mental health disorder.  By extrapolating these figures, we can arrive at the mammoths of the problem globally. It will also dawn on us that we cannot attempt to safely handle the cases of mental disorder patients by employing traditional counseling.  This is more so, given that the new normal will come up with its fair share of stress and related problems. With online counseling, you can now enjoy weekly live sessions with your licensed counselor (via video chat),  you have access to unlimited messaging, and can reach out to an online counselor from a safe environment as well as the privacy of your own home. You don't need to waste any time getting to your appointment; you can connect with your licensed counselor right away (as long as you have an internet connection). One other benefit online counseling offers is the regularity of communication with your licensed counselor. These are all great innovations and departures from traditional counseling, where clients only have the opportunity of meeting with their licensed counselors once a week. Tech Times External Link

    Misinformation could prompt people to turn against COVID-19 vaccines: Study

    12 November- Conspiracy theories and misinformation fuel mistrust in vaccines and could push levels that potential COVID-19 vaccines are taken in the United States and Britain below the rates needed to protect communities against the disease, a study found on Thursday. The study of 8,000 people in the two countries found that fewer people would "definitely" take a COVID-19 vaccine than the 55% of the population scientists estimate is needed to provide so-called "herd immunity". "Vaccines only work if people take them. Misinformation plays into existing anxieties and uncertainty around new (COVID)vaccines, as well as the new platforms that are being used to develop them," said Heidi Larson, a professor at the London School of Hygiene & Tropical Medicine, who co-led the study.  "This threatens to undermine the levels of COVID-19 vaccine acceptance," added Larson, who is also director of the international Vaccine Confidence Project. The study comes as one of the major vaccine efforts showed promising results this week. Pfizer Inc. PFE.N said on Monday its experimental COVID-19 vaccine is more than 90% effective based on interim data from late stage trials. The data were seen as a crucial step in the battle to contain a pandemic that has killed more than a million people. In the misinformation study, 3,000 respondents in each country were exposed between June and August to widely circulating misinformation on social media about a COVID-19 vaccine. The remaining 1,000 in each country, acting as a control group, were shown factual information about COVID-19 vaccines. Reuters External Link

    Pfizer says early analysis shows its Covid-19 vaccine is 90% effective

    9 November- Drug maker Pfizer said Monday an early look at data from its coronavirus vaccine shows it is more than 90% effective -- a much better than expected efficacy if the trend continues. Pfizer said that the vaccine provided protection seven days after the second dose and 28 days after the initial dose of the vaccine. The final goal of the trial is to reach 164 confirmed cases of coronavirus infection. In a news release, the pharmaceutical giant said it plans to seek emergency use authorization from the US Food and Drug Administration soon after volunteers have been monitored for two months after getting their second dose of vaccine, as requested by the FDA. The so-called interim analysis looked at the first 94 confirmed cases of Covid-19 among the more than 43,000 volunteers who got either two doses of the vaccine or a placebo. It found that fewer than 10% of infections were in participants who had been given the vaccine. More than 90% of the cases were in people who had been given a placebo. CNN External Link

    INFLUENZA

    WHO Influenza Update

    09 November 2020, based on data up to 25 October 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic have influenced to varying extents health seeking behaviors, 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 influenza detections were reported in some countries.

    - In the temperate zones of the southern hemisphere, no influenza detections were reported across countries.

    - In the Caribbean and Central American countries, sporadic influenza detections were reported. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, decreased in most reporting countries.

    - In tropical South America, there were no influenza detections across reporting countries.

    - In tropical Africa, influenza activity was reported in West Africa in Côte d'Ivoire and Niger, and in East Africa in Kenya.

    - In Southern Asia, influenza activity of predominately influenza A(H3N2) was reported in Bangladesh and India in recent weeks.

    - In South East Asia, influenza detections continued to be reported in Cambodia and Lao People's Democratic Republic (PDR).

    - Worldwide, of the very low numbers of detections reported, seasonal influenza A(H3N2) viruses accounted for the majority of detections. WHO External Link

    VETERINARY/FOOD SAFETY

    T&A recalls whole heads of romaine lettuce for E. coli contamination

    9 November- A public notice sent out today by the FDA announces a romaine lettuce recall three days after Tanimura & Antle initiated the action because of tests in Michigan that showed E. coli O157:H7 contamination. The notice from the Food and Drug Administration, dated Nov. 6, reports that the California company is recalling certain whole heads of romaine. Tanimura & Antle officials said the implicated romaine was packed on Oct. 15 and 16 and therefore no longer available to consumers. "The recall is being conducted in consultation with FDA, and is based on the test result of a random sample collected and analyzed by the Michigan Department of Agriculture and Rural Development as part of their routine sampling program," the company officials said in the recall notice. No confirmed illnesses have been associated with the recalled romaine, according to the company's notice. The company distributed 3,396 cartons of potentially affected product under the Tanimura & Antle brand. Potentially affected product was distributed in the following states: AK, OR, CA, TX, AR, OK, IN, NE, MO, TN, WI, NM, SC, WA, NC, OH, VA, MA, PR, and IL. Food Safety News External Link

    WELLNESS

    A timely intervention: Preventing suicide

    11 November- Youth suicide rates are increasing at a concerning rate. A 2019 Centers for Disease Control and Prevention report noted that the suicide rate for children ages 10-14 nearly tripled from 2007 to 2017, and the rate for those ages 15-19 rose 76%. While traditional factors like hopelessness, abuse, trauma and substance abuse remain significant, researchers are trying to determine whether others, including social media engagement and economic and political stressors, could be fueling the increase. And these factors likely are only exacerbated by the disruptions and anxiety caused by the COVID-19 pandemic. Regardless of the cause, most experts agree that parents and caregivers can be the first line of defense in protecting at-risk children. U.S. News spoke with John Ackerman, psychologist and suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children's Hospital, and Rhonda Boyd, a psychologist and assistant director of the Youth Suicide Prevention, Intervention and Research Center at Children's Hospital of Philadelphia, about the emerging crisis and families' roles in slowing the trend. The interview has been edited for length and clarity. U.S. News External Link

    USAFRICOM

    Africa: Malawi eliminates Lymphatic Filariasis as a public health problem

    11 November- The World Health Organization (WHO) announced recently that Malawi has been validated to have eliminated lymphatic filariasis as a public health problem. MSD, GSK, and the Mectizan Donation Program congratulate President Lazarus Chakwera, the government, and the people of Malawi for this remarkable achievement that has alleviated suffering for millions and highlights the perseverance of many dedicated partners. Malawi is only the second country in sub-Saharan Africa to mark this achievement. Lymphatic filariasis (LF), commonly known as elephantiasis, is a debilitating disease caused by a parasite transmitted to humans through the bites of mosquitoes. According to WHO, elephantiasis is found in 73 countries around the world with an estimated 120 million people infected. Long-term, chronic infection causes damage to the lymphatic system, and severe and irreversible swelling to the limbs, breasts, and/or genitals. These symptoms cause extreme discomfort, disability, and social stigmatization. A WHO resolution to achieve the goal of global LF elimination was passed by the World Health Assembly in 1997. In countries where LF and another parasitic disease called river blindness are co-endemic, WHO recommends co-administering two medicines, albendazole and ivermectin to achieve LF elimination.  In 1998, GSK announced the donation of albendazole for the elimination of LF and MSD expanded its donation of Mectizan® (ivermectin) through the Mectizan Donation Program to include the elimination of LF in countries where the disease co-exists with river blindness. In 2017, in support of new WHO guidelines, MSD's donation of Mectizan was once again expanded to provide up to 100 million additional treatments per year through 2025 to support the elimination of LF globally in countries where onchocerciasis is not endemic. Outbreak News Today External Link

    Nigeria: Yellow fever outbreak in Delta and Enugu States

    9 November- The Nigeria Centre for Disease Control (NCDC) reports supporting a response to suspected outbreak of yellow fever. This is following reports of a sudden spike in cases and deaths in some communities in both states. On the 2nd and 3rd of November 2020, NCDC was notified by the State Ministries of Health of Delta and Enugu States respectively, of cases presenting with symptoms indicative of a viral hemorrhagic fever. Most cases presented with fever, headache, fatigue, jaundice vomiting (with or without blood) among others. As at the 6th of November 2020, three samples from Delta and one sample from Enugu tested positive for yellow fever at Irrua Specialist Teaching Hospital Laboratory and NCDC's National Reference Laboratory, Gaduwa. More samples are being tested from both states to confirm the causative organism of this outbreak. Outbreak News Today External Link

    USCENTCOM

    Saudi Arabia reports 1st MERS cases in months

    9 November- The Saudi Arabia Ministry of Health reported a laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection in a 51-year-old male in Riyadh City. Health officials note that the patient had contact with camels and didn't contract the virus from another person. This is the first case confirmed in the Kingdom since May. According to the World Health Organization, 2562 laboratory-confirmed cases of infection with MERS-CoV have been reported since September 2012. In addition, 881 MERS-CoV associated deaths have been reported in the same period. Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels. MERS-CoV has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings. MERS-CoV appears to cause more severe disease in people with underlying chronic medical conditions such as diabetes mellitus, renal failure, chronic lung disease, and compromised immune systems. Therefore, people with these underlying medical conditions should avoid close unprotected contact with animals, particularly dromedary camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to. Outbreak News Today External Link

    USEUCOM

    Russia: Suspected Salmonella outbreak linked to Makhachkala café sickens 39

    8 November- The Ministry of Health of Dagestan, Russia are reporting that 39 people have been hospitalized with acute intestinal infection. Officials note that 39 people were hospitalized, including 12 children. The patient's condition is assessed as moderate. The main clinical symptoms include fever up to 38–39 degrees, abdominal pain, nausea, vomiting and frequent loose stools. According to the results of the survey of the sick, a single factor of transmission of infection was established, they all bought food in the Kazan-Kebab café in Makhachkala. Outbreak News Today External Link

    USINDOPACOM

    Philippines COVID-19 cases top 400K, Cebu City to ban Christmas caroling

    11 November- The Department of Health (DOH) reported 1,672 newly confirmed COVID-19 infections on Wednesday, bringing the country total to 401,416. Cavite topped the list of areas with new confirmed cases with 100 infections. It is followed by Davao City with 99, Quezon City with 81, Batangas with 78, and Baguio City with 70 infections. 49 new deaths were reported today, which brought the death toll to 7,710. While the DOH advised the public this week against holding and attending in-person gatherings and different kinds of celebrations which may increase the risk of COVID-19 transmission, officials in Cebu City said they will strictly enforce the "no-caroling" and "no Christmas party" policy to avoid mass gatherings. Mayor Edgardo Labella said, "I hope that our carolers would understand our point here that like other traditions, we tend to postpone caroling. We are still in the middle of the pandemic." He noted that carolers could be arrested by authorities. "Of course, we will give them the chance to stop their caroling activities," Labella said. Outbreak News Today External Link

    Taiwan local dengue transmission cases rise to 70

    8 November- The Taiwan CDC reported a new locally transmitted dengue fever case in a 40-year-old woman in Longhuali, Guishan District, Taoyuan City. She has no recent history of going abroad.  According to the statistics of the Department of Disease Control and Prevention, there have been a total of 70 local cases of dengue fever in Taiwan this year, 48 of which live in New Taipei City (37 cases in Three Gorges District, 3 cases in Luzhou District and Linkou District, 2 cases in Tucheng District, Banqiao District, 1 case each in Shulin District and Zhonghe District), 22 cases live in Taoyuan City (15 cases in Taoyuan District, 5 cases in Guishan District, 1 case each in Bade District and Zhongli District). In addition, 61 imported dengue cases have been reported, mostly from Indonesia, Vietnam and the Philippines. The Department of Disease Control has reminded that the recent increase in rainfall opportunities in the northern region is still an active period for vector mosquitoes. People are requested to strengthen "patrolling, dumping, cleaning, and brushing" to clean up the indoor and outdoor environment and remove stagnant water containers to avoid the formation of breeding sources. Increase the risk of the epidemic; if you need to spend a long time outdoors, please wear light-colored long-sleeved clothes and use government agencies approved anti-mosquito agents containing DEET or Picaridin. Once the public has suspected symptoms such as fever, headache, nausea, rash, posterior orbital pain, and joint pain, they should seek medical attention as soon as possible and inform their travel history. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Hillsborough County, Florida- Human West Nile virus case prompts Mosquito-Borne Illness Advisory

    11 November- Officials with the Florida Department of Health in Hillsborough County (DOH-Hillsborough) have issued a Mosquito-Borne Illness Advisory Tuesday after a human case of West Nile virus (WNV) had been confirmed.  Hillsborough County Mosquito Control and DOH-Hillsborough continue surveillance and prevention efforts. There is a heightened concern additional residents will become ill and DOH-Hillsborough reminds residents and visitors to avoid being bitten by mosquitoes and to take basic precautions to help limit exposure. DOH-Hillsborough advises the public to remain diligent in their personal mosquito protection efforts by remembering to "Drain and Cover"–DRAIN standing water to stop mosquitoes from multiplying, COVER skin with clothing or repellent and COVER doors and windows with screens to keep mosquitoes out of your house. WNV is the leading cause of mosquito-borne disease in the continental United States. It is most commonly spread to people by the bite of an infected mosquito. There are no vaccines to prevent or medications to treat WNV infections in people. Most people infected with West Nile virus do not feel sick. About 1 in 5 people who are infected develop a fever and other symptoms such as headache, pain, and fatigue. People with mild illness typically recover within about a week with symptomatic treatment. Outbreak News Today External Link

    U.S.: Wound botulism- Los Angeles reports 6 cases linked to heroin since June

    8 November- The Los Angeles County Health Department is reporting an increase in wound botulism cases linked to heroin injection in recent months. Since June 1, 2020, six suspected cases of wound botulism associated with heroin injection have been reported in Los Angeles County (one case a month June through August and three cases in October). The cases are apparently unknown to each other. The sources of the heroin remain unknown. Five of the six cases presented with wound infections or abscesses and a recent history of injecting heroin. Symptoms included diplopia, ptosis, dysphagia, slurred speech, facial paralysis, difficulty breathing, and muscle weakness. Five cases required intensive care treatment and had respiratory failure requiring intubation. All patients were treated with Botulism Antitoxin Heptavalent (BAT®). In 2020 to date, there has been a total of 9 reported cases of wound botulism, more than twice the annual average. Between 2015-2019, twenty confirmed cases of wound botulism occurred in Los Angeles County, all of which were associated with drug use. Of these twenty, 11 cases were associated with black tar heroin, 7 with heroin and 2 were associated with injection/inhalation of cocaine and/or methamphetamine. Botulism is a rare, potentially fatal paralytic illness caused by the neurotoxins produced by Clostridium botulinum. Wound botulism occurs when a wound is contaminated by C. botulinum spores that germinate and produce toxin inside the wound. Wound botulism in drug abusers occurs in dermal abscesses from subcutaneous or intramuscular injection (skin or muscle "popping"). Outbreak News Today External Link

    USSOUTHCOM

    Peru diphtheria update: 'Not a national emergency'

    8 November- In a follow-up on the diphtheria situation affecting the Lima area of Peru, The Ministry of Health (Minsa) assured this week that Peru is not in a national emergency situation due to the cases of diphtheria registered in two districts of the capital, and urged the population to remain calm because all measures are being taken containment requirements according to protocols. Luis Suárez Ognio, Deputy Minister of Public Health of the Minsa, explained that there is an outbreak focused on the district of La Victoria, with four members of the same family who were detected the bacteria Corynebacterium diphtheriae, – unfortunately, a five-year-old girl died – but to date no other case has been registered. He clarified that the 69-year-old woman, from San Martín de Porres, who died at the Cayetano Heredia Hospital, was a carrier of a type of diphtheria bacteria that did not produce toxins and that the clinical picture she presented – which was the cause of her death – was not compatible with this disease. In the district of La Victoria – he said – the Minsa vaccinated 7,097 people in 2,955 homes around the house where the family of the deceased girl lived and carried out 88 tests on people with respiratory problems, but all were negative. In San Martín de Porres no more suspected cases have been identified either. "There is no reason to generate alarm, there is no reason to carry out a vaccination campaign for diphtheria at this time," said Suárez Ognio, who clarified that the epidemiological alert issued by the Minsa is so that the country's health facilities are vigilant and report any suspicious case and not to alarm the population. All children who have their full Pentavalent vaccines (3 doses) plus two boosters are protected against diphtheria. Outbreak News Today External Link