Army Public Health Weekly Update, 14 May 2021

Date Published: 5/14/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents

    ​ANNOUNCMENTS 

    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: 12 July 2021 (1300-1410 ET)

    FY21 Registration: Registration is required. All attendees must register:

    1. Go to https://education.mods.army.mil/CME/Secured External Link

    2. Click on 'Activity Registration'

    3. Log in (or create an account)  

    4. Type Activity ID 2021-0060 or FY21 Army Medicine Campaign Research to Practice Education Series into the search box, click Search

    5. Follow prompts to complete registration. Once registered, you are registered for the entire fiscal year. 

    6. If you have questions, please contact the CME Planner. APHC

    U.S. MILITARY

    Army nurse recognized with national nursing honor

    10 May- An Army nurse has received national recognition for her commitment to critically ill patients and their families in the midst of a global health crisis. Army Lt. Col. DeAnna Hutchings, Brooke Army Medical Center's chief of critical care, is one of 18 nurses – and the only military nurse – to receive the 2021 Circle of Excellence award from the American Association of Critical-Care Nurses. Hutchings is also one of only two nurses recognized in Texas. "It's incredibly humbling," she said. "I work with so many amazing medical professionals and support personnel who work incredibly hard and deserve recognition. It's a surreal feeling to be singled out for this honor." The Circle of Excellence honors nurses who exemplify excellence in high-acuity and critical-care nursing practice, according to the association's release. Hutchings was nominated by her BAMC colleagues: Army Lt. Col. Trisha Bielski, Karriemah Munson and Nadia Perez. "Lt. Col. Hutchings lays down her heart and soul for the critical care mission at BAMC and the patients we serve," said Munson, assistant clinical nurse officer in charge of 3T. "She is selfless in her care and gives 110 percent daily without reservation. I wish there were more people in the world like her." Hutchings' leadership agrees. "DeAnna is extremely deserving of this award," said Army Lt. Col. Jody Brown, deputy commander for inpatient services. "A wildly driven and focused leader, DeAnna is dedicated to critical care nursing and wholeheartedly invested in pursuing excellence at all levels. I couldn't be more proud of her accomplishment!" A self-proclaimed Air Force brat, Hutchings knew she wanted to follow in her father's military footsteps at an early age. However, a career in medicine was not on her radar until she was selected for an ROTC scholarship at the University of Central Arkansas. "I enjoyed science, but hadn't considered nursing prior," she said. "But it definitely sounded interesting." After earning her bachelor's degree in nursing, Hutchings's active duty service started in September 2003, as did the start of her long-term service at BAMC. Health.mil External Link

    DHA, HA leaders discuss MHS Transformation at AHA panel

    6 May- Federal health leaders, including the director of the Defense Health Agency and the acting assistant secretary of defense for health affairs, discussed areas for synergy and collaboration between military and civilian health care partners at a virtual roundtable held by the American Hospital Association April 12. During a federal health update panel, DHA Director Army Lt. Gen. (Dr.) Ronald Place emphasized the importance of smarter data and information sharing in support of the health care mission. "We often talk about our interest in creating a more integrated health system, not simply within the Department of Defense, but within the broader American health system," he said. In doing so, the DHA is looking at multiple and different ways to integrate data sharing both from the Military Health System as well as from outpatient physicians' offices, Place explained. As an example, Place highlighted MHS GENESIS, the new electronic health record (EHR) system being deployed across the MHS, which the Department of Veterans Affairs will also incorporate. "In support of that, we're also growing our participation in health information exchanges so that we can more easily share clinical information within our network, with the network, and with other hospitals," he said. Having one centralized MHS database will facilitate the continuum of care for service members, veterans, and their families across different duty locations and after they retire. It will also provide a centralized repository of medical records that can be shared with DOD and civilian facilities and providers for more efficient, standardized care. Health.mil External Link

    Fact Sheet: U.S. Army North COVID-19 vaccination site support since February 2021

    10 May- U.S. Army North, U.S. Northern Command's Joint Force Land Component Command, has overseen the Department of Defense's COVID-19 response operation in support of the Federal Emergency Management Agency and the Department of Health and Human Services since March 2020. This fact sheet reflects joint assistance to state and federal vaccination sites since February 2021. Approximately 5,150 military medical and support personnel from the U.S. Army, U.S. Marine Corps, U.S. Navy and U.S. Air Forces are currently working or have worked in 25 states and one territory as part of the federal vaccine response to the pandemic. To date, these military personnel have administered approximately 4.5 million vaccines. DVIDS External Link

    Fast take: Vaccine skepticism among service members and other COVID unknowns

    9 May- In last week's episode, Military Matters examined the reasons why service members aren't taking the COVID-19 vaccine, as well as the politicization of the vaccine and the pandemic as a whole. One of that episode's guests, Defense One reporter Elizabeth Howe, returns in this week's fast take episode. Howe revisited her conversation with co-host Jack Murphy in which they discussed a flyer posted to Fort Carson's Facebook page listing reasons why service members weren't getting the vaccine...The flyer addressed the idea that service members aren't taking the vaccine because it isn't FDA approved with a counterargument about energy drinks being unhealthy. "I think Fort Carson's counterargument was along the lines of, do you really know what's in those Bangs and Rip Its?" Howe said. "And maybe they do; maybe these are very nutritionally aware troops." There are long-term effects from COVID-19 that are still not fully understood, including lung scarring and other issues. Similarly, some service members are wary of the vaccines because "we don't know enough about what these vaccines do long-term," Howe said. STRIPES External Link 

    Nearly half of female Soldiers still failing new Army fitness test, while males pass easily

    10 May- More than seven months after the official launch of the Army Combat Fitness Test, or ACFT, nearly half of female soldiers are still falling short, with enlisted women struggling the most, Military.com has learned. The data again raises questions about whether the Army's attempt to create a fitter force is creating more barriers to success for women. Internal Army figures from April show 44% of women failed the ACFT, compared to 7% of men since Oct. 1. "Female soldiers continue to lag male soldier scores in all events," according to a United States Army Forces Command briefing obtained by Military.com. FORSCOM data includes the results of 106,000 ACFTs taken in the first half of fiscal 2021. This amounts to 27% of women and 36% of men in the force who also have scores logged into the Army's database, meaning the data could potentially be incomplete. FORSCOM tracks 3,400 new fitness tests per week on average. The Army remains in a beta phase for the ACFT. Until March 2022, scores on the test will not affect soldiers' careers; officials have said they may implement additional changes before then, including gender-specific standards. Military.com External Link

    GLOBAL

    Coronavirus strain found in India is a 'variant of concern,' WHO says

    10 May- The World Health Organization on Monday classified a coronavirus variant first spotted in India as a global "variant of concern," saying preliminary studies showed it may be more transmissible than some other variants. The WHO didn't report any evidence suggesting that currently authorized vaccines would be less effective against the variant. The variant, known as B.1.617, is being studied by scientists around the world as they try to figure out its role in the fast growing Covid-19 surge in India, which reported more than 366,000 new daily cases on Monday. The variant has already spread to more than 30 countries, according to the WHO, including the U.S., the U.K., France and Japan. The surge in India rose rapidly last month, overwhelming hospitals in the country's hardest-hit cities. Anecdotally speaking, "the pattern now is that one person in the family gets it, the whole family seems to get it," said Dr. Soumya Swaminathan, the WHO's chief scientist, in an interview. "This is unlike the first wave. And so I think what we're seeing is more transmissible." WSJ External Link

    FDA meeting on COVID-19 vaccines in kids on June 10

    10 May- The Food and Drug Administration (FDA) announced a June 10 advisory committee meeting to discuss COVID-19 vaccines in pediatric populations amid speculation that the agency would decide on Pfizer-BioNTech's request to expand emergency use authorization (EUA) for its shot to teens ages 12-15 within the coming days. The memo was sent just two days before the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) is set to meet, although as of Monday there was no draft agenda for the meeting available on the agency's website. Fox News External Link

    Flu and COVID-19 combo vaccine candidate found effective in preclinical study

    10 May- Maryland-based Novavax, Inc. announced data from a preclinical study of the company's combination quadrivalent seasonal flu vaccine (NanoFlu™) and COVID-19 vaccine candidate (NVX-CoV2373) on May 10, 2021. The NanoFlu/NVX-CoV2373 combination vaccine demonstrated positive immune responses to both influenza and SARS-CoV-2 in hamsters. The combination vaccine-elicited robust responses to both influenza A and B and protected against the SARS-CoV-2 virus. Human-based clinical studies of the combination vaccine are expected to begin by the end of 2021. A pre-print of the manuscript, titled 'Combination Respiratory Vaccine Containing Recombinant SARS-CoV-2 Spike and Quadrivalent Seasonal Influenza Hemagglutinin Nanoparticles with Matrix-M™ Adjuvant,' studied a combination vaccine comprising a quadrivalent nanoparticle influenza vaccine formulated together with a recombinant SARS-CoV-2 spike protein vaccine and Matrix-M™ adjuvant. Precision Vaccinations External Link

    It may be time to relax indoor face mask mandates, Fauci says

    10 May- Dr. Anthony Fauci says federal guidance on wearing face coverings indoors may change soon. Sunday on ABC News, Fauci was asked whether it's time to start relaxing indoor masks requirements. Fauci replied, "I think so, and I think you're going to probably be seeing that as we go along, and as more people get vaccinated." The US Centers for Disease Control and Prevention will be updating its guidance almost in real time, as more Americans get vaccinated, said Fauci, director of the National Institute of Allergy and Infectious Diseases. The CDC relaxed its guidance last month on wearing masks outdoors, but still advises both vaccinated and unvaccinated people to still wear masks in indoor public spaces, such as a mall, movie theater or museum. "We do need to start being more liberal, as we get more people vaccinated," he added. CNN External Link

    New U.S. COVID weekly cases fall to lowest since September

    10 May- New cases of COVID-19 in the United States fell for a fourth week in a row, dropping 17% last week to just under 290,000, the lowest weekly total since September, according to a Reuters analysis of state and county data. Deaths from COVID-19 fell 1.3% to 4,756 in the week ended May 9, the fewest deaths in a week since July. More than a third of the country's population has been fully vaccinated as of Sunday, and 46% has received at least one dose of a COVID-19 vaccine, according to the U.S. Centers for Disease Control and Prevention. The rate of vaccinations, however, has been slowing for three straight weeks. In the past seven days, an average of 2 million vaccine doses were administered per day, which is down 17% from the previous week and represents the biggest percentage drop reported under the Biden administration. Reuters External Link 

    Pfizer COVID-19 shot expanded to US children as young as 12

    11 May- U.S. regulators on Monday expanded the use of Pfizer's COVID-19 vaccine to children as young as 12, offering a way to protect the nation's adolescents before they head back to school in the fall and paving the way for them to return to more normal activities. Shots could begin as soon as Thursday, after a federal vaccine advisory committee issues recommendations for using the two-dose vaccine in 12- to 15-year-olds. An announcement is expected Wednesday. Most COVID-19 vaccines worldwide have been authorized for adults. Pfizer's vaccine is being used in multiple countries for teens as young as 16, and Canada recently became the first to expand use to 12 and up. Parents, school administrators and public health officials elsewhere have eagerly awaited approval for the shot to be made available to more kids. "This is a watershed moment in our ability to fight back the COVID-19 pandemic," Dr. Bill Gruber, a Pfizer senior vice president who's also a pediatrician, told The Associated Press. The Food and Drug Administration declared that the Pfizer vaccine is safe and offers strong protection for younger teens based on testing of more than 2,000 U.S. volunteers ages 12 to 15. The agency noted there were no cases of COVID-19 among fully vaccinated adolescents compared with 16 among kids given dummy shots. More intriguing, researchers found the kids developed higher levels of virus-fighting antibodies than earlier studies measured in young adults. AP News External Link

    What you need to know about research linking sleep deprivation and dementia

    8 May- Sleep deprivation has been linked to hypertension, obesity and diabetes and has long been suspected of having a connection to dementia. Now, a large new study has more clearly established that association by concluding that people who sleep less than six hours a night in midlife have a greater risk of developing late-onset dementia. That doesn't mean middle-aged short sleepers should panic, according to experts. Although the study is an important step forward, much about the connection between sleep and dementia remains unknown, they said. Still, it can't hurt to work on your sleep habits while research continues, and you'll find some strategies listed below. In the study, European researchers followed nearly 8,000 people in Britain for 25 years, starting when subjects were 50. They found that those who consistently got six hours of sleep or less per night in their 50s and 60s were about 30 percent more likely to develop dementia later in life, compared to those who logged seven hours of sleep per night. That was independent of "sociodemographic, behavioral, cardio metabolic, and mental health factors," the study authors wrote. Findings were published in the journal Nature Communications in late April. The Washington Post External Link

    INFLUENZA

    CDC Influenza Update

    Key Updates for Week 17, ending May 1, 2021:

    Influenza-Associated Hospitalizations- The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in 14 states and represents approximately 9% of the U.S. population.

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths were reported to CDC during week 17. CDC External Link

    WHO Influenza Update

    29 March 2021, based on data up to 14 March 2021:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has 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 baseline, though sporadic detections of influenza A and B viruses continued to be reported in some countries.

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

    - In the Caribbean and Central American countries, no influenza detections were reported.

    - In tropical South America, no influenza but low levels of detection of other respiratory viruses (ORVs) were reported in some countries.

    - In tropical Africa, influenza activity was reported in some reporting countries in Western and Eastern Africa in recent weeks.

    - In Southern Asia, sporadic influenza detections were reported in India and Nepal.

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

    - Worldwide, influenza B detections accounted for the majority of the very low numbers of detections reported. WHO External Link

    VETERINARY/FOOD SAFETY

    Patient count grows in Salmonella outbreak linked to cashews in brie

    7 May- More people are sick in a Salmonella outbreak traced to Jule's brand cashew brie, according to an update today from the Centers for Disease Control and Prevention. Jule's recalled all of its products in April. As of today, seven people from three states have been confirmed with infections from Salmonella Duisburg and Salmonella Urbana. Three of the patients were so ill they had to be admitted to hospitals, the CDC reported. The sick people range in age from 23 to 72 years old. They live in California, Tennessee, and Florida. "The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses," according to the CDC update. "This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to determine if a sick person is part of an outbreak." The Food and Drug Administration reported the recalled brie products were distributed to primarily independently owned grocery stores in Arkansas, California, Colorado, Connecticut, Florida, Louisiana, Maryland, Minnesota, Nevada New York, New Jersey, Ohio, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas as well as direct to consumer. The recalled Jule's Foods Brie products are in 6-ounce packages and wrapped in white cheese paper. Food Safety News External Link

    Salmonella sickens 14 in Sweden; 40 sick in Danish outbreak

    8 May- Swedish authorities are investigating a Salmonella outbreak that has affected more than a dozen people in less than two weeks. From April 13 to 24, 14 people have been infected with Salmonella Braenderup in 10 different regions of the country. Whole genome sequencing has shown the patients to be linked, according to the Public Health Agency of Sweden (Folkhälsomyndigheten). People sick range from a few months old to 91 years of age and 10 are women. Infection control units, municipalities, the Swedish Food Agency (Livsmedelsverket) and the Public Health Agency of Sweden are investigating the outbreak. This involves interviewing patients to find out what they ate the week before falling ill, with the aim of identifying commonalities between them. The source of infection has not been identified but is suspected to be a food widely distributed in Sweden. Salmonella Braenderup entered the top 20 list of serovars causing confirmed infections in Europe in 2018 with 259 cases and was responsible for 300 infections in 2019. Food Safety News External Link 

    WELLNESS

    What to do if you're planning or attending a wedding during the pandemic

    10 May- They had the artsy, rustic venue, the tailored dress and a guest list including about 150 of their closest friends and family. But the pandemic had other plans, forcing Carly Chalmers and Mitchell Gauvin to make a difficult decision about their wedding -- twice. "Everything was changing," said Chalmers, a Toronto-based marketing manager whose nuptials were originally planned for May 2020, two months after her province's coronavirus lockdowns began. "In March 2020, it felt like every day something would happen that was kind of like another nail in the coffin for our wedding." The couple, who'd gotten engaged in 2018, quickly shifted gears, opting for a small wedding on their July dating anniversary in Chalmers' parents' backyard and rescheduling their big reception for May 2021. They ultimately canceled the latter, for good, in light of Ontario's recent Covid-19 case surge. "We just realized it wasn't going to be the day that we wanted," Chalmers added. "With travel restrictions and the (slow) vaccination rollout, we just knew that people wouldn't feel safe." Having to plan a wedding during normal times "is stressful enough," she added, but an additional burden was having "to worry like, 'Oh, somebody might get sick and die as a result of coming to my wedding." CNN External Link

    USAFRICOM

    South Africa reports 4 cases of India variant B.1.617.2

    8 May- In South Africa, the National Institute for Communicable Diseases (NICD) report sequencing COVID-19 specimens from individuals with a recent travel history to India. The institute can confirm that four of the specimens tested positive for B.1.617.2 (two cases from Gauteng and two from KwaZulu-Natal). The B.1.617.2 variant is currently highlighted as a variant of interest by the World Health Organization and is one of multiple variants circulating in India. All cases have been isolated and managed according to COVID-19 case management guidelines and contact tracing has been performed in order to limit the spread of this variant. As of Saturday, the cumulative number of COVID-19 cases identified in South Africa is 1,594,817, including 54,724 deaths. Outbreak News Today External Link

    USCENTCOM

    Saudi Arabia reports 8th MERS case of 2021

    8 May- The Saudi Arabia Ministry of Health reported this week a fatal case of Middle East respiratory syndrome coronavirus (MERS-CoV) in a 36-year-old male in Hafar Albatin city, Hafar Albatin. The deceased reportedly had contact with camels. This is the eighth MERS case of 2021 in the Kingdom and the 9th overall (one in the United Arab Emirates). Middle East respiratory syndrome coronavirus (MERS-CoV) is a virus transferred to humans from infected dromedary camels, according to the World Health Organization. It is a zoonotic virus, meaning it is transmitted between animals and people, and it is contractable through direct or indirect contact with infected animals. MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa and South Asia. In total, 27 countries have reported 2,590 cases since 2012, leading to 941 known deaths due to the infection and related complications. Outbreak News Today External Link 

    USEUCOM

    Sweden: 25% of blood donors in Stockholm test positive for SARS-CoV-2 antibodies

    9 May- The Swedish Public Health Agency said a study in early March on blood donors from eight regions in the country revealed up to 25 percent of donors in some regions had antibodies to SARS-CoV-2. The study showed that 22 percent of blood donors at the national level had antibodies. The incidence among blood donors was highest in the Stockholm region and in Västra Götaland with 25 percent and lowest in Västerbotten with 12 percent. These levels reflect a history of infection with covid-19 at least ten months back in time. But some groups have also received vaccines, even though we do not consider that it has any major significance for the results when it comes to blood donors in particular, says Karin Tegmark Wisell, head of department and deputy state epidemiologist at the Swedish Public Health Agency. This compares with a national level of 7 percent detected in December 2020. Outbreak News Today External Link

    USINDOPACOM

    China reports additional H9N2 avian influenza case in Guangdong Province

    8 May- The National Health Commission of the People's Republic of China reported one new case of human infection with avian influenza A(H9N2) during the last week of April. The case is a 30-year-old female from Huizhou, Guangdong Province. The case had onset of mild symptoms on 20 April 2021. To date, 12 cases of avian influenza A(H9N2) have been reported from China in 2021, and a total of 54 cases of human infection with avian influenza A(H9N2) have been reported in the Western Pacific Region since December 2015, according to WHO. In most human cases of H9N2 avian flu, the associated disease symptoms have been mild and there has been no evidence of human-to-human transmission. Influenza A(H9N2) viruses are enzootic in poultry populations in parts of Africa, Asia and the Middle East. Most human cases are exposed to the A(H9N2) virus through contact with infected poultry or contaminated environments. Human infection tends to result in mild clinical illness. Outbreak News Today External Link 

    USNORTHCOM

    U.S.: Indiana- Wild cottontail rabbits test positive for tularemia in Elkhart County

    8 May- Officials with the Indiana Department of Natural Resources recently learned from lab results that wild cottontail rabbit carcasses found on private land in Elkhart County near Middlebury tested positive for tularemia. While tularemia can be transmitted to humans, the Indiana Department of Health (IDOH) is not aware of any human cases of tularemia in the area at this time. "Seeing a local die-off of rabbits during a tularemia outbreak is not unusual," said Dr. Jennifer Brown, state public health veterinarian at IDOH. "You can prevent exposure to tularemia bacteria by wearing insect repellent and avoiding contact with sick or dead animals." According to the Indiana State Board of Animal Health (BOAH), pets are also susceptible to the bite of tick, flea or fly infected with tularemia. The bacteria can also be spread to pets by contact with water or soil that has been contaminated by an infected animal, by the bite from or consumption of an infected animal, or by the inhalation of contaminated particles. Among other signs of tularemia infection, dogs and cats may exhibit anorexia, fever, depression, enlarged lymph nodes and abscesses. If you suspect a pet has tularemia, contact a veterinarian. According to IDOH, if people contract tularemia, they can be treated with antibiotics. Residents of the Middlebury area should seek medical attention if they develop fever or respiratory symptoms within two weeks of potential exposure to sick or dead rabbits, tick bites, or aerosols of dust, or to soil or grasses from mowing, raking, plowing, or similar activities. Outbreak News Today  External Link

    USSOUTHCOM

    Trichinosis outbreak sickens more than 100 in Argentina, linked to chacinados

    9 May- Health officials in Argentina report that a trichinosis outbreak reported on April 27 has now affected 119 people in a number of cities and towns in Córdoba province. According to the information reported by different health centers in the province, the cases include 50 from Toledo, 23 from Lozada, 27 from Río Segundo and 19 from the city of Córdoba. All patients reported the consumption of chacinados (salami) without labeling, and they are being treated on an outpatient basis. Health officials warn about the risks of consuming or buying pork of doubtful origin or without the corresponding sanitary inspection, and remarked that the commercialization of meat or its derivatives from unauthorized establishments is totally prohibited. Trichinosis is a parasitic disease caused most commonly by the roundworm Trichinella spiralis. If someone ingests undercooked or raw meat with the encysted larvae, the stomach acid releases the larvae which mature to adults in the intestine. After about a week the female starts releasing larvae which enter the bloodstream and find their way to skeletal muscle where they encapsulate. There can be gastrointestinal symptoms mimicking acute food poisoning when there is activity of the adults in the intestine. Outbreak News Today External Link