Army Public Health Weekly Update, 15 October 2021

Date Published: 10/15/2021
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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


    2021 One Health Webinar

    Webinar Days is a scholarly sharing of ideas and innovations in the One Health space. This year's webinar will be held 3-4 November, 2021. This year's theme is One Health for a Bright Future: One Health Resiliency. This is a virtual event that will be held on Microsoft Teams, and registration is required. APHC


    Army meals undergo 'million dollar overhaul' to offer more healthy, dietary-specific choices

    6 October- Fort Knox offered a menu tasting event in Cantigny Dining Facility Oct. 5 as one of the final steps in implementing updates to Army dining that promises to provide more expansive food choices for Soldiers. One of the newest members of the Fort Knox dining facility team, Dana Womack said the new menu consists of a great deal more vegetarian and gluten-free items, nutritionally sound foods, and health-conscious preparation techniques. “As the new Food Program manager, my goal is to refocus nutrition in all installation Warrior Restaurants," said Womack. “This starts with reimagining the dining experience at Fort Knox to include quality, selection, presentation, training and infrastructure. “It's about giving every Soldier the opportunity to have access to optimum nutrition while taking their dietary needs into consideration." The new program is part of a million dollar overhaul to the existing “Go for Green" color coding system designed to show Soldiers which food options are healthiest, according to Womack. She said while it's not yet mandated Army-wide as it undergoes final changes, a number of installations have already implemented the new menus. The hope, according to Womack, is for Fort Knox to have these new changes fully rolled out by mid-November. Womack explained the items offered in this week's menu tasting had already been approved by the Joint Culinary Center of Excellence. However, each food and beverage now faces individual recommendations based on comment card responses. One Soldier in attendance said he was surprised how much he enjoyed many of the items offered at the tasting, including some of the plant-based and vegan options. “I definitely would get them once they're here," said Spc. Antonio Vazquez. “Now that we have a wider variety of things, I think you'll see a lot more people coming over to the DFAC." In addition to supplying Soldiers with nutritional options every day, Womack emphasized the important role future Cadet Summer Training will play in the dining transition at Fort Knox. The college students receive both a literal and figurative first taste of what it's like to eat as a Soldier. “These are the leaders, the commissioned officers of the future, so it's imperative that they are exposed to healthier food selections," said Womack. “The standard starts with them." Fort Knox Garrison Command Sgt. Maj. William Fogle also attended the menu tasting. He pointed out the program's success isn't going to just happen on its own. DVIDS External Link

    Fort Leonard Wood Soldiers assist in Army altitude study in New Mexico

    7 October- Forty-nine Soldiers from the 5th Engineer Battalion here spent four days at Taos Ski Valley, New Mexico, this past summer, hiking on and around Kachina Peak. While this might sound like an ideal summer vacation, the Soldiers were there for a more scientific reason. The Soldiers were taking part in an altitude study conducted by the United States Army Research Institute of Environmental Medicine. Dr. Beth Beidleman, a research physiologist with USARIEM and the principal investigator of the study, said the altitude study in Taos Ski Valley is part of the lab's effort to identify what physiologic and genomic factors put some individuals at higher risk of getting acute mountain sickness, or AMS. “Anyone who rapidly ascends to high altitude can experience AMS symptoms which can include headache, nausea, fatigue, poor sleep and loss of appetite," Beidleman said. AMS is an additional challenge for warfighters who are already facing life-and-death situations during missions, Beidleman added. “Symptoms can impact every aspect of a warfighter's performance," she said. “They won't be able to physically or mentally perform well." The data collected during the study is also being used to finalize an algorithm that can predict AMS in individuals prior to occurrence. “AMS-alert would be the first algorithm to predict individuals' AMS risk in real-time using physiologic monitoring," Beidleman said. “When implemented into a smartwatch or smart fabric, military leaders could use AMS-alert to identify warfighters at high risk of experiencing AMS at least four hours prior to occurrence." Beidleman said this would allow military leaders to intervene and prevent casualties and costly evacuations among Soldiers deployed to high altitudes. “Soldiers would be able to get the personalized care they need to perform to their full potential when deployed to high altitude," she said. While the time spent at Taos Ski Valley might have been the highlight of the study for the Soldiers involved, the journey began much earlier here. 1st Lt. Kyle Summers, a medical operations officer with the 5th Engineer Battalion, said the study started back in June when researchers collected baseline physiologic, cognitive, body fluid and sleep data. “For three days I had to wear a pulse oximeter. We would do blood draws, provide saliva and urine samples as well as take environmental and nutrition surveys," Summers said. External Link


    Doctors alerted to dangerous dry scooping workout trend

    8 October- Doctors are being warned about a dangerous pre-workout trend called dry scooping that some gym-goers are doing. It involves eating powder supplements neat, rather than diluting them in water, as recommended by manufacturers, to make a drink. Researchers, who are giving a talk at a US medical conference, are worried young teens may try it, spurred on by a flurry of internet videos of the fad. They scanned TikTok, counting the millions of likes. Doctors are being warned about a dangerous pre-workout trend called dry scooping that some gym-goers are doing. It involves eating powder supplements neat, rather than diluting them in water, as recommended by manufacturers, to make a drink. Researchers, who are giving a talk at a US medical conference, are worried young teens may try it, spurred on by a flurry of internet videos of the fad. They scanned TikTok, counting the millions of likes. BBC External Link 

    FDA allows e-Cigarettes, vape products to stay so people avoid excessive smoking; still a health risk

    12 October- The US Food and Drug Administration has allowed Vuse's vape and e-Cigarette products to stay on the market, despite initially gunning after all smoking alternatives for its health risks. This is to help people to avoid excessive tobacco smoking, but that does not mean that the FDA drops its case against these electrical products and the negative effects they bring. It was found that regular cigarettes and e-Cigarettes or Vapes have the same withdrawal symptoms and that they do not differ much from the negative effects they bring into a person's health. Any form of smoking has an effect on the body, and not many know that these devices still have nicotine in them, the known stimulant and addictive property in a regular cigarette. The US FDA has only allowed three products to be continued to stay in the market and has permits for the marketing of these electronic smoking products among the public. The focus of this new regulation is the RJ Reynolds (RJR) Vapor Company which are known for their e-Cigarette devices called "Vuse." Tech Times External Link

    Mask mouth does not exist, dentists say

    6 October- No, mask wearing won't ruin your teeth. Recently, there has been a lot of online chatter about "mask mouth" – an alleged condition that results from wearing a mask all day and causes tooth decay or gum disease, especially among children. But the American Academy of Pediatric Dentistry has "taken a position that current evidence does not support the notion of mask mouth," said Col. Thomas Stark, consultant to the Army Surgeon General for pediatric dentistry and an orofacial pain specialist at the U.S. Army Institute of Surgical Research at Joint Base San Antonio-Fort Sam Houston, Texas. "To date, there have not been any studies demonstrating a connection between mask use and tooth decay," Stark said. The truth is that people's dental routine and check-up schedules have been thrown off by the COVID-19 pandemic. That's why dentists may be seeing more cavities or other dental problems. Missing dental appointments can result in a host of infections requiring root canals, or inflammatory conditions such as gingivitis (bleeding gums). But any uptick in dental problems among children cannot be attributed to wearing masks at school, explained Army Maj. Matthew Eusterman, a pediatric dentist at Womack Army Medical Center at Fort Bragg, North Carolina. Any increase in cavities that dentists may be seeing, Eusterman said, is more likely attributed to other factors, such as:

    - The 2020 mandatory military dental clinic closures that delayed treatment for many kids

    - Families foregoing routine dental care for their kids during the recommended quarantines of the past 18 months

    - Kids spending more time at home may be snacking more often, meaning their exposure to cavity-causing foods may have increased

    - While spending more time at home, some families also may be brushing their teeth less often than the suggested American Dental Association guideline of at least twice a day after meals

    "Even if there is an increase in tooth decay since the pandemic started, we do not have the data to support a causal relationship with mask use," Stark said. Stark noted that wearing a mask all day is a long-standing practice in his field of medicine. "If a link between masks and cavities were to exist, dental personnel would certainly have an increased risk since we wear masks all day," he said. According to a March 2021 survey by the American Dental Association Health Policy Institute, there has not been a meaningful increase in oral conditions such as bad breath and dry mouth compared to pre-pandemic. External Link

    Studies confirm waning immunity from Pfizer's Covid-19 vaccine

    7 October- Two real-world studies published Wednesday confirm that the immune protection offered by two doses of Pfizer's Covid-19 vaccine drops off after two months or so, although protection against severe disease, hospitalization and death remains strong. The studies, from Israel and from Qatar and published in the New England Journal of Medicine, support arguments that even fully vaccinated people need to maintain precautions against infection. One study from Israel covered 4,800 health care workers and showed antibody levels wane rapidly after two doses of vaccine "especially among men, among persons 65 years of age or older, and among persons with immunosuppression." "We conducted this prospective longitudinal cohort study involving health care workers at Sheba Medical Center, a large tertiary medical center in Israel," Sheba's Dr. Gili Regev-Yochay and colleagues wrote. The researchers noted that levels of so-called neutralizing antibodies -- the immune system's first line of defense against infection -- correlate with protection against infection, but for this study they studied only antibody levels. "Published work about many vaccines, such as those against measles, mumps, and rubella, has shown a small decrease each year of 5 to 10% in the neutralizing antibody levels," they wrote. "We found that a significant and rapid decrease in humoral response to the BNT162b2 vaccine was observed within months after vaccination." CNN External Link

    U.S. FDA staff says Moderna did not meet all criteria for COVID-19 boosters

    13 October- Scientists at the U.S. Food and Drug Administration said on Tuesday that Moderna Inc. (MRNA.O) had not met all of the agency's criteria to support use of booster doses of its COVID-19 vaccine, possibly because the efficacy of the shot's first two doses has remained strong. FDA staff said in documents that data for Moderna's vaccine showed that a booster does increase protective antibodies, but the difference in antibody levels before and after the shot was not wide enough, particularly in those whose levels had remained high. The documents were released ahead of a meeting later this week of the FDA's outside expert advisers to discuss booster doses of the vaccine. The FDA typically follows the advice of its experts, but is not bound to do so. A panel of advisers to the U.S. Centers for Disease Control and Prevention (CDC) will meet next week to discuss specific recommendations on who can receive the boosters, if the FDA authorizes them. "There was boosting, sure. Was it enough boosting? Who knows? There's no standard amount of boosting that is known to be needed, and nor is it clear how much boosting happened in the study," John Moore, a professor of microbiology and immunology at Weill Cornell Medical College in New York, said in an email. Moderna is seeking authorization for a 50-microgram booster dose, half the strength of the original vaccine given in two shots about four weeks apart. The company has asked regulators to clear a third round of shots for adults aged 65 and over, as well as for high-risk individuals, similar to the authorization gained by rivals Pfizer Inc. (PFE.N) and German partner BioNTech for their mRNA vaccine. Reuters External Link

    U.S. task force proposes adults 60 and older should not take daily aspirin to prevent heart disease or stroke

    12 October- The US Preventive Services Task Force is considering making several changes to its guidance on taking a daily aspirin to prevent heart disease and stroke. On Tuesday, the task force posted a draft statement recommending that adults ages 40 to 59 who are at a higher risk for cardiovascular disease -- but do not have a history of the disease -- decide with their clinician whether to start taking aspirin, based on their individual circumstances. This is the first time the task force has recommended that adults in their 40s talk to their doctors about whether to take aspirin for heart health. The draft also says that adults 60 and older should not start taking aspirin to prevent heart disease and stroke because new evidence shows that potential harms cancel out the benefits, according to the task force. "The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended," Task Force member Dr. Chien-Wen Tseng said in a statement. "However, this Task Force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician." CNN External Link


    ​CDC: Weekly U.S. Influenza Surveillance Report

    2020-2021 Influenza Season for Week 39, ending October 2, 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. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2021, will not be included in FluSurv-NET. Data on patients admitted through April 30, 2021, will continue to be updated as additional information is received.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths were reported to CDC during week 39. CDC External Link


    Baby cereal sold at Walmart recalled because of excessive arsenic levels

    11 October- Maple Island Inc. is recalling three lots of its Parent's Choice Rice Baby Cereal that it manufactures for Walmart because of inorganic arsenic that tested above FDA guidance. This recall is a result of a routine sampling program by the FDA which discovered the problem. The products were distributed nationally through Walmart's stores and online. Walmart has pulled the product from its store shelves and put a register block on the product at its stores and online to prevent any further sales. The specific Parent's Choice Rice Baby Cereal 8 oz. lots being recalled were sold after April 5, 2021, and include:

    -Lot 21083 with UPC Code #00681131082907 with a best if used by date of JUN 24 2022.

    -Lot 21084 with UPC Code #00681131082907 with a best if used by date of JUN 25 2022.

    -Lot 21242 with UPC Code #00681131082907 with a best if used by date of NOV 30 2022.

    The best if used by date and product numbers can be found in the bottom left corner on the back of the Parent's Choice Rice Baby Cereal packaging. As of the posting of this recall, no illnesses related to the product lots have been reported. Customers who may have purchased any of the recalled products should discard the product or return it to Walmart for a full refund. Food Safety News External Link


    Blood clot symptoms to look out for

    9 October- In the United States, blood clots claim a life every six minutes.  While people of all ages can be affected, there's good news: With proper care, it's preventable. The risk of deep vein thrombosis (DVT), a clot in a deep vein, usually in the lower leg, thigh or pelvis, does increase with age. Clots can also occur in other parts of the body, such as the arm, and if one breaks off and travels through the bloodstream to the lungs, it can cause a pulmonary embolism (PE) – a blockage of arteries in the lungs. DVT and PE together are known as venous thromboembolism (VTE). which can cause serious illness, disability or death. As many as 100,000 people die from blood clots each year in the U.S., according to the U.S. Centers for Disease Control and Prevention, and VTE affects as many as 900,000 Americans each year. Fox News External Link


    Ebola in DR Congo: Africa CDC report

    10 October- On 8 October 2021, the Democratic Republic of Congo (DRC) Ministry of Public Health, Hygiene, and Prevention (MoH) reported a confirmed death of Ebola virus disease (EVD) in the Beni health zone, North Kivu province. This comes barely five months after the end of the most recent outbreak that was detected in the same province. The index case is a 3-year-old male, child who died on 6 October in a local health facility after presenting with hemorrhagic symptoms. Samples collected, tested positive for Ebola virus at the Goma reference laboratory. “We see this with great concern as we are going to fight against multiple disease outbreaks in DRC, including, cholera, monkeypox, yellow fever, meningitis and EVD, on top of the ongoing COVID-19 pandemic" said Dr. John Nkengasong, the Director of Africa CDC. Health teams decontaminated the affected health facility and 100 contacts have so far been identified. The provincial and zonal rapid response team have deployed to the affected area to conduct active case finding and identify additional contacts. In response to this new EVD case, the African Union Commission (AUC) has been informed of the outbreak and is ready to offer a comprehensive support of all AU organs. The Africa Centres for Disease Control and Prevention (Africa CDC)  has repurposed five (5) of the existing Africa CDC emergency response team of experts in Goma and Kinshasa to support the ongoing EVD response effort of the Government; and is working on deployment of additional technical assistance from the Headquarter. AUC/Africa CDC will continue to closely monitor the situation and will work with the Government of DRC to deploy more emergency response support team of experts, supplies and equipment as needed. Africa CDC will work closely with the World Health Organization (WHO) to coordinate and align emergency response activities across the region. Outbreak News Today External Link


    Northwest Syria COVID-19: 'The situation is dire and will prove catastrophic if not contained'

    5 October- The Union of Medical Care and Relief Organizations- USA (UOSSM) reports Northwest Syria is in a critical situation with the recent surge in COVID-19 cases. Since August 15, cases have risen at an alarming rate. The current positivity rate is lingering at around 55%. Hospital beds and ICUs are threatening to reach full capacity. Currently, there are only 173 ICU beds available throughout northwest Syria. This is further exacerbated by the shortage of PPEs, medical supplies and equipment, including oxygen. The gap in oxygen supplies is at about 40%. The situation is dire and will prove catastrophic if not contained. This comes at a time when there is a growing need for humanitarian assistance in northwest Syria. Between 2020 and 2021 the number of people in need has increased from 2.8 to 3.4 million people. Under current conditions, the effects of the COVID-19 pandemic on Northwest Syria will be devastating. Dr. Khaula Sawah, president of UOSSM USA said, “The situation is dire and deeply concerning and the results could be catastrophic with a high positivity rate, low vaccination rate and limited available ICU beds to treat the sick. In other countries, people have fought COVID-19 by staying home, social distancing, sanitizing their hands and wearing masks. When we ask the people of northwest Syria to stay home they have no home… we ask people to wear masks when there are no masks… We ask displaced and needy families to wash their hands where there is no water, and we ask people to social distance when they are living in crowded displacement camps. We call on the international community to take action by providing humanitarian and medical aid, increasing hospital capacity, and ensuring that people in northwest Syria get vaccinated to prevent a humanitarian disaster. Millions of lives are at stake.“ Outbreak News Today External Link


    Portugal achieves 85% complete vaccination, 1st country to reach target

    9 October- Portuguese health authorities report with the administration of about 15.3 million vaccines in mainland Portugal, the goal of having 85% of the population fully vaccinated against COVID-19 was achieved. Portugal becomes the first country in the world to reach the target of 85% of the vaccinated population, with around 8.4 million people having completed the complete vaccination schedule. The Director-General of Health, Graça Freitas, stated that October 9 was a “happy day", stressing that this goal was achieved by having given “an opportunity to everyone, without distinction from anyone, to be vaccinated". For Graça Freitas, overcoming that goal is “a pride" for the country, having highlighted, in statements to Lusa agency, that this was only achieved with the collaboration of the population of professionals involved in vaccination and the Task Force. The Ministry of Health said in a statement that, in relation to the adolescent population, between 12 and 17 years old, in mainland Portugal, it is estimated that around 88% have already started their vaccination scheme, and, of these, 83 % will already have full vaccination. “This important milestone was only possible thanks to the commitment and efforts of all health professionals and other entities involved in this vaccination campaign, including the armed forces, security forces and local authorities", he stressed. In the same communiqué, the Ministry of Health praises “the strong adhesion of the population to this vaccination campaign, an essential contribution for Portugal to reach the defined goals", concluding that “the Portuguese trusted in science, in vaccines and in their benefits". Outbreak News Today External Link


    Tokyo COVID-19: 49 cases reported, lowest daily total in 18 months

    11 October- The Tokyo Metropolitan Government reported 49 COVID-19 cases in the Japanese capital on Oct. 11, the lowest count this year and the third day in a row under 100. The last time Tokyo recorded under 50 cases in a day was on June 25 last year, when it marked 48 infections. The capital recorded 60 cases on Oct. 10. Since hitting a record 5,773 cases in Tokyo on Aug. 13, days after the closing of the Olympics, new infections across the country have declined sharply with the progress of vaccinations. In the first week of October, Tokyo saw an average of 154.3 new infections per day. The capital recorded 31,842 total coronavirus cases in September, for an average of 1,061.4 cases per day, down sharply from the 125,606 total infections — an average of 4,051.8 cases per day — tallied in August. By Oct. 10, 3,028 people had died of COVID-19 in Tokyo since the pandemic began in the spring of 2020. Tokyo has recorded 376,825 infections to date, the most among Japan's 47 prefectures. As of Oct. 10, there were 602 COVID-19 patients hospitalized in Tokyo, 67 with severe symptoms. With over 60 percent of the country's population fully vaccinated, the Japanese government lifted a state of emergency covering the capital and 18 prefectures on Oct. 1. Outbreak News Today External Link


    U.S.: Illinois- Binturong and a fishing cat test positive for SARS-CoV-2

    11 October- The United States Department of Agriculture's (USDA) National Veterinary Services Laboratories (NVSL) announced recently the confirmation of SARS-CoV-2 (the virus that causes COVID-19) in a binturong (bearcat) and a fishing cat at a zoo in Illinois. These are the first of either species confirmed with the SARS-CoV-2 virus in the United States. Samples from a variety of species at the zoo, including the binturong and fishing cat, were collected and tested after a tiger at the facility showed signs of the virus. SARS-CoV-2 infections have been reported in a small number of animal species worldwide, mostly in animals that had close contact with a person with COVID-19. At this time, routine testing of animals is not recommended. People with COVID-19 can spread the virus to animals during close contact. It is important for people with suspected or confirmed COVID-19 to avoid contact with pets and other animals to protect them from possible infection. Based on the information available, the risk of animals spreading the virus to people is considered to be low. Outbreak News Today External Link


    Dengue in Peru: Health emergency declared in 15 regions

    11 October- The Peru Minister of Health, Hernando Cevallos, announced Sunday the declaration of a health emergency in 15 regions of Peru due to an outbreak and imminent risk of a dengue outbreak. “Dengue is advancing, so the central level decided to declare 51 districts of the country in emergency, in addition to providing the necessary resources for the regional health directorates and care units to take the appropriate measures to protect the population", he noted. The legal norm establishes the declaration of emergency in 51 prioritized districts of the departments of Piura, San Martín, Loreto, Huánuco, Junín, Cajamarca, Cusco, Madre de Dios, Ayacucho, Lima, Amazonas, Ucayali, Pasco, Tumbes and Ica. The measure has a term of 90 days and will allow the prevention and control of this disease to be implemented. The National Center for Epidemiology, Prevention and Control of Diseases (CDC) of the Minsa reported that 36,200 cases of dengue were registered in 2021 to date, presenting an increase of 42.6 percent compared to the same period in 2020. The departments of Piura, Ica, San Martín, Loreto, Huánuco, Junín, Ucayali, Cajamarca, Amazonas and Madre de Dios account for 82.2 percent of cases nationwide. Health officials have also reported 27 dengue fatalities to date. Outbreak News Today External Link