Army Public Health Weekly Update, 18 December 2020

Date Published: 12/18/2020
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 8 January 2021. 

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


    COVID-19 Holiday Guidance

    To ensure we provide the most up-to-date information regarding the COVID-19 pandemic, the Military Health System created this all-inclusive information center, which is updated regularly. The Department of Defense is following guidance from the White House and coordinating with our interagency partners to provide a comprehensive, government-approved list of resources. External Link


    Frontline health care workers among first in DOD for COVID-19 vaccine

    15 December- U.S. military communities in Washington, D.C., San Diego, and San Antonio are among the first in the Department of Defense to receive the COVID-19 vaccine Dec. 14 as part of the DOD's initial distribution plan. Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland, started vaccinating select medical staff for COVID-19 Monday, with acting Secretary of Defense Christopher Miller on hand to witness the initial shots and receive one himself. "This is a very important day, not just for the Department of Defense, but for our nation," Miller said before getting his vaccination. Seven months after President Donald Trump announced Operation Warp Speed and the goal to deliver a vaccine by January 2021, "today ... the very first Americans are being inoculated by a safe and highly effective vaccine," Miller said. "Our service members, DOD civilians, and their families have demonstrated remarkable endurance and sacrifice throughout the pandemic," he added. "We know that our collective sacrifice would accelerate the path to a cure and save lives." Miller said that because of the DOD's precision logistics, "the first shipments of vaccines are arriving securely at hundreds of distribution sites around the country as we speak," he added. In addition to WRNMMC, Naval Medical Center San Diego in California and the Air Force's 59th Medical Wing in San Antonio, Texas, also received their first shipment Monday and expect to begin vaccinations Tuesday. These are the first of an initial 16 DOD sites to receive authorized COVID-19 vaccines as part of the DOD's phased approach to distribute and administer COVID-19 vaccines. Last week, the Pentagon outlined the DOD's plan to vaccinate its population of approximately 11.1 million.  "Our goal is to be transparent with the force about what is happening and to encourage our personnel to use the vaccine," said Pentagon Spokesman Jonathan Hoffman during a DOD press briefing last week with Assistant Secretary of Defense for Health Affairs Thomas McCaffery and Army Lt. Gen. Ronald Place, Defense Health Agency director. McCaffery and Place said the phased, standardized, and coordinated strategy for prioritizing, distributing, and administering COVID-19 vaccines was developed in collaboration with Operation Warp Speed, the Centers for Disease Control and Prevention (CDC), and the DOD's COVID Task Force assessment of unique mission requirements. It "will provide the COVID vaccine to DOD uniformed service members, both active and selective reserve components, including members of the National Guard, dependents, retirees, civilian employees, and select DOD contract personnel as authorized in accordance with DOD policy," added McCaffery. External Link

    Leaders, facilities throughout MHS honored with AMSUS awards

    11 December- The Society of Federal Health Professionals recently released their list of annual awardees. The awards highlighted outstanding leadership and facilities from throughout the Military Health System, spanning everything from excellence in leadership to safety, innovation and patient care. Assistant Secretary of Defense for Health Affairs Thomas McCaffery offered his congratulations to this year's recipients. "The MHS Awards are important because they recognize the men and women who carry out the MHS mission on a daily basis to ensure we have a ready medical force and a medically ready force," McCaffery said. "Their achievements are even more noteworthy during this pandemic. I commend their dedication to duty, professionalism, and innovative thinking during these unprecedented times. Their accomplishments improve our ability to effectively deliver high-quality health care to our warfighters, retirees and their families." External Link

    U.S. Army releases new Installations Strategy

    14 December- The Army released a new Installations Strategy today to guide future decision-making processes as Army installations transform into platforms that support multi-domain operations. The strategy outlines how every installation will be a "smart" platform of capabilities, utilizing connected sensors to enhance operational capacity and improve the delivery of services. The AIS mirrors the Army's priorities: people, readiness and modernization. Installations of the future will have modern facilities, services and safe operations with solutions to new requirements for protection, resilience, mission assurance, power projection, education and training. They will also have a focus on modernization and innovation, with expanded 5G backbone capability and innovations to modernize services, improve construction standards and find efficiencies. Future installations will continue to promote stewardship by caring for our natural and cultural resources through proactive programs in sustainability, remediation of contaminants and technology innovation. "The fence line is now the frontline and emerging trends require the Army to examine installations through a new lens," said the Honorable Alex A. Beehler, assistant secretary of the Army for Installations, Energy and Environment. "Installations are the platforms from which the Army builds culture, trains and projects power. The AIS addresses a range of emerging requirements related to multi-domain operations and the Army People and Modernization Strategies, and will harness the full capabilities of installations to help the Army compete, deter and win in an increasingly complex security environment." The National Defense Strategy calls upon the Department of Defense to transition to basing solutions that are smaller, dispersed, resilient and adaptive, and with a range of active and passive defenses. Additionally, the NDS states that, "The homeland is no longer a sanctuary." External Link

    Veterans who led on toxic exposure call defense bill passage a critical first step

    12 December- A massive defense bill passed by Congress on Friday includes provisions that would require government studies of military toxic exposure among fighter pilots and some of the first forces that deployed after the 9/11 attacks. Veterans see the approval of those provisions as a significant step that they hope will lead to a recognition by the U.S. government that their illnesses were tied to that service. The broader legislation faces a veto threat from President Donald Trump over other provisions, and veterans' advocates hope Congress will override any veto as they also begin working with the incoming Biden administration to keep this year's momentum on addressing toxic exposure going. The final version of the $740 billion fiscal year 2021 National Defense Authorization Act covers military pay and benefits and also funds warships, submarines, missiles and military aircraft. One provision would require government studies to determine whether veterans who served at a base in Karshi-Khanabad, Uzbekistan, or K2, after 9/11 developed illnesses from exposure to radiation, chemical weapons and other toxins that were in the ground. Another would require the Defense Department, working alongside the National Cancer Institute and National Institutes of Health, to conduct a study on whether military pilots face higher levels of cancer. "It's a victory for sure, because we now have legislation that codifies K2. It's official recognition by the U.S. government for the first time for K2 and Uzbekistan veterans," said retired Army Staff Sgt. Mark Jackson, a K2 veteran and cancer survivor. "It is a great start, having gone from nothing, and having no recognition whatsoever." External Link


    CDC reports uptick in child abuse-related hospitalizations amid pandemic

    12 December- Mounting stress, job losses, school closures, isolation and other factors have all compounded to raise the risk of child abuse and neglect amid the COVID-19 pandemic, according to the Centers for Disease Control and Prevention (CDC).  Earlier this spring, the medical community sounded the alarm that significantly fewer people were seeking emergency care for any cause, likely over fears of catching coronavirus infection.  In a report released Friday, the federal health agency said visits to the emergency department (ED) for reasons related to child abuse and neglect plummeted by 53% in early 2020 over the same period in 2019. The CDC said this mirrors an even greater drop-off in all ED visits among younger patients at around 71%-72%. However, related hospitalizations significantly increased. "Despite the ongoing pandemic, caregivers were more likely to take children to EDs for evaluation of complaints related to child abuse and neglect relative to other chief complaints. This pattern might reflect decreased health care–seeking for other medical complaints or a need to seek medical care because of persistence or worsening of child abuse and neglect," reads the report. Therefore, the CDC cited a "shift" in care-seeking patterns amid the pandemic, and the severity of child abuse-related injuries was just as severe, if not more so. "Child abuse is preventable; implementation of strategies including strengthening household economic supports and creating family-friendly work policies can reduce stress during difficult times and increase children's opportunities to thrive in safe, stable, and nurturing relationships and environments," the report continues. Fox News External Link

    Covid: 'Rash' Christmas rules 'will cost many lives'

    15 December- The plan to ease Covid rules over Christmas in the UK is a "rash decision" that will "cost many lives", two leading medical journals have said. The Health Service Journal and British Medical Journal said people might see the lifting of restrictions "as permission to drop their guard". Cabinet minister Michael Gove has held talks on the issue with leaders in Scotland, Northern Ireland and Wales. NI said scientific advisers would be consulted ahead of any decision. It comes after Labor called on ministers to hold an emergency review of the plans. Earlier, No 10 said the rules were "under constant review" but it still intended to allow families to meet up. The prime minister's spokesman said the government had been clear that people needed to "remain cautious and vigilant" during the five days of relaxed rules from 23 to 27 December. BBC News External Link

    Eosinophilic esophagitis treatment gains U.S. FDA review

    16 December- Takeda Pharmaceutical announced that the United States FDA has accepted the company's New Drug Application and granted Priority Review for the investigational therapy budesonide oral suspension, TAK-721, (Eohilia), which has been designed specifically for eosinophilic esophagitis (EoE). If approved, TAK-721 will be the first FDA-approved treatment for this chronic inflammatory disease that can cause damage the esophagus, impacting approximately one in 2,000 people in the U.S. The chronic inflammation of EoE can lead to a range of symptoms but most often results in difficulty swallowing. "Because food is so integral to our social lives and well-being, many facets of everyday life are impacted by the symptoms of EoE," said Karen Lasch, M.D., VP, Gastroenterology, U.S. Medical, Takeda, in a press statement issued on December 15, 2020. Precision Vaccinations External Link

    First-in-human study of coxsackievirus B vaccine candidate launches

    15 December- Prevention Bio, Inc. announced PROVENT initiation, a first-in-human study of its polyvalent inactivated coxsackievirus B (CVB) vaccine candidate, PRV-101. Prevention is developing PRV-101 to prevent acute CVB infection and the potential delay or prevention of type 1 diabetes (T1D) and celiac disease. CVB is a common, potentially serious infection that damages insulin-producing cells and gut-lining cells, triggering a T-cell immune response that is believed to cause autoimmunity in predisposed individuals. Francisco Leon, M.D., Ph.D., chief scientific officer, and co-founder, Prevention Bio, said in a press release: "We look forward to continuing to advance the development of PRV-101 to determine whether a common autoimmune disease can be delayed or prevented with a vaccine against an infectious trigger. If successful, PRV-101 has the potential to be the first vaccine to prevent CVB and could potentially decrease the incidence of T1D and celiac disease." Precision Vaccinations External Link

    Moderna vaccine safe and effective, say US experts

    15 December-Moderna's vaccine is safe and 94% effective, regulators say, clearing the way for US emergency authorization. The analysis by the Food and Drug Administration's (FDA) means it could become the second coronavirus vaccine to be allowed in the US. It comes one day after Americans across the country began receiving jabs of the Pfizer-BioNTech vaccine. The news comes as the US coronavirus death toll passes 300,000, according to Johns Hopkins University. Endorsement of the Moderna vaccine by FDA scientists was announced on Tuesday, two days before the vaccine panel meets to discuss emergency approval. The 54-page document said there were "no specific safety concerns" and that serious adverse reactions were rare. If approved by the team of experts later this week, and by the FDA's vaccine chief, shipments could begin within 24 hours. The FDA found a 94.1% efficacy rate out of a trial of 30,000 people, according to the document they released. BBC News External Link

    The COVID-19 vaccines rush: Participatory community engagement matters more than ever

    10 December- The announcement of effective and safe vaccines for COVID-19 has been greeted with enthusiasm. Discussions continue about the ethical challenges of ensuring fair access to COVID-19 vaccines within and across countries, and which groups should be prioritized. There are concerns about equity in access to COVID-19 vaccines. Estimates as of Dec 2, 2020, suggest direct purchase agreements have allowed high-income countries to secure nearly 4 billion confirmed COVID-19 vaccine doses, compared with 2·7 billion secured by upper and lower middle-income countries. Without such agreements, low-income countries would probably have to rely on COVAX, which would achieve only 20% vaccination coverage. States such as the UK, Russia, and Germany have promised or begun rapid access to vaccines, some early this month. While COVID-19 vaccines bring potential hope for a return to some kind of normality, vaccine-based protection is contingent on sufficient population coverage and requires effective governance, organizational, and logistical measures within a wider COVID-19 control strategy that includes continued surveillance and appropriate countermeasures. In this new phase of the COVID-19 response, successful vaccine roll-out will only be achieved by ensuring effective community engagement, building local vaccine acceptability and confidence, and overcoming cultural, socioeconomic, and political barriers that lead to mistrust and hinder uptake of vaccines. The Lancet External Link

    US Covid-19 vaccinations expected to begin Monday as CDC head gives final nod

    13 December- Vaccinations against Covid-19 can now begin in the United States. US Centers for Disease Control and Prevention Director Dr. Robert Redfield gave the final nod Sunday to the first coronavirus vaccine for the United States, clearing the way for shots to start. Redfield accepted the recommendation of the agency's Advisory Committee on Immunization Practices that Pfizer and BioNTech's Covid-19 vaccine may be given to people 16 and older. The first shots are expected to begin on Monday.  "This official CDC recommendation follows Friday's FDA decision to authorize the emergency use of Pfizer's vaccine. As COVID-19 cases continue to surge throughout the U.S., CDC's recommendation comes at a critical time," Redfield said in a statement. "Initial COVID-19 vaccination is set to start as early as Monday, and this is the next step in our efforts to protect Americans, reduce the impact of the COVID-19 pandemic, and help restore some normalcy to our lives and our country." The first freight trucks carrying approximately 184,275 vials of the vaccine departed Pfizer's facility in Kalamazoo, Michigan, on Sunday. "They will begin moving vaccine from the Pfizer manufacturing facility to the UPS and FedEx hubs, and then it will go out to the 636 locations nationwide, which were identified by the states and territories," Gen. Gustave Perna, chief operating officer of Operation Warp Speed, told a news conference Saturday. "We expect 145 sites across all the states to receive vaccine on Monday, another 425 sites on Tuesday, and the final 66 sites on Wednesday, which will complete the initial delivery of the Pfizer orders for vaccine," Perna added. CNN External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 49, ending December 5, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. A total of 61 laboratory-confirmed influenza-associated hospitalizations were reported by FluSurv-NET sites between October 1, 2020 and December 5, 2020 which is lower than average for this point in the season and comparable to counts seen at this point during the 2011-12 season. Hospitalization rates will be presented once case counts increase to a level that produces stable rates; in the interim, case counts will be reported each week.

    Influenza-Associated Pediatric Mortality: One influenza-associated pediatric death occurring during the 2020-2021 season was reported to CDC during week 49. This death was associated with an influenza B virus with no lineage determined and occurred during week 48 (the week ending November 28, 2020). A total of one influenza-associated pediatric death occurring during the 2020-2021 season has been reported to CDC. CDC External Link 

    WHO: Influenza update

    07 December 2020, based on data up to 22 November 2020:

    - 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 inter-seasonal levels, though sporadic detections of influenza A and B viruses were reported in some countries.

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

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

    - In tropical South America, there were no influenza detections in this reporting period.

    - In tropical Africa, influenza activity was reported in some countries of Western Africa.

    - In Southern Asia, influenza detections continued to be reported in Afghanistan and India.

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

    - Worldwide, influenza A and B viruses were detected in similar proportions. WHO External Link


    Sushi sold by Harris Teeter linked to more than 150 illnesses

    15 December- Cabarrus Health Alliance (CHA) and officials with the grocery chain Harris Teeter are investigating more than 150 reports of illness linked to AFC sushi purchased at two retail locations in North Carolina. As of Tuesday officials had not yet reported what pathogen might be involved. Those ill are experiencing symptoms of vomiting, diarrhea, fever, muscle aches and abdominal cramps. All have consumed sushi from the third-party AFC Sushi kiosk located within the two Harris Teeter stores between Nov. 13 and Nov. 19. Using loyalty card transaction data, Harris Teeter has identified and notified 429 households that purchased sushi products at the implicated locations in Concord, NC. An additional 107 sushi transactions occurred without the use of a loyalty card. "We are encouraging anyone who purchased sushi from the George w. Liles or the Concord Parkway Harris Teeter between Nov. 13 and Nov. 19, to throw away any purchased items or leftovers," said Chrystal Swinger, CHA Environmental Health Director. Anyone who ate sushi from one of the locations and developed symptoms of food poisoning should call Cabarrus Health Alliance – Environmental Health Department at 704-920-1207. Food Safety News External Link

    Washington dairy again pulls unpasteurized, raw milk for bacterial risk

    11 December- Cozy Vale Creamery of Tenino, WA, is advising consumers to throw out or return any of the dairy's retail raw milk and cream products with the best by dates of Dec. 12-14 through 12-23 because state tests showed E. coli contamination. The unpasteurized dairy products were bottled in a gallon, half-gallon, quart, and pint containers, were sold to customers, including retail stores, in Western Washington. The dairy had pathogen problems at least twice in 2017. "The advisory was initiated after routine sampling conducted by the Washington State Department of Agriculture (WSDA) revealed the presence of toxin-producing E. coli in retail raw cream dated Dec. 14. The pathogen was not detected in raw skim and whole milk products, however, all products were processed from the same milk. Cozy Vale Creamery and WSDA continue to work jointly to address the source of the problem," according to a statement from operators of Cozy Vale Creamery. Consumers with questions may contact the company at 360-481-4010. As of the company's posting of the alert no known illnesses had been linked to the unpasteurized, raw milk. Food Safety News External Link


    Some trainers tout HIIT as the best way to burn belly fat- Here's what science says

    15 December- Whether you consider a six-pack a goal or a beverage is beside the point when it comes to extra fat at your waistline. Abdominal adiposity — excess stomach fat — is associated with increased mortality risk, regardless of body mass index. But although the exercise community has long known that it's impossible to "spot train" to reduce inches anywhere on your body, some trainers have been touting high-intensity interval training (HIIT) as the best way to target stomach fat. The workout, which includes short bursts of intense work followed by short rest periods (think 30 seconds on, 30 seconds off), can take as little as 20 minutes. Before you start alternating burpees and jumping jacks with recovery intervals, however, let's look more closely at that claim. To understand HIIT's role in health and longevity, you need to first understand that all fat is not created equal. Two types of belly fat, subcutaneous fat and visceral fat, accumulate in your abdomen, but they look and act very differently. Subcutaneous fat is stored just underneath the skin, says Tom Holland, a Connecticut-based exercise physiologist and fitness consultant. It's visceral fat, however, that you should be concerned about. Nestled deeper in your abdomen, adjacent to your organs, it's "almost like an endocrine organ" that poses serious health risks, Holland says. Unlike belly fat, visceral fat is "metabolically active," says endocrinologist Reshmi Srinath, director of the Weight and Metabolism Management Program at Mount Sinai Hospital. It produces molecules known as adipokines that can increase inflammation in various organ systems. Such inflammation is associated with chronic conditions, such as insulin resistance, higher glucose levels, diabetes, heart disease and fatty liver disease. The Washington Post External Link


    Eliminate sleeping sickness before 2030: Sanofi supports WHO in commitment

    15 December- Sanofi has signed on December 10th a renewed partnership agreement with the World Health Organization (WHO), consolidating a 20-year collaboration to fight some of the most Neglected Tropical Diseases (NTDs) and supporting the WHO in its commitment to sustainably eliminate sleeping sickness before 2030. With this new 5-year commitment, Sanofi will provide a consistent financial support with US$ 25 million (US$ 5 million/year) dedicated to disease management, including screening of populations, disease awareness campaign, capacity building, as well as drug donation. This sustainable commitment is key to success to come to the end of NTDs. "Sanofi has been collaborating for 20 years with the World Health Organization in the fight against neglected tropical diseases (NTDs). The renewal of this collaboration today speaks volumes about our longstanding engagement in global health" indicated Paul Hudson, CEO Sanofi. "We also welcome the recent endorsement of the new NTDs roadmap by the World Health Assembly. Sanofi is committed to further contribute to the elimination of sleeping sickness, including advancing research and development for vulnerable communities exposed to the disease." "This decades-long collaboration exemplifies a successful public–private partnership that has created meaningful impact in several countries and has brought sleeping sickness closer to elimination," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. "In a world severely disrupted by the current pandemic, Sanofi's renewed commitment and support to end this disease will immensely benefit and improve the lives of marginalized populations." The partnership between Sanofi and the WHO started in 2001 to support the screening, control and treatment of sleeping sickness, one of the most Neglected Tropical Disease affecting for the most underserved populations of sub-Saharan African countries. For 20 years, thanks to a US$ 100 million financial support for the screening and control of patients as well as drug donations, the partnership has made it possible to reach impressive achievements. Outbreak News Today External Link


    UAE begins vaccination programme

    14 December- The United Arab Emirates (UAE) has begun a public vaccination programme against Covid-19 using the injection made by Chinese drugs giant Sinopharm. The scheme has been launched in the emirates' capital, Abu Dhabi, where at least 45 hospitals and clinics are participating, reports say. The programme makes the UAE one of the first countries to start widespread immunization. Residents in the capital can book an appointment through the local health services free of charge. The UAE has so far recorded more than 186,000 cases of the virus and 618 deaths, figures collated by Johns Hopkins University show. BBC News External Link


    SARS-CoV-2 in minks in Sweden not the same variant found in Denmark

    12 December- Swedish health officials, or Folkhalsomyndigheten report occasional genetic changes have been found in the virus SARS-CoV-2 in minks in Sweden, but it is not the same virus variant that has been noticed in minks with viruses in Denmark. In mid-October, it was discovered that the virus SARS-CoV-2, which causes covid-19 in humans, was found in minks on mink farms in Blekinge. The Swedish Public Health Agency and the Swedish Veterinary Institute (SVA), in collaboration with the Blekinge region, began monitoring the virus in mink for comparison with possible cases of covid-19 in humans. The monitoring consists of samples being collected from minks, from staff working in connection with minks and from people in the community where mink farms occur. If the SARS-CoV-2 virus is found in samples, the virus' genome is mapped. The purpose is to investigate the extent to which minks and personnel working with minks have been infected, and to monitor whether viruses spread from the mink farms to nearby communities. In addition, the monitoring aims to detect changes in the virus' genome (mutations) that can occur when the virus is spread among mink and from mink on to humans. Since the first report of SARS-CoV-2 in mink in mid-October, a total of 13 mink farms, all in Blekinge, have been shown to be infected. We have previously reported that a proportion of the staff who worked in connection with the mink farms were also infected with covid-19. It is not possible to show whether the staff infected the minks or vice versa. It is most likely that the staff initially infected the minks, but the infection may then have been transmitted from the minks to staff.  Experience from the Netherlands and Denmark indicates that the risk of infection from minks to humans in the vicinity of minks is high. The analysis of the viral genome made from mink in Blekinge can not say if this has happened in Sweden. Some genetic changes can be found in viruses in isolated cases of covid-19 in staff and from the minks on the farm where they work. The genetic changes found are not the same as those noticed in Denmark, but are changes that in several countries have been linked to mink. The changes are also found in viruses in humans in several different countries, completely independent of mink. These genetic changes have not given rise to any change in the disease picture in humans or that it is feared to affect the effect of vaccines. Spread of viruses with these genetic changes can not be seen in nearby communities. These genetic changes have not given rise to any change in the disease picture in humans or that it is feared to affect the effect of vaccines. Spread of viruses with these genetic changes can not be seen in nearby communities. These genetic changes have not given rise to any change in the disease picture in humans or that it is feared to affect the effect of vaccines. Spread of viruses with these genetic changes can not be seen in nearby communities. Outbreak News Today External Link 


    China reports H5N6 avian influenza death in Jiangsu Province

    12 December- Chinese health authorities report a human case of avian influenza A(H5N6) in a 81-year-old female farmer from Changzhou of Jiangsu Province. The individual had exposure to live chicken at home prior to developing symptoms on November 16. She was hospitalized and subsequently passed away on November 27. From 2014 to date, 25 human cases of avian influenza A(H5N6) have been reported by the Chinese health authorities. Avian influenza is caused by those influenza viruses that mainly affect birds and poultry, such as chickens or ducks. Clinical presentation of avian influenza in humans includes eye infection (conjunctivitis), flu-like symptoms (e.g. fever, cough, sore throat, muscle aches) or severe respiratory illness (e.g. chest infection). The incubation period ranges from 7 to 10 days. The more virulent forms can result in respiratory failure, multi-organ failure and even death. People mainly become infected with avian influenza virus through contact with infected birds and poultry (live or dead) or their droppings, or contact with contaminated environments (such as wet markets and live poultry markets). Human-to-human transmission is inefficient. People in close contact with poultry are more susceptible to contracting avian influenza. The elderly, children and people with chronic illness have a higher risk of developing complications such as bronchitis and chest infection. Outbreak News Today External Link

    Delhi hospital reports 13 cases of COVID-19-triggered mucormycosis

    15 December- Officials at the Sir Ganga Ram hospital in Delhi, India are reporting at least 13 cases of COVID-19-triggered mucormycosis, a serious but rare fungal infection, according to multiple local media reports. Times of India reports,  "In the last 15 days, we have seen 13 cases of COVID-19-triggered mucormycosis. Five have died. At least three patients have suffered vision and have had to undergo removal of the nose and jaw bone to prevent the spread of infection, Dr. Manish Munjal, senior ENT surgeon, said. "Usually, we see one to two cases of mucormycosis in a month," he added. In one case, a 32-year-old who had recovered from COVID-19 experienced a nagging left side nose obstruction, which rapidly became an eye swelling within two days, after which he reached out to the doctors. The left side of his face had become completely numb and he was brought to the hospital emergency in a partially disoriented and obtunded state, according to a Indian Express report. "His tests revealed the presence of steeply elevated sugar and infection levels, but even more deadlier, the presence of a killer rare fungus called Mucor, which was sampled from his nose debris. An MRI revealed that the infection had already destroyed a significant part of his left side sinuses, eye, upper jaw bone and muscles, and even had made passage into the brain," said Dr.Munjal. Low immunity in people recovering from COVID-19, either due to the infection or medications are being looked at as the cause of these unique cases. Outbreak News Today  External Link


    Mexico: Reports first Candida auris cases in Nuevo León hospital

    15 December- Mexico health authorities are reporting the first cases of the multi-drug resistant fungus, Candida auris, according a Saludiario report. The Ministry of Health (SSa) issued an alert due to the detection of at least 10 cases inside a hospital in Nuevo León. Although the name of the hospital has not been revealed, it is stated that the situation is under control and so far the affected patients are reported stable. The report notes the fungus was identified in patients hospitalized for COVID-19. In five cases it was detected in the bloodstream and in the rest in the urinary tract. There are also 34 other people classified as suspects and who remain under review. This report comes on the heels of the first reported case in Brazil. According to the alert of the Epidemiological and Sanitary Intelligence Unit (UIES) of the General Directorate of Epidemiology, the immediate instruction is that all the second and third level Hospital Epidemiological Surveillance Units in Mexico take preventive measures. The first cases of C. auris were detected in South Korea in 2009. Later, others were identified in India, the United States, the United Kingdom, Panama, Colombia, Venezuela, and Chile. In Mexico, cases have never been confirmed until now, which implies a new challenge in the field of health. Outbreak News Today  External Link

    U.S.: Louisville Zoo- Snow leopard tests positive for SARS-CoV-2

    13 December- The Louisville Zoo announced Friday that a snow leopard has tested positive for SARS-CoV-2, the virus that causes COVID-19 in humans. The affected animal is a 5-year-old female named NeeCee. The Zoo is awaiting confirmatory results of the other two male snow leopards – Kimti and Meru. All three cats are doing well with very mild symptoms, and the Zoo continues to monitor their health closely. All are expected to fully recover. It is suspected that they acquired the infection from an asymptomatic staff member, despite precautions taken by the zoo. In April, zoo keepers working with cats, non-human primates, bats and ferrets began wearing PPE when near the animals. All Zoo staff go through a health screening at the start of their day, stay at home if feeling unwell and are tested if symptoms of COVID-19 arise. The United States Department of Agriculture's (USDA) National Veterinary Services Laboratories (NVSL) says this is the first snow leopard in the United States to test positive for SARS-CoV-2. SARS-CoV-2 infections have been reported in a small number of animals worldwide, mostly in animals that had close contact with a person with COVID-19. At this time, routine testing of animals is not recommended, according to the USDA. To date, 58 Lions, tigers, mink, dogs and cats have tested positive by PCR at initial diagnosis and another 52 dogs and cats tested positive by antibody test. Outbreak News Today External Link


    Costa Rica COVID-19 cases top 150K, Vaccines to arrive in the first quarter of 2021

    12 December- The Ministry of Health announced Friday an additional 1,132 COVID-19 cases, bringing the country total to 150,947 confirmed cases. Of this total, 112,622 people have recovered and 1,895 deaths have been recorded. On Friday, Representatives of the Ministry of Health, the Costa Rican Social Security Fund and the National Emergency Commission recapitulated the progress of the country on the way to launch the vaccination campaign against COVID-19. "Costa Rica is acquiring high quality vaccines in terms of safety and efficacy, previously approved by strict regulatory agencies of the highest level of rigor worldwide," Vice Minister of Health, Pedro González said. Dr. González said to date, the Government of the Republic has signed three agreements for the purchase of vaccine: Pfizer-BioNTech (three million doses), AstraZeneca-Oxford (one million doses) and the COVAX initiative of the World Health Organization (two million doses). These six million doses, which are purchased through the National Emergency Commission, will protect three million people against SARS-CoV-2 (two doses per person). According to the bilateral agreements, the vaccines will begin to enter the country in the first quarter of next year. There is still no exact date for the delivery of the vaccines to the country. The health authorities explained that the six million doses that the country is acquiring will not arrive at the same time, so the vaccination will be deferred in the different months throughout the year 2021. Outbreak News Today External Link