Army Public Health Weekly Update, 18 March 2022

Date Published: 3/18/2022
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​​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command. 

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

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Table of Contents

    ANNOUNCEMENTS

    Army medics' exceed expectations' during inaugural exercise at Fort Lee

    14 March- Medical personnel from Kenner Army Health Clinic "exceeded expectations" while taking part in a first-time field training exercise here March 8-10. The FTX included urban rifle marksmanship, trauma scenarios, and the treatment and evacuation of casualties. "I was proud to see Kenner leaders bring this vision to reality and give our Soldiers a level of combat readiness training and team cohesiveness they have not previously experienced at this location," observed Lt. Col. M. Jordan Inman, KAHC commander, at the conclusion of the FTX. "It was great to see our experienced Soldiers coaching and teaching the young medics and techs, and to see the excitement resulting from this realistic readiness training at Fort Lee," he added. "I'm thankful for our great civilian teammates who continued to serve our patients like family while our Soldiers trained for their wartime missions." The vision for an event that allowed Soldiers to shoot, move, communicate and perform field medical skills was born during Army Medical Command's Semi-Annual Training Briefs conducted late last year. Kenner's Senior Enlisted Advisor, Master Sgt. Ryan F. O'Connell, and Medical Company Commander Capt. Javier Colon developed the idea to build on experiences and lessons learned while leading weapons ranges and medical training over the previous 18 months. Over that time, the medical company developed internal capabilities including certified range safety officers, ammo handlers, and tactical vehicle drivers to enable the unit to conduct the range solely with Kenner Soldiers. Leaders also spent significant effort training and validating range safeties for Urban Rifle Marksmanship to mitigate risk of the increased complexity of the reflexive fire scenarios. Integrating medical skills training with marksmanship scenarios tied the whole event together. "Planning for the FTX took about six months," Colon said. "Noncommissioned officers from across Kenner were selected to lead portions of the training. They developed the plan and continued refining it into the finished product, which incorporated individual critical tasks for Soldiers of each MOS and AOC at Kenner." DVIDS External Link

    U.S. MILITARY

    Commands are deferring alcohol treatment for troops in need: IG report

    14 March- Troops who have been referred for alcohol abuse treatment are not getting the care they need because of command deferrals, according to a Defense Department inspector general report published Monday. There were a few reasons for this, according to an audit. Some commanders thought the requirements for getting a service member into treatment were unclear; some treatment centers were understaffed or didn't have enough spots; and some commanders put off getting their troops into treatment because of “operational requirements, legal actions, or other reasons." “According to the medical records we reviewed and unit leadership we interviewed, leadership encouraged service members to self‑refer instead of submitting a command referral following an alcohol‑related incident or suspected alcohol misuse," DoD IG spokesman Megan Reed said in a statement. There was a reason behind it, she added, though in practice it amounted to passing the buck. “Personnel from a substance abuse center stated that there is stigma associated with the overall substance abuse program and there is a belief that service members will be more motivated to change and receive treatment if they self‑refer before a command or medical referral forces them to seek help," she said. “However, the substance abuse personnel stated that when left to the Service members to self‑refer, the Service members do not always choose to go to the substance abuse center." Army Times External Link

    COVID-19 responses underscore importance of patient safety

    14 March- Leaders across the Military Health System have to support patient safety in their everyday actions. This develops trust, and allows anyone who might identify patient safety concerns to speak up, including health care professionals, non-clinical staff, patients, and their families. And while every day is a patient safety day, a unique spotlight shines on this issue during Patient Safety Awareness Week, an international education and awareness-building campaign at the local level. "It's Important to take this additional time to focus on patient safety and being resilient in our daily practices," said Heidi King, chief of the DOD Patient Safety Program (PSP) within the Defense Health Agency. The theme for this year's Patient Safety Awareness Week, March 13-19, is "Standardizing Safety Solutions: Uniting for Ready, Reliable Care." The MHS introduced the Ready Reliable Care (RRC) approach in 2021 as an extension of the High Reliability Organization (HRO) concepts. The MHS adopted HRO concepts to improve health care access, quality, transparency, and patient engagement. An HRO standardizes patient safety practices and policies to reduce patient harm, as well as to encourage openness in communications with patients and their families. "We've learned from Army, Navy, and Air Force HRO advancements, and DHA has embraced the Ready Reliable Care approach in both clinical and non-clinical settings," King explained. Patient safety is paramount in all aspects of health care delivery. "Standardization of safe care practices plays a key role in this effort," King said, and MHS partners with internal and external stakeholders, and beneficiaries to share lessons learned, leading practices and other improvement opportunities, she noted. Health.mil External Link

    Data registry helps improve research and treatment for eye injuries

    14 March- The Defense Health Agency is expanding its capability for researching and treating eye injuries and vision problems to improve care for service members and veterans. Recent enhancements to the Defense and Veterans Eye Injury and Vision Registry Defense and Veterans Eye Injury and Vision Registry website, known as DVEIVR, are giving doctors and researchers new insights into ocular injuries and outcomes across the departments of Defense and Veterans Affairs. "DVEIVR transforms data into useful information and, ultimately, practical knowledge that can be applied at the user level for tangible clinical impacts," said Army Colonel Scott McClellan, Defense Health Agency Vision Center of Excellence branch chief in Silver Spring, Maryland. The registry is a managed clinical health tool overseen by VCE to provide the DOD/VA vision care community and, with appropriate agreements in place, academic eye care professionals with unique clinical ocular and vision-related data. Established in 2011 by congressional mandate, newly added components in the registry offer helpful context and supplemental information for doctors and researchers. "The value of DVEIVR in practice is related to the source of the data, which are medical records," said Dr. David Eliason, deputy chief for the VCE and a practicing ophthalmologist. "It's not just how the eye injury is coded [medically] but it has the doctor's note itself, so it's clinically relevant in that way. "Long-term research may be especially valuable. As the U.S. military conducts fewer combat operations overseas, there are fewer combat injuries, but the VA continues to provide follow-on care for veterans injured years ago, Eliason said. "I'm very much interested in the long-term disposition of these patients, 10 to 12 years post-injury. The registry data help us to determine who is going to the VA and who doesn't know about VA programs for eye injury follow-on care." Health.mil External Link

    GLOBAL

    Alternative sweeteners in your drinks can help with weight and diabetes risk, study says

    14 March- In our soda, tea, coffee and juice: We like to drink sugar. Americans eat about 60 pounds (27 kilograms) of sugar annually on average -- and almost half of that comes from drinks, according to the American Heart Association. For people who are at risk for or have diabetes, drinks sweetened without sugar may help, according to a study published Monday. In a meta-analysis published in JAMA Network Open, researchers found replacing sugar-sweetened beverages with low- or no-calorie sweetened beverages (called "LNCSB" by nutrition professionals) was associated with small reductions in weight and cardiometabolic risk factors, the study said. "Universally, everyone is recommending a reduction of sugar," said senior study author Dr. John Sievenpiper. "Now the next question is: What's the best way to replace it? "Some beverages will give you that intended benefit and in a way that's similar to what you would expect from water," said Sievenpiper, consultant physician at St. Michael's Hospital and associate professor in the department of nutritional sciences at the University of Toronto. CNN External Link

    Domestic violence brain injuries likely outnumber head trauma from football players

    14 March- Domestic violence victims likely suffer a higher rate of brain trauma than football players and soldiers, but the exact number is unknown because many of these injuries, which overwhelmingly occur in women, are never diagnosed, according to the New York Times. "People might think, someone smacked her in the head or pushed her, no big deal," says Dr. Eve M. Valera, associate professor of psychiatry at Harvard University and a leading expert on traumatic brain injuries among domestic violence survivors. In 1990, Dr. Gareth Roberts evaluated the brain of a 76-year-old woman who died after years of abuse from her husband who was reported to have become 'demented' in her final years, according to the news outlet. But he discovered on autopsy that her brain was similar to those patients with Alzheimer's and compatible "to a degree" with boxers who suffered from chronic traumatic encephalopathy, and the case became the first connection in the literature between neurogenerative disease and abused women, according to the Times. Intimate partner violence (IPV) includes physical, sexual or psychological abuse in a romantic relationship that approximately one in four women or one in 10 men have experienced as sexual or physical violence and/or stalking during their lifetime, according to the Centers for Disease Control and Prevention. Strangulation is defined as the external obstruction of blood vessels and/or airflow in the neck resulting in loss of oxygen, according to The Training Institute on Strangulation Prevention. Fox News External Link

    Pfizer pushes for 4th COVID-19 vaccine dose: Is this for life after the pandemic?

    15 March- Pfizer is gearing up for its new COVID-19 Vaccine, and it aims to push for a fourth dose for the public's immunization needs. The new dose protects the body further against the virus, and it focuses on protection as the world transitions to looser restrictions and dropping face mask mandates.  It may be something that will help for life after the pandemic. According to an interview with Pfizer's executive, Albert Bourla, the company is pushing a new shot for the public against the COVID-19 virus. The focus is a fourth dose that will add another layer of protection that will address the many variants and effects of the coronavirus, especially now that the public is transitioning to drop the mask needs. Complex reported that Pfizer intends to bring another dose of the virus, and it follows the booster shot that the company released in the past year. The new dose will be the booster of the booster, and it may be the one to seal the deal to protect against the virus. The public is still vulnerable to infection from COVID-19, but the vaccines may help avoid its strenuous effect on the body. Tech Times External Link

    Three mRNA HIV vaccine candidates launch clinical trial

    15 March- The Maryland-based National Institute of Allergy and Infectious Diseases (NIAID) announced it launched an early-stage Phase 1 study evaluating three experimental HIV vaccines based on a messenger RNA (mRNA) platform. The NIAID confirmed on March 14, 2022, it is sponsoring the HVTN 302 study, and the NIAID-funded HIV Vaccine Trials Network (HVTN), based at Fred Hutchinson Cancer Research Center in Seattle, WA, is conducting the trial. The specific mRNA sequences contained in the vaccines were designed and developed by investigators at the NIAID-funded Scripps Consortium for HIV/AIDS Vaccine Development at the Scripps Research Institute and the Bill & Melinda Gates Foundation-funded IAVI Neutralizing Antibody Center at Scripps, in collaboration with scientists at Cambridge, Massachusetts-based Moderna, Inc. Moderna manufactured the investigational vaccines through an NIAID-supported contract. "Finding an HIV vaccine has proven to be a daunting scientific challenge," said Anthony S. Fauci, M.D. NIAID director, in a related press release. "With the success of safe and highly effective COVID-19 vaccines, we have an exciting opportunity to learn whether mRNA technology can achieve similar results against HIV infection." Precision Vaccinations External Link

    Using melatonin for sleep is on the rise, study says, despite potential health harms

    14 March- More and more adults are taking over-the-counter melatonin to get to sleep, and some of them may be using it at dangerously high levels, a new study has found. While overall use among the United States adult population is still "relatively low," the study does "document a significant many-fold increase in melatonin use in the past few years," said sleep specialist Rebecca Robbins, an instructor in the division of sleep medicine for Harvard Medical School, who was not involved in the study. The study, published Tuesday in the medical journal JAMA, found that by 2018 Americans were taking more than twice the amount of melatonin they took a decade earlier. Melatonin has been linked to headache, dizziness, nausea, stomach cramps, drowsiness, confusion or disorientation, irritability and mild anxiety, depression and tremors, as well as abnormally low blood pressure. It can also interact with common medications and trigger allergies. While short term use for jet lag, shift workers and people who have trouble falling asleep appears to be safe, long-term safety is unknown, according to the National Center for Complementary and Integrative Health at the National Institutes of Health. Experts worry that the pandemic's negative impact on sleep may have further increased the public's reliance on any type of prescription and over-the-counter sleeping aid, Robbins said. "In an associational study we found that older adults who reported frequent use - every night or most nights - of a sleep aid (over the counter or prescription) had a higher risk of incident dementia and early mortality," she said. CNN External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 9, ending March 5, 2022:

    -Influenza activity is increasing in most of the country.

    -The highest influenza percent positivity levels were seen in states in the central and south-central regions of the country.

    -The majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus. Antigenic data show that the majority of the H3N2 viruses characterized are antigenically different from the vaccine reference viruses. While the number of B/Victoria viruses circulating this season is small, the majority of the B/Victoria viruses characterized are antigenically similar to the vaccine reference virus.

    -The percentage of outpatient visits due to respiratory illness increased slightly this week but is still below baseline. Influenza is contributing to levels of respiratory illness, but other respiratory viruses are also circulating. The relative contribution of influenza varies by location.

    -The number of hospital admissions reported to HHS Protect has increased each week for the past five weeks.

    -The cumulative hospitalization rate in the FluSurv-NET system is higher than the rate for the entire 2020-2021 season, but lower than the rate seen at this time during the four seasons preceding the COVID-19 pandemic.

    -Two influenza-associated pediatric deaths were reported this week. There have been 10 pediatric deaths reported this season.

    -CDC estimates that, so far this season, there have been at least 2.7 million flu illnesses, 26,000 hospitalizations, and 1,500 deaths from flu.

    -An annual flu vaccine is the best way to protect against flu. Vaccination can prevent serious outcomes in people who get vaccinated but still get sick. CDC continues to recommend that everyone ages 6 months and older get a flu vaccine as long as flu activity continues.

    -Flu vaccines are available at many different locations, including pharmacies and health departments. Visit www.vaccines.gov to find a flu vaccine near you.

    -There are also flu antiviral drugs that can be used to treat flu illness. CDC External Link

    DLA flu vaccine program attributes success to battle rhythm, partnerships

    15 March- Thanks to early action and teamwork between Defense Logistics Agency partners, three contracts totaling 3.4 million doses of the influenza vaccine were awarded Feb. 25, meaning DLA will start receiving shipments of the inoculations in August, well ahead of the 2022-2023 flu season. The awards went to three vendors with a total maximum value of $70.4 million and will satisfy the needs of warfighters and eligible dependents around the globe. This year's award timeline is similar to the 2021-2022 season, including an earlier contract award date that prior years and a steady “battle rhythm" of communication and collaboration with distribution partners, said DLA Troop Support Pharmaceutical Manufacturer and Distributor Division Chief Alex Quinones. Quinones attributed a large part of the success to an earlier timeline for the acquisition process, also used last year, to produce what he called “the most successful season" he's seen. “The key to all of it was teamwork," Quinones said. “All the feedback that I got from the [DLA Troop Support Medical] team and the comments from the customers – DHA and the [military] services … they all called it a successful season." The contracts guarantee a total minimum value of $35.3 million across three vendors – Sanofi, GlaxoSmithKline and Seqirus – to ensure Defense Health Agency facilities around the world will have the vaccines in-hand prior to the onset of the flu season. It also gives DLA the flexibility to support emerging requirements such as the 2021 Afghan Medical support mission, Quinones said. “When the Afghan [support] mission came up, we were able to 'piggyback' off [the 2021-2022 flu contracts] thanks to the early, multiple awards," he said. “It allowed a much faster response than a new contract solicitation would have taken by several weeks and stayed within the contracts' maximum values.". The other big key to success was good communication and collaboration with DLA Distribution and commercial carriers in making sure the vaccines got to their destinations safely and on time despite COVID-19 impacts on the nation's distribution networks. “The COVID-19 mission was going on simultaneously with the flu mission … and tied into the Christmas season. They call it the Santa Rush – [commercial carriers] just got bombarded," DLA Distribution Seasonal Influenza Program Manager Domon Barr said. DLA.mil External Link

    VETERINARY/FOOD SAFETY

    Cheese recalled because of link to Listeria infections

    11 March- A type of cheese linked to two cases of listeriosis has been recalled in New Zealand. Officials said there have been two reports of illness which could be associated with the product but a concrete link has not been confirmed. Gopals Sweets and Snacks recalled all batches and dates of its Gopala brand Paneer up to and including best before May 5, 2022. Vincent Arbuckle, New Zealand Food Safety deputy director general, said Listeria's long incubation period made it difficult to establish a definitive link between the sick people and the product. “However, because of the detection of Listeria in specific batches, we support the recall, and advise anyone who has bought paneer recently to take the precaution of checking the product date mark to see if it is affected," he said. The two illnesses, one that is pregnancy associated, were reported in December 2021 and January 2022. Testing found samples from patients were closely related, which means it is likely their infections came from the same source. Isolates from the cases were of a rare sequence type in New Zealand. Both sick people consumed high-risk foods, including a common brand of paneer cheese. Gopala brand Paneer is available in various weights between 300-grams and 1-kilogram in plastic packages. It was sold in supermarkets such as Foodstuffs and Countdown and ethnic grocery stores throughout New Zealand. The Ministry for Primary Industries (MPI) advised consumers that affected product needs to be cooked thoroughly and should not be consumed raw. Officials added that if people were in any doubt, they should throw the item out or return it to the place of purchase. Food Safety News External Link

    WELLNESS

    Sleeping with even a small amount of light may harm your health, study says

    14 March- Sleeping for only one night with a dim light, such as a TV set with the sound off, raised the blood sugar and heart rate of healthy young people participating in a sleep lab experiment, a new study found. The dim light entered the eyelids and disrupted sleep despite the fact that participants slept with their eyes closed, said study author Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine. Heart rate typically drops at night, slowing down as the brain is busy repairing and rejuvenating the body. An elevated heart rate at night has been shown in numerous studies to be a risk factor for future heart disease and early death. High blood sugar levels are a sign of insulin resistance, where the body stops using glucose properly and the pancreas goes into overdrive, flooding the body with extra insulin to overcompensate until it eventually loses its ability to do so. Over time, insulin resistance can ultimately lead to Type 2 diabetes. CNN External Link

    USAFRICOM

    Kenya: Dengue outbreak in Mombasa and Mandera, Chikungunya in Wajir County

    13 March- The World Health Organization (WHO) reports outbreaks of dengue fever and chikungunya in Kenya. The outbreak has been reported in two Counties Mombasa and Mandera. The cases are spread from 2021 in both Counties. In Mandera the reported cases are from Mandera east sub county while in Mombasa, six subcounties (Nyali, Mvita, Kisauni, Nyali, Liikoni and Jomvu) have been affected. As of 23 February 2022, a total of 2,359 cases with two deaths have been reported. Outbreak News Today External Link

    USCENTCOM

    Afghanistan measles outbreak affects nearly 16K children this year to date: Media report

    13 March- In a follow-up on the measles outbreak in Afghanistan, the Ministry of Public Health of the Islamic Emirate of Afghanistan reports measles has spread in several provinces of Afghanistan and infected 15,900 children since the beginning of 2022, according to a Khaama Press report. Officials also note measles has taken the lives of 124 children. The ministry has said that most of the children have lost lives in the Afghan capital Kabul, Helmand, and Kunduz provinces while most cases of measles have been recorded in Jawzjan, Ghor, and Kunduz provinces. Measles Facts:

    The measles virus is in the paramyxovirus family and normally grows in the back of the throat and lungs. Measles is a human disease and is not known to occur in animals. Measles is one of the leading causes of death among young children even though a safe vaccine is available. After getting the virus, the patient does not show any symptoms for two to three weeks. However, the infected patient can infect others four days before showing a rash and four days after the rash. Two doses of the vaccine are recommended to ensure immunity Severe measles is more likely among poorly nourished young children, especially those with vitamin A insufficiency, or whose immune systems have been weakened. Outbreak News Today External Link

    USEUCOM

    Sweden: Confirmed cases of COVID-19 continue to decrease

    12 March- New statistics show that the spread of infection in Sweden continues to decrease. There are also fewer people cared for with COVID-19 in the country's intensive care units. The Public Health Agency's updated statistics show that the number of confirmed cases of COVID-19 decreased by 29 percent in the country during the past week, but there are differences at local and regional level. Of those sampled, 26 percent were positive. The number of new admissions to the intensive care unit also continued to decrease. During the previous week, 24 newly admitted people have been reported so far, compared with an average of 55 in the previous three weeks. The declining spread of infection follows developments in Europe. We see a clear downward trend for the spread of infection in Sweden. At the same time, the dark figure is greater than before, as testing has decreased. It is now concentrated on health care and elderly care, where it is judged to do the most good to reduce the risks of further spread of infection and protect the most fragile groups from serious illness and death, says department head Britta Björkholm. Statistics also show that the number of confirmed cases of covid-19 decreased by 17 percent during the past week among people living in special housing for the elderly and those who have home care. But the infection is not gone, it is still important to stay home in case of symptoms and to follow the recommendations in health and care, including for visitors. Outbreak News Today External Link

    USINDOPACOM

    Taiwan reports 1st hantavirus case of 2022

    15 March- The Taiwan Centers for Disease Control and Prevention (CDC) reported the first case of hantavirus syndrome in the country this year in a male in his 40s in the north. The case developed muscle soreness, fever, chills and other symptoms on February 12. On February 14, because the symptoms did not improve, he went to the hospital for medical treatment and was admitted to hospital. The health unit has gone to the surrounding of the case's residence and workplace to carry out epidemic investigation, environmental disinfection, placement of mouse cages, and public health education and other prevention and control work. The Centers for Disease Control and Prevention stated that Hantavirus syndrome is a zoonotic infectious disease. Humans are at risk of infection by inhaling or contacting dust and objects contaminated by rat feces and urine, or by being bitten by rodents with the virus. The incubation period of hantavirus hemorrhagic fever is several days to two months. The main symptoms are sudden and persistent fever, conjunctival hyperemia, weakness, back pain, headache, abdominal pain, anorexia, vomiting, etc. Hemorrhagic symptoms appear on the 3rd to 6th day , followed by proteinuria, hypotension or oliguria, and some patients will develop shock or mild nephropathy, and may progress to acute renal failure, which can be improved after treatment. Outbreak News Today External Link

    USNORTHCOM

    U.S.: California- Legionnaires' disease cluster investigated in Coachella Valley

    15 March- Riverside University Health System-Public Health is investigating a cluster of Legionnaires' disease in Palm Springs, Palm Desert and some surrounding communities stretching back months. Health officials are aware of 20 confirmed cases of which 14 individuals were hospitalized. Two deaths were reported: one resident of Riverside County and the other a visitor to the area. The cases were reported to Public Health between the Fall of 2021 and early 2022. Public Health is coordinating investigative activities with the California Department of Public Health (CDPH) and Centers for Disease Control and Prevention (CDC). The source of the illness and extent of spread has not been determined, but health officials said it was important for the public to be aware of the outbreak. “This is a continuing investigation. The risk to anyone who lives in Palm Springs, Palm Desert, and surrounding areas is low," said Dr. Geoffrey Leung, public health officer for Riverside County. “The Department recommends that individuals who live in the identified areas who become ill with pneumonia like/respiratory symptoms, such as fever, chills, cough, shortness of breath, muscle aches, and headache, visit their healthcare provider." Outbreak News Today External Link

    USSOUTHCOM

    Cuba: Oral Polio Vaccination Campaign begins Monday

    13 March- The “61st National Oral Polio Vaccination Campaign" begins next Monday, March 14, in Cuba. All children from one month of age and up to two years, 11 months and 29 days of age, in both stages, will be vaccinated. In addition, all nine-year-old children will be reactivated with a dose of oral polio vaccine. The first stage of the campaign will take place between Monday, March 14 and Saturday, March 19, 2022, with a make-up week from March 21 to 26 for children who could not be vaccinated in the scheduled week. The second stage will run between Monday 16 and Saturday 21 May. The recovery week is scheduled to take place between May 23 and 28. The polio vaccination campaign will be carried out simultaneously throughout the national territory. Outbreak News Today External Link