Army Public Health Weekly Update,19 August 2022

Date Published: 8/19/2022
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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

    CDC ends recommendations for social distancing and quarantine for Covid-19 control, no longer recommends test-to-stay in schools​

    11 August- The US Centers for Disease Control and Prevention says the nation should move away from restrictive measures such as quarantines and social distancing and focus on reducing severe disease from Covid-19. In new guidelines released Thursday, the agency no longer recommends staying at least 6 feet away from other people to reduce the risk of exposure -- a shift from guidance that had been in place since the early days of the pandemic. The shift is a sign of how much has changed since the beginning of the pandemic more than two years ago. Nearly the entire US population has at least some immunity through vaccination, previous infection or, in some cases, both. "The current conditions of this pandemic are very different from those of the last two years," Greta Massetti, who leads the Field Epidemiology and Prevention Branch at the CDC, said Thursday. CNN ​External Link

    U.S. MILITARY

    Telemedicine privilege by proxy expands access to MHS care

    10 August- Part of putting patients at the center of everything we do is ensuring patients can quickly access high-quality care – particularly specialty care – wherever they happen to be. Virtual health is central to increasing timely access to care, which is why the MHS has Telemedicine Privilege by Proxy. This fast, efficient process that enables providers to file one application and get permission to virtually treat patients anywhere in the Military Health System. Telemedicine Privilege by Proxy plays a crucial role in meeting one of the MHS's biggest clinical needs: expanding access to limited specialty-care resources across the enterprise, especially to small, remote locations. The single, centralized process has also made it up to 30 times faster for providers to get permission to deliver care virtually at military hospitals and clinics. It only takes three to five days, down from 90 days or more. The MHS's Telemedicine Privilege by Proxy is a force multiplier that saves time, improves processes, and removes barriers to care for those we serve. By facilitating virtual health across state and federal jurisdictions, the process is an invaluable tool to increase military readiness, improve access, improve outcomes, and lower costs. Telemedicine Privilege by Proxy offers providers opportunities to improve all care, both virtual and in person. The process enables providers to deliver virtual care when appropriate and focus more effectively on patients that need in-person treatment. It also enables providers to share their expertise outside their home facilities to help patients around the world. Health.mil​ External Link

    Yoga shield: Building mental and physical resiliency​

    9 August- More than 30 Airmen assigned to the Ohio National Guard’s 178th Wing and the Iowa National Guard’s 132nd Wing began a week-long, 60-hour yoga training program July 18 at the 178th Wing in Springfield, Ohio. The training is a part of a pilot program called Yoga Shield, which aims to teach Airmen to reduce stress and to build mental and physical resiliency through yoga. The Airmen who complete the training program will become certified yoga instructors and will be able to provide yoga classes for their fellow Airmen. “A lot of people hear the word yoga and think we're teaching people how to stretch or relax we're really teaching people how to master their own mind and nervous system.” said Olivia Mead, the CEO of Yoga for First Responders and lead instructor of the course. “There is a missing skill set in our Armed Forces training. And that is a proactive way to combat the mental and neurological consequences of such a high stress job and we see that in the statistics, and not all resilience training has been able to make a dent.” Mead said the Airmen are learning a training protocol and how to deliver that to others. When the Airmen complete the program, they’ll be able to teach other Airmen how to process stress, build resilience and enhance performance proactively, addressing stress and other work-related issues before they become unmanageable. The program began in 2021 as a proposal for the Warrior Resilience and Fitness Innovation Incubator, which aims to develop, implement, and evaluate new wellness initiatives, analytics platforms, and strategic partnerships. Upon receiving initial funding, the program training 60 Airmen and Soldiers in Iowa and has expanded to eight new sites. Clare Long, The Sexual Assault Response Coordinator for the 132nd Wing and director of Yoga Shield, said the program has already had a lot of success. “People are finding connectedness, they are having better sleep, because they're able to have neurological reset, mindfulness, less burnout, and it’s also helping with our recruiting and retention,” Long said. “This is important for the longevity, the health and the welfare of our Airmen. It's another tool in our toolbox. It's not the only tool, but it's one that can definitely help Airmen.” Mead said it will help Airmen train for the mental and neurological impact of high stress professions, in the same way the military has proactively trained for the physical demands of military service. Health.mil​External Link

    GLOBAL

    Kidney transplant: Blood type change for universal application of organs

    16 August- Kidney transplant operations are crucial like other internal organs, as people need the right fit that medical professionals will put inside their bodies for the application to work. However, that is not the problem anymore as the University of Cambridge and the Kidney Research UK are joining forces to alter the blood type of a kidney to fit universally for patients in need. The University of Cambridge announced via a press release that there is a new venture in kidney transplant operations that may be applied to the world's need for the organ. It is to change the kidney blood type that would make it a universal application for all, not needing a specific organ donor for future needs for its replacement. Kidney Research UK is funding the project for Cambridge, and both are partners in the venture that will help focus on giving the novel medical procedure available for all transplants in the future. The focus of this development is to help ethnic and minority patients that need the internal organ to receive them from different donors and have their bodies accept the new kidney for their use. Tech Times​External Link

    Minorities are bearing the brunt of monkeypox cases in the US: CDC​

    28 July- Minorities are bearing the brunt of monkeypox cases in the United States, new data from the Centers for Disease Control and Prevention shows. During a telemedia briefing Thursday, Capt. Jennifer McQuiston, deputy director of the division of high consequence pathogens and pathology at the CDC, shared the first breakdown of infections by race and ethnicity. Of the more than 4,600 cases reported in the U.S., Hispanic and Black Americans make up a disproportionate share of cases compared to their share of the U.S. population. Hispanics account for 31% of all monkeypox cases in the country so far and Black people make up 27% of cases, McQuiston said. However, according to data from the U.S. Census Bureau, Hispanics only make up 19% of the population and Black people account for 13%. ABC News External Link​​

    Protein-Based COVID-19 vaccine seeks expanded authorizations

    15 August- Maryland-based Novavax, Inc. today announced that it is seeking to expand its protein-based  COVID-19 Vaccine, Adjuvanted, authorizations in Taiwan and the USA. On August 15, 2022, the company submitted an application to the U.S. Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) for its COVID-19 Vaccine (NVX-CoV2373) as a homologous and heterologous booster in adults aged 18 and older. In the USA, the FDA granted EUA, followed by a positive recommendation from the U.S. CDC's Advisory Committee on Immunization Practices and endorsement from the CDC's leadership, for a two-dose primary series in adults aged 18 and older in July 2022. Additionally, Novavax announced it submitted a request for expanded EUA to Taiwan's Food and Drug Administration for Nuvaxovid™ for adolescents aged 12 through 17. This request was based on data from the ongoing pediatric expansion of the Phase 3 PREVENT-19 trial of 2,247 adolescents across 73 sites in the USA, evaluating the safety, effectiveness, and efficacy of Nuvaxovid. In the pediatric expansion, Nuvaxovid achieved its primary effectiveness endpoint and demonstrated 80% clinical efficacy overall at a time when the Delta variant was the predominant circulating SARS-CoV-2 strain in the USA. In the 12 through the 17-year-old population, Nuvaxovid has been granted authorization in India, the European Union, Australia, Thailand, and Japan and is actively under review in other markets. Precision Vaccinations​External Link

    RSV monoclonal antibody clinical study focuses on toddlers

    16 August- Sanofi and the National Institute for Health and Care Research (NIHR) recently announced that the first patient had been enrolled in the Hospitalised RSV Monoclonal Antibody Prevention (HARMONIE) clinical study. HARMONIE is a phase 3b randomized open-label study of nirsevimab in preventing hospitalizations due to respiratory syncytial virus (RSV) in infants under 12 months and will take place across approximately 280 sites The first patient visit occurred at Cripps Health Centre at the University of Nottingham, U.K., on August 8, 2022. More than 20,000 infants across the U.K., France, and Germany will be enrolled from August 2022 to March 2023, of which the majority (up to 12,000) will be U.K. infants. HARMONIE is Sanofi's first hybrid digital study and requires only one patient visit. Nirsevimab is an investigational long-acting antibody aiming to protect all infants from birth entering their first RSV season with a single dose. Nirsevimab has been granted regulatory designations to facilitate expedited development by several regulatory agencies worldwide. These include Breakthrough Therapy Designation by The China Center for Drug Evaluation, Breakthrough Therapy Designation from the U.S. FDA, access granted to the European Medicines Agency PRIority MEdicines scheme, and Promising Innovative Medicine designation by the U.K. Medicines and Healthcare products Regulatory Agency. Precision Vaccinations External Link​​

    Why some communities are distrustful of doctors and public health efforts​

    15 August- As the latest updates on COVID-19, the monkeypox virus, polio and other health concerns and issues continue to circulate, one doctor pointed out that health care is very much like a product. Dr. Alexander Salerno, an internist in New Jersey, told Fox News Digital, "If you don't trust the seller or the product, why would you buy it?" Salerno works at Salerno Medical Associates, a family-run, second-generation practice that serves East Orange and Newark.He told Fox News Digital that trust is the "glue" between doctors and patients — especially in underserved communities."Less trust leads to patients not complying with treatment or screening recommendations, and that in turn leads to reactive health care, as opposed to preventive care," he said. Fox News​ External Link​​

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    2021-2022 Influenza Season for Week 31, ending August 6, 2022​​:

    Hospitalization Surveillance-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. FluSurv-NET hospitalization data are preliminary. Patients admitted for laboratory-confirmed influenza-related hospitalization after June 11, 2022, will not be included in FluSurv-NET for the 2021-2022 season. Data on patients admitted through June 11, 2022, will continue to be updated as additional information is received.​​

    Influenza-Associated Pediatric Mortality​​- No influenza-associated pediatric death occurring during the 2021-2022 season were reported to CDC during week 31.​​CDC External Link​​

    VETERINARY/FOOD SAFETY

    Capri Sun drink recalled because of cleaning solution issue found after consumer complaints​​

    15 August- Kraft Heinz is announcing a recall of 5,760 cases of Capri Sun Wild Cherry Flavored Juice Drink Blend beverages.“The voluntary recall comes after diluted cleaning solution, which is used on food processing equipment, was inadvertently introduced into a production line at one of our factories,” according to the recall on the company website. “Only the Wild Cherry flavored Capri Sun products with the case/package information below are affected.” The “Best When Used By” date on the products is June 25, 2023. The issue was discovered after the company received several consumer complaints about the taste of the affected product. The company is actively working with retail partners and distributors to remove potentially impacted product from circulation. Consumers who purchased these items should not consume the product and can return it to the store where it was purchased. Consumers can contact Kraft Heinz from 9 a.m. to 6 p.m. Eastern Standard Time, Monday through Friday, at 800-280-8252 to see if a product is part of the recall and to receive reimbursement. The company did not provide product photographs with the recall notice. Food Safety News External Link​​

    Is Kruse the ‘Bright Line’ case for the food safety community or not?​​​​

    17 August- The jury is hung. The judge declared a mistrial. The prosecution can try again, but it isn’t required. We could leave it there. As one famous Texan said, it might be the prudent thing to do. But what fun would that be? We’ve been covering the United States v. Paul Kruse from the first time. And we covered the 2015 listeriosis outbreak that the case comes from in real-time. So my sharing some after-action thoughts should be worth the risk. First, our publisher Bill Marler made an essential point to a Reuters reporter. He said there seems to be “no particular rhyme or reason” why prosecutors charge some food executives with felonies, others with misdemeanors, and others with nothing at all. That’s from the nation’s top lawyer for foodborne illness victims who has been in the business for 30 years. If he cannot figure it out, can anyone in the food industry? One thing the Texas trial was not was the “banality of evil“ that was on display in the 2014 jury trial in Albany, GA, that put away the Parnell brother for a long time. They knew about deadly pathogens in their peanut products, tested for them, and shipped their products knowing they had tested positive. That wasn’t the fact pattern for the government’s case against Paul Kruse, the retired president of Blue Bell Creameries. He wasn’t charged with knowingly putting adulterated food into interstate commerce. And this might be an excellent place to say that there are intelligent lawyers on both sides of the United States v. Paul Kruse. Kruse was trying to save his family’s company in crisis, but he was not trying to poison his customers. Charges were essentially financial, conspiracy, and fraud. This Texas jury is also worth a word or two. The Western District Court of the federal court system picked the jury in a session from 8:30 a.m. to 4:30 p.m.on Aug. 1. From 80 candidates came the 12-member jury with four alternates. Food Safety News​External Link

    WELLNESS

    How to get to sleep the night before an early call or big event​

    15 August- You're catching a 5 a.m. flight tomorrow. Your boss, a true early bird, has set an unbearably early weekly meeting. School is starting, and you have to rise and shine to goose the family into gear. The clock has rolled back, and suddenly you're climbing out of bed in the dark. Those are the nights you crawl into bed early and beg for sleep -- all too often in vain. "This has happened to me many times unfortunately," said Dr. Phyllis Zee, director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine in Chicago. "If you're unable to fall asleep, don't worry about it. It will not help." Sleep specialist Dr. Raj Dasgupta has similar guidance. "My general advice is 'don't force it' because that worry about getting those zzz's will begin to ruminate in your mind, making matters worse," said Dasgupta, an associate professor of clinical medicine at the Keck School of Medicine at the University of Southern California. "The reality is that often the harder we try to relax and transition into sleep, the more we worry that we're losing precious sleep time, making the elusive 'good night's sleep' more difficult to obtain, " he said via email. If your sleep chronotype -- the time your body is naturally programmed to want to sleep -- is that of a night owl (late to bed, late to rise), those nights (and subsequent days) can be especially rough, experts say. CNN​External Link

    USAFRICOM

    Zimbabw​e measles outbreak blamed on sect gatherings kills 157 children

    16 August- A measles outbreak in Zimbabwe has killed 157 children with the death toll nearly doubling in just under a week, the information minister said on Tuesday. The government last week blamed apostolic church sects for the surge in infections, saying measles was largely prevalent among those who had not received vaccinations.The total number of suspected cases nationwide has jumped from 1,036 to 2,056 in four days, information minister Monica Mutsvangwa said in a post-cabinet briefing. Reuters​External Link

    USCENTCOM

    Iraq update on Crimean-Congo hemorrhagic fever

    ​15 August- The Iraq Ministry of Health is now reporting 289 confirmed Crimean-Congo hemorrhagic fever (CCHF) cases and 52 deaths as of August 11. This is an increase of 16 cases and 3 deaths since our last report on August 3. Regarding the geographical distribution of the total cases and deaths in 2022 to date, the ministry states: 124 cases and 29 deaths in Dhi Qar governorate, 32 cases and 3 deaths in Maysan, 24 cases and 2 deaths in each of Babil and Wasit, 18 cases and 6 deaths in Al-Muthanna, 11 cases and 1 death in Basrah, 11 cases in Al-Diwaniyah, 10 cases and 2 deaths in Al-Karkh side of Baghdad, 8 cases in Karbala, 7 cases. Outbreak News Today​External Link

    USEUCOM

    Covid: UK first country to approve dual-strain vaccine​​

    16 August- The UK has become the first country to approve a dual vaccine which tackles both the original Covid virus and the newer Omicron variant. Ministers say the vaccine will now form part of the autumn booster campaign. Moderna thinks 13 million doses of its new vaccine will be available this year, but 26 million people are eligible for some form of booster. Health officials say people should take whichever booster they are offered as all jabs provide protection. The original vaccines used in the pandemic were designed to train the body to fight the first form of the virus which emerged in Wuhan, in China, at the end of 2019. The Covid virus has since mutated substantially, with a stream of new variants emerging that can dodge some of our immune defences. They have caused large surges in cases around the world. The original vaccines still provide strong protection against becoming severely ill or dying, but companies are tweaking them to match the virus as it evolves. Cases of coronavirus are currently falling in the UK. In mid-to-late July, around 2.5 million people tested positive for coronavirus. BBC News External Link​​

    USINDOPACOM​

    Monkeypox: Concern of 'undetected' cases as just 14 people tested so far​​​

    5 August- Fourteen people have been tested for monkeypox in New Zealand to date, which experts say raises concern there could be undiagnosed infections in the community. Aotearoa reported its first monkeypox case on July 9 and has three cases so far. All three had recently travelled and there was no evidence of community transmission. As of Thursday, the Institute of Environmental Science and Research had performed 48 tests on 14 patients, including confirmatory testing for the three confirmed cases, the Ministry of Health said. Joe Rich, the chief executive for the Burnett Foundation, was “concerned” by the number of tests run and said – given the rate of testing – it was possible cases could be going undetected. Stuff External Link​​​​

    USNORTHCOM

    New U.S. monkeypox vaccine strategy could be huge boost for supply, but much is unknown​

    11 August- In an effort to stretch the limited supply of the Jynneos monkeypox vaccine, federal health officials this week authorized giving smaller doses using a different method of injection. With more than 10,000 monkeypox cases in the United States and vaccine demand remaining high, Jynneos has been in short supply for weeks. The new injection strategy allows health-care providers to give shallow injections intradermally, in between layers of the skin, with one-fifth the standard dose size instead of subcutaneously, into the fatty layer below the skin, with the larger dose. Yet the specific efficacy data for the vaccine is not clear, and some experts argue that not enough is known about how the low-dose intradermal strategy might affect the protection it provides in the real world. Even at the original dosage size, "there is no traditional assessment of this vaccine," Dr. Robert Califf, commissioner of the US Food and Drug Administration, said Tuesday. It's approved for emergency purposes based on studies of immune responses, not clinical outcomes, because there haven't been smallpox or monkeypox outbreaks large enough to test it. CNN​External Link

    USSOUTHCOM

    Panama dengue and hantavirus cases 7 months into 2022​

    15 August- The Department of Epidemiology of the Ministry of Health (Minsa) indicated that from January 2 to July 30, 2022, 2,859 cases of dengue have been registered throughout the country. One death was reported. The five regions with the most cases of dengue registered at the national level are led by the Metropolitan Health Region with 659 cases; North Panama with 573 cases; Bocas del Toro with 457 cases; Panamá Oeste with 415 cases and San Miguelito with 252 cases. The Ministry of Health (Minsa) urges the population to clean their surroundings and inside their homes, cover the containers with water. Prevention and control of dengue must be intersectoral and involve the family and the community. Outbreak News Today External Link