Army Public Health Weekly Update, 19 June 2020

Date Published: 6/19/2020
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

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

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Table of Contents

    ​ANNOUNCMENTS

    APHC public website COVID-19 page

    This site provides Army-specific information and communication resources related to the 2019 Novel Coronavirus (COVID-19). The resources and tools available on this site may be shared with, tailored for, and/or used to create informational and educational materials for Army beneficiaries. APHC External Link

    Considerations for events and gatherings

    As some communities in the United States begin to plan and hold events and gatherings, the CDC offers the following considerations for enhancing protection of individuals and communities and preventing spread of coronavirus disease 2019 (COVID-19). Event planners and officials can determine, in collaboration with state and local health officials, whether and how to implement these considerations, making adjustments to meet the unique needs and circumstances of the local community. CDC External Link

    Support for Veterans

    Learn more about the VA's response to COVID-19 External Link and actions veterans can take to help manage stress and anxiety External Link during the COVID-19 pandemic. CDC External Link

    U.S. MILITARY

    Army public health experts offer tips to beat heat while training for virtual race competitions

    11 June- ABERDEEN PROVING GROUND, Md. –Although COVID-19 precautions may have shut down many of the planned running competitions and events scheduled for this summer and fall, there are still many athletes heading outside to train and maybe compete in virtual events. Running outside is a great way to train and stay in shape, but with the summer months here runners need to acclimate to the summer heat to stay competitive for that virtual race day. "It is important to acclimatize your body to the heat," said Dr. Alexis Maule, a Defense Health Agency epidemiologist who works at the Army Public Health Center. "Start your training with short distance runs and slowly work your way to longer time and distance spent running in the heat. It can take several weeks for your body to adjust to training in the heat." Maule recommends avoiding running in the middle of the day when the sun is at its peak.  "If possible, train early or late in the day to avoid the hottest times of the day or find a running route that has plenty of shade," said Maule. "You will get the same benefits of the aerobic exercise while avoiding unnecessary sun exposure." Maule recommends runners use sunscreen and eyewear that blocks UV rays to provide protection from the sun. "Sunburn is the most common sun exposure risk runners face during training and competition," said Maule. "Sunburn inhibits the skin's ability to release body heat, which increases the risk of heat illness. High heat and humidity are also environmental risks that runners face during training and competition. Repeated sun exposure can also lead to skin cancer." Maule recommends runners balance the goals of comfort by having loose, breathable clothing, which is important for protecting them from environmental hazards such as sun exposure. Army.mil External Link

    Army's new fitness test to be implemented in October, but scores won't count for some time

    15 June- The Army will adopt its long-planned, six-event physical fitness test as its official evaluation on Oct. 1, but with fitness testing suspended amid the coronavirus pandemic, service leaders said soldiers' scores will not count for some time. Sgt. Maj. of the Army Michael Grinston announced the shift to the Army Combat Fitness Test on Monday in a move that means most soldiers will never again have to take the 4-decade-old Army Physical Fitness Test. While the ACFT will become the test of record for soldiers on Oct. 1, the Army is still working to finalize the evaluation, Grinston said. "We're going to have to take physical fitness tests once we come out of this [pandemic-caused] pause," he told reporters Monday during a news briefing. "As we begin anew … we wanted to go to the new Army Combat Fitness Test, and pretty much the goal for this year is just to take the test." The Army initially planned for the new test to be fully implemented by Oct. 1, but with soldiers locked down under stop-movement orders and many of them teleworking, the service indefinitely paused its physical evaluation requirements in March and announced it would hold off on officially implementing the new evaluation. Stars and Stripes External Link

    Big changes to military health system will be delayed, top health official says

    12 June- The COVID-19 pandemic is having a significant impact on reforms of the Pentagon's health system, delaying plans to reduce services at 48 hospitals and clinics by months and forcing additional reviews of civilian care in locations affected by the changes. Assistant Secretary of Defense for Health Affairs Thomas McCaffery told reporters Thursday that efforts to alter operations at some military treatment facilities was scheduled to begin in September, but now may start "more toward the end of the year" or later.  The changes, designed to focus the facilities on providing medical care to active-duty personnel only as well as training military medical personnel, thereby shedding non-uniformed beneficiaries to the Tricare network, will result in outsourcing health care for at least 200,000 patients. For the plan to work, the Defense Department is dependent on the availability of providers within Tricare. With the ongoing pandemic, however, "it's going to affect the timeline as to when that happens," McCaffery said during a conference call with the Defense Writers Group, an association of defense and national security correspondents. Military.com External Link 

    DoD COVID-19 cases spike as Army moves forward with vaccine candidate

    12 June- New COVID-19 cases across the Department of Defense increased sharply this week. Meanwhile, the Army is moving forward with a vaccine candidate. After weeks of consistent decline in new COVID-19 cases, DoD is reporting more than 1,000 new cases for the second week in a row. The majority of these new cases are among the active-duty Army ranks. While the Army did not respond to Connecting Vets' request for comment regarding how it might be mitigating this spike in cases, the branch did announce this week that it identified a vaccine candidate to move into the next phase of testing. From more than two dozen prototypes, Walter Reed Army Institute of Research identified a lead vaccine candidate as well as two backup vaccine candidates that will advance to the next stage of research -- human testing. "USAMRDC is moving at unprecedented speeds in the effort to prevent, detect and treat COVID-19. We are supporting the whole-of-government response with the scientific knowledge and expertise to combat this world-wide challenge," said Brig. Gen. Michael J. Talley, commanding general of the U.S. Army Futures Command's Medical Research and Development Command. "With the recent selection of this vaccine candidate, we believe we are one step closer to that goal." That human testing still won't start until later this year, however, again calling to question Secretary of Defense Mark Esper's belief that DoD will have a vaccine ready for wide distribution before the end of 2020. Connecting Vets External Link 

    GLOBAL

    China's new virus outbreak comes from eating salmon? Here's what experts suggest

    16 June- China is experiencing the virus chaos all over again. A new coronavirus outbreak is now reported in the place of origin of the virus. At the time, experts point finger on bats. Now, a weird source has been reported by the health experts: virus comes from imported salmon fish... If WHO can't identify the reason behind the sudden increase of COVID-19 cases again in China, state-run media reported differently. Several of them reported that one of the main theories of the new outbreak came from salmon fish that were imported from Europe. They told the public that virus strands were found on chopping board, inside the said market. These items were used to chop imported salmon fish that were being sold in the market. Due to these claims, the Chinese government even halted the salmon products and packaging on major supermarkets in the country. Companies that sold salmon to Chinese stores immediately followed this new regulation. "We can't send any salmon to China now, the market is closed," Regin Jacobsen, CEO of Oslo-listed salmon supplier Bakkafrost, told Reuters. "We have stopped all sales to China and are waiting for the situation to be clarified," said Stein Martinsen, head of sales and marketing at Norway Royal Salmon. Tech Times External Link

    Coronavirus: Blood clots targeted in treatment trial

    15 June- Scientists are to test whether an experimental drug can prevent potentially deadly blood clots associated with Covid-19.
    The trial, funded by the British Heart Foundation, will test the theory the clots are caused by a hormone imbalance triggered by coronavirus infection.
    It will become one of several drugs currently being trialed to prevent the disease's worst effects. A third of hospitalized coronavirus patients develop dangerous blood clots. The drug, TRV027, works to rebalance hormones involved in blood pressure, water and salt. Scientists from Imperial College London, involved in the trial, think that when the virus enters the body, it uses an enzyme as a "handle" to enter the cells. But this disables the enzyme, which plays an important role in balancing the key hormones. When out of balance, the blood can become sticky, leading to clots. They theories that TRV027 - which won its creator a Nobel Prize in 2012 - can step in to play this rebalancing role. BBC External Link 

    COVID-19 forecasts: New hospitalizations

    10 June- CDC works with partners to bring together weekly forecasts for new COVID-19 hospitalizations. These forecasts make different assumptions about social distancing measures and use different methods and data sets to estimate the number of new hospitalizations.   Individual models are described in more detail below. CDC External Link .

    Cows help with COVID-19 treatment, no bull

    17 June- It turns out, cows may play an important role in responding to the COVID-19 pandemic. SAB Biotherapeutics is in the business of making what are known as polyclonal antibodies. These are a collection of different antibodies that a body makes to ward off a specific invading organism. The company has made polyclonal antibodies to treat influenza and MERS. Now it's making them with the aim of treating or even preventing COVID-19. To make them, SAB uses cows. These aren't just any cows. They are cows that have been given genes from the human immune system that make antibodies. These special cows are injected with what essentially amounts to a coronavirus vaccine that will then cause them to try to fight off what the body sees as an infection — and they will "produce a specifically targeted high-neutralizing antibody that can be used in patients," says SAB CEO Eddie Sullivan. These targeted neutralizing antibodies can, in theory, help slow an infection in someone who is sick or prevent an infection in someone who is exposed to the virus. Why a cow? The antibodies circulate in the animals' plasma, and you can get a lot of plasma from a cow. NPR External Link

    New guidelines on cancer prevention recommend cutting out alcohol completely

    9 June- The American Cancer Society (ACS) on Tuesday made a major change to its guidelines on cancer reduction and prevention, now saying it's best to cut alcohol completely out of one's diet. "It is best not to drink alcohol," said the ACS in the new guidelines. Previously, the society recommended limiting alcohol consumption to one drink a day for women, and no more than two a day for men. A drink is defined as 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. These amounts are still recommended for those who choose to not totally eliminate alcohol from their diet. In the United States, the ACS estimates that alcohol use accounts for about 6 percent of all cancers and 4 percent of all cancer deaths. "Alcohol use is one of the most important preventable risk factors for cancer, along with tobacco use and excess body weight," according to the ACS. Other significant changes included more physical activity and eating less processed and red meat — although the ACS also now recommends completely cutting processed and red meat from one's diet, as well as sugar-sweetened beverages and "highly processed foods and refined grain products." Fox News External Link 

    San Antonio doctor invents device to protect health care workers from COVID-19

    15 June- After seeing colleagues use bulky, makeshift hoods made out of plexi-glass for protection while treating coronavirus-infected patients, Dr. Steven Venticinque thought he could come up with a better shield. The anesthesiologist and critical-care doctor went to work in his home garage with wire and plastic bags, and researched the sizes of various patient beds. Less than 15 weeks and three re-designs later, the product — called a stat enclosure — has hit the market with orders starting to come in from U.S. hospitals. One manufacturer, Bell Medical, sells them for $60 each, when ordered in boxes of five. The device is a foldable, disposable barrier that can be used during high-risk procedures such as trachael intubation. The aim is to block droplets and aerosols from getting on doctors, nurses and paramedics performing the life-saving procedure. Express News External Link 

    Summer staycation could be the cure for COVID-19 travel blues

    11 June- As summer rapidly approaches, do you have a desire to travel? COVID-19 may impact your ability to travel very far from your assigned duty station. Instead of feeling down about the situation, bring your vacation to you. Thus a "staycation" could be just the right fix! Changing the atmosphere around your home may be just what the doctor ordered. With some creative thinking, you can put together the next best thing for summer relaxation. Here are a few ideas to get you started. Were you dreaming of an African safari? Take your backyard and set up a unique architectural canvas (tent). Establish a theme on the inside of the canvas with African tribal bedding. Outside your canvas, set up speakers and play night sounds from Kruger National Park (or another location). Talk to your family about sounds they may hear, such as a coucal, reed frogs, lions, leopards and ground hornbills. During the day, you might "hunt" for animals in your backyard using binoculars. Research and discuss animals you might see in Africa that are similar to the ones in your backyard. Army.mil External Link 

    Vaccine-hesitant parents especially leery of flu shots, study finds

    15 June- About 1 in 15 US parents (6.1%) is hesitant about routine childhood vaccines, and more than 1 in 4 (26%) are unsure about flu vaccines, according to a study published today in Pediatrics. Researchers surveyed 2,176 parents in February 2019 using an online panel and a modified five-point Vaccine Hesitancy Scale found that 12% strongly agreed, and 27% somewhat agreed, that they worried about perceived serious side effects of childhood and flu vaccines. And while 70% strongly agreed that routine childhood vaccines are effective, only 26% said they thought the same about flu vaccines. Thirteen percent either strongly or somewhat disagreed that all childhood vaccines offer benefit. Of hesitant parents, 67.5% reported having deferred or refused routine childhood vaccination, versus 8.7% of non-hesitant parents. Likewise, 70.1% of reluctant parents said they had deferred or refused flu vaccination for their child, versus 10.0% of non-reluctant parents. CIDRAP External Link

    Why a 2nd shutdown over coronavirus might be worse than the 1st -- and how to prevent it

    15 June- It's an outcome no one wants, but could become a "harsh reality": a second wave of shutdowns. Weeks after lifting stay-at-home orders, some states are seeing record numbers of hospitalizations from Covid-19 as thousands more Americans get infected every day. "We're going to have to face the harsh reality in some states that we may need to shut down again," said Dr. Jonathan Reiner, a professor at George Washington University School of Medicine. And the second wave of state shutdowns could be more damaging than the first. "Because of quarantine fatigue, because of the economic effects of quarantine, another round of shutdowns might have even larger effects on businesses that may be on the edge of not being able to stay solvent," said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. The economic toll from one round of shutdowns has been staggering. More than 44 million people in the United States have filed for initial unemployment benefits since mid-March. CNN External Link

    INFLUENZA

    CDC: Flu View - Weekly U.S. Influenza Surveillance Report

    2019-2020 Influenza Season Week 23, ending June 6, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age 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. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2020 will not be included in FluSurv-NET. Data on patients admitted through April 30, 2020 will continue to be updated as additional information is received.

    Pneumonia and Influenza (P&I) Mortality Surveillance : Based on National Center for Health Statistics (NCHS) mortality surveillance data available on June 11, 2020, 5.6% of the deaths occurring during the week ending June 6, 2020 (week 23) were due to P&I. This percentage is below the epidemic threshold of 6.2% for week 23. Weekly mortality surveillance data include a combination of machine coded and manually coded causes of death collected from death certificates. Percentages of deaths due to pneumonia and influenza (P&I) are higher among manually coded records than more rapidly available machine coded records. Due to the additional time needed for manual coding, the initially reported P&I percentages may increase as more data are received and processed and for week 23 this may push the percentage of P&I deaths above the epidemic threshold.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 23. A total of 182 influenza-associated pediatric deaths occurring during the 2019-2020 season have been reported to CDC. CDC External Link

    WHO: Influenza Update

    08 June 2020 - Update number 369, based on data up to 24 May 2020:

    -The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic might have 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-CoV2 virus transmission might also have played a role in interrupting influenza virus transmission. -Globally, influenza activity was at lower levels than expected for this time of the year. In the temperate zone of the northern hemisphere, influenza activity returned to inter-seasonal levels while in the temperate zones of the southern hemisphere, the influenza season has not started yet.

    -In the Caribbean and Central American countries, no or low influenza detections were reported in most reporting countries. Increased severe acute respiratory infection (SARI) activity was reported in some countries.

    -In tropical South American and tropical Africa, there were no influenza viruses detected across reporting countries.

    -In Southern Asia, influenza like illness (ILI) and SARI activity decreased in Bhutan and Nepal.

    -In South East Asia, no influenza detections were reported.

    -Worldwide, seasonal influenza A viruses accounted for the majority of detections. WHO External Link 

    VETERINARY/FOOD SAFETY

    Ciguatera poisoning from imported fish suspected in the Netherlands

    14 June- Five people in the Netherlands have been affected by ciguatera poisoning likely caused by frozen red snapper steaks from India. Those sick had a meal together in mid-May and developed symptoms including gastroenteritis and neurological complaints within three hours. None of them needed hospital treatment. Tjitte Mastenbroek, a press officer at the Netherlands Food and Consumer Product Safety Authority (NVWA), said probable ciguatoxin poisoning was established. "One original sealed package of the fish was still available in the household and is currently being analyzed for neurotoxins. Outcome of this analysis of the red snapper fish is expected next week. Currently it is unknown if this case is related to a point source (e.g. a single fish) within the batch, which could have been contaminated with ciguatoxins," he said. "The batch concerned has been recalled from sale and consumers in the Netherlands. The product was only offered for sale in the Netherlands in a limited number of toko's. These small stores have warned their customers through posters and shelf cards in the shops." In the Netherlands, the name for an Asian food store is a Toko. Food Safety News External Link

    Gel cups recalled from 25 countries because of choking risk

    15 June- Mini jelly cups from Taiwan have been recalled from more than 25 countries because they may pose a choking risk. ABC jelly fruit cup sweets are subject to recall because of the presence of gel-forming food additive ingredients. The additives are E407 (carrageenan) and E410 (carob or locust bean gum). E numbers are codes for food additives used in the European Union. All batch codes and dates of Girl Jelly Fruity Bites; Boy Jelly Fruity Bites; Fruitery Jelly Assorted Jar; Fruitery Jelly Assorted Bag; Jelly Straws; Pentagon Cup Jelly Snacks Bag; Pentagon Cup Taro Bag; Pentagon Cup Taro Jar; and Assorted Jelly Snacks are affected. None of the alerts mentioned any reported injuries linked to the products as of the posting of the recall. The jelly cups have a fruity taste such as strawberry, grape, pineapple and apple. Food Safety News External Link

    Raw pet food blamed for human E. coli outbreak

    16 June- Public health officials continue to investigate an E. coli outbreak linked to raw pet food sold under the Carnivora brand. Of four sick people identified so far, all had the same strain of E. coli O157 infection and all had been exposed to the raw pet food for dogs who had been fed it, according to an outbreak notice posted by Public Health Agency of Canada (PHAC). Riveriene Farm Ltd. operating as Carnivora Pet Foods of Saskatoon, Saskatchewan, Canada, recalled six varieties of the Carnivora brand raw food. All were manufactured in Canada and widely distributed, possibly nationwide, according to a recall notice posted by the Canadian Food Inspection Agency (CFIA). "The individuals became sick between early March and mid-May 2020. Two individuals have been hospitalized. No deaths have been reported. Individuals who became ill are between 3 and 43 years of age," the outbreak notice states. "The collaborative outbreak investigation was initiated because reports of E. coli O157 illnesses with similar genetic fingerprints were identified. All of the individuals who became sick reported exposure to Carnivora brand frozen raw pet food purchased at various pet stores before their illnesses occurred." It is possible that more recent illnesses will be reported in the outbreak because of the period between when a person becomes ill and when the illness is reported to public health officials. For this outbreak, the illness reporting period is between three and four weeks, according to the federal health agency. Food Safety News External Link

    Recall: Raw Macadamia Nuts, potential to be contaminated with Salmonella       

    14 June- NOW Health Group, Inc. (NOW), of Bloomingdale, Illinois, is voluntarily recalling its NOW Real Food® Raw Macadamia Nuts – Product Code 7119, Lot#3141055 – because this lot has the potential to be contaminated with Salmonella. This lot was distributed online and in retail stores nationwide. No other NOW Real Food® products are affected or are involved in this recall. No illnesses have been reported to date in connection with this product. Outbreak News Today External Link

    WELLNESS

    Inhaling toilet flushes may lead to Legionnaires' disease, according to experts; here's how to prevent it

    15 June- A recent study confirms that two patients are likely to have contracted the Legionnaires' disease by inhaling contaminated toilet water after flushing. According to a recent report published in the Emerging Infectious Diseases journal last week, the two patients were admitted at a hospital in France who likely contracted the disease after inhaling the toilet water that was sprayed with aerosol while flushing. They used the same hospital room, but five months apart. As reported in Live Science, Legionnaires' disease could spread through flushing the toilet, which releases "plumes" of contaminated water into the air. French researchers suspected that toilet plumes could spread the Legionnaires' disease. However, this is the first time that genetic analysis has linked patients' infections with contaminated toilet water. Tech Times External Link

    You're never too old to regain that lost muscle- And you can do it at home

    9 June- Pandemic life has a way of revealing our weaknesses. For those of us of a certain age, I mean that literally. If you are feeling like certain household activities — toting groceries, hoisting children, moving furniture, carrying laundry — are more difficult than they were in the past, you aren't alone. And you aren't imagining it. This isn't a new phenomenon; it just wasn't until the 1800s that many of us lived long enough to experience this decline. For me, it started a few years ago, when I noticed that lifting an air conditioner, carrying a child up to bed or bringing in a load of firewood seemed harder than they once did. I summoned excuses for each difficulty ("Darned kid gained 20 pounds today!"), but now, at age 54, I'm ready to concede: I simply can't lift as much as I once could. Starting sometime in our 30s (the data aren't precise), we lose up to 8 percent of our muscle mass per decade, a decline called sarcopenia, along with up to 30 percent of our strength and power. This leaves us weaker, less mobile and — especially after we cross age 50 — more vulnerable to injury from falls and similar accidents. The Washington Post External Link

    USAFRICOM

    Nigeria: Reports 500 additional COVID-19 cases, release guidelines to reopen places of worship

    14 June- Nigerian health authorities reported an additional 501 COVID-19 cases Saturday from 24 states, bringing the country total to 15,682. Eight more fatalities were reported putting the death toll to over 400. Lagos state has recorded the most cases with 7035, about 45 percent of the country total. The Nigeria Centre for Disease Control (NCDC) reported this weekend that they have developed new guidelines for places of worship in Nigeria. This is to ensure safe gatherings and prevent exposures to COVID-19 infection in religious settings. Outbreak News Today External Link

    USCENTCOM

    Yemen: Coronavirus death rates in Yemen's Aden could exceed its wartime fatalities

    12 June- Ghasan Saleh starts digging graves at the break of dawn to prepare for the dead bodies that will come in droves. Two men in white hazmat suits appear atop an approaching pickup truck. They hastily drop a corpse into a hole and cover it with dirt. The health workers come and go in near-silence. Fear of infection means there are no mourners for those suspected to have died from Covid-19. The cycle of digging and abrupt funerals continues under the blistering sun and suffocating humidity of Aden, the seat of power of the UN-recognized government in war-torn Yemen. The Al Radwan cemetery has quickly expanded over the past few months, with new graves creeping closer to the residential buildings that border it. "You can see my digging machine," says Saleh. "Just now I dug 20 graves." Local medical authorities say that death rates in Aden are soaring this year, despite a relative lull in a war that ravaged the place in previous years. In the first half of May, the city recorded 950 deaths -- nearly four times as many as the 251 deaths in the whole month of March, according to a Ministry of Health report. CNN External Link 

    USEUCOM

    Norway: Yersinia enterocolitica outbreak reported in five counties

    14 June- Norway's Institute of Public Health reports investigating an increased incidence of the gastrointestinal bacterium, Yersinia enterocolitica O3. The infection has been detected in 14 people living in several counties. The patients are between 2 and 57 years old and most are women. The infected are residents of Agder (4), Oslo (4), Rogaland (3), Trøndelag (2) and Viken (1) counties. Bacteria with similar DNA profiles have been detected in all 14 individuals and all samples were taken during the last two weeks of May and the first week of June. The Public Health Institute collaborates with the municipal health service, the Norwegian Food Safety Authority and the Veterinary Institute to identify whether the patients can have a common source of infection. Patients are interviewed and local food inspection takes samples of food products in the homes of those infected to find the source of the outbreak if possible. These tests are analyzed at the Veterinary Institute, says doctor Hilde Marie Lund at the Department of Infection Protection and Emergency Preparedness at FHI. Outbreak News Today External Link 

    Sweden: Three identified genetic groups of SARS-CoV-2 in European travelers identified

    14 June- The test results analyzed show that the three identified genetic groups of SARS-CoV-2 were present among travelers from several different European countries and the United States as early as February and early March.  It is therefore likely that the infection has entered Sweden from several different countries and that it has spread in these countries earlier than previously reported. In addition to the already known import of cases from Italy and Austria, the presence of various genetic groups also shows that infections were likely introduced in the country on a number of occasions. Our conclusion is that the infection protection in the regions, through isolation and infection tracking, to a large extent prevented the infection from Italy to gain a foothold in Sweden. Instead, the infection came into the country from a number of different countries because the pandemic was then already a fact, says Karin Tegmark Wisell, Head of Department at the Public Health Authority. This first survey of inheritance indicates that infection directly from Asia has not gained any major hold in Sweden. The mapping of the virus's genetic mass makes it impossible to draw conclusions about the origin of the infection. This is the first genetic survey of SARS-CoV-2 in Sweden. It focuses on the genetic groups identified in the diagnosis during the early phase of the pandemic's spread in Sweden as well as from sentinel surveillance data, a surveillance system where patients with influenza-like symptoms are tested to demonstrate what proportion of these have covid-19. By analyzing the genetic mass from the genetic sample in tests with SARS-CoV-2 from Swedish cases and comparing these with cases from the rest of the world, the understanding of how covid-19 was introduced in the country can be increased. Continued work will, among other things, analyze the prevalence of infection in Sweden and in different groups. Outbreak News Today External Link

    USINDOPACOM

    Beijing: COVID-19- Dozens more cases reported

    15 June- In a follow-up on the report of a COVID-19 cluster in Beijing, China, city health officials report 36 additional local COVID-19 cases Saturday–all related to Xinfadi market. China's National Health Commission said, Beijing recorded one new virus case on Thursday and six on Friday – the first cases in almost two months. The Beijing Municipal Health Commission reported (computer translated) today that the city's nucleic acid testing institutions tested a total of 76,499 people, with 59 positive results, including 27 cases in Ditan Hospital and 21 newly confirmed cases. There are 11 positive tests to be diagnosed. According to the Beijing News, Xu Hejian, a spokesman for the Beijing Municipal Government, introduced today that judging from the results of nucleic acid testing of people in key regions, the epidemic is highly correlated with the market of the new development area, and the law of the spread of new coronavirus has not been fully grasped. It is still spreading. The epidemic situation in the capital is very serious. We must fully understand its long-term nature, complexity, and difficulty. Outbreak News Today External Link

    Singapore: Reports 1158 dengue cases last week, highest weekly total in 6 years

    16 June- Singapore's National Environment Agency (NEA) reported 1,158 dengue cases last week. This is the highest number of weekly dengue cases ever recorded in Singapore, since the 891 cases recorded in 2014. To date, the cumulative number of dengue cases for this year is 11,166 and the total number of cases this year is expected to be similar to or exceed the 22,170 cases reported in 2013, the largest dengue outbreak in Singapore's history. As of 15 June 2020, there are 211 active dengue clusters reported. With the concerted efforts of the community and stakeholders, the 105-case cluster at Westwood Avenue, 78-case cluster at Ang Mo Kio Avenue 3, and 65-case cluster at Jalan Jurong Kechil, are closed. However, there are still large clusters located at Woodleigh Close, Leicester Road, Tampines Avenue 7, Chu Lin Road and Aljunied Road where intensive vector control operations are ongoing. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Pennsylvania- COVID-19 total cases near 80K, some symptoms of Lyme disease are similar

    16 June- Pennsylvania state health officials reported 362 additional positive cases of COVID-19, bringing the statewide total to 79,483. An additional 33 COVID-19 deaths were reported today, bringing the total deaths to 6,276."With more than half of the state now in the green phase of the process to reopen, it is essential that we continue to take precautions to protect against COVID-19," Secretary of Health Dr. Rachel Levine said. "The commonwealth's careful, measured approach to reopening is working as we see case counts continue to decline even as many other states see increases. But the virus has not gone away. Each of us has a responsibility to continue to protect ourselves, our loved ones and others by wearing a mask, maintaining social distancing and washing our hands frequently. Together we can protect our most vulnerable Pennsylvanians, our essential workers and our healthcare system." Most of the patients hospitalized are ages 65 or older, and most of the deaths have occurred in patients 65 or older. In nursing and personal care homes, there are 16,720 resident cases of COVID-19, and 2,955 cases among employees, for a total of 19,675 at 650 distinct facilities in 47 counties. Out of our total deaths, 4,279 have occurred in residents from nursing or personal care facilities.Outbreak News Today External Link 

    USSOUTHCOM

    Brazil: COVID-19 deaths now 2nd in world, 'this is the worst public health crisis we've faced'

    14 June- On Saturday, Brazil's Ministry of Health saw the total COVID-19 case count and deaths rise to 850,514 and 42,720, respectively. Brazil's coronavirus mortality rate is 5 per cent, according to the health ministry. Brazil is second in the world in each category following only the US. In addition, health officials reported that 379,245 people have recovered. The situation in Brazil is bad and there is growing anger at the conduct of president Jair Bolsonaro over the pandemic who once downplayed the threat of the virus, saying on that death was "everyone's destiny" and calling the pandemic a "fantasy". "This is the worst public health crisis we've faced – and it has come at a time when we have the worst government in the world," said Daniel Dourado, a public health expert and lawyer from the University of São Paulo who believes thousands of lives could have been saved by a swifter and less erratic response. "The country is adrift." In Brazil's largest city, Sao Paulo, officials have an unorthodox plan to free up space at its graveyards during the coronavirus pandemic. Outbreak News Today External Link