Army Public Health Weekly Update, 19 March 2021

Date Published: 3/19/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

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

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Table of Contents

    ANNOUNCMENTS 

    Health Hazards Assessor's Guide Hazards Related to Musculoskeletal Trauma, Vibration, Shock, and Thermal Stress

    The Health Hazard Assessor's Guide consists of a series of chapters, each focusing on a health hazard category addressed in the current version of Army Regulation (AR) 40– 10, Health Hazard Assessment Program in Support of the Army Acquisition Process. APHC

    U.S. MILITARY

    Army announces FDA clearance of field deployable TBI blood test

    12 March- The U.S. Army Medical Materiel Development Activity, in partnership with Abbott, announced the U.S. Food and Drug Administration approval of the Abbott i-STAT™ Alinity™ Traumatic Brain Injury plasma assay, a rapid blood test for TBI in January. Between 2000 and 2019, more than 400,000 service members experienced a TBI as a result of combat injuries and training accidents, as well as everyday activities such as sporting events. Developing a field-deployable solution for the detection and evaluation of TBI among our wounded service members serving at home and deployed overseas has been a top priority for the Department of Defense for more than a decade. "A rapid test for TBI is a critical addition to our downrange capability to care for the brain health of our most important weapon system, the Warfighter, and help maintain a high state of readiness across the Force," said Army Brig. Gen. Michael Talley, commanding general for the U.S. Army Medical Research and Development Command and Fort Detrick, Maryland. The i-STAT Alinity TBI plasma assay can identify two brain-specific protein markers that rapidly appear in the blood following a TBI. This blood test will provide medical professionals with objective markers that indicate injury to the brain, as opposed to relying on subjective descriptions of the injury-causing incident, reduce the need for head Computed Tomography scans. "A blood-based biomarker laboratory assay (blood test) for TBI will greatly enhance the ability of DOD medical personnel to objectively assess Service Members who have suffered a suspected TBI. The ability to avoid unnecessary evacuations for head CT scans could really impact the efficiency of TBI management," said Dr. Krista Caudle, product manager for USAMMDA's Warfighter Brain Health Project Management Office. health.mil External Link

    DOD tracking COVID vaccinations with new electronic health record system

    12 March- The Defense Department's relatively new electronic health record system—Military Health System, or MHS, GENESIS—is being used to track vaccinations against COVID-19, building a database of inoculations and ensuring the process is fast and safe for service members. DOD began deploying MHS GENESIS in 2017. The system has been steadily rolling out in waves since that time, save for a brief pause at the start of the pandemic. "Throughout 2020, like most of Americans, the entire Military Health System has faced very unique challenges," Brig. Gen. Ned Appenzeller, assistant director for combat support at the Defense Health Agency, told reporters in November as the launch schedule resumed. "However, even with those challenges, I think we're still on track to fully deploy Genesis by the end of '23." The system has been deployed to more than 20 medical facilities as of March and is now being used to track vaccinations throughout the military. In total, DOD has administered some 1.3 million doses of the vaccine at 335 locations as of early March. The release notes an additional "81,256 vaccinations at retail pharmacies were administered to MHS beneficiaries." Nextgov External Link

    Patient Safety Awareness Week 2021 highlights role of technology

    12 March- The Military Health System will once again join the annual national Patient Safety Awareness Week education campaign to bring awareness to health care safety and promote patient safety practices. The theme for this year's campaign, March 14-20, will focus on the role technology plays in promoting patient safety across MHS. "We focus on ensuring ready reliable care for every patient, every time, and are always seeking ways to improve our health care delivery system - establishing processes and optimizing technologies to provide products, services, educational opportunities, and training resources to health care leadership, health care professionals, staff and beneficiaries," said Heidi King, chief of the Defense Health Agency's Patient Safety Program for Medical Affairs.
    This includes web-based reporting tools to record and analyze data and create alerts and advisories that are swiftly disseminated to the MHS, standardized practices across the military services, and more rapid responses to ensure the safe delivery of immunizations and monitor infection control, she added.
    With patients at the heart of its mission, the Department of Defense's Patient Safety Program aims to engage, educate, and equip patient care teams to implement evidence-based safe practices across MHS, thereby eliminating preventable patient harm. It relies not only on health care professionals but also non-clinical staff, patients, and families who have an important role in promoting a culture of safety for patients and ensuring the safe delivery of health care to 9.6 million MHS beneficiaries. "Patient engagement is key, and the relationship between providers and patients and their families leads to safer care," said King. DVIDS External Link

    GLOBAL

    Can mRNA vaccines protect immunocompromised individuals?

    17 March- To better understand the immunogenicity of mRNA vaccines in immunocompromised individuals, researchers from Johns Hopkins University School of Medicine quantified the humoral response to the first vaccine dose in solid organ transplant recipients, reported a study published by the JAMA on March 15, 2021. After a median of 20 days post-vaccination, serologic tests showed that 17.4% of the study participants (76 of 436) had detectable antibody levels after the first dose of an mRNA vaccine. The study reviewed data from December 2020 to February 2021, with the median age of participants was 55.9, and 89% were white. Kidney (50.2%), liver (17.9%), and heart (15.1%) were the most common organ transplants, and the median time since the transplant was 6.2 years. In 2018, the total number of organ transplants in the USA exceeded 750,000 people since 1988, the first full-year national transplant data were collected. These findings of poor antispike antibody responses in organ transplant recipients after the first dose of mRNA vaccines suggest that such patients may remain at higher early risk for COVID-19 despite vaccination. This study's results contrast with the robust early immunogenicity observed in mRNA vaccine trials, including 100% antispike seroconversion by day 15 following vaccination with mRNA-12735 and by day 21 following vaccination with the BNT162b2 vaccine, concluded these researchers. Deeper immunophenotyping of transplant recipients after vaccination, including characterization of memory B-cell and T-cell responses, will be important in determining vaccination strategies as well as immunologic responses after the second dose, stated these researchers. Precision Vaccinations External Link

    CDC updates coronavirus guidance for child care centers

    13 March- The Centers for Disease Control and Prevention (CDC) updated guidance for operating child care programs in several areas including expanded background on what is known about COVID-19 and transmission in child care settings, recommendations for mask use and information for children with special needs and disabilities. The new guidance, which is intended for all types of child care programs, including child care centers, family child care homes, Head Start programs and other pre-kindergarten programs, marks the first update since July. "Throughout the pandemic parents and caregivers have faced the challenging task of balancing child care responsibilities with work responsibilities often operating in a virtual environment with limited child care options," Dr. Rochelle Walensky, CDC director, said in a White House COVID-19 briefing Friday.  "We know that child care programs and early child education are essential to healthy childhood development. The services these programs offer are important for working parents and provide a safe, stable and nurturing environment for kids to get them ready for school and develop critical social and emotional skills." Fox News External Link

    Children can participate in mRNA vaccine study

    16 March- Massachusetts-based Moderna Inc. announced that the first participants had been dosed in the Phase 2/3 study, called the KidCOVE study, of mRNA-1273, the Company's vaccine candidate against COVID-19, in children ages 6 months to less than 12 years. "We are pleased to begin this Phase 2/3 study of mRNA-1273 in healthy children in the U.S. and Canada, and we thank NIAID and BARDA for their collaboration," stated Stéphane Bancel, Chief Executive Officer of Moderna, in a press release. This Phase 2/3 two-part, open-label, dose-escalation, age de-escalation (Part 1), and randomized, observer-blind, placebo-controlled expansion study (Part 2) will evaluate the safety, tolerability, reactogenicity, and effectiveness of two doses of mRNA-1273 given 28 days apart. The Company intends to enroll approximately 6,750 pediatric participants in the U.S. and Canada, ages 6 months to less than 12 years. The study is being conducted in collaboration with the US National Institute of Allergy and Infectious Diseases and the Biomedical Advanced Research and Development Authority. Currently, the experimental Moderna COVID-19 Vaccine is authorized under an Emergency Use Authorization for active immunization to prevent COVID-19 caused by SARS-CoV-2 in individuals 18 years of age and older. Moderna COVID-19 Vaccine is investigational and not approved by the U.S. FDA. According to the US Centers for Disease Control and Prevention(CDC), very few children have been impacted by COVID-19. At the end of 2020, the CDC reported (888) hospitalization by children less than five years of age related to COVID-19. Precision Vaccinations External Link

    COVID-19 cases plunge 83% among U.S. nursing home staff, despite vaccine hesitancy

    15 March- Joan Phillips, a certified nursing assistant in a Florida nursing home, loved her job but dreaded the danger of going to work in the pandemic. When vaccines became available in December, she jumped at the chance to get one. Months later, it appears that danger has faded. After the rollout of covid vaccines, the number of new covid cases among nursing home staff members fell 83% — from 28,802 for the week ending Dec. 20 to 4,764 for the week ending Feb. 14, data from the Centers for Medicare & Medicaid Services shows. New covid-19 infections among nursing home residents fell even more steeply, by 89%, in that period, compared with 58% in the general public, CMS and Johns Hopkins University data shows. These numbers suggest that "the vaccine appears to be having a dramatic effect on reducing cases, which is extremely encouraging," said Beth Martino, spokesperson for the American Health Care Association and National Center for Assisted Living, an industry group. CNN External Link

    COVID-19 virus can literally catch up; research says 'slow walkers' may be infected more

    16 March- COVID-19 is one of the most notorious viruses that are present in the world, and it infects highly as its components can be carried by air towards other people, hence the masks and protective equipment. However, new research suggests that people whose pace while walking is slower might have a higher chance to contract the virus. The pandemic has been plaguing the world for more than a year now, and it has already evolved to multiple variants that produced massive scares as they are more robust and effective in infecting people. Different strains may have gone out, but it is still a massive threat to human health, providing danger and health risks with exposure. However, various studies have been surfacing on what makes people more susceptible to infection from the coronavirus, and one of them suggests something about human speed while walking. The return to the public with limited interaction and observing proper guidelines are allowed, but this study may lead people to think twice. Tech Times External Link

    Fewer people take a 'wait and see' approach to COVID-19 vaccine — here's what changed their minds

    14 March- Though access to COVID-19 vaccines remains limited, polling suggests a slice of Americans want to "wait and see" how the shots work for other people before they get vaccinated themselves. But experts say that getting the vaccine as soon as it's available to you will be vital for protecting yourself and others, stopping virus variants in their tracks, and resuming some level of normalcy. The share of people in this "wait and see" category has declined over time, according to polling by the health-policy think tank Kaiser Family Foundation, dropping from 39% in December to 31% in January. In February, the most recent survey, it stood at 22%. This happened alongside a gradual increase in the share of respondents (most recently 55%) reporting they'd either gotten at least one dose or would get the vaccine as soon as possible. Black adults (34%), young adults aged 18 to 29 (33%), Hispanic adults (26%), adults without a college degree (25%), and non-health essential workers (25%) had the highest shares of respondents in the wait-and-see group. The most common concerns in the wait-and-see cohort were the potential for serious side effects; the possibility of getting COVID-19 from the vaccine, which health authorities say cannot happen; the prospect of missing work due to side effects; and the potential need to pay out of pocket for the vaccine, though the vaccines are free. A quarter of wait-and-seers said a one-dose vaccine would make them more likely to get their shot. Market Watch External Link

    Massive Facebook study on users' doubt in vaccines finds a small group appears to play a big role in pushing the skepticism

    14 March- Facebook is conducting a vast behind-the-scenes study of doubts expressed by U.S. users about vaccines, a major project that attempts to probe and teach software to identify the medical attitudes of millions of Americans, according to documents obtained by The Washington Post. The research is a large-scale attempt to understand the spread of ideas that contribute to vaccine hesitancy, or the act of delaying or refusing a vaccination despite its availability, on social media — a primary source of health information for millions of people. It shows how the company is probing ever more nuanced realms of speech, and illustrates how weighing free speech vs. potential for harm is more tenuous than ever for technology companies during a public health crisis. While Facebook has banned outright false and misleading statements about coronavirus vaccines since December, a huge realm of expression about vaccines sits in a gray area. One example could be comments by someone expressing concern about side effects that are more severe than expected. Those comments could be both important for fostering meaningful conversation and potentially bubbling up unknown information to health authorities — but at the same time they may contribute to vaccine hesitancy by playing upon people's fears. The Washington Post  External Link

    Q&A: Are COVID-19 vaccines safe and effective?

    11 March- As the fight against COVID-19 continues, vaccination is one way to slow the spread and protect yourself. Chances are you know someone who's already been vaccinated. Still, you may be concerned about safety - and wondering when to schedule the vaccine for yourself. "It's important for people to know that these vaccines, though produced in record time, have gone through the same safety processes as other vaccines," said Dr. John Kugler, chief of the Clinical Support Division at the Defense Health Agency. "I got the vaccine when I became eligible and encourage you to get it to help keep you and your family safe." As the COVID-19 vaccine becomes available to you, you may have questions. Here are some answers about the vaccine. Question: Will I experience side effects after getting a COVID-19 vaccine?
    Answer: You may. most common side effects are pain and swelling in the arm where you received the shot. You may also have fever, chills, tiredness, and headache. These symptoms are a sign that your body is building protection against the coronavirus. They should go away in a few days. Contact your doctor if the side effects are worrying you or don't seem to be going away after a few days. Since vaccines, including the COVID-19 vaccines, carry a risk of allergic reactions, the Centers for Disease Control and Prevention (CDC) recommends that your vaccine provider monitors you for 15 to 30 minutes after vaccination. In the rare case that you think you're experiencing a severe allergic reaction after leaving the vaccination site, call 911 or go to the nearest emergency room. Health.mil External Link

    Thai sniffer dogs can detect COVID-19 in sweat, project shows

    17 March- Thai sniffer dogs trained to detect COVID-19 in human sweat proved nearly 95% accurate during training and could be used to identify coronavirus infections at busy transport hubs within seconds, the head of a pilot project said. Six Labrador Retrievers participated in a six-month project that included unleashing them to test an infected patient's sweat on a spinning wheel of six canned vessels. "The dogs take only one to two seconds to detect the virus," Professor Kaywalee Chatdarong, the leader of the project at the veterinary faculty of Thailand's Chulalongkorn University, told Reuters. "Within a minute, they will manage to go through 60 samples." The dogs can detect a volatile organic compound secreted in the sweat of COVID-19 sufferers, even in the absence of disease symptoms, the Thai researcher said. The dogs would not need to directly sniff people, but could screen samples of sweat, a task that should not be difficult in a tropical country such as Thailand, she added. Chile, Finland and India are other countries that have also launched efforts to get sniffer dogs to detect the virus, with a German veterinary clinic saying last month its sniffer dogs had achieved 94% detection accuracy in human saliva. "The next step is we will put them out in the field," said Kaywalee. "In the future, when we send them to airports or ports, where there is an influx of commuters, they will be much faster and more precise in detecting the virus than temperature checks." Thailand has been relatively successful in containing the virus, with a new wave of infections in the first two months of the year now levelling off and after recording 88 deaths. The southeast Asian nation has also started vaccinating front-line health workers and hopes to find a way to let visitors return in greater numbers after its tourism-dependent economy was battered by the pandemic. Reuters External Link

    WHO advisory group statement on AstraZeneca shot may come Wednesday

    17 March- A World Health Organization advisory group may make a statement on the AstraZeneca COVID-19 shot as early as Wednesday, a WHO spokesman said. Global health experts have come under increasing pressure to clear up questions over the safety of AstraZeneca's vaccine, as the number of countries suspending its use grows in a blow to Europe's vaccination rollout. The European Medicines Agency has said it is investigating reports of 30 cases of unusual blood disorders out of 5 million recipients of the AstraZeneca vaccine. In total, 45 million COVID shots have been delivered across the region. Reuters External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 9, ending March 6, 2021:

    Influenza-Associated Hospitalizations- The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in 14 states and represents approximately 9% of the U.S. population.

    Influenza-Associated Pediatric Mortality- A total of one influenza-associated pediatric death occurring during the 2020-2021 season has been reported to CDC. CDC External Link

    WHO: Influenza Update

    01 March 2021, based on data up to 14 February 2021

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission have likely played a role in reducing influenza virus transmission.

    - Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.

    - In the temperate zone of the northern hemisphere, influenza activity remained below baseline, though sporadic detections of influenza A and B viruses continued to be reported in some countries.

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

    - In the Caribbean and Central American countries, sporadic influenza detections were reported. Severe acute respiratory infection (SARI) activity was low in most reporting countries.

    - In tropical South America, sporadic detections were reported in Colombia.

    - In tropical Africa, influenza activity was reported in some reporting countries in Western, Middle and Eastern Africa in recent weeks.

    - In Southern Asia, sporadic influenza detections were reported in India.

    - In South East Asia, influenza A(H3N2) detections continued to be reported in most reporting countries.

    - Worldwide, influenza B detections accounted for the majority of the very low numbers of detections reported. WHO External Link

    VETERINARY/FOOD SAFETY

    Denmark investigates botulism outbreak

    16 March- Three confirmed cases of foodborne botulism are being investigated in Denmark. The outbreak occurred earlier this month at a private company in Southern Denmark. Six people had eaten together and three initially developed symptoms. Two other people have since shown signs of being affected. Fødevarestyrelsen (the Danish Veterinary and Food Administration), the National Food Institute (DTU- Food) and Statens Serum Institute are trying to identify the source of infection. Following a private party on March 5, three adults have been hospitalized because of botulism. They are being treated with botulism antitoxin and the condition of all of them is improving. Analysis of stool from one patient shows it is toxin type B. Another two people from the company have developed mild symptoms and samples from them are being studied. The Statens Serum Institute examined samples from the patients to confirm the botulism hypothesis. The agency is also analyzing the ingredients and leftovers of food that was eaten at the company. No other patients with botulism are known outside this business. Food Safety News External Link

    Imported meat linked to Salmonella outbreak in Norway

    13 March- Norwegian officials have traced the source of a Salmonella outbreak to meat from Germany. Salmonella Enteritidis with the same genetic profile as the outbreak strain has been detected in a batch of beef imported from Germany. This batch has been withdrawn from the market. It has been used in the production of ground (minced) meat and at the same plant as burgers. Folkehelseinstituttet (the Norwegian Institute of Public Health) previously reported 20 people were sick. Now it is known 22 people fell ill and 19 are confirmed to have been infected with the outbreak strain. For three people, confirmation is pending but preliminary analyzes indicate they belong to the outbreak. Food Safety News External Link

    WELLNESS

    Global rise in childhood mental health issues amid pandemic

    13 March- By the time his parents rushed him to the hospital, 11-year-old Pablo was barely eating and had stopped drinking entirely. Weakened by months of self-privation, his heart had slowed to a crawl and his kidneys were faltering. Medics injected him with fluids and fed him through a tube — first steps toward stitching together yet another child coming apart amid the tumult of the coronavirus crisis. For doctors who treat them, the pandemic's impact on the mental health of children is increasingly alarming. The Paris pediatric hospital caring for Pablo has seen a doubling in the number of children and young teenagers requiring treatment after attempted suicides since September. Doctors elsewhere report similar surges, with children — some as young as 8 — deliberately running into traffic, overdosing on pills and otherwise self-harming. In Japan, child and adolescent suicides hit record levels in 2020, according to the Education Ministry. Pediatric psychiatrists say they're also seeing children with coronavirus-related phobias, tics and eating disorders, obsessing about infection, scrubbing their hands raw, covering their bodies with disinfectant gel and terrified of getting sick from food. Also increasingly common, doctors say, are children suffering panic attacks, heart palpitations and other symptoms of mental anguish, as well as chronic addictions to mobile devices and computer screens that have become their sitters, teachers and entertainers during lockdowns, curfews and school closures. "There is no prototype for the child experiencing difficulties," said Dr. Richard Delorme, who heads the psychiatric unit treating Pablo at the giant Robert Debré pediatric hospital, the busiest in France. "This concerns all of us." Fox News External Link

    USAFRICOM

    Ebola in DRC: 1500 vaccinated, Healthcare providers threaten strike

    15 March- Health officials in Butembo, North Kivu province said that 1,515 people have already received the vaccine against the Ebola virus which has resurface in the province. "The vaccination to date is that out of the 1,517 eligible, we have been able to vaccinate 1,515 people. And in these figures of 1,515, 866 are in the Biena health zone (where the 1st case was declared on February 07, 2021, Editor's note) to say about 57.2%. With that we can say that the situation is evolving anyway well, " according to Guy Makelele, coordinator of the DPS-Butembo. Also in Butembo, healthcare providers at the Ebola Treatment Center (CTE) of Katwa, in the town of Butembo (North Kivu), ceased all care activities last Saturday. They are threatening to go on strike to decry the insignificant salary scale. "We have been in Katwa with the provincial minister of health to listen to the providers, to understand exactly what is wrong. It is because the providers told us that the fixed scale is low. You know, EVD (Ebola Virus Disease) is managed nationally and even locally. Having felt that this was a well-founded problem, the Minister of Health decided to go to Goma to share the information with the governor. Of course we will relay at the national level. It is up to providers to take their trouble patiently, " added Doctor Guy Makelele. Since the resurgence of the Ebola epidemic in North Kivu, the cumulative number of cases remains at 12. These are 11 confirmed cases and one probable case. Five people have already died from this virus. Outbreak News Today External Link

    Nigeria reports 25 additional Lassa fever cases, one death

    12 March- The Nigeria Centre for Disease Control (NCDC) reported 25 confirmed Lassa fever cases the week ending March 7, including one more death, bringing the country totals for 2021 to date to 161 cases and 32 deaths. The new cases were reported from six States (Edo, Ondo, Ebonyi, Taraba, Kaduna and Benue). In total for 2021, 12 States have recorded at least one confirmed case across 45 Local Government Areas. Of all confirmed cases, 79% are from Edo (45%), Ondo (24%) and Taraba (10%) States. Cumulatively from week 1 to week 9, 2021, 32 deaths have been reported with a case fatality rate (CFR) of 19.9%. Outbreak News Today External Link

    USCENTCOM

    Saudi Arabia health officials report two additional MERS cases in Riyadh

    12 March- In a follow-up report on Middle East respiratory syndrome coronavirus (MERS-CoV) situation in Saudi Arabia in 2021, on Thursday, the Saudi Arabia Ministry of Health (MOH) reported two additional cases in people from Riyadh City.  The first patient is a 57-year-old man from Riyadh who had contact with camels and the second patient is a 56-year-old female from Riyadh with no contact with camels. This brings the country total of MERS cases to seven for 2021. The World Health Organization (WHO) says MERS-CoV  is a virus transferred to humans from infected dromedary camels. It is a zoonotic virus, meaning it is transmitted between animals and people, and it is contractible through direct or indirect contact with infected animals. MERS-CoV has been identified in dromedaries in several countries in the Middle East, Africa and South Asia. In total, 27 countries have reported cases since 2012, leading to 858 known deaths due to the infection and related complications. Human-to-human transmission is possible, but only a few such transmissions have been found among family members living in the same household. In health care settings, however, human-to-human transmission appears to be more frequent. Outbreak News Today External Link

    USEUCOM

    Covid-19 pandemic: Italy to shut shops and schools amid infection spike

    13 March- Shops, restaurants and schools will be closed across most of Italy on Monday, with PM Mario Draghi warning of a "new wave" of the coronavirus outbreak. For three days over Easter, 3-5 April, there will be a total shutdown. Italy, which one year ago imposed one of the first national lockdowns, is once again struggling to contain the rapid spread of infections. The country has reported more than 100,000 Covid-related deaths, Europe's second-highest tally after the UK. Italy's vaccination campaign has been hit by delays, as has been seen elsewhere in the European Union. Anglo-Swedish drug company AstraZeneca has announced a further shortfall in the amount of its vaccine it can supply to the European Union, blaming export restrictions imposed by some countries. It did not elaborate. In January, it announced a large cut in the 100m doses it had originally expected to deliver to the EU by March, sparking a public spat with European Commission. Last week the government in Rome blocked the export of 250,000 doses of the Oxford-AstraZeneca vaccine to Australia to address shortfalls of vaccines. BBC News External Link

    Salmonella outbreak grows in Sweden

    14 March- In a follow-up on the Salmonella Enteritidis in Sweden, The Swedish Public Health Agency have now reported 25 confirmed cases across 14 regions in the southern and central parts of the country since December 2020. 72% of cases are children under 10 years (n = 18), 16% of cases are over 70 years (n = 4). The distribution between the sexes is even, except for cases over the age of 70 where all are men. The infection control units concerned, the Swedish Public Health Agency and the National Food Administration are jointly investigating the outbreak to identify the source of the infection. Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis. Outbreak News Today External Link

    USINDOPACOM

    Malaysia: Two additional human rabies fatalities in Sarawak

    13 March- The Malaysia Ministry of Health (MOH) has reported two additional confirmed cases of rabies among humans in Sarawak. Both the patients died. The first case of rabies was a 52 -year -old Malaysian man. He denied having a history of being bitten or scratched by dogs or other mammals. However, he once arrested and killed a pet dog in the area of his factory worker's house on 17 October 2020 after the dog bit two (2) workers there. However, the carcass of the dog was not handed over to the Sarawak Veterinary Services Department (DVS) for further investigation. On 31 January 2021, he was treated and admitted to a ward at Sibu Hospital for chest pain, numbness in his right hand, vomiting and shortness of breath. His health condition deteriorated to the point of requiring respiratory assistance on 5 February 2021. The deceased passed away on 8 February 2021 with the cause of death being due to rabies infection. The deceased's diagnosis was confirmed positive for rabies through a laboratory test conducted by University Malaysia Sarawak (UNIMAS) on February 6, 2021. Meanwhile, two workers who were bitten by the dog have received initial treatment and are still under follow -up monitoring by the health authorities. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Legionnaires' disease cluster reported in north New Jersey

    14 March- The New Jersey Department of Health (NJDOH) is investigating a cluster of Legionnaires' disease cases in Union County. The Department is aware of 14 confirmed cases of Legionnaires' disease, including one death, among individuals who live in or spend time in the county. The cases were reported to the Department between February 3 and February 26, 2021. The Department is working with the local health departments in Union County to investigate this cluster. The individual who died was a male resident of Union County in his late 60s. This is a continuing investigation. The risk to anyone who lives in Union County is very small," said New Jersey Health Commissioner Judith Persichilli.  "Out of an abundance of caution, the Department recommends that individuals who live in Union County who become ill with pneumonia-like/respiratory symptoms, such as fever, chills, cough, shortness of breath, muscle aches, and headache visit their healthcare provider." he risk of Legionnaires' disease among residents or recent visitors to Union County is low. Most healthy people exposed to Legionella do not develop Legionnaires' disease. People over the age of 50, especially those who smoke cigarettes, or those with certain medical conditions, including weakened immune systems, chronic lung disease or other chronic health conditions, are at increased risk for Legionnaires' disease. Outbreak News Today External Link

    USSOUTHCOM

    Brazil: Additional monkeys die from yellow fever in Santa Catarina, two human cases in 2021

    13 March- Santa Catarina already accounts for the death of 64 monkeys due to yellow fever. The latest epidemics (death or illness of a monkey) were confirmed this Thursday, March 11, in Lages (4), São José do Cerrito (3) and Rio Fortura (1). In addition, SC has two confirmed human cases in 2021. The first, recorded in January, was that of a 40-year-old resident of Taió, in the Alto Vale do Itajaí region. The second was confirmed in March, being of a 62 year old man, resident of Águas Mornas, in Greater Florianópolis. Both had no vaccine registration. For Arieli Fialho, immunization manager of the Epidemiological Surveillance Directorate (DIVE / SC), the disease scenario reinforces the importance of vaccination. "Yellow fever is a serious disease that can lead to death if it is not diagnosed and treated quickly. The vaccine is the best way to prevent the disease. The dose is free and available at health centers ", he warns. The vaccination coverage of SC for yellow fever is 76%, however, it is heterogeneous, that is, some regions of the state have indices below. "Especially in the places where we have the record of new epidemics, it is necessary that the population is vaccinated. In Greater Florianópolis and Serra we have the lowest coverage ", highlights João Augusto Brancher Fuck, director of DIVE / SC. All residents of Santa Catarina older than nine months should receive the dose. Those who are not sure if they have already had the vaccine, should look for a health unit to check the vaccination booklet. Outbreak News Today External Link