Army Public Health Weekly Update, 20 August 2021

Date Published: 8/20/2021
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 03 September 2021.

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

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

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Table of Contents

    ANNOUNCMENTS 

    COVID-19 Vaccines for Moderately to Severely Immunocompromised People

    16 August- CDC now recommends that people whose immune systems are compromised moderately to severely should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses. Widespread vaccination is a critical tool to help stop the pandemic. Read CDC's statement. CDC External Link

    U.S. MILITARY

    DOD's whole of government approach to COVID is working, says Adirim

    13 August- During the opening keynote at the Healthcare Information and Management Systems Society's annual conference, Dr. Terry Adirim, acting assistant secretary of defense for health affairs, explained how she has been extremely impressed by the Department of Defense's response to the COVID-19 pandemic since taking over her current role. She also detailed how adaptation and innovation have played key parts in that response. The panel, entitled "Preserving the Health of a Population – Early Lessons from a Global Pandemic," was hosted by Hal Wolf, HIMSS president and chief executive officer, and included Adirim, Dr. Ran Balicer, chief innovation officer for Israel's Clalit Health Services; Dr. Patrice Harris, CEO and co-founder of eMed; and Dr. Hans Henri Kluge, the World Health Organization's regional director for Europe. "I was very impressed when I came in in January with all of the work that the department has done. It really took a whole of government approach and that was very much emphasized by Secretary (of Defense, Lloyd) Austin," Adirim said. "He really supported all aspects and sectors in doing that, as well as taking care of our service members and beneficiaries." Adirim explained how she was also impressed with how "thoughtful," the DOD's Force Health Protection Guidance was regarding COVID, although emerging variants such as Delta may necessitate a shift in the department's approach. "Even pre-vaccination, we were able to protect our force and they were able to complete their mission," she said. "I think Delta has thrown a wrench in that a little bit, but I think overall, the Department of Defense has, and continues to do, a pretty good job." Adirim said the early lessons learned should be catalysts for change within DOD healthcare. "We need to take what we've done during the pandemic – and those things that are working, document that for going forward," she said. With the changing nature of the virus, and new information becoming available daily, she said flexibility and change are essential to the DOD's mission. "Our healthcare system has been fairly nimble when it comes to re-looking at how we do things and when it comes to completing our missions, especially our national security mission," said Adirim. "We've had to adapt and change. It was hard, but when people see that it's working, we'll continue to do those things going forward." Change includes looking at an issue and adapting to the current environment. She spoke specifically about addressing children's mental health citing that, of the Military Health System's 9.6 million beneficiaries, a significant portion are children of service members who have to deal with the anxiety that can go along with frequent moves, changing schools, etc. "We've been leveraging technology and we've greatly expanded tele-behavioral health," Adirim said. "Necessity is the mother of invention. The pandemic hit and we made sure we expanded that, so our families could have better access to mental health services." Adirim also spoke about the innovation that has taken place within the DOD. Just one example was using 3D printing for protective items such as face shields to overcome supply chain issues and equipment shortages that presented themselves early in the pandemic. "I think using technology for even the more mundane things would help us be more well-prepared," she said. Health.mil External Link

    Gen. George Washington ordered smallpox inoculations for all troops

    16 August- In late 1776, as Gen. George Washington led his troops through the opening battles of the American Revolution, it was not necessarily the enemy fighters who posed the biggest risk to the fledgling U.S. Army. An estimated 90% of deaths in the Continental Army were caused by disease, and the most vicious were variants of smallpox, according to the U.S. Library of Congress. That's why Gen. Washington made the controversial decision to order the mass inoculation of his soldiers, an effort to combat spread of the disease that was at the time a major deterrent to enlistments and posed the risk of debilitating his army and tipping the balance of power against America's first warfighters. According to the U.S. Library of Congress's Science, Technology, and Business Division, the smallpox inoculations began Jan. 6, 1777, for all of Washington's forces who came through the then-capital of Philadelphia, and through Morristown, New Jersey, following the Battle of Princeton. Smallpox is a potentially fatal disease that starts with fever and vomiting and an outbreak of ulcers in the mouth and a skin rash. The skin rash turns into highly contagious fluid-filled blisters. The fatality rate was very high. Inoculations were far more primitive - and dangerous - than today's vaccinations. The most common method was to cut a person's skin and rub the minor incision with a thread or cloth contaminated with a less-virulent version of smallpox, which in this case was a strain known as "variola." At the time, most English troops were immune to variola, and their immunity gave them an "enormous advantage against the vulnerable colonists," according to the library. By contrast, less than a quarter of the American colonial troops had ever had the virus. Washington knew a mass inoculation campaign could backfire and might cause more disease than it prevented. He also feared the mandatory inoculations would harm recruitment. Nevertheless, after weighing the odds, Washington informed Congress on Feb. 5, 1777, of his plans for a mass inoculation. The general's plans contraindicated a 1776 proclamation by the Continental Congress prohibiting inoculations. A Feb. 6 letter to Dr. William Shippen from Washington states: "Finding the smallpox to be spreading much and fearing that no precaution can prevent it from running through the whole of our Army, I have determined that the troops shall be inoculated. This expedient may be attended with some inconvenience and some disadvantages but yet I trust its consequences will have the most happy effects. Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army in the natural way and rage with its usual virulence, we have more to dread from it than from the sword of the enemy." Throughout February, the inoculations across the entire force were carried out in the model of the initial efforts in Morristown and Philadelphia. Health.mil External Link

    Half a million soldiers have taken the Army's new fitness test, but not in time to force leader to call himself 'big mouth'

    16 August- The Army's top enlisted leader won't have to fulfill his promise to call himself "a nobody with a big mouth" in his biographical information on Twitter. Sgt. Maj. of the Army Michael Grinston's offer was a challenge he issued to soldiers that sought to push the number of Army Combat Fitness Test scores registered to 500,000 by the service's 246th birthday, which occurred June 14. "Follow up: We didn't hit 500K in time," he tweeted Aug. 6, nearly two months after Stars and Stripes and others began inquiring about the results via Twitter, Reddit and emails to the Pentagon. The quip that Grinston had offered to add to his bio came from an insult written on his Twitter feed. He has amassed nearly 40,000 followers on the social media platform. Many senior Army leaders have embraced Twitter to share the service's official messages, expound on its efforts, highlight soldier achievements and engage with the force and the public. But even though the challenge missed the mark, Grinston's efforts weren't in vain. At the June deadline, the service was about 40,000 tests short of the tweeted target, Army spokesman Lt. Col. Gabriel J. Ramirez said via email Friday. As of Aug. 13, nearly 540,000 soldiers had entered more than 781,000 scores into the system, Ramirez said. The ACFT is the first overhaul of the Army's fitness test in 40 years and was initially rolled out with plans to make it official by October 2020. But Congress called for it to be halted in January, and lawmakers have expressed concerns over gender disparities in its results. Some 44% of women had failed an earlier version, compared with 7% of men, data showed. A new version, dubbed "ACFT 3.0," was meant to address the concerns and has been under evaluation since the spring. Stripes External Link 

    Reform, COVID-19 have been catalysts for change in Military medicine

    We cannot forget that healthcare is about taking care of people, so no amount of change or innovation is ever sufficient if modernization does not lead to helping patients, delivering better outcomes, saving lives or helping healthcare providers deliver care," said Dr. Terry Adirim, acting assistant secretary of defense for health affairs, during a Views from the Top educational session at the Healthcare Information and Management Systems Society 2021 annual conference. She spoke about the unique differences, as well as the similarities, between civilian and military medicine. "I believe there are unique lessons from our experience within the Military Health System, regardless of what sector of healthcare you sit in," said Adirim. "From data systems driving greater efficiencies and better outcomes within our agencies, to efforts helping us realize the advancements in science and medicine." These innovations, she said, are aligning federal healthcare providers with the best in private sector care, delivering the best results for service members and their families. Adirim said the two largest factors currently leading to innovations, changes and advancements within the MHS are:

    -MHS Reform

    -COVID-19

    "We can't discuss innovation, modernization and responding to change without also talking about the pandemic. COVID-19 continues to prove to be the ultimate disruptor," she said. "It has tested the readiness and resilience of the entire enterprise and put our providers at risk and, ultimately, threatens our service members' ability to do their jobs." Adirim explained how new approaches to medical care and public health such as virtual health and testing methodology have kept military health beneficiaries safe since the onset of the pandemic. These, "seemingly small but significant wins," she said, have created real change. Health.mil External Link 

    Services will make call on religious exemptions to COVID-19 vaccines

    13 August- In a memorandum released Aug. 9, 2021, the secretary of defense explained how he will ensure the continued health and safety of the U.S military through the use of the available COVID-19 vaccines. "I will seek the President's approval to make the vaccines mandatory no later than mid-September, or immediately upon the U.S. Food and Drug Administration licensure, whichever comes first," said Secretary of Defense Lloyd J. Austin III. Right now, there are three COVID-19 vaccines available. All are currently being used across the United States under "emergency use authorization," or EUA, from the Food and Drug Administration. Those vaccines include the ones from Pfizer and Moderna, both of which require two injections. The Johnson & Johnson vaccine requires only a single shot. If any of the three vaccines receive full licensure by the FDA before mid-September, Austin said, they will become mandatory immediately. If they do not receive the licensure by mid-September, however, the secretary will request a waiver from the president to make them mandatory. For service members who have religious objections to receiving a vaccine, the path for how they might seek an exception to the vaccine is defined by their individual military service's regulations, Pentagon Press Secretary John F. Kirby said during a meeting with the media on Aug. 10, 2021. "There is a religious exemption possibility for any mandatory vaccine, and there's a process that we go through to counsel the individual both from a medical and from a command perspective about using a religious exemption," Kirby said. Counseling, he said, includes a discussion with both a medical professional and a commander about the risks of not being vaccinated as well as how not being vaccinated might affect deployability, assignments or travel. Requests for religious exemption differ by service, he said. "We take freedom of religion and worship seriously, in the military, it's one of the things that we sign up to defend," he said. "And so it's something that's done very carefully." There are exemptions for mandatory vaccines for medical reasons as well, Kirby said, including pre-existing medical conditions. "The primary care physician will be able to help make that determination," he said. Nevertheless, the defense secretary and the department are confident that once the vaccines are mandatory, service members will do their part. "We have every expectation that once the vaccines are made mandatory, the troops are going to ... do the right thing," he said. "Going forward with this particular vaccine, the secretary's expectation is that commanders are going to treat the administration of that vaccine with — as he wrote in his memo — professionalism, skill and compassion." Kirby also said the department will ensure that every individual with reservations about getting a vaccine gets proper counseling on its safety and efficacy as well as how not getting the vaccine could affect teammates, readiness and the mission. Health.mil External Link

    GLOBAL

    Babies born during COVID-19 pandemic tied with lower IQ, study suggests

    14 August- Preliminary findings by U.S. researchers suggest children born during the COVID-19 pandemic show lower IQ scores than those who were born before January 2020, but the underlying causes are still unknown. It may be due to the first 1,000 days of a child's life being the most crucial to development. The findings were posted in medRxiv ahead of peer review on Aug. 11, stemming from a survey among roughly 605 children in Rhode Island, most of them White, including 39 born in 2018 and 2019. Environmental factors, including maternal mental and physical health, nutrition, stimulation and supportive caregiving can alter the child's development. The study of pre-pandemic babies shows that they had an IQ ranging from 98.5 to 107.3. But the IQs of babies born during the pandemic sharply fell 27 to 37 points. The study attributed lockdown policies aimed at slowing the spread of COVID-19 such as economic shutdowns, mask-wearing, school disruptions, social distancing and stay-at-home orders. Fox News External Link

    CDC: Kids' long COVID often involves fatigue, headache

    13 August- Children experiencing lingering symptoms weeks to months after initial COVID-19 infection, or so-called long COVID, most often face fatigue and headache, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC) said during a White House briefing. Walensky said the health agency is examining the condition among kids, and noted the rates appear to be lower than that among adults, at about 2%-3%, and efforts will continue as the delta variant sweeps the U.S. and exacerbates the country's case count. In a recent statement from Dr. Amanda Morrow and Dr. Laura Malone, co-directors of the Kennedy Krieger Institute's Post COVID-19 Pediatric Rehabilitation Clinic, long COVID in kids can involve a wide variety of symptoms beyond fatigue and headaches, including "activity intolerance, lightheadedness, cognitive complaints resulting in difficulty with schoolwork, and mood symptoms." "We do not know the expected recovery time, but many of our patients are having improvement in their symptoms over time," the co-directors told Fox News. The clinic has seen some 20-30 long COVID patients under the age of 21, but additional children await care. Patients seeing improvement are receiving multiple therapies and are following a care plan based initial and ongoing assessments, the co-directors said. Experts say it's unclear whether the delta variant is resulting in more severe COVID-19 disease among children. Dr. Anthony Fauci, the country's leading infectious disease expert, noted during the briefing Thursday that the delta variant is highly transmissible, which will result in additional infections and hospitalizations among kids. "There's no doubt that there are more children getting infected," Fauci said, later adding, "Regarding the severity of illness, there was a couple of studies, mostly international, which suggested delta was more severe in adults, namely causing more relative percentage of hospitalization and more severe disease. With regard to children, this could possibly be the case but we are not seeing this in a definitive way. The only thing we know for sure is that more infections mean more children will be in the hospital." Fox News External Link

    CDC recommends third Covid-19 vaccine dose for certain immunocompromised people

    13 August- Vaccine advisers to the US Centers for Disease Control and Prevention voted unanimously on Friday to recommend an extra dose of Covid-19 vaccine for some immunocompromised people, and the CDC director signed off on the recommendation almost immediately. The US Food and Drug Administration gave emergency use authorization Thursday night for a third dose in certain patients who are likely to have had a poor immune response to two doses of either Pfizer's or Moderna's vaccine. There's not enough data to discuss the possibility for an extra dose of Johnson & Johnson's one-shot Covid-19 vaccine, the FDA said. That brought the question to the CDC and its Advisory Committee on Immunization Practices to decide whether to recommend that people actually get these extra doses. "Yes, I agree ...that the benefits are tremendous and the potential negative impacts are minimal and so I agree that we should recommend," ACIP member Dr. Katherine Poehling, a professor of pediatrics and epidemiology at Wake Forest School of Medicine, said during the meeting. CDC Dr. Rochelle Walensky quickly endorsed the vote, which means people can begin getting third doses right away. CNN External Link

    CDC vaccination card works for Green Pass

    13 August- When Italy began requiring some businesses to scan a Green Pass to enter, Americans living in military communities entered a unique situation – unable to obtain a Green Pass through the Italian government, they are in the position of explaining how Italian health officials now recognize their U.S. vaccination card as a valid equivalent. Since Aug. 6, Italy has required proof of vaccination to access many establishments - including indoor dining, gyms, pools, theaters, and stadiums. Local transportation will soon be added. At U.S. Army Garrison Italy, with installations in Vicenza and Livorno, American community members have been turned away from local restaurants and other establishments since the policy began. "We rely upon goods and services from Italian establishments, as most of our Soldiers and their families live in local Italian communities here in the Veneto and in Tuscany," said Col. Matthew Gomlak, commander of USAG Italy, from his headquarters at Caserma Ederle in Vicenza. "American service members and their families hope to retain our patronage of Italian businesses." More than 75 percent of U.S. personnel at USAG Italy, to include soldiers, civilians and family members have received the COVID-19 vaccine. Many Italian workers were vaccinated on post. Americans carry a COVID-19 vaccination record card, issued by the U.S. Center For Disease Control. In Italy, the CDC card is recognized when entering Italian establishments that require a Green Pass, according to Italian health officials. The Italian Ministry of Health recently said that "certifications issued by non-EU states," to include the United States, are accepted in accordance with May 2021 European Union rules. The vaccine certification must have personal identification information, the type of vaccine and the dates of administration. Italy currently accepts these vaccinations; Pfizer, Moderna, AstraZeneca and Janssen. If the certificate is in English, no translation is required. "The note of the Ministry of Health made it clear," said Dr. Mariateresa Padovan, director of the Prevention and Public Health Service of the local health agency ULSS 8 Berica. "To all intents and purposes the vaccination certificate issued by the U.S. authorities is recognized as equivalent to the Green Pass and therefore allows free access to the services for which the European green certificate is required. This applies to military personnel stationed in Italy, but also to any American tourist in Italy. After all, it must be noted that unlike other non-EU countries, the vaccines used by the United States are the same as those authorized in Europe." Army.mil External Link

    Delta surge drives home painful truth: Covid isn't going away

    16 August- As alarm mounted over the coronavirus ripping through the country, Mayor Lori Lightfoot of Chicago was barraged with warnings: Lollapalooza was looking increasingly risky. The annual four-day music festival would draw hundreds of thousands of people downtown, unmasked, crowded into mosh pits, city parks, restaurants and L trains, setting up the threat of a super spreader coronavirus event in the Midwest. The mayor insisted that the festival go on. The decision to host the event, which injected a dormant downtown with energy and freely spending tourists at the end of last month, reflected a shifting response to the continuing pandemic. One year ago, Chicago was a muted version of itself: Businesses were restricted, schools were preparing to teach remotely, the police blocked access to beaches on Lake Michigan and Lollapalooza was canceled. But in recent days, even as the highly contagious Delta variant ravages the South and has caused upticks in all 50 states, mayors, governors and public health officials have treaded lightly when considering whether to reimpose restrictions. With more than twice as many new virus cases being reported nationally compared with last August, baseball games, music festivals and state fairs have forged ahead, and restaurants, gyms and movie theaters have stayed open. In many places, people have been largely left to decide for themselves whether to start wearing masks again or change the ways they work, socialize and vacation. The New York Times External Link

    Don't hesitate: Vaccinate today for school

    13 August- Back-to-school time is here already, and many parents are required to show proof of vaccinations before their children can return to in-person classes.TRICARE covers the cost of physicals for school enrollment, which include vaccinations. Parents should know that these vaccines have been proven safe and effective many times over in large clinical trials in this specific population to fight or eradicate childhood diseases. The same goes for teenagers. So, protect your children. Protect yourself. Stay up to date and talk to your pediatrician or health care provider today about vaccinations for children and teens. Think of childhood vaccines in five primary groups, said Army Capt. (Dr.) Nicholas DeStefano, officer in charge for primary care and a family physician at Weed Army Community Hospital, in Fort Irwin, California:

    1.Very early childhood vaccines generally given at 2, 4, and 6 months: hepatitis B (Hep B), diphtheria-tetanus and pertussis (DTaP), Haemophilus influenza B (Hib), pneumococcal conjugate vaccine (PCV), polio vaccine (IPV), and rotavirus vaccine.

    2.Early childhood vaccines generally given at 12 or 15 and 18 months include the very early vaccines again, except for rotavirus and Hep B, measles-mumps-rubella (MMR), varicella (chicken pox), and hepatitis A (Hep A).

    3.Childhood vaccines given at age 4: DTaP, IPV, MMR, and Varicella.

    4.Preteen vaccines given at age 11: DTaP, human papillomavirus (HPV), and meningococcal (meningitis).

    5.Teen vaccine given at age 16: meningitis.Health.mil External Link

    Metabolism peaks at age one and tanks after 60, study finds

    13 August- Middle-aged spread cannot be blamed on a waning metabolism, according to an unprecedented analysis of the body's energy use. The study, of 6,400 people, from eight days old up to age 95, in 29 countries, suggests the metabolism remains "rock solid" throughout mid-life. It peaks at the age of one, is stable from 20 to 60 and then inexorably declines. Researchers said the findings gave surprising new insights about the body.  The metabolism is every drop of chemistry needed to keep the body going. And the bigger the body - whether that is ripped muscles or too much belly fat - the more energy it will take to run. So the researchers tweaked their measurements, adjusting for body size, to compare people's metabolism "pound for pound". The study, published in the journal Science, found four phases of metabolic life:

    -birth to age one, when the metabolism shifts from being the same as the mother's to a lifetime high 50% above that of adults

    -a gentle slowdown until the age of 20, with no spike during all the changes of puberty

    -no change at all between the ages of 20 and 60

    -a permanent decline, with yearly falls that, by 90, leave metabolism 26% lower than in mid-life BBC External Link

    Younger children more likely to spread COVID-19, study finds

    16 August- Young children may be more likely to transmit the virus that causes COVID-19 within households compared with older children, a new study has found. Specifically, children 3 or younger were more likely to spread the virus to household members compared with those aged 14 to 17.  The study, published in JAMA, analyzed public health data from Ontario, Canada, to identify COVID clusters in which a child was the primary case within households. This study updates experts' understanding of COVID transmission risk, experts said. Earlier in the pandemic, some scientists suggested the risk of transmission declined with age. But this assumption was likely skewed by the fact that lockdowns and social distancing meant young children had very few social encounters. "In some ways, this is the opposite of what we had been told in the past," said Dr. Edith Bracho Sanchez, a primary care pediatrician and assistant professor of pediatrics at Columbia University Irving Medical Center. "It just shows how humble we have to be when it comes to children and this virus." "We always knew children could get it, could transmit it, and could get sick with COVID," she added. "I think we're learning more and more just how much." Meanwhile, babies and toddlers are probably more likely to spread disease to parents and caregivers because they are cared for directly, in close contact. ABC News External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    2020-2021 Influenza Season for Week 31, ending August 7, 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. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2021, will not be included in FluSurv-NET. Data on patients admitted through April 30, 2021, will continue to be updated as additional information is received.

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths were reported to CDC during week 31. One influenza-associated pediatric death occurring during the 2020-2021 season has been reported to CDC. CDC External Link

    VETERINARY/FOOD SAFETY

    Dozens of broccoli products recalled because of Listeria risk

    15 August- Almost 30 products containing broccoli are being recalled in Canada because of a risk of contamination with Listeria monocytogenes. Sold in a variety of packages and under numerous names the 29 products were available nationwide at retail stores, according to a recall notice posted by the Canadian Food Inspection Agency (CFIA). "This recall was triggered by the company. The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated Food Recall Warnings," according to the recall notice. No illnesses had been reported as of the posting of the recall notice, however it can take up to 70 days for symptoms of Listeria infection to develop. There is concern that consumers may have the products in their homes. Consumers can use the following information to determine whether they have the products in their homes. Food Safety News External Link

    WELLNESS

    A plant-based diet is the best way to avoid heart disease, according to a new report

    12 August- There is constant squabbling over the virtues of various diets, but a new report published in Cardiovascular Research makes one thing clear: The best way to avoid heart disease is to eat whole and plant-based foods. This is important because people are eating themselves to death: According to the 2017 Global Burden of Disease study, poor food choices account for almost 50 percent of all cardiovascular disease fatalities. Unfortunately, the typical American diet is filled with ultra-processed foods, which are cheap, tasty, convenient — and detrimental to heart health. And, anecdotally at least, some of us may be relying on such foods even more during the coronavirus pandemic. Eating this way opens the door for heart disease. "Excess sodium, sugar, trans fat, and ultra-processed foods can increase inflammation and insulin resistance in the blood vessels, which leads to the promotion of plaque in the arteries," says Michelle Routhenstein, a preventive cardiology dietitian in New York City. Plaque buildup in the arteries can lead to a heart attack or stroke. Gabriele Riccardi, a professor of endocrinology and metabolic diseases at Federico II University of Naples and co-author of the new meta-analysis, which included 99 studies, says that cardiovascular disease risk is reduced when the diet is lower in salt, sugar and refined carbs. Washington Post External Link

    Being a better listener for your loved ones might protect their brain health, study finds

    16 August- Can you count on anyone to listen to you when you need to talk? If so, your brain might be more resilient in the face of any future age- or disease-related changes, according to a study published Monday in the journal JAMA Network Open. Among senior adults, prior studies have associated greater social network size with higher levels of cognitive function before death than would be expected, given the number of signs of Alzheimer's disease and related disorders in participants' brains at autopsies, the current study's authors wrote. Cognitive function refers to a person's mental capacity for learning, thinking, reasoning, problem-solving, decision-making, remembering and paying attention. Other studies have found adults with these signs don't always develop dementia later in life. Experts have named this mysterious ability to remain cognitively unscathed despite age- or disease-related changes in the brain as "cognitive resilience." CNN External Link

    USAFRICOM

    Ebola case in Abidjan, Ivory Coast: Africa CDC, Statement from hospital

    15 August- The Africa CDC released the following statement Saturday on the case of an Ebola Virus Disease in Abidjan, Côte d'Ivoire: The Government of Republic of Côte d'Ivoire has declared the presence of a case of an Ebola virus disease (EVD) infection in the capital city of Abidjan. The case is 18-year-old Guinean girl who travelled from Labe in Guinea to Abidjan by road on 11August 2021 and hospitalized on the night of 12 August 2021 following a high-grade fever. On the 14th of August 2021, the Institute Pasteur in Cote d'Ivoire confirmed the infection to be EVD. The patient is currently in isolation and under the care of a Treatment Center for Highly Epidemic Diseases at the Treichville University Hospital. More recently, on 19 June 2021, the Republic of Guinea declared over the EVD outbreak after four months of concerted effort.  However, further investigation will be conducted to trace back the relation between this case and the concluded outbreak. "In this recent past outbreak in Guinea, Africa Centers for Disease Control and Prevention (Africa CDC) assessed and supported neighboring countries including Cote d'Ivoire in preparation for and response to potential spill over of cases. We witnessed the experience, expertise and resources in place in these countries to handle such incidents. However, as this case is reported in a busy capital city of Abidjan, Africa CDC is already in contact with senior health officials of the country to assess the situation and offer its expertise" said Dr. John Nkengasong, the Africa CDC Director. Outbreak News Today External Link

    USCENTCOM

    Iran reports record 655 COVID-19 deaths as six-day lockdown begins

    16 August- In a follow-up on the COVID-19 situation in Iran, the health ministry reported a record 655 COVID-19 deaths Monday, bringing total deaths since the beginning of the pandemic to 98,483. Health authorities have warned that daily deaths might reach 800 in coming weeks if Iranians fail to respect health protocols. The sharp surge in cases and deaths has forced the clerical establishment to allow imports of vaccines made by U.S. and British companies, which Iran's top authority, Supreme Leader Ayatollah Ali Khamenei, had forbidden in January. In addition, the government has announced a six-day country-wide shutdown to curb the rise in deaths and infections, which starts today. The national anti-coronavirus task force said the nationwide shutdown will begin on Monday and last through Saturday. All offices, banks and non-essential businesses will be shut down. Iran has reported more than 900,000 COVID-19 cases in the past month, including more than 10,000 deaths. Outbreak News Today External Link

    USEUCOM

    Sheep pox reported in Yaroslavl region, Russia

    16 August- In the Yaroslavl region, foci of sheep pox were identified, according to Russian media (computer translated). The virus was found in samples of biological material taken from sick sheep, which are kept on the territory of subsidiary farms in the village of Kharino and the working village of Nekrasovskoye, Nekrasovsky district. This was reported in the Department of Veterinary Medicine of the Yaroslavl Region. Now specialists of the state veterinary service are engaged in the elimination of foci of sheep pox. They also take measures to prevent the spread of the pathogen. To prevent the onset and spread of smallpox, owners of susceptible animals must follow these guidelines:

    – to prevent pollution of the environment with animal waste;

    – according to the requirements of specialists from bodies and institutions included in the system of the State Veterinary Service of the Russian Federation (hereinafter referred to as specialists of the state veterinary service), susceptible animals for examination;

    – notify the specialists of the state veterinary service within 24 hours about all cases of sudden death or illness of susceptible animals, as well as about changes in their behavior indicating a possible illness;

    – take measures to isolate suspected of the disease susceptible animals, for the care of which the equipment (inventory) used to care for suspected susceptible animals was used, as well as all susceptible animals that were in the same room with suspected susceptible animals that could contact with them, ensure the isolation of corpses of dead susceptible animals in the room in which they were kept; Outbreak News Today External Link

    USINDOPACOM

    Bangladesh: More than half the annual dengue cases reported in first half of August

    15 August- The Directorate General of Health Services (DGHS) in Dhaka, Bangladesh reported an additional 198 dengue fever hospitalizations Sunday, bringing the cumulative total for the year to 6,100. 189 of Sunday's cases were reported from Dhaka. The Directorate General of Health Services (DGHS) in Dhaka, Bangladesh reported an additional 198 dengue fever hospitalizations Sunday, bringing the cumulative total for the year to 6,100. 189 of Sunday's cases were reported from Dhaka. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Possible Naegleria fowleri case in North Carolina

    15 August- Just a week after the death of Tehama County, California boy, 7-year-old David Pruitt due to primary amebic meningoencephalitis (PAM) caused the serious amoeba infection, Naegleria fowleri, it appears a second case may have occurred in North Carolina. It came to the attention of Outbreak News Today that a 6-year-old boy from the Raleigh area may have died from the same infection. According to a Facebook post from the child's mother, he was admitted to the Pediatric intensive care unit at UNC since last Sunday. On Wednesday she wrote: A spinal tap revealed he has an extremely rare disease in which infections are almost always fatal. The infection will cause swelling on his brain. Today we made the difficult choice to have him intubated and a drain put in on his brain to drain the fluid that will soon start to build up. He is the sickest kid in the hospital. Unfortunately, the child died of the rare form of meningitis on Friday. Outbreak News Today External Link

    USSOUTHCOM

    Venezuela: Salmonella outbreak sickens nearly 600 in Anzóategui

    16 August- Anzoátegui State Governor, Antonio Barreto Sira said Saturday (computer translated) there is a salmonella outbreak in the state. He notes 571 cases of salmonellosis are registered in state in northeastern Venezuela, including two deaths. According to the epidemiological records of the Anzoatiguense Institute of Health (Saludanz), the disease mainly affects the Simón Bolívar municipality, with 262 cases in the El Carmen parish and 276 in San Cristóbal, while in the Sotillo municipality they have been diagnosed 23 and 9 in Urbaneja, all with positive antigen results and clinical signs of this pathology. The outbreak is attributed to the terrible services in the distribution of drinking water throughout the state and especially in the north. "The lack of maintenance and repair of fallen collectors in the capital of this entity, coupled with little or no collection of garbage and solid waste, are causes of this new outbreak," he said. "The inability of Hidrocaribe threatens the lives of Anzoateguians," said Barreto Sira, while demanding, once again, Hidrocaribe, address the water distribution situation or declare an emergency so that Caracas has the resources and this way "avoid more suffering to the inhabitants, who suffer from a lack of vital liquid and when it reaches them, it represents a risk to their health." In the same way, he urged the mayor of Barcelona to take care of the collection of waste in the city. "We see garbage in every corner of the capital, and that cannot be." Outbreak News Today External Link