Army Public Health Weekly Update, 20 November 2020

Date Published: 11/20/2020
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 04 December 2020.

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.

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Table of Contents

    ​ANNOUNCMENTS 

    Army to consider changes to uniform for expecting, new mothers

    13 November- The 152nd Army Uniform Board will convene on Nov. 18 to consider multiple issues, including changes to maternity clothing articles for expecting and new mothers. Specifically, the board is scheduled to make decisions on the Army Green Service Uniform-Maternity and a lactation shirt for the Maternity Utility Uniform in the Operational Combat Pattern. In 2018, the Army produced a maternity uniform for demonstrations associated with the unveiling of the AGSU. That maternity uniform resembled the style of uniform that has been issued since the 1980s and was first designed in 1979. The AUB will discuss whether to modernize the maternity uniform or continue with the current style. The AUB will also consider developing a lactation shirt, which would later become part of the Maternity Utility Uniform issue for new mothers. As things stand, a lactation shirt is not provided with the standard issue, and Soldiers must purchase them through private, commercial vendors. The Nov. 18 meeting will be held virtually, and discussion will be led by the AUB Chairman, Lt. Gen. Duane Gamble, Deputy Chief of Staff of G-4. Members of the AUB include male and female Soldiers at all levels, and representatives from the active component, Army Reserve and Army National Guard. Each member has an equal vote in deciding which recommendations go forth to Chief of Staff of the Army Gen. James C. McConville. The AUB meeting, which takes place twice each year, is the Army's only forum to address the changing requirements of Soldiers' uniforms and accessory items. All Soldiers can contribute to the Uniform Board process by providing recommendations to their sergeant majors. Incorporating the feedback from Soldiers is a big part of the AUB process. Army.mil External Link

    U.S. MILITARY

    Army efforts save lives following historic hurricane

    16 November- As Hurricane Eta pummeled through much of Central America earlier this month, a joint disaster relief response leapt into action, saving at least 289 lives and delivering life-saving supplies to the storm-ravaged region. Eta was the deadliest storm to hit the region in two decades. Its forceful winds and torrential rainfall left a trail of destruction in its wake, resulting in deadly floods and mudslides, especially in Nicaragua, Honduras, Panama, and Guatemala. On Nov. 3, the historic storm made landfall as a Category 4 hurricane in Nicaragua and left countries reeling, said Col. John Litchfield, commander of Joint Task Force-Bravo, or JTF-Bravo. "[We] maintain a high level of readiness to respond to crisis, particularly hurricanes and other disasters that require military support." JTF-Bravo began operations in Honduras on Nov.5, followed by Panama on Nov. 7 and Guatemala on Nov. 10, as each country declared a national state of emergency and requested the U.S. government's help. Around 250 troops from JTF-Bravo, U.S. Army South, U.S. Special Operations Command South, and other U.S. Southern Command teams were deployed to Central America's hardest-hit areas. "We've been able to help out partners in Central America," said 1st Lt. Paige M. Ziegler, a CH-47 Chinook pilot with Charlie Company, 1st Battalion, 228th Aviation Regiment, assigned to JTF-Bravo. "We're proud to assist in their time of need." Army.mil External Link

    Army Public Health Center experts recommend support, empathy for 'long-haul' COVID-19 patients

    10 November- An emerging threat facing about 10 percent of individuals who have had coronavirus disease 2019, or COVID-19, is the potential for lingering symptoms experienced after initial recovery. Those suffering from these symptoms describe themselves as COVID-19 "long-haulers." "Studies regarding the long-term effects to people who have become ill from COVID-19 are still being conducted," said W. Scott Monks, Jr., a certified physician's assistant with the Army Public Health Center. "The World Health Organization defines a typical recovery time from a mild infection to be around two weeks and for a severe infection between three to six weeks." According to the Centers for Disease Control and Prevention, a survey of patients diagnosed with COVID-19 found that only 65 percent returned to a baseline health 14 to 21 days after diagnosis. Symptoms that were most likely to persist beyond 14 to 21 days included cough (43 percent) and fatigue (35 percent); fever and chills persisted in only 3 and 4 percent. Although a lack of return to baseline health was associated with older age and a greater number of underlying health issues, approximately one in five individuals aged 18 to 34 years who were previously healthy reported that they did not return to baseline within two to three weeks. According to the Mayo clinic, the elderly and people with multiple serious medical conditions are at highest risk of experiencing lingering COVID-19 symptoms. The most common lingering symptoms include fatigue, cough, shortness of breath, headache and joint pain. A recent article published by the Journal of the American Medical Association estimated approximately 10 percent of COVID-19 patients become "long-haulers". Army.mil External Link

    Army training up, COVID rate down in Hawaii

    14 November- The number of COVID-19 cases within Hawaii's military community is "a little below 7%" of the state's total since March, U.S. Indo-Pacific Command said. That means no more than 1,148 cases as of Friday's cumulative 16,412 positives as the pandemic unfolded in Hawaii. The Defense Department still generally sticks to a policy of not reporting coronavirus cases at the local level and instead notes them as part of service branch totals. According to the state, about 43,000 active-duty members, 9,600 Guard and Reserve, 60,000 dependents and 20,000 military employees call Hawaii home. The coronavirus stat comes as the Army in Hawaii continues to train out of state in sometimes large groups and with foreign allies and partners — with COVID-19 prevention steps apparently working. The last of approximately 4,500 Schofield Barracks soldiers are returning to Hawaii from several weeks of combat certification training at Fort Polk, La., in October. None have tested positive for the novel coronavirus, said 25th Infantry Division spokesman Lt. Col. Adam Hallmark. "One hundred percent of our personnel are being screened by permanent- party medical professionals assigned to the Joint Readiness Training Center (in Louisiana) prior to departure," Hallmark said. The "capstone" training, which certifies the 2nd Infantry Brigade Combat Team for worldwide deployment, came amid not only the pandemic, but also Hurricane Delta. In mid-October, Schofield soldiers had to move temporarily from tents and command posts to permanent buildings and conference rooms when winds of more than 50 mph whipped through, knocking out power. Star Advertiser External Link

    How the military can lead on mental health and COVID-19

    17 November- For many, 2020 has been a long and arduous year. It has included a complex interplay of personal, professional, and community-based challenges resulting from ongoing public health pandemics, civil unrest, and general life stressors. The current environment can contribute to feeling overwhelmed and isolated — both of which factor into risk of suicide. Few people have not been touched by the tragedy of suicide. It is estimated that, on average, there is a suicide attempt made every 26 seconds and a death by suicide every 11 minutes in the United States. During National Veterans & Military Families Month, it's worth emphasizing how the military and veteran community benefit from well-funded, data driven prevention programs. Despite the number of suicides increasing in the military and family member populations, the rate remains comparable or lower than the non-military community. Recent findings also show that the suicide rate decreased for Veterans engaged in recent VHA care. Throughout September, numerous organizations shared stories and resources to help reduce the stigma around mental health, to increase help-seeking behaviors, and to reduce suicide ideations. Military leaders shared their personal mental health stories through a DOD-sponsored campaign and encouraged people to reach out, particularly in the context of COVID-19, something that was unheard of 20 years ago when America entered the Longest War. General Hyten, Vice Chairman of the Joint Chiefs of Staff, underscored the equal importance of physical and mental health and shared how he received the help he needed from a psychiatrist and was stronger for it. The Hill External Link

    Increased reporting of military sexual assaults has not led to more accountability, CBS News finds

    17 November- Despite service members reporting more sexual assaults over the past decade, courts-martial and convictions for the charge have declined, according to an investigation airing this week on CBS News. "What we have uncovered are what we call consequential failures by leaders to change a pervasive culture of sexual assault in the military," said Norah O'Donnell, CBS Evening News anchor and managing editor, who led the year-and-a-half long investigation. "The bottom line is it's time for 'Me Too' movement in the military." O'Donnell and the CBS Investigative Unit interviewed nearly two dozen victims and three whistleblowers who worked for the military sexual assault and harassment prevention program. The four-part series begins Tuesday on "CBS Evening News with Norah O'Donnell" and will also air on "CBS This Morning." "I love and respect the military. This is not the values that the U.S. military espouses. To either have service members commit this abuse or to not hold accountable those who commit this abuse," said O'Donnell, whose father served as an Army officer and doctor. "What we are really trying to uncover is not only to tell the stories of the men and women who have been abused and harassed after reporting the abuse, but also to look at question of why does this still continue? What is the problem?" By poring over hundreds of pages of court documents, criminal investigations and reports, the investigative unit uncovered that the number of cases of sexual assault in the military has doubled in the last 10 years. A fiscal year 2019 report from the Pentagon shows 7,825 sexual assault reports involving service members as victims or subjects, a 3% increase compared to 2018. An anonymous workplace survey -- the 2018 Workplace and Gender Relations Survey of Active-Duty Members -- found that 20,473 service members said they experienced sexual assault within the past year — an increase of 38% from 14,900 in fiscal year 2016, when the survey was last conducted. The workplace survey also found that 64% women who reported a sexual assault said they experienced retaliation. Of those who reported assaults in 2019, 57 victims said they faced retaliation because of the report, according to the investigation. Only one of those cases went to court-martial. Stars and Stripes External Link

    GLOBAL

    Covid: Chemicals found in everyday products could hinder vaccine

    17 November- The successful uptake of any vaccine for Covid-19, a crucial step in returning a sense of normalcy after a year ravaged by the coronavirus pandemic, could be hindered by widespread contamination from a range of chemicals used in everyday products. Small amounts of per- and polyfluoroalkyl (or PFAS) chemicals are commonly found in the bodies of people in the US, as well as several other countries. These man-made chemicals, used in everything from non-stick pans to waterproof clothes to pizza boxes, have been linked to an elevated risk of liver damage, decreased fertility and even cancer. But scientists warn some of these chemicals can also cause another little-known but potentially significant defect by reducing the effectiveness of certain administered vaccines. This impediment could cast a shadow over efforts to roll out a Covid-19 vaccine to enough people that restrictions on day-to-day life are eased. "At this stage we don't know if it will impact a corona vaccination, but it's a risk," said Philippe Grandjean, an adjunct professor of environmental health at the Harvard School of Public Health. "We would have to cross our fingers and hope for the best." Research led by Grandjean has found that children exposed to PFAS had significantly reduced antibody concentrations after given tetanus and diphtheria vaccinations. A follow-up study of adult healthcare workers found similar results. Meanwhile, a certain type of PFAS, called perfluorobutyrate (or PFBA), accumulates in the lungs and can heighten the severity of illness suffered by people who are infected with Covid-19, separate research by Grandjean, yet to be peer-reviewed, has suggested. German company BioNTech and the US pharmaceutical giant Pfizer provoked a surge of optimism over an impending Covid vaccine after announcing a contender was 90% effective in preventing people from falling ill with the disease. The scientist behind the vaccine has predicted it will "bash the virus over the head" and help lift the pandemic that has crippled much of the world since the beginning of the year. The Guardian External Link

    COVID-19 vaccine candidate: Moderna announces 94.5% efficacy in Phase 3 trial

    16 November- Cambridge, MA biotechnology company, Moderna, Inc. announced today that the independent, NIH-appointed Data Safety Monitoring Board (DSMB) for the Phase 3 study of mRNA-1273, its vaccine candidate against COVID-19, has informed Moderna that the trial has met the statistical criteria pre-specified in the study protocol for efficacy, with a vaccine efficacy of 94.5%. This study, known as the COVE study, enrolled more than 30,000 participants in the U.S. and is being conducted in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services. The primary endpoint of the Phase 3 COVE study is based on the analysis of COVID-19 cases confirmed and adjudicated starting two weeks following the second dose of vaccine. This first interim analysis was based on 95 cases, of which 90 cases of COVID-19 were observed in the placebo group versus 5 cases observed in the mRNA-1273 group, resulting in a point estimate of vaccine efficacy of 94.5% (p <0.0001). A secondary endpoint analyzed severe cases of COVID-19 and included 11 severe cases (as defined in the study protocol) in this first interim analysis. All 11 cases occurred in the placebo group and none in the mRNA-1273 vaccinated group. The 95 COVID-19 cases included 15 older adults (ages 65+) and 20 participants identifying as being from diverse communities (including 12 Hispanic or LatinX, 4 Black or African Americans, 3 Asian Americans and 1 multiracial). The interim analysis included a concurrent review of the available Phase 3 COVE study safety data by the DSMB, which did not report any significant safety concerns. A review of solicited adverse events indicated that the vaccine was generally well tolerated. The majority of adverse events were mild or moderate in severity. Grade 3 (severe) events greater than or equal to 2% in frequency after the first dose included injection site pain (2.7%), and after the second dose included fatigue (9.7%), myalgia (8.9%), arthralgia (5.2%), headache (4.5%), pain (4.1%) and erythema/redness at the injection site (2.0%). These solicited adverse events were generally short-lived. These data are subject to change based on ongoing analysis of further Phase 3 COVE study data and final analysis. Outbreak News Today External Link

    Fed up with Covid-19? You could have pandemic fatigue

    17 November- As the pandemic drags on, following COVID-19 prevention guidelines may seem like an increasing challenge. This type of fatigue is not unique to pandemic precautions, such as maintaining social distancing, wearing face masks, and washing hands. With all kinds of health-related behavior changes, including increased physical activity , healthy eating, and decreased tobacco use , at least half of people relapse within six months. Think early April. Much of the United States was under stay-at-home orders . New York City was experiencing close to 1,000 deaths from COVID-19 a day , with new cases of this previously unknown disease emerging across the country. Fears of the coronavirus caused people to ask for quarantine supplies or rush through stores as quickly as possible, avoiding everyone. When they got home, shoppers cleaned up their groceries, washed their hands vigorously, maybe even took a shower and put on clean clothes. People got used to staying home. Today, there is still no cure or vaccine for the coronavirus, and the numbers of infections are increasing. Nearly a quarter of a million Americans have died from COVID-19, and the risk of infection persists. Now is the time to strengthen your resolve and rededicate yourself to prevention measures. Enterpreneuer.com External Link

    How to host a safe holiday meal during coronavirus – an epidemiologist explains her personal plans

    10 November- Like many people in this unusual year, I am adjusting my family's holiday plans so that we can all be safe during the ongoing coronavirus pandemic. I am an epidemiologist and mother of four with a large extended family. Given the serious nationwide resurgence of COVID-19 infections, gatherings of family and friends over the upcoming holidays have the potential to amplify the spread of the virus. Several recent studies have further confirmed that indoor socializing at home carries a significantly higher risk of viral transmission than outdoor activities. Health officials, including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, have warned that much of transmission this fall is happening across all age groups at small indoor gatherings. For the past 15 years my family tradition is to travel from Washington, D.C., along with both grandparents, to sunny Florida to celebrate Thanksgiving with cousins. This year we decided to skip the travel and will have fall and winter celebrations at home. We are not canceling the holidays, but to keep ourselves and others safe, we are keeping plans small and flexible and remembering that the health of those we love is most important as we enter the season of gratitude. First, it is important that everyone who will be attending any holiday celebration is on the same page about how to take precautions before getting together. The idea is to lower infection risk in the weeks leading up to the holidays and then test to confirm. In general, everyone should plan to be vigilant in their public health practices beforehand, especially since grandparents are at higher risk. In my family, we have agreed to limit contact with other people as much as possible the week before Thanksgiving. We have also agreed that everyone needs to be extra cautious around the few close people we see regularly. In conjunction with quarantining, testing is the second strategy. Research has consistently shown that people are most contagious a day or two before they show symptoms, so everyone plans to get tested with an RT-PCR test within 72 hours of Thanksgiving, while still being able to get results in hand before we gather. If the demand for tests is high and wait times are long, we will get rapid tests. But these are a second choice, as they are less reliable and can be expensive. The Conversation External Link

    Many military Covid-19 cases show no symptoms, new reports find

    16 November- Covid-19 can spread quickly among active military members and recruits -- and two new reports detail how this has happened in some past outbreaks. The papers, published in the New England Journal of Medicine on Wednesday, reveal that many military personnel and recruits who test positive for coronavirus infection show no symptoms at all, which suggests asymptomatic spread of the disease has likely played a big role in outbreaks. One study -- by researchers at the Naval Medical Research Center, Icahn School of Medicine at Mount Sinai and other institutions -- included data on 1,848 recruits who were tested for Covid-19 after completing a two-week quarantine at home and then throughout a supervised quarantine on a college campus. While on campus, recruits wore masks and practiced social distancing. At the end of that second quarantine, all recruits were required to have a negative Covid-19 test before heading to Parris Island in South Carolina for training. The recruits, who were predominantly male, enrolled in the study from May 12 to July 15. CNN External Link

    Newborns not likely to contract coronavirus in the hospital, study says

    12 November- Newborns are very unlikely to contract the coronavirus while hospitalized, according to a new study. Researchers in the United Kingdom found just 66 cases of COVID-19 in newborns among 10,000 births at hospitals from March 1 through April 30, according to the study published in The Lancet medical journal. "Neonatal SARS-CoV-2 infection is uncommon in babies admitted to hospital," the study found. Of the 66 infected newborns, 28 of them had a severe case of the illness. One of the infected babies died, but not from coronavirus, the study said. The study also found that babies are unlikely to contract coronavirus even if their mothers had tested positive before giving birth. As of the end of July, 58 — or 88 percent — of the newborns that had COVID-19 were already released from the hospital. Fox News External Link

    INFLUENZA

    WHO: Influenza Update

    09 November 2020, based on data up to 25 October 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic 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-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 inter-seasonal levels, though sporadic influenza detections were reported in some countries.

    - In the temperate zones of the southern hemisphere, no influenza detections were reported across countries.

    - In the Caribbean and Central American countries, sporadic influenza detections were reported. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, decreased in most reporting countries.

    - In tropical South America, there were no influenza detections across reporting countries.

    - In tropical Africa, influenza activity was reported in West Africa in Côte d'Ivoire and Niger, and in East Africa in Kenya.

    - In Southern Asia, influenza activity of predominately influenza A(H3N2) was reported in Bangladesh and India in recent weeks.

    - In South East Asia, influenza detections continued to be reported in Cambodia and Lao People's Democratic Republic (PDR).

    - Worldwide, of the very low numbers of detections reported, seasonal influenza A(H3N2) viruses accounted for the majority of detections. WHO External Link

    VETERINARY/FOOD SAFETY

    Albright's Chicken Recipe for Dogs recalled for salmonella

    16 November- Albright's Chicken Recipe for Dogs is being recalled because it may be contaminated with Salmonella bacteria. This food is a raw food. One animal is sick, but no human illnesses have been reported to the company to date. Sixty seven cases are recalled. This product can make people sick if they don't thoroughly wash their hands after contact with the food, or if their dog sheds the bacteria and the person has contact with the dog. Animals can get sick too; symptoms are usually lethargy, diarrhea, fever, vomiting, and abdominal pain. Some pets can become carriers and infect other animals and people. Symptoms of Salmonella food poisoning in people include a fever, nausea, vomiting, stomach and abdominal cramps, and diarrhea that may be bloody.
    The recalled product is Albright's Raw Dog Food Chicken Recipe For Dogs that is packaged in 2 pound chubs/rolls. Each one is printed with "Lot number C000185, Best by 19 May 2021." The dog food was sold frozen, and was distributed from July 8, 2020 to August 27, 2o20 in California, Florida, Illinois, Indiana, New Hampshire, New Jersey, Nevada, New York, Pennsylvania, and Tennessee through retail stores, mail order, and direct delivery.
    The problem was discovered after testing conducted by the FDA. The problem is confined to this batch. The company has stopped distributing this batch until the FDA and the facility complete their investigation. Retailers and consumers may still have this product in their freezers. Please check your freezer carefully. If you do have it, throw it away after first double bagging it, or take it back to the store where you bought it for a full refund. Wash your hands thoroughly with soap and water after handling this product. Food Poisoning Bulletin External Link

    WELLNESS

    Exercise after Covid-19? Take it slow

    17 November- For the past 20 years, when patients asked me about exercising while recovering from a viral illness like the flu, I gave them the same advice: Listen to your body. If exercise usually makes you feel better, go for it. Covid-19 has changed my advice. Early in the pandemic, as the initial wave of patients with Covid-19 began to recover and clinically improve, my colleagues and I noticed that some of our patients were struggling to return to their previous activity levels. Some cited extreme fatigue and breathing difficulties, while others felt as if they just couldn't get back to their normal fitness output. We also began to hear of a higher than normal incidence of cardiac arrhythmias from myocarditis, inflammation of the heart muscle that can weaken the heart and, in rare cases, cause sudden cardiac arrest. Other complications like blood clots were also cropping up. What was most surprising is that we saw these problems in previously healthy and fit patients who had experienced only mild illness and never required hospitalization for Covid-19. In my sports medicine practice, a cyclist in her 40s with recent Covid-19 symptoms had leg pain that was abnormal enough to warrant an ultrasound, which showed near complete cessation of blood flow because of arterial blood clots in both legs. Thankfully, our team caught these early enough that they didn't spread to her lungs, which ultimately could have killed her. Recently, a college student in Indiana with Covid-19 died from a blood clot that traveled to her lungs. As the pandemic has evolved, we've learned of a much higher risk of blood clots from people who contract the virus. The New York Times External Link

    Fight winter blues by changing your mindset

    17 November- Darkness covers the Norwegian city of Tromsø from late November through January, a long, polar night when the sun never rises at all. The island community, which is more than 200 miles north of the Arctic Circle, is flanked by snowy peaks and frigid water. Northern lights flicker in the sky there. "If winter were a place, it would be Tromsø," said Kari Leibowitz, a doctoral student of psychology at Stanford University, who spent a year there for her graduate research. Leibowitz arrived in the Arctic city hoping to study seasonal affective disorder, the seasonal depression that some experience in the darkest time of year. This condition is a big problem. Prevalence of seasonal depression in North America increases with latitude; in New Hampshire, nearly 10% of the population is estimated to suffer from SAD. And while New Hampshire's northernmost town sits at 45 degrees north, Tromsø is at 69 degrees north — the Norwegian city is much, much closer to the North Pole. Everything Leibowitz learned as a psychology undergraduate suggested Tromsø would be ground zero for SAD. "When winter gets more extreme, you should have a higher prevalence of seasonal affective disorder, and you should have worse seasonal affective disorder," Leibowitz said. But after Leibowitz arrived, her Norwegian graduate adviser explained that in Tromsø, mental health and well-being actually remain pretty stable through the winter. CNN External Link

    USAFRICOM

    Africa: Malawi eliminates Lymphatic Filariasis as a public health problem

    11 November- The World Health Organization (WHO) announced recently that Malawi has been validated to have eliminated lymphatic filariasis as a public health problem. MSD, GSK, and the Mectizan Donation Program congratulate President Lazarus Chakwera, the government, and the people of Malawi for this remarkable achievement that has alleviated suffering for millions and highlights the perseverance of many dedicated partners. Malawi is only the second country in sub-Saharan Africa to mark this achievement. Lymphatic filariasis (LF), commonly known as elephantiasis, is a debilitating disease caused by a parasite transmitted to humans through the bites of mosquitoes. According to WHO, elephantiasis is found in 73 countries around the world with an estimated 120 million people infected. Long-term, chronic infection causes damage to the lymphatic system, and severe and irreversible swelling to the limbs, breasts, and/or genitals. These symptoms cause extreme discomfort, disability, and social stigmatization. A WHO resolution to achieve the goal of global LF elimination was passed by the World Health Assembly in 1997. In countries where LF and another parasitic disease called river blindness are co-endemic, WHO recommends co-administering two medicines, albendazole and ivermectin to achieve LF elimination.  In 1998, GSK announced the donation of albendazole for the elimination of LF and MSD expanded its donation of Mectizan® (ivermectin) through the Mectizan Donation Program to include the elimination of LF in countries where the disease co-exists with river blindness. In 2017, in support of new WHO guidelines, MSD's donation of Mectizan was once again expanded to provide up to 100 million additional treatments per year through 2025 to support the elimination of LF globally in countries where onchocerciasis is not endemic. Outbreak News Today External Link

    Nigeria Lassa fever update: 5 additional confirmed cases reported

    18 November- The Nigeria Centre for Disease Control (NCDC) reported an additional five confirmed Lassa fever cases last week, including one death, bringing the total confirmed cases/deaths for 2020 through the first week of the year to 1136 and 234 deaths. This is a drop in cases from the week prior when the NCDC reported 11 confirmed cases. The case fatality rate hovers around 20 percent for the year. On the 24th of January 2020, NCDC declared a Lassa fever outbreak and activated a national Lassa fever Emergency Operations Centre (EOC). In late April, officials declared the emergency phase of the 2020 Lassa fever outbreak over. Lassa Fever is an acute viral illness and a viral haemorrhagic fever (VHF). The causative agent is a single-stranded ribonucleic acid (RNA) virus in the family arenaviridae, the Lassa virus. This zoonotic disease is associated with high morbidity and mortality, transmitted by the multi-mammate rat (mastomys natalensis), one of the most common rats in equatorial Africa. The disease was first discovered in a town called Lassa in Borno State, Nigeria in 1969. The actual incidence rate in Nigeria is unknown, but case fatality rates range from 3% to 42% (and over the last two years has remained between 20% and 25%). Historically, outbreaks occur during the dry season (November to April); however, in recent years, cases have also occurred during the rainy season. Lassa fever importation into non-endemic countries has occurred in the UK, USA, and Germany, amongst others. Outbreak News Today External Link

    USCENTCOM

    Why businesses in Lebanon oppose new lockdown despite rise in coronavirus cases

    10 November- Industrialists, merchants and workers have raised their voices against their inclusion in a new general lockdown announced on Tuesday. Lebanon's caretaker prime minister announced a fresh two-week lockdown to stem the spread of coronavirus despite a grinding economic crisis that has already battered businesses. "We've reached a stage of critical danger as private and public hospitals don't have the capacity to receive severe cases," Hassan Diab said in a televised address. He said the lockdown, with limited exemptions, would go into force from Saturday until November 30. It follows a meeting of the Higher Defense Council on Tuesday. The number of Covid-19 cases has skyrocketed since the August 4 Beirut Port explosion, with the total number of infections surpassing 95,355 as of November 9.  By comparison, only 5,271 cases were registered in six months between February 21 and August 4 - the day of explosion. About 10 percent of those tested for the virus are positive, a percentage that health professionals describe as alarmingly high. The combination of high infection rates, along with the growing financial crisis, could soon overwhelm Lebanon's fragile healthcare system. Hospitals are already struggling to compensate staff, keep equipment running, maintain vital medical supplies, and even stay open. In July, the American University Medical Centre - one of the country's oldest and most prestigious university hospitals - laid off hundreds of staff. Arabian Business External Link

    USEUCOM

    Sweden report: Teachers do not have a higher risk of being infected with COVID-19

    14 November- Children still make up a small proportion of the reported COVID-19 cases in Sweden. A new report shows that primary school teachers, preschool teachers and childminders who meet larger groups of children do not have a higher risk of being diagnosed with COVID-19 compared with other occupational groups. The information is presented in two new reports from the Swedish Public Health Agency, Covid-19 in children and adolescents – a compilation of knowledge and Presence of covid-19 in different occupational groups within the school . The Swedish Public Health Agency closely monitors the state of knowledge and epidemiological developments in Sweden and internationally. The latest scientific knowledge confirms that infectivity between children is significantly lower than between adults. In Sweden, children up to the age of 19 continue to make up a relatively small proportion of the established covid-19 cases, 6.7 per cent. – In general, children get milder symptoms than adults, they rarely constitute the first case in a chain of infection and are not a driving force in the covid-19 pandemic, says department head Britta Björkholm. Outbreak News Today External Link

    USINDOPACOM

    COVID-19: Philippines cautioned of possible spike post typhoons

    14 November- Health officials in the Philippines are cautioning the public about a possible spike in coronavirus cases after the country experienced an onslaught of storms in recent week, with the most recent being Typhoon Ulysses. National Policy against COVID-19 chief implementer and vaccine czar, Secretary Carlito Galvez Jr. said the government expects a reasonable increase of Covid-19 cases as physical distancing in some evacuation centers might "difficult to be observed" making the virus transmission more possible. Galvez urged the public not to be complacent and keep safe against the risks of Covid-19 infection. He said people should not forget to "at least wear a face mask at all times." In a situation report, the Department of Health (DOH) reported that majority of its retained hospitals in the National Capital Region (NCR) are fully functional and operational after the onslaught of Typhoon Ulysses. On Friday, the DOH reported 1,902 new cases, bringing the total count to 406,337. Cavite reported the highest number of new cases yesterday with 122, followed by Davao City with 113, Quezon City with 84, Bulacan with 81, and Manila with 78. 7,791 deaths have been reported to date. Outbreak News Today External Link

    Covid: South Australia goes on high alert after first outbreak in months

    16 November- South Australian authorities say they are facing a "dangerous situation" after reporting 18 coronavirus cases in the state's first outbreak since April. Up to 13 infections were linked to a hotel quarantine worker in Adelaide who spread the virus to a family in the local community, officials said. The state has ramped up testing and brought in new restrictions. Australia had seen cases drop to near zero after beating a second wave that was largely confined to Victoria. Victoria's capital, Melbourne, spent almost four months in a stringent lockdown before re-opening last month. Its outbreak - which caused about 800 deaths - also originated from a hotel quarantine breach. "It's obvious that the highest risk in Australia right now is this risk of [virus] importation in our quarantine hotels," South Australia's chief health officer Nicola Spurrier said on Monday. State Premier Steven Marshall added: "We are facing our biggest test to date. We are working around the clock to stay ahead of this cluster - no effort will be spared." BBC News External Link

    USNORTHCOM

    U.S.: Washington- Gov. Inslee announces month-long, statewide restrictions

    16 November- On Sunday, Washington Gov. Jay Inslee announced a four-week statewide set of restrictions in response to the recent rapid spread of the COVID-19 virus in Washington and across the country. The new restrictions come as Washington sees consistent increasing daily case counts, with over 2,000 cases a day over the weekend and average cases in the state doubling over the past two weeks. "This spike puts us in a more dangerous a position as we were in March," Inslee said during a press conference Sunday. "And it means, unfortunately, the time has come to reinstate restrictions on activities statewide to preserve the public's well-being, and to save lives. These were very difficult decisions that have very real consequences to people's livelihoods. I recognize that and don't take those impacts lightly, but we must act now and act quickly to slow the spread of this disease." Outbreak News Today External Link

    USSOUTHCOM

    Chapare virus in Bolivia 2019: New evidence shows human-to-human transmission

    16 November- Researchers have discovered that a deadly virus found in Bolivia can spread from person to person in healthcare settings, raising potential concerns of additional outbreaks in the future, according to new findings presented today at the Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH). The research also provides preliminary evidence regarding the species of rodent that carries the virus and may spread it to people or to other animals that can infect humans. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) laid out new clues to the many mysteries surrounding the Chapare virus, which caused at least five infections near Bolivia's capital city, La Paz, in 2019—three of them fatal. Prior to that, the only record of the disease was a small cluster and a single confirmed case in 2004 in Bolivia's Chapare Province, about 370 miles east of La Paz. The recent outbreak surprised health authorities, since initially all they knew was that it was a hemorrhagic fever that produced symptoms similar to diseases such as Ebola. It sparked a rapid mobilization of infectious disease experts from Bolivia's Ministry of Health, the CDC and the Pan-American Health Organization (PAHO) to explore the origins of the disease, including securing samples from patients and developing a new diagnostic test. Outbreak News Today External Link

    Chile reports decreased COVID-19 cases in 11 regions, 14-day quarantine mandatory for foreign travelers

    15 November- The Chile Ministry of Health reported 1,597 new cases of COVID-19 in the country with 6 regions that saw their new cases decrease in the last 7 days and 11 regions in the last 14 days. The rate of PCR positivity in the Metropolitan Region remains low, at 2%, while the degree of occupancy of ICU beds due to COVID-19 is stabilized at 38%. "Regardless of whether the commune is in quarantine or advancing in the Step by Step Plan the people must maintain preventive measures against COVID-19 ", said the Minister of Health, Enrique Paris. The minister reported that the regions with the highest increase in new confirmed cases in the last 7 days are: Atacama, Ñuble, Tarapacá and Los Ríos. Of the 1,597 new cases of COVID-19, 545 are asymptomatic people and 1,029 of  those who have presented with symptoms. The total number of people who have been diagnosed with COVID-19 in the country has reached 531,273. 14,819 deaths have been recorded. On Friday, the Undersecretary of the Interior, Juan Francisco Galli, together with the Undersecretary of Public Health, Paula Daza, announced the Step-by-Step Border Opening Plan, which includes three fundamental pillars: gradualness, security and traceability. As of November 23 at 00:00, foreigners may enter the country only through the Arturo Merino Benítez airport, complying with all health requirements. "On March 18 we closed the borders to any Chilean or non-resident foreigner in our country. Our country took measures that were consistent with protecting the right of Chileans and residents who could return to our country. As progress has been made, the President has provided flexibility for the borders solely and exclusively through the Arturo Merino Benítez airport, subject to restrictive and sanitary measures, "explained Undersecretary Galli. Outbreak News Today External Link