Army Public Health Weekly Update, 21 May 2021

Date Published: 5/21/2021
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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 

    APHC COVID-19 Vaccination Information

    All DoD beneficiaries and other individuals who are eligible to receive vaccines from DoD will be offered and are encouraged to receive the COVID-19 immunization in accordance with recommendations from the Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) and under the Food and Drug Administration (FDA) guidelines. APHC

    U.S. MILITARY

    ADVISOR helps forward-deployed providers with phone access to experts

    14 May- For U.S. military medical personnel who often serve in remote operating locations with minimal communications and health care infrastructure, their only connection to the outside world is phones. When these highly trained clinicians encounter medical emergencies beyond their considerable skills and local resources, having experts on the other end of the line to guide them can vastly improve outcomes for forward-deployed patients. Providing a single point of contact makes it easier for those frontline personnel to get the immediate assistance they need, which is why the Military Health System offers the Advanced Virtual Support for Operational Forces program, or ADVISOR. The only program of its type across the Department of Defense, ADVISOR provides global on-demand access to a full spectrum of medical tele-consultation services for emergent and urgent care, and it delivers those services 24/7/365 to the point of need in austere environments that have limited to no local specialty support. Field medical personnel anywhere in the world can call one phone number – 1-833-ADVSRLN (1-833-238-7756 or DSN 312-429-9089) – and get immediate live help in 13 different medical specialties, from emergency care and critical care to infectious diseases and toxicology. Think of ADVISOR as a "phone-a-friend" capability that connects field medical personnel with the MHS' best experts for when medical situations require assistance far from home – similar in spirit to NASA Mission Control in movies such as "Apollo 13" and "The Martian." Field personnel are not on the Moon or Mars (yet) but handling a medical crisis in faraway, resource-constrained locations can feel that way. Imagine being hundreds of miles from the nearest medical facility and having to answer the question, "I have two intravenous saline bags, three bandages, and a lollipop stick from last night's Meals Ready to Eat – how do I keep this patient alive until the chopper comes?" With ADVISOR, field medics get real-time access to capabilities they otherwise lack and guidance on improvising care using whatever resources are at hand – huge confidence and capability boosters that can make a life-or-death difference for patients. DVIDS External Link

    Failing to do what is right is the most common breach of trust

    14 May- As part of the Army's transformational change, the philosophy of "People First and Winning Matters" is heard loud and clear across our formations. The idea of putting our people first is not necessarily new, but more a reevaluation of priority between people and mission. Putting people first comes in two forms – what we need to do, and what we must not do. Through defining these actions, we can build trust with our soldiers and increase the lethality of our force. As the chief of staff of the Army informs us, we need to be competent, disciplined and fit. These are foundational requirements of all soldiers: competence in individual and collective skills; disciplined in appearance, bearing and action; mentally and physically fit – resilient. What we must not do is tolerate behavior that dilutes trust. Failing to do what is right is the most common breach of trust. This all too often comes in the form of sexual harassment and assault, acts of racism, and can lead to suicides. All these actions and indicators display the amount of trust soldiers have in leadership and their ability to address concerns, provide a safe working environment and create an inclusive culture where all soldiers are respected and valued. Trust requires what I consider the tenants of trust: Transparency of our actions, Reliance on our character, an Understanding of those we lead, a culture of Support, and the Truth as we understand it (TRUST). Abiding by these tenants ensures integrity within our formations throughout the Army and will provide for environments where soldiers can serve with dignity and respect. Army Times External Link

    Fort Bragg, Womack Army Medical Center healthcare providers train to decrease musculoskeletal injuries among Soldiers

    14 May- Each year, more than two million U.S. Soldiers suffer non-combat-related musculoskeletal injuries (MSKIs) that may account for nearly 60% of Soldiers' limited duty days and 65% of Soldiers who cannot deploy for medical reasons, according to a 2020 study published in the journal of the Association of Military Surgeons of the United States. These injuries—which include falls, sports, motor vehicle and motorcycle accidents, and parachuting— affect readiness through increased limited duty days, decrease the ability of and the number of Soldiers who deploy, and increase the rates of medical separations from the Army. The study concludes that MSKIs have a significant impact on a Soldier's overall health and U.S. Army readiness. Army Medicine at Fort Bragg is determined to reverse these statistics through a series of hands-on training for its corps of healthcare providers. Robinson Health Clinic, the Army's largest health clinic and healthcare provider for the 82nd Airborne Division, recently held the second Musculoskeletal Care for Military Providers course at the 261st Multifunctional Medical Battalion Conference Room. The first course took place in 2019 in the wake of Fort Bragg's Musculoskeletal Champion Center grand opening and is held every second Wednesday from 1 p.m. to 5 p.m. at the 261st Multifunctional Medical Battalion Conference Room. Because of the COVID-19 pandemic, there was no course offered in 2020. The approximately 30 class enrollees in the course included physical therapists, physicians, physician assistants, nurse practitioners, integrated medical home providers, and medics (E6 and above) who participated in a series of lectures and hands-on demonstrations led by Capt. Kelly Scott, a physical therapist with the 2nd Brigade Combat Team, 82nd Airborne Division, and Capt. Kelly Lavallee, a physical therapist assigned to Robinson. According to MAJ Omici Uwagbai, Robinson's medical director and officer-in-charge, the Musculoskeletal Care for Military Providers course has a two-fold design that involves classroom lectures and hands-on demonstrations that ensure that healthcare providers are implementing the lessons learned with good clinical practices. DVIDS External Link

    GLOBAL

    Duke University expert says UTI vaccine is already FDA-approved but still needs a few years for public availability

    18 May- There is a chance that we could see a UTI vaccine in the next coming years, according to a researcher from Duke University in Durham, North Carolina. The solution for this bacterial infection could now be in the tip of the needle in the future. This could also boost the prevention campaign especially for those who commonly acquire it without knowing.  According to the American Urological Society, despite the number of Urinary Tract Infection or UTI in the United States, it is only second next to strep throat, a condition caused by Streptococcus bacteria. UTI, just like the common flu could hit anyone regardless of their age and gender. In the case of UTI, girls and women are reportedly more prone to the infection. At the moment, there is no known prevention for the UTI--or a vaccine that could prevent an individual from acquiring the virus in the urinary tract. While we are pleased with the idea of having a UTI vaccine, there is a high chance that we could see it in the next few years, according to an expert from Duke University, Soman Abraham. He is the one who took charge of the research that involves the development of a vaccine for UTIs. Tech Times External Link

    Indian data suggests runaway COVID infections as deaths hit daily record

    19 May- Nearly two-thirds of people tested in India have shown exposure to COVID-19, a chain of private laboratories said on Wednesday, indicating a runaway spread of the virus as the daily death toll rose to a record 4,529. India reported 267,334 new daily infections on Wednesday, taking its tally to 25.5 million, the world's second highest after the United States, with a death toll of 283,248, health ministry data showed. For months, nowhere has been hit harder than India by the pandemic, as a new variant discovered there fueled a surge of up to more than 400,000 new infections a day. Only the United States has had a worse single day death toll, when it lost 5,444 people on Feb. 12, a Reuters tracker shows. And with hospitals and crematoria overflowing and the health system overwhelmed, it is widely accepted that the official figures grossly underestimate the real impact of the epidemic, with some experts saying infections and deaths could be five to 10 times higher. There are fears that the new, highly infectious variant is out of control and that many cases are going unreported because of lack of testing, particularly in the vast countryside. Data from Thyrocare, a chain of private laboratories, appeared to back up those fears, showing that 63.5% of people tested positive for COVID-19 antibodies on average over the last seven days, up from 45% a month ago. The data from 25 states included individuals infected in the past, vaccinated, uninfected and those who had not been vaccinated, the company's Chief Executive Arokiaswamy Velumani said on Twitter. Reuters External Link

    More places in the US lift mask mandates- One local leader says the honor system is already not working

    18 May- Several days since the Centers for Disease Control and Prevention said fully vaccinated Americans can -- for the most part -- ditch their masks, more places are announcing changes to their mask policies, or doing away with the requirement altogether. CVS pharmacy and Target both said on Monday they will no longer require fully vaccinated guests to wear masks inside their stores unless mandated by local leaders, joining other businesses who have dropped mask mandates for those who have gotten their shots. "Face coverings will continue to be strongly recommended for guests and team members who are not fully vaccinated," Target said in a statement. Unvaccinated CVS customers are asked to continue masking up. Washington, DC, Mayor Muriel Bowser announced fully vaccinated people will no longer be required to wear masks in many locations, with exceptions for schools, healthcare facilities and transportation hubs. CNN External Link

    Pfizer produces much stronger protection if doses months apart: Study

    17 May- A study in the United Kingdom led by the University of Birmingham in collaboration with Public Health England reported that waiting months between doses of the Pfizer/BioNTech vaccine produces much stronger protection against COVID-19. Dr. Helen Parry, a senior author on the study at Birmingham, said: "We've shown that peak antibody responses after the second Pfizer vaccination are really strongly boosted in older people when this is delayed to 11 to 12 weeks. There is a marked difference between these two schedules in terms of antibody responses we see." Britain has a policy of delaying the second dose by up to 12 weeks to free up vaccines for more people. Britain announced Sunday that more than 20 million people have now received both doses. The two shots of the Pfizer vaccines were intended to be given three to four weeks apart. The study found that antibodies were three-and-a-half times higher when given after 12 weeks. "This study further supports the growing body of evidence that the approach taken in the U.K. of delaying that second dose has really paid off," said Dr. Gayatri Amirthalingam, consultant epidemiologist at Public Health England. "Individuals need to really complete their second dose when it's offered to them because it not only provides additional protection but potentially longer lasting protection against COVID-19." Fox News External Link

    Pfizer vaccine can now be stored in fridge for longer, EU drug regulator says

    18 May- The European Medicines Agency (EMA) said that once the vaccines thawed, unopened vials could be kept in the fridge for up to a month. The current limit is just five days. The increased flexibility is expected to have a significant impact on the vaccine roll-out across the EU. The need for transport and storage at very low temperatures has been one of the major disadvantages of the Pfizer jab. The previous storage requirements for Pfizer vaccines have made them harder to use in some parts of the world. In February, the United States approved storage and transport of the Pfizer vaccine at standard freezer temperatures of -15 to -25C for up to two weeks, as opposed to between -80 to -60C that it usually requires. BBC News External Link 

    Plant-derived COVID-19 vaccine candidate found effective

    18 May- Quebec City-based Medicago and GlaxoSmithKline (GSK) reported positive interim Phase 2 clinical trial safety and immunogenicity data for Medicago's plant-derived, refrigerator-stable COVID-19 vaccine candidate known as CoVLP, which has been tested in combination with GSK's pandemic adjuvant. As measured by the neutralizing antibody titer, immunogenicity was found about 10 times higher than those in a panel of sera from patients recovering from COVID-19. No related severe adverse events were reported, and reactogenicity was generally mild to moderate and short in duration. The Phase 2/3 study is a multi-portion design to confirm that the chosen formulation and dosing regimen of CoVLP (two doses of 3.75 µg CoVLP combined with GSK's pandemic adjuvant given 21 days apart) has an acceptable immunogenicity and safety profile in healthy adults 18-64 years of age, elderly subjects aged 65 and over and adults with comorbidities. The interim data from the Phase 2 study was published at MedRxiv on May 17, 2021. "After two doses, the adjuvant vaccine candidate induced robust neutralizing antibody and cellular immune responses in all subjects, irrespectively of age," said Nathalie Landry, EVP, Scientific, and Medical Affairs at Medicago, in a related press statement. "These results give us confidence as we continue to move forward with our Phase 3 clinical trial." The Phase 3 trial of the vaccine candidate launched on March 16, 2021. Trial sites are currently enrolling subjects in Canada, the United States, the United Kingdom, and Brazil, with additional sites expected to be added in the coming weeks. The vaccine candidate has received Fast Track designation by the U.S. FDA, and Health Canada has initiated a review of Medicago's COVID-19 rolling submission under the Interim Order. Precision Vaccinations External Link

    Rotavirus vaccines found very protective

    18 May- A new study published by the JAMA Pediatrics on May 10, 2021, found the high protection and low risk of serious adverse events for rotavirus vaccines in children who were fully vaccinated emphasized the importance of worldwide rotavirus vaccinations. This study's findings from a meta-analysis revealed that Rotarix and RotaTeq vaccinations reduced rotavirus gastroenteritis (RVGE) in children younger than 5 years by 68.4% and 63.6%, respectively, and this was confirmed in case-control studies (65.3% and 72.8%, respectively). An adjusted indirect comparison indicated no significant differences in the protection of Rotarix and RotaTeq. Other rotavirus vaccines, including Rotavac, Rotasiil, and Lanzhou lamb rotavirus vaccine, also showed positive associations with reduced RVGE risk. Furthermore, all rotavirus vaccines demonstrated no risk of serious adverse events in this analysis. The U.S. CDC states rotavirus commonly causes severe, watery diarrhea and vomiting in infants and young children. Each year, the vaccine prevents an estimated 50,000 hospitalizations among U.S. infants and young children. The first oral dose should be given before a child is 15 weeks of age. And children should receive all doses of rotavirus vaccine before they turn 8 months old.' Precision Vaccinations External Link

    SARS-CoV-2 testing to include people without symptoms

    18 May- California-based Roche announced that its cobas® SARS-CoV-2 Test for use on the widely available, high-throughput cobas® 6800/8800 Systems had received Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration (FDA) for testing individuals without symptoms or reasons to suspect COVID-19. And the EUA applies to pooled samples containing up to and including six individual samples. This EUA supports the guidance update from the Centers for Disease Control and Prevention (CDC) on March 17, 2021, to expand SARS-CoV-2 testing to include people without symptoms to reduce coronavirus spread. "One of the key strategies to reduce COVID-19 transmission is to stop the silent spread of disease early," said Cindy Perettie, Head of Molecular Lab, Roche Diagnostics Solutions, in a press statement issued on May 18, 2021. "Expanding highly sensitive testing to include people who are at risk of exposure but do not show symptoms will help guide contact tracing, isolation, and surveillance requirements." In 2020 Roche enabled 160 million molecular SARS-CoV-2 tests on the company's platforms, and the company continues to develop innovative diagnostic solutions to help healthcare professionals understand and manage the disease. Precision Vaccinations External Link

    WHO warns 'overworking' increases chances of serious health conditions like stroke or heart disease

    18 May- The World Health Organization (WHO) has discovered that an overworking employee that renders more than 55 hours per week for their companies has an increased chance of suffering from a fatal disease. These diseases include common health conditions like stroke and heart diseases and are alarming cases during the COVID-19 pandemic. People may not die from COVID-19 infections, but they may suffer from a stroke or a progressive heart disease now or sooner than later if they keep overworking themselves more than 8 hours a day. COVID-19 may only infect people and deal with severe effects by going out, but staying in and pouring all energy and effort into work may lead to a fatal end as well. Initially, WHO believed that the COVID-19 virus came from outside the laboratories of Wuhan, China, after many others believed that it came from a secret biochemical lab from the region. Also, the organization has been active in COVID-19 vaccine campaigns, especially as it acknowledged the country's efforts in focusing on vaccinations first, before patent disputesTech Times External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 18, ending May 8, 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- No influenza-associated pediatric deaths were reported to CDC during week 18. CDC External Link

    VETERINARY/FOOD SAFETY

    Bean supplier for Costco expands recall over compromised seals on beans

    18 May- Faribault Foods Inc. is expanding their Apr. 22 recall of certain cans of S&W Organic Black Beans and Chili Beans sold at Costco stores because the cans may have compromised seals that could lead to botulism poisoning. The compromised hermetic seals may affect can integrity and may cause the cans to leak, bloat or allow bacteria, such as Clostridium botulinum, to grow inside the product which could lead to serious illness. The recalled products were distributed to retail stores in California, Washington, Utah, Oregon, Arizona, Colorado, Arkansas, Hawaii, Texas, Georgia and Idaho. The recall was initiated after the firm had received consumer and customer complaints regarding the failure of the hermetic seals. Consumers should check their homes because of the long shelf life of the beans, which do not expire until 2023. Food Safety News External Link

    Enoki Mushrooms recalled in Canada over Listeria concerns

    17 May- The Canadian Food Inspection Agency (CFIA) is warning the public not to consume certain Metro Brands Enoki Mushrooms because of possible Listeria monocytogenes. This recall comes after other Enoki mushroom recalls in the United States last month. This warning was triggered by the CFIA's inspection activities. The product was distributed to Quebec and possibly nationally in Canada...The CFIA advises consumers to check to see if they have the affected product in their home and not to consume it. As of the posting of this recall, there have been no reported illnesses associated with the consumption of this product. Food Safety News External Link

    WELLNESS

    E-Bikes can provide a good workout

    19 May- Does riding an electric bike to work count as exercise, and not just a mode of transportation? It can, if you ride right, according to a pragmatic new study comparing the physiological effects of e-bikes and standard road bicycles during a simulated commute. The study, which involved riders new to e-cycling, found that most could complete their commutes faster and with less effort on e-bikes than standard bicycles, while elevating their breathing and heart rates enough to get a meaningful workout. But the benefits varied and depended, to some extent, on how people's bikes were adjusted and how they adjusted to the bikes. The findings have particular relevance at the moment, as pandemic restrictions loosen and offices reopen, and many of us consider options other than packed trains to move ourselves from our homes to elsewhere. In America, few of us bike to work. By most estimates, only about one-half of 1 percent of American workers regularly commute on a bicycle, a number that has been shrinking, not rising, in recent decades. Asked why, most people tell researchers that bike commuting requires too much time, perspiration and accident risk. Simultaneously, though, people report a growing interest in improving their health and reducing their ecological impact by driving less. In theory, both these hopes and concerns could be met or minimized with e-bikes. An alluring technological compromise between a standard, self-powered bicycle and a scooter, e-bikes look almost like regular bikes but are fitted with battery-powered electric motors that assist pedaling, slightly juicing each stroke. The New York Times External Link

    USAFRICOM

    Uganda CCHF update: 2nd case confirmed

    11 May- In a follow-up on the Crimean-Congo hemorrhagic fever (CCHF) situation in Kikuube district in the western part of the country, health officials report a second case epidemiologically linked to the case patient as a primary contact. According to the World Health Organization (WHO), the first case was confirmed on 28 April 2021 in a 16-year-old female from Munsiinsa-A village in the Kyangwali Refugee Settlement, Kikuube district on 27 April 2021. The second case is a 13-year-old male from Busisa-Kyangwali, who was admitted on 29 April 2021 with a high grade fever, blood in his urine and vomiting blood. A sample was shipped to the UVRI and returned PCR positive for CCHF on 4 May 2021. Both patients are currently stable and showing signs of improvement. WHO says Crimean-Congo hemorrhagic fever is known to be present in livestock in Uganda and the country is experienced in responding to outbreaks of infectious diseases, as evidenced by the prompt diagnosis, isolation and treatment of the two cases so far. Outbreak News Today External Link

    USCENTCOM

    CDC: All travelers to Pakistan are at risk of getting XDR typhoid fever

    15 May- The Centers for Disease Control and Prevention (CDC) updated their travel notice for Pakistan and the outbreak of extensively drug-resistant (XDR) typhoid fever this week. The ongoing outbreak began in 2016 in Sindh province, Pakistan, and spread throughout the country.  Cases of XDR typhoid fever have been reported among people in North America, Europe, East Asian, and the South Pacific who traveled to Pakistan. All travelers to Pakistan are at risk of getting XDR typhoid fever, they report. As of January 14, 2021, CDC has received 71 reports of XDR Typhi infection in the United States, with specimens obtained from February 9, 2018, through November 16, 2020. Among 67 patients with known travel history, 58 (87%) had traveled to Pakistan in the 30 days before illness began. Nine (13%) patients from six states (NY [3], CA [2], IL, MD, NJ, and TX) reported that they had not traveled to Pakistan or any other country. Specimens from these nine patients were obtained from November 7, 2019, through October 7, 2020, with eight obtained in 2020. Susceptibility testing of these specimens showed the same resistance pattern described in Pakistan. CDC has not identified linkages among these patients or a common source of infection. XDR Typhi strains are resistant to antibiotics generally recommended to treat typhoid fever, including ampicillin, ceftriaxone, chloramphenicol, ciprofloxacin, and trimethoprim-sulfamethoxazole. Isolates from patients linked to the outbreak in Pakistan are susceptible to carbapenems and azithromycin. Outbreak News Today External Link

    USEUCOM

    Ukraine reports 5 malaria cases in sailors to Africa

    16 May- The Public Health Center (PHC) of Ukraine reports (computer translated) in early May, a 43-year-old man was diagnosed with malaria in Odessa. For the past five months, the patient has been the captain of a seagoing ship (gas carrier) that transported to the ports of Angola. The man was hospitalized in a private medical institution on the sixth day after the onset of symptoms – fever up to 39 ° C, chills, sweating, weakness, headache. Prior to that, the man was taking antipyretic drugs. The next day after hospitalization due to the deterioration of the patient was transferred to the intensive care unit of the city infectious diseases hospital. Malaria was confirmed in the laboratory. The patient undergoes specific treatment according to the scheme and detoxification therapy. There is no information on chemoprophylaxis against malaria during the flight. A request has been sent to the crewing company. The epidemiological investigation continues. One imported case of malaria was fatal. A 31-year-old man from Odessa region died. For the past six months, he has worked as a cook on board a seagoing ship sailing to Africa (Senegal, Côte d'Ivoire, Congo). During the epidemiological investigation, it became clear that the man did not receive antimalarial drugs during the flight. Outbreak News Today External Link

    USINDOPACOM

    Australia: Leptospirosis spike reported in Queensland

    15 May- The number of leptospirosis cases reported in Queensland in 2021 have nearly doubled compared the same period last year, health officials report. Through May 9, Queensland has recorded 78 cases of leptospirosis across the state compared to 41 cases at the same time last year. This is a 70 per cent increase compared with the five-year mean (year to date). In 2020, a total of 81 cases were recorded, and 56 cases in 2019. Queensland Health spokesperson Professor Keith McNeil said leptospirosis is caused by Leptospira bacteria, which is found in urine from infected animals including rats, mice, cattle, pigs and dogs. "Leptospirosis is a notifiable condition that is most common in tropical and subtropical areas like northern Queensland and it can potentially cause serious illness," Professor McNeil said. "Cases tend to increase in the warmer months due to the corresponding wet season. "The bacteria can enter the body through skin cuts or abrasions or through the lining of the mouth, nose, and eyes by exposure to water, soil or mud contaminated with the urine from infected animals. "Agriculture workers are most at risk such as those working with animals or cane or banana farm workers, but it can also be caused by drinking or swimming in creeks, rivers or lakes contaminated by the urine of infected animals. Water affected by heavy rain or flooding are especially risky. "That means people who participate in camping, gardening, bushwalking and water sport pursuits can also be at risk of infection as they may have contact with contaminated water, soil or mud during these activities. "There are many different strains of the Leptospira bacteria, so it's possible to be infected with leptospirosis multiple times," he said. Professor McNeil said the rise in cases has coincided with an increase in rodent activity and flooding events this year, with a marked increase in cases compared to the same time last year in Cairns and Hinterland and Darling Downs regions. Outbreak News Today External Link

    Malaysia officials respond to ivermectin 'miracle drug' claims

    16 May- Ivermectin is an anti-parasitic drug mostly used in veterinary medicine, especially treating worm infestations. In April 2020, researchers using laboratory methods showed that Ivermectin can also inhibit the replication of SARS-CoV-2, the novel virus that causes COVID-19 illness. Since then, many authors relying on findings from small studies and case series have suggested the potential use of Ivermectin against COVID-19. Yet the recommendation for the 'off-label' use of Ivermectin in COVID-19 has been controversial since the beginning. Firstly, many Ivermectin studies had limitations including small sample size, non-controlled study designs or that the drug was used as add-on treatment. Therefore this had confounded the effect of Ivermectin, if any. In January 2021, a placebo-controlled randomized trial involving 24 non-severe COVID-19 patients did not manage to show reduction in the proportion of PCR positive patients at day 7 post Ivermectin 400 mcg/kg single oral dose treatment. The authors of the pilot study, published in EClinical Medicine (Lancet), opinionated that larger trials may be needed to understand the effects of Ivermectin. In March this year, the Journal of American Medical Association (JAMA) published a randomized-controlled trial involving 476 adults with mild COVID-19 disease given a 5-day course of Ivermectin. The results showed that there was no significant improvement in COVID-19 symptoms resolution time. Whilst Ivermectin may have some anti-viral and anti-inflammatory effects, the evidence remains inconclusive. Regulatory bodies including the US FDA and the European EMA, after evaluating these studies, have concluded that there was insufficient evidence to support the use of Ivermectin as treatment of COVID-19. The WHO also issued guidelines against the routine use of Ivermectin in the treatment of COVID-19 except in clinical trial settings. Outbreak News Today External Link

    USNORTHCOM

    Canada: Cluster of neurological syndrome of unknown cause in New Brunswick

    14 May- New Brunswick, Canada officials reports investigating a group of individuals who are experiencing signs and symptoms of a neurological syndrome of unknown cause (NSUC). At this time, the investigation is active and ongoing to determine if there are similarities among the reported cases that can identify potential causes for this syndrome, and to help identify possible strategies for prevention. The investigation team is exploring all potential causes including food, environmental and animal exposures. As of 6 May 2021, 48 cases have been reported, including six deaths. In some cases, more information is needed to determine if the cause of death was a result of this syndrome. Most cases have dates of symptom onset between 2018-2020, except for one case who experienced symptoms in 2013, the gender ratio is 1:1 and age ranges between 18 and 85 years. Most cases live in the south-eastern and north-eastern regions of New Brunswick, around the Acadian Peninsula and Moncton areas. However, there is no evidence so far suggesting that residents of these regions are at higher risk. Some symptoms include memory problems, muscle spasms, balance issues, difficulty walking or falls, blurred vision or vision hallucinations, unexplained and significant weight loss, behavior changes, and pain in the upper or lower limbs. Local health-care providers in New Brunswick have engaged the Public Health Agency of Canada's Creutzfeldt-Jakob Disease Surveillance System (CJDSS) to actively investigate the possibility of human prion disease, but to date, all test results have been negative for known forms of human prion disease.  Due to commonalities in signs and symptoms and the lack of a confirmed diagnosis among cases, a cluster of NSUC has been identified. Outbreak News Today External Link

    U.S.: Plague suspected in the death of squirrels in the Colorado Springs area

    15 May- El Paso County Public Health is encouraging residents to take precautions to prevent exposure after multiple squirrels have died of suspected plague in the Patty Jewett and Divine Redeemer neighborhoods in the Colorado Springs. Test results for the squirrels are currently pending confirmation at the Colorado Department of Public Health and Environment Laboratory, with results anticipated in the coming days. "We want to alert people to the fact that wild rodents and other small mammals in this area may be infected with plague, which is more common during cooler summers after wet winters," said Haley Zachary, communicable disease program manager for El Paso County Public Health. "By taking simple preventive measures, residents can help protect themselves and their pets." Plague is an infectious disease that is most commonly spread to people by the bite of an infected flea but also may be transmitted by infected animal tissues, fluids, or respiratory droplets. People with direct exposure to fleas or wildlife in the affected areas may be at risk. People who think they have been exposed should contact a health care provider immediately. Symptoms include sudden fever, headache, chills, weakness, and tender, painful lymph nodes. While there are no publicly available vaccines to prevent plague in people, if caught early, it can be successfully treated with antibiotics in both people and pets. Outbreak News Today External Link

    USSOUTHCOM

    Hispaniola: Diphtheria cases rise to 23 confirmed

    15 May- In a follow-up on the diphtheria situation on the island of Hispaniola, the two countries of Haiti and the Dominican Republic have now seen 23 total confirmed cases to date. The Dominican Republic with 12 confirmed cases including 9 deaths, and Haiti has seen 11 confirmed cases including 2 deaths. Vaccination coverage for both countries is below where it needs to be: In Haiti, since 1980, DTP3 coverage has been less than 95%, with an average of 75% between 2010 and 2019 (range: 60%-79%), while DTP4 coverage reached a maximum coverage of 46% in 2019. Outbreak News Today External Link