Army Public Health Weekly Update, 22 April 2022

Date Published: 4/22/2022
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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.

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Table of Contents


    H2F launches Thunderbolt Performance Center

    14 April- The Holistic Health and Fitness (H2F) team launched its post-pilot Thunderbolt Performance Center at the Soldier Center Medical Home in a ribbon-cutting ceremony, April 13. The 17th Field Artillery Brigade piloted the Army's H2F program in early 2018 at the 5th Battalion, 3rd Field Artillery Regiment with a team of five experts and it has since grown as an Army-wide brigade level institution. “This new system of readiness training shifts from the industrial, one-size fits all model, to a multidisciplinary approach, incorporating all aspects that impact Soldier readiness," said Susanne Koch Craig, director of the Thunderbolt H2F program. “H2F not only optimizes Soldier performance on the battlefield–but aims to positively influence Soldiers' lives through psychological and physiological means." The Thunderbolt Performance Center is designed to fulfill the FM 7-22 model for Holistic Health and Fitness within its 8000 square feet of training space. It is a fully equipped and staffed facility with a team of experts in nutrition, physical therapy, occupational therapy, sleep studies, mental wellness (behavioral therapy), and spiritual services (Chaplain) to help Soldiers maintain a better readiness across the mind, body and spirit. “Within our walls, our capacity to assist and empower Soldiers is exceptional," said Craig. “And I cannot be prouder of the professional team of experts who have worked to build trust with our Soldiers." The Army needs H2, since 70 percent of the American public is unqualified for military service physically or mentally. According to a HQDA EXORD 149-19 Health of the Force Study, prior to the H2F implementation across the Army, the force had a 30 percent attrition rate among first term enlistment Soldiers. Forty-two percent of the force were obese, 55 percent of Soldiers endured musculoskeletal injuries each year adding up to 10 million limited-duty days, and $557 million annually in patient care. Over 37,000 troops were undeployable due to medical reasons and 12 percent of Soldiers had sleep disorders wherein five percent of those needed medical aids to sleep. Suicide rates continued to rise. Just one percent reduction of non-deployable Soldiers would save the Army 40 million dollars. External Link

    Military Injury Prevention Research to Practice Education Series

    The Military Injury Prevention Research to Practice Education Series for military providers and staff covers medical readiness topics such as injury prevention, health promotion, and physical performance optimization.  The series is held five times a year on MS Teams and is co-led by APHC Injury Prevention and Uniformed Services University (USU) Consortium for Health and Military Performance (CHAMP).

    Next Webinar:

    When: 2 May 22, 1300-1410 Eastern

    Where: MS Teams, please subscribe to emails for seminar announcements APHC


    COVID-19 booster effectiveness remained high during omicron surge

    18 April- Active-duty service members who received a COVID-19 vaccine booster shot were significantly less likely to be infected and show symptoms of the disease during the surge of the Omicron variant this winter, according to a recent study. The study highlights the effectiveness of booster shots, which were first formally recommended by the Centers for Disease Control and Prevention in November. “The findings support the policy of booster doses at five months after the primary series and show improved vaccine effectiveness with a booster dose even during times of a newly emerging SARS-CoV-2 variant," said Shauna Stahlman. She is a senior epidemiologist in the Epidemiology and Analysis Branch of the Armed Forces Health Surveillance Division. But a separate study also found that the number of active-duty service members who were voluntarily getting booster shots lagged behind the general U.S. population. As of Jan. 31, only 24% of active-duty service members who were eligible for a booster had voluntarily received the additional shot, according to Army Col. (Dr.) James Mancuso. MancusoUniformed Services University website on Janes D. Mancuso chairs the Preventive Medicine and Biostatistics Department at the Uniformed Services University of Health Sciences' Hebert School of Medicine. His group led the booster uptake study in collaboration with Stahlman and AFHSD. By comparison, in the general U.S. population as of Feb. 10, about 46.8% of the booster-eligible population had received the additional shot. “This is likely reflective of [active-duty service members] being a relatively younger and healthier population," Stahlman said. The study found that service members were less likely to get a booster shot if they were younger, lower in rank or had lower education levels. Similar studies of the civilian population show that younger and healthier people have been less likely to seek out vaccines and booster shots. Overall, the rate at which service members sought out and received booster shots increased during the surge of infections linked to the Omicron variant beginning in December 2021. Vaccine uptake among active-duty service members also went up in November 2021 after the CDC recommended that all adults get a booster, Stahlman noted. The Pentagon mandated initial COVID-19 vaccinations for service members in August 2021. However, booster shots remain voluntary. External Link

    Seven medical soldiers and one hospital unit emerge as winners in RHC-C BLC

    14 April- With the desert sun shining on their faces and their newly awarded Army Accommodation Medals, seven Army leaders were recognized as winners in the 2022 Regional Health Command-Central (RHC-C) Best Leader Competition (BLC) hosted by the William Beaumont Army Medical Center. The Reynolds Army Health Clinic of Fort Sill, Oklahoma, took home the trophy as the competition's best squad. "Whenever we go to war we are integrated with the warfighter," Cpt. Erik Heitman, the RHC-C BLC Officer in charge, said. "So our medics need to be able to do the same things as our combat Soldiers." For five days, 64 of the Army's medical Soldiers converged on the 1.2 million-acre training area to compete against each other in numerous administrative, athletic and warrior tasks and battle drills to determine who would reign supreme as the RHC-C's best medical leaders. Heitman says the event is important to further the mission of the Army's medical personnel. 1st Lt. Cara Adams assigned to the General Leonard Wood Army Community Hospital was selected as the winner among all officers who competed. The Attleboro, Massachusetts, native said she gained a lot of confidence following her success in the competition. "I think a lot of the people around me almost believe more in me than I think I do," Adams said. "Going forward knowing I am more capable than I thought I was and that's a great place to be in." Sgt. 1st Class Timothy McCoole assigned to Reynolds Army Community Hospital was selected as the winner for all senior noncommissioned officers. The husband and father of two, said the week-long event was vigorous and physically demanding and the troops had little time for sleep. But, as a senior leader, McCoole was especially proud of the soldiers he was competing with and against. "It was awesome seeing Soldiers get out of their comfort zones," McCoole said. "Some of the Soldiers here haven't seen this type of environment at this extent, it was cool to see them giving it their all." DVIDS  External Link

    Sharing nursing knowledge: Madigan's 13th Annual Warman Conference

    18 April- Excellence Conference served to reinforce these strengths in the nursing community at Madigan Army Medical Center on Joint Base Lewis-McChord, Wash., on March 25. Nurses of all specialties and levels participated virtually to see presentations and interact with a slate of subject matter experts on topics of concern to the field. Interspersed were drawings for raffles and polls of what attendees would like to see in future conferences with subjects like, “Should the conference be in-person, virtual or hybrid?" and “What topics would you like to see addressed in future conference presentations?" In its in-person iterations in the past, the conference has included large and small group activities as well as a luncheon. The virtual platform pared it down to its presentations but was able to retain a good degree of interaction between presenters and participants. Bringing the conference together offers a learning opportunity for nurses who are newer to the field, like 1st Lt. Lauren Dexter, who is a clinical staff nurse and one of the organizers of this year's event. “This experience taught me the importance of creating deadlines, backwards planning, and communication. From the planning, to fundraising, to coordinating with all of our presenters, and trying to find the best way to provide an interesting and engaging virtual learning opportunity, it was absolutely a learning experience," said Dexter. “I am very grateful we had mentors in the CNSCI office to help us out, Jessica Rea and CPT [Danielle] Garcia. This experience taught me the importance of creating deadlines, backwards planning, and communication." Rea, a member of the Center for Nursing Science and Clinical Inquiry or CNSCI team, and Garcia, a clinical nurse specialist, also helped plan the conference, as did 1st Lt. Briana Inestroza. DVIDS External Link


    About 88,000 people die from alcohol-related causes annually

    8 April- Most adults in the United States who drink alcohol drink moderately and without complications. At the same time, alcohol-related problems are among the most significant public health issues in the country. Alcohol use disorder (AUD) affects about 15 million adults in the United States, and an estimated 88,000 people die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the nation. April is Alcohol Awareness Month, a good time to reflect on our drinking patterns and the role that alcohol plays in our lives. How do you know if drinking alcohol has become a problem for you or a loved one? And where do you go for help if it has? One way is to learn more about Substance Use Disorder (SUD) Alcohol becomes a problem when it impacts your life in a negative way. For example, is your personal or work life deteriorating because of your drinking? Have you had times when you drank more, or longer, than you intended? Are you drinking to feel better? Are you drinking to cope with stress or other problems? Do you feel anxious or irritable without a drink? In service members and Veterans, SUD commonly co-occurs with and complicates other conditions or issues. These conditions or issues may be health-related, such as other mental health conditions. They may also be societal, such as homelessness, criminal justice involvement or unemployment. External Link

    A common virus may be one contributing cause of multiple sclerosis

    19 April- Discovering the cause of a disease is not easy. One reason is that the vast majority of diseases do not have a single cause. Instead, most diseases occur because multiple factors combine to cause the disease. One factor is genes. Some people are born with one or more genes that make them vulnerable to a disease. Other factors come from your environment and behavior: what you eat, the air you breathe, the amount of physical activity you engage in, and habits such as smoking. Recent research finds that certain viruses may also be important contributing factors in causing multiple sclerosis (MS). Multiple sclerosis is a disease of the brain and spinal cord that can cause many neurological symptoms, including arm and leg weakness, loss of vision, and difficulty thinking, as well as severe fatigue. Over the past 50 years we've learned that MS is an autoimmune disease: in various ways, the immune system attacks the brain and/or the spinal cord, leading to the symptoms of the illness. However, we haven't figured out why:what causes the immune system to go on the attack? Over the years, several viruses have been proposed as causes of MS, only to have subsequent research show that they were not. That led some MS doctors and scientists to discount viruses as possible causes. Yet growing evidence in recent years points to several viruses that may be triggers of MS. The strongest evidence is for Epstein-Barr virus (EBV). This virus infects most people in developed nations like the US in their teen or young adult years. Once a person is infected, the virus quietly remains alive in the body for the rest of a person's life. In most people, it causes no health problems. But, rarely, it can cause certain cancers. Now, it has been linked to multiple sclerosis. Health.harvard External Link

    Excess weight a clear womb-cancer risk

    19 April- Being overweight substantially increases the risk of developing womb cancer, research suggests. If a 5ft 5in (1.65m) woman is two stone (12.7kg) above a healthy weight, her risk is nearly doubled, for example. The Cancer Research UK (CRUK)-funded research involved 120,000 women in the UK, US and five other countries. The charity says keeping a healthy weight can cut the risk of 13 different cancers. Genes and hormones may be other risk factors. One theory is fat cells can send out signals telling other cells to divide more often, which can lead to cancer. The growth of some breast cancers is linked to the female hormone oestrogen, which fat cells also produce, for example. The CRUK study, led by a team at the University of Bristol and published in BMC Medicine, is one of the largest into the link between fat and womb cancer. It looked at the effect of lifelong weight gain and uncovered two hormones, fasting insulin and testosterone, linked with obesity and womb cancer. The researchers hope scientists could in future use drugs to regulate levels of those hormones in people at risk of developing the cancer. BBC News External Link

    "I'm alive because people care, because people donate blood"

    14 April- In April 2012, a “normal day at work turned ugly" for Army Staff Sgt. Travis Mills. He and members of his paratrooper battalion in the 82nd Airborne Division were on routine patrol in Afghanistan when an improvised explosive device went off. He remembers regaining consciousness a few seconds later and hearing his medic call out for help to place tourniquets on his legs and arms. “I knew I was hit," he said. “I lifted my left arm and saw it was kind of tattered up pretty good." When he saw his hand, he knew it wasn't good. He wondered if he would ever see his baby girl again. Mills lost a lot of blood that day. Without a massive infusion of new blood, he said, he probably would not have made it home. “I'm alive because people care, because people donate blood," Mills said. “And without the blood given to the Armed Services Blood Program, I would not be able to stand here and tell you about how important it is." Mills, now 35 and a father of two, lives in Maine. He is one of only five quadruple amputees to survive injuries from the wars in Iraq and Afghanistan. “My job was the military," said Mills. “I loved it. Working with soldiers every day, doing my job was the greatest for me. He was on his third deployment. And coming home to his wife and little girl completed his dream life. “I had a really good life mapped out," he said. “I was really doing well." Mills' father, Dennis, said military service was what his son was meant to do. He recalls Travis as an energetic, motivated, active, and friendly kid growing up in Vassar, Michigan.  At 6 foot 3 inches tall, Mills was strong and excelled in sports. He was goofy and loved to tease his younger brother, and he always stuck up for the underdogs, Dennis said. Soon after starting community college, he realized his heart was somewhere else. He enlisted in the Army, never looking back. “You could see the joy in his face," his father recalled. He excelled in the Army. “Travis' leadership ability is like the guys that you see in movies, that people don't think really exist," said Army Sgt. 1st Class Josh Buck, Mills' friend, teammate, and brother-in-law. “He's the guy that when you're getting shot at, you would love him next to you no matter what, because he's fearless in a gun fight." External Link

    It's time to screen all kids for anxiety, physicians' task force recommends

    17 April- An influential panel of experts says all kids ages eight to 18 should be screened regularly for anxiety. This draft recommendation by the United States Preventative Task Force comes at a time when mental health problems among kids have escalated and are overwhelming the health system. The task force also recommends that kids 12 and older continue to be screened for depression, a recommendation that's been in place since 2016. The screenings are usually done by primary care physicians using standardized questionnaires that parents and/or kids answer, depending on their age. "We were already seeing rising rates of anxiety, depression and also suicide behaviors and suicide in our young people," says Martha Kubik, a professor of nursing at George Mason University and a member of the task force. The goal of the screenings, she says, is to help doctors and other providers identify at-risk kids early on in the trajectory of their illness so that they can be treated before symptoms escalate. Child and adolescent mental health experts welcome the recommendations. It has increasingly become clear that most mental illnesses manifest in childhood and adolescence, says Dr. Jennifer Havens, the chair of Child and Adolescent Psychiatry at NYU's Grossman School of Medicine. But anxiety disorder, one of the most common mental illnesses among children, can go undetected for a long time. "It can be quiet. Kids who are anxious are often very self-conscious and aren't going to share this with their families or their physicians, necessarily. So screening is a very, very good idea." Most cases of anxiety in children can be treated with psychotherapy, she adds. Only kids with severe anxiety need medication. That's why, she says, the earlier a child is diagnosed, the easier it is to treat. NPR External Link

    Pfizer says booster hiked immune response in children ages 5 to 11

    14 April-Pfizer-BioNTech said Thursday that, in a trial, a booster dose of its coronavirus vaccine in children ages 5 to 11 increased the level of antibodies that neutralized the original version of the virus and the Omicron variant.

    Why it matters: If federal regulators verify the companies' claims, children over the age of 5 could gain access to boosters.

    By the numbers: The trial detailed Thursday involved 140 children who received a booster dose six months after their second shot.

    -An analysis of blood samples from a smaller group of 30 of the kids showed that the booster produced a 36-fold increase in neutralizing antibodies against the Omicron variant.

    -Data from all participants showed a sixfold increase in antibodies against the original version of the virus.

    What's next: Pfizer and BioNTech said they plan to submit a request to U.S. regulators for an emergency authorization of a booster dose for children ages 5 through 11 in the coming days.

    -Moderna is also testing a booster shot for kids.

    The big picture: The World Health Organization said in January there was no evidence that healthy children and adolescents needed boosters shots.

    -The Food and Drug Administration expanded COVID-19 vaccine booster eligibility in January to allow children of ages 12 to 15 to receive a third shot of the Pfizer-BioNTech vaccine. AXIOS External Link

    Uber and Lyft drop face mask requirements on ride sharing, as per CDC

    19 April- Uber and Lyft are dropping their face mask requirements for all drivers and riders of the ride-sharing application, and it will give an option for some to be comfortable in the new normal. The move from both companies is based on the recent CDC guidelines that also dropped the face mask requirements on airplanes whenever traveling. Uber and Lyft announced that it is dropping the face mask requirements for the drivers and riders who will use their application, previously having guidelines to have it on during the ride. Before, drivers could drop or cancel the booking when a passenger refuses to wear one, and the same goes for customers with drivers removing it, something that people may still observe now. According to Uber, the recent CDC guidelines made way for this new regulation from the company, and it aims to give people a chance to remove the coverings and get accustomed to the new normal. On the other hand, Lyft also announced via a blog post that it allows everyone in the car to remove their coverings. It is important to note that while it is not a requirement anymore, people can still choose to wear it for personal reasons. Tech Times External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 14, ending April 9, 2022:

    - Influenza activity increased nationally this week. Influenza activity is highest in the central and south-central regions of the country and is increasing in most regions.

    - The majority of influenza viruses detected are A(H3N2). H3N2 viruses identified so far this season are genetically closely related to the vaccine virus. Antigenic data show that the majority of the H3N2 viruses characterized are antigenically different from the vaccine reference viruses. While the number of B/Victoria viruses circulating this season is small, the majority of the B/Victoria viruses characterized are antigenically similar to the vaccine reference virus.

    - The percentage of outpatient visits due to respiratory illness increased slightly this week compared with last week and remains below baseline. Influenza is contributing to levels of respiratory illness, but other respiratory viruses are also circulating. The relative contribution of influenza varies by location.

    - The number of hospital admissions reported to HHS Protect has increased each week for the past ten weeks.

    - The cumulative hospitalization rate in the FluSurv-NET system is higher than the end-of-seasons rates for the 2020-2021 and 2011-2012 seasons, but lower than the rate seen at this time during the four seasons preceding the COVID-19 pandemic.

    - Three influenza-associated pediatric deaths were reported this week. There have been 19 pediatric deaths reported this season.

    - CDC estimates that, so far this season, there have been at least 4.3 million flu illnesses, 42,000 hospitalizations, and 2,500 deaths from flu.

    - An annual flu vaccine is the best way to protect against flu. Vaccination can prevent serious outcomes in people who get vaccinated but still get sick. CDC continues to recommend that everyone ages 6 months and older get a flu vaccine as long as flu activity continues.

    - There are also prescription flu antiviral drugs that can be used to treat flu illness. CDC External Link


    Food and drug officials nationwide review the state of recalls and related needs

    19 April- An ongoing Association of Food and Drug Officials (AFDO) recall modernization project workgroup has released its recommendations after a three-year review of data and information. The AFDO team is made up of regulators and industry representatives from across the country. AFDO has released a Recall Whitepaper outlining the group's work, which it explained as follows: “In 2018, AFDO developed a Recall Working Group. Its goals were to capture the entire recall process, diagram it, and identify the pain points in that process. The outcome of the two face-to-face meetings was a series of recall response flowcharts. The summary flowchart breaks down a recall into phases. The red flags indicate a pain point experienced by either state regulators, industry or both. The group was initially composed of six Rapid Response Team (RRT) states, with representatives who came together for a 2-day, face-to-face discussion about recalls. “During this meeting, the six states broke apart the recall process from initiation to closure, identifying pain points along the way and developing a recall process diagram. A few months later, key industry leaders joined the six states to review the diagram. The combined state-industry AFDO Recall Working Group confirmed the unknowns of how recall activities are accomplished across all three entities. This knowledge gap presents an opportunity for further research and development." The report says that even with stringent protocols and processes used to produce food today, food recalls are still commonplace. To understand why this is so, it says we need to understand two basic problems associated with food recalls. Food Safety News External Link

    Salmonella test spurs recall of Marketside organic zucchini sold at Walmart stores

    19 April- World Variety Produce Inc. of Los Angeles is recalling organic zucchini shipped to Walmart stores in 18 states after government testing revealed contamination with Salmonella. “Consumers who have purchased the recalled organic Marketside zucchini are urged to destroy and dispose of recalled product," according to a company notice. The Marketside brand organic zucchini was shipped to Walmart stores in Arizona, Arkansas, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, North Dakota, Oklahoma, South Dakota, Texas and Wisconsin, according to the company's recall notice. The contamination was discovered during routine testing by the Food and Drug Administration...Consumers with questions may contact World Variety Produce Inc. at 800-588-0151. Food Safety News External Link


    How to do Tabata training, the short but exhausting, fat-blasting HIIT workout

    19 April- Short on time but want to blast away fat and calories? Consider Tabata training. It's a type of high-intensity interval training workout created by Japanese scientist Izumi Tabata. Like other forms of HIIT, it involves periods of exercising intensely with an elevated heart rate, alternated with shorter recovery periods. Tabata training consists of performing the same exercise through eight sets of 20 seconds of work and 10 seconds of rest. That's 4 minutes total per round of Tabata. Tabata is generally performed using only body-weight exercises, but you can apply light resistance by using bands or low-weight dumbbells with certain exercises such as squatting. You can also do exercises Tabata-style, using equipment such as a jump rope, Hula Hoop or mini-trampoline. If you're feeling up to the challenge, you can perform multiple rounds, doing a different exercise each time, taking at least a 1-minute break between rounds before starting the next exercise. Read on for four exercises you can try Tabata-style in single rounds or consecutively for a total-body HIIT workout. Consistent moderate-intensity cardio workouts offer myriad health benefits, but there are compelling reasons to add Tabata into your overall training. My friend and celebrity trainer Ashley Borden shared her experience with Tabata's benefits. "Despite the low time commitment, Tabata is not just a fad, but an exercise style based in science that offers a highly efficient means of burning fat," said Borden, who was a trainer on E!'s "Revenge Body With Khloe Kardashian" and who has been featured on "The Kelly Clarkson Show." In a 12-week study of overweight young men, participants saw an average 17% reduction of visceral fat by doing 20 minutes of high-intensity training three times per week without altering their diets. CNN External Link


    First COVID, now floods empty South Africa's eastern beach resorts

    20 April- After two years of the COVID-19 pandemic keeping tourists away, South African resorts along the popular eastern Indian Ocean coastline were hoping for a bumper Easter weekend. But torrential rain last week triggered floods and mudslides, killing more than 440 people, knocking out power and water supplies and covering the beaches in and around the main port city of Durban, KwaZulu-Natal province, with debris. Some hotels had a third of bookings cancelled and others were forced to close during what is normally the second-busiest time of the year. Provincial authorities say they were expecting around 360,000 arrivals, but got less than half of that. Tourism remains a big employer in a country with over 30% unemployment. "Coming out of COVID ... we needed the tourists back, we were getting there, but these rains caused havoc," financial planner Eugene Naidu told Reuters in his wrecked holiday home in the town of Umdloti, near Durban, where the walls were smeared with waist-high mud. Africa's southeastern coast is on the front line of seaborne storm systems that are being worsened by global warming, as it pushes up temperatures in the Indian Ocean, and scientists predict storms will get much worse in coming decades. Reuters External Link


    The State of Israel is in the throes of a polio outbreak

    16 April- According to the Israel Ministry of Health this week, The State of Israel is in the throes of a polio outbreak. In the Jerusalem area and the surrounding area – 7 asymptomatic cVDPV3 cases have been reported and one child with paralysis since the index case in early March. All are not vaccinated. As an immediate response, immunization activities with inactivated polio vaccine (IPV) and catch-up vaccination were initiated in Jerusalem, and a bivalent oral polio vaccine (bOPV) campaign started on 4 April 2022 in Jerusalem district which has been extended to the entire country as of 13 April. Given the high immunization coverage and robust surveillance system in the country, the risk of national spread is considered 'moderate', according to WHO. Poliomyelitis (polio) is a highly infectious viral disease that largely affects children under five years of age. The virus is transmitted by person-to-person and spread mainly through the fecal-oral route or, less frequently, by a common vehicle (e.g., contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and cause paralysis. Polio is a crippling and potentially deadly disease that affects the nervous system. Good hand washing practices can help prevent the spread of this disease. Because the virus that causes polio lives in the feces of an infected person, people infected with the disease can spread it to others when they do not wash their hands well after defecating. People can also be infected if they drink water or eat food contaminated with infected feces. Outbreak News Today External Link


    Mysterious liver illness seen in kids in US, Europe

    18 April- Health officials in several countries are investigating mysterious cases of severe liver disease in children, and they think it may be related to a kind of virus usually associated with colds. The U.K. has been investigating at least 74 cases in which children came down with hepatitis, or liver inflammation, the World Health Organization said Friday. Three similar cases in Spain and a few in Ireland are being investigated, the WHO said. Meanwhile, U.S. health officials say they are looking into nine similar cases. All were in Alabama, but officials say they are looking to see if there are more elsewhere. "Given the increase in cases reported over the past one month and enhanced case search activities, more cases are likely to be reported in the coming days," WHO officials said in a statement. The U.S. children ranged in age from 1 to 6 years old, and two required liver transplants. The European cases are in a similar age range, though some have been older, WHO officials said. The WHO first became aware of the unusual illnesses early this month, when they learned of 10 children in Scotland with liver problems. One got sick in January and the nine others in March. All became severely ill and were diagnosed with hepatitis after being taken to the hospital. Fox News External Link


    Shanghai hopes COVID tide turning, with fewer cases outside quarantine areas

    20 April- China's commercial capital of Shanghai reported no new COVID-19 infections outside quarantine areas in two districts on Wednesday, fanning hopes that the tide is turning in its pandemic battle, as some factories began to return to work. State media trumpeted the resumption of production by electric car company Tesla Inc (TSLA.O) at its Shanghai plant on Tuesday, after a halt of more than three weeks. The U.S. carmaker was on a list of 666 firms the Chinese government said last week would get priority to reopen, or keep operations running, in Shanghai. "The city's epidemic situation in recent days has shown a downward trend," city health official Wu Qianyu told a daily news conference on Wednesday. "Community spread has been effectively curbed." Stringent lockdown measures after the outbreak began in early March left the city's 25 million people struggling with the loss of income, irregular food supplies, family separations and poor conditions in quarantine. While 16.3 million people are still barred from leaving flats or housing compounds, Wu added, 7.85 million can return to factories or walk outside, a rise of 2 million from last week. But some of those subject to looser curbs say they are still unable to secure the permission they need from neighbourhood officials to go out. Authorities ramped up daily testing of residents this week, as well as transfers of positive cases and their close contacts to quarantine centres outside Shanghai. Reuters External Link


    U.S.: Alabama- Confirms nine adolescents infected with adenovirus/hepatitis

    18 April- The Alabama Department of Public Health (ADPH) and the U.S. Centers for Disease Control and Prevention (CDC) recently announced investigating an increase in hepatitis in young children in Alabama. As of April 15, 2022, nine children less than ten years old have been identified as positive for adenovirus, with a potential association with Adenovirus 41. No epidemiological linkage among these children in Alabama has not been determined. And none of these children has had underlying health conditions of note. However, two children have required liver transplants. ADPH issued a Health Alert Network (HAN) notification on February 1, 2022, and the ADPH is updating the HAN for redistribution to elicit additional cases. And the CDC is developing a national HAN looking for clinically similar cases with liver injury of unknown etiology or associated with adenovirus infection in other states and is discussing instances of similar hepatitis potentially associated with adenovirus with international colleagues. Similar outbreaks have recently been announced in the U.K., Scotland, and Spain. According to the CDC, adenoviruses are common viruses that typically cause a mild, self-limiting flu-like or gastrointestinal illness. Precision Vaccinations External Link


    Yellow fever death reported in tourist visiting Tocantins, Brazil

    17 April- One death from yellow fever was confirmed in Tocantins. The State Health Department (SES) reported that the victim is an unvaccinated tourist who was in the south of the state sport fishing between Peixe, São Salvador and Paranã. Tocantins has not recorded a positive case of the disease in humans since 2018. According to the government, the victim was already in the state of origin when he died. After the investigation, Tocantins was notified by the Ministry of Health. After carrying out technical advisory, immunization, vector collection and Yellow Fever investigation activities in the state, SES and the Arbovirus Surveillance Management issued a warning note about the incidence of the disease. Yellow Fever is an acute febrile, vaccine-preventable infectious disease that is transmitted by wild mosquitoes that can infect people mainly in forested areas. The most effective form of combat is immunization. The vaccine is offered at health posts throughout the national territory. “There is a need for guidance from municipal managers and companies that work with tourism, as well as the awareness of the population that they are entering the Amazon region, which is determined by the Ministry of Health, as a priority for vaccination against the disease", said Cristiane Bueno. Outbreak News Today External Link