Army Public Health Weekly Update, 23 April 2021

Date Published: 4/23/2021
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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 

    Clinic doors open wide for those wanting COVID-19 vaccine

    19 April- As of today, just about any adult in DOD can get a COVID-19 vaccine if they want one. That includes military personnel, adult dependents, retirees and civilians. "All Defense Department-eligible and authorized adults are able to make an appointment by contacting their local military treatment facility for a COVID vaccine directly, or using their military treatment facility's appointment process," Pentagon Press Secretary John F. Kirby said during a briefing today. To help ensure military personnel and their families stationed overseas are taken care of, the military services are getting an additional 31,500 doses of the Moderna vaccine for use at locations within the U.S. European Command. On the other side of the globe, an additional 30,000 doses of the Moderna vaccine are targeted at locations within both the U.S. Indo-Pacific Command and the U.S. Central Command. Defense.gov External Link

    U.S. MILITARY

    Army medicine answered the COVID-19 call

    20 April- Military medical transformation, turning hospitals and clinics over to the Defense Health Agency, continues while COVID-19-related missions continue to be a major effort, the Army surgeon general told Congress. Testifying April 20 before a Senate subcommittee, Lt. Gen. R. Scott Dingle, the 45th Army surgeon general and Army Medical Command commander, said medical reforms ordered by Congress "will be implemented," signaling an end to concerns by the Army that transferring medical facilities to a unified defense organization was happening too fast. The complete transfer of health care facilities is now expected by fall. It began in 2017. DoD has accumulated a $673 million health care funding shortfall because of COVID-19, and officials anticipate it will increase to $1.8 billion in fiscal 2021. There are no immediate plans to ask Congress for supplemental funding. Instead, the services have taken a first step of slowing spending on maintenance and construction while not slighting spending on direct health. Dingle appeared alongside defense and service health officials before the Senate defense appropriations subcommittee at a time when details of the 2022 defense budget are not yet known. Dingle said he believes direct readiness spending has not been harmed by COVID-19 spending, but it is being closely monitored. AUSA External Link

    Assessing Defense Health's strength at Madigan

    20 April- Madigan Army Medical Center is no stranger to the front line. From deploying to every conflict and humanitarian effort around the globe to researching, producing and testing innovative equipment and protocols to standing up the first military treatment facility response to COVID-19, Madigan expects to lead the way. In that vein, it has just completed the first Joint Commission survey for any MTF that has implemented the Department of Defense's new electronic health record, MHS GENESIS, and is the second MTF to complete the survey since the outbreak of COVID-19. The surveyors shared a collective assessment that Madigan was meeting the standard quite well. "All that we did is show the great work of Madigan; you create the environment for excellence to exist," Madigan Command Sgt. Maj. Albert Harris said to Madigan's leadership at an end-of-the-day briefing session. A team of surveyors scoped out every corner of Madigan and its outlying clinics from Tuesday, March 16 through Friday, March 19. The doctors, nurses, specialists and engineers of the team conducted tracers in clinics in Madigan's Medical Mall, hospital tower, South Sound Community Medical Home in Olympia, the Allen Soldier-Centered Medical Home, the McChord Clinic, embedded behavioral health clinics that are located within units around Joint Base Lewis-McChord, Wash., as well as testing all forms of environment of care and life and patient safety systems throughout the footprint. Army.mil External Link

    Oregon National Guard supports COVID vaccinations statewide

    20 April- Oregon National Guard Citizen-Soldiers and -Airmen have vaccinated almost 300,000 people since Jan. 8, helping the Oregon Health Authority (OHA) and regional medical partners distribute the COVID-19 vaccine. Members of the Oregon National Guard have also been trained to assist 211 Information, a call center connecting people with health and social service organizations. Guard members have handled approximately 80,000 phone calls, providing information about testing, vaccinations, appointments and other community resources. The Centers for Disease Control and Prevention report 2,549,201 vaccine doses have been administered in Oregon, with 1,600,343 people vaccinated. Of those, 1,033,175 people have completed their series. The seven-day average for new infections in Oregon is rising, at 650 new cases per day. More than 2,450 Oregonians have died of the coronavirus since the initial outbreak in March 2020. Having military members support vaccination efforts will increase the distribution of the vaccine to everyone who wants to be inoculated. In addition to the Oregon Guard members working at the largest mass vaccination site in Oregon, at the Portland Convention Center, 16 members of the U.S. Coast Guard Sector Columbia River are helping provide administrative support. Army.mil External Link

    GLOBAL

    California scientists identify which human genes fight COVID-19 infection

    20 April- Scientists at Sanford Burnham Prebys, located in La Jolla, CA, announced on April 18, 2021, they identified a set of human genes that fight SARS-CoV-2 infection, the virus that causes COVID-19. Knowing which genes help control viral infection can greatly assist researchers in understanding factors that affect disease severity and suggest possible therapeutic options. The genes in question are related to interferons, the body's frontline virus fighters. The study was published in the journal Molecular Cell on April 13th. "We wanted to gain a better understanding of the cellular response to SARS-CoV-2, including what drives a strong or weak response to infection," says Sumit K. Chanda, Ph.D., professor, and director of the Immunity and Pathogenesis Program at Sanford Burnham Prebys and lead author of the study, in a press statement. "We've gained new insights into how the virus exploits the human cells it invades, but we are still searching for its Achille's heel so that we can develop optimal antivirals." Based on knowledge gleaned from SARS-CoV-1, the beta coronavirus that caused a deadly but relatively brief outbreak of disease from 2002 to 2004, and knowing that it was similar to SARS-CoV-2, the investigators were able to develop laboratory experiments to identify the ISGs that control viral replication in COVID-19. Precision Vaccinations External Link

    Doctors home in on cause of blood clots potentially linked with Covid-19 vaccines

    17 April- Doctors say they are homing in on the cause of blood clots that may be linked with certain coronavirus vaccines, and add their findings have important implications for how to treat the condition, regardless of whether vaccines cause it. Even though the link is not yet firm, they're calling the condition vaccine-induced immune thrombotic thrombocytopenia or VITT. It's characterized by unusual blood clotting combined with a low number of blood-clotting cells called platelets. Patients suffer from dangerous clots and, sometimes, hemorrhaging at the same time. It's been linked most firmly with the AstraZeneca coronavirus vaccine, which is in wide use in Europe and the UK. The US Centers for Disease Control and Prevention and the Food and Drug Administration are checking to see if Johnson & Johnson's Janssen vaccine also might cause the blood clots. Both AstraZeneca's vaccine and the J&J vaccine use common cold viruses called adenoviruses as a carrier and some experts suspect the body's response to those viral vectors might underlie the reaction. AstraZeneca's vaccine is not authorized in the US. CNN External Link

    First prescription video game receives FDA approval--A post-COVID treatment for persons with ADHD

    20 April- You won't believe that health experts have been exploring the capabilities of a video game to contribute to the patients' well-being during post-COVID-19 treatment. Recovering from the disease might seem to be a long way especially since other people are found to have difficulty in doing their usual tasks. Even so, symptoms can still linger for some time, and they have not coped up with them for a while. The first video game to have been approved by the Food and Drug Administration (FDA) as a treatment for children with ADHD is now out for playing. Particularly, it targets those whose ages range from eight to twelve years old. The video game called "EndeavorRX" was developed by Akili Interactive last summer when it passed as an official prescription. New York-based neuropsychologist, Faith Gunning thought of this recreation to work similarly to the usual treatment for the symptoms. However, Gunning not only considered the certain bracket to benefit from playing it, but he also noted that it could also help other people who are not in the same group. It began when she has seen that those COVID-19 patients need something to cope up with their symptoms. Tech Times External Link

    Half of kids with coronavirus-linked MIS-C have neurological symptoms, study finds

    15 April- Half of children in a small study who had a rare but serious inflammatory illness following a coronavirus infection developed neurological symptoms, early findings suggest. Dr. Omar Abdel-Mannan of University College London in the United Kingdom, and member of the American Academy of Neurology, and his team shared preliminary findings Tuesday ahead of a virtual presentation at the American Academy of Neurology's 73rd Annual Meeting. Researchers looked at records for pediatric patients admitted to Great Ormond Street Hospital in London from April to September 2020, who met the criteria for multisystem inflammatory disorder in children (MIS-C), also referred to as PIMS-TS. The kids were 10 years old on average and 80% of patients were of non-white ethnicities. Fox News External Link

    Positive real-world evidence supports the effectiveness of adjuvanted seasonal influenza vaccine in adults 65 years and older

    20 April- Seqirus announced the publication of new real-world evidence (RWE) on the company's MF59® adjuvanted, trivalent influenza vaccine (aTIV) in the peer-reviewed medical journal Clinical Infectious Diseases. Study results published on February 19, 2021, indicate aTIV (Fluad) was more effective in reducing influenza-related medical encounters than standard egg-based quadrivalent influenza vaccine (QIVe) and high-dose trivalent influenza vaccine among adults 65 years and older during the 2017-2018 and 2018-2019 influenza seasons in the USA. "The use of large, real-world datasets allows for the evaluation of effectiveness on a scale not typically analyzed in a randomized trial," said Constantina Boikos, lead study author and Senior Manager, Center for Outcomes Research & Evaluation at Seqirus, in a press statement issued on April 20, 2021. "This retrospective cohort study, which includes 10.6 million vaccinated U.S. individuals, demonstrates the value that RWE can provide by illustrating the effectiveness of influenza vaccines in real-world settings." The MF59 adjuvant is designed to strengthen, broaden and increase the duration of the immune response. Precision Vaccinations External Link

    U.S. CDC expands COVID-19 vaccine eligibility to 16 and older

    20 April- Everyone in United States aged 16 years and above is now eligible for COVID-19 vaccination, the U.S. Centers for Disease Control and Prevention (CDC) said on Monday. People aged 16 years and above who have underlying medical conditions that increase the risk of serious, life-threatening complications from COVID-19, should be among those offered the vaccine first, according to the U.S. health agency's latest recommendations. Majority of U.S. states have already expanded their COVID-19 vaccine rollouts to people from this age group. Alaska was the first state to lower statewide eligibility to age 16 and was followed by states including Georgia, Texas and California. Earlier in April, U.S. President Joe Biden had directed states to widen the vaccine eligibility to people aged 18 or above by April 19. No COVID-19 vaccine is authorized yet for those under 16, although testing is underway. Reuters External Link

    Young people to be reinfected with Covid for study

    19 April- Healthy young people who have had Covid-19 are being asked to volunteer for a trial that will deliberately expose them to the pandemic virus. The experts behind the study, beginning this month, want to see how the immune system copes second time round. The ultimate aim is to design better treatments and vaccines. Up to 64 people aged 18-30 will spend 17 days in a quarantine unit at a hospital suite and have numerous tests, including lung scans. They will be re-exposed to the virus, the original strain from Wuhan, China, in a "safe and controlled environment" while the medical team monitors their health. BBC News External Link

    INFLUENZA

    CDC Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 14, ending April 10, 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 14. CDC External Link

    VETERINARY/FOOD SAFETY

    Government tests show E. coli in frozen beef; JBS launches recall

    18 April- JBS USA Food Co. a Greeley, CO, firm and Importer of Record, is recalling 4,860 pounds of imported boneless beef products that may be contaminated with E. coli O157:H7, according to the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS). The problem was discovered when FSIS collected a routine product sample that confirmed positive for the presence of E. coli O157:H7. There have been no confirmed reports of adverse reactions due to consumption of these products. FSIS is concerned that some product may be frozen and in cold storage at distributor or further processor locations. Distributors and further processors who received these products are urged not to utilize them. The raw, frozen, boneless beef products were imported on or around Nov. 10, 2020, and distributed for further processing. Food Safety News External Link

    Researchers review traceback investigations for the deadly romaine outbreaks

    19 April- The current edition of The Journal of Food Protection reports on another study into three outbreaks involving romaine lettuce contaminated with Shiga toxin-producing Escherichia coli.  This one focuses on determining the source of the outbreak vehicle through traceback investigations. The Food and Drug Administration personnel traceback investigation experts employ a standardized process to initiate, execute, and interpret the results of traceback investigations in collaboration with the Centers for Disease Control and Prevention and state and local health departments. This latest study was done by FDA and CDC professionals including Kari Irvin; Stelios Viazis; Angela Fields; Sharon Seelman; Karen Blickenstaff; Ellen Gee; Matthew Wise; Katherine Marshall; Laura Gieraltowski; and Stic Harris. Their focus was on the traceback investigation of the three outbreaks of STEC infections linked to romaine lettuce in 2018 and 2019. As part of it they took another look at the demonstrated challenges, limitations, and opportunities for improvement.  The three outbreaks occurred in 2018 and 2019 and caused a total of 474 illnesses, 215 hospitalizations, and five deaths. These illnesses were linked to the consumption of romaine lettuce from three distinct growing regions in Arizona and California. Food Safety News External Link

    WELLNESS

    All about your coronavirus vaccine card (and what to do if you lose it)

    17 April- There are various ways to document that you received a coronavirus vaccine. Some people have snapped selfies proudly displaying the Band-Aid on their upper arm. Some vaccination sites are handing out stickers. But the official form of documentation is the small white vaccination record card issued by the Centers for Disease Control and Prevention, which you receive after your first shot. "You do want to make sure you keep it safe," says Kelly Moore, deputy director of the Immunization Action Coalition. "You do want to make a copy of it and keep that on file, not because it's the only record, but because it's the one that you control." Here's what Moore and other experts say you need to know about the cards and what you should do after receiving one. Washington Post External Link

    USAFRICOM

    Anthrax vaccination drive in Mozambique

    16 April- According to the Provincial Governor of Gaza, Mozambique, Margarida Mapandzene, a livestock vaccination drive underway across the country will immunize more than two million animals against diseases such as anthrax, foot-and-mouth disease and other diseases. The annual vaccination drive is one of the government's foremost commitments to prevent and control outbreaks of animal diseases, some of which can be transmitted to humans. Mapandzene said more 500,000 cattle will be vaccinated against anthrax, while another 500,000 will be immunized against foot-and-mouth disease. Gaza is located in the southern portion of Mozambique. Outbreak News Today External Link

    USCENTCOM

    Pakistani man dies from rabies, anti-rabies vaccine was unavailable

    18 April- A man from the city of Thatta in Sindh province, Pakistan died from rabies after a dog bite due to the local hospital not having rabies post-exposure prophylaxis (PEP). The victim was reportedly attacked by a rabid dog around a week ago and suffered deadly injuries on the head and torso. Relative took him to the local civil hospital only to find anti-rabies vaccine was not available. Doctors there recommended the family take him to a private hospital; however, they could not afford the cost of his treatment at a private hospital. He died soon after. Outbreak News Today External Link

    USEUCOM

    Denmark's salmonella outbreak linked to herbal products

    17 April- A recent salmonella outbreak in Denmark has been found to be linked with intake of an herbal product that has now affected 33 people, on which 19 of them have been hospitalized and 3 have died. According to the Statens Serum Institute (SSI), the country's agency for preparedness against infectious diseases, the product in question was Psyllium seed HUSK herbal capsules. Reports from the Danish Veterinary and Food Administration state that they have recovered the product from the homes of two patients and were able to show that it contained salmonella. Several HUSK products were subsequently recalled. "This is the first time that we have been able to identify an herbal medicine as the cause of a salmonella outbreak. I am therefore concerned that the salmonella infection will not be detected because the individuals or their doctor believe that the symptoms of the salmonella infection stem from their existing stomach problems," said Luise Müller, an epidemiologist from the SSI. Outbreak News Today External Link 

    USINDOPACOM

    FDA Philippines warns about fake vaccine, clarifies use of Leronlimab

    17 April- The Food and Drug Administration (FDA) in the Philippines has recently warned the public about a fake vaccine, purposely labeling itself to be from Pfizer. According to the FDA advisory, the COVID-19 vaccine is identified as "BNT162b2", initially detected in Mexico last February 2021 and was recently confirmed as falsified to the WHO by the manufacturer. It has a lot of 783201 and an expiry date of August 24. "The FDA strongly advises the public to be vigilant on the circulation of this falsified COVID-19 vaccine since this poses a serious risk to global public health and further increases the burden on vulnerable populations and health systems," FDA stated in a press statement. They added, "A falsified vaccine deliberately or fraudulently misrepresents identity, composition, or source, and upon confirmation with the genuine manufacturer, it was confirmed that this vaccine was not manufactured by them, batch number and expiry date were falsified, and glass vials and labels were different from the authentic COVID-19 vaccine BNT162b2 vials." Meanwhile, FDA also clarified on the use of the drug Leronlimab that while it has been given a  Compassionate Special Permit (CSP) for COVID-19 patients, it is still not approved by the FDA for treatment of COVID-19. Leronlimab is an investigational product which is still undergoing clinical trials for the treatment of Cancer and Human Immunodeficiency Virus (HIV). Now, it is also being investigated for use in the treatment of COVID-19. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Chicago COVID-19 vaccines- Adults age 16 and older eligible starting Monday

    18 April- The City of Chicago will move to Phase 2 of COVID-19 vaccine eligibility on April 19, meaning all Chicagoans age 16 or older are eligible to get vaccinated against COVID-19. To date, more than 1 million Chicago residents have received at least one dose of vaccine—nearly half of the City's adult population. "Opening vaccine eligibility to all adults in Chicago is another important milestone in our goal of vaccinating everyone, and moving past the pandemic to reopen our city safely," said Mayor Lori E. Lightfoot. "I encourage everyone to get vaccinated, and everyone who wants a vaccine will receive one, but I want to remind people to be patient in getting an appointment, since our vaccine supply is still very limited."­ Last week, the City received less than 70,000 first doses, enough to vaccinate fewer than 10,000 residents per day. The City has been using all the vaccine it receives quickly and efficiently. Last week, 97% of doses received were distributed to providers, and 90% were administered to patients within a week. Over the course of the rollout about 350,000 non-Chicago residents have been vaccinated in the City, too. "I am encouraged by our increased vaccination rates, but we also continue to see a slow and persistent increase in COVID-19 case counts, especially among younger Chicagoans," said Allison Arwady, M.D., Commissioner of the Chicago Department of Public Health. "As we expand eligibility, we can increase vaccination for younger populations to slow the spread of the virus. Hopefully, our vaccine supply from the federal government will increase. We will continue to quickly use all the doses we receive." Outbreak News Today External Link

    U.S.: Georgia Aquarium- Otters test positive for SARS-CoV-2

    18 April- The Georgia Aquarium in Atlanta reported today that the Asian small-clawed otters at the aquarium have tested positive for SARS-CoV-2. The otters began exhibiting mild respiratory symptoms including sneezing, runny noses, mild lethargy, and coughing. While the Asian small-clawed otters are geriatric, they are already improving and expected to make a full recovery. They are off exhibit and being cared for behind-the-scenes by the Aquarium's expert animal health and animal care teams. "Our Asian small-clawed otters are under very close monitoring by veterinarians and animal care team members. They have displayed only mild symptoms and we expect them all to make a full recovery," said Dr. Tonya Clauss, vice president of animal and environmental health at Georgia Aquarium. "We are providing supportive care as needed so they can eat, rest and recover." The decision to test the Asian small-clawed otters for COVID-19 was made based on the clinical signs in the entire group. Georgia Aquarium veterinarians consulted with the state veterinarians' office and the department of health. Outbreak News Today External Link

    USSOUTHCOM

    Rabies in dogs is increasing in Haiti, CDC issues travel notice

    18 April- The Centers for Disease Control and Prevention (CDC) issued a travel notice for Haiti last week after reports of annual dog vaccination campaigns having been interrupted in Haiti and health officials have reported an increase of rabies in dogs there. In addition, health officials warn travelers that human rabies vaccine is also limited in Haiti, so if you are exposed to rabies, you may not be able to get appropriate treatment. Outbreak News Today External Link