Army Public Health Weekly Update, 25 March 2022

Date Published: 3/25/2022
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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.

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

    ANNOUNCEMENTS 

    Army seeks life-saving capabilities for future fight

    17 March- Army medical researchers are working to develop new capabilities as the force prepares for a more lethal but austere future battlefield, a senior medical officer said. Working with the expectation that battlefield casualties will need life-saving care farther forward for longer periods of time, the Army is looking for new capabilities suited for use in austere environments and will leverage emerging capabilities such as unmanned vehicles. “We're developing innovative technologies that augment, assist and amplify the capabilities as far forward as possible," Brig. Gen. Anthony McQueen, commander of the Army Medical Research and Development Command, said during a recent Association of the U.S. Army event. Addressing blood loss, the primary cause of preventable death on the battlefield, McQueen pointed out that there's never been “an exact science" other than provider observation for determining the amount of blood lost and when a patient might go into shock. “We're working to change that," he said, by developing technology that may have the ability to detect signs of shock before it's clinically evident. “Ultimately, this type of technology will be used in patient triage and in situations when there is limited provider care as our future force prepares for conflict in multidomain operations." McQueen said the Army's remotely operated vehicles that are currently being used for surveillance and reconnaissance missions will also be used to resupply forward teams with medical supplies. Other advancements such as medical robotics, artificial intelligence, autonomous systems and virtual health applications being developed at the command will be critical to prolonging life, he said. The command also has teams focused on getting the right products into a medic's aid bag, as well as enhancing human performance. Transformational technologies under development will help with en route care on autonomous platforms and with machine learning that can support organ function. AUSA.org External Link

    U.S. MILITARY

    Let's reduce drug-related conditions, poisonings among Soldiers

    21 March- For this year's National Poison Prevention Awareness Week, observed March 20-26, 2022, the Army Public Health Center encourages awareness of the poisonings that occur every day to members of the Army family. While many are familiar with the problem of poisonings among children, poisonings are actually a leading cause of injury hospitalizations among Soldiers. “The majority of Soldiers' injuries are treated through outpatient medical services," says Dr. Anna Renner, an APHC injury health analyst and statistician. “But some poisonings, like overdoses of medications, over-the counter medications, and illegal substances, tend to be more serious and are more likely to require inpatient care." Surveillance of Soldier's medical records identifies codes for drug-related injuries, which can include both accidental as well as possible intentional poisonings. In addition to conditions caused by ingestion and injection of drugs or medications, poisonings include adverse medical conditions caused by skin or eye contact, ingestion, and inhalation exposures to chemicals or toxins. “Poisonings accounted for 6,800 injuries among active-duty Soldiers in 2020," says Renner. “About 10 percent required inpatient stays in the hospital, and the majority of these hospitalizations were drug-related incidents." The APHC is hoping that through increased awareness the Army family can help reduce these numbers. Army.mil External Link

    Mental health, trauma experts offer Ukrainian-related resources

    18 March- In response to the humanitarian crisis in Eastern Europe, several centers at the Uniformed Services University of the Health Sciences (USU) have developed Ukrainian-translated resources for traumatic blood loss and mental health. USU's National Center for Disaster Medicine and Public Health (NCDMPH) has translated its lifesaving Stop the Bleed video into Ukrainian closed captioning. The five-minute Stop the Bleed video is designed to teach the lay person how to stop traumatic bleeding – be it from a natural disaster, an accident, or a violent attack – in hopes of saving lives from major trauma. The video, also available in eight other languages, explains how to evaluate whether bleeding is life-threatening, and how to determine whether an injury requires direct pressure or pressure via a tourniquet. It then explains how to properly use either a commercial tourniquet, or if one is not available, how to make-shift one. “Stop the Bleed" is a White House-launched effort between several federal and civilian agencies, including USU. The initiative launched in 2015 to teach citizens how to save lives from major trauma the same way bystanders would administer CPR to someone in cardiac arrest. Unlike other public education campaigns though, “Stop the Bleed" is based on important lessons learned on the battlefield and a decade of research by the U.S. military. Researchers found that equipping troops with individual first aid kits that contain tourniquets and hemostatic dressings to control severe blood loss, combined with training on hemorrhage control for medical and non-medical forces alike, paid off. Thousands of lives have been saved by these techniques on the battlefield. "We know that rapid bleeding control, with tourniquets and direct pressure, has saved the lives of injured Americans – both on and off the battlefield," said Dr. Craig Goolsby, NCDMPH's science director. “We hope this translated video, and the information it contains, can save the lives of Ukrainians who are suffering from the terrible wounds of war." DVIDS External Link

    GLOBAL

    Alcohol-related deaths in the U.S. spiked more than 25% in the first year of the pandemic, study shows

    18 March- The number of deaths in the US involving alcohol jumped 25.5% between 2019 and 2020, the first year of the Covid-19 pandemic, according to research published Friday in the Journal of the American Medical Association. This is a sharp incline from prior years; the average annual percent increase in deaths involving alcohol was 2.2% between 1999 and 2017. There were 78,927 alcohol-related deaths in the US in 2019 and 99,017 in 2020. These deaths also included motor vehicle crashes that happened as a result of driving under the influence of alcohol. Alcohol-related deaths made up 2.8% of all deaths in 2019 and 3% in 2020. "We're not surprised. It's unfortunate, but we sort of expected to see something like this," Aaron White, lead author of the study and a neuroscientist at the National Institute on Alcohol Abuse and Alcoholism, said. "It's not uncommon for people to drink more when they're under more duress, and obviously, the pandemic brought a lot of added stress to people's lives. In addition to that, it reduced a lot of the normal outlets people have for coping with stress, [like] social support and access to gyms." CNN External Link

    CDC: Omicron hospitalized young kids at 5 times the rate during delta surge

    17 March- The omicron variant of the coronavirus hospitalized U.S. children at about five times the rate during the previous delta surge, according to the Centers for Disease Control and Prevention (CDC). In a report published Tuesday, the agency wrote that from March 2020 through Feb. 19, 2022, weekly hospitalization rates peaked during omicron predominance in the week ending Jan. 8, 2022, at 14.5 per 100,000 infants and other kids under 5 years old. For infants younger than 6 months old, hospitalizations were "approximately six times as high during the peak week of omicron predominance as during delta predominance." "Omicron-predominant versus delta-predominant hospitalization rate ratios were also elevated among infants and children aged 6–23 months and 2–4 years," the report said. "Monthly ICU admission rates were approximately 3.5 times as high during the omicron predominance peak in January 2022 as during the delta predominance peak in September 2021." Fox News External Link

    Dentists launch HPV cancer prevention webinar

    22 March- The American Dental Association (ADA) Council on Advocacy for Access and Prevention recently announced hosting a three-part webinar series, Preventing HPV Cancers in Action, as part of Oral Cancer Awareness Month. Beginning on March 23, 2022, Part 1, The Critical Role of the Dentist, will present how 'Dentists play a critical role in detecting oral cancers and educating their patients on the importance of HPV vaccination.' In June 2020, the U.S. FDA added prevention of oropharyngeal and other head and neck cancers to the list of indications for the HPV vaccine. Gary Heyamoto, D.D.S., president of the Academy of General Dentistry Foundation, will discuss the importance of performing a consistent and thorough clinical oral exam. As well as how to discuss HPV vaccination with patients, describe anterior mouth and posterior mouth from a medical perspective, and participate as an office fighting HPV oral cancers through awareness and promotion of the HPV vaccine. Recently, Dentists and individuals around the globe united on March 20, 2022, in honor of World Oral Health Day. Precision Vaccinations External Link

    Diabetes & COVID-19: Scientists explore potential connection

    16 March- When their 11-year-old son started losing weight and drinking lots of water, Tabitha and Bryan Balcitis chalked it up to a growth spurt and advice from his health class. But unusual crankiness and lethargy raised their concern, and tests showed his blood sugar levels were off the charts. Just six months after a mild case of COVID-19, the Crown Point, Indiana, boy was diagnosed with Type 1 diabetes. His parents were floored — it didn't run in the family, but autoimmune illness did and doctors said that could be a factor. Could his diabetes also be linked with the coronavirus, wondered Nolan's mom, a respiratory therapist. Turns out scientists in the U.S. and elsewhere are asking the same question and investigating whether any connection is more than a coincidence. It's clear that in those who already have diabetes, COVID-19 can worsen the condition and lead to severe complications. But there are other possible links. Emerging evidence shows that the coronavirus — like some other viruses — can attack insulin-producing cells in the pancreas — a process that might trigger at least temporary diabetes in susceptible people. Rising cases might also reflect circumstances involving pandemic restrictions, including delayed medical care for early signs of diabetes or unhealthy eating habits and inactivity in people already at risk for Type 2 diabetes. AP News External Link 

    Moderna asks FDA to authorize second booster dose for all adults

    17 March- Moderna announced on Thursday that it had asked the Food and Drug Administration (FDA) for emergency use authorization for a second booster dose of its COVID-19 vaccine for all adults. Moderna said in a press release that it requested the authorization for all adults with the intent that health care providers and the Centers for Disease and Control and Prevention can have flexibility in determining the appropriate use for a second booster shot. It said it made the request based in part on recent data from the U.S. and Israel following the emergence of the highly contagious omicron variant. This comes after Pfizer and BioNTech on Tuesday asked the FDA for emergency use authorization for a second booster dose of their vaccine for adults age 65 and older. The companies said a second booster administered at least four months after an initial booster dose could restore antibody levels to peak post-third dose level, noting that emerging evidence suggests the vaccine's effectiveness against symptomatic infection and severe disease caused by the omicron variant wanes three to six months after receipt of an initial booster. The requests come as COVID-19 cases have been declining around the country following a surge in infections driven by the omicron variant. The Hill External Link

    New ACC guidance on cardiovascular consequences of COVID-19

    17 March- The American College of Cardiology (ACC) has issued an expert consensus clinical guidance document for the evaluation and management of adults with key cardiovascular consequences of COVID-19. The document makes recommendations on how to evaluate and manage COVID-associated myocarditis and long COVID and gives advice on resumption of exercise following COVID-19 infection.  The clinical guidance was published online March 16 in the Journal of the American College of Cardiology. "The best means to diagnose and treat myocarditis and long COVID following SARS-CoV-2 infection continues to evolve," said Ty Gluckman, MD, MHA, co-chair of the expert consensus decision pathway. "This document attempts to provide key recommendations for how to evaluate and manage adults with these conditions, including guidance for safe return to play for both competitive and noncompetitive athletes." The authors of the guidance note that COVID-19 can be associated with various abnormalities in cardiac testing and a wide range of cardiovascular complications. For some patients, cardiac symptoms such as chest pain, shortness of breath, fatigue, and palpitations persist, lasting months after the initial illness, and evidence of myocardial injury has also been observed in both symptomatic and asymptomatic individuals, as well as after receipt of the COVID-19 mRNA vaccine. "For clinicians treating these individuals, a growing number of questions exist related to evaluation and management of these conditions, as well as safe resumption of physical activity," they say. This report is intended to provide practical guidance on these issues. Medscape External Link

    New federal ventilation guidelines mark next step in fight against COVID

    17 March- The Biden administration will announce new building ventilation standards for schools and businesses on Thursday -- a welcome step for experts who feel the U.S. has long been behind the curve on using air filtration as a valuable tool to fight COVID-19. The new guidance, the latest addition to President Joe Biden's recent COVID-19 plan, is the first time such a standard has been created at the national level, synthesizing expert guidance on how clean air can prevent the spread of illness. The new recommendations, which will be rolled out by the Environmental Protection Agency, urge all building owners and operators to hit four main steps in the form of a detailed "checklist" to ultimately get more fresh air in. "It's a two-page document. It's written in plain language, very straightforward," Mary Wall, a senior policy adviser at the White House, told ABC News. "We think this is an action list that really all buildings can draw from." The checklist includes tasks that cost money, like hiring an expert in HVAC systems to assess the building or adding extra ventilation to "higher risk areas," like a school nurses office, but also immediate, low-effort advice like opening windows and doors at opposite sides of a room to allow for "cross ventilation." ABC News External Link

    Research roundup: E-cigs aren't safe

    18 March- As a physician with the VA San Diego Healthcare System, Dr. Laura E. Crotty Alexander has heard from more and more patients over recent years that they're thinking of switching to vaping e-cigarettes as a safe alternative to traditional cigarettes. Not so fast, says the pulmonologist, who is also an associate professor at the University of California San Diego. She calls it a “dangerous situation," with so many people apparently unaware that e-cigarettes come with wide-ranging dangers of their own. While some tout e-cigarettes as a solution to quitting conventional smoking, the truth about relative risks is complicated, says Crotty Alexander, who is a researcher in addition to providing patient care and teaching. In a major recent undertaking to help clarify the effects of e-cigarettes, the physician-investigator conducted a review of the best available evidence about vaping and lung harms. She and her co-authors published their roundup of the evidence in an article titled “Vaping and Lung Inflammation and Injury," which appeared online Feb. 10 in the journal “Annual Review of Physiology." As substantiated in the review, a convincing body of evidence exists that confirms e-cigarettes cause lung inflammation and injury, as well as negative health effects in multiple organs. Crotty Alexander says e-cigarettes come with far more dangers than even she expected. Blogs.va External Link

    INFLUENZA

    Denmark reports 'steep' increase in influenza cases

    21 March- Since large parts of Danish society were shut down on 12 March 2020 due to Covid-19, the incidence of influenza has been at a very low level until the beginning of 2022. Now the number of people infected with influenza A is doubling from week to week. In Denmark, the incidence of influenza tends to increase at the end of December. But this season, the flu has started very late, after being almost completely absent for the last two years during covid-19. currently, however, there is a steep increase in the number of flu cases in most of the country. In recent weeks, the number of infected has thus doubled from week to week and in week 10 reached 1,179 infected. A total of 2,533 cases of influenza have been detected this season. The vast majority of cases – a total of 2,459 – are caused by the type of influenza virus called A / H3N2.It is a well-known flu type, which is also circulating in other countries. H3N2 is included in the seasonal vaccine, but it is known to change and this may mean that the effect of the vaccine is reduced. This season, changes have been seen in the H3N2 viruses in circulation, which may mean that the vaccine has a reduced effect. Influenza has been detected in all age groups. At present, however, a predominance of children and the younger part of the population aged 15-44 as well as +85 year olds are affected by influenza. It is now more than five months since seasonal flu vaccines became available. The late onset of influenza prevalence is therefore a challenge, as it is well known that the effect of vaccines decreases over time. In the age group 2-6 years, the effect of the influenza vaccine, which is targeted at children, is calculated at 71% against influenza A. In the age group 7-44 years, the effect is calculated at 43%, while in the age group 45 years and over, no effect against the circulating influenza A type. Outbreak News Today External Link

    VETERINARY/FOOD SAFETY

    Documents show ongoing problems at infant formula plant linked to outbreak

    22 March- The FDA has released documents showing a pattern of problems with food safety practices at the infant formula production plant implicated in an outbreak of illnesses that includes two deaths. Form 483 documents from inspections in 2019, 2021 and 2022 of Abbott Nutrition's Sturgis, MI, facility, show problems at the plant, according to the Food and Drug Administration. Findings in the FDA Form 483 documents from the inspections include:

    - Abbott Nutrition did not establish a system of process controls covering all stages of processing that was designed to ensure that infant formula does not become adulterated due to the presence of microorganisms in the formula or in the processing environment.

    - Abbott Nutrition did not ensure that all surfaces that contacted infant formula were maintained to protect infant formula from being contaminated by any source.

    A representative of Abbott Nutrition provided the following statement: “We are currently reviewing the U.S. FDA's 483 observations from the inspection of our powder formula manufacturing in our Sturgis, Mich., facility. We're taking this very seriously and are working closely with the FDA to implement corrective actions. While there are actions we need to take to address the FDA observations, it is important to note that no Cronobacter sakazakii or Salmonella was found in any of our testing of products distributed to consumers. Additionally, the unique genetic makeup of the Cronobacter sakazakii microbes found in non-product areas at the Sturgis facility did not match the Cronobacter sakazakii microbes from the reported cases. This follows the FDA's removal of the Salmonella case from its investigation earlier this month." Food Safety News External Link

    More than 3 million Airborne Gummies recalled after consumer complaints

    22 March- Reckitt is recalling 3.74 million bottles of Airborne Gummies in assorted fruit, orange, and blueberry pomegranate flavors because, when opened for the first time, pressure build up in the bottle can cause the cap and underlying seal to pop off with force when opened for the first time, posing an injury hazard. Reckitt has received 70 reports of the cap or seal popping off the bottles, including 18 reports of minor injuries and one report of an eye injury requiring medical attention. The products were distributed to Target, Walgreens, CVS, Kroger, Sam's Club, BJ's Wholesale Club, Costco, Walmart and other stores nationwide and online at Amazon.com and www.schiffvitamins.com from May 2020 through February 2022. The company asks that consumers with unopened bottles please not open them. Consumers with the recalled product can return the unopened bottles to receive a full refund. Bottles that have already been opened are not subject to this recall as they would have released any pressure build up and do not present an injury hazard. Food Safety News External Link

    WELLNESS

    Drop boxes are making it easier to get rid of old medication

    14 March- If there's anything the pandemic has taught us, it's that we have a lot of excess stuff in our homes — including bottles and bottles of expired or no-longer-needed medications. But although many of us might be aware that we shouldn't toss pill bottles in the trash or flush medication down the toilet, we're less knowledgeable about safe alternatives. And there haven't been many options beyond the Drug Enforcement Administration's semiannual National Prescription Drug Take Back Day. That's a problem, according to Elizabeth Skoy, an associate professor at North Dakota State University's School of Pharmacy. “In recent years, there's been a spotlight on medication disposal, because of the opioid epidemic," she said. “It's important to get rid of any medication when you are done with it to prevent misuse or having it fall into the hands of others." Plus, having old medications in the home increases the chances of accidental poisoning of children or pets. In the past decade, however, pharmacies, hospitals and law enforcement agencies have been stepping up to help clean out medicine cabinets year-round. One of the most accessible solutions is medication collection bins, which are being added to convenient locations such as retail stores, health clinics, police stations and other easily accessed sites. The Washington Post External Link

    USAFRICOM

    Mauritania Crimean-Congo hemorrhagic fever update

    19 March- In a follow-up on the human Crimean-Congo hemorrhagic fever (CCHF) outbreak in the African country of Mauritania, the World Health Organization (WHO) reports a total of six confirmed cases including two deaths as of March 14. According to WHO, on 4 February 2022, a case of Crimean-Congo hemorrhagic fever (CCHF) was confirmed by polymerase chain reaction (PCR) at the Institute National de Recherche en Santé Publique in Nouakchott, Mauritania. The patient is a 52-year-old male farmer living in the department (moughataa) of Koubeni in the region (wilaya) of Hodh Elgharbi. He presented with epistaxis and hematemesis for which he consulted five health facilities in Kubeni and Nouakchott between 27 January and 4 February 2022. Outbreak News Today External Link

    USCENTCOM

    Measles outbreak in Afghanistan prompts travel warning

    19 March- On Thursday, the US Centers for Disease Control and Prevention (CDC) issued a travel notice for Afghanistan due to an ongoing measles outbreak. Federal health officials report cases have been reported in all provinces, with the highest rates occurring in Paktya, Balkh, Kunduz, Zabul, Kandahar, and Logar. The latest numbers according to local media are 18,000 children infected, including 142 deaths since the beginning of the year. CDC says all travelers to Afghanistan, including infants and preschool-aged children, should be fully vaccinated against measles according to Advisory Committee on Immunization Practices (ACIP) immunization schedules. Travelers should seek medical care if they develop a rash, high fever, cough, runny nose, or red, watery eyes. Measles is highly contagious. Travelers with suspected measles should notify the healthcare facility before visiting so staff can implement precautions to prevent spread within the facility. Outbreak News Today External Link

    USEUCOM

    France: E. coli prompts recall of Buitoni frozen pizza

    21 March- The French Public Health Agency (Sante Publique France) announced as part of the investigations carried out by the authorities on the cases of serious hemolytic uremic syndrome (HUS) reported since January 1, 2022, analysis (epidemiological, microbiological and traceability) carried out suggest, at this stage, a possible link with the consumption of frozen pizzas from the Fraîch'Up range of the Buitoni brand. Investigations are continuing to determine the origin of the contamination, including for other products, as well as epidemiological investigations in order to establish potential links with all the cases detected on the territory since the beginning of January 2022. Consequently, as a precautionary measure, and pending additional analyses, the company is proceeding today with the withdrawal-recall of all the pizzas in the Fraîch'Up range, of the Buitoni brand, marketed on this day. As of March 17, 2022, 27 cases of HUS or serious infection, linked to E. coli bacteria with similar characteristics, have been identified, and 31 additional cases are under investigation. These 58 cases occurred in 12 regions of metropolitan France: Hauts-de-France (13 cases), New Aquitaine (9 cases), Pays de la Loire (9 cases), Brittany (6 cases), Ile-de-France ( 6 cases), Grand Est (5 cases), Auvergne-Rhône-Alpes (3 cases), Bourgogne Franche-Comté (2 cases), Center Val-de-Loire (2 cases) Normandy (1 case), Occitanie (1 case ) and Provence-Alpes-Côte d'Azur (1 case). The sick children, aged 1 to 18 years with a median age of 5 ½ years, presented symptoms between 10/01/2022 and 10/03/2022. Two children died. Outbreak News Today External Link

    USINDOPACOM

    Vietnam reports decrease in COVID-19 cases, Tops 8 million cases since beginning of pandemic

    21 March- Vietnamese health authorities continue to see a decrease in daily COVID-19 cases. On Monday, 131,713 cases were reported, down from 141,151 cases reported Sunday. Today, Vietnam passed the 8 million case mark now reporting 8,089,761 total cases. Vietnam has recorded 5,170,555 cases in the past 28 days, second only to South Korea (7,524,631).The average number of new infections in the country recorded in the past 7 days is 164,328 cases/day, according to officials. Localities with a high cumulative number of infections during this outbreak include Hanoi (1,170,170), Ho Chi Minh City (582,747), Binh Duong (359,557), Nghe An (345,848) and Hai Duong (314,225). Outbreak News Today External Link

    USNORTHCOM

    U.S.: New Hampshire- Highly pathogenic avian influenza (HPAI) confirmed in Rockingham County backyard flock

    18 March- The United States Department of Agriculture's (USDA) Animal and Plant Health Inspection Service (APHIS) has confirmed the presence of highly pathogenic avian influenza (HPAI) in a non-commercial backyard flock (non-poultry) in Rockingham County, New Hampshire. Samples from the flock were confirmed at the APHIS National Veterinary Services Laboratories (NVSL) in Ames, Iowa. APHIS is working closely with state animal health officials in New Hampshire on a joint incident response. State officials quarantined the affected premises. Birds from the flock will not enter the food system. According to the U.S. Centers for Disease Control and Prevention, the recent HPAI detections do not present an immediate public health concern. No human cases of these avian influenza viruses have been detected in the United States. Outbreak News Today External Link

    USSOUTHCOM

    Argentina: Two botulism cases reported in Buenos Aires

    18 March- Two women have been hospitalized for botulism, including one in serious condition, according to a La Voz report. The patients ate matambre (Argentian flank steak) and Russian salad delivered from a  traditional restaurant in the Buenos Aires neighborhood of Boedo.“The salad is prepared with boiled potatoes and carrots and dried peas soaked in a can, with salt and mayonnaise added. Orders are shipped in disposable plastic containers with lids, and they include four slices of homemade matambre along with a portion of Russian salad", according to the restaurant. Outbreak News Today External Link