Army Public Health Weekly Update,26 June 2020

Date Published: 6/26/2020
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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

    ​ANNOUNCMENTS

    APHC public website COVID-19 page

    This site provides Army-specific information and communication resources related to the 2019 Novel Coronavirus (COVID-19). The resources and tools available on this site may be shared with, tailored for, and/or used to create informational and educational materials for Army beneficiaries. APHC External Link

    Now available: 2019 Health of the Force Report

    Through annual reporting of key indicators that impact readiness and Soldier well-being, Health of the Force improves awareness and understanding of the health status of the Army. Results are communicated through an online digital platform and traditional reports. The Health of the Force suite of products gives leaders tools to advance programs and strategies that improve performance and reduce illness and injury. Access the new report here. External Link

    U.S. MILITARY

    Most active-duty soldiers with severe COVID-19 have preexisting health conditions, study finds

    22 June- Most of the small number of active-duty soldiers who became seriously ill after contracting the coronavirus had underlying health conditions such as obesity and high blood pressure, the first study to look at that group of service members has found. The findings, which mirror what has been found among civilians, were "kind of a relief," said Dr. John Ambrose, a senior epidemiologist with the Army Public Health Center. "It tells us there's no factor that's changing outcomes in the military population. And so we know we can effect public health mitigation measures and interventions" that have been proven to work, he said, such as social distancing, mask-wearing and good hygiene. More than 200 active-duty soldiers who were diagnosed with the coronavirus between Feb. 11 and April 6 took part in the study, the results of which were published in the current issue of the military's Medical Surveillance Monthly Report. Only 12 of the 219 soldiers in the study — just over 5% — were hospitalized, and of those, four were treated in intensive care units. None required a ventilator and none died. No active-duty soldiers had died of the disease as of June 21, Ambrose said. In the general U.S. population, 14% of people who became ill with the coronavirus required hospitalization, 2% were admitted to an ICU, and 5% died, data gathered through the end of May and published last week by the Centers for Disease Control and Prevention show. Nearly half of patients with an underlying condition were hospitalized, compared with just under 8% without, and deaths were 12 times higher among patients with underlying conditions than those without, the CDC report said. The lower rate of infection and death from coronavirus in the active-duty population likely has to do mainly with youth and "the healthy soldier effect," Ambrose said. Active-duty troops are younger than the general population and tend to be fitter than civilians of similar age. But a quarter of the 12 soldiers who had to be hospitalized had high blood pressure, nearly 60% were obese and half had a neurological disorder such as migraines or traumatic brain injury. All four soldiers who required intensive care had three or more underlying health conditions, the study found. Of the eight soldiers who were hospitalized but not admitted to an ICU, two had three or more underlying conditions and three had none at all, it said. Stars and Stripes External Link 

    Proper hydration enhances warrior fitness

    17 June- Everyone needs water, but drinking water is a habit, not a reflex. "Thirst is a really poor indicator of hydration," said Melissa Mahoney, an athletic trainer at the Marine Corps Recruit Depot in San Diego. "People need to shift their mindset when thinking about water not so much as a reflex or an urge, but it really is a behavior." By the time your body actually wants to drink water, it's already dehydrated, she said. Dehydration results from not replacing fluids and electrolytes that are either lost from illness, physical exertion, or even from sitting, said Dr. Chad Hulsopple, an assistant professor of family medicine at Uniformed Services University of the Health Sciences. "Even at rest, our body loses fluids slowly due to evaporation from the skin and moisture in the breath. It is essential to consume fluids and electrolytes to stay hydrated even when not exercising." According to Hulsopple, people may experience different symptoms of dehydration aside from thirst, such as dry mouth, dry lips, headache, or dizziness. Dehydration is preventable and could lead to heat-related illnesses. Physical exertion and humidity can contribute to dehydration and heat-related injuries, such as heat exhaustion and heat stroke. Reports of both increased among active service members between 2014 and 2018, according to a recent Medical Surveillance Monthly Report. Multiple factors could play a role in heat-related illness, including obesity, personal protective equipment—such as helmets or thick and long-sleeved clothing, and gastrointestinal illnesses and those involving a fever, explained Hulsopple. Mahoney found most of the heat-related injuries among the recruits at the Marine Depot in San Diego were due to upper respiratory infection or pneumonia. Someone sick with a fever who goes out to exercise increases the risk of heat-related injuries, she said. So how much water should you be drinking? On average, a person engaged in physical activity that lasts less than one hour should be drinking 16 ounces to 32 ounces of water every hour, said Mahoney. "The easy guideline to remember is to drink half your body weight in fluid ounces," she said, adding not to exceed more than 48 ounces of water per hour. "Your kidneys specifically can't process the water that quickly and if you consistently drink that much, you run the risk of hyponatremia or an overhydrated state." Hyponatremia is serious and potentially fatal, added Hulsopple. Health.mil External Link 

    Tackling mosquitos to protect the force

    23 June- Warmer temperatures bring mosquitoes – and these pesky flying insects present a potential health hazard. Through biting, mosquitoes may transmit serious or even deadly illnesses. According to experts including the World Health Organization, there's no evidence mosquitoes can transmit the COVID-19 virus. But mosquitoes are to blame for the spread of many other germs. West Nile is the most common virus spread by mosquitoes in the continental United States, according to the Centers for Disease Control and Prevention. Mosquitoes also spread malaria. About 2,000 cases of this flu-like illness are diagnosed in the United States every year, according to the CDC. It can be severe and even lethal in young children, said Anne Radavich, chief of product development and education in the Entomological Sciences Division of the U.S. Army Public Health Center, or APHC. Other ailments spread by mosquitoes include the dengueyellow feverZika, and chikungunyaviruses. "Vaccines are not available for many of the illnesses and diseases that mosquitoes spread," Radavich said. "So the best prevention is to control mosquitoes and eliminate their breeding habitat." June 21-27 marks National Mosquito Control Awareness Week. The Department of Defense has enacted measures to protect the health of service members in parts of the world where mosquito-borne illnesses are common. Those steps include pretreating uniforms with permethrin, an insecticide that kills or repels mosquitoes. Permethrin also can be applied in the field to clothes and other items, but it should not be applied to skin. Health.mil External Link

    U.S. Army training resumes in Europe amid pandemic and the threat of troop cuts

    22 June- Buoyed by the recent Allied Spirit exercise in Poland, U.S. Army officials in Europe are eyeing a resumption of their training schedule amid the continued danger of the coronavirus and talk in Washington of removing almost 10,000 troops from Germany. "We continue to fight for opportunities to train," Brig. Gen. Christopher Norrie, the head of 7th Army Training Command based at Grafenwöhr, Germany, said in an interview. That is, so long as relevant health protocols can be followed, he added. The exercise at the Drawsko Pomorskie Training Area in northwestern Poland, which ended on Friday, served as something of a trial balloon on whether live training can be done at all. The drill was an offspring of the larger Defender Europe-20 training campaign that had to be curtailed somewhat when the novel coronavirus outbreak swept through Europe in March. "There is some momentum that we expect to build coming out of Allied Spirit in preparation for the remainder of the summer," Norrie told Defense News. "All of the resources are aligned, the commands in place." The general idea of these exercises is to demonstrate a U.S. commitment to Europe vis-a-vis Russia, which officials here believe is feeling out the limits of NATO's resolve on the continent. Defense News External Link

    GLOBAL

    CDC coronavirus test kits were likely contaminated, federal review confirms

    20 June- The test kits for detecting the nation's earliest cases of the novel coronavirus failed because of "likely" contamination at the Centers for Disease Control and Prevention, whose scientists did not thoroughly check the kits despite "anomalies" during manufacturing, according to a new federal review. The review, conducted by two Department of Health and Human Services lawyers, also said there was "time pressure'' at the CDC to launch testing, and "lab practices that may have been insufficient to prevent the risk of contamination.'' The lawyers, from the department's general counsel's office, were not named. Neither the review, released late Friday, nor an accompanying statement from President Trump's chief spokesman at HHS assigned blame to any CDC scientist or official by name. The review is the first confirmation by the Trump administration that the original test kits were likely contaminated, and that the problem appeared to have occurred in late January within the CDC's headquarters in Atlanta. In general, HHS has defended the administration's efforts to counter the pandemic. The three-page review also acknowledged that, after weeks of delay, the likely contamination ultimately prompted the CDC to jettison a problematic component of the test kit. The component was intended to detect coronavirus strains other than the one that causes covid-19, the disease that has killed more than 119,000 Americans. The Washington Post reported on April 18 that the test kits had generated false-positive results — caused by the CDC's contamination — at 24 of the first 26 public health labs that tried them out before analyzing samples from actual patients. The Post also reported that an examination by the Food and Drug Administration had concluded that the tests failed because of substandard manufacturing practices and that the CDC violated its own laboratory protocol in making the kits. Washington Post External Link

    COVID-19 could cause a mental health crisis- It can also spark post-traumatic growth

    22 June- Some experts are warning of a looming mental health crisis in the wake of the Covid-19 pandemic that we are apparently ill-prepared for, and journalists are amplifying this message. Everyone, it seems, is depressed and there is a new health curve to flatten. We believe these warnings are being overdone, and definitely overlook the potential for post-traumatic growth (more on that in a minute). There's no question that the Covid-19 pandemic, the largest global disruption since World War II, is devastating millions of people with unexpected illness, disability, or death; financial insecurity; postponed weddings or virtual graduations; and more. A recent census study of Americans estimated the rates of anxiety and depression to be as high as 35%. We are being warned that the pandemic may increase rates of post-traumatic stress disorder, since being exposed to actual or potential death is the very definition of trauma. Stat News External Link

    COVID-19 Update: Men likely to get virus but are lucky for it; here's why

    23 June- If you currently survived Coronavirus and you're a man, the United Kingdom National Health Service (NHS) wants you to donate your plasma for testing. This was after studies shown that men have more antibody-rich plasma compared to women. It also means that once men get diagnosed with COVID-19 and healed from it, his blood will be more helpful to heal other people experiencing the virus. Everything bad that happens in our life may have a silver lining on it. For men, specifically. The Guardian reported that the U.K. hospitals are now seeking more donations of blood plasma from COVID-19 survivors in the country. It was explained that blood plasmas with antibodies can help other patients to fight against the virus. Anyone infected with the virus has its own antibodies. These cells are the main fighters of our body when an unexpected virus takes over the human organs. Most of the time, the convalescent plasma, wherein the antibodies were found, are formed when someone recovered from COVID-19. Though every person could have these antibodies, not everyone has strong units of it. And men are the usual population that got the stronger ones. Study shows that out of the 600 plasma donations in the past months in the U.K, 43% from men have more antibodies. This was compared to women only having 29%. "We'd still like to hear from anybody who had coronavirus or the symptoms," said Prof David Roberts, associate director for blood donation at NHS Blood and Transplant. "More plasma donors are needed. But we would especially want to hear from men." The reason behind this fact is that men are more likely to acquire the virus than women. Therefore, it produces more antibodies that are stronger to fight the virus. Tech Times External Link 

    F.D.A. warns of potentially toxic hand sanitizers

    22 June- The Food and Drug Administration is warning consumers to avoid nine hand sanitizer products manufactured in Mexico because, it said, they may contain methanol, a substance that can be toxic if absorbed through the skin or ingested. In an advisory dated Friday, the agency said it had tested samples of two products, Lavar Gel and CleanCare No Germ, and found they had 81 percent and 28 percent methanol, also known as wood alcohol. "Methanol is not an acceptable ingredient for hand sanitizers and should not be used due to its toxic effects," the agency said. The F.D.A. said on June 17 that it had recommended that the manufacturer, Eskbiochem SA de CV of Mexico, remove its products from the market but that so far the company had not responded. The New York Times External Link

    Patients with underlying conditions were 12 times as likely to die of COVID-19 as otherwise healthy people, CDC finds

    15 June- People with underlying medical conditions such as heart disease and diabetes were hospitalized six times as often as otherwise healthy individuals infected with the novel coronavirus during the first four months of the pandemic, and they died 12 times as often, according to a federal health report Monday. The Centers for Disease Control and Prevention released data on more than 1.7 million coronavirus cases and 103,700 deaths from covid-19, the disease caused by the virus, reported to the agency from state and territorial health departments from Jan. 22 through May 30. The data is consistent with earlier reports showing the disproportionate impact the pandemic has had on people with underlying medical conditions. The report also highlighted the disease's stark disparities between whites and minority groups. Among nearly 600,000 people who were sickened and for whom the CDC has race and ethnicity information, 33 percent of patients were Hispanic, although they make up 18 percent of the U.S. population; 22 percent were black, while they constitute 13 percent of the population; and 1.3 percent were Native American or Alaskan Natives, nearly double their representation in the overall population...In Monday's report, the CDC said the most common underlying conditions reported in people with covid-19 were heart disease (32 percent), diabetes (30 percent) and chronic lung disease (18 percent). Other preexisting conditions included liver disease, kidney disease, neurodevelopmental or intellectual disability, and immunocompromised conditions. Although the disease is typically more severe among older people, people of any age with underlying medical conditions are at increased risk if they contract the virus, for which there is no vaccine and only limited drug treatment. The Washington Post External Link

    Pig trial of AstraZeneca's COVID-19 vaccine shows promise with two shots

    23 June-  A trial in pigs of AstraZeneca's (AZN.L) experimental COVID-19 vaccine has found that two doses of the shot produced a greater antibody response than a single dose. Research released by Britain's Pirbright Institute on Tuesday found that giving an initial prime dose followed by a booster dose of the vaccine elicited a stronger immune response than a single dose. This suggests a two-dose approach may be more effective in getting protection against COVID-19, the disease caused by the new coronavirus. "The researchers saw a marked increase in neutralizing antibodies, which bind to the virus in a way that blocks infection," the Pirbright team said in a statement. They added, however, that it is not yet known what level of immune response will be required to protect humans. The ChAdOx1 nCoV-19 vaccine, also known as AZD1222, was originally developed by Oxford University scientists, who are now working with AstraZeneca on development and production. "These results look encouraging that administering two injections ... boosts antibody responses that can neutralize the virus, but it is the response in humans that's important," said Bryan Charleston, Pirbright's director. Reuters External Link

    Psychiatrist explores possible benefits of treating PTSD with ecstasy or cannabis

    22 June- People who have been taking antidepressants for several years sometimes hit a wall, a point when that treatment no longer seems to ease their symptoms. Psychiatrist Julie Holland says that's where psychedelic drugs could help. Holland was in charge of Bellevue Hospital's psychiatric emergency room on the weekends from 1996 until 2005, and currently has a private psychotherapy practice in Manhattan. She's a medical monitor on the MAPS studies, which involve, in part, developing psychedelics into prescription medication. Her new book, Good Chemistry, explores how she thinks psychedelic drugs, including LSD, psilocybin, MDMA and marijuana, might be used more widely in psychiatry to make treatment more efficient and effective. "There are certain plant medicines in particular — things like psilocybin or ayahuasca — that really help people not only explore their personal trauma," she says, but also "this feeling of unity and connection. People really come away from these experiences having a new perspective. "Holland acknowledges that the use of psychedelic drugs in psychiatry is controversial — but she says the practice is slowly gaining acceptance. NPR External Link

    INFLUENZA

    CDC: Flu View - Weekly U.S. Influenza Surveillance Report

    2019-2020 Influenza Season Week 24, ending June 13, 2020:

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. As in previous seasons, patients admitted for laboratory-confirmed influenza-related hospitalization after April 30, 2020 will not be included in FluSurv-NET. Data on patients admitted through April 30, 2020 will continue to be updated as additional information is received.

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on June 18, 2020, 5.6% of the deaths occurring during the week ending June 13, 2020 (week 24) were due to P&I. This percentage is below the epidemic threshold of 6.1% for week 24.

    Influenza-Associated Pediatric Mortality: Three influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 24. One death was associated with an influenza B/Victoria virus and occurred during week 5 (the week ending February 1, 2020); one death was associated with an influenza B virus with no lineage determined and occurred during week 10 (the week ending March 7, 2020); and one death was associated with influenza A virus which was not subtyped and occurred during week 13 (the week ending March 28, 2020). CDC External Link 

    WHO: Influenza Update

    08 June 2020 - Update number 369, based on data up to 24 May 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic might have influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV2 virus transmission might also have played a role in interrupting influenza virus transmission.

    - Globally, influenza activity was at lower levels than expected for this time of the year. In the temperate zone of the northern hemisphere, influenza activity returned to inter-seasonal levels while in the temperate zones of the southern hemisphere, the influenza season has not started yet.

    - In the Caribbean and Central American countries, no or low influenza detections were reported in most reporting countries. Increased severe acute respiratory infection (SARI) activity was reported in some countries.

    - In tropical South American and tropical Africa, there were no influenza viruses detected across reporting countries.

    - In Southern Asia, influenza like illness (ILI) and SARI activity decreased in Bhutan and Nepal.

    - In South East Asia, no influenza detections were reported.

    - Worldwide, seasonal influenza A viruses accounted for the majority of detections. WHO External Link

    VETERINARY/FOOD SAFETY

    Brandt recalls sausage after government tests for Listeria monocytogenes

    17 June- G. Brandt Meat Packers Ltd. is recalling "Mini Smoked Farmer Sausage" from the marketplace because of possible Listeria monocytogenes contamination. Consumers should check to see if they have the recalled products in their homes. Recalled products should be thrown out or returned to the store where they were purchased, according to a recall notice posted by the Canadian Food Inspection Agency. "This recall was triggered by Canadian Food Inspection Agency (CFIA) test results. The CFIA is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated food recall warnings," according to the recall notice. The CFIA is verifying that industry is removing the recalled products from the marketplace. There have been no reported illnesses associated with the consumption of these products. Food Safety News External Link

    Dried cranberries recalled in Quebec for E. coli O157:H7

    23 June-  Certain sweetened dried cranberries were recalled over the weekend by Quebec's Les Aliments Johnvince for E. coli O157: H7 contamination. This recall was triggered by the company. The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated Food Recall Warnings. The CFIA is verifying that the industry is removing the recalled product from the marketplace. The dried cranberries were subject to a Food Recall Warning by the government's Canadian food Inspection Agency. The dried cranberries were sold with or without odes from May 28. 2020 up to and including June 8, 2020. Consumers who are unsure if they have purchased the affected product are advised to contact their retailer. The product was sold in variable weights in plastic bags of approximately 300 grams. No illnesses are yet known to be associated with the recall. Food Safety News External Link

    WELLNESS

    Fiber 2.0—Fiber's new science of health-boosting benefits

    19 June- Fiber may seem like a somewhat frumpy nutrient, but it is actually one of the hottest nutrition topics right now. That's partly because fiber plays such a big role in the health and function of the gut microbiota. And anything to do with the microbiome is trending—for good reason! The way we define and categorize fiber has also gotten a complete overhaul in recent years. We used to think of fiber simply as "roughage;" the parts of plants that our digestive system could not break down and convert into energy. Dietary fiber was further broken down into soluble and insoluble fiber. Soluble fiber, like that in oat bran, was thought to act like a sponge, soaking up cholesterol and keeping it out of your bloodstream. Insoluble fiber, like that in wheat bran, was thought to work more like a broom, helping to move waste through the system. We now recognize that fiber does a lot more than soak stuff up and move stuff out. And the list of benefits attributed to fiber has been expanded to include reduced inflammation, enhanced immune function, appetite and weight control, enhanced nutrient absorption, better blood sugar control, and Type 2 diabetes prevention.  A lot of this happens via the microbiome: the fiber in our diet affects the number and variety of beneficial bacteria in our gut. The fiber story is far more complex (and interesting!) than we ever imagined. Instead of just recommending you add more fiber to your diet in general, we now know that specific types of fiber have different effects. If you're looking for a particular benefit, you'd want to match your choices to your concern. Scientific American External Link 

    Sit less, move more to lower cancer mortality risk, study says

    19 June- The findings from a new study may encourage you to get off your couch and start walking around the neighborhood. Research published on Thursday in JAMA Oncology has found that sedentary behavior is associated with a higher risk of cancer death. In a study of 8,002 participants from 2009 to 2012 (and a follow-up taking place in 2019 to 2020), researchers from The University of Texas MD Anderson Cancer Center examined the correlation between physical activity and cancer mortality through hip-mounted accelerometers worn during waking hours for seven consecutive days. The participants were U.S. middle-aged and older adults enrolled in the Reasons for Geographic and Racial Differences in Stroke, or REGARDS, study. Those receiving active cancer treatment were excluded from participation. In multivariable-adjusted models, replacing just 30 minutes of sitting with some light exercise can reduce risk of death by cancer by 8 percent, researchers found. This type of activity includes slow walking, light gardening or gentle yoga. While previous studies relied on self-reported data, the method using accelerometry is believed to offer a more objective and precise measurement. "Cancer is a leading cause of death in U.S. adults, although more than 50 percent of cancer deaths are preventable through healthy lifestyle choices," study authors wrote. Fox News External Link

    USAFRICOM

    Global polio (WPV1) cases now at 67, Nigeria attains Polio-Free status

    18 June- The number of wild poliovirus type 1 (WPV1) reported globally so far in 2020 is now 67 as Afghanistan and Pakistan report additional cases this week.  In Afghanistan, four additional WPV1 cases were reported: one each Farah and Hirat and two in Hilmand bringing the number of cases reported in 2020 to 16. In neighboring Pakistan, one wild poliovirus type 1 (WPV1) case was reported in Balochistan province. The number of cases reported in 2020 stands at 51. There was exciting news in the third polio endemic country of Nigeria. Special Assistant to President Muhammadu Buhari on Digital and New Media, Tolu Ogunlesi tweeted: Milestone moment & awesome news for #Nigeria, today June 18, 2020: Attained Polio-Free status, for the first time in our history. Official announcement will come next month, at a planned Health Ministers' meeting! Well done to @NphcdaNG  & everyone involved in making this happen! Outbreak News Today External Link

    Nigeria: COVID-19- Cases top 20,000; testing with GeneXpert, rapid test kits

    22 June- On Sunday, Nigerian health officials reported an additional 436 confirmed COVID-19 cases in the last 24 hours from nineteen states. This brings the total COVID-19 cases to 20,244. The death toll in the African country now stands at 518. Lagos state has reported 8576 cases and 126 deaths, the most of any state. The Nigeria Centre for Disease Control (NCDC) is leading the expansion of testing capacity for COVID-19 in Nigeria. As part of the national strategy to scale up COVID-19 testing published in March 2020, we are leveraging GeneXpert equipment currently used for the diagnosis of tuberculosis. The use of GeneXpert will significantly scale-up testing for COVID-19 and improve turn-around time for results in the country. There are 400 sites in Nigeria with GeneXpert equipment for the diagnosis of tuberculosis. Eventually, NCDC plans to roll out the GeneXpert testing sites for COVID-19 in every state in Nigeria. Lastly, the Premium Times reports how a professor of molecular biology and genomics at African Center of Excellence for Genomics of Infectious Diseases (ACEGID) has set to deploy rapid diagnostic test kits, using paper strips, to trigger a regime of mass testing across the continent. Outbreak News Today External Link

    South Africa: Human trials for coronavirus vaccine start

    23 June- Human trials for a Covid-19 vaccine developed by Oxford University are beginning in South Africa and in Brazil. Some 2,000 people in South Africa will be involved in what is widely considered to be one of the earliest and most advanced trials for a vaccine to tackle the pandemic. The first doses of the vaccine are being administered in Johannesburg this week. South Africa has been chosen, not just for its expertise in this field, but because Covid-19 is now spreading fast here. That makes it far easier for scientists to find a community at immediate risk of infection, and to then tell whether this British vaccine is effective. Similar tests are already underway in the UK, but the infection rate there is slowing. Hence the move, not just to South Africa, but to Brazil too, where 5,000 people will be involved in the vaccine trial. BBC News External Link

    USCENTCOM

    Pakistan: 'Smart lockdown' to target 500 coronavirus hotspots

    23 June- Pakistan's government has identified 500 coronavirus hotspots across the country to be targeted in its "smart lockdown" strategy, according to the country's top health official. Zafar Mirza, the prime minister's special adviser on health and head of the federal health ministry, told legislators at a briefing on Monday that these areas would be targeted for limited locality-based lockdowns - which the government has dubbed "smart lockdowns" - to control the spread of the coronavirus. "Due to the current economic situation, it is impossible to implement complete lockdown in the country. However, the government [is] focusing on smart lockdown policy," a statement released after the meeting said. Pakistan has emerged as one of the countries with the fastest rate of coronavirus infections in recent weeks, according to the World Health Organization (WHO). On Monday, countrywide cases rose by 3,946, taking the overall tally to 185,034 since the country's outbreak began in late February, according to government data. At least 105 patients died on Monday, according to the data, taking the death toll to 3,766. Al Jazeera External Link

    USEUCOM

    Russia: COVID-19 cases near 600K, Coronavirus vaccine study starts

    23 June- Health officials report a national COVID-19 case count of 599,705 confirmed cases, including 8,359 deaths. The City of Moscow and the Moscow region account for more than 270,000 cases, followed by St. Petersburg with 22,632. The long-awaited stage of phased removal of restrictions has begun. Professor Igor Molchanov, the chief specialist of the anesthesiologist-resuscitator of the Ministry of Health of Russia said in order to prevent negative consequences: "Maintaining commitment to individual preventive measures, doctor's prescriptions. Mandatory wearing masks in public places, on transport. Favorable trends can be quite insidious. Another important measure is maintaining social distance. If possible, avoid crowds." On June 16, the Russian Ministry of Health issued permission to conduct clinical trials of two forms of the vaccine against the new coronavirus infection COVID-19, developed by the Federal State Budget Scientific Research Center of Epidemiology and Microbiology named after N.F. Gamalei of the Ministry of Health of Russia. A clinical study of the COVID-19 vaccine began on June 17. Studies of two forms of vaccine: liquid and lyophilized – will be carried out in two medical institutions in Moscow. The vaccine in the form of a solution for intramuscular administration will be carried out in a military hospital. Burdenko. Another, in the form of a powder for the preparation of a solution for intramuscular administration, is at Sechenovskiy University. The research will be attended by 2 groups of volunteers of 38 people each. A clinical trial directly during a pandemic is a unique case. Therefore, unprecedented measures were taken – potential participants in the study, who will only be screened, spent two weeks in the sanatorium on observation. Outbreak News Today External Link

    Sweden: COVID-19 studies- Ongoing infection, antibody tests in blood donors

    19 June- The Swedish Public Health Authority released the results of the second national survey of ongoing infection with a total of 2,933 participants, which showed an estimated 0.3 percent of the population had an ongoing infection with COVID-19 when the samples were collected during the period May 25-28.  Samples were taken from the pharynx and nasal cavity and the participants also submitted saliva samples. The samples were then analyzed in the laboratory to see if the samples contained SARS-CoV-2, which is the virus that causes COVID-19. The result can be compared with those from the previous national survey conducted in late April which showed that around 0.9 percent had an ongoing infection with COVID-19 .The results of the 760 participants in the survey, who are based in Stockholm, showed that a total of 0.7 percent of the population there had an active infection with COVID-19 during the period 25-28 May. In the previous survey at the end of April, the corresponding figure was 2.3 percent. 560 children aged 0-15 years participated and none of them had an ongoing infection with COVID-19. In addition, Swedish health officials reported on the results of the first antibody assays to detect the COVID-19 in blood donors.  During the week 17-22, the Public Health Authority collected 400 samples per week from blood donors aged 18-72 in the nine regions: Jämtland, Jönköping, Kalmar, Skåne, Stockholm, Uppsala, Västerbotten, Västra Götaland and Örebro. The first preliminary results show that the proportion of blood donors with antibodies to COVID-19 was 1.6 percent at week 17 and had changed to 5.0 percent at week 22. However, the test responses are too few to make it possible to divide them statistically by regions. The Public Health Authority also continues to investigate excess blood samples collected from laboratories in clinical chemistry and clinical immunology via outpatient care in the same nine regions as above. Collection takes place during eight weeks in spring 2020. A total of 1,200 samples are collected each week for analysis of antibodies that show that the immune system recognizes the SARS-CoV-2 virus that causes COVID-19. Outbreak News Today External Link

    USINDOPACOM

    India: COVID-19 outbreak tops 425K cases, Maharashtra state reports 132K

    22 June- The India Ministry of Health remains fourth in the world with COVID-19 cases with 425,282 total cases after reporting 14,821 new cases registered June 22, India's biggest single-day spike. 143,267 tests were performed this day. The total cases includes 174,387 active cases, 237,195 recovered and discharged patients and 13,699 deaths. Maharashtra state has reported the most cases and deaths with 132,075 and 6,170, respectively. Delhi and Tamil Nadu are both on the edge of topping 60,000 with 59,746 and 59,377 cases, respectively. Despite the recent spike in cases, Prime Minister Narendra Modi ruled out a new nationwide lockdown. Individual states are maintaining their own restrictions. In Tamil Nadu, one of the hardest hit states, a fresh 12-day lockdown was imposed on Monday. Outbreak News Today External Link

    Japan: Measles, rubella cases down in 2020, syphilis cases remain high

    22 June- According to data from Japan's National Institute of Infectious Diseases (NIID), cases of the vaccine preventable diseases–measles and rubella–are way down during the first half of 2020. To date, Japan has reported 12 measles cases, down from hundreds of cases in 2019, while only 77 rubella cases have been reported year-to-date, down from more than 2,000 last year. However, syphilis cases are something of a different story. After reporting more than 5,000 syphilis cases three years straight and two consecutive years with more than 6,000 cases–Prior to 2018, the last time Japan saw more than 6,000 syphilis cases was 48 years ago. NIID data through June 10 shows 2,404 syphilis cases. Tokyo reports 612 cases, followed by Osaka with 405 and Fukuoka and Aichi prefectures reporting 133 and 132 cases, respectively. Through May 26 last year, the National Institute of Infectious Diseases report 2472 syphilis cases, with a quarter of cases being reported in Tokyo. Syphilis was a major issue in Japan until shortly after the end of World War II, but the total reported cases declined to several hundred annually until 2011, when a rebound began. Syphilis is a sexually-transmitted disease (STD) that can cause long-term complications if not treated correctly. Symptoms of syphilis in adults include a painless sore that will go away without treatment followed by a non-itchy body rash. If left untreated syphilis can lead to damage through the body including neurological and cardiovascular complications. Syphilis also increases the risk of HIV infection and, for women, can cause problems during pregnancy and for the newborn. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Maine- Confirms Hepatitis A outbreak

    20 June- The US state of Maine has seen an increase in hepatitis A cases in Penobscot, Somerset, and York counties over the past  4-months, the Maine Center for Disease Control and Prevention (MeCDC) reported. MeCDC announced on June 18, 2020, the number of reported hepatitis A (HepA) cases climbing from zero in January and has now identified 39 cases in these 3 counties. Recent case MeCDC investigations, however, have not identified a source of the infections. Historically Maine reported 7 to 10 cases of HepA per year over the past decade. But, in 2019, MeCDC identified 45 HepA cases.  This increase was driven by a restaurant-associated outbreak and cases related to injection drug use or homelessness. Precision Vaccinations External Link

    U.S.: Minnesota- Sexually transmitted infections continue to rise among youth

    22 June- While pregnancy and birth rates continue to decline to historic lows for 15 to 19-year-olds, Minnesota youth are contracting sexually transmitted infections (STI) at alarmingly high rates. The 2020 Minnesota Adolescent Sexual Health Report from the University of Minnesota Medical School's Healthy Youth Development – Prevention Research Center (HYD-PRC) attributes the rise in STI rates to a combination of factors, including barriers to prevention, screening and treatment services, education, transportation, cost, concerns about confidentiality and peer and media influences. Outbreak News Today External Link 

    U.S.: Young people in the US South and West are increasingly getting coronavirus

    22 June- The major thrust of new coronavirus cases in the United States is in the South and West, where officials say more young people are ignoring social distancing measures and testing positive. Young people are more likely to have milder outcomes from coronavirus, but they can still infect others who are more at risk. "With younger age of recent infections in at least some places such as Florida, expect a lower death rate in this wave ... until the 20-40 year olds who are infected today go on to infect others," Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention, said on Twitter. Dr. Anthony Fauci, the nation's top infectious disease expert, told Axios that the recent high number of cases in young people is "not surprising." Like Frieden, he warned of what's to come. CNN External Link

    USSOUTHCOM

    Brazil: Chikungunya cases top 38,000 for 2020 to date

    20 June- The Brazil Ministry of Health has reported 38,085 chikungunya cases through May 30 this year. This number is down from 109,000 cases this period in 2019. Of the cases this year, the state of Bahia accounts for 39.1% of probable cases of chikungunya in the country, followed by Espírito Santo with 30.5% of the cases and Rio de Janeiro with 8.6% of the cases. Nine deaths have been recorded in lab confirmed cases– Bahia (2) and one each in Rio de Janeiro, Mato Grosso, Espírito Santo, Paraíba, Rio Grande do Norte, Pernambuco and Ceará. Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain, which is often debilitating. Other symptoms include muscle pain, headache, nausea, fatigue, and rash. Outbreak News Today External Link