Army Public Health Weekly Update, 28 August 2020

Date Published: 8/28/2020
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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.

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

    Army Medical Command recognizes APHC Leader for Women's Equality Day

    24 August- Army Medical Command and the Army Public Health Center are celebrating Women's Equality Day by recognizing some outstanding Army Medicine Women. 1st Sgt. Teresa Mayo has served in the Army since June 2003 as a Preventive Medicine Specialist. Mayo has served in a variety of leadership positions, to include Squad Leader, Class Advisor, Senior Instructor/Writer, Nuclear Disablement Team NCOIC, and First Sergeant. She has twice deployed and led Soldiers in combat zones in Iraq during Operation Iraqi Freedom and during Operation New Dawn, and has participated in humanitarian missions with Joint Task Force-Bravo in Honduras. She has positively influenced and impacted the development of newly-inducted 68 Sierras as a member of the Tri-Service Medical Education and Training Campus cadre, and now leads the Soldiers assigned to Headquarters and Headquarters Company, U.S. Army Public Health Center. APHC

    Army Medical Command recognizes APHC PAO for Women's Equality Day

    25 August- Army Medical Command and the Army Public Health Center are celebrating Women's Equality Day by recognizing some outstanding Army Medicine Women. Chanel Weaver, Army Public Health Center chief of Public Affairs and Marketing Division, has been working in public affairs for nearly 20 years. During her career, she has supported the Army Corps of Engineers, 20th CBRNE Command, deployed as a public affairs civilian to Baghdad, Iraq, and over the past few years helped APHC navigate a number of serious public health crises, including Zika virus, Ebola, and most recently the Coronavirus pandemic. APHC

    Army Medical Command recognizes APHC scientist for Women's Equality Day

    25 August-  Army Medical Command and the Army Public Health Center are celebrating Women's Equality Day by recognizing some outstanding Army Medicine Women. Dr. Robyn Nadolny is a gifted scientist who started her career at the Army Public Health Center as a Department of Defense Science, Mathematics and Research for Transformation or SMART scholar. Throughout her career at APHC, Nadolny has continually evolved and developed professionally. After receiving her doctorate in Ecological Sciences in 2016 from Old Dominion University, Nadolny joined the APHC team in the Laboratory Sciences Directorate as a biologist in the Tick Borne Disease Laboratory, also known as TBDL. Her outreach efforts were critical to the success of a Human Tick Test Kit Program recently renamed to MilTICK or the Military Tick Identification/Infection Confirmation Kit program. APHC

    COVID-19 Risk reduction: Important information about your face covering

    Face coverings help prevent the person wearing the cover from spreading respiratory droplets when talking, sneezing, or coughing. Since people spread the virus without having any symptoms or feeling ill, wearing a face covering can protect others around you.  For more information on face coverings visit APHC .

    Hurricane and typhoon preparedness & response

    Hurricanes are severe tropical storms that form in the Atlantic Ocean, Caribbean Sea, Gulf of Mexico and Eastern Pacific Ocean. Be prepared and stay safe from hurricanes during COVID-19. APHC

    U.S. MILITARY

    CRDAMC expands virtual health services, becomes top user among military treatment facilities

    21 August- Carl R. Darnall Army Medical Center was on a steady course to increase its virtual health services when the COVID-19 pandemic swept the nation. Now, due to the opportunities within the crisis, CRDAMC is by far the biggest provider of virtual health services in the DoD. Since March 2020, CRDAMC has provided over 25,000 virtual video visits to patients. "A significant number of CRDAMC patients prefer the convenience of face-to-face discussions with their clinicians from the setting of their choice," said Col. Richard Malish, CRDAMC commander. "Even so, virtual healthcare offers more than convenience. It frees our clinical teams from time-intensive requirements, increasing their capacity to meet more patient needs. By leveraging the efficiency of virtual care we can now expand on prevention efforts and offer urgent care access." The concept of using virtual health services to manage healthcare needs is not a new one. CRDAMC also leads DoD in patient utilization of the Tricare online portal application and internet-based Secure Messaging. "Based on patient feedback we rapidly embraced video visits as the best means to replace traditional face-to-face appointments for most routine care appointments. This still allowed for an optimal patient-provider connection, minimized risk to the patient and diminished the potential for a care gap due to disrupted operations," said Lt. Col. Garrett Meyers, chief of the Department of Family and Community Medicine. "It was a huge task to get all clinics up and running in such a short time. After analyzing capabilities of all clinics, we identified what resources were needed, how we could leverage regulatory changes to policies and developed solutions to overcome any challenges." Meyers said they looked at using existing hardware--laptops, cellular phones and tablets--wherever possible. But found that some of the current laptop or desktop computers or the available Wi-Fi services weren't able to give the functional connection they needed.
    "So we procured or repurposed tablets and smartphones and expanded Wi-Fi access to ensure clinicians could conduct hassle-free video visits using approved DHA platforms Google Duo, VA Video Connect, or Facetime," he said. As everyone then needed to be quickly trained on the hardware, platform/software and workflow processes, Meyers said, they created a tiger team that rotated to all primary care clinics to ensure everyone on staff could operate the equipment and troubleshoot any connection problems. "We sought continual feedback from patients along the way, too, to ensure we were meeting our patients' expectations, Meyers said. "We received many ICE comments applauding our virtual video visits. The recurrent theme was that patients liked the ease and convenience, and looked forward to this being the norm for future appointments." DIVIDS External Link

    Defense Health Agency creates COVID-19 registry to improve care quality

    25 August- The Defense Health Agency created a clearinghouse for information about COVID-19 patients' medical and service histories, journeys with the disease, and clinical outcomes to help it improve treatment quality and keep Defense Department guidance for COVID-19 care current, DHA Director Army Lt. Gen. Ronald J. Place told Air Force Magazine in an exclusive interview on Aug. 20. "It's a way of tracking all of those different things so that we can both provide best care to the patients that we do have, but using continuous process improvement with the data within the system to continuously update the guidance that we give to the field on best modalities on how we care for our patients," Place said. The registry looks at patients in two ways.  First, it aims to understand their personal and medical histories leading up to their battles with COVID-19, Place said. This includes factors such as age, sex, medical issues that run in the families, where they serve within the Defense Department, deployments (and things troops might've been exposed to while overseas), current medical problems and medications, and their history of surgeries. Next, the registry aims to understand what actually happened to the patient. Air Force Magazine External Link

    Food and fuel

    21 August- U.S. Army Soldiers are deployed and often found in austere environments such as the desert where food and water can be scarce, but even when available, it might not be healthy. Nutritionists, or Military Occupation Specialty 65C, help Soldiers know what and what not to eat. "So, when you think of the Army, you think of the performance triad, physical fitness, hydration and nutrition," said 1st Lt. Carolyn Parlato, a registered dietitian and officer in charge of the 411th Hospital Company's dietitian clinic. "I see patients and am able to advise them on what foods have the best nutrition." This performance triad is not likely something that will go away even during a quarantine. This quarantine means limited ability to move about, but the Army has not left Soldiers without the opportunity for success. "We are limited in quarantine," said Parlato. "I think they do a good job; there's a lot of fresh items offered." This fresh food allows Soldiers options to eat healthily. "Four of the top leading cause of death in the U.S. are nutrition-related," said Parlato. "It is important on how we fuel our body." "I tell my patients to try and find whole foods," said Parlato. "Look for fresh fruit, milk, and with lean protein go grilled or broiled." Food choices are not the only key to nutrition. "Dehydration kills," said Parlato. "Staying hydrated in this warm, arid conditions is important." Soldiers are provided with access to clean bottled water. "With hydration and a balance of micro and macronutrients," said Parlato., "I think Soldiers can successfully eat nutritionally in quarantine." Soldiers do not have the same items available as in garrison. "Well, I do believe there are definitely pros to this quarantine," said Parlato. "Their chicken is moist and good protein options. Lunch and dinner are very good." "They are overall good." With a little guidance, Soldiers can overcome nutrition obstacles while deployed. "Soldiers are warrior athletes, and they have to fuel their body and keep hydrated," said Parlato. "It just does so much for Soldier's morale." DVIDS External Link

    The Army had the most hospital trips among the services for alcohol-related problems, study finds

    21 August- More than 101,000 active-duty troops ended up in the hospital between 2009 and 2018 because of a problem related to excessive drinking, a new study has found. About half of them had potentially deadly alcohol poisoning — caused by drinking too much in a short period of time — 35% sought care for alcohol dependence disorders, 17% for alcohol-related injuries and over 10% for alcohol-induced psychosis, according to the study in the Defense Health Agency's monthly publication. Broken down by service, soldiers had the highest rate of alcohol-related trips to the hospital, followed by Marines and sailors. Airmen had the lowest rate — about half that of soldiers. Soldiers also comprised more than half of those who went to the hospital more than once for a drinking-related problem, the study said. The high rate among soldiers for repeat visits to the hospital is "likely related to the higher rate of alcohol-related encounters attributable to the Army in general," the study said.  "However, it may also suggest higher tolerance of these episodes and stronger efforts to rehabilitate soldiers and salvage careers than in the other service branches." Problems caused by excessive drinking that required hospital care were most common in combat-specific and motor transport occupations, with pilots and air crew the least likely to be affected, the study found. While the incidence rate of alcohol-related medical encounters declined 14% over the 10-year period, there was an increase in 2011 and 2012 — a period that corresponded with a surge in troop levels in Afghanistan, the study said. Once the surge ended, the rate of alcohol-related encounters declined, it said. Active duty service members are known to have a higher prevalence of alcohol use, heavy drinking and binge drinking than the general population, the study said. That could be due in part because those who drink in high school are more likely to join the military, but also because "binge and heavy drinking are an accepted part of military culture," the study said. Stars & Stripes External Link

    GLOBAL

    Anti-hypertension drugs could help reduce COVID-19 deaths, new study shows

    23 August- Experts claim that COVID-19 survival rates can be improved using blood pressure medication. They also suggest that it can reduce the severity of infection, as stated in a new research from the University of East Anglia. 28,000 patients taking antihypertensives, a type of drug used for treating high blood pressure or hypertension, participated in the study. The results showed that Angiotensin-Converting Enzyme inhibitors (ACEi) or Angiotensin Receptor Blockers (ARB) lessens the risk of extreme COVID-19 illness and even death of patients suffering from high blood pressure.  "We know that patients with cardiovascular diseases are at particular risk of severe Covid-19 infection," said Dr. Vassilios Vassilou, the lead researcher from UEA's Norwich Medical School. "But at the start of the pandemic, there was concern that specific medications for high blood pressure could be linked with worse outcomes for Covid-19 patient," he further explained. Dr. Vassiolou added that the team's goal is to know the impact of the medications for COVID-19 patients. The researchers observed the antihypertensives' outcomes for infected individuals. "Critical outcomes," such as being put on a ventilator, being admitted to intensive care, and death, were mainly observed. UEA leads the new research together with the Norfolk and Norwich University Hospital. Tech Times External Link

    Flu season could make coronavirus testing delays even worse

    25 August- Come fall, the rise of influenza and other seasonal respiratory infections could exacerbate already staggering delays in coronavirus testing, making it easier for the virus to spread unnoticed, experts said. In typical years, doctors often don't test for flu, simply assuming that patients with coughs, fevers and fatigue during the winter months are probably carrying the highly infectious virus. But this year, with the coronavirus bringing similar symptoms, doctors will need to test for both viruses to diagnose their patients — further straining supply shortages in an already overwhelmed testing system. A handful of manufacturers have begun making tests that can screen for several pathogens at once. But these combo tests are expensive and will likely make up only a fraction of the market. Some researchers are trying to make their own multi-virus tests as well, but they almost certainly won't fill in the gaps. "The flu season is a bit of a ticking time bomb," said Amanda Harrington, medical director of microbiology at Loyola University Medical Center. "We are all waiting and trying to prepare as best we can." Flu viruses and coronaviruses differ in many ways, including how they spread, how long they linger in the body and the groups they affect most severely. Food and Drug Administration-approved antivirals and vaccines exist for the flu, but no such treatments yet exist for the coronavirus, which has killed about 800,000 people worldwide in less than a year. The New York Times External Link

    Four scenarios on how we might develop immunity to Covid-19

    25 August- As the world wearies of trying to suppress the SARS-CoV-2 virus, many of us are wondering what the future will look like as we try to learn to live with it. Will it always have the capacity to make us so sick? Will our immune systems learn — and remember — how to cope with the new threat? Will vaccines be protective and long-lasting? These pressing questions gained even greater urgency Monday with the news that scientists in Hong Kong have confirmed a 33-year-old man was reinfected with Covid-19; his second infection as diagnosed — by airport screening — came 4.5 months after his first infection in March. "I've been thinking about it a lot," Malik Peiris, a coronavirus expert at the Hong Kong University who was one of the co-discoverers of SARS-1, said when asked about the question of immunity. Peiris isn't alone. STAT asked a number of experts to map out scenarios of how we might come to coexist with this new threat. In a time of uncertainty, the scenarios they sketched were actually hopeful, even if the relief most envisage is not immediately around the corner. STAT News External Link

    New measures aim to boost vaccine rates for flu and children's shots

    20 August- The Trump administration has announced measures intended to boost childhood vaccination rates that have sagged during the coronavirus pandemic, putting hundreds of thousands at risk of contracting serious and life-threatening diseases. The Department of Health and Human Services is giving permission to pharmacists nationwide to administer all scheduled shots to children as young as 3, including the flu vaccine, a step that makes immunization more convenient for parents. The Centers for Disease Control and Prevention said on Thursday that a high-dose flu shot aimed at better protecting people 65 and older will guard against four strains of the virus this year, rather than three. Because the conventional flu vaccine can be less successful in older people, an enhanced shot to boost their immune system has been offered in recent years and this one is stronger than ever. Protecting against the impending flu season in the United States is foremost on the minds of public health officials, who worry about the confluence of cases of flu and Covid-19 hitting hospitals this fall and winter. On Wednesday, Massachusetts announced that it will require all students, ranging from 6-month-olds in day care centers to those under 30, to get flu shots by Dec. 31. It is the first state to institute such a sweeping requirement for the shot, which is rarely mandated in the U.S. The Massachusetts order includes elementary and secondary school students who are currently learning remotely. But it allows exceptions for students with medical and religious exemptions, those who are home-schooled and those in colleges and universities who learn remotely and do not set foot on their campuses. Usually, public health officials recommend that people get flu shots between the middle of September and the end of October. Because immunity can take up to two weeks, the goal would be to have people fully protected in time for the onset of the holiday season, when travel and indoor gatherings make the risk of infection with the flu virus exponentially more likely. Moreover, because immunity wanes over several months, the hope is that protection could last through early spring, when a final surge of flu can emerge. The New York Times External Link

    New tumor gene test can help predict survival for advanced ovarian cancers- Study

    21 August- A new tumor gene test may better predict survival for advanced ovarian cancers, a study says.  The study, compiled by many researchers around the world, was recently published in Annals of Oncology. The average survival for women with high-grade serous ovarian cancer is around four years, but this varies widely from patient to patient, study authors wrote. "At the moment, the majority of ovarian cancer patients get the same treatment. It's not like breast cancer or other cancers where they look at your tumor and select from a range of treatments," said Susan Ramus, senior author and professor at the University of New South Wales in Sydney, in a news release provided by the University of Southern California. "So this is a way to stratify patients and potentially give more personalized treatment down the track." The USC release noted that the typical way of making survival estimates is "based on a patient's age and cancer stage." Fox News External Link

    Oxford coronavirus vaccine data could go to regulators this year

    25 August- Trial data for the University of Oxford and AstraZeneca's possible coronavirus vaccine could be given to regulators this year but corners cannot be cut to speed up approval for emergency use, a scientist leading the trials said on Tuesday.  The Oxford vaccine produced an immune response in its first human trials, underlining its position as one of the leading candidates in the race to combat a virus that has led to hundreds of thousands of deaths and crippled the global economy. "It is just possible that if the cases accrue rapidly in the clinical trials, that we could have that data before regulators this year," Andrew Pollard, director of the Oxford Vaccine Group, told BBC Radio of progress in larger, late-stage trials. "Then there would be a process that they go through in order to make a full assessment of the data." The trials hit the headlines earlier this week when the Financial Times reported the Trump administration was considering fast-tracking the vaccine for use in the United States ahead of the Nov. 3 presidential election. Reuters External Link

    Public health's share of the blame: US COVID-19 risk communication failures

    24 August- A reporter recently asked me what I consider "the single biggest communication failure" of public health experts and officials with regard to COVID-19. It took me a few weeks to think it through, but I now have a five-part answer to this question. Let me state the obvious at the outset: Public health professionals are not single-handedly responsible for the dire COVID-19 situation in which the United States finds itself. If I had to specify a single culprit, I'd name the federal government, and especially President Trump. But I believe the public health profession bears a good deal more of the blame than it's getting. Several public health professionals who gave me comments on an earlier version of this article said a lot of the failings I attribute to public health professionals are actually down to the President and the federal public health agencies that report to him. There's enough blame to go around. But I have spent the past 7 months reading and watching media, zeroing in especially on what experts and officials (especially those outside the federal government) were saying about COVID-19 in news stories, interviews, and op-eds. I don't have a formal content analysis of their messaging and how it morphed over time. But my strong impression, bordering on conviction, is that their messaging often misled the public, and the political leadership as well. How that happened is the subject of this article. I want to look at the big picture. I'll ignore public health professionals' smallish risk communication failures, such as their abrupt about-face without an apology on the advisability of wearing masks and their absolution of antiracism protesters for gathering in large crowds. The story I want to tell focuses on how the public health profession drastically underreacted to COVID-19 at first and left us unprepared, then overreacted and sent us into lockdown, and then justified the lockdown by switching from a "flatten the curve" narrative to a "prevent infections at all costs" narrative instead of teaching us to balance priorities and "dance" with the SARS-CoV-2 virus. CIDRAP External Link

    US FDA announces emergency authorization for convalescent plasma to treat Covid-19

    23 August- The US Food and Drug Administration on Sunday issued an emergency use authorization for convalescent plasma to treat Covid-19, saying the "known and potential benefits of the product outweigh the known and potential risks of the product." The FDA said more than 70,000 patients had been treated with convalescent plasma, which is made using the blood of people who have recovered from coronavirus infections.  "Today I am pleased to make a truly historic announcement in our battle against the China virus that will save countless lives," President Trump said at a White House briefing, referring to the coronavirus that causes Covid-19. "Today's action will dramatically increase access to this treatment." Last week, Trump accused some health officials of playing politics regarding an EUA for convalescent plasma. When asked about the FDA not having granted an EUA, Trump said the reason was political.  On Sunday, a source who is close to the White House Coronavirus Task Force told CNN the FDA had reviewed additional data to inform its EUA decision. This official has not personally reviewed the data. They added the FDA is under no obligation to consult anyone outside the agency about its decision. Convalescent plasma is taken from the blood of people who have recovered from Covid-19. At the end of March, the FDA set up a pathway for scientists to try convalescent plasma with patients and study its impact. It has already been used to treat more than 60,000 Covid-19 patients. CNN External Link

    INFLUENZA

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

    2019-2020 Influenza Season Week 33, ending August 15, 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.

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on August 20, 2020, 6.1% of the deaths occurring during the week ending August 15, 2020 (week 33) were due to P&I. This percentage is above the epidemic threshold of 5.5% for week 33.

    Influenza-Associated Pediatric Mortality: One influenza-associated pediatric death occurring during the 2019-2020 season was reported to CDC during week 33. This death was associated with an influenza B virus and occurred during week 8 (the week ending February 22, 2020). CDC External Link 

    WHO: Influenza Update

    17 August 2020 - Update number 374, based on data up to 02 August 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-CoV-2 virus transmission might also have played a role in mitigating influenza virus transmission.

    -Globally, influenza activity was reported at lower levels than expected for this time of the year. In the temperate zones of the southern hemisphere, the influenza season has not commenced. Despite continued or even increased testing for influenza in some countries in the southern hemisphere, very few influenza detections were reported.

    -In the temperate zone of the northern hemisphere, influenza activity remained below inter-seasonal levels.

    -In the Caribbean and Central American countries, sporadic influenza detections were reported. Severe acute respiratory infection (SARI) activity remained elevated in some reporting countries.

    -In tropical South America and tropical Africa, there were sporadic influenza virus or no detections across reporting countries.

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

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

    VETERINARY/FOOD SAFETY

    Brandt brand sausage recalled due to possible Listeria

    24 August- G. Brandt Meat Packers Ltd. is recalling Brandt brand mini spicy cheese sausage because of possible Listeria monocytogenes contamination. This recall was triggered by the Canadian Food Inspection Agency's (CFIA) test results. The CFIA is currently conducting a food safety investigation, which may lead to more recalls The product was distributed in Ontario, Quebec and Saskatchewan. The CFIA is verifying that the recalled product is removed from the marketplace. Consumers are being told not to consume the recalled product... So far, there have been no reported illnesses associated with the consumption of the recalled product. Questions can be directed to the CFIA at 800-442-2342 (Canada and U.S.), or 613-773-2342 (local or international). Food Safety News External Link

    Peach recall spreads to Canada as Salmonella outbreak continues

    23 August- Wawona, the company that has recalled peaches across the U.S. because of a link to a Salmonella outbreak, is expanding the recall to include peaches distributed in Canada. The Public Health Agency of Canada is investigating an outbreak in that country, according to the Canadian Food Inspection Agency (CFIA), but the health department had not posted a public notice as of this afternoon. In the United States, the outbreak has sickened 68 people across nine states. At least 14 people had to be admitted to hospitals. No deaths have been confirmed, according to the U.S. Centers for Disease Control and Prevention. Grocery chains in the U.S. that received the recalled peaches include Walmart, Kroger, and Wegmans. For a list, see below. Eleven different weights and brands of fresh peaches are subject to the recall in Canada.  "The CFIA is warning the public not to consume and retailers, distributors, manufacturers, and foodservice establishments such as hotels, restaurants, cafeterias, hospitals, and nursing homes not to serve, use, or sell the products described below," according to the recall notice. "Prima Wawona, located in Fresno, California, has recalled fresh peaches with various brand names due to possible Salmonella contamination. Various importers in Canada are conducting a recall of the affected products. Peaches with the same PLU numbers and that are 'Product of Canada' are not affected." Food Safety News External Link

    WELLNESS

    Having some caffeine in pregnancy 'is fine'

    25 August- Their comments come as a new research paper in a medical journal suggests there is no safe level in pregnancy. But the experts say that is alarmist.
    The NHS and many other organizations say consuming 200mg or less a day should not pose any significant risk in terms of miscarriage or growth of the baby while in the womb. The stillbirth charity Tommy's has a caffeine intake calculator to help women keep track of their consumption. The controversial research paper, published in BMJ Evidence Based Medicine, looked at 48 studies on the topic. The author of that paper, Prof Jack James, a psychologist at Reykjavik University in Iceland, acknowledges that the work is observational, so can't prove definitively that any caffeine in pregnancy is harmful. But he says his analysis, which links caffeine with harm, suggests avoiding drinks like tea and coffee entirely would be the best advice for mums-to-be and women trying to get pregnant. Other experts strongly disagree, saying this is overkill. Just as the NHS does, the European Food Safety Authority and the American and UK Colleges of Obstetricians and Gynecologists recommend limiting, but not eliminating, caffeine consumption during pregnancy. Dr. Luke Grzeskowiak, a pharmacist at the University of Adelaide, Australia, said the research paper was "overly alarmist" and inconsistent with accepted evidence. BBC News External Link

    USAFRICOM

    Nigeria: Lassa fever cases drop significantly in recent months

    23 August- On January 24, the Nigeria Centre for Disease Control (NCDC) declared a Lassa fever outbreak. By May 10, the country had reported their 1,000th case–the largest Lassa fever outbreak ever reported in any country, 'anywhere in the world'.  Since early May, Nigerian health officials have reported 61 confirmed Lassa fever cases. In the week ending August 16, one case was reported from Edo State, bringing the country total to 1061, an increase from 658 cases reported during the same period in 2019. 222 deaths have been reported to date with a case fatality rate (CFR) of 20.9%. Lassa fever is endemic in Nigeria and cases are recorded all year round. The Lassa fever virus is transmitted by rodents which can be found in our environment. This contributes largely to the risk of spread that occurs in Nigeria and other countries with similar ecological factors. Lassa fever is largely transmitted through contact with items or surfaces contaminated with urine, feces, saliva or blood of infected rats. It can also be transmitted from person-to-person through contact with blood, urine, feces and other body fluids of an infected person. To minimize the risk of infection, members of the public are advised to ensure their environment is always kept clean to avoid contact with rodents. Outbreak News Today External Link

    Uganda: COVID-19 single day high, yellow fever vaccination campaign, suspected anthrax

    24 August- The Uganda Ministry of Health reported Sunday that the country registered the highest number COVID-19 cases at 318 in a single day.

    The breakdown of the cases is as follows:

    • Amuru Prisons: 154 (153 inmates, 1 prison staff)
    • Contacts and Alerts (136) : Kampala -65, Kiryandongo-14, Gulu-9, Mbarara-9, Kitgum-8, Arua-8, Wakiso-7, Mbale-4, Buikwe-4, Masaka-2, Bugiri-1, Jinja-1, Luweero-1 Manafwa 1, Masindi 1, Mityana 1
    • Health workers (20): Kitgum 9, Kampala 6, Arua 2, Adjumani 1, Kiryandongo 1, Luweero 1
    • Truck drivers (8): Malaba 3, Busia 2, Mpondwe 1, Oraba 1, Madi Opei 1

    In addition, one COVID-19 death, a 49 year old male from Mbale District was reported, bringing the total cumulative COVID-19 deaths to 20. The cumulative number of confirmed cases of COVID-19 in Uganda is 2,166. Currently, Kampala Metropolitan Area has the highest numbers of community transmission. A cumulative total of 540 COVID-19 cases have been reported in Kampala since the 23rd March. Of these, 342 cases were registered within the last week, from 15th August to 21st August 2020 including 5 COVID-19 deaths. Outbreak News Today External Link

    USCENTCOM

    Pakistan: Polio vaccination- More than 32 million children reached across the country

    25 August- More than 32 million children under the age of five vaccinated in 130 districts across Pakistan during the immunization campaign. In addition to the polio drops, children (aged between 6-59 months) received Vitamin A supplements during the campaign started on 13 August.  According to the National Emergency Operations Centre for Polio Eradication, a total of 32,100,802 children have been vaccinated against poliovirus across the country. "We have managed to achieve impressive coverage despite the challenging context of the COVID-19, hot weather and heavy rainfall. Our valiant trained frontline workers work hard to reach eligible children across the country. Children have also been administered Vitamin A supplements to strengthen their immune system for greater protection against diseases during this campaign. Celebrities, intellectuals and religious leaders have come forward to support the polio eradication efforts," said Dr. Rana Muhammad Safdar, Coordinator of the National Emergency Operations Centre, Pakistan Polio Eradication program. "Still, we have challenges to overcome. Data-driven analysis of challenges at the grassroots level helps us identify the underlying issues associated with missed children, pockets of refusals as well as reservoirs of poliovirus circulation. Strengthening essential immunization is also important to facilitate the interruption of all poliovirus transmission. The program is prioritizing essential immunization as part of the national agenda. I'm confident that we will be able to bring positive changes and make Pakistan polio-free so that no child remains at risk of contracting polio disease and getting paralyzed for life," he further said while highlighting the challenges. So far in 2020, Pakistan has reported 65 wild poliovirus type 1 (WPV1) cases. in 2019, the country saw 147 cases. Outbreak News Today External Link

    Polio outbreak declared in Yemen

    21 August- The Global Polio Eradication Initiative (GPEI) announced that a circulating vaccine-derived poliovirus type 1 (cVDPV1) outbreak has been declared in Yemen.  Fifteen cVDPV1 cases were reported this week. These genetically-linked VDPV1 were isolated from 14 AFP cases, with onset of paralysis ranging from 31 January to 18 June 2020 (with a further AFP case from June 2019 retrospectively confirmed). The cases are from different districts of Saada Governorate, a relatively densely populated area, which has also been affected in the past by conflict and access issues, in the north-west of the country. Officials say the isolates have 17-24 Nt changes from Sabin 1, suggesting circulation of potentially up to two years. WHO and UNICEF are supporting local health authorities to plan and launch an effective outbreak response to limit virus spread. Elsewhere, wild poliovirus type 1 (WPV1) cases were reported in Afghanistan (3) and Pakistan (2), bringing the country totals to 37 and 65 cases, respectively. Lastly, nine circulating vaccine-derived poliovirus type 2 (cVDPV2) were reported in four African nations–Cote d'Ivoire, Nigeria, Somalia and Sudan. Outbreak News Today External Link

    USEUCOM

    Sweden: Reports increase in campylobacter infections this month

    22 August- Since the beginning of August, there has been a general increase in the country in the number of reported cases of disease caused by the intestinal bacterium campylobacter. Since the end of July, an increase in the incidence of campylobacter in Swedish broiler flocks has also been observed.  The Swedish Public Health Agency, regional infection control units, the Swedish Veterinary Institute, the National Food Administration, the Swedish Board of Agriculture and the Swedish Work Environment Authority are working to investigate the causes of the increase and to reduce the number of disease cases. For the past three years, the Swedish Public Health Agency and the National Food Administration have compared campylobacter from fresh chicken bought in stores during the summer with campylobacter from cases of human disease during the corresponding period. In the comparisons, about a third of the disease cases could be linked to chicken meat and the majority to Swedish conventionally bred chicken. There is much to suggest that the increase in cases in humans and the occurrence in flocks of broilers is also this time directly related. The Swedish Public Health Agency and the Swedish Veterinary Institute will now analyze campylobacter samples from cases of disease and broiler flocks as part of the outbreak investigation. Campylobacter infection in humans is more common in the summer, but the increase now seen occurs after a period when the incidence has been unusually low. The prevalence of campylobacter in broiler flocks has been very low during the first half of the year. Outbreak News Today External Link

    Ukraine: 3 Meningococcal infections reported in Transcarpathia, 'the problem with the availability of vaccines in our region is more acute than ever'

    24 August- Officials in the Transcarpathian region in southwestern Ukraine have reported three cases in children of meningococcal disease, with one fatality being reported.  Infectious disease physician, Viktor Petrov said on his Facebook page (computer translated), Increased interest in coronavirus significantly diverts our attention from other, no less dangerous infectious diseases like meningococcal disease. He also addresses the issue of vaccines in Ukraine-The problem with vaccine accessibility in our region is more than ever, overreact and it, for some reason, has not been solved for a year in a row. Meningococcal disease is a contagious infection that can be very serious. It may cause infection of the covering of the spinal cord, bacteria in the blood or pneumonia. It is spread by close contact, such as living with or kissing an infected person. Disease outbreaks typically occur in communities, schools, colleges and other high-risk populations. Symptoms of meningitis include, but are not limited to, a sudden onset of fever, headache, stiff neck, confusion and sometimes a rash. Quick medical attention is important if meningococcal disease is suspected. Individuals with concerns should contact their healthcare provider. Outbreak News Today External Link

    USINDOPACOM

    New Zealand: COVID-19 update- Auckland will stay at Alert Level 3 through Sunday

    24 August- The New Zealand Ministry of Health reported nine new cases of COVID-19 Monday (eight confirmed cases and one probable case.)  One confirmed case is an imported case picked up in MIQ at the Four Points by Sheraton in Auckland at routine testing around day 12. The person who has tested positive is a woman in her 30s and we will provide an update on where she travelled from when the information is available. The other eight cases – seven confirmed and one probable – are in the community and are all linked to the Auckland cluster. One of these had contact with another confirmed case on bus transport. Four are household contacts of confirmed cases. One has had contact with a confirmed case at a church. Two are workplace contacts – one of these is the probable case. These cases bring our total number of confirmed cases to 1,332, which is the number we report to the World Health Organization. Our total number of probable cases is now 351, and our combined total of confirmed and probable cases is now 1,683. The total number of active cases in New Zealand is 123, of which 19 are imported cases from managed isolation facilities. Outbreak News Today External Link

    Philippines: Report an additional 1000 COVID-19 cases from Manila area

    23 August- Philippines health officials reported an additional 2,378 COVID-19 cases Sunday, bringing the country total to 189,601.  The Metro Manila area accounted for 1,022 of the cases, while Cebu saw 196 cases, Cavite with 132 cases, Laguna with 128 cases and Rizal with 115 cases. Approximately 91.5 percent of the cases are mild, 6.1 percent are asymptomatic, 1.0 percent are severe, and 1.4 percent are critical patients. Outbreak News Today External Link

    USNORTHCOM

    U.S.: California- Reports increase in Candida auris cases, Health advisory issued

    23 August- The California Department of Health issued a health advisory last week due to increasing reports of the multi-drug resistant organism (MDRO), Candida auris (C. auris).  State and local health officials have say an increasing number of C. auris cases reported in southern California in recent months. Personal protective equipment (PPE) conservation strategies and other containment practices (e.g., cohorting) on the basis of COVID-19 status alone might be contributing to this resurgence of C. auris. The number of newly identified C. auris cases in California more than doubled from May (N=15) to June (N=40); and the number of newly identified C. auris cases in July (N=73) exceeded the combined total for April, May and June (N=59). Most recently, C. auris outbreaks have been reported in healthcare facilities in Los Angeles and Orange Counties. According to the CDC, Candida auris is an emerging fungus that presents a serious global health threat. C. auris causes severe illness in hospitalized patients in several countries, including the United States. Patients can remain colonized with C. auris for a long time and C. auris can persist on surfaces in healthcare environments. This can result in spread of C. auris between patients in healthcare facilities. Strains of C. auris in the United States have been linked to other parts of the world. U.S. C. auris cases are a result of inadvertent introduction into the United States from a patient who recently received healthcare in a country where C. auris has been reported or a result of local spread after such an introduction. Outbreak News Today External Link

    USSOUTHCOM

    Colombia: COVID-19 cases now 489K, Bogotá's El Dorado airport is scheduled to officially reopen

    19 August- The Colombia Ministerio de Salud y Protección Social that the outbreak of COVID-19 in the country has reached 489,122 confirmed cases since the pandemic reached the country in Bogotá in March. 12,462 cases were reported on Tuesday and officials say the death numbers decreased for the third consecutive day with 247 reported. This is much lower than the high of 380 fatalities reported in late July. Bogotá has seen the most cases in this pandemic with 171,312, followed by Antioquia with 64,679. The improvement in conditions has prompted the Colombian government to reopen flights at Bogotá's El Dorado airport, which has been closed for some 5 months. The country's civil aviation authority presented the government of President Iván Duque 14 domestic routes ready to resume operations. The destinations with direct flights to Bogotá are Rionegro, Medellín, Cali, Bucaramanga, Barranquilla, Cartagena, Santa Marta, Monteria, Pereira, Cucuta, Pasto, Villavicencio and San Andrés. Outbreak News Today External Link