Army Public Health Weekly Update, 29 October 2021

Date Published: 10/29/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.
The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents

    ANNOUNCEMENTS

    Coronavirus self-checker

    The Coronavirus Self-Checker is an interactive clinical assessment tool that will assist individuals ages 13 and older, and parents and caregivers of children ages 2 to 12 on deciding when to seek testing or medical care if they suspect they or someone they know has contracted COVID-19 or has come into close contact with someone who has COVID-19. The online, mobile-friendly tool asks a series of questions, and based on the user's responses, provides recommended actions and resources. CDC External Link

    U.S. MILITARY

    'Getting vaccinated is like wearing body armor' says Army Public Health Center expert

    25 October- The recent death of former U.S. Secretary of State and retired Army Gen. Colin Powell of complications related to a COVID-19 breakthrough infection has led some to criticize the effectiveness of COVID-19 vaccinations. Powell, who was 84 years old, was also immunocompromised due to multiple myeloma, a blood cancer that studies show can make the vaccine shots less effective. “Saying 'vaccines don't work' is like saying 'seat belts don't work'," said Dr. John Ambrose, Army Public Health Center senior advisor for Clinical Public Health & Epidemiology. “Car accidents are a risk despite any individual's best efforts. However, by wearing a seatbelt, an individual is far more likely to survive if in an accident." Ambrose says getting vaccinated is like wearing body armor. “Vaccines strengthen the body's immune response to a particular pathogen," said Ambrose. “When the body's immune system needs to fight pathogens, having a vaccine is like having body armor. I don't know of a Soldier that would prefer to be without body armor when heading into a battle." Sometimes the reporting around breakthrough infections can create a perception that the COVID-19 vaccines are not effective, but this is far from the case. Unvaccinated individuals are at a far greater risk of hospitalization and death than those who have been vaccinated, said Ambrose. “When comparing the clinical outcomes of SARS-CoV-2 infection between fully vaccinated and unvaccinated individuals, the data are clear," said Ambrose. “Unvaccinated individuals are far more likely to both test positive and to die due to infection when compared to fully vaccinated individuals of similar ages." Army.mil External Link

    Ultra-Endurance Military Athletes: What motivates them?

    25 October- For some, sports are simply a way to stay fit, for others a way to de-stress. But for endurance athletes - who push themselves to go faster and longer for events such as marathons, cycling races, cross-country skiing, triathlons, and long-course swimming - it's a mental and physical challenge with themselves. Such is the case of Coast Guard Lt. Cmdr. Duane Zitta, intelligence chief for Sector Anchorage, on Joint Base Elmendorf-Richardson in Alaska. Zitta has embarked on the world's most extreme endurance events ever since he ran his first marathon at age 23 just "to see" if he could run that far. (He completed it in just over three hours - 3:09 to be exact - which is a far better time than the average marathoner, who takes about 4.5 hours). For Zitta, endurance sports began as a way to let his energy out. "When I was young, running was always something that I enjoyed," he said. "It was an outlet for me, I was a super hyperactive kid with a lot of energy. And running was a way to get that energy out." Later in life, it became a way to give back to the Coast Guard community. After losing a fellow Coastguardsman during a helicopter search-and-rescue operation, these ultra-endurance events became a way to raise funds for his colleague's children. Since then, he's competed in high-profile events to raise funds for the non-profit Coast Guard Foundation, which provides college scholarships for the children of fallen "Coasties." Competing in extreme endurance events "for fundraisers that have such a personal connection for me also made some of the hardest events so much easier," he said. "When your body wants to quit and you remind yourself that you're out here raising money for somebody's children to go to college and they're not around anymore, that motivation makes any of these endurance events that much easier." He's completed many events that others would deem impossible. The list includes climbing 12 back-to-back mountain peaks in Alaska in less than 24 hours; completing several Ironman triathlons, including the competitive Hawaii Ironman World Championship triathlon; swimming 12.5-miles around Key West in six hours; climbing 10,000 feet across 20 miles from sea level to the top of the Haleakala Volcano in Hawaii; and running several 100-mile races at an average pace of 6 minutes, 45 seconds per mile. And on every birthday, he runs the distance (in miles) that corresponds to his age - just for fun. This November, he will run 41 miles in Anchorage's snowy terrain and sub-freezing temperatures. Health.mil External Link

    GLOBAL

    COVID-19 vaccine recipients had lower rates of non-COVID-19 mortality

    26 October- In a cohort study of 6.4 million COVID-19 vaccines and 4.6 million demographically similar unvaccinated persons, recipients of the Pfizer-BioNTech, Moderna, or Janssen vaccines had lower non–COVID-19 mortality risk than did the unvaccinated comparison groups, reported the U.S. CDC on October 22, 2021. And, there is no increased risk for mortality among COVID-19 vaccine recipients. This finding published in the CDC's Morbidity and Mortality Weekly Report reinforces the safety profile of currently approved COVID-19 vaccines in the U.S. The lower mortality risk after COVID-19 vaccination suggests substantial healthy vaccinee effects (i.e., vaccinated persons tend to be more beneficial than unvaccinated persons), which will be explored in future analyses. Among persons aged 12–17 years, mortality risk did not differ between Pfizer-BioNTech vaccinees and unvaccinated persons, with only 12 deaths occurring in this age group during the study period. The stratified analyses by age, sex, race, and ethnicity showed that vaccinated adults had lower mortality than unvaccinated adults across subgroups. The findings in this report are subject to at least four limitations, such as the study was observational, and individual-level confounders that were not adjusted for might affect mortality risk, including baseline health status, underlying conditions, health care utilization, and socioeconomic status. Despite limitations, this study had several strengths. First, this was a cohort study with a large, sociodemographically diverse population, and it encompassed a study period of >7 months. This cohort study found lower rates of non–COVID-19 mortality among vaccinated persons than unvaccinated persons in a large, sociodemographically diverse population during December 2020–July 2021. Thus, there is no increased risk for mortality among COVID-19 vaccine recipients. Precision Vaccinations External Link

    Help available to abusers, victims of domestic violence

    25 October- The question concerning domestic abuse is not whether it exists, but to what extent it happens. The answer might surprise some. One-in-four women and one-in-nine men are subject to severe intimate partner physical violence and other aggressive behaviors, reported Terri Ceaser, a domestic abuse victim advocate with the Army Family Advocacy program here. “This is a big problem in the United States," she said, “and military communities are not excluded." Perhaps even more astounding is that national statistics – the more than 10 million men and women physically abused by intimate partners annually, for example – fall short when summing up the full scope of the problem. This is because perpetrators and victims may be fearful of reaching out for help, Ceaser said. Abusers may fear legal consequences or embarrassment. Victims may be apprehensive due to further threats of violence, social expectations and financial insecurity. “So often, victims suffer in silence," she acknowledged, “and it can go on for years." An accepted definition of domestic abuse – sometimes-labeled domestic violence or intimate partner violence – is a “pattern of behavior in any relationship that is used to gain or maintain power and control over intimate partners." Those behaviors include actions intended to frighten, terrorize, intimidate, manipulate, hurt, humiliate, injure or wound someone. It also can be physical, sexual, emotional, economic or psychological in nature. Military personnel are not exempt from the specter of domestic violence. In fact, those in uniform are more likely to experience partner abuse compared to their civilian counterparts, according to the Department of Veteran Affairs. Contributing factors typically cited include long duty hours, deployments and other stresses associated with military life. Because domestic abuse affects Soldier and family readiness, it should be on the radars of leaders at all level, advised Sgt. Maj. of the Army Michael A. Grinston. “There's no room for domestic violence in our military," he said at an Oct. 12 town hall. “I'd ask every leader in the Army to go out there and just talk to your people and their families." Meaning leaders should actively engage with Soldiers and loved ones as a means to identify behaviors or conditions leading to abuse, elaborated Secretary of the Army Christine Wormuth. “What we'd like to do is catch families that are having problems and support them before violence happens," she said at the same town hall. “And that's really what we're trying to get at … making sure that our leaders are looking at promoting a healthy command climate." Wormuth mentioned the Strong Bonds and Family Advocacy programs as sources of support for military personnel and Army communities. Strong Bonds is a chaplain-led program promoting healthy relationships through recreational activities, retreats and discussion. FAP, a division of Army Community Service, provides counseling, emergency assistance and behavioral health. DVIDS External Link

    Make hand hygiene a successful wash for infection prevention

    25 October- From bedside to bathroom, desktop to doorknob, cell phone to computer keyboard, there's nothing quite like a good wash. Especially in a hospital setting where eliminating germs, bacteria and viruses is crucial. In conjunction with International Infection Prevention Week, October 17-23, 2021, Naval Hospital Bremerton staff are ensuring co-workers, along with patients and visitors are aware of such infectious, communicable threats and understand how to protect themselves and others. Helping to lead that effort at NHB is Infection Prevention Nurse, Elma Faye Miller. “I am responsible for supporting our command in efforts to prevent and control the spread of infections by following trends, reviewing policy and procedures for best practices, and for providing education and recommendations to help improved our mission which is to 'keep our warfighters and their families ready, healthy, and on the job,'" explained Miller, who has a history of applying practices and procedures to minimize the risk of infection. As an Army Reserve medic attending a medic-training course in Massachusetts she received unexpected recognition with a Aseptic Technique Medic Award. “It was given as a joke, because even in practice for starting an IV or drawing blood, my approach was always to provide infection prevention measures, even on the battlefield. I was vocal about it with other soldiers in my course. Infection prevention should be the first step for any procedure performed in a health care environment," Miller said.

    A few facts on why there is an International Infection Prevention Week:

    The average office desk has 400 times more bacteria than a toilet handle

    Mobile phones have 18 times more bacteria than someone's toilet

    Eighty percent of all infectious diseases are transmitted by touch Health.mil External Link

    Moderna says low-dose COVID-19 vaccine is safe and appears to work for kids age 6-11

    25 October- Moderna said Monday that a low dose of its COVID-19 vaccine is safe and appears to work in 6- to 11-year-olds, as the manufacturer joins its rival Pfizer in moving toward expanding shots to children. Pfizer's kid-size vaccine doses are closer to widespread use. They are undergoing evaluation by the Food and Drug Administration for youngsters in nearly the same age group, 5 to 11, and could be available by early November. The company's vaccine already is authorized for anyone 12 or older.  Moderna hasn't yet gotten the go-ahead to offer its vaccine to teens but is studying lower doses in younger children while it waits. Researchers tested two shots for the 6- to 11-year-olds, given a month apart, that each contained half the dose given to adults. Preliminary results showed vaccinated children developed virus-fighting antibodies similar to levels that young adults produce after full-strength shots, Moderna said in a news release. The study involved 4,753 children ages 6 to 11 who got either the vaccine or dummy shots. Moderna said that like adults, the vaccinated youngsters had temporary side effects, including fatigue, headache, fever and injection site pain. The study was too small to spot any extremely rare side effects, such as heart inflammation that sometimes occurs after either the Moderna or Pfizer vaccines, mostly among young men. Fox News External Link

    The A.30 coronavirus variant warrants closer monitoring

    26 October- The journal Cellular & Molecular Immunology published a peer-reviewed study on October 25, 2021, stating, 'COVID-19 vaccines that protect against severe disease and death are considered central to ending the pandemic.' However, the emergence of SARS-CoV-2 coronavirus variants with S protein mutations that confer resistance to neutralization might compromise COVID-19 vaccine efficacy. Furthermore, emerging viral variants with enhanced transmissibility, likely due to altered virus-host cell interactions, might rapidly spread globally. Therefore, it is essential to investigate whether emerging SARS-CoV-2 variants exhibit altered host cell interactions and resistance against antibody-mediated neutralization. 'We investigated host cell entry and antibody-mediated neutralization of the variant A.30 (A.VOI.V2), which was detected in several patients in Angola and Sweden in spring 2021 and likely originated in Tanzania.'  The 'results of our study suggest that the SARS-CoV-2 variant A.30 can evade control by vaccine-induced antibodies and might show an increased capacity to enter cells in a cathepsin L-dependent manner, which might particularly aid in the extra pulmonary spread.' 'Consequently, the potential spread of the A.30 variant warrants close monitoring and rapid installment of countermeasures.' Precision Vaccinations External Link

    Vaping marijuana by teens doubles in last seven years, with potentially harmful consequences, study says

    25 October- Marijuana vaping by school-aged youth doubled between 2013 and 2020, a new study found, with reported use within the last 30 days rising seven-fold during the same time period. The study, published Monday in JAMA Pediatrics, analyzed 17 studies conducted throughout Canada and the United States that involved nearly 200,000 adolescents. The study found that teens in their senior year of high school were most likely to be vaping marijuana compared to younger adolescents. In 2018, for example, one in three grade-12 students reported vaping weed. In one of the studies, adolescents also reported a preference for vaping cannabis extracts over dried herbs to get the buzz they desired from THC. THC, or tetrahydrocannabinol, is the main psychoactive compound in cannabis, the one that produces the "high" users desire. Today's "high" is much more intense than in the past, even that of a mere decade ago, according to the National Institute on Drug Abuse, or NIDA. Modern ultra-potent strains of weed can contain over 15% THC, compared to the 4% or so available in the 1990s. Choosing vaping oils, extracts and resins over dried weed, called "dabbing," is a disturbing and potentially dangerous trend because vape extracts contain "3 to 5 times more THC than the plant itself," noted the NIDA. "The use of cannabis products with high THC (that are) easily achievable through vaping raises several potential problems," said study author Carmen Lim, a PhD candidate on Health and Behavioral Sciences at the University of Queensland in Australia via email. "Not only it is linked to poorer cognitive development in adolescents, it could increase risk of dependence, other substance use and many other health, social, and behavioral problems later in life," Lim wrote. CNN External Link

    Virtual care is still preferable for people even after the pandemic ends

    25 October- Virtual care will still be preferred by both doctors and patients in Canada long after the pandemic ends. According to Global News, the virtual care trend is being preferred by patients because of the convenience it affords them. They're saying that never having to leave the safety of their own homes has given them peace of mind. To them, it is more preferable to sit on their own couches than in a clinic or hospital waiting room, which they say can be more stressful because of the presence of other people who are sick. As for doctors, they're likely pushing for the continuation of both in-person and virtual care, not choosing one over the other. This is the sentiment of the College of Physicians and Surgeons, the Canadian Ministry of Health, and the Chief Medical Officer of health in the city of Ontario. In an open letter sent to family doctors recently, the authorities are advising healthcare groups to set a limit on just how much healthcare assistance virtual care can provide. They've also said that it can't really match the quality of an in-person checkup. As a result, a few healthcare authorities in Canada have been setting new standards of practice for offering virtual care. Tech Times External Link

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 41, ending October 16, 2021:

    Influenza-Associated Pediatric Mortality- No influenza-associated pediatric deaths occurring during the 2021-2022 season have been reported to CDC.

    Outpatient Illness Surveillance- The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) monitors outpatient visits for influenza-like illness [(ILI) fever plus cough or sore throat], not laboratory-confirmed influenza, and will capture visits due to other respiratory pathogens, such as SARS-CoV-2, that present with similar symptoms. Due to the COVID-19 pandemic, health care-seeking behaviors have changed and people may be accessing the health care system in alternative settings not captured as a part of ILINet or at a different point in their illness than they might have before the pandemic. Therefore, it is important to evaluate syndromic surveillance data, including that from ILINet, in the context of other sources of surveillance data to obtain a complete and accurate picture of influenza, COVID-19, and other respiratory virus activity. CDC is tracking the COVID-19 pandemic in a weekly publication called COVID Data Tracker Weekly Review. Information about other respiratory virus activity can be found on CDC's National Respiratory and Enteric Virus Surveillance System (NREVSS) website. CDC External Link

    VETERINARY/FOOD SAFETY

    Mexican onions recalled because of link to large outbreak of Salmonella infections

    25 October- Keeler Family Farms of Deming, NM, is recalling red, yellow, and white onions that were imported from Chihuahua, Mexico, and have been connected to a 37-state outbreak of Salmonella infections. This recall is being conducted  in cooperation with the U.S. Food and Drug Administration, based on ProSource Produce LLC onions sourced in Chihuahua, Mexico, being connected to a Salmonella Oranienburg outbreak that has infected more than 650 people. The implicated ProSource recalled onions were distributed to wholesalers, restaurants, and retail stores in all 50 states and the District of Columbia.

    Recalled Products:

    -The Keeler Family Farms onions were distributed in 25lb/50lb mesh sacks. They contain a label that is marked as MVP (product of MX), but were processed at Keeler Family Farms. 

    -The last to ship was on Aug. 25, 2021.

    Consumers, restaurants, and retailers should not eat, sell, or serve red, white, yellow, or onions from Keeler Family Farms or products containing such onions. If you cannot tell if your onion is from Keeler Family Farm's, or your food product contains such onions, you should not eat, sell, or serve it, and should throw it out. As of now, no specific root source of contamination or individual contaminated shipment has been identified. Food that is contaminated with Salmonella bacteria usually does not look, smell or taste spoiled. Anyone can become sick with a Salmonella infection, but infants, children, seniors and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC. Anyone who has eaten any of the recalled products and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis. Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients need to be hospitalized. Food Safety News External Link

    Onions connected to U.S. Salmonella outbreak recalled in Canada

    26 October- Gwillimdale Farms is recalling Gwillimdale Farms brand onions, product of Mexico from the marketplace because of possible Salmonella contamination. This recall was triggered by an onion recall by ProSource Produce LLC, of Hailey, Idaho. ProSource Produce LLC onions have been connected to a Salmonella Oranienburg outbreak that has infected more than 650 people. Federal officials say the outbreak has been traced to the fresh onions from Mexico. Consumers should not consume the recalled products described below or foods containing these raw onions. Retailers, distributors, manufacturers, and foodservice establishments such as hotels, restaurants, cafeterias, hospitals, and nursing homes should not serve, use, or sell the recalled products. Food Safety News External Link

    White mushrooms recalled in Canada because of Listeria concerns

    26 October- Carleton Mushroom is recalling sliced white mushrooms prepared for Metro Brands because of possible Listeria monocytogenes contamination. This recall was triggered by Canadian Food Inspection Agency (CFIA) test results. The products were distributed in Ontario, Quebec and possibly nationally in Canada. Consumers should not consume the recalled product described below...Consumers should check to see if they have the recalled product in their home. Recalled products should be thrown out or returned to the store where they were purchased. As of the posting of this recall, there have been no reported illnesses associated with the consumption of these products. Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has consumed any recalled product and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible Listeria exposure. Specific tests are required to diagnose the infections, which can mimic other illnesses. Also, anyone who has consumed any of the recalled products should monitor themselves for the food poisoning symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. Symptoms of Listeria infection can include vomiting, nausea, persistent fever, muscle aches, severe headache, and neck stiffness. Specific laboratory tests are required to diagnose Listeria infections, which can mimic other illnesses. Pregnant women, the elderly, young children, and people such as cancer patients who have weakened immune systems are particularly at risk of serious illnesses, life-threatening infections, and other complications. Although infected pregnant women may experience only mild, flu-like symptoms, their infections can lead to premature delivery, infection of the newborn, or even stillbirth. Food Safety News External Link

    WELLNESS

    Breast cancer screening saves lives through early detection

    22 October- It's Breast Health Awareness Month. According to the Centers for Disease Control and Prevention (CDC), breast cancer follows skin cancer as the most common cancer among American women. Also, according to the CDC, mammograms are the most effective way to catch breast cancer early, “when it is easier to treat and before it is big enough to feel or cause symptoms." Ms. Domife (“Mimi") Valdueza is Naval Hospital Twentynine Palms' Breast Health Coordinator. Ms. Valdueza earned her registered nursing degree in the Philippines and in the U.S. she earned her RN license, her public-health-nurse license and case-manager certification. Ms. Valdueza provided emailed responses to the following questions: What is your best advice for a woman regarding breast health? Stay healthy by maintaining a balanced diet with plenty of green, leafy vegetables; limit your amount of drinking (alcohol); be physically active; quit smoking and get routine breast screening (breast self-exams, clinical breast exams and mammograms). Women should also be aware of the symptoms of breast cancer and breast cancer risks. How does a woman's age affect how she should approach breast health? Most breast cancers are found in women who are age 50 and older. As we age, women's breast cells are constantly changing and growing, mainly due to the activity of female hormones. Although, young women can also be at increased risk for breast cancer. High-risk patients should ask their primary-care provider if they can start early mammograms before age 40. In general, woman should start screening with mammograms at age 40 and older. What are the consequences of ignoring breast health? A woman may not know she has breast cancer until it's in the late stage. If breast cancer is found at a late stage, it may be too late for effective treatment. Then it will be fatal. It's better to detect breast cancer at an early stage, it's easier to treat and they will have a good chance at a full recovery. Why should a woman not solely rely on self-exams? Some cancers may not be found by doing breast self-exams but could be found through mammography imaging or during clinical breast exams. According to the CDC, about 255,000 women in the U.S. get breast cancer annually and 42,000 women die from the disease. DVIDS External Link

    USAFRICOM

    COVID-19's threat to wild mountain gorillas: Study

    21 October- A COVID-19 outbreak among wild mountain gorillas in the Volcanoes National Park, Rwanda, could lead to the collapse of the population, according to a modelling study published in Scientific Reports. SARS-CoV-2 infections have previously been identified among captive western lowland gorillas, however, the potential risk that COVID-19 poses to wild apes, including endangered mountain gorillas, has been unclear. Fernando Colchero and colleagues simulated the probability that a COVID-19 outbreak in a population of mountain gorillas living in Volcanoes National Park could lead to the collapse of this population. Using data gathered between 1967-2018 on 396 gorillas by the Dian Fossey Gorilla Fund, the authors took into consideration yearly variations in the size and structure of this population. They also accounted for epidemiological factors that influence COVID-19 disease dynamics in humans, including the number of individuals that contract the disease from an infected individual (R0); the probability of death after infection; the probability of developing immunity; and immunity duration. The authors ran 2,000 simulations in which the size and structure of the population in the park varied at different rates and found that, under similar epidemiological conditions to those reported in human outbreaks, 71% of these simulated populations would collapse within 50 years. However, the authors suggest that mortality may be higher among gorillas than humans, owing to the lower availability of treatments for gorillas. When this was accounted for in the model, the proportion of the 2,000 simulated populations in the park that would collapse within 50 years increased to 80%. While the average Rof COVID-19 in humans has previously been found to be approximately 2.5, the authors found that when the R0 among gorillas was at least 1.05, the probability of population collapse increased. This demonstrates the importance of limiting SARS-CoV-2 transmission within the population. The authors note that the tendency of gorilla groups to naturally socially distance from each other likely decreases the risk of SARS-CoV-2 transmission. However, this population has grown in recent years, leading to higher rates of intergroup encounters and potentially increasing the opportunity for disease transmission. Outbreak News Today External Link

    USCENTCOM

    Israel: AY4.2 Delta variant detected

    20 October- The Israel Ministry of Health reported Tuesday the AY4.2, previously detected in several European destinations, variant was detected in Israel. The patient in question is an 11-year-old boy who was detected already upon arrival in Ben Gurion International Airport, ordered to go into isolation and currently there are no additional confirmed contacts. Investigation is underway. The Ministry of Health regularly monitors variants of concern of all types and their development. Scientists said AY4.2 carries two characteristic mutations in the spike, Y145H and A222V, both of which have been found in various other coronavirus lineages since the beginning of the pandemic. The first strains carrying both mutations were sequenced in April 2020. AY4.2 is rare outside the UK. Outbreak News Today External Link

    USEUCOM

    Sweden continues recommending Pfizer vaccine to anyone born in 1991 or later

    24 October- In a follow-up on a post from earlier this month, the Swedish Public Health Agency has decided to continue to recommend Pfizer / Biontech's COVID-19 vaccine, Comirnaty, to anyone born in 1991 or later. On 6 October 2021, the Swedish Public Health Agency decided to recommend a break for vaccinations with Moderna's vaccine Spikevax among people born in 1991 and later. The decision was valid until 1 December. The Swedish Public Health Agency has now decided that the recommendation will continue to apply, for example even after 1 December. People born in 1991 and later are recommended to receive Comirnaty as protection against covid-19. This applies to both those who have not previously been vaccinated against covid-19, and those who have received Spikevax as the first dose. Outbreak News Today External Link

    USINDOPACOM

    Vietnam averaged 3500 COVID-19 cases daily in past seven days

    24 October- The Vietnam Ministry of Health reported 4,045 COVID-19 cases in 47 provinces and cities Sunday, with 966 in Ho Chi Minh City. Over the last seven days, health officials report an average of 3,544 cases/day. Since the beginning of the epidemic, Vietnam has recorded a cumulative total of 888,940 infections, of which 884,177 cases were recorded since April 27 this year. 53 death were reported today, bringing the total death tally to 21,673. During the past seven days, Vietnam has averaged 68 per day. On October 23, 936,739 doses of COVID-19  vaccine were injected. Thus, the total number of doses of vaccine injected is 72,929,311 doses, of which the 1st dose is 51,883,474 doses, the 2nd dose is 21,045,837 doses. Outbreak News Today External Link

    USNORTHCOM

    U.S.: Florida- Reports 9th Vibrio vulnificus death of 2021, latest from Levy County

    23 October- Florida state health officials reported one additional case/death due to Vibrio vulnificus, according to data published October 22. The latest case/death is reported from Levy County in north-central Florida on the Gulf Coast. This brings the state's death total to nine this year–Manatee (2), Duval, Escambia, Lee, Leon, Levy, Orange and Polk counties. It is also the 31st case through Oct. 22–Brevard, Charlotte, Clay, Duval, Escambia (3), Franklin, Hernando, Hillsborough (2), Lee (5), Leon, Levy, Manatee (2), Orange, Palm Beach, Polk (3), Santa Rosa (2), Seminole, Taylor and Volusia (2). Vibrio vulnificus can cause disease in those who eat contaminated seafood or have an open wound that is exposed to warm seawater containing the bacteria. Ingestion of Vibrio vulnificus can cause vomiting, diarrhea and abdominal pain. Vibrio vulnificus can also cause an infection of the skin when open wounds are exposed to warm seawater; these infections may lead to skin breakdown and ulcers. Healthy individuals typically develop a mild disease; however, Vibrio vulnificus infections can be a serious concern for people who have weakened immune systems, particularly those with chronic liver disease. Outbreak News Today External Link

    USSOUTHCOM

    Costa Rica: COVID-19 vaccination opens for minors between 12 and 17 years Monday

    24 October- The Costa Rica Ministry of Health said as of Monday, October 25, vaccination against COVID-19 will be opened for minors between 12 and 17 years old, throughout the country, as part of the national vaccination strategy. “Excellent news for our adolescent population, as well as for their mothers, fathers and guardians who we know are eager to have access to vaccines that protect them against COVID-19," said the Minister of Health, Dr. Daniel Salas Peraza. “The availability of vaccines allows us to start with this group and brings us closer to protecting the entire vaccinable target population. We have seen the enthusiasm of the youth and their parents for receiving the vaccine and this is great news for everyone, "said Dr. Mario Ruiz Cubillo, medical manager of the Costa Rican Social Security Fund (CCSS). Dr. Diana Paniagua Hidalgo, epidemiological surveillance of the CCSS, explained that in order to be vaccinated, young people must be accompanied by an adult and present their identification document. Paniagua noted that the first and second doses of the vaccine should be administered in the same place, but that if necessary they could change the place of vaccination if previously coordinated with the health area and according to the availability of vaccines. Outbreak News Today External Link