Army Public Health Weekly Update, 30 September 2022

Date Published: 9/30/2022
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​​​​​​​​​​​​​NOTICE: There will be a pause in publication of the Army Public Health Weekly Update after this week. Publication will resume on 04 November 2022.  We appreciate your patience and understanding. 

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 Defense Health Agency opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the Defense Health Agency.

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Table of Contents

    ​ANNOUNCEMENTS

    CDC says some nursing homes and hospitals no longer need to require universal masking​​

    23 September- Outside of communities seeing "high" levels of COVID-19 transmission, the Centers for Disease Control and Prevention has ended a blanket plea for Americans in hospitals and nursing homes to wear masks indoors. The change, one of many published Friday evening to the agency's guidance for COVID-19 infection control for healthcare workers, marks one of the final sets of revisions in a sweeping effort launched in August to overhaul the CDC's recommendations for the virus. Since early in the pandemic, the agency had urged "everyone" to wear "source control" like well-fitting masks or respirators while in healthcare settings. Now, the CDC says facilities in just over a quarter of counties can "choose not to require" all doctors, patients, and visitors to mask. "Updates were made to reflect the high levels of vaccine-and infection-induced immunity and the availability of effective treatments and prevention tools," the CDC's new guidance says. Originally, the agency made only a narrow set of exceptions for not masking indoors. For example, Americans visiting patients could "choose not to wear source control" if they were all up to date on their vaccines when alone together in a room.  Doctors and nurses who were up to date on their shots could take off their masks when in parts of their hospital not seeing patients, like in a kitchen or staff meeting room.  Instead, after Friday's revisions, the agency now has exceptions for where masking "remains recommended." These include situations like during an outbreak among patients, or "when caring for patients who are moderately to severely immunocompromised." Holly Harmon, a senior vice president for the American Health Care Association and the National Center for Assisted Living, celebrated the decision in a statement. CBS News External Link​​

    ​​U.S. MILITARY

    181st airmen incorporate medical capabilities with search and extraction​​​

    28 September- Medics from the 181st Medical Group packed up their equipment and rolled out to support the 19th Chemical, Biological, Radiological, Nuclear, and high-yield Explosives Enhanced Response Force Package, known as a CERFP, during a pre-external evaluation sustainment year collective training event at Camp Atterbury Joint Maneuver Training Center, Aug. 7-12 by bringing medical capabilities to the search and extraction element. The team of medics from the 181st Intelligence Wing participated in the 19th CERFP SYCTE, embedding medics within search and extraction teams. The medics offer specialized training and capabilities, providing time-critical, lifesaving assistance during the initial search and extraction phase of disaster events on-site. “We have a lot of specialized training, specifically to respond to natural disasters, terrorist events and things of that nature, so it gives us a unique skillset that exists outside of the civilian sector, to include [a] CBRNE environment,” said Air Force Senior Master Sgt. Cody Eslick, a Terre Haute native who serves as the senior medic in the 19th CERFP. “That's what makes our unit special. We can operate in that environment and save lives.” Search and extraction teams are operated by Army National Guard units and are qualified in specialized rescuer skill sets such as training in rope rescue to include lifting and loading, confined space operations and structural collapse techniques. The Air National Guard brings medical capabilities to the teams, embedding medics who train in the same rescuer skills while being qualified to provide life-saving medical treatments on site. “In this specific cell, we operate a search and extraction team that integrates with Army fire teams from anything from high-angle ropes rescue to breaching, breaking, search and extraction, and recon missions,” said Eslick. “We have medics that integrate with each Army fire team. They take care of not only patients but also their Army counterparts. "Aside from their proficiency in their medical and rescue skills, search and extraction medics are expected to be proficient even when working long hours in full hazardous materials suits and masks. DVIDS External Link

    COVID Bivalent Booster Available at Naval Hospital Bremerton​

    28 September- Naval Hospital Bremerton is offering the COVID-19 bivalent booster vaccine for all eligible beneficiaries. This vaccine will be available Monday, Wednesday and Friday in NHB's Immunization Clinic, by appointment only: https://informatics-stage.health.mil/BremertonCOVIDApp/COVID.aspx “The new COVID bivalent boosters from Pfizer and Moderna are formulated to boost your immunity against all prior COVID variants as well as the currently circulating Omicron variants, including the latest BA.4 and BA.5 variants,” explained Cmdr. Brian Legendre, Preventive Medicine officer and department head. “Like all prior vaccinations, they should greatly reduce your risk of hospitalization and death from a COVID infection, and these new formulations may reduce your chances of getting sick at all with the Omicron variants.” According to Legendre, people eligible for the booster include those who have completed a primary series of a COVID vaccine - one to three doses depending on the recipient and the vaccine type – or who have received one or more booster doses after completing their primary series. “As long as there have been at least two months since their last dose of COVID vaccine [primary series or booster], the bivalent booster vaccine can be given. The Pfizer bivalent booster is emergency use authorization approved for people ages 12 and up. The Moderna bivalent booster is EUA approved for people ages 18 and up,” noted Legendre, adding that the COVID bivalent booster may be given at the same time as other vaccines, including seasonal influenza vaccine. For those scheduling to receive the COVID booster, it is recommended to bring the COVID-19 Vaccination Record Card to annotate accordingly. According to recent complied data from Kitsap County Public Health, there were 243 reported COVID cases and five deaths in the week ending September 25, 2022, an increase from 179 cases the previous week. There have been 48,752 cases and 389 deaths since the onset of the pandemic. In neighboring Mason County, there were 61 cases and two deaths last week with a reported 14,677 and 162 deaths overall. Additionally, for those who have recently received the JYNNEOS vaccine for monkeypox, it is recommended to wait four weeks between receiving that vaccine and a COVID bivalent booster dose. DVIDS External Link​​​​

    Cutting-Edge Science Featured at Military Health System Research Symposium​​

    15 September- The 2022 Military Health System Research Symposium DVIDS Video, held in Kissimmee, Fla., opened this week after a two-year pandemic hiatus. The audience was enthusiastic as MHS leaders shared their opening remarks. Under the theme, “Optimizing Readiness: The Power of Military Medical Research,” MHSRS showcases advances in military medicine, with sessions discussing new and lifesaving solutions to those on the battlefield, as well as enhancing care for warfighters and their families at home. The conference takes place September 12 through 15.

    Those providing opening remarks at MHSRS included:

    - Ms. Seileen Mullen, acting assistant secretary of defense for health affairs

    - Dr. Terry Rauch, acting deputy assistant secretary of defense for health readiness, policy and oversight

    - Dr. Jonathan Woodson, president of the Uniformed Services University of the Health Sciences

    - Army Lt. Gen. (Dr.) Ron Place, director of the Defense Health Agency

    - Army Brig. Gen. Katherine Simonson, DHA acting assistant director for support

    Mullen discussed the different MHS research portfolios and innovations. “What we learn and share here, benefits all of our citizens in countless ways. I also ask you to keep in mind how the research you are doing to support the warfighter also supports our whole of government research agenda,” she remarked. Woodson followed her statement, saying, “Education, leveraging digital learning platforms or immersive VR, assists in research, as the Department of Defense cannot do it alone. We have to learn to leverage the future of the battle space.” Research presented during MHSRS explores a wide range of topics surrounding military medicine and warfighter care. Panel discussions addressed issues such as combat casualty care, clinical and rehabilitative medicine, medical simulation, operational medicine, infectious diseases, and warfighter performance. As the DOD evaluates the recent battlefields, and prepares for upcoming conflicts, “… science and technology need to empower the medics, giving them as much experience and training as possible, while addressing new challenges in combat casualties,” Rauch stated. Health.mil External Link​​

    GLOBAL

    Cancer-killing virus shows promise in patients​

    23 September- A new type of cancer therapy that uses a common virus to infect and destroy harmful cells is showing big promise in early human trials, say UK scientists. One patient's cancer vanished, while others saw their tumors shrink. The drug is a weakened form of the cold sore virus - herpes simplex - that has been modified to kill tumors. Larger and longer studies will be needed, but experts say the injection might ultimately offer a lifeline to more people with advanced cancers. Krzysztof Wojkowski, a 39-year-old builder from west London, is one of the patients who took part in the ongoing phase one safety trial, run by the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust. He was diagnosed in 2017 with cancer of the salivary glands, near the mouth. Despite surgery and other treatments at the time, his cancer continued to grow. "I was told there was no options left for me and I was receiving end-of-life care. It was devastating, so it was incredible to be given the chance to join the trial." A short course of the virus therapy - which is a specially modified version of the herpes virus which normally causes cold sores - appears to have cleared his cancer. "I had injections every two weeks for five weeks which completely eradicated my cancer. I've been cancer-free for two years now." The injections, given directly into the tumor, attacks cancer in two ways - by invading the cancerous cells and making them burst, and by activating the immune system. About 40 patients have tried the treatment as part of the trial. Some were given the virus injection, called RP2, on its own. Others also received another cancer drug - called nivolumab - as well.​ BBC News External Link

    Emergent BioSolutions Buys FDA-Approved Smallpox Oral Antiviral​​

    ​​27 September- Maryland-based Emergent BioSolutions Inc. announced yesterday that it had completed its acquisition of exclusive worldwide rights to TEMBEXA® (brincidofovir) from Chimerix. This oral antiviral was approved by the U.S. FDA in 2021 for all age groups to treat smallpox caused by the variola virus. The effectiveness of TEMBEXA for treating smallpox disease has not been determined in humans because adequate and well-controlled field trials have not been feasible, and inducing smallpox disease in humans to study the drug’s efficacy is not ethical. Furthermore, TEMBEXA is not indicated for treating diseases other than human smallpox. Despite the successful eradication of smallpox in the 1970s, there is considerable concern that the variola virus could reappear. According to the U.S. Centers for Disease Control and Prevention, the variola virus is ranked in Category A due to its ease of transmission and high mortality rate. “The addition of TEMBEXA to our smallpox medical countermeasure franchise, which consists of our smallpox vaccine and therapeutic for smallpox vaccine complications, creates a more comprehensive offering to combat this deadly public health threat,” said Paul Williams, SVP government/MCM business at Emergent, in a press release issued on September 26, 2022.​​ Precision Vaccinations External Link​​

    Hurricane Ian weather tips: How to keep your pet safe during a storm​​

    27 September- Hurricane Ian made landfall in Venice, Fla., as a category 3 hurricane. With hurricane season here and preparations for this latest storm already well underway, keeping pets safe is a topic of concern for many Americans right now. Freshpet veterinarian Dr. Aziza Glass joined FOX Weather’s Nick Kosir and Marissa Torres to explain how to make sure a pet is kept safe this hurricane season. Dr. Glass recommended preparing for the worst.  "Make sure [you] have your emergency kit ready to go," she told the FOX Weather team. She's referring to "all the different things you might need if you have to get out quickly." That could include a pet’s medical records, leashes, water bottles and even an emergency bowl for food, Glass said. Speaking of pet food, Glass said many owners will forget to bring food for their dogs, cats or other pets in the chaos of trying to pack and evacuate the home.​ Fox News External Link

    Monkeypox Vaccine Availability Exceeds Demand​​

    27 September- According to the latest monkeypox vaccine availability and administration data published by the U.S. CDC, the months-long imbalance between supply and demand may have turned positive. As of September 26, 2022, the U.S. HHS's Administration for Strategic Preparedness and Response reported that 833,193 Jynneos® vaccines had been shipped since May 2022. And the CDC recently confirmed that 684,980 doses had been administered in the 48 reporting U.S. Jurisdictions. Even the monkeypox virus (MPVX) hot-spot of New York City is opening up second Jynneos vaccination appointment on a 'walk-up' basis. This good news is matched with a slowing down of new MPVX cases confirmed by the CDC. On September 26, 2022, the CDC reported 25,162 cases this year. Moreover, a new non-peer-reviewed study published in Israel indicates that the Jynneos vaccination can be effective in people.​ On September 23, 2022, Clalit Health Services researchers evaluated real-life vaccine effectiveness (VE) after providing one vaccine dose to individuals at risk of MPVX infection. A total of 1,970 subjects met the study eligibility criteria (0.04% of CHS members). Of them, 44% were vaccinated with Jynneos and completed at least 25 days of follow-up. These researchers found the VE was estimated at 79%, but with an extensive confidence interval (24%-94%). The two-dose Bavarian Nordic Jynneos (MVA-BN, IMVANEX®, IMVAMUNE®) vaccine was approved by the U.S. FDA on September 24, 2019. Precision Vaccinations External Link​​

    On National Concussion Awareness Day, Learn the Truth about TBI​​

    16 September- Some service members might call a hard hit to the head having your bell rung, getting knocked out, or seeing stars. Your doctor calls it something else: a traumatic brain injury. National Concussion Day is Sept. 16, bringing awareness to TBIs, signs and symptoms, the impact to the military community, and how to get help. A TBI is the disruption of normal brain function caused by a jolt or blow to the head, and the military population is especially susceptible. Nearly 459,000 service members worldwide were diagnosed with a first-time TBI from 2000 through the first quarter of 2022, according to the Traumatic Brain Injury Center of Excellence, which tracks multiple TBI-related data points for the Department of Defense. Concussion—also known as mild TBI—accounts for over 80% of these injuries, making it by far the most common type of active-duty TBI.  A diagnosis of TBI requires a medical exam. With a population that has volunteered to put their lives on the line to protect and defend, it may be tempting to prioritize the mission over medicine, downplaying or ignoring any symptoms.  Retired Marine Corps Capt. William Greeson, who was treated for brain injury at the end of a long military career, says this attitude is especially true for what he calls “military alphas.” “[Their attitude is] ‘I’m going to go out front, I’m going to lead, I’m going to get it done, and we'll talk about this later,’” he said. “And then later never comes.” The team at TBICoE believes that later should come sooner. In addition to researching TBI in service members and veterans, TBICoE provides training in the condition’s diagnosis, prevention, and treatment. Regional education coordinators, who are embedded in TBI rehabilitation and research facilities across the DOD and the Department of Veterans Affairs, offer educational programs for military medical providers, service members, veterans, families, and caregivers. On National Concussion Awareness Day, there’s no better time to test your knowledge about the most common type of TBI. Can you separate fact from fiction in the following statements? ​Health.mil External Link

    Pfizer, Moderna seek authorization for updated Covid-19 boosters for younger children​

    26 September- Younger children could soon be eligible to receive an updated Covid-19 booster shot. Pfizer and BioNTech on Monday said they completed their submission to the US Food and Drug Administration for emergency use authorization of their updated Covid-19 booster for children ages 5 through 11. Moderna on Friday said it had requested FDA authorization for its updated booster for adolescents ages 12 to 17 and for children ages 6 to 11.Like the boosters that became available for older people earlier this month, these bivalent boosters target the original coronavirus strain as well as the Omicron BA.4/BA.5 subvariants. Pfizer’s updated booster is currently authorized for use in people 12 and older and Moderna’s is authorized for adults age 18 and older. Pfizer said on Monday it has initiated a Phase 1/2/3 study of the safety, tolerability and immunogenicity of the vaccine in people ages 6 month to 11-year-olds has also been initiated. Moderna tweeted that its authorization application for an updated booster for children ages 6 months through 5 years is expected later this year. Currently, people too young to receive an updated booster can still be boosted with earlier versions of the Covid-19 vaccines. CNN External Link

    ​​What is rainbow fentanyl? Colorful pills drive new warnings about deadliest drug in the US​​

    25 September-  A new wave of concern has spread across the United States over multi-colored “rainbow fentanyl” pills, powders and blocks – that look similar to candy or sidewalk chalk – being sold and used in several states, and potentially posing a threat to young people. But parents of young children should not overly panic, and the emergence of this new product is one small part of the larger ongoing opioid crisis. Rainbow fentanyl comes in bright colors and can be used in the form of pills or powder that contain illicit fentanyl, a powerful synthetic opioid, making them extremely addictive and potentially deadly if someone overdoses while trying to achieve a high off of the drugs.​ This multi-colored fentanyl may a​​peal to young people or fool them into thinking it’s safe, but experts say illicit fentanyl has been hiding in what appears to be other products for a long time, and fentanyl is fentanyl – it’s all dangerous, rainbow or not. “Colored fentanyl pills have been around for a few years. Typically, they’ve been blue pills labeled ‘M30’ to counterfeit oxycodone, which is a much weaker opioid,” Joseph Palamar, an associate professor in the Department of Population Health at NYU Langone Health, who has studied trends in illicit fentanyl, said in an email to CNN. “I think the big difference people are concerned about is with regard to accidental ingestion. People are worried that their kids will take one of these pills thinking they’re another drug or even thinking they’re some sort of candy,” Palamar said. “I don’t think the color of the pills greatly increases danger to people who don’t use fentanyl, but there is always a possibility of someone who uses fentanyl leaving their pills around in the reach of children.”​ CN​N External Link

    Why experts are telling parents to be cautious about giving melatonin to children to help them sleep​​

    27 September- If your child is having trouble sleeping, it might be tempting to reach for “natural” melatonin supplements at the drug store. But parents may want to think twice before giving melatonin to young children and seek a physician’s opinion first, according to a new health advisory from the American Academy of Sleep Medicine (AASM). Melatonin, a hormone that’s produced naturally in the brain and helps regulate sleep, is the second-most popular supplement that parents give their children after multivitamins. AASM officials say this poses potential harm given that melatonin is sold in the United States as a dietary supplement and therefore is not regulated by the Food and Drug Administration. The past decade has seen a sharp increase in melatonin-related calls to poison control centers in the United States, increasing 530 percent from 2012 to 2021, according to the Centers for Disease Control and Prevention Trusted Source (CDC). “The availability of melatonin as gummies or chewable tablets makes it more tempting to give to children and more likely for them to overdose,” Dr. M. Adeel Rishi, vice chair of the AASM Public Safety Committee, said in a press release. “Parents should talk directly with their child’s healthcare professional before giving their children melatonin products. Often, behavioral interventions other than medication are successful in addressing insomnia in children.” Health Line External Link​​

    INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    2021-2022 Influenza Season for Week 37, ending September 17, 2022:

    Public Health Laboratories- The results of tests performed by public health laboratories nationwide are summarized below.  Data from public health laboratories are used to monitor the proportion of circulating viruses that belong to each influenza subtype/lineage. Data from public health laboratories are used to monitor the proportion of circulating viruses that belong to each influenza subtype/lineage.  Viruses known to be associated with recent live attenuated influenza vaccine (LAIV) receipt or found upon further testing to be a vaccine virus are not included, as they are not circulating influenza viruses.

    Outpatient Respiratory Illn​ess 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 therefore capture respiratory illness visits due to infection with any pathogen that can present with similar symptoms, including influenza, SARS-CoV-2, and RSV. 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.​

    ​​Outpatient Respiratory Illness Visits- Nationwide during week 37, 2.0% of patient visits reported through ILINet were due to respiratory illness that included fever plus a cough or sore throat, also referred to as ILI. Multiple respiratory viruses are co-circulating, and the relative contribution of influenza virus infection to ILI varies by location. CDC External Link​​

    VETERINARY/FOOD SAFETY

    Keswick Creamery recalls cheeses because of potential Listeria contamination​​

    27 September- Keswick Creamery at Carrock Farms LLC of Newburg, PA, is recalling various raw and pasteurized cheese products because all products manufactured by the firm have the potential to be contaminated with Listeria monocytogenes. The recalled products were distributed to farm stores and farmers markets in Washington DC, Maryland, Virginia and Pennsylvania. The recall was initiated on Aug. 25 and is ongoing... Food contaminated with Listeria monocytogenes may not look or smell spoiled but can still cause serious and sometimes life-threatening infections. Anyone who has eaten any recalled products and developed symptoms of Listeria infection should seek medical treatment and tell their doctors about the possible Listeria exposure. Also, anyone who has eaten any of the recalled product should monitor themselves for symptoms during the coming weeks because it can take up to 70 days after exposure to Listeria for symptoms of listeriosis to develop. Food Safety News External Link

    Nearly 44 tons of meat products recalled after Listeria found in processing facility​

    ​​26 September- Behrmann Meat and Processing Inc., of Albers, IL, is recalling 87,382 pounds of various ready-to-eat (RTE) meat products that may be adulterated with Listeria monocytogenes, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) announced. The problem was discovered through product and environmental testing performed by FSIS and the establishment, which identified Listeria monocytogenes in the processing environment and in products produced by the establishment. FSIS is concerned that some product may be in consumers’ pantries, refrigerators or freezers. FSIS also expects there to be additional product labels added in the near future. These items were shipped to retail locations and wholesale distributors in Illinois, Kentucky and Missouri. The various RTE meat items were produced from July 7, 2022, to Sept. 9, 2022. 

    Recalled products:

    - The list of products and product codes for the RTE meat products that are subject to recall can be found here and includes all package sizes for all products with the affected lot codes.

    - Available labels for the RTE meat products can be found here.

    The products subject to recall bear establishment number “EST 20917” inside the USDA mark of inspection. As of the posting of this recall, there have been no confirmed reports of illness or adverse reactions due to consumption of these products. Consumers who have purchased these products are urged not to consume them. These products should be thrown away or returned to the place of purchase.​ Food Safety News External Link​​

    ​​​WELLNESS

    What you should know about sleep loss and inflammation, according to new study​​​

    27 September- Chronic sleep deprivation in a small group of healthy adults increased production of immune cells linked to inflammation while also altering the immune cells’ DNA, a new study found. “Not only were the number of immune cells elevated, but they may be wired and programmed in a different way at the end of the six weeks of sleep restriction,” said study coauthor Cameron McAlpine, an assistant professor of cardiology and neuroscience at the Icahn School of Medicine at Mount Sinai in New York City. “Together, these two factors could potentially predispose someone for diseases like cardiovascular disease.” A certain amount of immune system inflammation is necessary for the body to fight infections and heal wounds, but an overactive immune system can be harmful and raise the risk of autoimmune disorders and chronic disease, experts say. The study was published September 21 in the Journal of Experimental Medicine. “This work aligns with views in the field that sleep restriction can increase risk for type 2 diabetes and hypertension,” said Steven Malin, an associate professor in the department of kinesiology and health at Rutgers University in New Jersey. “Practically then, these findings support ideas to develop good sleep habits such that most of the time you are getting adequate sleep,” added Malin, who was not involved in the study.​ CNN External Link​​

    USAFRICOM

    Uganda's transplant revolution brings hope to thousands​​

    19 September- Uganda's parliament is scrutinizing a proposed law that would enable organ transplants to happen in the country for the first time, transforming the lives of thousands hoping for operations. Annita Twongyeirwe had pictured a different future for herself. But since being diagnosed with kidney failure three years ago, the 28-year-old is preoccupied either by having dialysis or thinking about the next session. "It has taken over my life," she says, looking defeated. During dialysis a machine essentially performs the kidneys' function and cleans the blood of waste products and excess fluids. Each session lasts about four hours and she has to go to hospital twice a week. In between sessions she spends most of her time at home - a relative's house - helping out with chores where she can, and keeping an eye on a WhatsApp group she created through which friends and well-wishers can donate money. "I was this ambitious girl. I wanted to go further with studies. I would probably be somebody's girlfriend or wife, so all that life is cut short. It took away all the dreams I had," she adds. A kidney transplant could bring them back. But an operation abroad, currently the only option, comes with a price tag of about $30,000 (£26,000) - and is out of reach of most. Hundreds of Ugandans, who like Ms. Twongyeirwe cannot afford this, live on dialysis for as long as possible. But even at the subsidised price of around $100 a week for the treatment and drugs, that is more than five times the average total income in Uganda and so is only an option for a small fraction of the population. BBC News External Link​​

    USCENTCOM

    Cholera deaths in Syria reach 29​​​

    26 September- A choler​a outbreak in several regions of Syria has killed 29 people, the Syrian health ministry said on Monday in what the U.N. has called the worst outbreak in the war-torn country for years. Rapid assessment testing confirmed 338 cases since the outbreak was first recorded last month, with the bulk of deaths and cases in the northern Aleppo province, the ministry said in a statement. It said 230 cases were in Aleppo province where 25 people were confirmed dead. The rest were spread across the country. The United Nations this month said the outbreak was believed be linked to irrigation of crops using contaminated water and people drinking unsafe water from the Euphrates river which bisects Syria from the north to the east.  The highly contagious disease has also spread to the country's Kurdish-held and opposition areas in north and northwestern Syria where millions have been displaced by the decade-old conflict, medical officials said. Suspected cholera cases have risen to 2,092 in the northeast of Syria since the outbreak was announced this month, said the U.S.-based International Rescue Committee (IRC) which operates in the northern region. It said there were fears about significant under-reporting of cases. Fox News External Link

    USEUCOM

    Europe's generic drugmakers may cut output due to surging energy bills​

    27 September- Europe's drug makers have warned they may stop making some cheap generic medicines because of surging electricity costs and are calling for an overhaul of the way they are priced, the latest industry to seek help as the energy crisis deepens. The generic drug industry lobby group Medicines for Europe, which represents companies including Teva (TEVA.TA), Novartis's (NOVN.S) Sandoz unit and Fresenius SE's (FREG.DE) Kabi business, on Tuesday sent an open letter to European Union member states' energy and health ministers ahead of their extraordinary EU Council meeting on Friday, calling for measures to ease the cost burden. The letter was also addressed to key European Commissioners. The recipients did not respond to requests for comment given the late hour. Electricity prices have risen ten-fold for some drug factories in Europe and raw material costs have risen by between 50% and 160%, according to the letter. Generics associations in member states are also petitioning national heath authorities for more flexibility on drug prices, said Medicines for Europe. "We may discontinue maybe three, maybe five products due to the direct and indirect impact of increasing energy costs," said Elisabeth Stampa, chief executive of Medichem SA, a generic drugs and pharmaceutical ingredients maker based near Barcelona, Spain. Reuters External Link​​

    USINDOPACOM 

    Vietnam: Mucormycosis cases at Hanoi hospital​​​

    26 September- Since the beginning of 2020, especially after the appearance of the COVID-19 wave, the number of patients with black fungus, or mucormycosis has increased rapidly. At Bach ​Mai Hospital in Hanoi, there have been more than 20 cases of black fungus hospitalized for treatment. Most of these patients had underlying disease on admission and in severe infection, there were fungal lesions that spread from the sinuses to the jawbone, eye sockets, nervous system, etc. According to doctors, black fungus is an invasive fungus that has been mentioned in the literature, especially in India in the recent period with a sudden increase in the number of patients, which is one of the causes of death after being infected with COVID-19. Zygomycosis, or mucormycosis, is an acute fungal infection from a number of genera of molds. Infections with these fungi typically cause disease that is rapidly progressive, destructive and associated with a high fatality rate of 50% of higher. It is most prevalent in those with a weakened immune system or other debilitating disease like diabetes. These fungi have an affinity for blood vessels, and cause thrombosis, infarction and tissue necrosis. It is not communicable from person-to-person.​ Outbreak News Today External Link​​

    USNORTHCOM

    U.S. ramps up search for undetected polio, as vaccinations stall in New York​​

    27 September- Health authorities in New York's Rockland County say they have seen the pace of their emergency polio vaccination effort stall in recent weeks, amid fierce opposition from anti-vaccine groups. The first U.S. polio case in over a decade was confirmed in the county in July, in a young man who wasn't vaccinated, and health officials said the illness left him paralyzed. The slowing immunization campaign comes as states around the country say they are preparing to expand the testing of wastewater to search for undetected cases. Authorities are concerned polio could now be spreading undetected more widely around the country, especially in communities with low vaccination rates. "We have a lot of infiltration of especially our insular community in Rockland by the anti-vaxxers, and we are now working to supersede them as best we can. It's going to be very, very difficult," Rockland County's chief medical officer Patricia Schnabel Ruppert said last week at a meeting of the federal National Vaccine Advisory Committee. CBS ​News External Link​​

    USSOUTHCOM

    Peru: Dengue cases nearly double 2021 numbers​

    25 September- The Peru Ministry of Health (Minsa) issued an epidemiological alert to public and private health facilities nationwide due to the increase in cases and occurrence of dengue outbreaks in the country. To date, 58,117 cases and 75 deaths have been reported. This compares to the 30,873 cases and 28 deaths reported during the same period in 2021. Health officials say the most affected regions include Piura, Loreto, San Martín, Junín, Cajamarca, Ucayali, Cusco, Amazonas, Huánuco and Madre de Dios. The transmitting mosquito Aedes aegypti is reported to be scattered in 22 regions, 94 provinces and 528 districts of the country. Piura and Madre de Dios have high cumulative incidence rates that reach 175 people affected for every 100,000 inhabitants. According to clinical form, 87.53% (50,870) of the cases correspond to dengue without warning signs, 12.14% (7,054) to dengue with warning signs, and 0.33% (193) to severe dengue. The national fatality rate is 0.13%. It should be noted that the persistence of dengue transmission is due to environmental, geographic, and social determinants, high population migrations to and from endemic sites, lack of drinking water, inadequate water storage, among other factors that constitute a risk. high for the presence of buds. In addition, dengue has presented a seasonal behavior that coincides with the rainy season in the Amazon regions and with the summer season on the coast of the country. In this way, the Minsa recommends that the population put into practice prevention measures such as washing and brushing the containers where water is stored, correctly covering the containers and allowing the entry of health personnel to apply larvicide​ in the water tanks and perform the fumigation.​ Outbreak News Today External Link​​