Army Public Health Weekly Update, 03 December 2021

Date Published: 12/3/2021
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 17 December 2021.

The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents

    ANNOUNCEMENTS

    Army Medicine's Immediate Response to Operation Allies Refuge

    24 November- The United States military's humanitarian and evacuation response at Hamid Karzai International Airport (HKIA) for Operation Allies Refuge, along with the tragic events of Aug. 26, remain etched in our minds. With the withdrawal from Afghanistan actively ongoing, a dynamic situation existed at HKIA, which required an adaptable and ready medical force. A contingent of joint and multi-national medical providers, with a mixture of more than a dozen 936th Forward Resuscitative Surgical Detachment (FRSD) Soldiers and Norwegian medical forces; later augmented with U.S. and Coalition Armed Forces Medical Services, moved to action. These providers, operating out of a role 2 Enhanced (R2E) Medical Treatment Facility (MTF), continually engaged and treated military and civilian patients from mid-August until the last elements of the 82nd Airborne Division departed on Aug. 30. R2E provides basic secondary healthcare, built around primary surgery, an intensive care unit, and ward beds with the MTF able to stabilize post-surgical cases for evacuation. These medical providers included junior and senior Soldiers comprising of combat medics, preventive medicine specialists, nurses, and physicians, who worked around the clock. They maintained security and staffed trauma and patient recovery teams. During this mission, they also assisted a British Surgeon in delivering a newborn baby. MTF personnel treated those in need of immediate medical care, and provided food, water, shelter, and sanitation. Their efforts ultimately prevented a public health crisis during the evacuation mission. In addition, the R2E MTF coordinated with the U.S. Department of State, coalition partners, and the United Nations Children's Fund (UNICEF) in efforts to care for vulnerable Afghans. “One of the first things that stood out to me was when the civilians initially rushed the airfield," said Maj. Katherine Sego, commander of the 936th FRSD and a 66T emergency room nurse. “We would look across the airfield and see a large wall of people. We didn't know what they were planning on doing." “It was chaotic," Sego said of the situation in mid-August, adding, “But eventually, everything settled down, including the constant day and night gunfire outside the gate, into a more normal routine." Part of this normal routine was lending a helping hand wherever needed. Col. Kenneth Nelson, an active duty 61M orthopedic surgeon attached to the 936th FRSD, was in the orphanage the morning of Aug. 26 and noticed the kids were bored with the potential of getting into trouble. “I have four boys, I know the warning signs and Afghan kids are not all that different," Nelson said. “I remembered all the games and puzzles we had in the USO, so I took a rickshaw with a gurney loaded it up with balls, games, and toiletries. Brought everything back to the orphanage building and gave it to the UNICEF people for the kids. It was a massive hit." DVIDSExternal Link

    U.S. MILITARY

    A Thanksgiving tradition resumes at MEDCoE

    26 November- Maj. Gen. Dennis P. LeMaster and Command Sgt. Maj. Clark J. Charpentier, the U.S. Army Medical Center of Excellence, or MEDCoE, Command Team, were all smiles as they had the pleasure of serving a special meal for Advanced Individual Training, or AIT, Soldiers. In what has become an Army tradition, senior leaders served Thanksgiving meals to Soldiers at the Joint Base San Antonio-Fort Sam Houston dining facilities, or DFAC, on Thanksgiving Day, November 25, 2021. Dozens of leaders and drill sergeants throughout MEDCoE joined LeMaster and Charpentier to take part in the tradition of serving their troops, making the DFACs feel like home. “I think it is important for Soldiers to know that they have leadership present, that leadership is involved and cares for them," LeMaster said between meals. “It sends a message: Hey, we want to be with you." LeMaster and Charpentier's spouses also helped serve. LeMaster said that being with Soldiers to kick off their own Thanksgiving has become a tradition for their Family: “Traudi and I have done this for a number of years, everywhere we have been stationed together, and we both look forward to this." JBSA DFACs are used to serving thousands of meals per day and instrumental in meeting mission readiness and lifting spirits, whether during the challenges of COVID-19 in the last couple years or over the Holidays. DFAC staff took special care to make Thanksgiving special for Soldiers by providing an impressive feast that consisted of healthy servings of turkey, ham, stuffing, potatoes, yams, macaroni and cheese, vegetables, yeast rolls and many cakes and pies. Over 1,400 MEDCoE trainees were served at Slagle DFAC and over 1,600 at Rocco DFAC. Staff also decorated the facilities with inviting seasonal displays, to include an ice sculpture. “This is our Super Bowl for the year," James Brooks, the Installation Food Service Manager at Fort Sam Houston, JBSA, said. “We go all out for the military members to make sure they get a good meal and feel at home." Charpentier said going to all of the extra effort for the meal is important for Soldiers. “For the majority of Soldiers, not only is this the first time they have been away from home," Charpentier explained, “for many of them, this is the first holiday that they had to be away from home." While Soldiers are committed to their training and understand the sacrifice of their service, for some it can be lonely being away. Pvt. Drew Burton of West Virginia said he was having a particularly hard time with the separation since he is in a more restrictive phase of his 68W Combat Medic training. He and his battle buddy, Spc. Matthew Burgess of Virginia, believe their spirits will be lifted once they get off-post privileges, expected as soon as this Saturday, for their AIT class assigned to Bravo Company, 232d Medical Training Battalion, 32d Medical Brigade. Burgess, who came to MEDCoE after attending college at James Madison University, said it is not his first time away from home; it is his first holiday away. “It is a little difficult," Burgess said. “But I am thankful for the things we can control and am grateful to be here." Though the 32d Medical Brigade is hosting dozens of Thanksgiving-themed events throughout the weekend, Burgess plans to spend his free time Face Timing with friends and Family, hanging out with his battle buddies, and venturing off base later this weekend when day passes are granted in the next phase of training. LeMaster agrees that some Soldiers have a harder time over the Holidays than others but believes unit cohesion and camaraderie can help to ease the hardship. “It's tough, but the Army becomes a Family unto itself," he said. Charpentier believes that accepting that this could be the first of many holidays spent with their units sharing a holiday meal during their time in service is important for the young Soldiers just entering a life of service. Army.milExternal Link

    How health care for new mothers is improving across the MHS

    24 November- For years the Military Health System has provided new mothers with high-quality care that consistently tops the civilian health care sector. Now, the MHS is working to further improve that safety record by standardizing prevention and treatment for one of the biggest health risks for new mothers: post-partum hemorrhaging. A rare, but serious condition that women can experience up to 12 weeks after childbirth, post-partum hemorrhaging, known as PPH, is the leading cause of preventable maternal deaths worldwide, said Air Force Col. Sheelah Walker, interim lead of the Defense Health Agency's Women's Health Clinical Management Team (WHCMT). "While prevention of PPH is not always possible, prompt assessment, recognition, and communication of maternal hemorrhage risk, as well as timely interventions according to risk level, can reduce maternal morbidity and mortality and improve outcomes," she said. The ongoing focus on maternal health care in the MHS has already pushed the rates of maternal and infant mortality down much lower than the United States overall, according to a 2019 report from the Office of the Secretary of Defense. The MHS rates in recent years were at 7.4 deaths per 100,000 live births, significantly lower than the 11.3 reported at non-MHS facilities nationally. To build on that performance, the MHS has put in place new treatment protocols following national guidelines for staff to provide standardized care. In January 2021, the DHA issued a procedural instruction (PI), establishing a set of standardized components to assist with postpartum hemorrhage clinical processes and resources that are aimed at improving maternal care. Since then, the WHCMT has led a campaign to improve the implementation of risk assessment and access to resources to speed up the treatment and prevention of maternal complications during a mother's entire journey of obstetrical care – meaning before, during, and after the birth of her baby. The campaign sought to implement the new guidelines and encourage staff compliance at 12 military hospitals in two initial waves. The process to decrease complications from postpartum hemorrhage is a world-wide initiative. MHS has been introducing the concepts and standards for the past two years. The teams used adopted measures to track the changes in clinical practice and established a baseline for outcome metrics – such as incidence of PPH, blood transfusions, intensive care unit admission, and hysterectomy associated with PPH. The goal is to track improvements on the short and long-term impact on maternal outcomes, Walker said. Health.milExternal Link

    Mental stress is like a 'check engine light' flashing–don't ignore it

    29 November- For one Air Force senior enlisted leader, the problem of “combat stress" and the toll it takes on warfighters – and often on their families, too – continues to be an issue that the military community struggles to fully understand. “Sometimes they don't feel right about only having mental injuries. They don't think it's a big deal, but it is," said Air Force Chief Master Sgt. Jason David, the chief enlisted manager for the Defense Media Activity. David spoke about his own journey of recovery through the Air Force Wounded Warrior Program during a video conversation with Defense Health Agency Command Sgt. Major Michael Gragg at Joint Base San Antonio-Randolph, Texas, Nov. 19. They were both attending Virtual CARE Week events as part of the DOD's Warrior Care Month observance. David was seriously wounded in Operation Iraqi Freedom and said he “had a hard time with recovery in general." He later was deployed to Afghanistan, and made use both times of mental health care services available to troops and veterans as part of his recovery. “I'm not ashamed to say that I've seen a psychiatrist. I'm not ashamed to say I've been to behavioral or mental health care," he told Gragg during their conversation during the Day of Healing events David also spoke about the continued societal stigmatization of wounded warriors. “Aside from the physical [injuries], the mental stress – they call it combat stress – that is a bizarre concept for folks that are not serving, who haven't served, or don't know anyone who has served in the armed forces," he said. The physical and mental recovery “takes a toll on yourself, your family, and your livelihood." And for those who have invisible wounds, the burden can even be bigger, David said. He used the analogy of an automobile engine warning light to help explain the effects that psychological injuries can have. “What happens when your check engine light turns on? Do you just ignore it until your engine stops or are you responsible because you're thinking about the longer game, you're thinking about the big picture?" “You don't know if it's going to be a dramatic chain of events that's going to ultimately hurt you in the long run." The priority placed on mental health and total force fitness reflects a generational change for many senior leaders, David said. “Leaders should include Warrior Care in their toolbox," David said. “You can't be the leader you grew up with today in 2021. You have to evolve" in your thoughts and actions about wounded warriors and warrior care. health.milExternal Link

    Summit focuses on research, treatments for lung cancer

    24 November- The John P. Murtha Cancer Center at Walter Reed National Military Medical Center hosted the 2021 Virtual Lung Cancer Summit Nov. 9. November is Lung Cancer Awareness Month, observed to educate the public about the disease, encourage action to increase research and treatment of lung cancer, and share stories concerning lung cancer survivors and their families. According to the Centers of Disease Control and Prevention (CDC), lung cancer is the leading cause of cancer deaths among both men and women in the United States. This year, approximately 250,000 people in the United States will be diagnosed with lung cancer, and about 130,000 people will die from the disease, according to retired Army Col. (Dr.) Craig Shriver, director of the Murtha Cancer Center. In addition, the CDC indicates “different people have different symptoms for lung cancer, and most people with lung cancer don't have symptoms until the cancer is advanced." This is why awareness of the disease is vital, and why the Murtha Cancer Center annually hosts its lung cancer summit. The John P. Murtha Cancer Center is named after the longest-serving member of the U.S. House of Representatives from Pennsylvania who was also the first Vietnam War veteran elected to the House and a champion for veteran causes including health care. Officials dedicated the center at WRNMMC on Dec. 3, 2012, it's the Department of Defense's only center of excellence for cancer care, Shriver stated. Its lung cancer summit also began in 2012 with a focus on providing researchers and clinicians an opportunity to find out the latest advances in the treatment of lung cancer, including early detection, advances in surgical techniques, molecular analysis, targeted therapies in development and treatment options including advanced radiation, endobronchial techniques and palliative therapy. Dr. Robert Browning, a retired Navy captain and medical director for interventional pulmonology (IP) at WRNMMC, discussed IP in lung cancer at this year's summit. Interventional pulmonology uses endoscopy and other tools to diagnose and treat conditions in the lungs and chest. Browning explained military medicine has ventured into a number of areas to gain a better understanding of lung cancer, including Detection of Early Lung Cancer Among Military Personnel (DECAMP), Genomics of Early Lung Cancer Among Military Personnel (GELCAMP), and Applied Proteogenomics Organizational Learning and Outcomes (APOLLO). The latter screens patients for genomic abnormalities and proteomic information to match their tumor types to targeted therapies. DVIDSExternal Link

    Survivors of Suicide Loss Day events share emotional trauma family, friends experience after loss

    24 November- Participants in a U.S. Army Sustainment Command-sponsored virtual candlelight vigil offered heart-wrenching stories and feelings of grief and guilt they experienced following the loss of a friend or family member to suicide. In observance of International Survivors of Suicide Loss Day on Nov. 20, ASC held two virtual candlelight vigils on Nov. 17 in hope of supporting those in the Army family who have been affected by the suicide of a loved one or teammate. The events were presented by Dr. Joy Summerlin, ASC G-1 (Human Resources) Health Wellness and Resiliency Program specialist and ASC Chaplain (Lt. Col.) Kevin Niehoff. Also taking part in both events was Robert Donohoo, program coordinator for the Rock Island Arsenal Employee Assistance Program. An invocation was given by Niehoff, followed by the survivors sharing their personal stories, lighting of candles in remembrance, and concluding with a moment of silence. International Survivors of Suicide Loss Day is an opportunity for those left behind to share their stories to support others who are suffering a loss. It is also a time to bring suicide prevention to the forefront, and to urge those with suicidal thoughts to get the medical and mental health assistance they need. Several participants offered emotional stories of experiencing grief and guilt following the loss of a friend or family member to suicide. Summerlin said it's not unusual for friends or loved ones of a suicide victim to feel a wide range of emotions. She also said it can be a crushing burden for those left behind. The holidays can be especially traumatic, said Donohoo, because “they are bombarded with television movies, commercials and community events that celebrate the joy of the holiday season, typically showing families gathering around a busy dining table eating a meal or sitting around the Christmas tree opening gifts. “For those who have lost a loved one to suicide," he said, “this focus on celebration and joy only reinforces that person is no longer present. And, for many, the holiday season is an annual reminder that their family is 'incomplete' after losing a loved one to suicide many years earlier." One of the common threads throughout the two sessions was people often don't realize that a friend or loved one is harboring suicidal thoughts. A person contemplating suicide often seems “normal" to those around them, and intentionally hides signs of their struggle. Army.milExternal Link

    Wounded Warriors and caregivers online resources

    29 November- There are a lot of places for Wounded Warriors and their caretakers to go online for information or support, including the website you are reading right now. Sometimes, it can be overwhelming or hard to navigate for even the most, well-versed of caregivers. The Defense Health Agency's Recovery Coordination Program ensures uniform guidelines and standards for the care of wounded, ill and injured service members throughout the military. The following is a list of resources provided by the program. Jonathan Morris, the DHA's project manager for the National Resource Directory, says the two websites the NRD uses most for sharing information with the community are NRD.gov and the Warrior Care blog.  But there's much more than just those two sites. In addition to the programs listed below, each military service branch has recovery care programs. They are staffed with nearly 800 recovery care coordinators and case managers who are responding to individual queries. “We respond to them with resources and benefits information no matter where they are, and we do it at the national, state and local levels," Morris said. Morris noted that the emails sent via the NRD site and the Warrior Care blog “are answered by real live people," and that even for those who have transitioned out of the military and may not be eligible for benefits through the Department of Veterans Affairs, the NRD folks do their best to help get them find civilian benefits and services. Morris said his team does its best to respond within 72 hours. “We actually do the homework," he said. “The only questions we usually ask ... is their military affiliation, if there is one, and their location, so that we can provide them the best responses within their local communities." The Warrior Care Recovery Coordination Program consists of several programs, including the NRD, the Education and Employment Initiative, Operation Warfighter, the Military Adaptive Sports Program, Caregiver Support, the Caregiver Resource Directory and the Warrior Care blog. Health.milExternal Link

    GLOBAL

    As Omicron variant cases spread, countries rush to impose travel bans

    29 November- Omicron, the newest coronavirus variant, is also the quickest to be labeled a "variant of concern" by the World Health Organization (WHO) because of its seemingly fast spread in South Africa and its many troubling mutations. The first sample of the Omicron or B.1.1.529 lineage was taken November 9, according to WHO. It got noticed because of a surge of cases in South Africa. "This new variant ... seems to spread very quick!" Tulio de Oliveira, director of South Africa's Center for Epidemic Response & Innovationand a genetics researcher at Stellenbosch University, said on Twitter. Also, genetic sequencing showed it carried a large number of troubling mutations on the spike protein -- the knoblike structure on the surface of the virus that it uses to grapple onto the cells it infects.

    - Some of those mutations were already recognized from other variants and were known to make them more dangerous, including one called E484K that can make the virus less recognizable to some antibodies -- immune system proteins that are a frontline defense against infection and that form the basis of monoclonal antibody treatments.

    - It also carries a mutation called N501Y, which gave both the Alpha and Gamma variants their increased transmissibility. Just last week, Scott Weaver of the University of Texas Medical Branch and colleagues reported in the journal Nature that this particular mutation made the virus better at replicating in the upper airway -- think in the nose and throat -- and likely makes it more likely to spread when people breathe, sneeze and cough.

    - Like Delta, Omicron also carries a mutation called D614G, which appears to help the virus better attach to the cells it infects.

    "The number of mutations per se does not mean that the new variant will cause any problems; although it may make it more likely to look different to the immune system," Dr. Peter English, former chair of the British Medical Association's Public Health Medicine Committee, said in a statement. What worries scientists is the number of mutations affecting the spike protein. That's because most of the leading vaccines target the spike protein. Vaccines made by Pfizer/BioNTech, Moderna, Johnson & Johnson, AstraZeneca and other companies all use just small pieces or genetic sequences of the virus and not whole virus, and all of them use bits of the spike protein to elicit immunity. So a change in the spike protein that made it less recognizable to immune system proteins and cells stimulated by a vaccine would be a problem. So far, there's no evidence this has happened but there is no way of knowing by looking at the mutations alone. Researchers will have to wait and see if more breakthrough infections are caused by Omicron than by other variants. CNNExternal Link

    BioNTech CEO says vaccine likely to protect against severe COVID from Omicron

    30 November- BioNTech and Pfizer's (PFE.N) established COVID-19 vaccine will likely offer strong protection against any severe disease from the new Omicron virus variant, BioNTech's Chief Executive told Reuters. Lab tests are underway over the next two weeks to analyse the blood of people who had two or three doses of BioNTech's (22UAy.DE) Comirnaty vaccine to see if antibodies found in that blood inactivate Omicron, potentially shedding light on whether new vaccines are needed. "We think it's likely that people will have substantial protection against severe disease caused by Omicron," said BioNTech CEO and co-founder Ugur Sahin. He specified severe disease as requiring hospital or intensive care. Sahin told Reuters he expects the lab tests to show some loss of vaccine protection against mild and moderate disease due to Omicron, but the extent of that loss was hard to predict. ReutersExternal Link

    COVID-19 Omicron Variant: How to protect yourself from being infected

    30 November- COVID-19 has a new mutation called the "Omicron" variant that was said to be worse than the Delta variant which was initially said to be the most infectious one present in the world. Now, health experts and world leaders are calling upon protecting one's self against this mutation as it can infect people immediately, far more notorious than in previous cases. The World Health Organization (WHO) has released a new technical brief that addresses the global community of the many risks and infections that the Omicron variant brings to the public. The organization said that global infection risk is high, something that somehow orders to slow down the reopening of many industries like traveling or leisure activities.  According to NPR, some warnings say countries which have low vaccination rates are more likely to succumb to the Omicron variant, something that provides a risk for all who will get infected by it. Moreover, this affects the many problems of the country that are anti-maskers and anti-vaxxers, something that would contribute to the spread of the virus.  With that, here are old guidelines that would protect people against COVID-19 which are still the recommended safety precaution to be used now. Tech TimesExternal Link

    Covid omicron variant poses 'very high' global risk and is likely to spread, WHO warns

    29 November- The Covid omicron variant is likely to spread further and poses a “very high" global risk, according to the World Health Organization. It warned Monday that surges of Covid infections caused by the variant of concern could have “severe consequences" for some areas. The WHO issued a technical brief to its 194 member states on Monday. The omicron variant of the coronavirus is likely to spread further and poses a “very high" global risk, according to the World Health Organization, which warned Monday that surges of Covid infections caused by the variant of concern could have “severe consequences" for some areas. “Given mutations that may confer immune escape potential and possibly transmissibility advantage, the likelihood of potential further spread of Omicron at the global level is high," the WHO said in its risk assessment on Monday within a technical brief to its 194 member states. “Depending on these characteristics, there could be future surges of Covid-19, which could have severe consequences, depending on a number of factors including where surges may take place. The overall global risk related to the new VOC [variant of concern] Omicron is assessed as very high," the U.N. health agency said. CNBCExternal Link

    Pfizer to apply for COVID-19 booster approval for 16- and 17-year-olds: report

    29 November- Pfizer and BioNTech are reportedly set to seek approval for booster shots of their COVID-19 vaccine for 16- and 17-year-olds. People familiar with the company's plans told The Washington Post that the Food and Drug Administration is expected to approve the company's request for the additional shots quickly.  Currently, Americans ages 18 and older are eligible for booster shots six months after their second doses of the Pfizer or Moderna vaccine or two months after the single dose of the Johnson & Johnson vaccine. The possible expansion of booster eligibility comes as concerns surrounding the new omicron variant mount. On Monday, President Biden said omicron "is a cause for concern, not a cause for panic" and that lockdowns to address it are not needed. “On Thursday, I'll be putting forward a detailed strategy outlining how we're going to fight COVID this winter, not with shutdowns or lockdowns but with more widespread vaccinations, boosters, testing and more," Biden said. The HillExternal Link

    INFLUENZA

    Increasing seasonal influenza A (H3N2) activity: CDC health advisory

    28 November- The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory about increased influenza A(H3N2) activity that could mark the beginning of the 2021-2022 influenza season. Recent increases in influenza activity in many places in the United States could mark the beginning of the 2021-2022 influenza season in the United States. While influenza activity is still low overall nationally, an increase of influenza A(H3N2) viruses has been detected in recent weeks, with most of these infections occurring in young adults. CDC also is aware of influenza outbreaks in colleges and universities in several states. Influenza vaccination coverage is still low and there is still time this season to benefit from getting an annual influenza vaccine. The influenza A(H3N2) component of this season's vaccines was recently updated in response to the evolution of a new group of viruses called 2a (i.e., 3C.2a1b.2a) that did not circulate widely last year and were not included in last season's H3N2 vaccine component. Most H3N2 viruses that have been analyzed in the United States so far are genetically closely related to the current vaccine's H3N2 component. CDC recommends that healthcare providers continue to recommend and offer influenza vaccination to persons aged six months and older because influenza activity is ongoing. Vaccination protects against four different viruses and is likely to reduce hospitalization and death associated with currently circulating influenza viruses and other influenza viruses that might circulate later in the season. Outbreak News TodayExternal Link

    VETERINARY/FOOD SAFETY

    Conagra recalls Birds Eye tots because of consumer complaints of injuries

    26 November- Reports of injuries have led Conagra Brands to recall certain lots of frozen Birds Eye broccoli tots because of small rocks and metal fragments in the product. “Conagra has received two reports to date of injury — dental damage — associated with the recalled product," according to the company recall notice posted by the Food and Drug Administration. “Conagra Brands was made aware of this issue through calls from consumers." Conagra did not report where the product was distributed or what states consumers who reported injuries live in. The 12-ounce bags of frozen, breaded broccoli tots have best-by dates through November 2022 so there is concern that consumers may still have the product in their home freezers. Consumers can use the following information to determine whether they have the broccoli tots on hand. Food Safety NewsExternal Link

    Concerns about cyanide poisoning prompt recall of apricot kernels

    27 November- Sungiven Foods Canada Inc. is recalling One Tang brand bitter apricot kernels from the marketplace because of the natural toxin amygdalin, which can cause cyanide poisoning. The recalled product has been sold in British Columbia. The problem was found when the Canadian Food Inspection Agency tested the product. There is concern that consumers may have the product in their homes because of its long shelf life. Consumers can use the following information to help them determine whether they have the recalled kernels on hand...Apricot kernels naturally contain amygdalin, which can release cyanide after being eaten. The human body can eliminate small amounts of cyanide, but larger amounts — such as those when the kernels are eaten as snacks —  can result in cyanide poisoning, which could lead to death. Symptoms of cyanide poisoning include weakness and confusion, anxiety, restlessness, headache, nausea, difficulty breathing and shortness of breath, loss of consciousness, seizures and cardiac arrest. As of the posting of the recall Friday there had been no reported illnesses associated with the this product. The CFIA is conducting a food safety investigation, which may lead to the recall of other products. If other high-risk products are recalled, the CFIA will notify the public through updated food recall warnings. The CFIA is verifying that industry is removing the recalled product from the marketplace. Food Safety NewsExternal Link

    WELLNESS

    Digital multitasking can be detrimental to a child's mental health, study warns

    28 November- Children face a deluge of electronic information from traditional television and computers to tablets, smartphones and video games, but prior studies examining the impact of electronic media on children and adults have yield mixed results. The team of researchers from the University of Luxembourg and University´ de Genève studied 118 Swiss boys and girls, ranging from age eight to 12, asking them to fill out surveys with questions crafted to examine their electronic media use as well as their attention spans, sleep, grades, and mental health, according to the report. The questionnaires were also given to the children's teachers and parents, but focused more their perception of how they felt the children's electronic use impacted their mental health, the study noted. Unlike other previous published studies which showed a correlation between total time spent on media and poorer outcomes, when this study controlled for other types of media consumption, they found total time spent on media did not contribute to mental health problems, but rather when the children used multiple devices simultaneously, like watching television while texting, this could lead to more stress, behavioral, or emotional issues. "In contrast to total media time, media multitasking is associated with more frequent ADHD-like behavior as rated by their teachers, when controlling for total media time, gender, and age," the paper noted. Fox NewsExternal Link

    Sudden Infant Death Syndrome: How to keep babies safe while sleeping

    https://www.health.mil/-/media/Images/MHS/Photos/SIDS-and-baby-November-2021.ashx?h=407&la=en&mw=720&w=720&hash=24 November- More than 1,000 young babies die in their sleep every year in America due to Sudden Infant Death Syndrome, also known as SIDS. It's a terrifying thought for parents – the unexplained death of a seemingly healthy child less than a year old. The exact cause of SIDS remains unclear; doctors have been unable to fully explain the cause despite years of research. However, there are several important precautions that parents of newborns can take to reduce the risk. Some of those safety measures for newborns include:

    - Always put a baby down to sleep on their back – not the stomach. 

    - Keep objects out of the crib or bassinette -- no pillows, no toys, no crib bumpers, no blankets.

    - Consider having the baby sleep in the same room as a parent – but never in the same bed. 

    SIDS accounts for more than one out of three sudden or unexpected infant deaths in the United States each year. For military families, the Family Advocacy Programs at military installations offer a New Parent Support Program, which can provide one-on-one advice at home. The program offers up-to-date parenting practices supported by the latest research. Although the incidents of SIDS and other sleep-related infant deaths have decreased in recent years, it remains a risk that parents and other caretakers should be aware of. Most SIDS deaths happen among babies who are between 1 and 4 months' old, and 90% of SIDS deaths involve babies less than 6 months of age. However, SIDS deaths can happen anytime during a baby's first year. Slightly more boys die of SIDS than girls but the reason for the gender difference is unknown, according to Dr. Stacey Frazier, a retired Air Force colonel who is now chief of inpatient pediatrics at William Beaumont Army Medical Center in El Paso, Texas. Health.milExternal Link

    USAFRICOM

    Omicron COVID-19 variant: Africa CDC statement

    27 November- This statement was prior to the naming of Omicron: On 25 November 2021, the National Institute for Communicable Diseases (NICD) in South Africa announced the detection of a new variant of the SARS-COV-2, the virus that causes COVID-19, following genomic sequencing. This variant is currently labelled as lineage B.1.1.529. The emergence of this new variant coincides with a sudden increase in cases in the Gauteng province over recent days and is accordingly being closely monitored by the health authorities in South Africa. Outbreak News TodayExternal Link 

    USCENTCOM

    Israel 'red list' now includes 50 African countries

    28 November- In a follow-up from Israel, the government reports 50 destinations in the African continent have been classified as red destinations...There is a ban on Israelis leaving Israel for red destinations, with the exception of those with the approval of the exceptions committee headed by the Ministry of the Interior. All returnees from a red destination, including vaccinated and recovered travelers must go into full isolation. Before leaving Israel, it will be necessary to declare on the website of the Ministry of Health and to the airline that the trip is not to a red destination. Foreigners are not allowed to enter from these countries except in exceptional humanitarian cases and with the approval of the committee headed by the Ministry of the Interior. The government also approved the obligation to isolate in a government-run isolation facility until a negative result is obtained in a PCR test performed at the entrance to Israel. The obligation will apply immediately to all entrants from the countries of Ethiopia, Botswana, South Africa and Malawi and in the second phase, starting at midnight between Sunday and Monday (29th Nov. 2021) for entrants from the other listed destinations. Anyone who is found to be positive in the PCR test will continue to stay in isolation in the government-run isolation facility until the end of the isolation days required by the guidelines. Outbreak News TodayExternal Link

    USEUCOM

    Netherlands reports 13 Omicron cases in airline travelers

    28 November- The National Institute for Public Health and the Environment in the Netherlands (RIVM) report that Friday, 624 passengers returning from South Africa were tested for the coronavirus SARS-CoV-2 by the GGD Kennemerland. The passengers were tested at Schiphol Airport; 61 of them tested positive for COVID-19. These test samples were sent to RIVM National Institute for Public Health and the Environment for further analysis to determine which variant of the coronavirus was involved. Initial results from genome sequencing showed the Omicron variant (B.1.1.529) in 13 of the samples from the positive tests. Sequencing has not been completed yet. It is possible that the new variant will be found in more test samples. Officials are asking people who returned on Monday 22 November 2021 or after from countries where the Omicron variant is present are requested to get tested, even if they do not have any symptoms. This applies to people returning from the following countries: South Africa, Botswana, Malawi, Lesotho, Swaziland, Namibia, Mozambique and Zimbabwe. Lastly,  people who recently travelled from one of the designated high-risk countries to the Netherlands should go into quarantine and stay home. Outbreak News TodayExternal Link

    USINDOPACOM

    Philippines records less than 1000 COVID-19 cases for 4th day in a row, Monitoring for Omicron

    27 November- The Philippines Department of Health recorded 899 new COVID-19 cases on Saturday, the fourth day reporting less than 1,000 cases–following Wednesday 11/24 (890), Thursday 11/25 (975), Friday 11/26 (863). This brings the country's total since the start of the pandemic to 2,831,177. An additional 188 COVID-19 related deaths were also reported, bringing the death tally to 48,205. The government Friday reported monitoring the new coronavirus variant B.1.1.529 that already has cases in South Africa. During the Palace briefing, acting Presidential spokesperson and Cabinet Secretary Karlo Nograles said members of the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) and the Department of Health (DOH) are widely aware of the variant described by experts as “heavily mutated". “We are monitoring — intently monitoring this situation. We continue to conduct our genomic surveillance on the ground," Nograles said. Outbreak News TodayExternal Link

    USNORTHCOM

    Canada reports two cases of the Omicron variant of concern in Ontario

    28 November- The Public Health Agency of Canada reported today that testing and monitoring of COVID-19 cases has confirmed two cases of the Omicron variant of concern in Ontario. Minister of Health, Jean-Yves Duclos said, “As the monitoring and testing continues with provinces and territories, it is expected that other cases of this variant will be found in Canada. “I know that this new variant may seem concerning, but I want to remind Canadians that vaccination, in combination with public health and individual protective measures, is working to reduce the spread of COVID-19 and its variants in our communities." Canada has implemented enhanced border measures for all travelers who have been in the Southern Africa region — including South Africa, Eswatini, Lesotho, Botswana, Zimbabwe, Mozambique, and Namibia— within the last 14 days before arriving in Canada, until January 31, 2022. The Government of Canada advises Canadians to avoid travelling to countries in the Southern African region and will continue to monitor the situation to inform current or future actions. Restrictions are changing quickly and may be imposed by countries with little warning, disrupting travel plans. Should individuals choose to travel outside Canada, they may be forced to remain outside of Canada longer than expected. Outbreak News TodayExternal Link

    USSOUTHCOM

    Brazil reports human rabies death in Chapadinha, Maranhão state

    28 November- Brazilian media report on a two-year-old child boy died after contracting rabies during an attack by a fox, in the town of Santa Rita, municipality of Chapadinha, in Maranhão state. The incident occurred in August and the doctors who treated him did not give the child the rabies vaccine, a standard procedure at the beginning of treatment for these cases. After a series of comings and goings to the hospital, he was transferred to São Luís, already with advanced symptoms of the disease, on September 23, where he ended up dying. According to Chapadinha's health secretary, Richard Wilker, the doctors involved were removed and are being investigated for possible negligence. The boy was seen on August 4, by a doctor, with a report of a cat scratch, and only the bandage and cleaning of the wound was done. On the second visit, on September 19, at the Municipal Hospital, a second doctor treated a condition of respiratory distress, irritability and nausea in the patient, who received nebulization and antibiotics, medication for pain and nausea, before being given discharged to return to the clinic. “On the 20th he returns to the hospital again, in the Emergency Unit, with a lot of irritability, aggressiveness, reactions as if he were going to bite. An acute situation of the disease. And only then is he referred to the Children's Hospital, in São Paulo. Luis, with suspicion of rage, “said the secretary. Luís Samuel was admitted to the health unit for four days before being transferred to the Maternal and Child Hospital, where he stayed for about a month until he died yesterday morning. In a video released by the Chapadinha City Council on October 15, the secretary explained the case and talked about how the teams reached a consensus that it was an attack by a fox, not a cat. The finding arose from a long investigation and the confirmation, on October 6, in the laboratory, of the rabies virus and the presence of genetic material from a compatible wild animal. In the Chapadinha region, the Maranhão government created a task force to investigate dogs and cats that may have contracted the disease. The population of the Santa Rita Chapadinha village, in the rural area, and the entire family of Luís also received the rabies vaccine, as a precautionary measure. This was the first confirmed case of rabies in Maranhão in the last 8 years. Before, in 2013, the last two cases were reported in the municipalities of Humberto de Campos and São José de Ribamar. Outbreak News TodayExternal Link​​