Army Public Health Weekly Update, 24 July 20

Date Published: 7/24/2020
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.
 The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link

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Table of Contents


    36th Annual Army Ten-Miler, Virtual Edition Registration

    Registration is now open! Train at your own pace, run in your own town! The 36th Annual Army Ten Miler is now available for runners to participate, virtually. Click Here to Register   External Link

    APHC: COVID Health Information Products

    Visit APHC's e-Catalog to access COVID health information products. APHC

    APHC: 2019 Novel Coronavirus (COVID-19) Information

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


    Air Force wants a wearable performance tracker to prevent neck and back pain

    20 July- The Air Force revealed intentions to purchase a wrist-worn gadget that captures data about wearers' health—and provides individual and team analyses from that data—to address neck and back strains felt by fighter aircrew abroad. Officials released a request for information Friday, inviting feedback on the department's plans to buy and deploy an "Aircrew Performance Tracker." "The U.S. Air Force, 48th Fighter Wing, Royal Air Force Lakenheath, United Kingdom is looking to purchase a wearable device to track our aircrew's performance both in and out of the jet and make them more lethal," according to the statement of work that accompanies the RFI. "This device and its data needs to be tailorable to each aircrew and monitored by our squadron leadership as well as our squadron health care providers." Specifically, the wing aims to acquire a physiological tactical wearable device, capable of non-stop data collection "at the highest frequency available to measure" the heart rate, nervous system and sleep tracking of the wearers. The Air Force notes that the tool must be outfitted with data-tracking capabilities and applications that gauge individual's "performance, strain, recovery, and sleep" and also provide a means for top officials and physicians to address those functions across teams. Officials also require the security of all biometric data collected in the effort and emphasize that the device must not incorporate Wi-Fi or GPS tracking. The ideal to-be-used device would be "rugged, water resistant, and have an adjustable strap," the statement notes, but it would not include any screen distractions. The chosen wearable and corresponding program would likely be implemented across the RAF Lakenheath-based 48th Operations Group Aircrew, which includes five squadrons of F-15 aircraft and staff that conduct fighter and rescue operations that span the world. Nextgov External Link

    Data shows large drop in Army's domestic abuse reports during pandemic

    21 July- Data maintained by the Army shows a significant drop in reported incidents of domestic abuse during the months of March, April and May, when the coronavirus pandemic forced many people to shelter in their homes to limit viral spread. There were 126 total domestic abuse incidents reported in May, compared to a high of 561 incidents reported in January. The months of April and March had the second and third lowest rates of reported incidents in the past year, as well. Army officials cited their own preparation as a possible reason for the downturn, saying they were aware that domestic abuse rates were expected to climb in U.S. cities and abroad during the pandemic. The service prepared for the shelter-in-place orders by encouraging commanders to engage soldiers and provide information on resources to help troops cope. Others are skeptical that the numbers reflect an actual decrease, however. The drop could simply reflect people's inability to report abuse to the Army Family Advocacy Program, which tracks domestic abuse and child neglect, according to some victim advocates. Army Times External Link

    MHS addresses sleep in the military through sleep studies

    20 July- Sleep complications are common in the military, from the early-rise culture that can disrupt normal sleeping patterns to the bouts of insomnia resulting from night operations, early morning physical therapy workouts, sustained combat operations, and other such disruption. Researchers and doctors within the Military Health System work to address these concerns and improve the efficiency of service members suffering from sleep complications. Army Lt. Col. (Dr.) Vincent Capaldi, sleep medicine consultant to the surgeon general and chief of behavioral biology at the Walter Reed Army Institute of Research in Silver Spring, Maryland, stressed the importance of the military perspective when addressing sleep concerns in service members. Capaldi pointed out that while proper sleep is necessary for mission effectiveness in the field, 62% of service members sleep less than six hours a night on average—resulting in chronic sleep deprivation and insomnia. "When people are chronically sleep deprived and do a sleep study in the civilian sector, we found that they're being diagnosed with narcolepsy at significantly higher raters compared to those diagnosed in the Military Health System," Capaldi said. "We're able to take a more nuanced approach in the MHS to evaluate what's causing their difficulty and prevent a misdiagnosis that can result in a service member getting medically boarded." External Link

    Will a new push to end veteran suicide have more success than past promises?

    17 July- Carol Rasor-Cordero vividly remembers struggling to explain the problem of veterans suicide to several friends after her son Joseph, a Marine veteran, took his own life in 2017. "At the funeral, I told them the number is 20 a day, and they told me they never knew the problem was that size," she said. "That's because no one likes to hear about suicide and no one wants to talk about it. We need to get past these stigmas." The veterans suicide rate that has remained consistent over the last decade despite numerous large-scale Veterans Affairs programs aimed at finding solutions. According to department records, more veterans died by suicide from 2005 and 2017 (nearly 79,000) than the total number of U.S. troops who died in 30 years of war in Vietnam, Iraq and Afghanistan (about 65,000).But advocates say even as that number of losses grow, public awareness of the problem hasn't. Many report that individuals outside the veterans community are shocked by the 20-a-day statistic, even though it has been referenced frequently and consistently by military leaders, health experts and the last two presidents. "I still talk to people who never heard that 20 veterans die by suicide each day," said Danica Thomas, whose Army veteran husband, Allen, suffered from combat-related post-traumatic stress disorder and died by suicide in 2013. "It's a shock to them that the problem is that large." Military Times External Link


    Actual Covid-19 case count could be 6 to 24 times higher than official estimates, CDC study shows

    21 July- The true number of coronavirus cases in the U.S. could be anywhere from six to 24 times higher than the confirmed number of cases, depending on location, according to a large federal study that relied on data from 10 U.S. cities and states. The vast majority of Americans, however, are still vulnerable to Covid-19. The study, published Tuesday in JAMA Internal Medicine, relied on serological tests — blood screens that search for antibodies to the virus and that determine whether someone was previously infected. They are different from diagnostic tests, which only detect people who currently have the virus, called SARS-CoV-2. Overall, an estimated 1% of people in the San Francisco Bay Area have had Covid-19, while 6.9% of people in New York City have, according to the paper's authors, who included researchers at the Centers for Disease Control and Prevention and state health departments. In seven of the 10 sites, the estimated number of cases was 10 times the number of reported cases. The study was based on tests from more than 16,000 people across the 10 sites, but one limitation is that it relies on old data. The San Francisco samples were collected from April 23 to 27, while the New York tests were on blood from March 23 to April 1. The latest tests were conducted in May, and a lot can change during two months in the course of an outbreak. In South Florida, for example, researchers estimated that 1.9% of the population had antibodies to the virus. But that figure is based on samples collected from April 6 to 10, and given the spread of the virus since then in the state, the number now would certainly be some amount higher. Stat News External Link

    A silver lining to the pandemic response? Doctors hope to see fewer cases of a polio-like condition that affects children

    17 July- If the pattern from recent history holds, starting next month, doctors in the U.S. will begin seeing a spike in cases of a polio-like condition in children that leaves them with muscle weakness, paralysis, and, in the most severe cases, trouble breathing. But 2020, if you haven't noticed, is not your average year. Now, experts are waiting to see what will happen this go-around with the condition, called acute flaccid myelitis, or AFM. They've witnessed bursts of cases in the late summer and fall of 2014, 2016, and 2018, but they're wondering if AFM, which is thought to be a rare result of a common viral infection, might be influenced by all the distancing measures put in place to slow the coronavirus pandemic. That is, efforts to cut down on the spread of the coronavirus might have the same effect on the virus believed to lead to AFM. "That's an idea that very well may play out," said Matthew Vogt, a pediatric infectious disease specialist at University of North Carolina at Chapel Hill. "And all of us who pay attention to AFM are watching that." It's not clear that will happen, and experts are urging clinicians to be on the lookout for children with muscle weakness or slow reflexes. AFM progresses quickly once symptoms start, and getting children to specialists quickly can improve outcomes. And as people have started emerging from shelter-at-home policies in the past few months, it's possible that the virus that thought to lead to AFM, EV-D68, is rebounding, just as circulation of SARS-CoV-2, which causes Covid-19, has resurged. "I'm uncertain what kind of impact social distancing practices are going to have on EV-D68," said Megan Culler Freeman, a pediatric infectious disease specialist at Children's Hospital of Pittsburgh. STAT News External Link

    Coronavirus: Are mutations making it more infectious?

    19 July- Sars-Cov-2, the official name of the virus that causes the disease Covid-19, and continues to blaze a path of destruction across the globe, is mutating.
    But, while scientists have spotted thousands of mutations, or changes to the virus's genetic material, only one has so far been singled out as possibly altering its behavior. The crucial questions about this mutation are: does this make the virus more infectious - or lethal - in humans? And could it pose a threat to the success of a future vaccine? This coronavirus is actually changing very slowly compared with a virus like flu. With relatively low levels of natural immunity in the population, no vaccine and few effective treatments, there's no pressure on it to adapt. So far, it's doing a good job of keeping itself in circulation as it is.
    The notable mutation - named D614G and situated within the protein making up the virus's "spike" it uses to break into our cells - appeared sometime after the initial Wuhan outbreak, probably in Italy. It is now seen in as many as 97% of samples around the world. The question is whether this dominance is the mutation giving the virus some advantage, or whether it's just by chance. Viruses don't have a grand plan. They mutate constantly and while some changes will help a virus reproduce, some may hinder it. Others are simply neutral. They're a "by-product of the virus replicating," says Dr. Lucy van Dorp, of University College London. They "hitch-hike" on the virus without changing its behavior. The mutation that has emerged could have become very widespread just because it happened early in the outbreak and spread - something known as the "founder effect". This is what Dr. van Dorp and her team believe is the likely explanation for the mutation being so common. But this is increasingly controversial. A growing number - perhaps the majority - of virologists now believe, as Dr. Thushan de Silva, at the University of Sheffield, explains, there is enough data to say this version of the virus has a "selective advantage" - an evolutionary edge - over the earlier version.
    Though there is still not enough evidence to say "it's more transmissible" in people, he says, he's sure it's "not neutral". When studied in laboratory conditions, the mutated virus was better at entering human cells than those without the variation, say professors Hyeryun Choe and Michael Farzan, at Scripps University in Florida. Changes to the spike protein the virus uses to latch on to human cells seem to allow it to "stick together better and function more efficiently". BBC News External Link

    Dysbiotic oral microbiome may raise cancer risk

    20 July- Dysbiosis of the oral microbiome associated with periodontal disease may raise the risk of esophageal and gastric cancers, a large prospective cohort analysis suggested. The analysis of data from 98,459 women in the Nurses' Health Study (1992-2014) and 49,685 men in the Health Professionals Follow-up Study (1988-2016) over 22 to 28 years was conducted by an international team led by Mingyang Song, MD, ScD, of Harvard T.H. Chan School of Public Health in Boston. The study, published in a letter online in Gut, found the following risks and multivariable-adjusted hazard ratios (aHRs):

    -History of periodontal disease was associated with a 43% and 52% increased risk of esophageal adenocarcinoma (aHR 1.43, 95%CI 1.05-1.96) and gastric adenocarcinoma (aHR 1.52, 95% CI 1.13- 2.04)

    -Compared with individuals with no tooth loss, the risks of esophageal and gastric adenocarcinoma for those who lost at least two teeth were also modestly increased -- aHRs of 1.42 (95% CI 1.00- 2.03, Ptrend 0.05) and 1.33 (95% CI 0.95-1.86, Ptrend 0.09), respectively

    -In those with a history of periodontal disease, no tooth loss and losing at least one tooth were equally associated with a 59% increased risk of both esophageal adenocarcinoma (aHRs 1.59, 95% CI 1.04-2.41 and 1.59, 95% CI 1.04-2.44, respectively) compared with those with no history of periodontal disease and no tooth loss; similarly, these individuals had a 50% and 68% greater risk of gastric adenocarcinoma (aHRs 1.50, 95% CI 1.01-2.23 and 1.68, 95% CI 1.13-2.50, respectively)

    For the study, dental measures, demographics, lifestyle, and diet were all assessed using validated follow-up questionnaires, and self-reported cancer diagnoses were confirmed by review of medical records. MedPage Today External Link

    FDA named 75 hand sanitizers contaminated with toxic substance methanol

    20 July- The Food and Drug Administration (FDA) has named 75 hand sanitizers containing toxic substance methanol or wood alcohol on Friday, July 17. According to The Independent report, the agency has listed 75 hand sanitizers that are contaminated with methanol, which can be toxic when absorbed through the skin or even deadly when swallowed. The FDA said in a statement that it is aware of cases of adverse effects of hand sanitizer ingestion, which include hospitalizations, blindness, and even death on both children and adults. Last month, the agency recalled nine dangerous hand sanitizers. Then earlier this month, a manufacturer issued a voluntary recall of 18,940 bottles of its sanitizers. Tech Times reported about the recall of All Clean Hand Sanitizer, Moisturizer, and Disinfectant with UPC Code 628055370130 due to the risk of methanol content. ITECH 361 has a nationwide distribution of the product through its wholesale distributors and retailers. Meanwhile, the FDA noted the products that have been recalled already and those it recently recommended for recall. The FDA list also includes the names of companies as well as the names and NDC numbers of products that are being recalled.  The agency also updated its import alert list, based on analytic tests. The products on the list, which are mostly produced in Mexico, at risk for contamination that poses a health risk "due to contamination, substandard quality, or ingredient substitution." Per guidelines from the Centers for Disease Control and Prevention during the coronavirus pandemic, the public is advised to frequently wash their hands with soap and water to reduce the amounts of germs and chemicals. If soap and water are not available, people may use hand sanitizers with at least 60% alcohol to help prevent germs from spreading. Tech Times External Link

    Genes may influence COVID-19 risk, new studies hint

    21 July- As COVID-19 continues its fateful march around the globe, researchers have seen patterns of characteristics tied to bad cases of the disease. Increased age, diabetes, heart disease and lifelong experiences of systemic racism have come into focus as risk factors. Now some connections to certain genes are also emerging, although the links are fuzzier. Combing through the genome, researchers have tied COVID-19 severity and susceptibility to some genes associated with the immune system's response, as well as a protein that allows the disease-causing SARS-CoV-2 coronavirus into our cells. They have also turned up links between risk and a person's blood type—A, B, AB or O. The findings are not cut-and-dried, however. Scientists caution that even valid effects may be small, although knowledge about genes involved in serious disease outcomes may help to identify therapeutic drugs. Complicating the work are the effects of social and economic inequalities that also increase risk and tend to be concentrated in populations with specific ethnic backgrounds and ancestries.The work of separating the genetics from these inequalities is important, says Priya Duggal, director of the genetic epidemiology program at the Johns Hopkins Bloomberg School of Public Health. "We don't want that to be conflated," she says. "Race is representing many factors, including people who are essential workers" and may be routinely exposed to more chances of infection because of their job or who may not have good access to health care. "These are things we have all known to have existed in this country for a long time, and COVID-19 just brings them right to the front." Scientific American External Link

    People are more likely to contract COVID-19 at home, study finds

    21 July- South Korean epidemiologists have found that people were more likely to contract the new coronavirus from members of their own households than from contacts outside the home. A study published in the U.S. Centers for Disease Control and Prevention (CDC) on July 16 looked in detail at 5,706 "index patients" who had tested positive for the coronavirus and more than 59,000 people who came into contact with them. The findings showed just two out of 100 infected people had caught the virus from non-household contacts, while one in 10 had contracted the disease from their own families. By age group, the infection rate within the household was higher when the first confirmed cases were teenagers or people in their 60s and 70s. "This is probably because these age groups are more likely to be in close contact with family members as the group is in more need of protection or support," Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention (KCDC) and one of the authors of the study, told a briefing. Children aged nine and under were least likely to be the index patient, said Dr. Choe Young-june, a Hallym University College of Medicine assistant professor who co-led the work, although he noted that the sample size of 29 was small compared to the 1,695 20-to-29-year-olds studied. Children with COVID-19 were also more likely to be asymptomatic than adults, which made it harder to identify index cases within that group. Reuters External Link

    Promising early findings for 2 more COVID-19 vaccines

    20 July- In a pair of promising developments today, researchers from Oxford University and another group from China reported in The Lancet that two different adenovirus-vectored COVID-19 vaccines prompted an immune response and appeared to be safe, paving the way for efficacy trials. Meanwhile, the global COVID-19 total passed 14.5 million today and is at 14,604,077 cases with 608,487 deaths, according to the Johns Hopkins online dashboard. The publication of the two studies today brought the number of peer-reviewed COVID-19 vaccine trials to three. They come just 5 days after scientists reported that an mRNA vaccine developed by Moderna, with support from the US National Institute of Allergy and Infectious Diseases, generated immune response and was generally well tolerated. The Oxford vaccine, supported by AstraZeneca, uses a chimpanzee adenovirus viral vector (ChAdOx1) that expresses the SARS-CoV-2 (the virus that causes COVID-19) spike protein. Researchers conducted the phase 1/2 trial in 1,077 healthy adults ages 18 to 55 at five hospitals in the United Kingdom. Those in the control group received a meningitis vaccine, and the study details what investigators found 56 days after vaccination. Since the vaccine was given in a high dose to trigger a strong immune response, researchers gave 113 participants—half in the SARS-CoV-2 group and half in the meningitis vaccine group—acetaminophen before and after vaccination to help reduce vaccine-related reactions. A group of 10 people received only the SARS-CoV-2 vaccine and were given a booster dose 28 days later. The vaccine induced strong antibody and T-cell immune responses, which were even higher in the booster-dose subgroup. When measured by neutralization assay, antibody responses were found in 32 of 35 participants at day 28. All of the subjects who got the booster dose had an antibody response. CIDRAP External Link

    West Nile virus overlooked during coronavirus pandemic? Public health expert cites similar symptoms

    20 July- After mosquitoes recently tested positive for West Nile virus near Austin, Texas, one public health professional was concerned that the medical community would overlook the illness amid the coronavirus pandemic. Most people infected with West Nile don't feel sick. However, one in five infected people does develop a fever and other symptoms such as headache, vomiting or rash, according to the Centers for Disease Control and Prevention. An estimated one in 150 infected people develop a severe, potentially fatal, illness affecting the brain and spinal cord. In the case of the novel coronavirus, the CDC also lists fever among other symptoms including congestion or runny nose, nausea, diarrhea, chills, cough and shortness of breath. Williamson County officials in Texas said a pool of mosquitoes in a regional park tested positive for West Nile virus on July 9, though there haven't been any human cases of the mosquito-borne illness in the county since 2017. The county's Vector Management Program Lead, Jason Fritz, told Fox News that while roughly 80 percent of people infected with West Nile Virus are asymptomatic, about 20 percent develop West Nile fever. "With COVID being such a big issue that it is, we're starting to see more of those mild symptoms in people with COVID, fever, body aches, similar to what you'd see in West Nile fever," Fritz said. "But when you go to the doctor, it seems that more questions are geared toward the pandemic." Fritz said it's usually not until more severe cases of West Nile virus, like encephalitis and meningitis, that specialized tests are performed. These severe cases are rare. Fox News External Link


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

    2019-2020 Influenza Season Week 28, ending July 11, 2020:

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

    Pneumonia and Influenza (P&I) Mortality Surveillance: Based on National Center for Health Statistics (NCHS) mortality surveillance data available on July 16, 2020, 5.3% of the deaths occurring during the week ending July 11, 2020 (week 28) were due to P&I. This percentage is below the epidemic threshold of 5.7% for week 28.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 28. CDC External Link

    WHO: Influenza Update

    20 July 2020 - Update number 372, based on data up to 05 July 2020:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic might have influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission might also have played a role in mitigating influenza virus transmission.

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

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

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

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

    - Worldwide, seasonal influenza A and B viruses were detected in similar proportion. WHO External Link


    Chicken samosas recalled for lack of federal inspection

    17 July- Houston-based Hafiz Foods, Inc. has recalled approximately 675 pounds of chicken samosas that contain poultry produced without the benefit of federal inspection, according to the U.S. Department of Agriculture's Food Safety and Inspection Service (FSIS). The ready-to-cook, frozen chicken samosas were produced from May 2020 to June 29, 2020. The following products are subject to recall:

    - 12-oz. box packages labeled "RAZA FOODS Chicken Samosa" with date codes 05/21, 06/21, or 0527021 through 062921 (inclusive).

    - 12-oz. box packages labeled "TAZA CHICKEN SAMOSAS" with date codes 05/21, 06/21, or 0527021 through 062921 (inclusive).

    - 100-oz clear plastic bags containing approximately 100 chicken samosas that do not bear any labeling or codes.

    The products subject to recall bear establishment number "EST. 44163" inside the USDA mark of inspection. The boxed items were shipped to retail and deli locations in New Jersey, New York, Pennsylvania, Texas, and Virginia. The plastic bag items were donated to community organizations in the Houston, Texas area in May and June 2020. The inspection avoidance was discovered when FSIS conducted routine in-plant verification activities and the agency determined that the ground chicken used in the samosas was not federally inspected. Food Safety News External Link

    More than 100 sick in Salmonella outbreak of unknown origin

    21 July- More than a month after the first illness onset, federal officials have announced a Salmonella outbreak that has been making people sick since June 19. Of those for whom the information is available a fourth have been admitted to hospitals. The Centers for Disease Control and Prevention reports the source of the pathogen, which is frequently foodborne, remains the subject of the investigation. The "rapidly growing" outbreak has sickened at least 125 people across 15 states. Though the outbreak announcement comes weeks after people started becoming sick, the CDC took only 11 days to go public with the information once a lab-based computer network identified 13 sick people, all infected by Salmonella Newport. Overall, the outbreak victims' ages range from 2 to 92 years old. Officials have not confirmed any deaths. Food Safety News External Link


    Cinnamon linked to blood sugar control in prediabetes, study finds

    21 July- Cinnamon may improve blood sugar control in people with a condition known as prediabetes and may slow the progression to type 2 diabetes, according to a new pilot study of 51 people with elevated blood sugars. "We are looking for safe, durable and cost-effective approaches to reduce the progression from prediabetes to type 2 diabetes," said study author Dr. Giulio Romeo, a staff physician at Boston's Joslin Diabetes Center and the division of endocrinology at Beth Israel Deaconess Medical Center. The study published Tuesday in the Journal of the Endocrine Society. "Our 12-week study showed beneficial effects of adding cinnamon to the diet on keeping blood sugar levels stable in participants with prediabetes," Romeo said. "These findings provide the rationale for longer and larger studies to address if cinnamon can reduce the risk of developing type 2 diabetes over time." CNN External Link


    Ebola cases increase by 3, total now 60 in Équateur Province, DRC

    20 July- In a follow-up on the Ebola Virus Disease (EVD) outbreak in Equateur province in western Democratic Republic of the Congo (DRC), UN health officials report three more confirmed Ebola infections, bringing the total to 60–(56 confirmed, 4 probable) 24 deceased, 17 recovered. Mike Ryan, MD, World Health Organization (WHO) emergencies expert said, "The disease is active, not controlled". The outbreak spread across 21 health areas in seven health zones. Ryan noted burial practices are a concern as investigations so far suggest that about one in three cases are linked to attending funeral, also a known transmission risk. EVD is transmitted by contact with the blood, body fluids, secretions or organs of an infected or recently deceased person. The death rate is typically high, ranging up to 90 percent in some outbreaks. In addition, the DRC is battling measles, malaria, acute respiratory infections, typhoid, COVID-19, cholera, meningitis, diarrhea with dehydration in children under the age of five years, influenza, monkey pox and yellow fever. Outbreak News Today External Link


    Tests, home quarantine as Qatar reopens borders on August 1

    22 July- Qatar will begin reopening its borders to foreign travelers and allow citizens and permanent residents to travel in and out of the country from August 1, according to a government statement, as the Gulf state moves to gradually lift restrictions imposed to control its coronavirus outbreak. The Government Communications Office (GCO) said on Wednesday that arrivals to Qatar from "low-risk countries" will be required to take a coronavirus test at the airport and sign a formal pledge to adhere to quarantine at home for a week. After seven days, the travelers will be required to undergo a second test and their quarantine period will end if results come back negative. However, if the traveler tests positive, he or she will be transferred to a government facility for isolation. The GCO said the list of low-risk countries will be published on the Ministry of Public Health's website and will be reviewed every two weeks. The current list has 40 countries and includes China, Thailand and Malaysia in the Asia Pacific, United Kingdom, France, Germany and Greece in Europe, and Algeria and Turkey in the Middle East. Al Jazeera External Link


    Germany: Reports 'swine flu' case in child

    20 July- The World Health Organization (WHO) was told of one human case of infection with a swine influenza A(H1N1)v virus from Germany on 3 July. Details include the infection was detected in a 2-year old male who developed an influenza-like illness on 9 June 2020. The patient received healthcare on 9 June 2020. A sample was collected as part of routine ILI surveillance and an unsubtypeable influenza A virus was detected on 15 June. Whole genome sequencing characterized this virus as a Eurasian avian-like swine A(H1N1) virus (1C.2.2) on 1 July. The case recovered and no further cases were detected among contacts. The patient had visited a swine farm and had close contact with pigs two days before onset of illness. Swine influenza viruses circulate in swine populations in many regions of the world. Depending on geographic location, the genetic characteristics of these viruses differ. Most human cases are exposed to swine influenza viruses through contact with infected swine or contaminated environments. Human infection tends to result in mild clinical illness in most cases. Outbreak News Today External Link


    Philippines: Polio vaccination campaign, 'Sabayang Patak Kontra Polio', to resume in Mindanao

    20 July- The Philippines Department of Health (DOH), with support from the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), is resuming its Sabayang Patak Kontra Polio campaign to combat the poliovirus outbreak in the Philippines. The polio immunization campaign was shortly put on hold because of the COVID-19 pandemic. The next phase of the Sabayang Patak Kontra Polio campaign in the whole of Mindanao will start on 20 July and last until 2 August 2020 for children under 5 years old. Children under 10 years old in selected areas in Mindanao will also receive polio drops. Meanwhile, new polio immunization campaigns for children under 5 years old will begin in a phased approach in Region 3 (Central Luzon) on 20 July and in the provinces of Laguna, Cavite and Rizal in Region 4A in August. "Continuous implementation of polio response amid the present health crisis we are facing is important as this will prevent not only the debilitating effects of the disease, but also interrupt the transmission during a pandemic," said Health Secretary Francisco T. Duque III. "Polio is a vaccine-preventable disease and we cannot let our gains over the years go to waste by deprioritizing our polio response. It is imperative for parents and caregivers to have their children vaccinated, while strictly adhering to infection prevention and control protocols, as we cannot afford to overwhelm our health system with another outbreak," Duque emphasized. The total number of polio cases in the country remains at 16 as of 26 June 2020. The Philippines is affected by both cVDPV1 and cVDPV2. cVDPV is considered a public health emergency of international concern (PHEIC). Currently, there are 13 cases of cVDPV2, one case with cVDPV1; one case with VDPV1; and one case with immunodeficiency related VDPV type 2 (iVDPV2). Outbreak News Today External Link


    U.S.: South Carolina rabies- Cat exposes two people in Honea Path

    21 July- South Carolina health officials report the confirmation of a rabies positive cat in Honea Path, Abbeville County. The Department of Health and Environmental Control (DHEC) say the cat exposed two people and some 10 pets. "To reduce the risk of getting rabies, always give wild and stray animals plenty of space," said David Vaughan, Director of DHEC's Onsite Wastewater, Rabies Prevention, and Enforcement Division. "If you see an animal in need, avoid touching it. Contact someone trained in handling animals, such as your local animal control officer or wildlife rehabilitator. The possibility of exposure to rabies can occur anywhere, anytime. If you believe that you or someone you know has had contact with or been potentially exposed to this or another suspect animal, please reach out to your local Environmental Affairs office. An exposure is defined as a bite, a scratch, or contact with saliva or body fluids from an infected or possibly infected animal." It is important to keep pets up to date on their rabies vaccination, as this is one of the easiest and most effective ways to protect against the disease. This cat is the third animal in Abbeville  County to test positive for rabies in 2020. There have been 71 cases of rabid animals statewide this year. Since 2011, South Carolina has averaged approximately 130 positive cases a year. In 2019, three of the 148 confirmed rabies cases in South Carolina were in Abbeville County. Outbreak News Today External Link

    U.S.: Texas reports increase in kissing bugs, could increase Chagas risk

    19 July- Entomologists with Texas A&M University's AgriLife Research are reporting an increase in kissing bugs collected in multiple regions of Texas this year. Kissing bugs, aka triatomine bugs and conenose bugs, are potential vectors for the parasitic disease, Chagas disease, an infections of both people and animals. "We have already collected over 300 adult kissing bug specimens in a location where we only collected six individuals in 2019," said Gabriel Hamer, Ph.D., AgriLife Research entomologist, College Station. He is also a member of the Texas Chagas Taskforce — a group of experts raising awareness about the disease. The collection site Hamer described is near Mission, about a four-hour drive south of San Antonio. He collected 115 kissing bugs there in about three hours one night in May. "The lab's kissing bug collections from College Station are also higher than in normal years," he said. AgriLife entomologists across the state continue to search for factors leading to above-average number of kissing bug encounters. Outbreak News Today External Link


    Bolivia reports more than 2,000 COVID-19 cases in a day, a new record

    19 July- The Bolivia Ministry of Health recorded a record 2,036 COVID-19 cases Saturday, bringing the total in the country to 58,138. La Paz registered 713 new infections, Santa Cruz 495, Tarija 319, Cochabamba 232, Pando 121, Oruro 65, Chuquisaca 52, Beni 28 and Potosí 11. The accumulated number of COVID-19 infections by department places Santa Cruz in first place with 29,484, La Paz 8,922, Cochabamba 6,277, Beni 5,068, Oruro 2,177, Tarija 2,347, Chuquisaca 1,588, Pando 1,178 and Potosí 1,097. In addition, 57 new deaths were reported (Santa Cruz 19, Cochabamba 15, Pando 7, Tarija 6, Chuquisaca 5, La Paz 2, Oruro 2 and Beni 1), making a total of 2,106 deaths nationwide. A study by the Epidemiology Directorate of the Ministry of Health established that Bolivia has a coronavirus case fatality rate of 4.2% per day. "The accumulated case fatality rate in Bolivia is 3.7 per 100 patients, with Pando (7.9), Cochabamba (7.4), Oruro (6.6) and Beni (5.5) being the departments with the highest accumulated rate in the region", pointed out the epidemiological analysis. Outbreak News Today External Link

    Brazil: Tops 80,000 COVID-19 deaths as 2 government ministers test positive for virus

    21 July- Two government ministers in Brazil have tested positive for the coronavirus as the country – second only to the U.S. in the number of infections – surpassed 80,000 deaths from the disease. Citizenship Minister Onyx Lorenzoni, a close ally of President Jair Bolsonaro, and Education Minister Milton Ribeiro announced separately their diagnoses on social media. In a tweet, Lorenzoni said he had begun feeling COVID-19 symptoms on Thursday night and had received confirmation that he was infected on Monday. Bolsonaro himself tested positive for the coronavirus earlier this month and two other top government officials, national security adviser Augusto Heleno and the minister of mines and energy, Bento Albuquerque, have also been infected. The news that COVID-19 can't be contained even at the top echelons of government comes as Brazil marked a grim milestone in the pandemic, with more than 80,000 now dead from the disease, according to a tally kept by Johns Hopkins University. The country has more than 2.1 million confirmed infections. Bolsonaro has been accused of endangering the public with his consistent efforts to downplay the virus, campaigning against COVID-19 shutdowns and referring to the disease as "a little flu." After he was diagnosed, the president promoted the anti-malarial drug hydroxychloroquine, which he has credited with his recovery. Despite several studies showing no efficacy and warning about the drug's potential side effects, hydroxychloroquine has also been touted by President Trump. In June, the U.S. Food and Drug Administration revoked an emergency authorization for the drug. NPR External Link