Army Public Health Weekly Update, 25 November 2022

Date Published: 11/25/2022
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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 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


    Vaccination Against COVID-19 is Key to Maintaining Readiness​

    15 November- Maintaining readiness is a key priority of the Army and receiving your COVID-19 vaccination and staying up-to-date on eligible boosters are the most effective ways to reduce the likelihood of COVID-19 infection and reducing the chance of severe illness, hospitalization, long-COVID, and death. All Service members are required to be fully vaccinated against COVID-19. Commanders continue to initiate involuntary administrative separation proceedings for Soldiers who have refused the lawful order to be vaccinated against COVID-19 and who do not have a pending or approved exemption request. Soldiers with questions about the safety, effectiveness and possible side effects of the COVID-19 vaccine should discuss them with their health care provider.​..Department of Defense 05 October 2021 guidance - Service members who are pregnant, postpartum and/or breastfeeding should be vaccinated as part of mandatory COVID-19 vaccination of DoD Service as they are not medically exempt from COVID-19 vaccination, unless they request and are qualified/approved for a temporary medical exemption from their health care provider.​ For information about COVID-19 vaccine requirements for the federal workforce please check with your local human resources department or the Office of Personnel Management. The Safer Federal Workforce website provides ongoing guidance to keep employees safe and agencies operational.​​ APHC


    DOD Brain Health Initiative is at Work Across the Military​​

    17 November- The Department of Defense continues its research work to improve brain health across all services and operational environments. As part of a congressionally directed research effort on brain health and blast exposures, DOD Health Affairs and the Defense Health Agency implemented a pilot study that took place at the U.S. Army's Fort Campbell, Kentucky, with 333 members of the 101st Airborne Division and their trainers. The study ran from March 15 to Nov. 24, 2021. The study evaluated current monitoring capabilities for brain health and blast overpressure, which is the shock wave that occurs from firing weapons or weapon systems, for example. Presented at the recent Military Health System Research Symposium, the study looked at soldiers outfitted with small wearable blast gauges. The two-part study reviewed the gauge measurements during a single day of supervised training in heavy munitions including additional contextual metavariables and longitudinally during a three- to four-month training period. The study then surveyed participants, asking troops' perceptions on blast overpressure and brain health. One goal of the study was for the results to be included in service member medical records. Study participants who believed damage may have occurred to their brains and bodies from blast exposure would have proper documentation in their medical files. One participant agreed on the need to address brain health and occupational exposure to blast overpressure, stating: "I hope the blast program is able to gather the impact that blasts are having on our bodies and brains, and hopefully use it to protect and innovate." The next steps of the study included U.S. Marines at the Marine Corps Air Ground Combat Center Twenty-nine Palms, California, and ran from July 6 to Oct. 28, 2022. The study compared their experiences and supported more broadly applicable recommendations. Steve Jones, assigned to the DOD Health Affairs, and directly involved with determining how best to implement blast-overpressure monitoring across the DOD, said "similar to other operational and environmental exposures, monitoring blast over-pressure is a very important with regard to the health and readiness of the force, and to mitigating such exposures."​​ External Link

    From evaluation to treatment, what Veterans should know about toxic exposure​

    21 November- The following story is an example of the treatment a Veteran may receive for health concerns related to toxic exposure from airborne hazards and burn pits. After experiencing a worsening of shortness of breath over the past 15 years, a 37-year-old Veteran visited her primary care doctor to try to find answers and relief. She told her doctor she becomes short of breath with any level of exertion and that she has chronic nasal congestion and difficulty sleeping. Even though she was once quite active, she has not been physically able to exercise—even at low intensity—for at least five years. She reported moderate improvement with the use of an inhaler but her symptoms always came back. Despite these persistent symptoms, the results of all tests and evaluations came back normal.​​ She deployed to northern Iraq in the early 2000s. During the deployment she was exposed to a fire in a sulfur mine as well as dust storms and burn pits. Knowing her symptoms could be related to her exposure, she added her information to the Airborne Hazards and Open Burn Pit Registry online. After adding her information to the Registry, she received a letter in the mail from the VA Post-Deployment​ Cardiopulmonary Evaluation Network (PDCEN) inviting her to participate in a specialty evaluation. She asked her doctor if she should consider moving forward with it. Although her doctor was not familiar with the PDCEN, they wanted to find out more about how best to care for her and recommended participating in the evaluation.​ VA News​ External Link

    Operating at Speed of Relevance, Key to Great Outcomes, DHA’s Maturation​

    21 November- The Defense Health Agency’s reputation as it stands today rests in large part on its successes during COVID-19. The pandemic defined the agency’s value to the Department of Defense as a “trusted partner,” DHA Director U.S. Army Lt. Gen. (Dr.) Ronald Place said at his last town hall meeting with the workforce, Nov.16. When DOD called upon the DHA for help in responding to the pandemic in March 2020, “we became an organization that was trusted by the senior leaders of the Office of the Secretary to include the secretary, himself, and the deputy secretary,” Place said. DHA senior enlisted leader, Command Sgt. Maj. Michael Gragg, echoed that sentiment for all DHA members. “Thank you all for changing our perception and making the exception the expectation, because that’s what you’ve done as an agency. In the past, our successes were looked at as exceptions,” he said. “Now, your success is considered the expectation that when given a mission by the DOD, the DHA will accomplish that mission.” During the pandemic, the DHA’s most successful actions include:

    - Creating a real-time COVID-19 global registry to track hundreds of thousands of DOD patients and their health outcomes.

    - Collecting more than 12,000 units of convalescent plasma from recovered COVID-19 patients in less than four months, exceeding the original DOD request for 8,000 - 10,000 units.

    - Conducting the COVID-19 and subvariant vaccine delivery system worldwide.

    - Expanding telehealth services to more than half of all health care patient encounters early in the pandemic.

    By completing all these projects, the DHA showed its value as an operational combat support agency. “If we didn’t have a Defense Health Agency before COVID-19, COVID-19 would have driven the Department of Defense to create one,” Place commented. The DHA was awarded the Joint Meritorious Unit Award for Excellence for its work on COVID-19 from January 2020 through October 2020.​ Health​.m​il​​ External Link

    U.S Army Public Health Command Europe Soldiers receive highly sought-after expert medical field badge​​​

    21 November- One officer and one enlisted Soldier assigned to Public Health Command Europe earned the coveted Expert Field Medical Badge on their first try during a grueling three-week testing event conducted by the 173rd Infantry Brigade at Caserma Del Din. The final event, a 12-mile road march and an M4 proficiency test, was followed by an award and graduation ceremony hosted by Maj. Gen. Todd R. Wasmund, Commanding General U.S. Army Southern European Task Force, Africa, at the Caserma Del Din Parade Field on November 9. The EFMB is one of the toughest and most highly sought-after U.S. Army special skill badges. Of the many Soldiers who compete for the badge annually, few successfully obtain the prestigious award. According to the EFMB Test Control Office, the EFMB test event pass rate for fiscal year 2021 was 27 percent. The EFMB test event began October 24 with six Soldiers from PHCE, starting with a two week standardization, or familiarization, phase. For nearly three weeks, the candidates were challenged with technically rigorous and physically demanding fitness assessments, as well as having to complete advanced day and night land navigation at the mountains of Asiago. Successful candidates demonstrated proficiency in warrior skills, evacuation skills, a litter obstacle course, an arduous tactical combat casualty care lane under simulated combat conditions, a 12-mile road march, and a weapons proficiency exam. Thirty-one percent of the 218 medical branch troops who sought the Expert Field Medical Badge succeeded. Lt. Alejandro Davila, Public Health Command Europe brigade S1, and Sgt. Stephanie Hardin, an animal care specialist, were the two PHCE recipients of the expert field medical badge. “I decided to go for it when I had the opportunity,” said Davila. “Less than 10% of the Army medical community have the badge; I wanted to set myself apart from my peers and challenge myself personally. So I gave it a shot.” According to Hardin, EFMB was an incredible experience. External Link

    ​​​Veterans and traumatic brain injury; Healing headaches​

    18 November- Nearly 500,000 American servicemen and women suffered post-traumatic stress disorder after the Afghanistan and Iraq conflicts. Traumatic brain injury, or TBI, was also more frequently diagnosed in veterans serving in post 9-11 conflicts. Now, a new non-drug therapy addresses veterans struggling with headaches caused by both. Memory loss and headaches still plague Army veteran Michael Gatter 18 years after three traumatic brain injuries during deployment in Iraq. “Somebody had taken an explosive satchel and threw it on top of the vehicle, and it detonated,” Gatter remembers. Then, Michael’s military vehicle swerved to avoid a runaway truck, rolled over, suspending him in mid-air. He says, “I unbuckled my harness and when I unbuckled, it came head-first down on the driver’s hatch.” And strike three, a tank hatch knocked Michael in the head. Those three incidents triggered 20 years of debilitating headaches and memory loss. That is until Michael participated in a groundbreaking cognitive behavioral study conducted by UT Health San Antonio. It’s called cognitive behavioral therapy for headache, or CBTH. The researchers modified psychotherapy treatment traditionally used for migraine sufferers. Professor at UT Health San Antonio and South Texas Veterans Health Care System, Don McGeary, PhD, explains, “Not only did we see better headache outcomes from this headache treatment, which was expected, we showed PTSD improvements that were comparable to a gold standard PTSD treatment.”​ WAFB​ External Link


    FDA approves 1st drug to delay the onset of Type 1 diabetes​

    18 November- The Food and Drug Administration on Thursday approved the first drug to delay the onset of Type 1 diabetes. The drug, called Tzield, is a monoclonal antibody injection. It’s been approved for people ages 8 and older who have early signs of Type 1 diabetes. Nearly 2 million people in the United States have Type 1 diabetes, according to the American Diabetes Association. Symptoms can appear at any age, although it is usually diagnosed in children and young adults. In people with Type 1 diabetes, the body doesn’t make insulin, a hormone that tell cells to use sugar from the bloodstream to make energy. Without insulin, too much sugar can stay in the blood, which can lead to health problems. The new drug, from drugmakers Sanofi and Provention Bio, works by preventing the body’s immune system from mistakenly attacking cells in the pancreas that make insulin. The FDA said its approval was based on a phase 2 clinical trial of 76 participants who were randomly assigned to receive the drug or a placebo once daily intravenously for 14 days. People in the trial had an early form of Type 1 diabetes in which blood sugar levels are abnormal but symptoms haven't yet developed. The trial found that the median time to diagnosis for people who got the drug was about four years, compared to about two years for people in the placebo group.​​ NBC News​ External Link

    'Good' cholesterol may not protect against heart disease, study finds​​

    21 November- For decades doctors have been telling their patients that high levels of HDL, otherwise known as “goo​​d cholesterol,” could protect them from heart disease. But a new study suggests that having a lot of so-called good cholesterol doesn’t mean a lower risk of heart attacks. That doesn’t mean HDL levels have no impact. An analysis of data from nearly 24,000 American adults revealed that too little HDL cholesterol was associated with an increased risk of heart disease — in white adults, but not in Black adults, researchers reported Monday in the Journal of the American College of Cardiology. The new findings surprised the researchers, who originally designed their study to understand how cholesterol levels in Black and white middle-aged adults without heart disease affected their future risks. Previous research on "good" cholesterol and heart disease consisted of mostly w​white adults.  “I did not expect high levels of HDL would not be protective,” said the study’s senior author, Nathalie Pamir, an associate professor of cardiovascular medicine in the Oregon Health and Science University School of Medicine. “And I certainly did not expect low levels to have no predictive value for Black adults.” The new research, co-funded by the National Institutes of Health, is part of a growing body of evidence disputing that high HDL cholesterol levels are protective against heart disease, experts say, although people may not always be getting the message.​ NBC​ External Link

    Mental health workforce shortages linked to rising youth suicides, study says​

    ​21 November- The rising suicide rate for children and adolescents is linked to increasing shortages of mental health professionals at the county level, even pre-pandemic, a new study suggests. And an accompanying editorial says the U.S. mental health system is so broken even money cannot fix it. "Mental health was a major issue before the COVID-19 pandemic, and it has only worsened since," said Dr. Aaron E. Carroll, a distinguished professor of pediatrics at Indiana University. Carroll, who is director of the Center for Pediatric and Adolescent Comparative Effectiveness Research at Indiana University School of Medicine, added: "Countless youth need help. Unfortunately, help is often in short supply." Suicide is the second leading cause of death for children, adolescents, and young adults ages 15 to 24, according to the American Academy of Child & Adolescent Psychiatry. And most who attempt suicide have a significant mental health disorder, usually depression. The origin​al investigation, published Monday in JAMA Pediatrics, explored the suicide rate for even younger people, ages 5 to 19. The article, with Dr. Jennifer A. Hoffmann, a pediatric emergency medicine physician in Chicago as first author, cited higher adolescent suicide rates in rural areas and high-poverty areas.​​ UPI​ External Link

    New Covid boosters work better against infection than previous shots, CDC finds​​

    22 November- The first real-world data on the new omicron vaccines find that they are better at preventing symptomatic Covid infections than the earlier doses, the Centers for Disease Control and Prevention said Tuesday. The findings fortify messaging from public health officials that the new shots, from Pfizer-BioNTech and Moderna, should provide people with the best protection against Covid this winter, according to the CDC report. Both Pfizer’s and Moderna’s new boosters target BA.4 and BA.5, along with the original coronavirus strain, in a single dose. The vaccine efficacy from the new boosters isn't "stellar," said Dr. Ofer Levy, the director of the Precision Vaccines Program at Boston Children’s Hospital, noting that scientists would love to see a vaccine that blocks infections entirely. But, he said, it is "something" and outperforms earlier doses of the original formulation.​ NBC​ External Link

    No more mad cow worries, banned blood donors can give again​​​​

    20 November- U.S. Army veteran Matt Schermerhorn couldn’t give blood for years because he was stationed in Europe during a deadly mad cow disease scare there. Now, he’s proud to be back in the donor’s chair. Schermerhorn, 58, is among thousands of people, including current and former military members, who have returned to blood donation centers across the country after federal health officials lifted a ban that stood for more than two decades. “It’s a responsibility. It’s a civic duty,” said Schermerhorn, who donated on Veterans Day at the ImpactLife center in Davenport, Iowa. “You really don’t have to go out of your way too much to help your fellow man.” Blood collectors nationwide are tracking down people like Schermerhorn, U.S. citizens who lived,​ worked or vacationed in the United Kingdom, France, Ireland or served at military bases in Europe during various periods between 1980 and 2001, as well as anyone who received blood transfusions in those three countries anytime since 1980. ​ AP News​ External Link

    Pregnancy soon after miscarriage no more risky - study​​

    22 November- Contrary to current advice, getting pregnant within a few months of an abortion or a miscarriage does not appear to be extra risky for the mum and baby, say researchers who have looked at recent real-life data. The World Health Organization (WHO) recommends at least a six-month gap. This is to give the woman time to recover. But a study in PLoS Medicine, anal​yzing 72,000 conceptions, suggests couples might safely try sooner for a baby. The baby loss support charity Tommy's says women who feel ready to try again immediately after a miscarriage should do so if there is no medical reason against it. The WHO says more research into pregnancy spacing is already under way and would inform any future updates to the advice. The research from Norway, spanning eight years from 2008 to 2016, found no major differences in outcomes when a new pregnancy happened sooner than a six-month delay. That is a different finding to earlier work in Latin America that - along with other studies - informed the WHO recommendations on pregnancy spacing. The authors of the latest Norwegian analysis say the advice needs reviewing so that couples can make an informed decision about when to try for a baby. Asking parents to wait six months after a miscarriage or an abortion may be unacceptably too long for some, particularly when the emerging medical evidence does not appear to support it, they say. They recommend more studies.​ BBC​ ​External Link

    Shortages of antivirals, antibiotics compound stress of a rough season for viral illnesses in kids​

    22 November- Shortages of key medications used to treat common childhood illnesses like flu, ear infections and sore throats are adding to the misery of this year’s early and severe respiratory virus season. “Right now, we are having severe shortages of medications. There’s no Tamiflu for children. There’s barely any Tamiflu for adults. And this is brand-name and generic,” said Renae Kraft, a relief pharmacist in Oklahoma City. Additionally, “as far as antibiotics go, there’s not a whole lot.” Kraft often works in rural areas of the state, floating between pharmacies when extra help is needed. On Monday, she worked in Holdenville, where there are two pharmacies: Pruett’s and Walmart. The same wholesaler stocks both stores, so if one pharmacy is out, the other usually is, too. Kraft estimates that she had 20 people come in to Pruett’s to fill prescriptions for Tamiflu on Monday, but she didn’t have any, so she sent them to Walmart, which still had some. On social media, families say they’ve hunted for hours for Tamiflu and the first-line antibiotics amoxicillin and Augmentin. Inhalers of the drug albuterol, which is used to open airways in the lungs, are also in short supply, according to the American Society of Health-System Pharmacists, which maintains a list of drug shortages. Anyone can report a shortage for the society’s list, and pharmacists from the University of Utah verify the information with drug manufacturers. “In my 25 years of being a pediatrician, I’ve never seen anything like this,” said pediatric infectious disease specialist Dr. Stacene Maroushek of Hennepin Healthcare in Minnesota. “I have seen families who just aren’t getting a break. They have one viral illness after another. And now there’s the secondary effect of ear infections and pneumonia that are prompting amoxicillin shortages.” CNN​ External Link

    Should you drink water before bed? Experts chime in​

    16 November- Some people may keep a water bottle near their bedside for a nighttime sip, but experts say drinking water at this time could lead to disrupted sleep if one is not careful. It appears it's not all doom and gloom, though, if parting ways with water before bed is something that doesn’t mesh well with already-established nighttime routines. Here's what six health and sleep experts have to say about drinking water before retiring for the night.​​ Tara Clancy, a New York City-based sleep strategist and host of "The Counterfeit Sleep" podcast, said there are pros and cons of drinking water before bed because it can affect sleep performance in different ways. "Drinking a very small amount if you feel thirsty is better than going to bed [feeling] dehydrated," Clancy told Fox News Digital. "That's because dehydration invites congestion and inflammation, which lower sleep performance." Clancy recommends limiting water intake before bed to an ounce or two. "Any more than that, and you risk waking up in the middle of the night for a trip to the bathroom — and that means lower sleep performance," she said. People should start hydrating as soon as they wake up and discontinue drinking water three hours before they g​o to bed, Clancy said.​ Fox News​ External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 45, ending November 12, 2022:

    - Seasonal influenza activity is elevated across the country.

    - The majority of influenza viruses detected this season have been influenza A(H3N2) viruses, but the proportion of subtyped influenza A viruses that are A(H1N1) is increasing slightly.

    - Two more influenza-associated pediatric deaths were reported this week, for a total of seven pediatric flu deaths reported so far this season.

    - CDC estimates that, so far this season, there have been at least 4.4 million illnesses, 38,000 hospitalizations, and 2,100 deaths from flu.

    - The cumulative hospitalization rate in the FluSurv-NET system is higher than the rate observed in week 45 during every previous season since 2010-2011.

    - The majority of influenza viruses tested are in the same genetic subclade as and antigenically similar to the influenza viruses included in this season’s influenza vaccine.

    - An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu.

    - CDC recommends that everyone ages 6 months and older get a flu vaccine annually. Now is a good time to get vaccinated.

    - There are also prescription flu antiviral drugs that can be used to treat flu illness; those need to be started as early as possible. CDC External Link​​


    Poundcake recalled in Canada because of plastic in product​​​

    22 November- Hafner Canada Inc. is recalling Sélection du Pâtissier brand lemon and poppyseed poundcake because of pieces of plastic in the product. The recalled products were sold in Nova Scotia, Ontario and Quebec, Canada, according to the recall notice posted by the Canadian Food Inspection Agency. Consumers, hotels, restaurants and institutions should not use, sell, serve or distribute the affected products. Food Safety News​ External Link

    Unripened, soft cheese recalled because of the possibility of botulism poisoning​

    ​​​18 November- Mounet Group brand Labneh soft unripened cheese in vegetable oil is being recalled because it may be contaminated with Clostridium botulinum, which causes botulism poisoning. There is concern that consumers may have the product in their homes because its expiration date is not until Aug. 15, 2023, according to a recall notice posted by the Canadian Food Inspection Agency. This recall was triggered by the Canadian Food Inspection Agency’s inspection activities. The recalled product has been sold in Quebec. The agency is warning people to not consume, use, sell, serve or distribute the recalled cheese As of the posting of the recall notice on Nov. 18 there have not been any confirmed illnesses related to the recalled cheese. The Canadian Food Inspection Agency (CFIA) is conducting a food safety investigation, which may lead to the recall of other products. The CFIA is verifying that the industry is removing recalled products from the marketplace. The recalled soft cheese can be identified by the following information.​ Food Safety News​ External Link


    Be Antibiotics Aware; misuse can lead to ineffective drugs​​​

    18 November- The Army Public Health Center is promoting the Centers for Disease Control and Prevention’s annual U.S. Antibiotic Awareness Week, November 18-24. The CDC slogan is “BE ANTIBIOTICS AWARE. SMART USE. BEST CARE.” The annual campaign is to increase awareness of the essential need for appropriate antibiotic use, what constitutes antibiotic misuse, and antibiotic side-effects. Many common infections are becoming harder and sometimes impossible to treat as routine antibiotics become less effective. When antibiotics become less effective, people are then at risk of severe illness or even death from infections that have previously been curable, such as tuberculosis, pneumonia and gonorrhea. The impacts can mean longer hospital stays, increased medical costs and more deaths, such as those due to sepsis. Most people have taken antibiotics at some point in their lives. Commonly prescribed antibiotics include penicillins, cephalosporins and tetracyclines. These are used to treat bacterial infections such as strep throat, urinary tract infections, “pink eye” (conjunctivitis) and sexually transmitted infections such as chlamydia, syphilis and gonorrhea. Antibiotics are made to kill bacterial infections or prevent bacteria from reproducing, thus getting rid of infections and their symptoms. But they are not a cure for every type of infection. Importantly, antibiotics do NOT work on viruses such as those that cause colds, flu, COVID-19 or herpes. “Antibiotics have effectively treated mild to severe illness and saved countless lives,” says Maj. Christine Basca, Army Public Health Nurse Division staff officer at the U.S. Army Public Health Center. “But many of the antibiotic drugs that we have relied on for many years to cure common illnesses will become—or are already becoming—ineffective because of antimicrobial resist​ance.” Antibiotic resistance means the bacteria that live in and on our bodies have developed the ability to defeat the antibiotics that are designed to kill them. The CDC now considers antibiotic resistance as one of the most urgent threats to the public’s health. More than 2.8 million antibiotic-resistant infections occur in the United States each year, and more than 35,000 people die as a result.​ External Link


    South Africa measles outbreak: 57 cases in two provinces​​

    21 November- The South Africa National Institute of Communicable Diseases (NICD) reports 57 measles outbreak cases were reported in Limpopo province and Mpumalanga province from September 1 to November 16, 2022. Capricorn and Waterberg districts in Limpopo province and Ehlanzeni in Mpumalanga province reported three or more laboratory-confirmed measles cases within 30 days in the district that meets the criteria for declaring a measles outbreak. Laboratory-confirmed measles cases in Limpopo province have increased to 52 measles cases since the beginning of the measles outbreak, and laboratory-confirmed measles cases are increasing in Capricorn, Greater Sekhukhune, Mopani, and Waterberg districts. Vhembe district reported two laboratory-confirmed measles cases; one measles case epidemiologically linked to the measles circulation in Zimbabwe. In the past seven days, four laboratory-confirmed measles cases were reported in the Bushbuckridge area of Ehlanzeni district in Mpumalanga province. Ehlanzeni district shares the border with Greater Sekhukhune and Mopani districts which were the first districts to declare measles outbreaks. The spread of measles cases in Limpopo province and Ehlanzeni district, Mpumalanga province, poses the risk of measles spread. The sporadic laboratory-confirmed measles cases were reported in Northern Cape, Free State, Gauteng, Free State, and the Western Cape Provinces.​ Outbreak News Today​ External Link


    Iran situation 'critical' with more than 300 killed -UN rights chief​​

    22 November- The U.N. High Commissioner for Human Rights said on Tuesday that the situation in Iran was "critical", describing a hardening of the authorities' response to protests that have resulted in more than 300 deaths in the past two months. "The rising number of deaths from protests in Iran, including those of two children at the weekend, and the hardening of the response by security forces, underline the critical situation in the country," said a spokesperson for U.N. human rights chief Volker Turk at a Geneva news briefing. The Islamic Republic has been gripped by nationwide protests since the death of 22-year-old Kurdish woman Mahsa Amini in morality police custody on Sept. 16 after she was arrested for wearing clothes deemed "inappropriate". Tehran has blamed foreign enemies and their agents for orchestrating the protests, which have turned into a popular revolt by Iranians from all layers of society, posing one of the boldest challenges to the clerical rulers since the 1979 revolution. Iran's World Cup team declined to sing their anthem​ before their opening World Cup match on Monday in a sign of support for the protests.​ Reute​rs​ External Link


    Britain says monkeypox shot offers strong 78% protection​

    22 November- A single dose of the monkeypox vaccine provides 78% protection against the virus, according to data from England released on Tuesday that health officials said was the strongest evidence yet of its effectiveness. Monkeypox cases have remained low but the World Health Organization​ continues to classify the disease as a global health emergency, its highest level of alert. The new analysis reviewed data for the Bavarian Nordic (BAVA.CO) vaccine in England between July 4-Nov. 3, the UK Health Security Agency (UKHSA) said.​ Reute​rs​ ​External Link


    How many Covid cases does China have and what are its rules?​​

    21 November- China has seen its first deaths from Covid-19 in six months, and thousands more people are catching the disease, despite the government's strict lockdown policy. The World Health Organization (WHO) has said China should rethink its strategy. On Sunday 20 November alone, there were 26,824 new cases recorded in China. That is close to the peak back in April 2022. Three people in Beijing are reported to have died from Covid-19 over the past few days. New Covid cases have been reported throughout China. Guangdong, in the south, is the worst affected region.​ China is no longer imposing a national lockdown and has relaxed a number of previous measures. However, the central government is telling local authorities to impose strict lockdowns in their areas when they detect a Covid-19 outbreak - even if only a handful of cases are found. Mass testing is being carried out in places where cases have been reported. People found to have Covid-19 are isolated at home or placed under quarantine at a government-supervised facility. Businesses and schools are closed, and so are all shops except for those selling food. It is one of the toughest anti-Covid regimes in the world and lockdowns last until no new infections are reported. Tens of millions of people have been living under some kind of lockdown since the latest wave of Covid-19. Guangzhou, a southern city of nearly 19 million people, recently ordered a five-day lockdown for Baiyun, its most populous district.​ BBC News​​External Link​​


    Canada Expands Access to Protein-based COVID-19 Booster​​​

    21 November- Novavax, Inc. recently announced that Health Canada had granted expanded authorization for Nuvaxovid™ for active immunization to prevent COVID-19 as a homologous booster in adults. "Canadians now have access to our protein-based Nuvaxovid COVID-19 vaccine as an adult booster," said Stanley C. Erck, President and Chief Executive Officer, Novavax, in a press release on November 18, 2022.  "With the winter months upon us, it's important to have options for vaccination to help protect against COVID-19." Novavax's vaccine (COVID-19 Vaccine (Recombinant protein, Adjuvanted)) (NVX-CoV2373) has been authorized as a heterologous and homologous booster in the U.S., European Union, United Kingdom, Japan, Australia, New Zealand, and Switzerland, as well as several other countries. Novavax has ongoing trials to explore further the vaccine's immunogenicity and safety as a heterologous booster.​ Novavax' patented saponin​-based Matrix-M adjuvant has demonstrated a potent and well-tolerated effect by stimulating the entry of antigen-presenting cells into the injection site and enhancing antigen presentation in local lymph nodes, boosting immune response.​ Precision Vaccinations​ External Link


    Ecuador: Measles case reported in Ibarra, Vaccination campaign activated​​​​

    22 November- The Ecuador Ministry of Public Health (MSP) commenced a measles vaccination campaign for boys and girls between the ages of six months and 11 years, in Ibarra (Imbabura) on Saturday. This action was transferred Monday, November 21, 2022 to the educational establishments of the city, after the identification of a case of measles in that town in the northern Sierra of the country. On Friday, November 18, 2022, an eight-month-old patient with measles was identified. He is in home isolation and has no complications. The epidemiological fence was carried out on more than 150 contacts where two suspected cases were identified that after the analysis were negative. In addition, 330 homes surrounding the patient’s residence were visited to comply with the vaccination sweep. Francisco Pérez, National Undersecretary of Surveillance of the MSP, explained that Ecuador is a country that has the measles elimination certification. This implies that vigilance is maintained and the regular vaccination schedule is reinforced. “Thanks to the surveillance processes we can determine whether or not there are suspected cases. Take samples and send them to the National Institute for Public Health Research (INSPI) for immediate analysis.​ Outbreak News Today​ External Link