ANNOUNCMENTS
One Health Webinar Days
In celebration of One Health Week 2020, the Veterinary One Health Division is hosting the 3rd Annual One Health Day Seminar Day as a 2 Day Webinar Event on Microsoft CVR Teams. Come join us for part of the day or the entire event to listen, learn, collaborate and discuss One Health topics. APHC
U.S. MILITARY
Navy doctors are bringing back this medical screening to prevent sailors' sudden deaths
20 September- On April 1, 2019, Gillian Bush couldn't shake the anxiety she'd felt over the previous 24 hours. In the classroom where she taught second grade in Overland Park, Kansas, she texted a fellow Marine wife in San Diego to ask whether she had heard anything about her husband, Gunnery Sgt. Paul Bush, an instructor at the recruit depot living there as a geographical bachelor. "He didn't show up to work," came the reply. Trying not to panic, Gillian made one phone call but learned little about her husband's whereabouts. It was unlike Paul, a 16-year veteran of the Marine Corps, to miss work. The Bushes had been married eight years and had a toddler, and Paul was transferring back to Kansas for recruiting duty in two months. But it wasn't to be. As Gillian finished the school day, she received another text -- this from a person expressing condolences and referring to her husband in the past tense. Hours later, Gillian was sitting with a Marine Corps casualty assistance officer who confirmed the news: Gunny Bush, 33, had died in his sleep from what Gillian later learned was familial hypertrophic cardiomyopathy -- an inherited disorder that causes thickening of the heart muscles. He never knew of his heart condition, never experienced symptoms, never had an electrocardiogram or saw a cardiologist. "It can be detected by an EKG. How was this not found? To work in a place that won't let you in if you have a tattoo in the wrong place but doesn't do a heart screening other than listen with a stethoscope?" Bush said during an interview Sept. 17. Until 2002, electrocardiograms, also known as ECGs or EKGs, were part of routine screening to join the U.S. military. But they were notoriously famous for false positives, requiring expensive follow-on medical testing and handing young people potentially life-changing misdiagnoses. With technology having advanced substantially in the past 18 years, and after two sudden deaths at the U.S. Naval Academy in February from sudden cardiac arrest, however, a group of Defense Department physicians is working to determine whether reviving the routine EKG for recruits would save lives. Military.com 
Sergeant Major of the Army questions military child care in wake of COVID
22 September- Defense officials should expand child care capacity to ensure that military families' needs are met during crisis conditions such as the COVID-19 pandemic, according to a recommendation on its way to Secretary of Defense Mark Esper from the high-level DoD Military Family Readiness Council. The council also voted Tuesday to recommend addressing shortages of specialty medical care, especially for special needs families; shortages of behavioral health care; and to further explore the implications of the services' access to childhood health care records of potential recruits who are military children. Citing the current challenges with child care during the COVID environment, Sergeant Major of the Army Michael A. Grinston said, "What if we had to do our wartime job and didn't have child care available?" He said DoD needs to evaluate whether it has the right model for providing military child care "given the conditions we're in right now." He specifically suggested expanding child development center capacity. Grinston also suggested officials review the cost structure of child care to ensure it's not an increased burden on military families in the COVID environment. The availability of affordable child care has been an issue for military families for decades. Grinston is one of 18 members of the DoD Military Family Readiness Council, a congressionally-mandated group that meets at least three times a year. In this Tuesday meeting, members voted on their annual recommendations to improve family readiness. The council also voted on their focus topics for next year's work. One is the education of the 1.6 million military-connected school-age children, whether they attend DoD schools or schools in the civilian community, as the majority do. The council will look at COVID impacts on the education of military children, as well as broader issues related to their education and transitions to new schools. Military Times
The US military's latest wearables can detect illness two days before you get sick
22 September- Some troops in the U.S. military are wearing a watch and ring kit that can alert them and their command if they're going to get sick in the next day or two. It's part of a new system that the Defense Innovation Unit, or DIU, has built with Philips Healthcare and the Defense Threat Reduction Agency, or DTRA. The watch and ring — by Garmin and Oura, respectively — are commercially available; they detect subtle biometric indicators, like slight changes in skin temperature. But a new algorithm, trained on Philips' massive cache of patient bedside data, can analyze the data and predict whether the wearer will soon become ill from any of a wide variety of diseases, including COVID-19. Called Rapid Analysis of Threat Exposure, or RATE, the system can't tell you exactly what you have, but can tell you the likelihood, on a scale of 1 to 100, that a sick day is ahead. "Originally, this wasn't designed for COVID-19, but the algorithm was trained against some SARS variants, of which COVID-19 is one," said Dr. Christian Whitchurch, who runs the human systems portfolio at DIU. "We trained this algorithm on something like a quarter-million patient records. These are folks that went into the hospital for an elective surgery…and then became unwell." The researchers identified six markers that allowed the Philips-made algorithm to provide a 48-hour heads-up, before the wearer even feels sick in most instances. "We are pivoting this hospital-developed model into the context of a warfighter using commercially available wearable tech," said Whitchurch. In June, DIU and DTRA began giving the kits to about 400 people.. "Within two weeks of us going live we had our first successful COVID-19 detect" — that is, an indication that the wearer was unwell, which led to a further diagnostic test the revealed COVID-19, he said. "That was amazing." Defense One
This Army-backed research could unlock ways to combat sleep deprivation
18 September- New discoveries uncovered by Army-backed scientists may help future soldiers better combat the ever-present problem of sleep deprivation.
Researchers at the University of Rochester Medical Center in New York recently published a study that shows how a complex set of molecular and fluid dynamics that clear waste from the brain during sleep my be affected when soldiers sleep during the day, out of sync with their natural rhythms. "This knowledge is crucial to developing future countermeasures that offset the deleterious effects of sleep deprivation and addresses future multi-domain military operation requirements for Soldiers to sustain performance over longer periods without the ability to rest," said Dr. Frederick Gregory, program manager for the Army Research Office's neurophysiology of cognition initiative. And it goes way beyond the lab. If soldiers today think that nighttime patrols and months-long deployments are straining their sleep, researchers see a host of challenges for future troops. The types of combat scenarios strategists envision in the not-too-distant future are especially concerning, such as multi-domain operations against peer adversaries such as Russia or China, A focus on such scenarios is embedded in many of the scientific approaches undertaken by the Army's Combat Capabilities Development Command. Army Times
Weed ACH poised to implement new EHR
22 September- On September 26, MHS GENESIS, the Department of Defense's new electronic health record system, is slated to go live at the Weed Army Community Hospital at Ft. Irwin, California. WACH is the first military treatment facility within Regional Health Command- Central, which includes more than six active duty hospitals, and the second hospital in the Army to make the switch to the new electronic health record system. When fully deployed, MHS GENESIS will provide a single electronic health record for service members, veterans, and their families. Through MHS GENESIS, beneficiaries can view their health information, exchange secure messages with their care team, request prescription renewals, view notes from clinical visits, request medical and active duty dental appointments, and more. Army Lt. Col. Meshelle Taylor, a program manager and the MHS GENESIS point of contact for WACH, said the transition to MHS GENESIS will initially reduce appointment availability since appointments will be extended to one-hour appointments to accommodate the learning curve for providers and other staff sing the new system. The initial friction point will be partially mitigated with the use of virtual appointments and will ultimately lead to long-term benefits, she stated. "MHS Genesis will provide one inclusive record for in-patient, out-patient and dental care leading to safer quality care to our patients" Taylor explained. WACH staff began preparing for MHS GENESIS last April and went through several phases to get ready for the transition. The phases included online training, a sign-on fair, and a mock go-live. Army Capt. Steven Fowler, the WACH patient administration division chief, oversaw the sign-on fair and arranged the time slots for more than 400 employees to sign on and resolve any issues with the system. "Sign-on fair is to validate that every individual who touches MHS GENESIS has their right account and the right accesses based off of their job," he said. Ten days before the launch, WACH staff participated in a mock go-live event. During the event, staff ran through scenarios to practice how they would use the system in real life. From a patient checking in at the front desk, having a nurse take their vitals, being seen by a provider, all the way to picking up prescriptions from the pharmacy, many departments had a role to play in one or more scenarios. Health.mil
GLOBAL
3-D printing inside the body could patch stomach ulcers
22 September- Stomach ulcers and other gastric wounds afflict one in eight people worldwide, but common conventional therapies have drawbacks. Now scientists aim to treat such problems by exploring a new frontier in 3-D printing: depositing living cells directly inside the human body.
Just as 3-D printers set down layers of material to create structures, bioprinters extrude living cells to produce tissues and organs. A long-term dream for this concept is that people on active waiting lists for organ donations—nearly 70,000 individuals in the U.S. alone, according to the nonprofit United Network for Organ Sharing—might one day have the option of getting a bioprinted organ. Although the ability to produce a functional heart or kidney this way likely lies years in the future, realistic near-term goals include bioprinting simpler structures, such as bone grafts. Living tissues printed outside the body, however, would still require implantation surgery, which often involves large incisions that increase the risk of infection and lengthen recovery times. What if doctors could instead print cells directly inside the body? The idea would be to use current minimally invasive surgical techniques to insert 3-D printing tools into patients through small incisions and then lay down new tissues. Potential applications for such "in vivo bioprinting" might include surgical meshes to help repair hernias and patches for ovaries to help reverse infertility. Much of the previous research on in vivo bioprinting has focused on treatments of skin and other tissues in the outer part of the body, because the necessary equipment is normally too large to access the digestive tract and other centrally located organs without extensive surgery. In their effort to treat stomach lesions less invasively, scientists in China wanted to develop a miniature bioprinting robot that could enter the human body with relative ease. The researchers used existing techniques for creating dexterous electronic devices, such as mechanical bees and cockroach-inspired robots, says the study's senior author Tao Xu, a bioengineer at Tsinghua University in Beijing. Scientific American
Airlines call for COVID-19 tests before all international flights
22 September- Global airlines on Tuesday called for pre-departure COVID-19 testing for all international flights to replace the quarantines and other restrictions blamed by the industry for exacerbating the travel slump. Rapid and affordable tests that can be administered by non-medical staff are expected to become available in "coming weeks" and should be rolled out under globally agreed standards, the head of the International Air Transport Association said during an online media briefing. "We don't see any alternative solution that would be less challenging or more effective," IATA Director General Alexandre de Juniac said. Reuters
Blood protein test could detect severity of head trauma in minutes
17 September- A blood protein test could detect the severity of head trauma in under 15 minutes, according to research published recently in the Journal of Neurotrauma. By showing that glial fibrillary acidic protein (GFAP) can accurately determine the severity of a brain injury through a blood test, the research team working on this study, led by author David Okonkwo, M.D., Ph.D., director of the Neurotrauma Clinical Trials Center at UPMC and professor of neurological surgery at the University of Pittsburgh School of Medicine, advanced the development of a point-of-care testing device designed to help clinicians assess traumatic brain injury (TBI) in minutes. For the rapid test, the vision included using a hand-held device with a cartridge that would measure GFAP in a patient's blood. Researchers at Abbott Laboratories, a global health care company, will need to finalize the test for the i-STAT device, which already is used by the military and health care providers around the world to perform several common blood tests within minutes. The blood test would reveal a patient's GFAP level. For this study, which expanded upon previous GFAP findings, researchers enrolled 1,497 people who sought care at one of the 18 Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) level 1 trauma centers nationwide over four years. GFAP is a Food and Drug Administration-approved marker for ruling out whether a patient needs a head computed tomography (CT) scan within 12 hours after a mild TBI. News Medical Life Sciences
Coronavirus is becoming stronger: Researchers discover it's heat-resistant and can heal itself
20 September- Researchers claim coronavirus is stronger than what other studies say. A team of scientists in Hungary tried to pierce the novel coronavirus's viral particle using a fine needle. They conducted the experiment to see how much force the virus could withstand before it explodes like a balloon. However, the scientists were surprised by the result since it did not explode. The Sars-Cov-2's native virion, the complete virus particle, is only 80 nanometers wide. The needle that the researchers used is smaller compared to the virus's size. They put the needle's tip from the top of the virus and then pierced it until it reached the viral particle's bottom, squashing the virion. However, it was able to recover quickly after the needle was removed. The scientists repeated the drill 100 times, but the viral particle remained almost intact. Dr. Miklos, a scientist from Kellermayer of Semmelweis University in Budapest who led the study, said that it is "surprisingly resilient." The research's results were posted in a non-peer-reviewed paper of biorxiv.org on Thursday, Sept. 17. Tech Times
Coronavirus pediatric fatalities mostly among minorities, those with underlying conditions, CDC says
17 September- Less than 1% of coronavirus-related deaths were among Americans younger than 21, and minorities and those with underlying conditions accounted for the vast majority of lives lost, according to new data. The Centers for Disease Control and Prevention (CDC) released findings on Tuesday of 121 coronavirus-related deaths (around 0.08% of all deaths) among U.S. kids reported to the health agency by July 31. Though COVID-19 infections tend to run a milder course in younger populations, complications do happen, the agency said. Of the 121 deaths, around 75% were among Hispanic, non-Hispanic Black, and non-Hispanic American Indian/Alaskan Native kids, even though these populations represent 41% of kids in the U.S. This disproportionate representation echoes patterns among essential workers, the CDC said, and the agency pointed to disparities in social determinants of health (i.e. crowded living conditions, wealth and educational gaps) for the racial and ethnic disparities driving COVID-19 incidence and outcomes. Also, 10% of the deaths were among infants and 70% were between ages 10 to 20. Further, the majority (75%) of the deaths were among youth with at least one underlying medical condition, while 25% were previously healthy. Common health conditions involved lung issues (including asthma), obesity, developmental conditions and heart problems. Fox News
COVID-19 pandemic tied to worse stress, depression among US adults
21 September- Acute stress and depression rates rose in US adults as COVID-19 cases and deaths accumulated from mid-March to mid-April, largely related to preexisting mental and physical conditions and stressors such as job and wage loss, according to a study of 6,514 people from three large, nationally representative cohorts. In the study, published late last week in Science Advances, researchers from the University of California at Irvine evaluated stress and depression symptoms using the NORC AmeriSpeak panel over three 10-day periods. Before the pandemic, participants reported, on average, one physical illness, and 17.7% had been diagnosed as having a mental illness. During the pandemic, 23.5% of participants said that they or a close friend or family member had symptoms of or were diagnosed as having COVID-19, while 29.8% said they had been exposed at work. Participants noted, on average, 1.4 secondary stressors such as job loss or waiting in long lines for supplies and reported consuming a mean of 7.1 hours of pandemic-related media coverage each day. Compared with men, women reported higher stress, but not depressive symptoms, while older people and residents of suburban versus urban areas had lower levels of stress and depressive symptoms, respectively. Respondents who lived in the Midwest, South, and West reported lower acute stress, but not depression, than those in the Northeast. Respondents with higher incomes reported fewer depressive symptoms than low-income participants, but not less stress. People with personal exposure to COVID-19 reported more stress and depressive symptoms than others, as did those with job and income loss, while those with work-related exposures or community-related issues such as lockdowns had no more depression symptoms than usual. More hours spent consuming media coverage of the pandemic, higher media consumption than before the pandemic, and more exposure to conflicting information about COVID-19 were predictive of more severe stress and depression. CIDRAP
Flu jab 'more important than ever' this winter
22 September- People are being advised to get a flu jab to help protect against the "double danger" of flu and coronavirus. Research shows people can catch both diseases at the same time, with serious and sometimes deadly consequences. More people will be offered a free flu vaccine this year - anyone over 50 in England is eligible. A vaccine for coronavirus is not available yet and experts are worried the UK could see the virus rip through the population this winter. Research from Public Health England looking at Covid-19 illness between January and April among nearly 20,000 hospital patients suggests risk of death is more than doubled for people who catch flu on top of coronavirus, compared to coronavirus alone. Flu by itself can also be a serious condition - it kills around 11,000 people in England each year and hospitalizes many more. People at high risk from flu are also most at risk from Covid-19. BBC
New report says Covid-19 pandemic has caused historic setbacks in global health
14 September- A new report paints a bleak picture of the far-ranging impact of the Covid-19 pandemic, with a major backsliding in the percentage of children around the world getting essential vaccinations, food insecurity on the rise, and a sharp increase in the number of people living in extreme poverty. The first six months of the pandemic saw the number of people living in extreme poverty around the globe rise by 7%, after declining year after year for the past two decades. "That one is super worrying," billionaire philanthropist Bill Gates said of the extreme poverty trend, one of more than a dozen metrics for global development assessed in the 2020 issue of the Bill and Melinda Gates Foundation's Goalkeepers report. The annual report evaluates progress toward what are known as the United Nations' Sustainable Development Goals, adopted in 2015. The 17 SDG are effectively a global pledge to improve life for all people on the planet by 2030 through a range of measures such as increasing the percentage of children who are vaccinated, providing clean water and sanitation, reducing inequality, and ending hunger. The Gates Foundation typically likes to accentuate the positive, focusing on progress that is being made. To date, the Goalkeepers reports have been cast in that vein. STAT News
Quitting smoking apps that help you acknowledge your triggers work better, study shows
21 September- If you're trying to quit smoking, it could pay to acknowledge and accept your cravings rather than avoid them. And downloading a smartphone app that takes that approach could increase your odds of success, according to a study published Monday in JAMA Internal Medicine. "The problem is that when you try to avoid what you're feeling and what you're thinking, you paradoxically create more of what you're trying to avoid," said Jonathan Bricker, lead author of the new study and a professor in the cancer prevention program at Fred Hutchinson Cancer Research Center in Seattle. That approach to behavioral change could be beneficial to the more than one in 10 Americans who smoke. One shortcoming of this tech-driven approach, however, is that it requires people trying to quit to have a smartphone and a working phone line, according to Dr. Panagis Galiatsatos, an assistant professor of medicine at Johns Hopkins School of Medicine in Baltimore and a volunteer spokesperson for the American Lung Association. He was not involved in the study. "I need primary care physicians to be cognizant of this type of product being available," he said. However, this should be as an adjunct (to medical care), not as a replacement." The majority of his patients are Black, he noted, and the average annual income for those in his surrounding community is about $15,000. Galiatsatos directs the Tobacco Treatment Center at Johns Hopkins Bayview Medical Center. Although smoking tobacco has fallen to record lows, 34 million Americans still smoke, according to Smoking Cessation: A Report of the Surgeon General, which was released earlier this year. CNN
Rural hospitals teeter on financial cliff as COVID-19 Medicare loans come due
22 September- David Usher, chief financial officer for a 12-bed rural hospital in western Kansas, is sitting on $1.7 million he's scared to spend. The money lent from the federal government is meant to help hospitals and other health care providers weather the COVID-19 pandemic. Yet some hospital administrators have called it a payday loan program that is now brutally due for repayment at a time when the institutions still need help. Coronavirus cases have "picked up recently and it's quite worrying," says Usher, who is the chief financial officer for Edwards County Medical Center in Kinsley, Kan. He would like to use the federal loan money to build a negative-pressure room; such rooms are a common and effective strategy for keeping contagious patients apart from those in the rest of the hospital. But he's not sure it's safe to spend that cash. Officially, the total repayment of the loan is due this month. Otherwise, according to the loan's terms, federal regulators will stop reimbursing the hospitals for Medicare patients' treatments until the loan is repaid in full. The federal Centers for Medicare & Medicaid Services has not yet begun trying to recoup its investment, with the coronavirus still affecting communities nationwide, but hospital leaders fear it may come calling for repayment any day now. Hospital leaders across the country say there has been no communication from CMS on whether or when they will adjust the repayment deadline. A CMS spokesperson did not respond to our questions by press time. "It's great having the money," Usher says. "But if I don't know how much I get to keep, I don't get to spend the money wisely and effectively on the facility." Usher took out the loan from Medicare's Accelerated and Advance Payments program. The program, which existed long before the pandemic, was generally used sparingly by hospitals when they were faced with emergencies such as hurricanes or tornadoes. It was expanded for use during the coronavirus pandemic — part of billions approved in federal relief funds for health care providers this spring. NPR
'You need a test': CDC reverses guidance for asymptomatic COVID contacts
18 September- Asymptomatic people who have been exposed to COVID-19 should be tested, the CDC said on Friday, in a reversal of controversial guidance the agency introduced in late August. It is now unequivocal, with the agency stating that for individuals without symptoms who have been in close contact with an infected person for at least 15 minutes: "You need a test." The Infectious Diseases Society of America (IDSA) applauded Friday's reversal. Its president, Thomas File, MD, said in an emailed statement, "The return to a science-based approach to testing guidance from the Centers for Disease Control and Prevention is good news for public health and for our united fight against this pandemic." Until a few weeks ago, the CDC recommendations stated: "Testing is recommended for all close contacts of persons with SARS-CoV-2 infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important that contacts of individuals with SARS-CoV-2 infection be quickly identified and tested." But the agency quietly altered its guidance on August 24, stating that if patients did not have symptoms, they did not "necessarily" need a test, unless it was recommended by a healthcare provider or state/local health official or they were "vulnerable" -- bringing a barrage of criticism from public health professionals. Adm. Brett Giroir, assistant secretary for health in the Department of Health and Human Services, defended the policy, asserting that screening asymptomatic contacts of infected people was unhelpful and testing should focus on individuals with symptoms. Those remarks, in turn, followed President Trump's repeated complaints about excessive testing. MedPage Today
INFLUENZA
CDC: Flu View - Weekly U.S. Influenza Surveillance Report
2019-2020 Influenza Season Week 37, ending September 12, 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.
Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths occurring during the 2019-2020 season were reported to CDC during week 37. CDC
WHO: Influenza Update
14 September 2020 - Update number 376, based on data up to 01 September 2020:
- The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic 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 have likely played a role in reducing influenza virus transmission.
- Globally, influenza activity was reported at lower levels than expected for this time of the year. In the temperate zones of the southern hemisphere, the influenza season has not started. Despite continued or even increased testing for influenza in some countries in the southern hemisphere, very few influenza detections were reported.
- In the temperate zone of the northern hemisphere, influenza activity remained below inter-seasonal levels.
- In the Caribbean and Central American countries, no influenza detections were reported. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, appeared to decrease in some reporting countries.
- In tropical South America, tropical Africa and Southern Asia there were sporadic or no influenza detections across reporting countries.
- In South East Asia, influenza A(H3N2) virus detections were reported in Cambodia.
- Worldwide, of the very low numbers of detections reported, seasonal influenza A viruses accounted for the majority of detections. WHO
VETERINARY/FOOD SAFETY
Indiana officials investigating cluster of Salmonella infections
18 September- Health officials are urging anyone who ate or drank anything from an Indiana grocery store since Sept. 7 to monitor themselves for signs of Salmonella infection. Local media, FOX59, reported county officials are investigating a cluster of illnesses among patrons of La Aldea Grocery Store at 2801 Klondike Rd #D. Public health staff from the Tippecanoe County Health Department are reportedly working with the state health department on the investigation. As of this evening, state officials had not responded to a request from Food Safety News for confirmation of the investigation. The county health department requests that anyone who ate or drank anything from the store in West Lafayette between Sept. 7 and 17 and became ill contact a health care provider as well as the county department. Sick people should call 765-423-9222 Ext. 1, according to the FOX59 report. Food Safety News
More microgreens recalled in relation to Salmonella outbreak
22 September- A third recall has been initiated in Canada related to a Salmonella outbreak associated with fresh sprouts from Sunsprout. The recall covers micro-greens including alfalfa and onion, and alfalfa and radish. There is concern that consumers may have the recalled microgreens in their homes because of their relatively long shelf life. The sprouted greens named in the expansion of the Sunsprout product recall have best-before dates up to and including Oct. 5, according to the recall notice posted by the Canadian Food Inspection Agency. Previously recalled Sunsprout microgreens have best-before dates up to and including Oct. 13. Food Safety News
WELLNESS
An optimistic outlook may be a healthier one
18 September- In a population of relatively young and healthy U.S. Army active-duty soldiers, we found that those who tested highest for optimism at the start of the study had a 22% lower risk of developing hypertension during three-and-a-half years of follow-up than those who scored the lowest. We know that people in the military are more susceptible to early-onset hypertension because of the stressors associated with their jobs (for example, combat exposure), so it was striking to see that much of a protective effect—and also that the finding held for both women and men, and across racial and ethnic groups. We took into account of a lot of other factors that might have explained away the apparent effects of optimism, including number of deployments, smoking, and levels of depression, but none of them substantially altered our key finding. People who are optimistic don't tend to be depressed, but our analysis further suggests that optimism confirms protection over and above signaling the absence of a risk factor—it's a positive health asset. Given that early-onset hypertension can lead to many cardiac and cardiovascular problems down the road, it's important that we identify protective factors and seek ways to foster them early on. Harvard.edu
USAFRICOM
Ebola: DRC's 11th outbreak rises to 124 cases
21 September- Health officials recorded an additional Ebola Virus Disease (EVD) case in the Democratic Republic of the Congo's (DRC) Equateur province, bringing the total in the 11th Ebola outbreak in the country to 124 (118 confirmed and 6 probable). The death toll remains at 50 (44 confirmed and 6 probable). The case fatality ratio among confirmed cases is 37.3% (44 deaths/118 confirmed cases). The number of health workers affected remains at three, making up 2.4% of all cases. The number of health areas that have reported at least one confirmed or probable case of EVD since the start of this outbreak has risen to 40 (14.2%) of 281 health areas, in 12 (66.7%) of the 18 health zones in the province. The World Health Organization says the EVD outbreak in Équateur Province is showing a slow rise in case numbers and deaths. Although this slow rise in numbers is encouraging, there are still contacts lost to follow up, confirmed cases still remain in the community and safe and dignified burials continue to be a challenge. In addition, two of the affected health zones, Bomongo and Lilanga Bobangi, border Republic of Congo, requiring reinforcement of trans-boundary surveillance. Outbreak News Today
USCENTCOM
UAE: Reports 674 new cases of coronavirus
20 September- Health officials in the UAE reported 674 new cases of coronavirus across the country on Sunday. The new infections were announced by the Ministry of Health and come after 97,251 Covid-19 tests were carried out over the last 24 hours. It takes the total number of cases in the country to 84,916. The authority also revealed 761 recoveries since the numbers were last reported on Saturday, with the number of patients to have recovered standing at 74,273. There were no new fatalities reported on Sunday. Arabian Business
USEUCOM
Covid: UK coronavirus alert level moving to 4
21 September- The UK's coronavirus alert level should be raised from level 3 to 4, meaning transmission is "high or rising exponentially", its chief medical officers have said. It comes after the government's scientific adviser warned there could be 50,000 new coronavirus cases a day by mid-October without further action. The PM will make a statement in the Commons on Tuesday. On Monday, a further 4,368 daily cases were reported in the UK, up from 3,899. A further 11 people have also died within 28 days of a positive test, although these figures tend to be lower over the weekend and on Mondays due to reporting delays. Speaking at Downing Street alongside chief medical adviser, Prof Chris Whitty, Sir Patrick Vallance said: "At the moment we think the epidemic is doubling roughly every seven days. "If, and that's quite a big if, but if that continues unabated, and this grows, doubling every seven days... if that continued you would end up with something like 50,000 cases in the middle of October per day. "Fifty-thousand cases per day would be expected to lead a month later, so the middle of November say, to 200-plus deaths per day. BBC News
Sweden: 97 percent of two-year-olds were fully vaccinated in 2019, HPV vaccination rates also high
20 September- According to the Swedish Public Health Agency's and the Medical Products Agency's joint annual report for 2019, adherence to the vaccination program remains high: 97 percent of two-year-olds were fully vaccinated in 2019. Last year, not a single case of rubella and tetanus was reported, and only isolated cases of cutaneous diphtheria. Pneumococcal infections among children under the age of two remain at a low level. There were also fewer measles cases, 20, after two years with relatively many due to major outbreaks. About 30 people fell ill with mumps, most aged 25-39 years. The total number of cases of pertussis increased slightly compared with 2018. Since 2014, however, pertussis among infants has decreased significantly, and a small decrease was also seen in 2019 compared with the year before. In addition, an increasing proportion of girls are also vaccinated against HPV: At the end of 2019, 86 percent of all 13-year-old girls were vaccinated with at least one dose of HPV. vaccine and 80 percent with two doses. In September 2019, vaccination against rotavirus infection was introduced in the childhood vaccination program, and from the autumn term 2020, vaccination against HPV is offered to all children, regardless of gender, in year five. Vaccination against rotavirus has got off to a good start. Vaccination coverage was close to 90 percent among the children who were the first to be covered by the vaccination program. "We have a well-functioning and stable vaccination program that we must take care of", says Sören Andersson, unit manager at the unit for vaccination programs at the Swedish Public Health Agency. Outbreak News Today
USINDOPACOM
China: Thousands of people test positive for brucellosis, linked to biopharmaceutical company leak in 2019
19 September- The Health Commission of Lanzhou in Gansu province in northeastern China has announced (computer translated) 3,245 people have been confirmed positive for the bacterial disease, brucellosis linked an outbreak caused by a leak at a biopharmaceutical company last year. The outbreak began from a leak at the Zhongmu Lanzhou biological pharmaceutical factory last summer. Health officials say as of September 14, 21,847 people were tested, of which more than 3,000 were confirmed. In December 2019, a joint investigation showed the Zhongmu Lanzhou biological pharmaceutical factory used expired disinfectants and sanitizers in the production of Brucella vaccine and contaminated waste gas formed aerosols that contained the bacteria that was carried by the wind down to the Lanzhou Veterinary Research Institute, where the outbreak first hit. Outbreak News Today
USNORTHCOM
U.S.: Massachusetts- Reports 5th human Eastern Equine Encephalitis case
19 September- The Massachusetts Department of Public Health (DPH) announced the fifth confirmed human case of Eastern Equine Encephalitis (EEE) virus infection of the year in a female in her 60s who was exposed to EEE in Plymouth County. More than 95 percent of the EEE cases that have occurred in Massachusetts since 2000 have been exposed to the virus before mid-September. Mosquito populations are declining although some risk will continue until the first hard frost. All residents are reminded to use mosquito repellent any time they are outside, and those in high and critical risk communities are advised to schedule their outdoor activity to avoid the dusk to dawn hours to reduce exposure to the mosquitoes most likely to spread EEE. EEE is a rare but potentially fatal disease that can affect people of all ages. There have already been four other human cases identified this year. In 2019, there were 12 human cases of EEE in Massachusetts with 6 deaths. Outbreak News Today
U.S.: South Florida Dengue fever- 65 confirmed local cases reported
22 September- Florida state health officials report the number of locally-transmitted dengue fever cases reported this year is up to 65, with the addition of nine reported in Monroe County last week. These cases were identified through retrospective case finding efforts to better characterize activity early in the outbreak. Of the 65 local transmission cases, 64 have been reported in Monroe County (the Key Largo vicinity) and one in Miami-Dade County. The Florida Department of Health in Monroe County (DOH-Monroe) and Florida Keys Mosquito Control District (FKMCD) are working closely to continue surveillance and prevention efforts. FKMCD is assisting with these investigations and continue to intensifying mosquito control activities in the Key Largo (Upper Keys) Area. In addition to the indigenous cases, 32 travel associated cases have been reported in 2020 to date. Outbreak News Today
USSOUTHCOM
Colombia: COVID-19 cases top 758K, now 5th in the world
20 September- The Colombia Health Ministry reported an additional nearly 8,000 confirmed COVID-19 cases Saturday, putting the country total to 758,398, surpassing Peru to become the country with the fifth most cases globally. More than 620,000 cases have recovered, or some 82 percent to date and 24,039 deaths have been recorded. Colombia has reported 2,726 confirmed cases of COVID-19 among pregnant women reported, including 40 deaths (2%, including 32 early maternal deaths and 8 late maternal deaths) through September 14. 737 of the cases were reported in Bogota. To date, Colombia has seen 15,537 confirmed cases of COVID-19 among persons of indigenous ethnicity, including 578 deaths (3.7%). This number of cases represents 2% of the total number of COVID-19 cases in Colombia. More than 9,600 confirmed cases of COVID-19 were reported among healthcare workers, including 65 deaths and 9,385 recovered. Of the total confirmed cases, 646 (7%) were asymptomatic. About one-third of the cases were reported in Bogota. Colombia has reported 3 cases of multisystem inflammatory syndrome (MIS) in children and adolescents temporally related to COVID-19 and no deaths. Outbreak News Today
