Defense Public Health Weekly Update, 02 June 2023

Date Published: 6/2/2023
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Table of Contents


    2022 Health of the Force Now Available

    10 May- Through annual reporting of key indicators that impact readiness and Soldier well-being, Health of the Force improves awareness and understanding of the health status of the Army. Results are communicated through an online digital platform and traditional reports. The Health of the Force suite of products gives leaders tools to advance programs and strategies that improve performance and reduce illness and injury. DCPH​​​


    DHA Senior Leader: ‘Virtual First’ is the Future of Military Health System​​​

    25 May- The Defense Health Agency plans to advance its use of virtual technology with an aim to get the patient connected to the medical provider no matter where they are, according to one of the agency’s top doctors. Dr. Brian Lein, assistant director for health care administration for the DHA, said the agency needs to invest in people, capabilities, systems, and processes to achieve a virtual future for DHA. “What's the most important thing we need to invest in?” asked Lein. “It's culture. How do we invest in the culture within the military health care system to get to a virtual-first environment?” The solution, he said, is all about the patient. “It's investing in a culture change of who we are as a military health care system to truly put the patient first.” Lein was one of several Military Health System leaders who talked about the future of using health care technology at the annual Healthcare Information and Management Systems Society conference, held in Chicago, Illinois, in April. In his presentation, titled “Virtual First/Digital Always in the Defense Health Agency,” he talked about how the MHS can achieve integrated, digital-health capabilities. Lein discussed DHA’s current use of health technology across the enterprise and where it needs to invest to achieve modernization.  Lein, who manages the administration of health care delivery across all Department of Defense hospitals and clinics around the world, noted DHA’s undertaking of “the biggest merger and acquisition the health care industry has seen. We've combined 48 inpatient hospitals, hundreds of clinics, urgent care centers, dental clinics, 180,000, health care professionals, 100,000 or so in uniform and 60,000 or so out of uniform wear all into one health care system.” “Before connecting this network of military hospitals and clinics, there was no one system, and no “standardized workflow (or) standardized processes. We had three different analytics systems, three different budgets, three different resource allocation systems,” Lein said. “Now we're going to completely redesign that health care technology interface to better serve our patient population.” “We need to implement a fundamental redesign of how we interact with the individual beneficiary and how that beneficiary interacts with an incredibly complex health care system,” he added. Health.m​il​ External Link

    ​Space Force Rolls Out Fitness Trackers to Guardians in Lieu of Traditional Testing​

    ​25 May- The Space Force announced Thursday it will conduct a two-year testing period on wearable fitness trackers as part of its newly unveiled fitness policy. The service will start the assessment of wearable technology this month, and use will be voluntary, according to a press release. It will work with the Air Force Research Laboratory to develop the guidelines for the wearable devices, with the aim of regularly monitoring fitness and wellness of Guardians. Those who opt in will not be required to take the old fitness assessment that included push-ups, sit-ups and a 1.5-mile run. "The Air Force Research Laboratory is proud to work with the U.S. Space Force to ensure that Guardians receive a highly effective, safe, and secure fitness assessment capability," Dr. James Christensen, a lab product line lead, said in a statement.​ In 2022, Space Force leaders promised to unveil a revolutionary fitness program called the Holistic Health Approach that would use fitness wearables -- similar to Apple Watches or Fitbits -- to help track exercise, diet and sleep instead of using a physical test like the other services have embraced for decades. But progress on that program and details of how it will work had not been fully disclosed until Thursday, when Space Force officials released the memo detailing the structure of the program.​ External Link


    A new antibiotic, discovered with artificial intelligence, may defeat a dangerous superbug​​

    26 May- Using artificial intelligence, researchers say, they’ve found a new type of antibiotic that works against a particularly menacing drug-resistant bacteria. When they tested the antibiotic on the skin of mice that were experimentally infected with the superbug, it controlled the growth of the bacteria, suggesting that the method could be used to create antibiotics tailored to fight other drug-resistant pathogens. The researchers also tested the antibiotic against 41 different strains of antibiotic-resistant Acinetobacter baumannii. The drug worked on all of them, though it would need to be further refined and tested in human clinical trials before it could be used in patients.​ What’s more, the compound identified by AI worked in a way that stymied only the problem pathogen. It didn’t seem to kill the many other species of beneficial bacteria that live in the gut or on the skin, making it a rare narrowly targeted agent. If more antibiotics worked this precisely, the researchers said, it could prevent bacteria from becoming resistant in the first place. The study was published in the journal Nature Chemical Biology. “It’s incredibly promising,” said Dr. Cesar de la Fuente, an assistant professor at the University of Pennsylvania’s Perlman School of Medicine who is also using AI to find new treatments but was not involved in the new research. De la Fuente says this type of approach to finding new drugs is an emerging field that researchers have been testing since about 2018. It dramatically cuts the time it takes to sort through thousands of promising compounds. “I think AI, as we’ve seen, can be applied successfully in many domains, and I think drug discovery is sort of the next frontier.”​ CNN​ External Link

    Doctors say this is the most important virus you’ve never heard of​​

    29 May- The past winter was a heavy one for respiratory viruses, dominated by surges of RSV, influenza and Covid-19. But just as it was winding down, a little-known virus that causes many of the same symptoms – a lower lung infection, hacking cough, runny nose, sore throat and fever – was just picking up steam. Cases of human metapneumovirus, or HMPV, spiked this spring, according to US Centers for Disease Control and Prevention’s respiratory virus surveillance systems. It filled hospital intensive care units with young children and seniors who are the most vulnerable to these infections. At its peak in mid-March, nearly 11% of tested specimens were positive for HMPV, a number that’s about 36% higher than the average, pre-pandemic seasonal peak of 7% test positivity. Most people who caught it probably didn’t even know they had it, however. Sick people aren’t usually tested for it outside of a hospital or ER. Unlike Covid-19 and the flu, there’s no vaccine for HMPV or antiviral drugs to treat it. Instead, doctors care for seriously ill people by tending to their symptoms. Studies show that HMPV causes as much misery in the US each year as the flu and a closely related virus, RSV. One study of patient samples collected over 25 years found that it was the second most common cause of respiratory infections in kids behind RSV. A study in New York conducted over four winters found that it was as common in hospitalized seniors as RSV and the flu. Like those infections, HMPV can lead to intensive care and fatal cases of pneumonia in older adults. Diane Davison caught human metapneumovirus during a family celebration in early April. Two weeks later, she was coughing so violently, she couldn’t talk on the phone.​ CNN​ External Link

    Pfizer's hemophilia therapy reduces bleeding in late-stage study​

    30 May- U.S. drugmaker Pfizer Inc. (PFE.N) said on Tuesday late-stage study data for its experimental hemophilia therapy showed superiority to the current standard of care treatment in reducing bleeding rates in patients. The therapy, marstacimab, met its main trial goal, demonstrating superiority to factor replacement therapies, with a 92% reduction in bleeding in patients with severe hemophilia A and moderately severe to severe hemophilia B, Pfizer said. Hemophilia hampers the body's ability to make blood-clotting proteins, leading to prolonged bleeding following injuries or surgery, and it primarily affects males, according to government data. The esti​mated prevalence in the United States is 12 cases per 100,000 males for hemophilia A and 3.7 cases per 100,000 males for hemophilia B. The current standard of care requires regular infusion of the missing proteins. Reuters​ External Link

    SIDS linked to brain abnormality that increases babies’ risk in ‘unsafe sleep conditions,’ study finds​​

    ​27 May- About 3,400 babies die of sudden infant death syndrome (SIDS) each year in the U.S., according to the Centers for Disease Control and Prevention (CDC).  Now, a new study led by researchers at Boston Children’s Hospital and Harvard Medical School suggests that some of the unexplained deaths may be caused by an abnormality in the medulla, which connects the brain stem and the spinal cord. The study was published in the Journal of Neuropathology & Experimental Neurology on May 25." We found abnormalities in a particular receptor (the serotonin receptor 2A/C) in the medulla oblongata, part of the lower brain stem that regulates autonomic and respiratory function, in a subset of SIDS infants," lead author Dr. Robin Haynes, PhD, who is a principal associate at Harvard Medical School, told Fox News Digital via email. When a baby isn’t getting enough oxygen, the serotonin receptor 2A/C triggers the baby’s natural instinct to gasp for air, the doctor explained.  When the receptor has an abnormality that doesn’t allow it to function correctly, it doesn’t send the signal to the baby to "reoxygenate the brain." "This places them at greater risk in unsafe sleep conditions, such as prone sleep and bedsharing, when the levels of oxygen around the infant’s airway may be lower than normal," Haynes said. Fox News​ External Link​​


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 20, ending May 20, 2023:

    - Seasonal influenza activity remains low nationally.

    - This week is the last full version of FluView for the 2022-2023 influenza season. Starting with week 21, an abbreviated summer version of FluView will be published. The full version is expected to resume for week 40 of 2023, which is the start of the 2023-2024 influenza season.

    - Nationally, outpatient respiratory illness is below baseline, and eight of 10 HHS regions are below their respective baselines.

    - The number of flu hospital admissions remains low.

    - During week 20, 36.1% of the 36 viruses reported by public health laboratories were influenza A and 63.9% were influenza B. All six influenza A viruses detected and subtyped during week 20 were influenza A(H1N1).

    - Two influenza-associated pediatric death that occurred during the 2022-2023 season were reported this week, for a total of 154 pediatric flu deaths reported so far this season.

    - CDC estimates that, so far this season, there have been at least 27 million illnesses, 300,000 hospitalizations, and 19,000 deaths from flu.

    - 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.

    - All viruses collected and evaluated this season have been susceptible to the influenza antivirals peramivir, zanamivir, and baloxavir, and all viruses except for one (> 99.9%) have been susceptible to the influenza antiviral oseltamivir.

    - CDC continues to recommend that everyone ages 6 months and older get an annual flu vaccine as long as flu activity continues. CDC​ External Link​​


    Company recalls cheese because of Listeria infection in one customer; testing showed pathogen​​

    30 May- A person has fallen ill with an infection from Listeria monocytogenes after testing found the pathogen in cheese from Cricket Creek Farm of Williamstown, MA. The company is recalling certain Sophelise and Tobasi cheeses that were distributed in Massachusetts and New York through Wild Oats, Williamstown, MA; Provisions Williamstown, Williamstown, MA; McEnroe Organic Farm Market, Millerton, NY; New Lebanon Farmers Market; New Lebanon, NY, at restaurants, and farmers markets, according to the company’s recall notice posted by the Food and Drug Administration. Other than the reporting of one illnesses, no patient information has been revealed. It is not known what state or city the person lives in. The product code on the recalled Sophelise product is 087055. It is a washed, pasteurized milk cheese with a soft rind and pinkish hue; the circular cheese measures 4 inches in diameter and roughly 1 inch tall. It is sold in semi-transparent packaging with a round blue label. The Sophelise was distributed between March 29, 2023 and May 26, 2023. Food Safety News​External Link

    Trader Joe’s instant coffee recalled over glass in product​

    ​​26 May- Trader Joe’s is recalling their brand of instant Cold Brew Coffee after being alerted by their suppliers that the product may contain pieces of glass. There is concern that consumers may have this product in their homes because of its long shelf life.

    Recalled product:

    - Trader Joe’s Instant Cold Brew Coffee 

    - SKU# 67436 

    - EXP date codes 6/13/2024, 11/26/2024 and 12/30/2024 

    As of the posting of this recall, no injuries have been reported to date, and all potentially affected product has been removed from sale. Consumers who have purchased or received donations of any Instant Cold Brew Coffee with the aforementioned date codes, should not use them.  Consumers should discard the product or return it to any Trader Joe’s for a full refund.​ Food Safety News​ External Link


    ​It’s never too late for exercise to boost your brain health​

    31 May- Exercise can sharpen your thinking and keep your brain healthy as you age — even if you don’t start exercising until later in life. That’s the finding of a new study that found that previously sedentary 70- and 80-year-olds who started exercising, including some who had already experienced some cognitive decline, showed improvement in their brain function after workouts. The study adds to mounting evidence that one of the best ways to protect our minds may be to move our bodies. “Exercise does seem to be key” to maintaining and even improving our ability to think as we age, said J. Carson Smith, a professor of kinesiology at the University of Maryland at College Park, who led the study. As many of us know from doleful experience, mental agility often stutters as we grow older, beginning in early middle age and accelerating from there. We have increasing trouble remembering names or where we parked the car or whether we took a vitamin this morning or was that yesterday? Brain scans and other research suggest this decline occurs in part because the brain’s structure and function can fray over time. Neurons weaken or die and the connections between individual neurons, as well as between broader networks of cells within the brain, wither.​ The Washington Post​ External Link


    Uganda enacts law to stop stealing of human organs​​​

    30 May- Ugandan President Yoweri Museveni has approved a law to stop the stealing of human organs and tissues, the health minister said on Tuesday, in a nation where women have been reportedly duped into unnecessary surgeries. Local media have in recent years reported cases of women recruited for domestic work in the Middle East being conned into medical procedures after which their kidneys are sold in global trafficking rings. In a tweet, Health Minister Jane Aceng thanked Museveni for signing the Uganda Human Organ Donation and Transplant Bill 2023 to better regulate the area. "The door is now open for #Uganda to begin a new chapter of Organ Transplant," she said. That came a day after Museveni and government lawmakers drew widespread international condemnation for enacting one of the world's harshest anti-LQBTQ laws, which included the death penalty for "aggravated homosexuality." The donation and transplant law, the first of its kind in Uganda, prohibits any commercial dealings in human organs and tissues. Punishments include life imprisonment and stiff fines.​​ Reuters​ External Link


    Crimean-Congo Hemorrhagic Fever - Iraq​​

    1 June- Between 1 January to 22 May 2022, the health authorities of the Republic of Iraq notified WHO of 212 cases of Crimean-Congo Hemorrhagic Fever (CCHF), of which 115 (54%) were suspected and 97 (46%) laboratory-confirmed; there were 27 deaths, 14 in suspected cases and 13 in laboratory confirmed cases. The number of cases reported in the first five months of 2022 is much higher than that reported in 2021, when 33 laboratory confirmed cases were recorded. Cases have been reported in several areas (governorates) in Iraq and the outbreak may pose additional pressure to an already over-stretched health care system. Between 1 January and 22 May 2022, 212 cases of CCHF have been reported to the WHO from the Iraqi health authorities of which 169 (80%) were reported in April and May alone. Of the 212 cases, 115 were suspected and 97 laboratory confirmed.  Twenty seven deaths occurred overall, of which 13 were in laboratory confirmed cases [case fatality ratio (CFR) 13%; 13/97]. The Iraq Central Public Health Laboratory confirmed the cases by polymerase chain reaction (PCR). Among confirmed cases, most had direct contact with animals, and were livestock breeders or butchers. Just over half of the confirmed cases were 15 to 44 years old (n=52; 54%) and of male gender (n=60; 62%). Nearly 50% of confirmed cases (n=47; 48%) were reported in Thiqar governorate, southeast Iraq, and the remainder of cases were reported from 12 different governorates; Missan (13), Muthanna (7), Wassit (6), Diwaniya (4), Baghdad Karkh (4), Kirkuk (3), Basrah (3), Najaf (3), Nineveh (3), Baghdad-Rusafa (2), Babylon (1) and Karbala (1) (Figure 1). Figure 1. Distribution of laboratory confirmed cases of Crimean-Congo Hemorrhagic Fever by governorate, Iraq, 1 January to 22 May 2022 (n=97). WHO​ External Link​​


    Poland: Free HPV vaccinations for 12 and 13 year olds starting June 1 - Outbreak News Today​

    29 May- Starting June 1, it will be possible to vaccinate against HPV for children aged 12 and 13 free of charge. Registration starts on May 27, according to Polish health officials. Wherever it is possible to act preventively, to prevent cancer, we introduce very specific solutions – a free and voluntary HPV vaccine – said Prime Minister Mateusz Morawiecki during the "Family Health" conference at the Ministry of Health. He noted that more than 2.5 thousand of women in Poland fight cervical cancer – unfortunately, more than half of them lose this fight. – I hope that this will change soon thanks to the fact that we are implementing the HPV vaccination program – he announced. News Knowledia​ External Link


    Dengue cases up 170% in Malaysia​​

    29 May- The Malaysia Ministry of Health has reported 43,619 dengue fever cases through May 21, an increase of 170 percent compared to the same period in 2022 (16,144). In addition, a total of 28 deaths due to dengue fever complications have been reported compared to nine (9) deaths for the same period in 2022. Health officials also reported 131 chikungunya cases to date. Various control activities have been carried out by the Ministry of Health to reduce the incidence of dengue and other arbovirus cases.  Among the control activities done is the destruction of Aedes mosquito breeding places, larvaciding, spraying, health education and enforcement.​ Outbreak ​News T​oday​ External Link


    Cases of chickenpox on the rise among school-aged children​

    31 May- Montana Department of Public Health and Human Services officials are seeing an increase in the number of cases of chickenpox reported in school-aged children across the state. There has been a 200% increase in the number of cases year-to-date in the state when compared to May 2022. A release from state health officials said at least half of the infections were acquired from an adult family member with shingles. Chickenpox, or varicella, can be a serious illness and is preventable with vaccination. “The best way to protect yourself and your child from chickenpox is vaccination,” said Jessica Lopeman, a registered nurse and epidemiologist with the Department of Public Health and Human Services. Montana saw 23 reported cases of chickenpox in 2022. Early numbers from 2023 show 18 reported cases of chickenpox with no known hospitalizations. Just six cases were reported during the same period last year. While there hasn’t been an uptick in Flathead County, according to Malia Freeman with the Flathead City-County Health Department, staff remain on the lookout. Shingles is not a reportable condition, so there is no data on the number of cases last year in Montana.​​ White Fish Pilot​ External Link


    Chile: Sernapesca avian influenza update​​

    31 May- Servicio Nacional de Pesca y Acuicultura, or Sernapesca reported this week that there are 13 regions with confirmed cases of Avian Influenza in marine animals, with positive cases from Arica to Biobío, in addition to Los Lagos, Magallanes and now Aysén has been added. To date, a total of 44 specimens of marine animals confirmed as HPAI-positive have been counted, corresponding to 4 Humboldt penguins, 2 Chilean dolphins, 2 chungungos, 2 spiny porpoises, 1 huillín and 33 sea lions. After confirmation by the Agricultural and Livestock Service (SAG), Aysén registered its first HPAI positive case in marine animals, which corresponded to a common sea lion that stranded in Puerto Aysén on May 19. This fact adds to the recent news of the first case of Avian Influenza in Magallanes confirmed on May 22 and which corresponded to a hu​illín, a marine mammal of the otter family. Outbreak News Today​ External Link​​