Defense Public Health Weekly Update, 15 February 2023

Date Published: 2/17/2023
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​​​​​​​​​The Defense Public Health Weekly 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


    Inauguration of Fort McNair Health Clinic Celebrated​​

    3 February- Leaders from the Military Health System and Military District of Washington celebrated the inauguration of the Fort McNair U.S. Army Health Clinic at a ribbon-cutting ceremony held in Washington, D.C., Feb. 3. The ceremony marked the completion of a four-year renovation project. “The modern-day Fort McNair Clinic is responsible for providing medical readiness through the delivery of safe, high-quality care in support of our nation’s finest,” said Brig. Gen. Mary Krueger, Medical Readiness Command, East commanding general. Patients of the Fort McNair Health Clinic will include approximately 500 enrolled beneficiaries along with nearly 4,000 students and faculty assigned to the National Defense University, Eisenhower School for National Security and Resource Strategy and the Inter-American Defense College, among other organizations located on Fort McNair and throughout the National Capital Region. “This newly renovated clinic is what our beneficiaries deserve and it demonstrates the Military Health System’s unrelenting pursuit of excellence as we support the Total Force and those that we are privileged to serve alongside,” Krueger said. The Fort McNair Health Clinic has provided health care services dating back to the Civil War era and represents the legacy of Maj. Walter Reed, whose work contributed to the discovery of the cause of yellow fever. “This small but mighty clinic carries on its shoulders the sacred responsibility of ensuring that our Nation’s military leaders and their families remain medically ready,” Krueger said. The Fort McNair main medical facility is the Andrew Rader Health Clinic located on Joint Base Myer-Henderson Hall, and is a part of the Fort Meade Medical Department Activity headquartered on Fort Meade. The Meade MEDDAC is part of MRC, East and National Capital Region Market and includes a number of health, occupational, and environmental health clinics at locations throughout Maryland, Virginia, Pennsylvania and the District of Columbia. DVIDS External Link​​


    Army Restoration and Reconditioning Centers (RRC) help Soldiers with deployment stress and optimize unit readiness​

    2 February- The day-to-day stress that comes with stability and support operations and being deployed away from home can sometimes be as traumatic as being in combat. To help rotational forces who are forward stationed in Europe deal with stress related challenges, the Army established two Restoration and Reconditioning Centers (RRCs) – one center in Grafenwoehr, Germany and another in Zagan, Poland. The Restoration and Reconditioning Centers are part of the 254th Combat and Operational Stress Control (COSC) Medical Detachment located in Baumholder, Germany. The mission of the 254th COSC is to provide expeditionary behavioral health services across the entire European theater. By definition, combat and operational stress reactions are defined as physical, emotional, cognitive, or behavioral reactions, adverse consequences, or psychological injuries of service members who have been exposed to stressful or traumatic events in combat or military operations. “Our restoration and reconditioning centers here in Europe were developed to meet the needs of the regionally aligned forces who are forward deployed, however, we found our RRC services, specifically the Grafenwoehr site, practical and effective for our permanent party soldiers located in the garrison environment,” said Army Capt. Shelley Aurand, a psychiatric nurse practitioner and officer-in-charge of the RRC in Zagan, Poland. Reflecting on their recent participation in the RRC program, one Soldier stated that the RRC staff and other participants really listened to him, and he felt he could share his feelings in a safe environment. The Soldier highly recommends this program to service members of all ranks. According to Army officials, the RRC is 100 percent voluntary for service members and is intended for those who have the capacity to return to duty. It is not, however, designed to be a rest and relaxation center, inpatient psychiatric ward or Soldier holding facility. “Command teams can recommend a service member attend the RRC program, but the individuals must first be screened and referred by their primary care provider, behavioral health officer, and chaplain,” added Aurand. “It is important to note, however, that command teams cannot directly refer individuals to the RRC program.” Army behavioral health experts indicate that combat and operational stress are not considered a mental health disorder like post-traumatic stress disorder, which is a diagnosed condition.​ ​External Link

    From the battlefield to the football field: Air Force surgeon’s skills knows no bounds​​​

    7 February- On January 2nd, when many football fans were watching the game between the Buffalo Bills and the Cincinnati Bengals, Lt. Col. Valerie Sams, an Air Force surgeon, was on call at UC Health’s University of Cincinnati Medical Center not knowing what she was about to face. That night, Buffalo Bills’ safety, Damar Hamlin’s heart stopped during the game and he was immediately rushed to the hospital and directly into Sams’ care. Relying on her experience and extensive training, Sams worked with her UC Medical Center colleagues to care for Hamlin during his time in the hospital’s Surgical Intensive Care Unit. “We have taken care of a lot of patients in the military similar to Damar Hamlin, and it is just a basic skill set in critical care,” said Sams. “Working seamlessly with our UC Health colleagues to save a life only highlights what we can do for anyone. We have the capabilities in this hospital to deliver the best care to anyone that comes through these doors. Everyone from the cardiology team to the trauma team all came together for Mr. Hamlin. It was truly a remarkable experience to see different medical teams come together and save a life.” Air Force Medicine​ External Link


    American Heart Month: Add these heart-healthy foods recommended by experts to your grocery list​​​

    14 February- February is American Heart Month. Of course, it’s a good idea to eat a nutrient-dense diet year-round — but this month, here are some foods that are especially a boon for your cardiovascular health. Heart disease remains the leading cause of death for men and women in th​e United States, according to the Centers for Disease Control and Prevention. Moreover, the cost of treating cardiovascular via health care services and other medicines is approximately hundreds of billions per year.  Hundreds of thousands of individuals die from heart disease annually, with one person dying every 34 seconds, according to the CDC. Some of the leading lifestyle factors for the disease include obesity, lack of physical exercise and an unhealthy diet. ​Vegetables, fruits, whole grains, fish, and other foods, such as poultry, are the backbone of a healthy diet to avoid cardiovascular illness. In early February, across the United States, individuals wear red on National Wear Red Day to highlight the importance of combating heart disease. Fox News​ ​External Link

    Bird flu spreads to new countries, threatens non-stop "war" on poultry​​

    ​15 February- Avian flu has reached new corners of the globe and become endemic for the first time in some wild birds that transmit the virus to poultry, according to veterinarians and disease experts, who warn it is now a year-round problem. Reuters spoke to more than 20 experts and farmers on four continents who said the prevalence of the virus in the wild signals that record outbreaks will not abate soon on poultry farms, ramping up threats to the world's food supply. They warned that farmers must view the disease as a serious risk all year, instead of focusing prevention efforts during spring migration seasons for wild birds. Outbreaks of the virus have continued in North and South America, Europe, Asia and Africa, undefeated by summer heat or winter cold snaps, since a strain arrived in the United States in early 2022 that was genetically similar to cases in Europe and Asia. Reuters​ External Link​​

    FDA considers making Narcan opioid overdose antidote available without prescription​

    15 February- Advisers to the US Food and Drug Administration will meet Wednesday to discuss whether a nasal spray version of the opioid overdose antidote Narcan should be made available over-the-counter. The Baltimore-area company Emergent BioSolutions Inc. submitted an application to the FDA late last year to be allowed to sell generic naloxone hydrochloride without a prescription, the first such application for a naloxone spray. Emergent’s application was granted priority review after the FDA signaled that it would support submissions to improve access to the lifesaving medication. Wednesday’s meeting will involve the FDA’s Nonprescription Drugs Advisory Committee and the Anesthetic and Analgesic Drug Products Advisory Committee, which will hear evidence on the nasal spray. Approval could come this year. Research shows that a wider availability of the antidote could save lives as opioid overdose numbers in the US skyrocket. Naloxone has been around for more than five decades. It was approved by the FDA in 1971 and was initially used by first responders and hospitals to resuscitate people who may otherwise have died from an overdose. It comes in several strengths, dosages and applications. In briefing documents submitted to the committees for the meeting, Emergent argues that its nasal spray has been specifically designed for use even by people with no medical training. The spray is easier to administer than an injection, the company says. Briefing documents from the FDA show concern about the label and ease of use. In the meeting, agency representatives will ask the advisers whether they think there is enough evidence to make this change or if the company should submit more data.​ CNN​ External Link

    Male contraceptive pill prototype stops sperm swimming​

    15 February- An on-demand, non-hormonal male contraceptive pill may be a real possibility say scientists who have found a cell pathway, or switch, that stops sperm from being able to swim. Tests in mice suggest it keeps sperm stunned for at least a few hours - long enough to stop them reaching the egg. Many more tests are planned and needed, moving to rabbits before people. The idea is users could pop a pill an hour before sex and keep an eye on the clock for when it wears off. Unlike the female contraceptive pill, it does not involve any hormones. Scientists say that is one of the advantages of the approach they are exploring - it will not knock out testosterone and cause any male hormone deficiency side effects. Instead, the "sperm-swim" switch they are targeting is a cellular signaling protein called soluble adenylyl cyclase or sAC. The experimental male pill inhibits or blocks sAC.​ In the early study in mice, funded by the US National Institutes of Health and published in the journal Nature Communications, a single dose of the drug, called TDI-11861, immobilized sperm before, during and after mating. The effect lasted for around three hours. By 24 hours, it appeared to have fully worn off with the next batch of sperm swimming normally. One of the scientists, Dr. Melanie Balbach from Weill Cornell Medicine in New York, said it showed promise as a reversible, easy-to-use contraceptive. If it does ultimately work in humans, men might be able to take it only when, and as often, as needed. They could make day-to-day decisions about their fertility.​​ BBC News​ External Link

    Teens, especially girls, are experiencing more violence, suicidal thoughts and mental health challenges, CDC survey finds​

    13 February- Teen girls in the United States experienced record high levels of violence, sadness and suicide risk in recent years, amid “significant” and “heartbreaking” declines in youth health and well-being overall, according to data published Monday by the US Centers for Disease Control and Prevention. Responses​ for the CDC’s bi-annual Youth Risk Behavior Survey were collected in the fall of 2021, offering the first look at trends since the start of the Covid-19 pandemic. “Many measures were moving in the wrong direction before the pandemic. These data show the mental health crisis among young people continues,” Kathleen Ethier, director of the CDC’s division of adolescent and school health, said at a media briefing. The findings are “alarming,” she said. The survey found increasing mental health challenges, experiences of violence, and suicidal thoughts and behavior among all teens. More than 40% of high school students said that feelings of sadness or hopelessness prevented them from engaging in their regular activities for at least two weeks of the year. Girls broadly fared worse than boys, and there is “ongoing and extreme distress” among teens who identify as lesbian, gay, bisexual or questioning (LGBQ+). Most teen girls (57%) felt persistently sad or hopeless in 2021, double the rate for teen boys (29%). Nearly one in three teen girls seriously considered attempting suicide. Both rates “increased dramatically” over the past decade, according to the CDC. CNN​ ​External Link

    Tips to keep cancer at bay in observance of National Cancer Prevention Month​​

    ​10 February- Every February, cancer prevention and health communities from all over the United States use National Cancer Prevention Mo​nth to offer tips and advice for lowering the risk of the deadly disease with everyday lifestyle decisions. Cancer affects tens of millions of people and families around the world, especially in impoverished nations and communities that do not have funds for treatment. In 2022, more than 1.9 million people in the United States were diagnosed with cancer, and over 600,000 people died of the disease, according to the National Cancer Institute. The most deadly form of cancer for the year was lung and bronchus cancer, which killed an estimated 130,000 individuals in the U.S. The second most deadly diagnosis was colorectal cancer, with approximately 52,000 deaths in 2022. A combination of important lifestyle tips will may help people reduce their risk of developing a deadly cancer.​ Fox News ​External Link


    CDC: Weekly U.S. Influenza Surveillance Report​​

    Key Updates for Week 5, ending February 4, 2023​:

    - Seasonal influenza activity is low nationally.

    - Seven of 10 HHS regions were below their outpatient respiratory illness baselines.

    - The number and weekly rate of flu hospital admissions decreased compared to week 4.

    - Hospitals reported 2,137 influenza hospitalizations to HHS Protect during week 5 compared to 2,678 reported during week 4.

    - The weekly rate of flu hospital admissions in the FluSurv-NET declined again during week 5.

    - Of influenza A viruses detected and subtyped during week 5, 54.2% were influenza A(H3N2) and 45.8% were influenza A(H1N1).

    - Nine influenza-associated pediatric deaths that occurred during the 2022-23 season were reported this week, for a total of 106 pediatric flu deaths reported so far this season.

    - CDC estimates that, so far this season, there have been at least 25 million illnesses, 280,000 hospitalizations, and 18,000 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.

    - 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​​


    Listeria outbreak investigation leads to raw milk cheese recall​​​

    13 February- Le Fromage au Village Inc. is recalling Le Cru du Clocher raw milk cheddar cheese from the marketplace because of Listeria monocytogenes contamination. This recall was triggered by findings by the Canadian Food Inspection Agency during its investigation into a foodborne illness outbreak. There have been reported illnesses that may be associated with the consumption of these products. Further lab testing is underway to confirm the link. The recalled products have been sold in Canada in Ontario, Quebec , online and may have been distributed in other provinces and territories. Consumers should not consume, use, sell, serve or distribute recalled products. Recalled products should be thrown out or returned to the location where they were purchased. 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 industry is removing recalled products from the marketplace. Food Safety News​ External Link

    Mother Dairy Paneer recalled for third time since August over E. coli concerns​

    ​​10 February- Mother Dairy is recalling its brand of Paneer Fresh Cheese because of generic E. coli. There have been several recalls of this same Paneer during the past several months. Mother Dairy recalled Panner Fresh Cheese in Aug. 2022 because of generic E. coli. 1228300 Alberta Ltd. also recalled Mother dairy brand Paneer Fresh Cheese because of generic E. coli last month. According to the Canadian Food Inspection Agency, the recalled product has been sold in Alberta and Manitoba, Canada. Consumers, hotels, restaurants and institutions should not use, sell, serve or distribute the affected product.​ Anyone who has eaten any of the implicated products and developed symptoms of E. coli infection should seek medical attention and tell their doctor about their possible food poisoning. Specific tests are required to diagnose the infections, which can mimic other illnesses. The symptoms of E. coli infections vary for each person but often include severe stomach cramps and diarrhea, which is often bloody. Some patients may also have a fever. Most patients recover within five to seven days. Others can develop severe or life-threatening symptoms and complications, according to the Centers for Disease Control and Prevention (CDC). About 5 to 10 percent of those diagnosed with E. coli infections develop a potentially life-threatening kidney failure complication, known as a hemolytic uremic syndrome (HUS). Symptoms of HUS include fever, abdominal pain, feeling very tired, decreased frequency of urination, small unexplained bruises or bleeding, and pallor. Food Safety News​ External Link


    Study finds link between ‘free sugar’ intake and cardiovascular disease​​

    15 February- Eating a lot of free sugars — also known as added sugars — might feel harmless in the moment, but it could increase your risk for getting cardiovascular disease, a new study has found. Free sugars are those added during the processing of foods; packaged as table sugar and other sweeteners; and naturally occurring in syrups, honey, fruit juice, vegetable juice, purees, pastes and similar products in which the cellular structure of the food has been broken down, according to the United States Food and Drug Administration. They don’t include sugars naturally occurring in dairy or structurally whole fruits and vegetables. Previous studies have reported that links between carbohydrate consumption and cardiovascular disease might depend on the quality, rather than the quantity, of carbohydrates consumed, according to the new study published Monday in the journal BMC Medicine. To test that theory, the authors behind the latest research assessed diet and health data from more than 110,000 people who participated in UK Biobank, a cohort study that collected data between 2006 and 2010 from more than 503,000 adults based in the United Kingdom. People included in the new study participated in two to five 24-hour online dietary assessments, logging their food and beverage intake multiple times within each 24-hour period. After over nine years of follow-up, the researchers found total carbohydrate intake wasn’t associated with cardiovascular disease. But when they analyzed how outcomes differed depending on the types and sources of carbohydrates eaten, they found higher free sugar intake was associated with a higher risk for cardiovascular disease and greater waist circumference. CNN​ External Link​​​​


    Uganda Confirms Outbreak of Ebola, One Reported Dead​​

    9 February- The Ministry of Health has confirmed an outbreak of the deadly Ebola Virus Disease in Uganda, with the first case and death reported in Mubende district. According to a tweet by the Ministry, the confirmed case is a 24-year-old male a resident of Ngabano village of Madudu Sub County in Mubende District who presented symptoms of the EVD, and tested positive for the hemorrhagic fever before passing on. The Permanent Secretary at the Health Ministry, Dr Diana Atwiine while addressing the media on Tuesday morning confirmed that at least six other people in the same area have died this month after suffering “a strange illness.” She however reassured that the country is ready to take on the outbreak as it has in the past. “The good thing is that every district has a rapid response, so any clinic in that area which get any patient with symptoms should contact the district authorities so we can constitute the measures for investigation and isolation.” The Democratic Republic of Congo, which neighbors Uganda to the west, is currently battling an outbreak of Ebola Virus Disease, previously categorized as a hemorrhagic fever. According to the World Health Organization, the disease is transmitted to people from animals and spreads through human-to-human infection. In a statement released by WHO, the reported case in Uganda was of the relatively rare Sudan strain, after health ministry authorities investigated six suspicious deaths in the district this month. “There are currently eight suspected cases who are receiving care in a health facility,” WHO Africa said, adding it was helping Uganda’s health authorities with their investigation and deploying staff to the affected area. Uganda has had at least three previous episodes of Ebola Virus Disease, the most deadly being in 2000 which claimed hundreds of lives, including Doctor Matthew Lukwiya, who was the lead medical officer in charge of the disease then.​​​ Africa Health​ External Link


    MERS case reported in Oman​​​

    9 February- The World Health Organization reports the Oman IHR-NFP notified them of a case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) on January 5. The case, a 60-year-old male, non-healthcare worker, with comorbidities, who is a resident of North Batinah Governorate, developed symptoms including chest discomfort, shortness of breath, and fever on 28 December which lasted for six days. On 2 January, he was taken to the emergency department of a secondary hospital where he was admitted to the Cardiology Unit for non-invasive ventilation. Prior to admission at the hospital, the case sought medical attention in two healthcare facilities for his symptoms. The case subsequently showed clinical and radiological improvement and was discharged on 16 January 2023. Investigation of the history of exposure to the known risk factors in the 14 days prior to the onset of the symptoms identified camel racing exercises conducted in the same area as the patient’s residence in North Batinah Governorate. The case, a driving instructor by occupation, had no history of physical contact with dromedaries, goats, sheep or contact with camel products, milk, or urine. Since the first MERS case in Oman in 2013, Oman has reported 26 cases of MERS-CoV including seven deaths (CFR 27%). Outbreak News Today​ External Link​​


    Disease the new threat as Turkey faces post-quake water shortage​

    15 February- More than a week after his home was wrecked in a deadly earthquake that hit southern Turkey, Mohammad Emin's body is still covered in dust and grime. Like countless other victims of a catastrophe that killed more than 41,000 in Turkey and Syria, he is still waiting for a wash - affected by a shortage of clean water that international health bodies say poses a risk to public health. "We haven't been able to rinse off since the earthquake," said Emin, a 21-year-old graphic design student, as he carried flu medicine from the clinic of an open-air stadium serving as a camp for displaced people in the city of Kahramanmaras.​ With much of the region's sanitation infrastructure damaged or rendered inoperable by last Monday's two 7.8- and 7.6-magnitude earthquakes, Turkish health authorities face a daunting task in trying to ensure that survivors, many homeless, now remain disease-free. A doctor at the clinic, Akin Hacioglu, said between 15 and 30 medics operated the facility, the only one of its kind at the camp, which serves up to 10,000 people during the day. Reuters​ External Link​​


    Low immunity, overwhelmed hospitals fuel Covid-19 deaths in ageing Japan​​

    2 February- Low immunity against Covid-19 and a growing population of frail elderly is driving a surge in coronavirus deaths in Japan which had, for a long time, upheld some of the strictest pandemic restrictions. Japan once boasted one of the lowest Covid mortality rates, but the figure has been trending upwards since the end of 2022. It hit an all-time high on 20 January this year, surpassing the UK, US and South Korea, according to Oxford University's Our World in Data. Japan was largely closed to foreign visitors from 2020 till mid-June last year. It opened its borders cautiously - at first, travelers had ​to be part of a package tour, buy medical insurance, and be masked in all public places. Some schoolchildren had meals in silence for over two years as schools imposed bans on lunchtime conversations. As restrictions are eased, however, the population's low Covid immunity may be causing infections to spike, local health experts told the BBC. Most of the latest Covid fatalities are elderly people with underlying medical conditions, experts said. This contrasts with the initial spate of deaths that were due to pneumonia and were often treated in intensive care. "It is also difficult to prevent these deaths by treatment," says Hitoshi Oshitani, one of Japan's leading virologists, adding that Covid was only the trigger. "Due to the emergence of immune-escaping variants and sub-variants and the waning of immunity, it is getting more difficult to prevent infections," he says. BBC News​ External Link


    U.S.: Roaches in the operating room: Doctors at HCA hospital in Florida say patient care has suffered from cost cutting

    15 February- On Dec. 7, 2021, more than a dozen surgeons convened a meeting at their hospital, HCA Florida Bayonet Point in Hudson, Florida. Their concerns about patient safety at the 290-bed acute care facility owned by HCA Healthcare Inc. had been intensifying for months and the doctors had requested the meeting to push management to address their complaints. Unsanitary surgical instruments, inadequate monitoring of ICU patients, an overflowing emergency department, anesthesiology errors that resulted in patients waking up while in surgery — all were allegations ripe for discussion. The meeting soon took an extraordinary turn, four doctors who attended told NBC News. With a hospital administration official on hand to hear the answers, the group was asked two questions. Is the hospital providing a safe environment in which to perform surgery? “No,” everyone in the group answered, according to the four doctors. Is it a dangerous place to practice? “Yes,” came the unanimous reply. ​For more on this story, tune in to NBC Nightly News with Lester Holt tonight at 6:30 p.m. ET/5:30 p.m. CT or check your local listings. The hospital administrator promised to address the doctors’ issues, attendees told NBC News. But more than a year later, little has changed, they said. A spokeswoman for the hospital declined to comment on the meeting.  HCA Healthcare Inc., owner of Bayonet Point, is America’s largest hospital company, operating 182 hospitals and 125 surgery centers across the nation and in the U.K. HCA is highly profitable — last year it earned $5.6 billion — and its stock is an investor favorite. ​NBC News​ External Link


    Bolivia reports 579 new dengue cases, puts cumulative total over 6,000​​

    ​14 February- The Bolivia Ministry of Health and Sports reported 579 new dengue fever cases, bringing the cumulative total to 6,453. The department of Santa Cruz is the province with the highest number of infected with a total of 4,869,Beni 797, Tarija 359, La Paz 159, Pando 55, Chuquisaca 132 and Cochabamba 62. The total number of deaths reached 26. The national head of the Ministry of Health’s Program for Reemerging and Diseases, Rubén Montero, reported that Bolivia is under siege by dengue serotype 2. “The serotype that is predominating now is serotype 2, which has more complications and is much stronger, more aggressive in patients, than in the case of (dengue) 1,” said the Health authority.​ Outbreak News Today​​ External Link