Defense Public Health Weekly Update, 19 May 2023

Date Published: 5/19/2023
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​​​​​​​NOTICE: There will be no Defense Public Health Weekly Update next week. Publication will resume on 02 June 2023.

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

    ​ANNOUNCEMENTS

    Walter Reed Celebrates U.S. Navy Nurse Corp's 115th Birthday​​

    12 May- Walter Reed National Military Medical Center celebrates the 115th Birthday for the U.S. Navy Nurse Corp. as part of WRNMMC’s National Nurse Week celebration. National Nurse Week is a weeklong event that celebrates and acknowledges nurses and the hard and selfless work they put in, in service of their patients. (DoD video by Ricardo J. Reyes) DVIDS​ External Link

    U.S. MILITARY

    Air Force medics support US and UAE medical capabilities, partnership, readiness​

    9 May- U.S. Air Force medical personnel are working with sister services to partner with the United Arab Emirates to build a hub for complex trauma, burn and rehabilitation capabilities in Abu Dhabi. The U.S. Department of Defense has committed to sharing trauma, burn and rehabilitative medicine best practices with partners through global health engagement. In 2017, the Secretary of Defense directed elements of the DoD to collaborate with the UAE in a series of bilateral cooperation initiatives to deepen and expand military-to-military ties between the United States and this key regional partner. One of these initiatives focused on building an intensive, long term, bilateral joint military trauma and rehabilitative care capability within the UAE. This culminated in the UAE Abu Dhabi Executive Office, along with U.S. Central Command, to establish the Trauma, Burn, and Rehabilitative Medicine program, or TBRM, with an initial operation starting in 2019. Since this inception, U.S. Air Force medics have participated in the TBRM program, which uses global health engagement to share military medical knowledge. This increases readiness, enhances international military–civilian partnerships, and supports U.S. strategic priorities. In January 2023, the UAE Ministry of Defense held their first annual Emirates Military Health Conference in collaboration with the TBRM team to provide a forum for civilian and military medical experts to exchange knowledge and skills. At this conference, the UAE Armed Forces Surgeon General, Staff Brigadier Dr. Aysha Aldhaheri, emphasized the ongoing improvement in trauma care organized by this unique partnership between two militaries and the civilian sector. “The purpose of the conference was to exchange knowledge and skills and increase military–civilian cooperation to enhance trauma, burn, and rehabilitative capabilities,” said Lt. Col. Erik DeSoucy, U.S. Air Force Trauma Deputy Director of the U.S. and UAE TBRM team. To support this goal, the TBRM team and their UAE partners have taken a comprehensive approach to enhance trauma care infrastructure at the national level, which benefits both the military and civilian sectors. DVIDS External Link

    Occupational Medicine, Industrial Hygiene work together to protect DOD workers​​

    9 May- One of the advantages of working in an organization like the Defense Centers for Public Health – Aberdeen are the synergies created by having professionals from multiple disciplines working together to support service member and government civilian worker health. A good example of this can be found in DCPH-A’s Occupational Medicine and Industrial Hygiene specialties. Members of these teams work together to understand what issues Department of Defense civilian and military staff are facing in the various workplaces, and to create ways to keep these workers safe and healthy. DCPH-A defines occupational health as promoting excellent physical health, mental health and well-being of Department of Defense workers by monitoring employee health and identifying and eliminating or mitigating chemical, biological, physical, psychological and other workplace hazards in operational and non-deployed environments. “As an integral member of the OH team, Occupational Medicine professionals focus on preventing and managing work-related injury, illness and disability,” said Renita Shoffner, a certified occupational health nurse specialist with DCPH-A. “Occupational Medicine also provides clinical services, including medical qualification examinations, medical surveillance examinations, and, when necessary, potential exposure evaluations and diagnosis and treatment of work-related illness and injury.” Within the public health discipline, the industrial hygiene program plays a crucial role in promoting and maintaining a healthy and safe workplace, said Jennifer Mancini, an industrial hygienist with DCPH-A. The industrial hygiene staff often work under Preventive Medicine Services at military medical treatment facilities and provide support to all tenant organizations on an installation. Some of the larger commands, such as the Army Combat Capabilities Development Command, Army Futures Command and Army Materiel Command have their own dedicated industrial hygiene staff. DVIDS​​ ​External Link

    GLOBAL

    Low Vitamin D Levels Could Increase Risk of Long COVID, New Study Finds​

    13 May- New research presented at the 25th European Congress of Endocrinology in Istanbul reveals a potential link between low levels of vitamin D and an increased risk of developing long COVID. The findings highlight the importance of monitoring individuals' vitamin D levels after recovering from COVID-19. Long COVID, also known as post-COVID-19 syndrome, refers to a condition where the effects of the virus persist for more than 12 weeks after the initial infection.  Despite the fact that a significant proportion of COVID-19 patients who have been hospitalized (50-70%) develop long COVID, there is limited understanding of this condition. Although low levels of vitamin D have been recognized as a risk factor for severe consequences in hospitalized COVID-19 patients, such as intubation, mechanical ventilation, or fatality, its impact on long COVID has not been thoroughly explored. Supported by Abiogen Pharma SpA, researchers from Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital in Milan conducted a study involving 100 patients aged 51-70 years, both with and without long COVID. Tech Times​ External Link​​​​

    Tick bites and Lyme disease: What to do if a tick bites you or your pet​

    16 May- Lyme disease is a threat to people and their pets, especially as people spend more time outdoors in these warmer months.  For Lyme Disease Awareness Month this May, Fox News Digital spoke to health experts about ways to lower the risk of contracting a tick-borne illness such as Lyme disease, especially in areas known to have a high prevalence of cases. In the U.S., the most reported cases of Lyme occurred in the Mid-Atlantic states, comprising nearly a quarter of cases during the period 2016-2019. Pennsylvania topped the list of states with nearly 33,000 cases during that time span, followed by New Jersey with just under 12,000 and New York with over 11,000 cases during that time period. That's according to a special reports team at veterinarians.org, which looked at data collected from the Centers for Disease Control and Prevention (CDC) from 2016 to 2019. Wisconsin ranked fourth with over 5,600 cases, while Virginia came in 10th, with just over 3,500 cases.  The Mid-Atlantic states saw a high number of cases due to their abundant wooded and grassy areas, mild winters and warm summers that provide optimal conditions for ticks to live and breed. A high prevalence of white-tailed deer also plays a role in this statistic, the report said. The deer are hosts for the black-legged tick that typically can transmit Borrelia burgdorferi, the bacteria that causes Lyme disease. ​Fox News​ External Link

    Trust in childhood vaccines holds steady, despite skepticism of Covid-19 vaccines, survey finds​

    16 May- Divisive views on the Covid-19 vaccines haven’t shaken the broadly favorable views of routine childhood vaccines, a new survey suggests. Nearly nine out of 10 adults in the US say that the benefits of the measles, mumps and rubella (MMR) vaccines outweigh the risks – a share that’s remained unchanged since before the Covid-19 pandemic, according to data published Tuesday by the Pew Research Center. Only about six out of 10 adults say the same about the Covid-19 vaccines. For the MMR vaccines, most adults say that the preventative health benefits are high and the risk of side effects is low. But for the Covid-19 vaccines, most rate the health benefits low and the risk level medium to high. The findings are based on responses from a representative sample of nearly 11,000 adults from mid-March, three years into the Covid-19 pandemic. Vaccine hesitancy may have ramped up during the pandemic, but it’s not a new phenomenon, experts say. “We’ve seen it with other vaccines because they’re new technology. Sometimes we see it because parents underestimate the amount of disease that’s really out there that they should be worried about. And the third way is when our messaging about the vaccine is confusing,” said Dr. Buddy Creech, professor of pediatric infectious diseases and director of the vaccine research program at Vanderbilt University Medical Center. The Pew survey data shows that those who didn’t get vaccinated against Covid-19 have less positive views of the MMR vaccines in general, and there’s a strong link between Covid-19 vaccination status and the likelihood a person will get the flu shot. Still, the findings suggest that adults in the US “make important distinctions across vaccines.” Even among adults who did not get the Covid-19 vaccine, about three-quarters say that when it comes to the MMR vaccines, the overall benefits outweigh the risks. About 70% of parents who didn’t get the Covid-19 vaccine said that their child has gotten the MMR vaccine.​ CNN​ External Link

    ​​When too much exercise is bad for your heart​

    17 May- Exercise is, without question, good for our hearts. But can we potentially get too much of a good thing? A growing body of science, including a new r​report of the health of almost 1,000 longtime runners, cyclists, swimmers and triathletes, finds that years of heavy endurance training and competition may contribute to an increased chance of developing atria​l fibrillation, especially in men. Atrial fibrillation, or AFib as it’s commonly called, is an irregular heart beat that can lead to blood clots and a higher risk of stroke. This new science does not mean that any of us should panic and dial back our training, particularly if our exercise routines are relatively moderate. But it does hint that nobody is immune from cardiac concerns, no matter how fit we may feel.​ The Washington Post ​​​External Link

    ​INFLUENZA

    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 18, ending May 6, 2023:

    - Seasonal influenza activity remains low nationally.

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

    - The number of flu hospital admissions remains low.

    - During week 18, 48.6% of viruses reported by public health laboratories were influenza A and 51.4% were influenza B. Of the 12 influenza A viruses detected and subtyped during week 18, 3 were influenza A(H3N2) and 9 were influenza A(H1N1).

    - One influenza-associated pediatric death that occurred during the 2022-2023 season was reported this week, for a total of 150 pediatric flu deaths reported so far this season.

    - CDC estimates that, so far this season, there have been at least 27 million illnesses, 290,000 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.

    - 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​​

    VETERINARY/FOOD SAFETY

    Six E. coli infections linked to fermented raw milk​​​

    18 May- Five people are sick in France, two seriously, and one in Belgium after drinking a brand of raw fermented milk. In France, four children and one adult have been infected by Shiga toxin-producing E. coli (STEC) O26:H11. They fell ill between the end of March and the beginning of April this year. Santé publique France has been investigating two cases of Hemolytic Uremic Syndrome (HUS) in the Hauts-de-France and Île-de France regions. The latter was in the context of a family outbreak. The suspected food was fermented raw milk. HUS is a severe complication associated with E. coli infections that causes kidney failure. “The sequencing of the strains isolated within these outbreaks confirmed the same genomic profile. Food investigations made it possible to identify, for the case in Hauts-de-France, the place of purchase and to sample milk on sale at the time of the inspections. It was fermented raw milk made in Belgium,” agency officials told Food Safety News. Samples of this milk taken from Hauts-de-France have been tested by the National Reference Laboratory (NRL). The NRL is carrying out sequencing to see if there is a link based on results and comparison with human strains, with the help of the National Reference Center (CNR). This past week, fermented raw milk of the brand Ferme Dumortier was recalled in France. The farm is based in Rekkem, Belgium. The announcement covers all lots sold since mid-March. The drink comes in a 2-liter bottle with a red or green cap. It was distributed in some L’Oasis stores in Lille. Food ​Safety News​ External Link

    WELLNESS

    Be well: Get regular eye exams to protect vision and catch warning signs early​​

    15 May- Most people understand the importance of healthy eyes, but only half of them get annual eye exams, according to a study conducted by VSP Vision Care and market research agency YouGov. Just as you would schedule regular dental cleanings and physicals, the American Optometric Association (AOA) recommends that all adults aged 18 to 64 get an eye exam every year. "Going in for an eye exam is about more than seeing clearly — it should be a priority for your overall health and wellness," Dr. Pamela Riedy, an optometrist in Chesterfield, Missouri, and vice president of patient care at Vision works, told Fox News Digital via email.​"In addition to ensuring you can see clearly, an eye exam also provides an incredible window into your overall health." Through an eye exam, your eye doctor has an unobstructed view of blood vessels and the optic nerve, which is an extension of the brain, Riedy explained.  "Because of that, eye doctors are often the first to detect signs of more than 270 chronic health conditions – everything from early signs of diabetes to high blood pressure and even some cancers," she said. Beyond chronic conditions, eye doctors can detect glaucoma, cataracts and macular degeneration during exams.  "Those three conditions share a common characteristic: no early warning signs," said Riedy.  "It’s critical to get an annual eye exam, which can help detect them earlier before they progress and impact your sight."​ Fox News​ ​External Link

    USAFRICOM

    Mali Becomes 17th Country to Beat Trachoma​

    16 May- Mali has become the 17th country to receive the World Health Organization’s validation of the elimination of trachoma as a public health problem. The Carter Center, Helen Keller Intl, and Sightsavers are proud to have worked together in partnership to support the government of Mali in their fight against trachoma. “Together, the Malian people have shown persistence and dedication to eliminate trachoma in their communities. It has been a privilege to work alongside dedicated government staff, communities, and partners to reach this trachoma elimination milestone, which impacts the lives of the millions in Mali,” said Professor Lamine Traoré, Coordinator of the National Eye Health Program (PNSO ) of Mali. “The burden of trachoma was severe when the program started, yet Mali showed what is possible with collaboration and partnership. I am proud to share this incredible achievement with the people of my country and hope it’s an inspiration to other countries facing similar battles.” Mali’s PNSO has overcome significant challenges to achieve this accomplishment, including vast terrain, disease prevalence, political instability, and conflict. A 1996 survey found trachoma in nearly every region of the country with nearly 10 million people at risk of going blind. Mali has now become the first country with such significant levels of trachoma at program inception to achieve validation status.

    - Benin E​liminates Trachoma

    Trachoma, one of the world’s oldest diseases and leading cause of infectious blindness, afflicts the most under-resourced members of society. Repeated trachoma infections beginning in childhood cause inner-eyelid scarring that can lead to irreversible blindness in adults. Women are exposed to repeated infections through their role as caretaker to children who typically are the reservoir for disease. For this reason, they are two times more likely than men to suffer from the blinding stage of the disease. “Eliminating trachoma will have a huge impact for people in Mali and have a ripple effect on our society in so many different ways,” said Boubacar Dicko, Sightsavers’ country director for Mali. “Ending the disease will break the vicious cycle of pain, disability, and stigma for many patients, as well as increase productivity, improve school attendance and allow greater empowerment for women.” Mali and The Carter Center’s partnership on trachoma began when President Carter traveled there to visit President Amadou Toumani Touré in 1998. During that trip, former US President Jimmy Carter emphasized that working in close partnership to help implement health programs was a guiding principle of The Carter Center. “Reaching this goal together shows what we can accomplish when we gain the trust of our partners and follow the leadership of Mali’s Ministry of Health,” said Sadi Moussa, the Carter Center’s senior country representative in Mali. “This success has given us confidence to continue investing in neglected tropical diseases to ensure all families can both access and afford the care they need not only to eliminate specific diseases, but also to achieve improved public health in general.” Outbreak News Today​ External Link​​

    USCENTCOM

    Sheikh Shakhbout Medical City provides advanced, multidisciplinary care for breast cancer patients​

    18 May- Breast cancer is the most commonly diagnosed cancer in the UAE and, in 2020, it accounted for 38.8% of cases in women of all ages [1]. As the designated lead for cancer services within the SEHA network, Sheikh Shakhbout Medical City (SSMC) has invested greatly into providing comprehensive and holistic care for our cancer patients, especially those with breast cancer, in the UAE. Through a multidisciplinary approach, the team of locally and internationally trained physicians at SSMC work seamlessly together, supported by cutting-edge research and technologies, to provide integrated human-centric and compassionate care. The need for early screening and the process – Dr. Holland Ravelle, consultant radiologist, chair of Clinical Imaging, Sheikh Shakhbout Medical City “Detecting breast cancer early is critical because, when found early, it becomes easier to treat. Generally, we’ve found that women who live a healthy, active lifestyle and regularly undergo screening once they reach the age of 40 have higher chances of early detection and better treatment outcomes. “When it comes to the screening process, doctors perform a mammogram, which is an X-ray picture of the breast. During this, a patient’s breasts are compressed between two firm surfaces and an X-ray captures black-and-white images, which are examined for signs of cancer. “Over the last few years, SSMC has launched several campaigns and initiatives to increase regular screening in women over the age of 40 for earlier detection and treatment.”​ Middle East Health​ External Link

    USEUCOM

    UK detects bird flu in two poultry workers - health agency​​

    17 May- Britain has detected avian influenza virus in two poultry workers in England following testing for people who have been in contact with infected birds, the country's health security agency said on Tuesday. "The two people returning positive tests are known to have recently worked on an infected poultry farm in England. Neither has experienced any symptoms of avian influenza and both have since tested negative," a statement from the UK Health Security Agency (UKHSA) said. The health agency said this did not change the level of risk to human health and they had not detected evidence of "human-to-human transmission".​​ Reuters​ External Link

    USINDOPACOM

    3rd Swine Flu Case Confirmed in Taiwan​​

    12 May- CNA reported yesterday another young woman living in Taiwan was diagnosed with the A H1N2 variant (H1N2v) of the novel swine influenza virus. As of May 11, 2023, this is only the third swine flu case ever seen in Taiwan, according to the Centers for Disease Control. This zoonotic influenza case came into contact with swine from working at a pig farm. But the virus was not detected in any of the pigs on the farm where the girl worked. Close contacts were identified, but none tested positive for the H1N2v virus. Taiwan's first human H1N2v infection was reported in April 2021. Unlike swine flu, avian influenza Highly Pathogenic Avian Influenza (HAPI) viruses have been detected in birds, mammals (cats, bears, dogs), and humans during 2022-2023. The U.S. Centers for Disease Control and Prevention (CDC) Technical Report issued on March 17, 2023, confirmed the current risk to the public from HPAI A(H5N1) viruses remains low. However, continued sporadic human infections are anticipated because of the potential for influenza viruses to evolve.​ Precision Vaccinations​ External Link

    USNORTHCOM

    CDC warns about potential risk of U.S. mpox resurgence this summer​​

    15 May- The US Centers for Disease Control and Prevention is raising the alarm about the potential risk for new cases of mpox, previously known as monkeypox, to emerge this summer. “Spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events,” the CDC said in an official update to its Health Alert Network on Monday. The CDC is investigating a cluster of mpox cases in the Chicago area with its local partners, the agency said in Monday’s health advisory, and the CDC “continues to receive reports of cases that reflect ongoing community transmission in the United States and internationally.”​ Twelve confirmed cases and one probable case of mpox were reported to the Chicago Department of Public Health between April 17 and May 5, according to the CDC. All of the cases were among men between the ages of 24 and 46. All had symptoms, but none of the patients has been hospitalized. Nine of those 13 cases were among men who had received both doses of the two-dose Jynneos mpox vaccine. Four of the men had recently traveled to New York, New Orleans and Mexico. The CDC noted in its alert that although there can sometimes be cases among vaccinated people, vaccination can reduce the severity of the infection, lowering the chances of hospitalization. “The purpose of this Health Alert Network (HAN) Health Update is to inform clinicians and public health agencies about the potential for new clusters or outbreaks of mpox cases and to provide resources on clinical evaluation, treatment, vaccination, and testing,” the agency said. CNN​ ​External Link​​

    USSOUTHCOM​

    Brazil detects H5N1 avian flu in wild birds as USDA OKs vaccination for endangered condors​​​

    ​16 May- In the latest highly pathogenic avian flu developments, Brazil reported the H5N1 strain for the first time in wild birds, and US officials today announced the emergency use of vaccine to stave off more deaths in endangered California condors. Brazil has reported its first H5N1 outbreaks involving wild birds, according to a notifica​tion yesterday from the World Organization for Animal Health (WOAH). Two sick terns were found on beaches on the coast of Espirito​ Santo state in the southeast. The birds, plus a brown booby at the rescue facility, showed neurologic symptoms. One died, and the two others were euthanized. Samples from all three birds were positive for H5N1. Since the latter part of 2022, H5N1 has spread southward in the Americas, part of global expansion of the current clade. Following the introduction of H5N1 to South American countries, the virus has turned up in sea mammals, such as sea lions in Chile, and in poultry flocks. Also, Chile and Ecuador have each reported a human case, which are rare and typically limited to people who have extensive exposure to infected birds or their environments. CIDRAP​ External Link