Defense Public Health Weekly Update, 24 February 2023

Date Published: 2/24/2023
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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

    ​ANNOUNCEMENTS

    CDC adds COVID-19 vaccines to official immunization schedule for kids as young as 6 months​​​

    20 February- The Centers for Disease Control and Prevention released a few updates last week to its child and adolescent immunization schedule. One update was the addition of COVID-19 vaccines to the child and adolescent immunization schedule. The schedule, which is posted on the CDC's website, recommends that children between six months of age and 18 years old should receive two doses of the primary series between four and eight weeks apart — followed by a booster dose at least eight weeks later.​​ Children who are "moderately or severely immunocompromised" should include a third dose in the primary series, says the CDC.  The CDC first recommended the COVID-19 vaccine for young children between six months and five years old in June 2022. ​However, the vaccine was not officially added to the immunization schedule until just this month. Fox News​ External Link​​

    U.S. MILITARY

    Genome Sequencing Work at U.S. Air Force School of Aerospace Medicine​

    16 February- The U.S. Air Force School of Aerospace Medicineopens AF.mil, part of the Air Force Research Laboratory’s 711 Human Performance Wing at Wright-Patterson Air Force Baseopens WPAFB, Ohio, oversees the Department of Defense’s Global Respiratory Pathogen Surveillance Program. This program has a unique reach across the Military Health System and secures biological samples for sequencing from an incredibly expansive geographic footprint across the globe. “The approach of the program is to capture a representative set of samples from MHS patients who show up each week to their health care provider with respiratory illness, such as COVID-19 and influenza,” said Dr. Anthony Fries, principal lead for the program at USAFSAM. During the COVID-19 pandemic, the program was essential in fostering communication among the partner laboratories, securing funding, and championing the need for genomic surveillance in the DOD, which was exemplified by their shepherding of the DOD SARS-CoV-2 Whole Genome Sequencing Action Plan.​ USAFSAM has sequenced over 15,000 SARS-CoV-2 samples, the majority within DOD partner labs, and consistently had less than 14-day turn-around times for sample processing. Their unique access to samples from MHS populations throughout the United States and around the world has greatly aided ongoing surveillance of novel SARS-CoV-2 variants for the DOD. USAFSAM data are shared weekly with international databases where they are immediately interpreted and MHS beneficiary data are placed in context with the SARS-CoV-2 genomic data coming out from every corner of the globe.​ Health.mil ​External Link

    Opinion: Why a healthy heart matters at any age​​

    14 February- In February, many Americans are thinking about Valentine’s Day and how to best show those who matter to us that they are special. Let’s start by caring not just about Valentine hearts, but especially about our heart health. February is also National Heart Health Month or American Heart Month, which is endorsed by the American Heart Association and the Centers for Disease Control and Prevention. Additionally, the second week of every February is Heart Failure Awareness Week, sponsored by the Heart Failure Society of America. Celebrating National Heart Health Month is consistent with the core mission of the Defense Centers for Public Health–Aberdeen, formerly known as the Army Public Health Center. A healthy and fit service member is a deployable and combat-ready service member. Heart disease and heart failure are not compatible with continued active-duty service. I want to remind service members and their family members that maintaining a healthy heart is important at any age. Not taking care of our heart when we are younger can lead to serious cardiovascular problems and heart disease – or even heart failure – in later years. Army.mil​ External Link

    ​'You Can't Fix the Problem If You're in Denial:' The Military's Surge of Fentanyl Overdoses​

    ​​17 February- Carole De Nola, a Gold Star mother whose son had died of a fentanyl overdose, stood at the elegant San Francisco War Memorial for a Christmas party in 2022 with a rolled-up scroll festooned with long holiday ribbons in her hand. Inside the bundle of documents was De Nola's appeal for congressional attention to the accumulating toll on service members of the drug that had killed her son, a dangerous synthetic opioid.​ De Nola spotted the target of her appeal, then-Speaker of the House Nancy Pelosi, and made a beeline for her, only to be swarmed by aides who took the scroll and swept De Nola aside. Ari McGuire, De Nola's only child, had been a 23-year-old reconnaissance scout with Fort Bragg's storied 82nd Airborne Division. He'd wanted to go to Ranger School and had already received an Army Commendation Medal in 2018 for a deployment to Afghanistan. But on a Friday night in August 2019, De Nola got a call from an Army officer: Her son was on life support in a Fayetteville, North Carolina, hospital. Ari's heart had stopped beating while riding in an Uber, coming through the gate at Fort Bragg. An ambulance had managed to revive him, and Ari was induced into a coma upon arriving at the hospital. De Nola, her husband Joseph, and the cantor from their synagogue had made the daylong trek from California to North Carolina to say goodbye to Ari. "When we got there, the doctor told us that there was nothing they could do. I'm sure that the whole hospital heard me screaming."​ Military.com​ External Link

    GLOBAL

    5th person confirmed to be cured of HIV​​

    20 February- Researchers are announcing that a 53-year-old man in Germany has been cured of HIV. Referred to as "the Dusseldorf patient" to protect his privacy, researchers said he is the fifth confirmed case of an HIV cure. Although the details of his successful treatment were first announced at a conference in 2019, researchers could not confirm he had been officially cured at that time. Today, researchers announced the Dusseldorf patient still has no detectable virus in his body, even after stopping his HIV medication four years ago. "It’s really cure, and not just, you know, long term remission," said Dr. Bjorn-Erik Ole Jensen, who presented details of the case in a new publication in "Nature Medicine." "This obviously positive symbol makes hope, but there's a lot of work to do," Jensen said​​. ABC News​ External Link

    Another RSV Vaccine Candidate Fast-Tracked​​

    21 February- Icosavax, Inc. today announced the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for IVX-A12, a bivalent respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) virus-like particle (VLP) vaccine candidate, in older adults 60 years of age and above. Niranjan Kanesa-thasan, Chief Medical Officer of Icosavax, commented in a press release on February 21, 2023, "IVX-A12 is differentiated as the most advanced vaccine candidate against these two leading causes of pneumonia in older adults." In October 2022, Icosavax initiated a Phase 1, randomized, observer-blinded, placebo-controlled, multicenter study of IVX-A12, with and without CSL Seqirus' proprietary adjuvant MF59®, in up to 120 healthy older adults aged 60 to 75 years. Icosavax anticipates announcing topline interim results from this Phase 1 trial in mid-2023, with subjects after that followed through 12 months after vaccination. The company plans to initiate a Phase 2 trial for IVX-A12 in the second half of 2023. According to the FDA, Fast Track is a process designed to facilitate the development and expedite the review of investigational drugs to treat serious conditions and fulfill an unmet medical need. An investigational drug that receives Fast Track designation may be eligible for more frequent interactions with the FDA to discuss the candidate's development plan and, if relevant criteria are met, eligibility for Accelerated Approval and Priority Review. Precision Vaccinations​ External Link​​​

    A year later, formula stock has recovered from the shortage, but parents haven’t​​

    17 February- It has been a year since a major formula manufacturing company recalled several products, which escalated a widespread shortage in the United States and evoked fear in parents and caregivers nationwide. By some measures, the acute shortage is mostly resolved; data from market research firm IRI shows that stock rates have been back near pre-shortage levels for months. But for many families with newborns and others who rely on formula, it doesn’t feel that way. “In the early months of the shortage, it was absolute desperation,” said Hannah Kroll, whose second child turned 1 in July. Last spring, after struggling to find formula herself, Kroll launched a Facebook group to help connect others in need. The group – Baby Formula Search and Swap: Parents Helping Parents – still has thousands of members and multiple posts each day, and there are many others like it. The desperation has eased some, but caution remains, Kroll said. Find My Baby Formula, a tool that monitors formula stock and sends notifications to users when it’s available, is still getting new sign-ups every day. Ken Bean, the programmer behind it, wanted to help others who were having trouble finding formula like he was after his son was born in April. He said he hoped the site would last two or three months, but about 5,000 people still visit each day. That’s down from a peak of about 12,000 visitors a day – perhaps a sign that things are getting better but aren’t fully resolved.​​ CNN​ External Link

    Dementia risk rises if you live with chronic pain, study says​

    20 February- Chronic pain, such as arthritis, cancer or back pain, lasting for over three months, raises the risk of cognitive decline and dementia, a new study found. The hippocampus, a brain structure highly associated with learning and memory, aged by about a year in a 60-year-old person who had one site of chronic pain compared with people with no pain. When pain was felt in two places in the body, the hippocampus shrank even more — the equivalent of just over two years of aging, according to estimates in the study published Monday in the journal Proceedings of the National Academy of Sciences, or PNAS. “In other words, the hippocampal (grey matter volume) in a 60-y-old individual with (chronic pain) at two body sites was similar to the volume of (pain free) controls aged 62-y-old,” wrote corresponding author Tu Yiheng and his colleagues. Tu is a professor of psychology at the Chinese Academy of Sciences in Beijing. The risk rose as the number of pain sites in the body increased, the study found. Hippocampal volume was nearly four times smaller in people with pain in five or more body sites compared with those with only two — the equivalent of up to eight years of aging. “Asking people about any chronic pain conditions, and advocating for their care by a pain specialist, may be a modifiable risk factor against cognitive decline that we can proactively address,” said Alzheimer’s disease researcher Dr. Richard Isaacson, a preventive neurologist at the Institute for Neurodegenerative Diseases of Florida. He was not involved in the new study. CNN​ ​External Link

    Kids’ screen time skyrocketed during pandemic — and it’s still higher than pre-COVID​​​​

    ​​21 February- Kids’ screen time increased early in the COVID-19 pandemic amid lockdowns and stay-at-home measures. But even after precautions were lifted and people resumed normal activities, it remained higher, according to a new study published on Feb. 15 in JAMA Network Open. The study — led by Monique M. Hedderson, PhD, a research scientist at the Kaiser Permanente Northern California Division of Research — looked at the screen usage of 228 children aged 4 years to 12 years across three U.S. states. Researchers compared screen times during three periods: pre-pandemic (July 2019 to March 2020), early pandemic (December 2020 to April 2021), and later in the pandemic (May 2021 to August 2021). Fox News​ External Link​​

    Merck's COVID pill fails to prevent infection among household members​

    21 February- Merck & Co Inc. (MRK.N) said on Tuesday its COVID-19 pill was not effective at cutting the risk of coronavirus infections in people living with someone infected with the virus. The results were similar to data from rival Pfizer Inc. (PFE.N), whose COVID pill Paxlovid also failed to prevent infections among household contacts. The two antiviral drugs are approved as treatments for individuals at risk of severe disease, but enthusiasm for the Merck pill has waned since it was shown to be only 30% effective versus 90% for Pfizer's Paxlovid. Merck's late-stage trial enrolled over 1,500 participants, who were household contacts exposed to an individual with at least one symptom and had recently tested positive for COVID-19. Its Lagevrio pill, also known as molnupiravir, was given every 12 hours for five days and was compared with a placebo group. Participants treated with the pill were 23.6% less likely to develop COVID than those given a placebo through day 14, failing to meet the main goal of the trial, Merck said. Reuters​ External Link​​

    Researchers link certain genes to obesity complications in women​​

    16 February- With hundreds of genes thought to be linked to obesity, the challenge is sifting through them all to determine which ones increase the risk of downstream complications like heart disease and diabetes. In a study published Thursday in Nature Genetics, researchers took the first steps in finding a potential candidate specifically in women. Comparing the genetic data of hundreds of individuals, they looked for genes associated with the accumulation of fat in the abdomen as measured by the waist-to-hip ratio, which has been found to be a better predictor of cardiovascular risk than body mass. They identified 91 genes linked to the waist-to-hip ratio for women, much more than the 42 genes they found for men. They then homed in on one gene called SNX10, which had the strongest association with a high waist-to-hip ratio in women. Men and women store fat in different areas of the body, and even though SNX10 is expressed in both sexes, they found that it’s associated with abdominal fat buildup only in women. STAT News​ ​External Link​​​

    INFLUENZA

    This Flu Season Returns to Normal​​

    ​​17 February- The World Health Organization (WHO) Influenza Update N° 438 recently reported influenza activity decreased globally. In the countries of North America, most indicators of influenza activity fell to levels similar to or below levels typically observed this time of year. As of February 9, 2023, Influenza A(H3N2) was the predominant virus detected in the U.S., whereas A(H1N1)pdm09 and A(H3N2) were co-circulated in Canada in the most recent reporting week. In Europe, overall influenza activity continued to decrease, but influenza positivity from sentinel sites remained above the epidemic threshold at the regional level.  Separately, a leading mRNA-based flu shot candidate for adults announced encouraging interim results from its pivotal Phase 3 safety and immunogenicity trial of mRNA-1010 (P301).As of February 4, 2023, the U.S. CDC confirmed about 172.76 million influenza vaccines had been distributed for the 2022-2023 flu season in the U.S.​ Precision Vaccinations​ External Link

    VETERINARY/FOOD SAFETY

    Baby formula recalled over concerns of Cronobacter contamination​​

    20 February- Reckitt is recalling approximately 145,000 cans of ProSobee Simply Plant-Based Infant Formula because of a possibility of cross-contamination with Cronobacter sakazakii. According to the company announcement posted by the Food and Drug Administration, all product distributed went through extensive testing and tested negative for the bacteria, and there have been no reported adverse consumer reactions to date. The recalled product was manufactured between Aug. 2022 and Sept. 2022. The products were distributed through retail stores nationwide in the U.S. and in Guam and Puerto Rico. 

    Recalled product:

    - ProSobee Simply Plant-Based Infant Formula in 12.9 oz. containers.

    - The batches in question can be identified by the number on the bottom of the can. 

    - Recalled product batches are ZL2HZF and ZL2HZZ both with a UPC Code of 300871214415.

    - “Use By Date” of “1 Mar 2024.” 

    - The recall involves approximately 145,000 cans.

    If parents have any questions, they should consult with their pediatrician. According to the company, the batches in question tested negative for Cronobacter and other bacteria and this is an isolated situation. After a thorough investigation, the company says they have identified the root cause, which was linked to a material from a third party. ​Food Safety News​ External Link

    Louis Latour Pinot Noir recalled over glass in product​​

    20 February- The Liquor Control Board of Ontario is recalling Louis Latour brand Pinot Noir because of the possible presence of glass in the product. This recall was triggered by a recall in another country. The Canadian Food Inspection Agency (CFIA) did not name the country in the recall warning. The recalled product has been sold in Ontario, Canada. Consumers should check to see if they have recalled products Recalled products should not be consumed. They should be thrown out or returned to the location where they were purchased. Food Safety News​ External Link​​​

    WELLNESS

    For a longer life, afternoon exercise may be best, a large study shows​

    22 February- Afternoon exercise may reduce the risks of premature death more than morning or evening workouts, according to a new large-scale study of more 90,000 men and women. But if morning or evening exercise is your preference, don’t despair. The study also finds that physical activity at any time of day is better for longevity than not exercising. And other new research indicates that there can be unique benefits to slotting exercise into the morning hours, suggesting that the best time to exercise depends on what we want from a workout. There is already mounting evidence that the health effects of exercise depend, to some extent, on when we are active. In past research, people at risk for diabetes improved their blood-sugar control more if they worked out in the evening than in the morning, while in other studies, people lost more body fat if they exercised early rather than later in the day. But most of these studies were small and their results narrow and inconsistent, so it’s been difficult to draw conclusions about when we should exercise. One of the new studies helpfully steamrolls any concerns about study size, though. Published this month in Nature Communications, the new study marshals data about 92,139 men and women who had joined the UK Biobank, a health study of adults in the United Kingdom, and worn an activity tracker for a week. The Washington Post​ ​External Link​​

    USAFRICOM

    Nigeria confirms diphtheria outbreak, monitors situation in 4 states​

    21 January- In Kano state, one of the worst-hit states in the country's north, Dr. Aminu Tsanyawa the health commission for the state has recorded more than 70 suspected cases along with 25 deaths related to the bacterial infection. The total number of confirmed cases and deaths is not yet known. Nigeria's Centre for Disease Control and Prevention revealed it initiated an emergency response to the outbreak and is monitoring the situation in four of the nation’s 36 states. Authorities were first alerted about an outbreak among children in Kano state in late December, according to the state's chief epidemiologist. Diphtheria causes breathing difficulties, heart failure and paralysis. The people most at risk are unvaccinated or live areas or with poor sanitation. Nigeria has not had a diphtheria outbreak of this magnitude in recent years. The nation's capacity to diagnose the disease and treat patients is limited in many remote areas. Africa News​ External Link​​

    USCENTCOM

    MBRU research team awarded grant to investigate subtypes of type 2 diabetes​​

    ​22 January- A team of researchers at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) and clinicians from Dubai Diabetes Center, Dubai Hospital, and Kings College Hospital Dubai have received almost AED 1 million (US$272,000) from Sandooq Al Watan, as a research grant to pursue precision medicine research for type 2 diabetes. Over the next three years, Dr.Riad Bayoumi, Professor of Basic Sciences at MBRU, and his team of five researchers at MBRU will work alongside the clinicians to investigate and classify subtypes of type 2 diabetes. They hypothesize that if distinct subtypes of type 2 diabetes are identified, then clinicians can identify characteristics of the disease leading to treatment strategies that are specific to an individual patient. Funding by Sandooq Al Watan, a private UAE philanthropic organization with a significant endowment to invest and support innovative researchers and organizations, will allow the team to research, develop, and deploy precision medicine for type 2 diabetes patients in the UAE. The aim of precision medicine is to customize the diagnosis, treatment, and aftercare of an individual rather than deploying a one‐drug‐fits‐all model. In similar studies, precision medicine has resulted in significant improvements to the diagnosis and management of cancer patients. Middle East Health​ External Link

    USEUCOM

    UK watchdog recommends improvement at Isle of Man hospice​

    22 February- Concerns over staff training and reduced respite services at the Isle of Man's hospice have been raised after an independent inspection. The Care Quality Commission (CQC) also found issues with sepsis awareness, cleaning systems and medicine storage. But the UK health watchdog found staff at the facility to be "effective" and "compassionate" overall. A total of 11 recommendations were made, some of which had "already been addressed," a hospice spokeswoman said. The week-long CQC review, commissioned by the Department of Health and Social Care (DHSO), highlighted some good practices and recognized a "strong culture of working together". But concerns were raised that the service was not always safe. The inspection found there was a risk of cross contamination as cleaning equipment was not separated for use into specific areas. This included using one mop per floor, which meant it was being used to clean bathrooms, bedrooms, communal areas and kitchens. Other areas of concern included medicine room temperatures not being monitored and resuscitation equipment not being easily accessible. Recommendations were made to introduce training for staff on how to work with patients with mental health needs, learning disabilities and autism. Although the UK watchdog has no enforcement powers on the island, a hospice spokeswoman confirmed a training programme using learning disability nurses would be rolled out in 2023. Hospice Isle of Man chief executive John Knight welcomed the report's findings and said the organization would look to make the recommended changes throughout 2023. BBC News​ External Link

    USINDOPACOM

    South Korea's world lowest fertility rate drops again​​

    22 February- South Korea's fertility rate dropped last year to a record low, data showed on Wednesday, in yet another grim milestone for the country with the world's lowest number of expected children for each woman. The average number of expected babies per South Korean woman over her reproductive life fell to 0.78 in 2022 down from 0.81 a year earlier, the official annual reading from the Statistics Korea showed. That is the lowest among countries in the Organization for Economic Co-Operation and Development (OECD), which had an average rate of 1.59 in 2020, and far below 1.64 in the United States and 1.33 in Japan the same year. The government has failed to reverse the falling birth rate despite spending billions of dollars each year on childcare subsidies. As of 2020, South Korea was the only country among the OECD members to have a rate below 1, giving it a shrinking population.​ R​euters​ ​External Link​​

    USNORTHCOM

    East Palestine residents worry rashes, headaches and other symptoms may be tied to chemicals from train crash​

    17 February- Some residents of East Palestine, Ohio, say they have developed rashes, sore throats, nausea and headaches after returning to their homes this week, and they’re worried these new symptoms are related to chemicals released after a train derailment two weeks ago. The February 3 incident caused a massive fire and prompted officials to evacuate hundreds of people who lived near the site because of fears that a hazardous, highly flammable material might ignite. To prevent a potentially deadly explosion, toxic vinyl chloride gas was vented and burned, releasing a plume of black smoke over the town for days.​ Other chemicals of concern at the site include phosgene and hydrogen chloride, which are released when vinyl chloride breaks down; butyl acrylate; ethylene glycol monobutyl ether acetate; and 2-ethylhexyl acrylate, according to the US Environmental Protection Agency. All these chemicals can change when they break down or react with other things in the environment, creating a stew of potential toxins. Residents were given the all-clear to return to their homes February 8 after air monitoring in East Palestine did not detect any elevated chemicals of concern. Officials say further testing of indoor air in about 500 homes has also not shown any hazards. Tests of tap water from the municipal system didn’t show any chemicals at levels that would pose a health hazard, although officials are still testing water from rivers, streams and residential wells in the area. These test results have failed to reassure some residents, who say something is making them sick – even if officials can’t find it.​​ CN​N​ External Link

    USSOUTHCOM​

    Paraguay reports 1st monkeypox case in a woman​​

    21 February- The General Directorate of Health Surveillance, under the health portfolio, confirmed the first case of monkeypox in a woman, in national territory, identified in the Central department. The patient is  between 40 and 50 years of age, without comorbidities. The woman reported fever, sore throat, muscle pain, and rash. She was admitted for pain management. Currently, she is discharged, in good clinical condition and under follow-up. With this finding, there are 104 confirmed cases of monkeypox​ in the country, among which 103 are males.​ Outbreak News Today ​External Link