Defense Public Health Weekly Update, 27 January 2023

Date Published: 1/27/2023
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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


    Health benefits interrupted for 17,000+ soldiers by HR platform launch​​

    23 January- As the Army celebrated the launch of its new human resources platform, at least 17,110 soldiers and 8,000 family members found their TRICARE health benefits were terminated “due to an unexpected error” it caused, according to an announcement from official TRICARE social media pages and officials contacted by Army Times. Benefits are now restored for all but 25 troops as of Monday, said Lt. Col. Joseph Payton, spokesperson for the Army’s personnel directorate. Reached via phone, he apologized on behalf of the Army for any impact the outage had on troops or their families, and he added that the service is aware of reports that some civilian pharmacies are still unable to bill insurance for those who were affected. The official TRICARE account on Twitter also addressed the outage Monday, explaining that the problem occurred because “approximately [25,000] Army Active Guard and Reserve (AGR) personnel records were incorrectly updated” in the Defense Enrollment Eligibility Reporting System, which controls benefits eligibility for members of the military. Defense Health Agency spokesperson Peter Graves said “our focus is on uninterrupted healthcare.” He added the agency is taking steps to help troops maintain their benefits. “In the event of a medical emergency, impacted individuals can request their managed care support contractor correct individual records,” Graves said in an emailed statement. “In the meantime, ESI, the company that manages the TRICARE Retail Pharmacy Network, is communicating to network pharmacies to reprocess pharmacy claims of impacted beneficiaries at a later time and if an impacted member presents a valid prescription or prescription refill, pharmacies should fill in good faith.” Military Times​ External Link​​


    Donated Blood Saves Lives​​

    20 January- In recognition of National Blood Donor month in January, the Armed Services Blood ProgramOpens ASBP reminds the military community about the importance of donating blood. “Blood is a critical tool to save lives and the need for blood is constant, from the patient undergoing emergency surgery to the person receiving treatment at a military treatment facility to our warfighters far forward,” said ASBP Division Chief Navy Capt. Leslie Riggs. “A steady and ready supply of quality blood products will always be needed.” Riggs noted that during the holidays and winter months, the number of donations often decrease, with things like vacations, illnesses, and weather changes hindering people from giving blood. “The military health care system needs many units of blood every day. The ASBP has a mission to meet that need globally, whenever, and wherever needed,” Riggs said. When the need arises, the ASBP will coordinate additional blood donation events, including large-scale blood drives that elevate the message of the importance of donating blood. “An adage within the industry is ‘the most-needed type is the one not on the shelf’; fully stocked and ready supply is ultimately what is needed and always the ASBP goal, regardless of type,” explained Riggs. He added that donors with Type O blood are considered ‘universal blood donors’ while those with Type AB are considered ‘universal donors’ for platelet donations. These donations can be used for any type of recipient in certain situations, or when treatment facilities are low on other blood types. Established over 70 years ago as the official blood program of the U.S. military, “the ASBP focuses on equipping the warfighter with lifesaving blood products needed on the battlefield as well as in military treatment facilities. The ASBP mission is to provide quality blood products and support for military health care operations worldwide,” Riggs said. Besides collecting donations, the ASBP also tests, stores, transports and distributes blood worldwide. There are over 20 ASBP blood don​or centers Download the Blood Centers document stateside and overseas. Each of the services operates multiple blood donor centers, with many donor centers traveling to conduct mobile drives in their surrounding areas or further out for large-scale blood drives. While ASBP blood recipients are most often thought of as service members injured in the line of duty, the ASBP also provides blood for service members and their families back home and in military hospitals and clinics around the globe.​ External Link

    Genome Sequencing Assists Research at Naval Health Research Center​

    24 January- The staff at Naval Health Research Center (NHRC)Opens added whole genome sequencing capability to their surveillance program. During the COVID-19 pandemic, NHRC brought on scientists and lab technicians to support this work and bioinformatics, which enriched their data collection and analysis capabilities. “Coordination was a team effort. Lab technicians worked together to test samples, identify candidates for WGS, and ultimately perform the sequencing reactions. This data was handed off to NHRC scientists for process and analysis,” said U.S. Navy Lt. Cmdr. Michelle H. Lane, who holds a doctorate in biomedical science and is the director of operational infectious diseases at NHRC. The U.S. Navy laboratory has access to a number of unique samples from naval vessels, U.S. and Mexico border populations, Department of Defense (DOD) beneficiaries, as well as recruits and trainees across all DOD services. These samples have been important to the DOD across multiple areas of responsibilities during the pandemic. NHRC continues to provide critical sequencing and epidemiological support for the COVID-19 efforts and have even developed a new serological quantitative assay that enables the differentiation between the immune response generated by natural infection compared to immunity generated through vaccination. Serology, in conjunction with molecular, sequencing, and bioinformatics data, will collectively inform a better understanding about vaccine efficacy metrics. The Armed Forces Health Surveillance Division Global Emerging Infections Surveillance’s Next Generation Sequencing and Bioinformatics Consortium supported their efforts. “In addition to the financial support, the consortium has shared knowledge and offered support in troubleshooting new protocols and procedures. These resources were critical in initiating the new WGS program,” said Lane. She believes that this work is important to military and local civilian populations, adding, “Knowledge of diseases circulating in any population, military or civilian, is critical to keeping that population healthy. WGS offers a more precise, close-up look at these diseases and allows doctors and scientists to monitor disease evolution at a molecular level. All of this information contributes to more precise diagnoses and better treatment decisions.” Health​.mil​ External Link​​


    Creating a safer fentanyl- How researchers are making the deadly drug less addictive​

    23 January- A group of scientists say they've created a safer version of fentanyl that could potentially diminish the drug's addictive side effects, which have resulted in annual deaths of tens of thousands of people across the United States. Fentanyl is a powerful synthetic opioid that is prescribed to treat patients with severe pain though it's also sold illegally and mixed with other drugs, including cocaine and heroin, making it more deadly. It's Exhibit A in the country's decades-long opioid crisis. The crisis, which began with prescription opioids in the 1990s and resulted last year in a nearly $6 billion U.S. Justice Department settlement with Purdue Pharma and its owners, the Sackler family, for their deceptive practices in selling OxyContin, is now in its "fourth wave." In this stage, fentanyl is mixed with other drugs, often without buyers knowing it. The lacing of fentanyl with deadly drugs like heroin is leading to a rise in stimulant-related overdoses, according to Melissa Ward, an assistant professor in the epidemiology department at Florida International University's Robert Stempel College of Public Health & Social Work. Medical Express​ External Link

    Dementia: Brain check-up tool aims to cut risk at any age​​

    18 January- People of all ages are being encouraged to do more to look after their brains to try to reduce their dementia risk. A new brain check-up tool from Alzheimer's Research UK offers tips on staying sharp, keeping active and connecting with others. Getting regular hearing checks in your 40s and 50s is one way to prevent social isolation, it says. But most cases of dementia cannot be prevented, so early detection and better treatments are still vital.​ Research suggests there are 12 risk factors for dementia which, if modified, could stop four in 10 people developing memory loss, confusion and communication problems. Advice based on these risk factors is to stop smoking, do regular exercise, cut back on alcohol and challenge your brain - and it is never too early or too late to start doing it, experts say. Anyone can take the brain check, which has been based on the latest research, to find out how to lower their individual chances of dementia. But it is particularly aimed at adults aged 40-50 because this is seen to be an important window for taking action to look after brain health. Prof Jonathan Schott, chief medical officer at the charity, said it would "provide a practical and easy means to allow people to take action to reduce their risk of dementia".​ BBC News​ External Link

    FDA panel to consider annual COVID-19 vaccine shots​​

    23 January- The Food and Drug Administration’s (FDA) advisory panel on vaccines is set to consider an annual schedule for the coronavirus vaccine, akin to how flu vaccines are administered, when it meets this week. The FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet Thursday to discuss how to simplify and streamline the COVID-19 vaccination process, including the composition of coronavirus vaccines and the recommended scheduling for these shots. The rapid evolution of the SARS-CoV-2 virus, resulting in variants with an improved ability to escape immune protection, means that “periodically updating the composition of COVID-19 vaccines as needed,” as was done with the updated bivalent booster, requires consideration, according to panel documents posted Monday. The panel said it anticipates evaluating the composition of the COVID-19 vaccine annually in June and making a recommendation for the following year — though it acknowledged the difficulties of mounting a globally coordinated vaccine recommendation. “FDA anticipates conducting an assessment of SARS-CoV-2 strains at least annually and to engage VRBPAC in about early June of each year regarding strain selection for the fall season,” the VRBPAC documents said. While acknowledging that COVID-19 and the flu are not identical, VRBPAC said the deployment of the bivalent COVID-19 boosters, created to target both the ancestral strain of the virus as well as the BA.4 and BA.5 omicron subvariants, was “analogous” to annual flu vaccinations.​ The Hill​ External Link

    Omicron Silver Lining: Fewer, Milder Cases of MIS-C in Kids​​

    23 January- The COVID-19 Omicron variant caused fewer cases of a rare but sometimes deadly complication for children than the earlier Delta variant did, new research shows. "Our study is one of the first to show that during the change to Omicron, MIS-C has become milder and increasingly rare," said senior researcher Dr. Mark Hicar, a University at Buffalo infectious disease specialist. "This trend has continued and MIS-C is currently quite rare, per anecdotal reports from colleagues across the country." MIS-C (multisystem inflammatory syndrome in children) typically occurs two to six weeks after a child's COVID infection, and can cause dangerous inflammation in different organs throughout the body, according to the U.S. Centers for Disease Control and Prevention. Nearly 1% of children who develop MIS-C die, the researchers said. The syndrome can also cause organ damage that can haunt children for the rest of their lives. For the study, researchers tracked 271 patients admitted to Oishei Children's Hospital in Buffalo, N.Y., between August 2021 and February 2022. That span included the majority of the Delta wave, as well as the time when the Omicron wave surged the strongest. During Delta, MIS-C comprised up to 12% of admissions at the children's hospital. But the syndrome only accounted for 6% of admissions during Omicron, the findings showed. The risk of MIS-C from Omicron was about 32% lower than it was during Delta, the investigators concluded. Overall, pediatric cases of both COVID-19 and MIS-C were generally less severe during the Omicron wave than they had been in previous waves of the pandemic, the researchers reported. The team also noted that the majority of children admitted for COVID-19 or MIS-C had not been vaccinated. Among 88 children admitted with COVID during the Omicron wave, only five were fully vaccinated and one had received a single dose. The rest were unvaccinated. Based on local vaccination rates, the researchers calculated that the vaccines were as much as 92% effective in preventing hospitalizations for either COVID-19 or MIS-C. "Our data show that even during major changes in the virus, from the Delta to Omicron variants, vaccines can be highly protective in preventing hospitalizations among children," Hicar said in a university news release.​ Health DayExternal Link

    PFAS Foam Replacement Challenges Nation’s Fire Departments​

    ​​24 January- Fire departments face liability risks and potentially huge costs and uncertainties as they switch from PFAS-enabled firefighting foam, according to lawyers and groups working with them. The Pentagon’s recent release of its requirements for firefighting suppressants that could substitute for PFAS-based aqueous film-forming foam increases the pressure on fire departments to stop using AFFF, said Bradley M. Pinsky, an attorney with the Pinsky Law Group, PLLC, which counsels fire departments and districts. AFFF, used primarily by the military but also by civilian firefighters, has polluted drinking water across the country and raised concerns about potential harm to health, including an elevated risk of cancer. Twenty-four states have banned training with AFFF or otherwise restrict its use. Fire departments need information on the performance and safety of alternatives, guidance to get rid of old foam safely, and money to pay for disposal and buy substitutes, attorneys, state officials, and fire professionals said in recent interviews. Departments also face potential liability over cleanups in places where they used the old foam, they said. Firefighters are looking to the federal government for help. The Pentagon’s new standards don’t change firefighters’ questions, said H. Todd Bullard, an attorney leading Harris Beach PLLC’s team that works with emergency responders. “If we can’t use what we have, how do we get rid of it? What’s the alternative and does it work? How can we acquire the new foam?” The Pentagon didn’t respond to questions about whether and how it will make information about the alternatives it tested available.​ Bloomberg Law​ ​External Link

    Rest isn’t necessarily best for concussion recovery in children, study says​​​

    20 January- Sending kids back to school rather than isolating and resting may be a better way to help them recover faster from a concussion, a new study finds. The study, published in JAMA Network Open on Friday, finds that an earlier return to school was associated with better outcomes for some children.​ The study looked at data from 1,630 children ages 5 to 18 who went to nine different emergency rooms across Canada. The study found that for kids ages 8 to 18 who were recovering from a concussion, an early return to school, in two days or fewer, was associated with children experiencing fewer symptoms 14 days after their injury. That was not the case in children ages 5 to 7. Patients who followed recommendations for a slower return to activity in the study, including being restricted from school and their electronics, took longer to recover and had more symptoms at 10 days post-injury on average than those that did not follow these steps. Prolonged restrictions after a concussion is thought to increase a child’s risk of depression and anxiety, earlier studies have shown. The researchers believe that socialization, reduced stress from not missing too much school, and returning to a normal sleep and school schedule may play a role in helping kids recover faster. Light to moderate physical activity may also help a child recover faster. CNN ​External Link

    The Future of Maternal Care: How Technology Can Improve Maternal Health Outcomes in the U.S.​

    23 January- Most Americans would be surprised to discover that the United States has the worst maternal mortality rate among all developed countries. In fact, our instances are almost three times higher than the next nearest country, France, and more in line with statistics in Rwanda. However, the US has the distinct advantage of partnerships among governmental agencies and industry, such as innovators like Philips aimed at reducing the maternal mortality rates through relevant technology. The March of Dimes just released their annual report indicating that preterm birth rates have reached a 15-year high.​ The issue of maternal and infant health is multifaceted. First and foremost, the rate of high-risk pregnancy is on the rise with more than 30% of pregnancies classified as high risk. Conditions such as gestational diabetes, hypertension, excessive weight gain and pregnancies of multiples all require extra monitoring. In addition, healthcare equity is a contributing factor, particularly among Medicaid patients, people of color and those living in remote areas. Some two million women reside in one of the country’s 1,000 or so counties considered maternity care “deserts” with no available obstetric care or birthing centers. This lack of facilities puts both mothers and the 150,000 babies born annually in these areas in danger. Couple this with Medicaid patients who often delay maternal care until the second or third trimester, and the US has a maternal mortality issue to solve. “Approximately 32% of all pregnant women on Medicaid only start receiving care in the third trimester,” explained Michael Lemnitzer, Vice President, State Government Healthcare at Philips. “This leads to these women being more likely to have a pre-term birth, compared to if they were receiving care earlier in their pregnancy.” Fed Health External Link

    Yearly COVID vaccine as proposed by FDA? 'Cart before the horse,' says doctor​​​​

    ​​24 January- The Food and Drug Administration (FDA) has just proposed treating COVID-19 vaccines in the same way in which many Americans receive the annual flu shot — in order to protect people against mutations of the virus. Not everyone is jumping up and down about this idea. The proposal aims to simplify future vaccination efforts — and under this strategy, most adults and children would receive a once-a-year shot to protect against the mutating virus, the FDA said Dr. Marc Siegel, a clinical professor of medicine and a practicing internist at NYU Langone Medical Center as well as a Fox News contributor, told Fox News Digital on Monday evening about this plan, "I believe that the risk-benefit favors continued consideration for the COVID vaccination, especially in high-risk groups — but this must be a one-on-one discussion," he said, referencing doctor-patient communication and decision-making. "They are putting the cart before the horse," he said of the agency's new idea, "showing a tin ear to the public's COVID fatigue." While "the idea of a yearly COVID vaccine makes sense, they are ignoring that they really don't have the vaccine for it yet," he added. ​​Fox News​ External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 2, ending January 14, 2023:

    ​- Seasonal influenza activity continues to decline across the country.

    - Three regions were below their outpatient respiratory illness baselines for the first time since October 2022.

    - The number of flu hospital admissions reported in the HHS Protect system decreased compared to week 1.

    - Of influenza A viruses detected and subtyped during week 2, 81% were influenza A(H3N2) and 19% were influenza A(H1N1).

    - Six influenza-associated pediatric deaths that occurred during the 2022-23 season were reported this week, for a total of 85 pediatric flu deaths reported so far this season.

    - CDC estimates that, so far this season, there have been at least 25 million illnesses, 270,000 hospitalizations, and 17,000 deaths from flu.

    - The cumulative hospitalization rate in the FluSurv-NET system was 1.6 times higher than the highest cumulative in-season hospitalization rate observed for week 2 during previous seasons going back to 2010-2011. However, this in-season rate is still lower than end-of-season hospitalization rates for all but 4 pre-COVID-19-pandemic seasons going back to 2010-2011.

    - 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 oseltamivir, peramivir, zanamivir, and baloxavir.

    - An annual flu vaccine is the best way to protect against flu. Vaccination helps prevent infection and can also prevent serious outcomes in people who get vaccinated but still get sick with flu.

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

    - CDC issued Interim Guidance for Cli​nicians to Prioritize Antiviral Treatment of Influenza in the Setting of Reduced Availability of Oseltamivir through the Health Alert Network (HAN) on December 15, 2022.​ CDC​ External Link


    Mushrooms recalled over presence of insects and mold​​

    24 January- Aliments Tousain Inc. is recalling Dubon brand Mixed Forest Mushrooms because of insects and mold. The recalled product was sold in Quebec, Canada, according to the Canadian Food Inspection Agency. There is concern that consumers may have the products in their homes because of the long shelf life, which reaches into 2026.Consumers and retailers should not use, sell, serve or distribute the affected product. Food Safety News​ External Link​​​

    Parsley imported from Mexico recalled by multiple firms over Salmonella contamination​

    24 January- Church Brothers, LLC and FreshPoint South Florida, Inc. are recalling parsley imported from Mexico because of Salmonella contamination. According to the FDA, both recalls were initiated on Dec. 12, 2022, and are ongoing. Church Brothers, LLC distributed the recalled product in Louisiana, Michigan and Florida. FreshPoint South Florida, Inc. distributed the recalled product in Florida...Food contaminated with Salmonella bacteria does not usually look, smell, or taste spoiled. Anyone can become sick with a Salmonella infection. Infants, children, seniors, and people with weakened immune systems are at higher risk of serious illness because their immune systems are fragile, according to the CDC. Anyone who has eaten any recalled parsley and developed symptoms of Salmonella infection should seek medical attention. Sick people should tell their doctors about the possible exposure to Salmonella bacteria because special tests are necessary to diagnose salmonellosis. Salmonella infection symptoms can mimic other illnesses, frequently leading to misdiagnosis. Symptoms of Salmonella infection can include diarrhea, abdominal cramps, and fever within 12 to 72 hours after eating contaminated food. Otherwise, healthy adults are usually sick for four to seven days. In some cases, however, diarrhea may be so severe that patients require hospitalization. Older adults, children, pregnant women, and people with weakened immune systems, such as cancer patients, are more likely to develop severe illnesses and serious, sometimes life-threatening conditions. Food Safety News​ ​External Link​​


    One type of physical activity protects the brain more than others, study finds​

    23 January- What if you could look at all the things you do daily — walking from room to room, preparing a presentation at your desk, running up and down stairs to deliver folded laundry or taking a jog around the block — and know which ones will best help or hurt your brain? A new study attempted to answer that question by strapping activity monitors to the thighs of nearly 4,500 people in the United Kingdom and tracking their 24-hour movements for seven days. Researchers then examined how participants’ behavior affected their short-term memory, problem-solving and processing skills. Here’s the good news: People who spent “even small amounts of time in more vigorous activities — as little as 6 to 9 minutes — compared to sitting, sleeping or gentle activities had higher cognition scores,” said study author John Mitchell, a Medical Research Council doctoral training student at the Institute of Sport, Exercise and Health at University College London, in an email. Moderate physical activity is typically defined as brisk walking or bicycling or running up and down stairs. Vigorous movement, such as aerobic dancing, jogging, running, swimming and biking up a hill, will boost your heart rate and breathing. The study, published Monday in the Journal of Epidemiology & Community Health, found doing just under 10 minutes of moderate to vigorous exertion each day improved study participants’ working memory but had its biggest impact on executive processes such as planning and organization.​​ CNN​ External Link

    Still dry for January? Try these sober activities for non-alcoholic fun

    24 January- If you are among those participating in Dry Jan​uary this year, you’re in the home stretch. Peter Jackson, an addiction psychiatrist at the University of Vermont Medical Center, suggests shifting focus for the remainder of month. “Instead of saying I am not going to drink, say I am going to do these other enjoyable things,” he said. “Make a list of what you can or plan to do, rather than only focusing on what you can’t or won’t do.” And sober fun doesn’t have to end with a change of the calendar. Whether it’s your last week of abstaining or you’re planning to keep your sober streak going in February, here’s some advice for activities best enjoyed without alcohol. Getting together for potluck dinners, where everybody brings a dish, is a great way to shift the social focus away from alcohol. The “focus is around the food,” said Rob, who speaks from personal experience after two years in Alcoholics Anonymous and, like many in the program, prefers not to share his last name.​If dinner still feels like a trigger for drinking alcohol, consider hosting a potluck luncheon followed by a brisk walk or meandering hike.​Socializing during exercise is a great way to break alcohol’s grip on your social life. Go for a morning run or gym workout and meet for cof​fee and a smoothie afterward. Or try yoga or another kind of group class. You could also plan a hike, which gives you camaraderie without the pressure to drink anything but water. The Washington Post External Link​​


    Senegal institute wins $50 million in boost to Africa's vaccine capacity​​​

    19 January- The Coalition for Epidemic Preparedness (CEPI) will invest up to $50 million over 10 years to help Senegal's Institute Pasteur expand Africa's ability to produce vaccines at scale, it said on Thursday. The deal - which will also reserve capacity to produce vaccines specifically for Global South countries during future outbreaks of disease - will help Africa take charge of its own health security, said CEPI CEO Richard Hatchett. The funds, which will initially include up to $15 million over three years, will support development of the institute's manufacturing facilities for routine and outbreak vaccinations. CEPI, a global initiative headquartered in Norway, is creating a network of vaccine manufacturers in developing countries to help boost capacity and reserves for future outbreaks and pandemics. "The facility will ensure regional outbreaks are not neglected by deploying the latest technology for the greatest need," said Amadou Alpha Sall, CEO of Institute Pasteur de Dakar, a non-profit foundation in Senegal's capital.​At the outset of the COVID-19 pandemic, Africa, like other poorer regions, was left without adequate vaccine supplies, highlighting the need to develop its own production. However, by the time the shots became more widely available, the take-up on the continent was slow, as many were less afraid of the virus and misinformation about vaccines had spread. Reuters​ External Link​​


    Iran coronavirus: 4 deaths, over 110 new infections​​

    24 January- Four more Iranians have died from the coronavirus over the past 24 hours bringing the total deaths to 144,741, Iran’s Health Ministry said on Tuesday. 118 new cases of infection with COVID-19 were found over the past 24 hours, 51 of whom were hospitalized, it added. The Iranian Health Ministry noted that 7,337,159 patients out of a total of 7,563,623 infected people have recovered or been discharged from hospitals. 224 COVID-19 patients are in critical condition and in intensive care units, it added. The Iranian Health Ministry also announced that 65,186,114 Iranians have received the first dose and 58,581,803 people have so far received the second dose of the COVID-19 vaccine. Moreover, 31,584,373 people have also received the third or fourth shots as the booster jab. Iran Front Page​ External Link


    UK panel calls for COVID booster dose for higher-risk groups in autumn​

    25 January- Britain's vaccine advisers on Wednesday said plans should be made to offer a COVID-19 booster vaccination dose to those at higher risk of severe disease this autumn. The Joint Committee on Vaccination and Immunization also called for an extra booster vaccine dose in the spring for a smaller group of people, such as older and immunosuppressed people.​ Reuters​ External Link


    Japan PM says country on the brink over falling birth rate​

    24 January- Japan's prime minister says his country is on the brink of not being able to function as a society because of its falling birth rate. Fumio Kishida said it was a case of "now or never." Japan - population 125 million - is estimated to have had fewer than 800,000 births last year. In the 1970s, that figure was more than two million. Birth rates are slowing in many countries, including Japan's neighbors.​ But the issue is particularly acute in Japan as life expectancy has risen in recent decades, meaning there are a growing number of older people, and a declining numbers of workers to support them. Japan now has the world's second-highest proportion of people aged 65 and over - about 28% - after the tiny state of Monaco, according to World Bank data. "Japan is standing on the verge of whether we can continue to function as a society," Mr. Kishida told lawmakers. "Focusing attention on policies regarding children and child-rearing is an issue that cannot wait and cannot be postponed." He said that he eventually wants the government to double its spending on child-related programmes. A new government agency to focus on the issue would be set up in April, he added. However, Japanese governments have tried to promote similar strategies before, without success.​ BBC News​ External Link


    U.S. : Ohio's Measles Outbreak Spreads South

    24 January- A recent measles case in Christian County, Kentucky, has been associated with Ohio’s ongoing measles outbreak, according to Kentucky Cabinet of Health and Family Services spokesman Brice Mitchell on January 20, 2023. reported Mitchell indicated several other Kentucky residents are being monitored for measles symptoms. The U.S. Centers for Disease Control and Prevention (CDC) says measles symptoms appear 7 to 14 days after contact with the virus, and rashes appear 3 to 5 days after the first symptoms. Measles isn’t just a little rash. According to the CDC, measles can be dangerous, especially for young children. The good news is measles is a vaccine-preventable disease. Recently, the city of Louisville, Kentucky, and the Jefferson County Public Schools began conducting measles vaccination clinics for about 10,000 unvaccinated students. On January 18, 2023, local media reported on-campus measles clinics at Iroquois High School, Marion C. Moore School, Newcomer Academy, and Fern Creek High School on February 7, 2023. Since June 2022, the Health Department of the City of Columbas, Ohio, and Franklin County Public Health have reported (85) confirmed measles cases in children, of which (36) were hospitalized as of January 24, 2023. The CDC reported there were 121 measles cases in six U.S. jurisdictions in 2022. Precision Vaccinations​ ​External Link​​


    Brazil: Norovirus linked to Florianópolis acute diarrhea epidemic​

    ​23 January- In a follow-up on the diarrhea epidemic in Florianópolis, Santa Catarina Island, Brazil, a team from the Federal University of Santa Catarina (UFSC) have identified the presence of norovirus.​ The UFSC Applied Virology Laboratory team reported yesterday the detection of human norovirus genotype 1 in 12 of 19 fecal samples from patients and also in three from river and beach water, as reported to the municipality’s Sanitary Surveillance (VISA), in what they defined as an emergency work alliance, together with the local health biotechnology company BiomeHub. “The microorganism [by the norovirus identified] is a pathogen and its presence represents a public health problem,” warned researcher Gislaine Fongaro , coordinator of the laboratory where they continue to investigate environmental and fecal samples from the outbreak. “It is strongly recommended to increase surveillance in patients and water, as well as in food samples, mainly for direct consumption or minimally processed, vegetables and others,” she added. To date, 3,241 people, including tourists and residents, have been affected, especially in the north and south of the island. Santa Catarina state health authorities reported that the cases are spreading north to eight other seaside resorts– Camboriú , Bombinhas , Itapema , Navegantes , Peña , Balneário Picarras , Porto Belo and Itajaí. In samples taken from beaches and rivers for recreational use, the UFSC team detected norovirus compatible with the finding in patient samples only in the water of the Río do Brás, in Canasvieiras, north of Florianópolis and where the 64 5% of the cases. This, for Fongaro, would indicate that the virus arrives “mainly through [discharges of] illegal wastewater. From the river –he stated–, it is possible that it is transported to the sea”, where the virus has not yet been identified. Outbreak News Today​External Link​​