Defense Public Health Weekly Update, 05 May 2023

​​NOTICE: There will be no Defense Public Health Weekly Update next week. Publication will resume on 19 May 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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​ANNOUNCEMENTS

Surgeon general releases advisory calling for improved social connection​​

2 May-  As part of the federal government’s initiatives to improve mental health care, the U.S. Surgeon General Dr. Vivek Murthy in Washington, D.C., has released an advisory titled "Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community." The surgeon general, in the advisory, warned that Americans "wired for social connection" have become more isolated over time. Loneliness presents a serious health risk, the doctor warned — even more so than heart disease, dementia, stroke, depression and anxiety. "The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity," he wrote. Fox News ​​​​

U.S. MILITARY

11th Annual NoVA B2G Conference and Expo​​​​

3 May- ​11th Annual NoVA B2G Matchmaking Conference & Expo

• 11th Annual NoVA B2G Conference and Expo

• Start Date: 5/4/2023, 8:00 AM

• End Date: 5/4/2023, 1:00 PM​​ Health.mil​ 
  

Lt. Gen. Telita Crosland Thanks MHS Nurses During Nurses Week​​

3 May- Defense Health Agency Director U.S. Army Lt. Gen. Telita Crosland offers remarks on the impact of nurses and nursing in improving health and building readiness in the Military Health System. DHA will celebrate how nurses make a difference – anytime, anywhere—always – during National Nurses Week May 6-12, 2023. National Nurses Week recognizes how nurses – whether in uniform, civilians or contractors -- exemplify excellence in the DHA. National Nurses Week is an opportunity to showcase how nurses are a critical part of the integrated health care team delivering exceptional health care experiences to military health beneficiaries. Nurses remain central to DHA’s support for the National Defense Strategy, helping maintain military readiness to defend the nation. Hea​lth.mil​ ​

GLOBAL

Gene Therapy in Dogs With Eye Disease Now Ready for Human Clinical Trial​​​

27 April- ​A gene therapy that has shown success in treating dogs with inherited eye disease at Michigan State University is now prepared to undergo clinical trials in humans to assist those with retinitis pigmentosa, a collection of rare genetic illnesses that result in vision loss due to the death of light-sensing cells in the retina. Vision loss commences at a young age and progresses throughout the lifespan. There is no current cure for retinitis pigmentosa, and this therapy may have the ability to halt vision loss in patients with CNGB1-retinitis pigmentosa, which affects an estimated 2 million people globally, 100,000 of whom are in the United States.  Simon Petersen-Jones, the lead author of the study, stated​ that "This promising therapy that works so well in dogs is now sufficiently developed that the next step is to take it forward for a clinical trial in human patients." Tech Times​ ​​​

Lilly drug slows Alzheimer's by 35%, bolstering treatment approach​​​

3 May- An experimental Alzheimer's drug developed by Eli Lilly and Co (LLY.N) slowed cognitive decline by 35% in a late-stage trial, the company said on Wednesday, providing what experts say is the strongest evidence yet that removing sticky amyloid plaques from the brain benefits patients with the fatal disease. Lilly's drug, donanemab, met all goals of the trial, the company said. It slowed progression of Alzheimer's by 35% compared to a placebo in 1,182 people with early-stage disease whose brains had deposits of two key Alzheimer's proteins, beta amyloid as well as intermediate levels of tau, a protein linked with disease progression and brain cell death. The study also evaluated the drug in 552 patients with high levels of tau and found that when both groups were combined, donanemab slowed progression by 29% based on a commonly used scale of dementia progression known as the Clinical Dementia Rating Scale (CDR-SB). Using that scale, experts said Lilly's findings were roughly on par with Eisai Co Ltd (4523.T) and Biogen Inc.'s (BIIB.O) lecanemab, sold under the brand name Leqembi, which reduced cognitive decline by 27% in patients with early Alzheimer's in a study pub​lished last year.​ Reuters​ ​

Melatonin gummies found to contain potentially dangerous levels of the hormone: study​​

29 April- Melatonin has soared in popularity as a treatment for insomnia and jet lag, with adults five times likelier to use it in 2018 compared to 2000, per the nonprofit National Sleep Foundation, based in Washington, D.C.  More than 60% of surveyed adults who take melatonin use the gummy form — but a recent study in the Journal of the American Medical Association (JAMA) suggested that the contents of those gummies might not exactly match what’s noted on the bottle. Researchers from the Cambridge Health Alliance in Somerville, Massachusetts and the University of Mississippi evaluated 25 unique brands of gummies that were purchased online and included "melatonin" as an ingredient on their labels. Twenty-two of the 25 gummy brands test (88%) were inaccurately labeled, the study found. Only three of the products contained within 10% of the amount of melatonin that was indicated on the label, with the actual amounts of the hormone ranging from 74% to 347%. One contained CBD (cannabidiol) — but no melatonin at all. Of the five products that declared CBD as an ingredient, the actual amount was more than 100% in excess of the amount listed on the label.​ Fox News​ 

Players told to 'sit it out' under new concussion guidance​

​28 April- Anyone with suspected concussion must be immediately removed from football, rugby and other sports and rest for at least 24 hours, under new guidance for grassroots clubs. It says the NHS 111 help-line should be called and players should not return to competitive sport for at least 21 days. The UK-wide guidelines are aimed at parents, coaches, referees and players. Its authors say a "culture change" in the way head injuries are dealt with is needed. "We know that exercise is good for both mental and physical health, so we don't want to put people off sport," Prof James Calder, the surgeon who led the work for the government, said. "But we need to recognize that if you've got a head injury, it must be managed and you need to be protected, so that it doesn't get worse."​ Concussion - a traumatic brain injury affecting mental function - can alter the way someone thinks, feels and remembers things. Only about 10% result in being knocked out and losing consciousness. Effects are usually temporary and most people recover fully with rest. BBC News​ 

Study shows HIV status does not change treatment outcome for mpox​

​​2 May- HIV status did not affect treatment outcomes in mpox patients treated with the antiviral tecovirimat (Tpoxx), according to findings published today in the Annals of Internal Medicine. The study, conducted by researchers from Columbia University Medical Center and New York Presbyterian Hospital, included 196 people treated with tecovirimat in New York City from June 20 to August 29, 2022, during the height of the mpox outbreak in the United States. Of 154 patients who tested positive for mpox, 72 were also HIV-positive, 82 were HIV-negative, 134 completed at least 1 follow-up visit, and 88 completed a post treatment follow-up. The global mpox outbreak of 2022 was defined by cases among men who have sex with men (MSM), as the virus was spread primarily through close sexual contact. Various studies on the outbreak have shown that people with HIV have been disproportionately affected in the outbreak and represent between 35% and 47% of mpox cases. How much of a role HIV status has on mpox progression and as an independent risk factor for contracting the virus is unknown; however, some studies have shown that people with HIV may be more likely to experience severe mpox or require hospitalization. CIDRAP​ ​​

INFLUENZA

CDC: Weekly U.S. Influenza Surveillance Report

Key Updates for Week 16, ending April 22, 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 and weekly rate of flu hospital admissions remain low.

- During week 16, 60.5% of viruses reported by public health laboratories were influenza A and 39.5% were influenza B. Of the 17 influenza A viruses detected and subtyped during week 16, 4 were influenza A(H3N2) and 13 were influenza A(H1N1).

- Two influenza-associated pediatric deaths that occurred during the 2022-2023 season were reported this week, for a total of 145 pediatric flu deaths reported so far this season.

- CDC estimates that, so far this season, there have been at least 26 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​ ​

VETERINARY/FOOD SAFETY

Raw milk recalled in California after testing finds campylobacter bacteria​

2 May- The California Department of Food and Agriculture (CDFA) is announcing a recall of raw cow milk produced at Raw Farm, LLC of Fresno County, CA. The quarantine order came following the confirmed detection of the bacteria Campylobacter jejuni in the farm’s packaged raw whole milk sampled and tested by the California Department of Food and Agriculture. CDFA found the campylobacter bacteria in a routine sample collected at the Raw Farm, LLC packaging facility. Raw whole cow milk produced and packaged by Raw Farm, LLC of Fresno County is the subject of a statewide recall and quarantine order announced by California State Veterinarian Dr. Annette Jones.​ Food Safety News​ ​

Recalls declined in Finland for the first time in several years​​​​

3 May- The number of recalls in Finland fell in 2022, according to figures released by the Finnish Food Authority (Ruokavirasto). Products were withdrawn from the market 288 times due to potential microbiological contamination, pesticide residues, and undeclared allergens. The amount was 309 in 2021. It is the first decline in several years and was at least in part due to fewer recalls related to ethylene oxide compared to the previous year. In 2021 there were 72 recalls due to ethylene oxide compared to 14 in 2022. The number of recalls due to microbial reasons went up from 49 to 59 in 2022. Salmonella was found in 18 cases in different foods, such as meat and fish products, fresh herbs, and spices. There were 10 recalls due to Listeria in products or detected at the production facility. There were 35 recalls due to an allergen error. Sulfites, gluten, and milk were the most frequent causes. Of the recalled food and food contact materials, 32 percent originated from another European country and 48 percent from outside the EU. The remaining 20 percent of cases were foodstuffs produced in Finland. Recalls due to pesticide residues increased by 48 percent from the previous year. Fruits, vegetables or other foods were withdrawn from the market 49 times. In nine notices, rice was involved. Reasons for action included the level of a substance being too high or its use being prohibited.​ Food Safety News​ ​​

WELLNESS

Hidden high blood pressure in young people revealed​​

27 April- A "considerable" number of young people in England - about 170,000 aged 16 to 24 - unknowingly have risky high blood pressure, experts are warning.

USAFRICOM

DRC: Nearly 500 children under 5 died of malaria in Kasai in 2022​

1 May- A total of 670 people including 494 children under 5 died of malaria in Kasai province in 2022. These figures were revealed by the provincial coordinating doctor of the National Malaria Control Program (PNLP), Chuck Kamasa, during the celebration of World Malaria Day in Tshikapa, on Saturday April 29, 2023: In the province of Kasaï, malaria represents 32% of hospital consultations in 2022. 1,187,856 cases have been recorded, including 1,081,124 cases of simple malaria and 106,732 cases of severe malaria. 637,547 children under the age of 5 have been affected by this pandemic. 670 deaths have been recorded and children under 5 represent 74% or 494 out of 670 recorded deaths,” he said. In addition, Kamasa advised the public to sleep under the mosquito net impregnated with long-lasting insecticides to fight against this disease. Outbreak News Today​ ​​

USCENTCOM

Port Sudan, the Red Sea refuge for many fleeing Sudan's violence​​

3 May- With the ease of someone who has done this many times, Mohamed stacks falafel, fresh-cut vegetables, then french fries onto pita bread, adding sauces and a sprinkle of salt before swiftly wrapping it all in white parchment paper. The Red Sea glimmers blue behind him, and Mohamed, who did not want to share his last name, assembles the sandwiches with a smile, despite the heat and his circumstances. The Syrian man fled Sudan’s capital Khartoum in recent days with his wife and children, just two years after the family fled their hometown of Hama, a west-central city in Syria. Mohamed left behind an air conditioning shop in Khartoum to retreat to the safety of Port Sudan after fighting broke out between the Sudanese army and its rival paramilitary Rapid Support Forces (RSF) in Khartoum on April 15. Despite past broken truces, the warring sides have agreed to a weeklong ceasefire starting on Thursday, in efforts to ease the deadly conflict that has so far killed some 550 people, injured another 4,926, and displaced some 330,000. As Port Sudan swells with Sudanese and foreigners hoping to escape the conflict-struck country, Mohamed is selling falafel to be able to afford the city’s soaring rents. “This job I’m doing now is just something to make sure we have food on the table,” he told Al Jazeera. “Daily rent is 20,000 [Sudanese] pounds (about $34) - no one can pay that,” Mohamed added. “So we had to start working.” Still, Mohamed serves anyone who wants his sandwiches, even if they don’t have money.​ Al Jazeera​ ​​

USEUCOM

Rise in UK measles cases causing concern​​​

4 May- A "very concerning" rise in the number of people catching measles in the UK has been reported by health officials. The virus spreads incredibly easily and a fall in vaccination rates is leaving more children vulnerable to infection. There were 54 cases of measles in the whole of last year. However, there have already been 49 in the first four months of 2023. The UK Health Security Agency (UKHSA) is encouraging parents to ensure their children's vaccinations are up to date. The main symptoms of measles are a fever and a rash. But it can cause more serious complications including meningitis, and an infection can be fatal. That is why the measles, mumps and rubella (MMR) vaccine is part of routine childhood immunizations. Vaccination rates had been falling in the UK before the Covid pandemic. However, the disruption caused by Covid has dented vaccination programs around the world, including in the UK, meaning even more children have missed out. The World Health Organization has already warned of a "perfect storm" for measles, because the fewer people who receive protection from vaccines, the easier it is for outbreaks to happen. Measles jumps from person to person so readily that 95% of people need to be immunized to block its spread. However, the UKHSA said only 85% of five-year-olds in England have received the recommended two doses. The increase in UK measles cases is centered on London, but there have been infections elsewhere. Twelve of the cases were caught while abroad, with the rest reflecting spread within the UK.​ BBC News​​

USINDOPACOM

Australia to ban recreational vaping in major public health move​​

2 May- Recreational vaping will be banned in Australia, as part of a major crackdown amid what experts say is an "epidemic". Minimum quality standards will also be introduced, and the sale of vapes restricted to pharmacies. Nicotine vapes already require a prescription in Australia, but the industry is poorly regulated and a black market is thriving. Health Minister Mark Butler says the products are creating a new generation of nicotine addicts in Australia. Also known as e-cigarettes, vapes heat a liquid - usually containing nicotine - turning it into a vapour that users inhale. They are widely seen as a product to help smokers quit. But in Australia, vapes have exploded in popularity as a recreational product, particularly among young people in cities. "Just like they did with smoking... 'Big Tobacco' has taken another addictive product, wrapped it in shiny packaging and added sweet flavours to create a new generation of nicotine addicts," Mr. Butler said in a speech announcing reforms on Tuesday. "We have been duped." Vapes are considered safer than normal cigarettes because they do not contain harmful tobacco - the UK government is even handing them to some smokers for free in its "swap to stop"​ programme. But health experts advise that vapes are not risk-free - they can often contain chemicals - and the long-term implications of using them are not yet clear. BBC News​ ​​

USNORTHCOM

U.S. fentanyl-related deaths more than tripled over five years​​​

3 May- The rate of drug overdose deaths involving the synthetic opioid fentanyl more than tripled in the United States from 2016 through 2021, according to a report by the U.S. Centers for Disease Control and Prevention (CDC) released on Wednesday. Fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine, and has increasingly been mixed with other illicit drugs often with lethal results. The CDC report showed that the rate of drug overdose deaths involving fentanyl increased from 5.7 per 100,000 people in 2016 to 21.6 per 100,000 in 2021. Fentanyl-related deaths rose by about 55% in 2019-2020, and 24.1% in 2020-2021, said Merianne Rose Spencer, one of the report's authors. In the United States, difficulties in getting treatment for substance use disorders during the COVID pandemic coincided with a jump in use of synthetic opioids like fentanyl, and opioid-related deaths soared​d to a record-high in 2020. Reuters​ ​

USSOUTHCOM

Brazil: Paraná state dengue update​

2 May- The new epidemiological bulletin from the State Department of Health (Sesa) released today confirms 6,889 new cases and six deaths from dengue compared to the previous week’s report. To date, Paraná has registered a total of 35,433 confirmed cases and 21 deaths.​ Of the six deaths recorded, five occurred in the 17th Health Region of Londrina and one in the 9th Health Region of Foz do Iguaçu. There were three patients from Londrina (two men aged 59 and 69 years and a woman aged 62 years), one from Ibiporã (male, 68 years old), one from Prado Ferreira (male, 87 years old) and one from Foz do Iguaçu (male, 72 years). All had comorbidities. Of the 22 Health Districts, only União da Vitória does not have autochthonous cases (when the disease is contracted in the city of residence). Outbreak News Today​ ​​