ANNOUNCEMENTS
CDC's new opioid guidelines are too little, too late for chronic pain patients, experts say
13 March- Jessica Layman estimates she has called more than 150 doctors in the past few years in her search for someone to prescribe opioids for her chronic pain. “A lot of them are straight-up insulting,” said the 40-year-old, who lives in Dallas. “They say things like ‘We don’t treat drug addicts.’” Layman has tried a host of non-opioid treatments to help with the intense daily pain caused by double scoliosis, a collapsed spinal disc, and facet joint arthritis. But she said nothing worked as well as methadone, an opioid she has taken since 2013. The latest phone calls came late last year, after her previous doctor shuttered his pain medicine practice, she said. She hopes her current doctor won’t do the same. “If something should happen to him, there’s nowhere for me to go,” she said. Layman is one of the millions in the U.S. living with chronic pain. Many have struggled to get opioid prescriptions written and filled since 2016 guidelines from the Centers for Disease Control and Prevention inspired laws cracking down on doctor and pharmacy practices. The CDC recently updated those recommendations to try to ease their impact, but doctors, patients, researchers, and advocates say the damage is done. “We had a massive opioid problem that needed to be rectified,” said Antonio Ciaccia, president of 3 Axis Advisors, a consulting firm that analyzes prescription drug pricing. “But the federal crackdowns and guidelines have created collateral damage: patients left high and dry.” Born of an effort to fight the nation’s overdose crisis, the guidance led to legal restrictions on doctors’ ability to prescribe painkillers. The recommendations left many patients grappling with the mental and physical health consequences of rapid dose tapering or abruptly stopping medication they’d been taking for years, which carries risks of withdrawal, depression, anxiety, and even suicide. NBC News 
U.S. MILITARY
ORION Program Engages Sailors and Marines To Help Ensure Mental Well-Being
8 March- A Navy program connecting Sailors and Marines who were involved in or close to a non-combat incident, accident, or suicide, with mental health assistance, has reached more than 2,200 sailors since it’s inception. The program, Organizational Incident Operational Nexus (ORION), began as a pilot program through the Bureau of Medicine and Surgery (BUMED) following the USS Fitzgerald (DDG 62) and USS John S. McCain (DDG 56) collisions in 2017. The success led to ORION’s implementation as an enterprise-wide program in 2021. When ORION is activated, outreach coordinators conduct caring contacts with Sailors and Marines at routine intervals for one year after the incident. They ask if they are receiving care, or if they are interested in accessing care. If an individual is interested in a referral to mental healthcare, then ORION outreach coordinators work with them to ensure a connection to the level of care they prefer. Service members are offered options for mental health services to include direct care at military treatment facilities or embedded mental health, purchased care through the TRICARE network, or care through Military One Source, Fleet and Family Support Services, Marine Corps Community Services, and Military and Family Life Counseling. ORION is used following unit-level, non-combat incidents that involve unexpected loss of life or potential loss of life. ORION can also be activated at the discretion of a commanding officer. After activation, the chain of command works with the Naval Center for Combat & Operational Stress Control (NCCOSC) to determine which of their command service members may have been most affected by the event. “Tragic events don’t typically impact just one or two people, they can have a far-reaching impact and that is especially true in a military unit,” said U.S. Navy Surgeon General Rear Adm. Bruce Gillingham. “ORION helps our commanding officers provide access to care which will help the people they lead process the impact of unpredictable and tragic events. The Navy’s highest priority is keeping every member of the Navy family as mentally and physically healthy as possible and ORION gives us another tool to help make sure our sailors receive the personal care and attention they need.” Med.Navy.Mil
The Science Behind the Army Comprehensive Body Composition Study: USARIEM completes critical data collection
10 March- The U.S. Army Research Institute of Environmental Medicine (USARIEM) cross-divisional team recently completed the U.S. Army Center for Initial Military Training (USACIMT)-directed Army Comprehensive Body Composition (ACBC) study. The ACBC is an Army-wide study of more than 2,690 Soldiers evaluating the effectiveness of the tape test and providing the scientific data and analysis to advise Army senior leaders to make data-driven decisions about the future of the Army Body Composition Program (ABCP). It has been roughly 20 years since the last time body composition equations have been evaluated and 10 years for body composition standards and Army Regulation 600-9. Even then, neither was the in-depth and diverse approach of the ACBC study. Questions from Senior Leaders emerged about the link between fitness, health, and physical performance and the current methods used to measure body composition in the Army. In January 2021, USACIMT called upon USARIEM to provide answers. “There were lots of questions about body composition and USACIMT saw us as subject matter experts and asked us to lead an Army-wide study to look at body composition,” said Holly McClung, ACBC study lead and nutritional physiologist at USARIEM. To do this, McClung collaborated with Dr. Kathryn “Katie” Taylor, director for USARIEM’s Soldier, Performance, Health and Readiness (SPHERE) database and built a team of military, civilian, and contractor personnel across USARIEM. The team approached the task in two phases – Phase 1: an analysis of historical data using the SPHERE Database and Phase 2: a field study, to assess what the current Total Army Soldier population looked between 2021 and 2022. Phase One – A look backward “For the first phase, we wanted to look at a snapshot of what the Army looked like in the two years prior to the onset of the global pandemic,” said Taylor. “We looked at body composition and performance on the [Army Physical Fitness Test], which was the test before the ACFT, and a series of other metrics. We looked at how all these outputs were impacted by a number of different demographic variables – sex, age, race/ethnicity, postpartum status among women and injury outcomes – to understand whether these variables effected body size measurements using body mass index.” Using the SPHERE database, a large repository with access to multiple administrative, medical and performance-based data sources currently collected by the Army, the team was able to collect the data needed to generate a retrospective look of body composition for each individual Soldier during the required timeframe. If a Soldier did not meet the height and weight requirements of ABCP, they then had their body fat estimated using the circumference-based tape method, for a final pass or fail measurement. DVIDS
The US Military Has Been Testing Pulsed Energy on Animals Trying to Recreate the Mysterious 'Havana Syndrome' Symptoms
11 March- The U.S. military has been carrying out experiments on animals in an effort to replicate the symptoms caused by the mysterious "Havana Syndrome," according to a new report. The Pentagon has been exposing primates to pulsed radio frequency waves to see if that could be the cause of the unexplained ailment that has sickened scores of U.S. government personnel over the past few years, Politico reported on Thursday. The new report comes days after the outlet reported that the Department of Defense was continuing to test weapon systems in an attempt to recreate Havana Syndrome symptoms after an intelligence community dismissed the theory that a foreign adversary or energy weapon was to blame. Radio frequency waves have also been tested on ferrets because they have similar brains as people, the report said. These experiments have been taking place at Michigan's Wayne State University, which was awarded a $750,000 grant in September for a program with the description: "Traumatic brain injury and psychological health research." A defense official told Insider that the Department of Defense, in accordance with congressional requirements, "continues to address the challenges posed by" anomalous health incidents, "including the causation, attribution, mitigation, identification, and treatment for such incidents. Our foremost concern remains providing care to affected individuals — since the health and wellbeing of our personnel are our top priority." Military.com
GLOBAL
5 Things We've Learned from COVID in Three Years
13 March- Three years ago, on March 11, 2020, Tedros Adhanom Ghebreyesus, director general of the World Health Organization (WHO), announced that the coronavirus that causes COVID was spreading worldwide and that the outbreak was officially a pandemic. At the time, there were more than 118,000 confirmed cases of COVID and 4,291 official deaths. “In the days and weeks ahead,” Ghebreyesus said in a press conference at the time, “we expect to see the number of cases, the number of deaths and the number of affected countries climb even higher.” Three years later the WHO has recorded more than 6.8 million COVID deaths, though studies of global excess mortality, or deaths above and beyond the expected amount in a given time, suggest the actual number is more than double that amount. In the U.S., there have been an estimated 1.1 million deaths from COVID, according to the U.S. Centers for Disease Control and Prevention. Long COVID, which occurs when people experience lingering or new symptoms even after recovering from the initial infection, has also emerged as a threat that is still mysterious, though doctors are increasingly honing in on possible causes and treatments. The most at-risk populations now are individuals with preexisting chronic illnesses whose health is fragile and for whom hospitalization is a regular occurrence, says Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital in Boston. COVID is one more factor that can push those individuals toward death. As a result, the pandemic is still causing excess mortality in the U.S. Mortality fluctuates from month to month but was approximately 10 percent higher in November 2022 than it was prepandemic, Faust says. If March 2020 was like a flood, Faust says, today the world is no longer drowning. But the new normal is just a bit worse than before, he says: “Sea level is just higher,” Faust adds. Scientific American
Early menstruation could mean higher heart health risks, research says
11 March- When did you get your first period? The question is common in gynecologists’ offices, but research suggests cardiologists should be asking it, too. In a study published last month in the Journal of the American Heart Association, researchers write that they’ve confirmed links between the genes that predict a woman’s age at first menstruation and menopause, age of first birth and number of live births with their risk of cardiovascular disease, strokes and other heart-related conditions. Using genetic data from over 100,000 women worldwide, researchers determined that a variety of reproductive factors were associated with higher risk for atrial fibrillation, coronary artery disease, heart failure and stroke.Women whose genetics predicted a lower age the first time they gave birth had 1.49 times the odds of coronary artery disease than those without those gene variations, and 1.25 times the odds of stroke. And women whose genetics predicted more than two live births had 2.91 times the odds of atrial fibrillation than their counterparts. The Washington Post
FDA approves new nasal spray to treat migraine headaches in adults, Pfizer says
10 March- The US Food and Drug Administration approved a new nasal spray as a rapid treatment for migraine pain in adults. The nasal spray zavegepant, sold as Zavzpret, may relieve pain and other bothersome migraine symptoms as soon as 15 minutes after use, drugmaker Pfizer said in a news release. The drug is expected to be available in pharmacies in July 2023, the company said. There are already a number of different types of medications available to treat migraines, including several kinds of nasal sprays. Zavzpret is the first to work by blocking the calcitonin gene-related peptide, CGRP, a protein that is released in the brain that contributes to inflammation. Several pills block CGRP, but many people with migraines experience significant nausea and can’t tolerate medications they have to swallow. Zavzpret is also an alternative for people who have heart disease or other conditions that prevent them from being able to safely use other kinds of migraine treatments. In two studies where people with migraines didn’t know if they were getting the drug or a placebo, Zavzpret was more effective at relieving migraine pain within two hours compared with a nasal spray without any active ingredients. In one study published in the journal The Lancet Neurology, about 24% of people who took a single 10 milligram dose of Zavzpret reported they had no pain two hours later, compared with 15% of the group who got a nasal spray without any active ingredients, a difference that was statistically significant. The main side effect reported in the study was an altered sense of taste, which affected about 1 in 5 people who took the drug. Other side effects were nasal discomfort and nausea.CNN
Men with early prostate cancer can safely hold off on radiation or surgery, study finds
11 March- Men with early-stage prostate cancer can safely hold off on radiation or surgery , confirms a new study that offers the longest-term treatment data yet. "Watchful waiting," more recently renamed "active surveillance," has long been an option for men with early prostate cancer. But doctors didn't know how long was safe to wait and men were often concerned they were taking a risk by delaying treatment. The new research, published Saturday in The New England Journal of Medicine, shows that less than 3% of British men whose prostate cancer was detected early died of their disease within 15 years. People who chose watchful waiting were no more likely to die than those who opted for surgery or radiation and they suffered no side effects, other than perhaps some anxiety. "It's a strong endorsement for active surveillance and reaffirms that our treatments for prostate cancer, when detected early, are very effective," said Dr. Behfar Ehdaie, a surgeon at Memorial Sloan Kettering Cancer Center in New York City, who was not involved in the new study. The new research also found little difference between the more aggressive treatment strategies. "This study reaffirms what we have believed that cancer outcomes between radiation and surgery are similar," Ehdaie said. USA Today
Study: Testing urine for genetic mutations may detect bladder cancer early
10 March- Identifying genetic mutations in urine could help detect bladder cancer years before symptoms arise, a new study presented Friday at the European Association of Urology annual congress in Milan, Italy, found. "Diagnosis of bladder cancer relies on expensive and invasive procedures such as cystoscopy, which involves inserting a camera into the bladder," lead researcher Florence Le Calvez-Kelm, from the International Agency for Research on Cancer, said in a news release. "Having a simpler urine test that could accurately diagnose and even predict the likelihood of cancer years in advance could help to spot more cancers at an early stage and avoid unnecessary cystoscopies in healthy patients." Early diagnosis and treatment of bladder cancer is crucial for survival from the disease, which is expected to include more than 82,000 new cases in the United States this year and about 16,700 deaths, according to the American Cancer Society. Le Calvez-Kelm led investigators in France, Iran and the United States, who examined the UroAmp test, a urine test developed by Convergent Genomics, a company that spun out of the Oregon Health Science University. Researchers narrowed down the test, which identifies mutations in 60 genes, to create a new one that focuses on mutations in 10 genes. UPI
The knowns — and known unknowns — of long Covid, explained
13 March- Three years since the beginning of the coronavirus pandemic in the US, the syndrome known as “long Covid” remains one of its chief mysteries. Those mysteries include what the syndrome even is. The long-term fatigue and brain fog some people report after recovering from an acute infection are the symptoms most commonly associated with long Covid, but more than 200 distinct symptoms have been reported. The novel coronavirus may also change people’s cardiovascular systems permanently in ways that could lead to long-term health problems, even strokes and heart attacks. Is it all long Covid? There are other elusive questions: How frequently do people get long Covid? Who is at the highest risk of developing it? And what is causing these long-term symptoms in the first place? The remaining uncertainties can mask the scientific progress of the past few years. Scientists have a better idea of how long Covid works, and why it might cause a wide array of seemingly unconnected symptoms. But — and this is more important than it might seem — we know what we don’t know. We have a stronger sense of what the most important unanswered questions are and where there is genuine debate among even the experts about this bedeviling condition. The highly charged public discourse over long Covid can be overwhelming. There is a plethora of research being released at all times, some of it well-vetted, but some of it not. If you or someone you love has long Covid — or you’re worried that you might get it — it can be hard to get even basic answers. One of the clearest takeaways of the past three years is this: Long Covid does not look the same in every patient. VOX
INFLUENZA
Flu Shots More Effective this Season
15 March- The U.S. Food and Drug Administration (FDA) presented some good news last week regarding influenza vaccines. The FDA confirmed this season's influenza vaccination provided substantial protection against inpatient, emergency department, and outpatient illnesses among all ages. On March 7, 2023, Lisa Grohskopf, MD, MPH, with the U.S. Centers for Disease Control and Prevention (CDC), presented to the FDA's Vaccines and Related Biological Products Advisory Committee updated vaccine effectiveness (VE) information through January 2023. Dr. Grohskopf's presentation highlighted influenza vaccination significantly reduced disease by the following:
- 39% (95%CI: 31, 45) against adult hospitalizations,
- 44% (95%CI: 41, 47) against adult ED or UC visits, and
- VE was observed across age groups and immunocompromised.
Furthermore, this flu season's estimates are higher than VE estimates against hospitalization (25%) and ED or UC visits (25%) from the 2021–22 season. As of March 15, 2023, the CDC says various flu shots remain available at most clinics and pharmacies in the U.S., and late-season vaccinations are advised for certain at-risk people. Over 173 million influenza vaccines have already been distributed this flu season. Precision Vaccinations
VETERINARY/FOOD SAFETY
Contaminated imported tahini prompts mass recalls in New Zealand
14 March- Authorities in New Zealand are monitoring a large recall of foods containing imported tahini because of Salmonella. Officials said consumers should be aware that some products are incorrectly labeled as “Product of Mexico or Israel” when they were actually made in Türkiye. “Testing has identified the possible presence of Salmonella in the Turkish manufacturers’ line of organic tahini imported by Ceres Enterprises,” said Vincent Arbuckle, New Zealand Food Safety (NZFS) deputy director-general. “No further product from the Turkish manufacturer will be released for sale while the matter is being investigated. We have informed food safety authorities in Türkiye and will work together with them to identify and manage any further risk.” Tahini from the Turkish manufacturer was used as an ingredient in a range of hummus and tahini items that have been pulled from shelves in New Zealand because of the possible presence of Salmonella. There have been no official reports of related illnesses but local media reported people thinking they had become sick after eating the implicated products. Authorities are trying to identify cases of salmonellosis related to the recall. They said whole genome sequencing might be required to confirm any association. In 2022, an outbreak of Salmonella Kintambo involved three patients who had consumed sesame-based products from Syria. Two people were hospitalized. Testing of tahini and halva products found Salmonella Kintambo, Salmonella Amsterdam, and Salmonella Orion. Food Safety News
Report finds an enormous increase in the number of food items recalled in 2022
15 March- The total number of “units” recalled under the authority of the FDA increased by 700 percent in 2022 compared to 2021, according to a recently released report. The report, from the Sedgwick organization, quarterly collects and analyzes data and also compiles yearly totals. The organization uses data from the U.S. Food and Drug Administration and the U.S. Department of Agriculture. The FDA oversees 80 percent of the country’s food supplies with the USDA responsible for the other 20 percent. In addition to food, the FDA oversees drugs, medical devices, and cosmetics. The food side of the agency has a much smaller budget than the medical side. Sedgwick reports that the number of Food and Drug Administration food recalls rose marginally at a rate of 2.2 percent from 414 recalls in 2021 to 423 recalls in 2022. However, the number of “units,” such as individual bags of salad or containers of infant formula, went up 700.6 percent. There were 52.1 million recalled units in 2021 with an average size of 125,796 units compared to 416.9 million units in 2022 with an average recall size of 985,658 units. “A recall of infant formula that (was connected to) two deaths was the biggest story of the year in terms of food recalls,” states the report. “While it was not the largest recall by volume, it had lasting repercussions on the supply of formula for months and led to calls for reform in the industry and within the FDA itself. The bacteria that led to the recall of 14.89 million units of infant formula and the closing of major production facilities had been reported on eight separate instances between 2019-2022 at one of the facilities, but no further action seemed to have been taken by the FDA. “The food industry faced another crisis when a major recall of peanut butter products impacted 21 different food items and led to the recall of 12.2 million units. However, the widespread damage was not as great as it was with the infant formula event.” Food Safety News
WELLNESS
Sleep deprivation could reduce vaccine antibodies, new study found
13 March- Getting insufficient sleep in the days before or after a vaccination could weaken its effectiveness particularly for men, a new study has found. Researchers from the U.S., France, the U.K. and Sweden conducted the study, which was published in the journal Current Biology on Monday. Men who reported getting six or fewer hours of sleep per night in the days before and after getting vaccinated showed a significant reduction in antibody response. Women did not show that same association — although more data is needed. Pulling data from seven past studies in the PubMed database, researchers evaluated the antibody responses to influenza and hepatitis vaccines among 299 adults between the ages of 18 and 60. (They excluded adults 65 years and older, as that age group generally has reduced quality and duration of sleep.) "It is well-known that sleep plays an important role in regulating the immune system," study co-author Aric A. Prather, PhD, professor of psychiatry and behavioral sciences at the University of California, San Francisco, told Fox News Digital in an email. "How that happens is not well understood, but data suggests that aspects of sleep — like slow wave sleep, or the hormones released during sleep, like growth hormones — may directly communicate with the immune system to support protection." Fox News
USAFRICOM
Laboratories in Kenya and Tanzania train rats to detect tuberculosis
1 January- Already known for finding land mines, the rodents could now transform the way the disease is detected. The African giant pouched rats work with scientists at the APOPO Project, a Belgian non-profit organisation in Tanzania, because they can detect the smell of the deadly disease. A study conducted by APOPO in 2016 compared the accuracy of the rats to that of standard methods used in laboratories such as smear microscopy, bacteria culture tests and Genexpert - a rapid test for tuberculosis. Joseph Soka, programme manager for TB at APOPO, said: "The sensitivity of these rats is as high as compared to microscopes and as compared to other tests, their sensitivity is independent of HIV status. "That is, they can easily identify tuberculosis in people living with HIV, keeping in mind that these people living with HIV, it is very difficult to be diagnosed by the standard test, including Genexpert in microscopes."APOPO is already known for training rats to find landmines but training them to detect TB was new territory when they adopted the programme back in 2008. Now the animals work in 21 medical centres in the Tanzanian capital Dar es Salaam as they are thought to be faster at detecting the illness than standard methods. Many developing countries heavily rely on old TB detection techniques that entail the use of microscopes to examine the sputum of potentially infected patients. Dhaval Shah, veterinary pathologist at Pathologists Lancet Kenya, said rats can speed up the process. "So, the conventional laboratory techniques can take anywhere from two hours to even 14 days per sample, depending on what technique you use," he said. "While the rats will be able to complete testing of fifty samples within two hours and this would be ideal in far places or remote places like Mozambique or places in Mozambique which are rural." Africa News
USCENTCOM
Israel reports more polio cases
12 March- The Israeli Health Ministry recently reported following the case of polio in an 8-year-old girl from the Safed area who was not vaccinated against polio as part of routine vaccinations, the Northern District of the Ministry of Health conducted an epidemiological investigation, during which it was found that three other children who came in close contact with the case, were found to be positive for the virus the polio. The three children at this stage have no clinical symptom.In recent months, there is evidence of continued discharge of polio into the sewers in many settlements in Israel, when in Israel there are over 150,000 children who are not vaccinated against polio. Outbreak News Today
USEUCOM
Progress towards elimination of hepatitis C in the UK
15 March- A new report by the UK Health Security Agency has detailed the country's progress in tackling hepatitis C. It noted that 92 900 people were living with chronic hepatitis C virus (HCV) infection in the UK in 2021, a decrease of 47% since 2015. HCV-related deaths fell by 31% from 2015 to 2020. The authors attributed the reductions to improvements in testing and the roll-out of direct-acting antivirals. They concluded that the UK was on course to achieve the WHO target of reducing new chronic infections with HCV by 80% by 2030, relative to 2015 levels, though more work is required to attain the accompanying target of a 65% reduction in mortality. The Lancet
USINDOPACOM
India Embraces HIV-Self Testing
13 March- Communities in India have voiced strong interest in accessing HIV self-testing, says the World Health Organization (WHO). The WHO today announced it recommends HIV self-testing (HIVST) as an important approach to address gaps in HIV diagnoses, including among key populations in India. HIVST can also generate demand for prevention services and facilitate pre-exposure prophylaxis delivery. The first of the United Nations’ 95-95-95 targets to end the HIV epidemic is for 95% of people living with HIV to know their HIV status by 2025. HIV testing is therefore essential to achieving “the first 95”. A report launched in New Delhi in 2022 showed HIVST is acceptable to key populations and their partners in India. In the U.S., clinicians are recommended to screen for HIV infection in all pregnant women, including those who present in labor or at delivery and whose HIV status is unknown. And screening is endorsed for certain adolescents and adults who are at increased risk of HIV infection. Globally, 98 countries now have policies supportive of HIVST, and 52 are routinely implemented, yet many countries have not yet introduced HIVST as a routine approach. Precision Vaccinations
USNORTHCOM
Florida surgeon general’s Covid vaccine claims harm public, health agencies say
12 March- U.S. health agencies have sent a letter to the surgeon general of Florida, warning that his claims about Covid-19 vaccine risks are harmful to the public. The letter was sent to Joseph Ladapo on Friday by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). It was a response to a letter Ladapo wrote to the agencies last month, expressing concerns about what he described as adverse effects from Covid vaccines. “It is the job of public health officials around the country to protect the lives of the populations they serve, particularly the vulnerable,” said the federal letter, which was signed by the FDA commissioner, Robert Califf, and CDC director, Rochelle Walensky. “Fueling vaccine hesitancy undermines this effort.” Ladapo was appointed by the Republican governor of Florida, the prospective Republican presidential candidate Ron DeSantis, in 2021. Ladapo has attracted national scrutiny over his close alignment with the governor in opposing Covid vaccine mandates and other health policies embraced by the federal government. Last year, Ladapo released guidance recommending against Covid vaccinations for healthy children, contradicting federal public health leaders whose advice says all kids should get the shots. He has recommended against men aged 18 to 39 getting Covid vaccines, claiming an analysis by the Florida health department showed an 84% increase in cardiac-related deaths. In their letter, the federal agencies debunked that conclusion, saying cardiovascular experts who studied the concern had concluded the risk of strokes and heart attacks was lower in people who had been vaccinated, not higher. More than 13bn doses of Covid vaccines have been given around the world with little evidence of adverse effects, the federal agencies said. The Florida health department did not respond to a request for comment. The Guardian
USSOUTHCOM
Minas Gerais reports 25,000 confirmed dengue cases to date
14 March- The State Department of Health of Minas Gerais (SES) reports through March 12, 83,911 probable dengue fever cases, including 25,265 confirmed cases were reported. There are nine confirmed deaths from dengue in Minas Gerais and 40 deaths under investigation. Concerning chikungunya and Zika, state officials report 27,514 probable and 7,555 confirmed chikungunya cases. So far, there are no deaths confirmed by Chikungunya in Minas Gerais and four are under investigation. As for the Zika virus, 116 probable cases have been registered so far. There are five confirmed cases of the disease and there are no deaths from Zika in Minas Gerais, to date. Outbreak News Today
