VOLUME 2
Malaria Prevention for Ships
Even brief port visits may require preventive and protective measures. …………2
ISSUE 1 JANUARY 2010
BDU and NWU Permethrin Treatment: Spray and Pray? The new Navy Working Uniforms can and should be treated in certain situations…3
Triangle Defense Against Malaria
It is necessary to take all available measures to lower the risk of malaria as much as possible…………3
Bug
bytes
A publication of Navy Environmental and Preventive Medicine Unit 2
W
elcome to this edition of Bug Bytes. I hope everyone had a joyous holiday season. Although I realize that the work of Preventive Medicine and Public Health personnel never ends, collaboratively we certainly have done an outstanding job over that season in stemming the tide of H1N1 and seasonal influenza.
Helping You Promote Public Health But we need to stay vigilant as the traditional peak of the influenza season is nearly upon us. We need to continue to work for 100% vaccination and to push the personnel hygiene and general sanitation measures that will contribute greatly towards our success in minimizing cases. In this edition, you will also find additional information and emphasis on malaria prevention. Of late, there has been an increase in reported malaria cases, including one fatal case, in our active duty population. All of these cases were preventable with appropriate use of prophylactic medication and the proper use of routine personal protective measures such as appropriate clothing, DEET, bed nets, etc. We hope that this edition will provide some additional emphasis toward and a reminder of this often quiet but potentially fatal disease. NEPMU-2 stands ready to assist in providing additional information to assist you and your commands in that regard. Thanks again for all you are doing toward the Force Health Protection of our fighting forces! T.L. Wagner CDR MC USN OIC NEPMU-2
MALARIA PREVENTION AND CONTROL*
LABORATORY IDENTIFICATION OF MALARIA
Description: This course includes didactic instruction in pathogenesis, etiology, treatment, diagnosis, relevant recent medical intelligence and preventive aspects of malaria.
Description: Provide instruction in the performance of malaria laboratory testing, species identification, and the procedures for deployment to the Western Pacific and Indian Oceans. Topics include collection of blood specimens, preparation of slices for staining, staining procedures, and interpretation of blood smears.
Target Audience: Medical Department Representatives (HM, NP, PA, MD)
Target Audience: HM Continuing Education Credits: IDC-5 *The course is on NKO (Course Code:
NMMPC081)
Continuing Education Credits: IDC-3.5
Courses available at NEPMU2:
Did you know? -Only one genus of mosquito, Anopheles, can spread malaria. -A side effect of some antimalaria medications is vivid dreams. -Male mosquitoes feed on flower nectar, only female mosquitoes are blood suckers. -While we think of malaria as a tropical disease, it used to be native to as far north as Norway. -There are five species of malaria that infect humans (P. falciparum, P.vivax, P. malariae, P. ovale, and P. knowlesi), but fatal illness is caused almost exclusively by P. falciparum. -Hypnozoites of several malaria species can remain dormant in the liver for many months and re-emerge to cause illness long after exposure.
T R A I N I N G C O R N E R
Food Safety Managers (B-322-2101): 22-23 February, 29-30 March Lab Identification of Malaria (B-322-2210): 31 March Shipboard Pest Management (B-322-1075): 2 March For further info contact Jeff Bolden: (NEPMU2Norfolk-EducationandTraining@med.navy.mil) The following courses are available on NKO: Health Aspects of MSD, Hearing Conservation Afloat, Heat Stress Afloat, Water Sanitation Afloat, FDPMU Orientation Training, FDPMU Equipment Orientation Training and Health Promotion Basics IMMUNIZATION TRAINING BUMED Instruction 6230.15A requires all immunizers obtain 8 hours of annual training. Here are some of the ways you can get that training: MILVAX conducts CONUS and OCONUS, no-cost training: • Immunization Leaders Course – 3 day Three National Capital Region, Three Regional, Four OCONUS annually • Immunization Basic Course – 1 day • Online Courses (DoD Smallpox Vaccination) • Live Webcast Meetings (monthly) •The dates for courses are posted on the MILVAX website at www.vaccines.army.mil • Regional Analysts perform local site visits at commands and information briefings for service members and leaders.
Entomology: “Our patients aren’t expected to survive”
-In any given year, nearly ten percent of the global population will suffer a case of malaria.
Malaria Prevention for Ships LT Roxanne Danielson
-April 25 is World Malaria Day
Malaria is a mosquito-borne infectious disease widespread in areas where armed forces currently deploy. If uncontrolled, the disease significantly impacts operational readiness and mission performance. Sailors and Marines have died of malaria, as recently as 2009. It is commanders’ responsibility to ensure that personnel are properly protected from this potentially fatal disease. Prevention of malaria is far easier than treatment of infections. Any unit deploying to a malarious region must be properly protected prior to, during, and after at-risk exposure. Even brief port visits may require preventive and protective measures. Because malaria risk varies by location and season, up-to-date threat assessment is crucial – and NEPMU-2 is here to provide it. Contact us for current information regarding chemoprophylaxis, personal and unit protective measures.
Web: Recommendations by Country, Malaria Pocket Guide E-mail: NEPMU2NorforlkThreatAssessment@med.navy.mil
Eye Protection HM1 John Preku “Eye injury is a significant disabling American health problem. The National Next Issue Research Council reported that ‘Injury is probably the most under-recognized 31 March major health problem facing the nation today. The study of injury presents 2010 unparalleled opportunities for reducing morbidity and for realizing significant savings in both financial and human terms’.” -United States Eye Injury Registry.
Newsletter Editors LT Chris Coetzer LTJG Matthew Montgomery
Everyone should be aware of eye safety. Chapter 20 of OPNAVINST 5100.23G states; “Employees shall wear approved eye and/or face protection when there is a reasonable probability that wearing such equipment will prevent injury.” Anytime you’re going to do a task (e.g. spraying uniforms with permethrin) where there is a risk of chemical exposure, impact, penetration, harmful dust, or radiation to your eyes, you need eye protection.
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Triangle Defense Against Malaria CDR Edwin Long and LCDR Jennifer Espiritu Malaria can be fatal in less than 24 hours, but it is a curable and preventable disease. Prevention malaria is achieved through a triangle of efforts: personal protective measures, mosquito control, and chemoprophylaxis (anti-malarial medications).
GET YOUR ANSWERS HERE EMAIL NEPMU-2 click on the links below Fleet/FMF -Entomology -Environmental Health -Industrial Health
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Training
3311Assessment M Maarrcchh 22001100 Threat EPM Senior Enlisted Leader
RESOURCE LINKS NMCPHC (NEHC) Navy and Marine Corps Public Health Center Instructions Navy Medicine Publications PrevMed Topic Page NMCPHC (NEHC) supported page of Preventive Medicine topics and resources CHPPM U.S. Army Center for Health Promotion and Preventive Medicine
Supplies Permethrin - Individual Impregnation Kit (NSN 6840-01-345-0237) -Aerosol Spray Can (NSN 6840-01-278-1336) - 40 percent Concentrate (NSN 6840-01-334-2666) DEET Lotion NSN 6840-01-284-3982 Standard Military Bed Net NSN 7210-00-266-9736
Sunscreen with DEET NSN 6840-01-228-2188
Personal protective measures (PPM) include the use of insect repellent clothing treated with permethrin spray. Instruction on the proper wearing of uniforms (i.e. sleeves down and buttoned) is critical. Additionally, insect repellent (such as DEET), should be applied directly to exposed skin (areas not covered by permethrin-treated clothing). DEET protects against biting insects for up to 12 hours per application. More frequent applications may be required in hot climates or heavy rains. PPMs also include the use of permethrin-treated bed nets. Work parties and unit formations should be rescheduled to non-biting periods. Furthermore, shower and bath time should be scheduled during hours when the mosquitoes are not as active. Mosquito control includes outdoor Ultra Low Volume (ULV) spraying with pesticides/insecticides, and eliminating breeding sites (standing water). Available screening material (for example, screens on windows) should be used in areas that protect the largest number of personnel during peak mosquito biting times. Chemoprophylaxis is the last line of defense against all mosquito carried diseases. There are several different medications taken for the prophylaxis against malaria. Some are taken daily, while others are taken weekly. Malaria chemoprophylaxis is required for deployments to all countries as identified by current COCOM FHP guidance. Directly observed therapy (DOT) is recommended for all regimens. Support from the Chain of Command is required to successfully carry out this method. In summary, it is necessary to take all available measures to lower the risk of malaria as much as possible.
BDU and NWU Permethrin Treatment: Spray and Pray? LTJG Matthew Montgomery The treatment of uniforms with permethrin based insecticides is one of the most effective personal protective measures against vector borne-diseases. While only dessert and woodland camouflage uniforms have been officially evaluated and approved for permethrin treatment, the new Navy Working Uniforms can and should be treated in certain situations. BDUs can be treated with a 40% permethrin concentrate or with a baggie type “shake and bake� permethrin kit that is effective for the life of the uniform (up to 50 wash cycles). There is also an aerosol can application available, however for BDUs this treatment lasts for only six wash cycles or six weeks, whichever comes sooner. It should be noted that preliminary evaluations of the NWU have shown that permethrin treatment is effective for up to six wash cycles, but the permanent press treatment that this uniform receives may interfere with full permethrin impregnation. Further testing will need to be done to determine the exact effectiveness of permethrin applications to the NWU.
3-Phenoxybenzyl (1RS)-cis,trans-3-(2,2dichlorovinyl) -2,2-dimethylcyclopropanecarboxylate Common Name: Permethrin
Contact us: Phone (757) 953-6600 DSN 377 Fax (757) 953-7212 1887 Powhatan St, Norfolk, VA 23511 Website: http://www.med.navy.mil/sites/nmcp/Partnerships/nepmu2/Pages/default.aspx
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