Surveillance: Surveillance is the process of determining the presence of vectors and pests and estimating their general population levels. Such information is the basis for developing a risk assessment that can be used to qualitatively or quantitatively predict the occurrence of vector-borne disease or pest outbreaks. Upon arrival at the deployment site, conduct on-site entomological surveillance using the DOEHRS (Defense Occuptional & Environmental Health Readiness System) Entomology Survey, Vector Surveillance Survey, and Pest Surveillance Survey forms to verify or refute the pre-deployment risk assessment. Surveillance should be ongoing, as conditions affecting risk are likely to change with weather, unanticipated changes in the mission profile taking troops into new areas, etc. There are many methods, techniques, and equipment that can be used to accomplish surveillance. The AFPMB TG 48, Contingency Pest and Vector Surveillance is an excellent source for obtaining comprehensive guidance on surveillance during deployment operations.
Properly conducted surveillance of disease vectors and medical pests during deployments should answer the following:
Do vectors and medical pests in the deployment area threaten the health and morale of deployed personnel?
Determine who is at risk. Available medical information seldom gives more than a general idea of the vector-borne disease threat in an area. Pre-deployment risk assessment must be validated and refined on-site. Presence or absence of a key vector, abundance of the vector, and presence of pathogen-specific antibodies in animal reservoirs or in people living in the area of operations can all provide useful information that can help assess risk and facilitate the development of targeted control programs. Multiple surveillance techniques for immature and adult vectors should be used to accurately quantify vector abundance. Arthropod Vector Rapid Detection (AV-RDD) kits are hand-held assays that can be used to determine whether arthropods are infected with pathogens capable of infecting deployed personnel. Video instructions on procedures for the Malaria Detection Kit (MAL-K020), Leishmania Antigen Assay Kit (P/N LMAJ-K020), and Dengue Kit were prepared by the Walter Reed Army Institute of Research (WRAIR) and the U.S. Army Medical Materiel Development Activity (USAMMDA) staff. These instructional videos can be accessed on the USAMMDA YouTube site or by clicking the links below:
Introduction video for Arthropod Vector Rapid Detection (AV-RDD)
Procedures for Detecting Malaria in Mosquitoes
Procedures for Detecting Leishmaniasis in Sand Flies
Procedures for Detecting Dengue in Mosquitoes
Where (by geographical area and type of terrain) and when (by season and time of day) could vectors and medical pests occur in the area of operation?
Not all disease vectors may be present in a given area, or their occurrence may be associated with different times of day or seasons.
In addition to vector surveillance, review your area of operation (AO) disease and non-battle injury (DNBI) reports for possible cases of vector-borne illnesses. This information is valuable in determining Soldiers compliance or non-compliance with recommended preventive medicine (PM) countermeasures.
Additional information on vector distributions can be found at VectorMap, a product of the Walter Reed Biosystematics Unit (WRBU). VectorMap provides disease maps, and mapped collection data and distribution models for arthropod disease vector species, including mosquitoes, ticks, sand flies, mites, and fleas, as well as the hosts/reservoirs of vector-borne disease pathogens.
Command Emphasis: Command emphasis in all phases of deployment is the cornerstone of prevention. Commanders can influence the use of personal protective measures (PPM) and are responsible for implementing the theater policy on prevention of disease and DNBI during all aspects of a deployment. Unit Commanders are also responsible for implementing practices which prevent disease or injury caused by association with feral animals. Good sanitation and field hygiene as well as full implementation of PPM in deployed forces is critical to successful mitigation efforts and should be continually stressed through the chain of command.
Does the unit commander make force health protection a priority?
Preventive medicine personnel can make recommendations, but only the chain of command can enforce PPM measures. The individual Soldier is the most important element in any combat system. Protection of his/her health is absolutely critical to maintenance of a high state of combat readiness. Medical advisors have the job of supporting the commander by providing sound technical advice and training in the prevention of arthropod-borne diseases. Thus, it is imperative that DoD leaders at all levels understand and endorse the need and the use of these personal protective measures. At the individual level, education on the safety and efficacy of DoD approved skin repellents and permethrin-treated uniforms, emphasis on proper and regular use of PPM, and availability of supplies is crucial.
Pest Control Measures: Surveillance of vectors and pests is the basis for determining what, when, and if control measures should be implemented. Vector control must never be implemented unless surveillance shows there is an actual, or potential, problem that must be prevented. Better understanding of the types and numbers of vector species in a deployed area and the diseases they transmit affords a better opportunity for their control, and ultimately a healthier force. The AFPMB TG 24, Contingency Pest Management Guide is an excellent source for obtaining guidance on vector control during deployment.
Where and when pest controllers should apply control measures against vectors and pests?
Communication between the unit conducting surveillance and the organization providing control is essential for effective control.
Do implemented control measures actually control the target vectors and pests?
Post-control surveillance serves as a validation of control efforts. Alternative control or management efforts must be considered if initial control measures fail.
Are pest management practices recorded and reported?
"Record and report all pesticide application, except arthropod skin and clothing repellent applications, according to the guidance in DA Pam 40-11 (Preventive Medicine).