The pre-deployment planning process begins with the identification of the hazards and, once identified, evaluation to estimate the risk associated with the hazard.
What military entomological hazards are endemic to this area?
Do you have a copy of the EORA (Entomological Operational Risk Assessment) for the country where you are deploying? Access a list of available EORAs.
Have you checked out the Infectious Disease Risk Assessment (IDRA) at the NCMI (National Center for Medical Intelligence ) web page for the country where you are deploying?
Another good source of hazard information is the Armed Forces Pest Management Board (AFPMB) Disease Vector Ecology Profiles (DVEP).
What is the estimated impact of each endemic vector borne disease on the operation?
The EORAs and NCMI IDRAs include risk assessments. These risk assessment products are on a country wide basis therefore you should consider making an assessment for the specific region of your deployment. Technical Guide 288 has been written to lead you through this process. Estimate the Entomological Risk.
Exposure to Entomological hazards that pose health threats, those that affect individual Soldiers but not the operation, should also be addressed. Therefore, in addition to diseases listed in the EORA, identify entomological hazards faced by Soldiers such as: medical pests (biting and stinging arthropods), rodents, snakes, poisonous plants and pesticide exposure.
Are the Command Surgeon and the medical staff aware of entomological threats and their potential impact on the operation?
Does the current PM Annex to the OP Order contain medical threat information or have PM personnel received a medical threat briefing? Does the medical threat brief include the entomological threats?
FORCE HEALTH PROTECTION ISSUES THAT MUST BE ADDRESSED DURING PRE-DEPLOYMENT PLANNING
Command emphasis is the cornerstone of prevention. We know how to prevent disease. Appropriate countermeasures are common knowledge in the preventive medicine community. Carrying out PM measures at the unit level is the hard part. PM personnel cannot make troops use a bed net or take their chemoprophylaxis, unit leaders make these things happen.
Does the unit commander make force health protection a priority?
PM personnel can make recommendations, but only the chain of command can enforce PM measures.
Field Sanitation Team (FST)
FSTs provide unit-level preventive medicine and are responsible for teaching Soldiers how to use protective measures, issue skin and clothing repellents and monitor their use, provide timely feedback to the commander regarding compliance, and coordinate with Division or Corps preventive medicine assets.
Are Unit Field Sanitation Teams manned?
Each company-sized unit or equivalent is required to have an FST.
Are field sanitation teams ready?
FST personnel must be trained and equipped to meet the identified vector borne disease threat.
Individual force protection measures include the DoD Insect Repellent System (skin and clothing repellants and proper wear of uniform), sleeping under treated bed nets, chemoprophylaxis, and vaccination. Implemented appropriate to the entomological hazard.
Do the units have an adequate supply of DoD approved skin repellents?
FM 4-25.12 requires 4 tubes per person be prestocked for use by the FST.
Have soldiers’ uniforms been treated with Permethrin?
If not, do units have an adequate supply of IDA kits? FM 4-25.1 requires 4 IDA Kits per person be prestocked for use by the FST.
Have bed nets been issued to personnel?
If not, do units have an adequate supply on-hand?
Are bed nets treated with Permethrin?
If not, do units have an adequate supply of aerosol permethrin spray? FM 4-25.1 requires 1 can aerosol permethrin spray per person be pre-stocked for use by the FST.
Are Personal Protective Measures (PPM) items taken on all deployments?
History has shown that disease outbreaks occur when units encounter a highly focal area of vectors/disease during deployment that were not expected. Even in areas relatively free of vector-borne diseases exposure to biting arthropods have caused many casualties from secondary infections and allergic reactions.
Prophylactic antimalarial regimens must be started before deployment (up to two weeks) to be effective.
Has “reach back“ expertise been identified?
These persons can provide assistance when a problem or unexpected hazard is encountered during the deployment. Contact these persons during pre-deployment planning to help with developing the sampling plan and identifying region or vector specific sampling equipment requirements. Contact us to assist you with identifying region or vector specific sampling and equipment requirements.
Has a sampling plan for vector surveillance for each of the identified threats been prepared?
A sampling plan should be developed during pre deployment planning. If a disease has been identified as a hazard and a risk estimate developed in the EORA, then sampling of the vector must be conducted. Keep in mind that EORA is a risk ESTIMATE and other significant threats may be present in any given deployment area. Maintaining the flexibility to collect a wide variety of vectors is a fundamental component of a thorough sampling plan. The PM assets, once on site, will use this plan to confirm or disprove the potential hazards identified.
After preparing a pre-deployment sampling plan review the list of items in the standard sampling kit to insure that items needed for planed surveillance are included.
Do the Preventive Medicine Detachments that will be deployed have all their required table of organization and equipment (TOE) and basic load of pesticides and pesticide dispersal equipment on hand to control identified pests/vectors?
See Appendix C, FM 4.25.12 (FM 21-10-1), Unit Field Sanitation Team, for the list of supply items for control of arthropods/rodents.
Have provisions been made to record and report pesticide use?
Access the Reporting Pesticide Use for Archiving page.