RAAUZYUW RUEWMCS1500 0962043-UUUU--RUCOBRJ. ZNR UUUUU ZUI RUENMED1500 0962043 R 052043Z APR 04 ZYB PSN 101072I11 FM BUMED WASHINGTON DC//alt="NEHC Index"// TO AIG 7783 AIG 6947 AIG 13776 INFO RUCBACM/JFHQ HLS NORFOLK VA//JJJ// RHMFIUU/CHPPMDCSOPSOPNSBRCH ABERDEEN PROVING GROUND MD//JJJ// RHMFIUU/NAVENVIRHLTHCEN PORTSMOUTH VA//PH// RUENMED/BUMED WASHINGTON DC//M09B172// BT UNCLAS //N00000// MSGID/GENADMIN/BUMED WASHINGTON DC/alt="NEHC Index"/APR// SUBJ/MEDICAL SITREP ONE: LEISHMANIASIS CY-04// REF/A/DOC/ASD(HA)/12SEP2003// REF/B/GENADMIN/NAVENVIRHLTHCEN/101750ZOCT2003// REF/C/GENADMIN/BUMED WASHINGTON DC/032217ZFEB2004// REF/D/DOC/BUMED WASHINGTON DC/YMD:19981021// REF/E/DOC/AFPMB TG36/YMD:20030430// REF/F/GENADMIN/BUMED WASHINGTON DC/091751ZJAN2004// NARR/REF A, B, AND C PROVIDE PREVIOUS GUIDANCE ON LEISHMANIASIS. PAGE 02 RUEWMCS1500 UNCLAS REF D IS BUMEDINST 6220.12A ON MEDICAL EVENT REPORTING. REF E IS ARMED FORCES PEST MANAGEMENT BOARD TECHNICAL GUIDE 36: PERSONAL PROTECTIVE TECHNIQUES AGAINST INSECTS AND OTHER ARTHROPODS OF MILITARY IMPORTANCE. REF F IS RECENT BUMED MEDICAL GUIDANCE ON PERMETHRIN UNIFORM TREATMENT. REFS A THROUGH D AND F ARE AVAILABLE AT www.nmcphc.med.NAVY.MIL/PREVMED/EPI/DEPSURV2.HTM. REF E AVAILABLE AT WWW.AFPMB.ORG/COWEB/GUIDANCE_TARGETS/PPMS/TG36/TG36.HTM. ACCESSED 29MAR2004.// POC/BOHNKER/CAPT/NEHC/LOC:PORTSMOUTH VA/TEL:COM 757-953-0710 /TEL:DSN 377/EMAIL:BOHNKERB@NEHC.MED.NAVY.MIL// POC/TETREAULT/LCDR/NEHC/LOC:PORTSMOUTH VA/TEL:COM 757-953-0717 /TEL:DSN 377/EMAIL:GETETREAULT@MAR.MED.NAVY.MIL// RMKS/1. THIS MESSAGE HAS BEEN COORDINATED WITH THE COMMANDANT OF THE MARINE CORPS. THE COMMANDANT HAS AUTHORIZED TRANSMISSION TO MARINE CORPS ACTIVITIES. 2. CURRENTLY NAVY MEDICINE IS TRACKING 15 CASES OF CUTANEOUS LEISHMANIASIS (12 MARINE CORPS AND 3 NAVY). THE ARMY IS CURRENTLY TRACKING OVER 500 CASES OF CUTANEOUS LEISHMANIASIS IN MILITARY PERSONNEL RETURNING FROM IRAQ. TWO US ARMY SOLDIERS HAVE RECENTLY BEEN DIAGNOSED AND TREATED FOR PAGE 03 RUEWMCS1500 UNCLAS VISCERAL LEISHMANIASIS CONTRACTED IN AFGHANISTAN. 3. LEISHMANIASIS IS TRANSMITTED BY PAINLESS BITES FROM SAND FLIES, AND HAS BOTH CUTANEOUS AND VISCERAL PRESENTATIONS. THE VISCERAL FORM IS MORE SERIOUS AND CAN BE FATAL. ACTUAL OR PRESUMED CASES OF LEISHMANIASIS ARE MEDICAL REPORTABLE EVENTS PER REF D. APPROPRIATE HANDLING OF INDIVIDUALS WITH SUSPICIOUS LESIONS AND ILLNESS INCLUDES COMMUNICATION WITH THE DEPLOYMENT HEALTH CLINICAL CENTER AT WALTER REED ARMY MEDICAL CENTER. POC IS LTC GLEN WORTMANN, TEL: 202-782-1663, DSN 662. THE CHAIN OF COMMAND SHOULD ALSO BE INFORMED OF PRESUMED AND ACTUAL CASES. 4. PRIOR TO DEPLOYMENT TO ENDEMIC AREAS, PERSONNEL SHOULD BE EDUCATED ON PREVENTION OF LEISHMANIASIS. TRANSMISSION PRIMARILY OCCURS FROM APRIL THROUGH NOVEMBER, PEAKING FROM AUGUST TO OCTOBER IN IRAQ AND AFGHANISTAN. UTILIZATION OF PERMETHRIN IMPREGNATED UNIFORMS, BEDNETS AND TOPICAL APPLICATION OF DEET REPELLENT ARE HIGHLY EFFECTIVE IN REDUCING THE RISK OF SAND FLY BITES. ADDITIONAL GUIDANCE FOR PROPER APPLICATION IS IN REFS E AND F. LEADERSHIP SHOULD PROVIDE PAGE 04 RUEWMCS1500 UNCLAS ACCESS TO AND ENSURE COMPLIANCE WITH PERSONAL PROTECTION MEASURES (PPMS) AND EDUCATION REGARDING DISEASE RISKS. 5. NAVY AND MARINE CORPS PERSONNEL REDEPLOYING FROM ENDEMIC AREAS SHOULD RECEIVE INFORMATION ON THE DISEASE PRESENTATION. THEY ALSO SHOULD BE MADE AWARE OF METHODS TO ACCESS THE HEALTH CARE SYSTEM SHOULD THEY DEVELOP SKIN LESIONS OR BECOME ILL. HEALTH CARE PROVIDERS SHOULD CONSIDER THIS DIAGNOSIS IN EVALUATING ACTIVE DUTY PERSONNEL WHO HAVE SERVED IN ENDEMIC AREAS AND PRESENTING WITH APPROPRIATE CLINICAL CONDITIONS. 6. HEALTH THREAT ASSESSMENT. THE THREAT WILL BE INCREASING DUE TO THE LARGE NUMBERS OF MARINE CORPS AND NAVY PERSONNEL WHO ARE DEPLOYING INTO HIGH RISK AREAS OF SOUTHWEST ASIA. THOSE PERSONNEL WARRANT INCREASED AWARENESS AND AGGRESSIVE USE OF PPMS. PERSONNEL RETURNING FROM THOSE HIGH RISK AREAS CONTINUE TO BE AT RISK DUE TO DEPLOYMENT RELATED EXPOSURES. 7. INFORMATION ON LEISHMANIASIS IS AVAILABLE FROM THE DEPLOYMENT HEALTH CLINICAL CENTER WEBSITE, WWW.PDHEALTH.MIL/LEISH.ASP; TEL 1-800-796-9699. EMAIL: PDHEALTH@AMEDD.ARMY.MIL, USACHPPM WEBSITE, CHPPM-WWW.APGEA.ARMY.MIL/NEWS/LEISHMANIASIS.ASP, AND THE CDC LEISHMANIA WEBPAGE, WWW.CDC.GOV/NCIDOD/DPD/PARASITES/LEISHMANIA/ PAGE 05 RUEWMCS1500 UNCLAS DEFAULT.HTM. FOR INFORMATION ON AREAS AT RISK, REVIEW AFMIC WEBSITE AT MIC.AFMIC.DETRICK.ARMY.MIL/ OR SIPRNET EMAIL TO AFMICOPS@AFMIC.DIA.SMIL.MIL. 8. ADDITIONAL INFORMATION RESOURCES: A. Navy and Marine Corps Public Health Center (www.nmcphc.med.NAVY.MIL) (757) 953-0700, DSN 377-0700, AFTER HOURS (757) 621-1967, EPI@NEHC.MAR.MED. NAVY.MIL B. NAVY DISEASE VECTOR ECOLOGY AND CONTROL CENTER, JACKSONVILLE, FL (904) 542-2424, DSN 942-2424, CMD@DVECCJAX.MED.NAVY.MIL C. NAVY DISEASE VECTOR ECOLOGY AND CONTROL CENTER, BANGOR, WA (360) 315-4450, DSN: 322-4450, MAIL@NDVECC.NAVY.MIL D. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT TWO (757) 444-7671, DSN 564-7671, EPI-NEPMU2-NOR@MAR.MED.NAVY.MIL E. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT FIVE (619) 556-7070, DSN 526-7070, NEPMU5@NEPMU5.MED.NAVY.MIL F. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT SIX (808) 473-0555, DSN 473-0555, EPI@NEPMU6.MED.NAVY.MIL G. NAVY ENVIRONMENTAL AND PREVENTIVE MEDICINE UNIT SEVEN PAGE 06 RUEWMCS1500 UNCLAS 39-095-86-9251, DSN 624-9251, NEPMU7@NEPMU7.SICILY.NAVY.MIL// BT #1500 NNNN